The Effect of Instructor Nonverbal Immediacy Behaviors and Feedback Sensitivity on Hispanic Students' Affective Learning Outcomes in Ninth-Grade Writing Conferences

ERIC Educational Resources Information Center

Martin, Laura; Mottet, Timothy P.

2011-01-01

The purpose of this study was to show how instructor use of nonverbal immediacy behaviors influence Hispanic students' affective learning in ninth-grade writing conferences, regardless of the level of feedback sensitivity provided. According to Kluger and DeNisi's (1996) feedback intervention theory, when feedback is direct and targeted on the…

Mental Imagery Training Increases Wanting of Rewards and Reward Sensitivity and Reduces Depressive Symptoms.

PubMed

Linke, Julia; Wessa, Michèle

2017-09-01

High reward sensitivity and wanting of rewarding stimuli help to identify and motivate repetition of pleasant activities. This behavioral activation is thought to increase positive emotions. Therefore, both mechanisms are highly relevant for resilience against depressive symptoms. Yet, these mechanisms have not been targeted by psychotherapeutic interventions. In the present study, we tested a mental imagery training comprising eight 10-minute sessions every second day and delivered via the Internet to healthy volunteers (N = 30, 21 female, mean age of 23.8 years, Caucasian) who were preselected for low reward sensitivity. Participants were paired according to age, sex, reward sensitivity, and mental imagery ability. Then, members of each pair were randomly assigned to either the intervention or wait condition. Ratings of wanting and response bias toward probabilistic reward cues (Probabilistic Reward Task) served as primary outcomes. We further tested whether training effects extended to approach behavior (Approach Avoidance Task) and depressive symptoms (Beck Depression Inventory). The intervention led to an increase in wanting (p < .001, η 2 p = .45) and reward sensitivity (p = .004, η 2 p = .27). Further, the training group displayed faster approach toward positive edibles and activities (p = .025, η 2 p = .18) and reductions in depressive symptoms (p = .028, η 2 p = .16). Results extend existing literature by showing that mental imagery training can increase wanting of rewarding stimuli and reward sensitivity. Further, the training appears to reduce depressive symptoms and thus may foster the successful implementation of exsiting treatments for depression such as behavioral activation and could also increase resilience against depressive symptoms. Copyright © 2017. Published by Elsevier Ltd.

Pregnancy eating attributes study (PEAS): a cohort study examining behavioral and environmental influences on diet and weight change in pregnancy and postpartum.

PubMed

Nansel, Tonja R; Lipsky, Leah M; Siega-Riz, Anna Maria; Burger, Kyle; Faith, Myles; Liu, Aiyi

2016-01-01

The rising prevalence of maternal overweight/obesity and excessive gestational weight gain poses a serious public health concern due to the contribution of these factors to increased risk of negative health outcomes for both mother and child. Scant intervention research has indicated moderate short-term improvement in maternal diet and gestational weight gain, with little evidence of long-term behavior change, in parallel with findings from interventions outside of pregnancy. Recent laboratory-based findings from neuroscience implicate aberrant reward processing of food at the brain level ("food reward sensitivity," the between-individual variation in the response to food stimuli) as a contributor to eating beyond energy needs. However, scant research has examined the influence of these processes on weight change in population-based settings, and the relevance of these processes to pregnancy-related weight change has not been explored. The purpose of the Pregnancy Eating Attributes Study (PEAS) is to examine the role of food reward sensitivity in maternal diet and weight change during pregnancy and postpartum. The study examines the interplay of food reward sensitivity with behavioral control, home food environment, and related aspects of eating behavior in the context of weight-related biomedical, psychosocial, genetic and behavioral factors including physical activity, stress, sleep and depression. Women of varying baseline weight status (n = 450) are enrolled early in pregnancy and followed, along with their infants, until 1 year postpartum. Assessments occur during each trimester of pregnancy, and postpartum at approximately 2 months, 6 months, 9 months and 12 months. Maternal food reward, self-control, home food environment, eating behaviors, dietary intake, health behaviors, and anthropometrics are assessed along with maternal and infant clinical and biological data, infant anthropometrics, and feeding practices. Primary exposures of interest include food reward sensitivity, behavioral control, and home food environment. Primary outcomes include gestational weight gain, postpartum weight retention and maternal diet quality. With increasing evidence suggesting the relevance of food reward sensitivity for understanding eating behavior, PEAS aims to advance understanding of the determinants of eating behavior during pregnancy, informing future interventions for improving maternal diet and weight change, and leading to improved maternal and child health and weight trajectories. Clinicaltrials.gov, NCT02217462. Date of registration: August 13, 2014.

Extending the Minority Stress Model to Incorporate HIV-Positive Gay and Bisexual Men's Experiences: a Longitudinal Examination of Mental Health and Sexual Risk Behavior.

PubMed

Rendina, H Jonathon; Gamarel, Kristi E; Pachankis, John E; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T

2017-04-01

Minority stress theory represents the most plausible conceptual framework for explaining health disparities for gay and bisexual men (GBM). However, little focus has been given to including the unique stressors experienced by HIV-positive GBM. We explored the role of HIV-related stress within a minority stress model of mental health and condomless anal sex. Longitudinal data were collected on a diverse convenience sample of 138 highly sexually active, HIV-positive GBM in NYC regarding sexual minority (internalized homonegativity and gay-related rejection sensitivity) and HIV-related stressors (internalized HIV stigma and HIV-related rejection sensitivity), emotion dysregulation, mental health (symptoms of depression, anxiety, sexual compulsivity, and hypersexuality), and sexual behavior (condomless anal sex with all male partners and with serodiscordant male partners). Across both sexual minority and HIV-related stressors, internalized stigma was significantly associated with mental health and sexual behavior outcomes while rejection sensitivity was not. Moreover, path analyses revealed that emotion dysregulation mediated the influence of both forms of internalized stigma on symptoms of depression/anxiety and sexual compulsivity/hypersexuality as well as serodiscordant condomless anal sex. We identified two targets of behavioral interventions that may lead to improvements in mental health and reductions in sexual transmission risk behaviors-maladaptive cognitions underlying negative self-schemas and difficulties with emotion regulation. Techniques for cognitive restructuring and emotion regulation may be particularly useful in the development of interventions that are sensitive to the needs of this population while also highlighting the important role that structural interventions can have in preventing these disparities for future generations.

The Meaningful Roles Intervention: An Evolutionary Approach to Reducing Bullying and Increasing Prosocial Behavior.

PubMed

Ellis, Bruce J; Volk, Anthony A; Gonzalez, Jose-Michael; Embry, Dennis D

2016-12-01

Bullying is a problem that affects adolescents worldwide. Efforts to prevent bullying have been moderately successful at best, or iatrogenic at worst. We offer an explanation for this limited success by employing an evolutionary-psychological perspective to analyze antibullying interventions. We argue that bullying is a goal-directed behavior that is sensitive to benefits as well as costs, and that interventions must address these benefits. This perspective led us to develop a novel antibullying intervention, Meaningful Roles, which offers bullies prosocial alternatives-meaningful roles and responsibilities implemented through a school jobs program and reinforced through peer-to-peer praise notes-that effectively meet the same status goals as bullying behavior. We describe this new intervention and how its theoretical evolutionary roots may be applicable to other intervention programs. © 2015 The Authors. Journal of Research on Adolescence © 2015 Society for Research on Adolescence.

Sensitivity to Change and Concurrent Validity of Direct Behavior Ratings for Academic Anxiety

ERIC Educational Resources Information Center

von der Embse, Nathaniel P.; Scott, Emma-Catherine; Kilgus, Stephen P.

2015-01-01

Multitiered frameworks of service delivery have traditionally underserved students with mental health needs. Whereas research has supported the assessment and intervention of social and academic behavior across tiers, evidence is limited with regard to mental health concerns including internalizing behaviors (e.g., anxiety and depression). In…

Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

PubMed

Frerichs, Leah M; Araz, Ozgur M; Huang, Terry T-K

2013-01-01

Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may be more efficient, and research should strengthen and expand adult-focused interventions that have a high residual impact on children.

Modeling Social Transmission Dynamics of Unhealthy Behaviors for Evaluating Prevention and Treatment Interventions on Childhood Obesity

PubMed Central

Frerichs, Leah M.; Araz, Ozgur M.; Huang, Terry T. – K.

2013-01-01

Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2–1.8% and 0.2–1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may be more efficient, and research should strengthen and expand adult-focused interventions that have a high residual impact on children. PMID:24358234

Regulatory competence and social communication in term and preterm infants at 12 months corrected age. Results from a randomized controlled trial.

PubMed

Olafsen, Kåre S; Rønning, John A; Handegård, Bjørn Helge; Ulvund, Stein Erik; Dahl, Lauritz Bredrup; Kaaresen, Per Ivar

2012-02-01

Temperamental regulatory competence and social communication in term and preterm infants at 12 months corrected age was studied in a randomized controlled intervention trial aimed at enhancing maternal sensitive responsiveness. Surviving infants <2000 g from a geographically defined area were randomized to an intervention (71) or a control group (69), and compared with term infants (74). The intervention was a modified version of the "Mother-Infant Transaction Program". Regulatory competence was measured with the Infant Behavior Questionnaire, and social communication with the Early Social Communication Scales. Preterm intervention infants with low regulatory competence had higher responding to joint attention than preterm control infants. A sensitizing intervention may moderate the association between temperament and social communication, and thus allow an alternative functional outlet for preterm infants low in regulatory competence. The finding may have implications for conceptualizations of the role of early sensitizing interventions in promoting important developmental outcomes for premature infants. Copyright © 2011 Elsevier Inc. All rights reserved.

Applying a Cognitive Neuroscience Perspective to Disruptive Behavior Disorders: Implications for Schools.

PubMed

Tyler, Patrick M; White, Stuart F; Thompson, Ronald W; Blair, R J R

2018-02-12

A cognitive neuroscience perspective seeks to understand behavior, in this case disruptive behavior disorders (DBD), in terms of dysfunction in cognitive processes underpinned by neural processes. While this type of approach has clear implications for clinical mental health practice, it also has implications for school-based assessment and intervention with children and adolescents who have disruptive behavior and aggression. This review articulates a cognitive neuroscience account of DBD by discussing the neurocognitive dysfunction related to emotional empathy, threat sensitivity, reinforcement-based decision-making, and response inhibition. The potential implications for current and future classroom-based assessments and interventions for students with these deficits are discussed.

Mobile Sensing and Support for People With Depression: A Pilot Trial in the Wild.

PubMed

Wahle, Fabian; Kowatsch, Tobias; Fleisch, Elgar; Rufer, Michael; Weidt, Steffi

2016-09-21

Depression is a burdensome, recurring mental health disorder with high prevalence. Even in developed countries, patients have to wait for several months to receive treatment. In many parts of the world there is only one mental health professional for over 200 people. Smartphones are ubiquitous and have a large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms and providing context-sensitive intervention support. The objective of this study is 2-fold, first to explore the detection of daily-life behavior based on sensor information to identify subjects with a clinically meaningful depression level, second to explore the potential of context sensitive intervention delivery to provide in-situ support for people with depressive symptoms. A total of 126 adults (age 20-57) were recruited to use the smartphone app Mobile Sensing and Support (MOSS), collecting context-sensitive sensor information and providing just-in-time interventions derived from cognitive behavior therapy. Real-time learning-systems were deployed to adapt to each subject's preferences to optimize recommendations with respect to time, location, and personal preference. Biweekly, participants were asked to complete a self-reported depression survey (PHQ-9) to track symptom progression. Wilcoxon tests were conducted to compare scores before and after intervention. Correlation analysis was used to test the relationship between adherence and change in PHQ-9. One hundred twenty features were constructed based on smartphone usage and sensors including accelerometer, Wifi, and global positioning systems (GPS). Machine-learning models used these features to infer behavior and context for PHQ-9 level prediction and tailored intervention delivery. A total of 36 subjects used MOSS for ≥2 weeks. For subjects with clinical depression (PHQ-9≥11) at baseline and adherence ≥8 weeks (n=12), a significant drop in PHQ-9 was observed (P=.01). This group showed a negative trend between adherence and change in PHQ-9 scores (rho=-.498, P=.099). Binary classification performance for biweekly PHQ-9 samples (n=143), with a cutoff of PHQ-9≥11, based on Random Forest and Support Vector Machine leave-one-out cross validation resulted in 60.1% and 59.1% accuracy, respectively. Proxies for social and physical behavior derived from smartphone sensor data was successfully deployed to deliver context-sensitive and personalized interventions to people with depressive symptoms. Subjects who used the app for an extended period of time showed significant reduction in self-reported symptom severity. Nonlinear classification models trained on features extracted from smartphone sensor data including Wifi, accelerometer, GPS, and phone use, demonstrated a proof of concept for the detection of depression superior to random classification. While findings of effectiveness must be reproduced in a RCT to proof causation, they pave the way for a new generation of digital health interventions leveraging smartphone sensors to provide context sensitive information for in-situ support and unobtrusive monitoring of critical mental health states.

Extending the minority stress model to incorporate HIV-positive gay and bisexual men’s experiences: A longitudinal examination of mental health and sexual risk behavior

PubMed Central

Rendina, H. Jonathon; Gamarel, Kristi E.; Pachankis, John E.; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T.

2016-01-01

Background Minority stress theory represents the most plausible conceptual framework for explaining health disparities for gay and bisexual men (GBM). However, little focus has been given to including the unique stressors experienced by HIV-positive GBM. Purpose We explored the role of HIV-related stress within a minority stress model of mental health and condomless anal sex. Methods Longitudinal data were collected on a diverse convenience sample of 138 highly sexually active, HIV-positive GBM in NYC regarding sexual minority (internalized homonegativity, gay-related rejection sensitivity) and HIV-related stressors (internalized HIV stigma, HIV-related rejection sensitivity), emotion dysregulation, mental health (symptoms of depression, anxiety, sexual compulsivity, and hypersexuality), and sexual behavior (condomless anal sex with all male partners and with serodiscordant male partners). Results Across both sexual minority and HIV-related stressors, internalized stigma was significantly associated with mental health and sexual behavior outcomes while rejection sensitivity was not. Moreover, path analyses revealed that emotion dysregulation mediated the influence of both forms of internalized stigma on symptoms of depression/anxiety and sexual compulsivity/hypersexuality as well as serodiscordant condomless anal sex. Conclusions We identified two targets of behavioral interventions that may lead to improvements in mental health and reductions in sexual transmission risk behaviors—maladaptive cognitions underlying negative self-schemas and difficulties with emotion regulation. Techniques for cognitive restructuring and emotion regulation may be particularly useful in the development of interventions that are sensitive to the needs of this population while also highlighting the important role that structural interventions can have in preventing these disparities for future generations. PMID:27502073

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

PubMed

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

2016-10-01

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

Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial

PubMed Central

Burzinski, Cindy A.; Cox, Jennifer; Kloke, John; Stegner, Aaron; Cook, Dane B.; Singles, Janice; Mirgain, Shilagh; Coe, Christopher L.; Bačkonja, Miroslav

2016-01-01

Objective. To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). Design. 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). Setting. Outpatient. Subjects. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months. Methods. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein). Results. Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen’s d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits. Conclusions. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP. PMID:26968850

Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial.

PubMed

Zgierska, Aleksandra E; Burzinski, Cindy A; Cox, Jennifer; Kloke, John; Stegner, Aaron; Cook, Dane B; Singles, Janice; Mirgain, Shilagh; Coe, Christopher L; Bačkonja, Miroslav

2016-10-01

To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). Outpatient. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein). Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen's d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cultural sensitivity in public health: defined and demystified.

PubMed

Resnicow, K; Baranowski, T; Ahluwalia, J S; Braithwaite, R L

1999-01-01

There is consensus that health promotion programs should be culturally sensitive (CS). Yet, despite the ubiquitous nature of CS within public health research and practice, there has been surprisingly little attention given to defining CS or delineating a framework for developing culturally sensitive programs and practitioners. This paper describes a model for understanding CS from a public health perspective; describes a process for applying this model in the development of health promotion and disease prevention interventions; and highlights research priorities. Cultural sensitivity is defined by two dimensions: surface and deep structures. Surface structure involves matching intervention materials and messages to observable, "superficial" characteristics of a target population. This may involve using people, places, language, music, food, locations, and clothing familiar to, and preferred by, the target audience. Surface structure refers to how well interventions fit within a specific culture. Deep structure involves incorporating the cultural, social, historical, environmental and psychological forces that influence the target health behavior in the proposed target population. Whereas surface structure generally increases the "receptivity" or "acceptance" of messages, deep structure conveys salience. Techniques, borrowed from social marketing and health communication theory, for developing culturally sensitive interventions are described. Research is needed to determine the effectiveness of culturally sensitive programs.

Pairing attachment theory and social learning theory in video-feedback intervention to promote positive parenting.

PubMed

Juffer, Femmie; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H

2017-06-01

Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) is a social-learning and attachment-based intervention using video feedback to support sensitive parenting and at the same time setting firm limits. Empirical studies and meta-analyses have shown that sensitive parenting is the key determinant to promote secure child-parent attachment relationships and that adequate parental discipline contributes to fewer behavior problems in children. Building on this evidence, VIPP-SD has been tested in various populations of at-risk parents and vulnerable children (in the age range of zero to six years), as well as in the context of child care. In twelve randomized controlled trials including 1116 parents and caregivers, VIPP-SD proved to be effective in promoting sensitive caregiving, while positive social-emotional child outcomes were also found. Copyright © 2017 Elsevier Ltd. All rights reserved.

Strategies for Implementing and Sustaining Therapeutic Lifestyle Changes as Part of Hypertension Management in African Americans

PubMed Central

Scisney-Matlock, Margaret; Bosworth, Hayden B.; Giger, Joyce Newman; Strickland, Ora L.; Van Harrison, R.; Coverson, Dorothy; Shah, Nirav R.; Dennison, Cheryl R.; Dunbar-Jacob, Jacqueline M.; Jones, Loretta; Ogedegbe, Gbenga; Batts-Turner, Marian L.; Jamerson, Kenneth A.

2009-01-01

African Americans with high blood pressure (BP) can benefit greatly from therapeutic lifestyle changes (TLC) such as diet modification, physical activity, and weight management. However, they and their health care providers face many barriers in modifying health behaviors. A multidisciplinary panel synthesized the scientific data on TLC in African Americans for efficacy in improving BP control, barriers to behavioral change, and strategies to overcome those barriers. Therapeutic lifestyle change interventions should emphasize patient self-management, supported by providers, family, and the community. Interventions should be tailored to an individual’s cultural heritage, beliefs, and behavioral norms. Simultaneously targeting multiple factors that impede BP control will maximize the likelihood of success. The panel cited limited progress with integrating the Dietary Approaches to Stop Hypertension (DASH) eating plan into the African American diet as an example of the need for more strategically developed interventions. Culturally sensitive instruments to assess impact will help guide improved provision of TLC in special populations. The challenge of improving BP control in African Americans and delivery of hypertension care requires changes at the health system and public policy levels. At the patient level, culturally sensitive interventions that apply the strategies described and optimize community involvement will advance TLC in African Americans with high BP. PMID:19491553

Using Dynamic Sensitivity Analysis to Assess Testability

NASA Technical Reports Server (NTRS)

Voas, Jeffrey; Morell, Larry; Miller, Keith

1990-01-01

This paper discusses sensitivity analysis and its relationship to random black box testing. Sensitivity analysis estimates the impact that a programming fault at a particular location would have on the program's input/output behavior. Locations that are relatively \\"insensitive" to faults can render random black box testing unlikely to uncover programming faults. Therefore, sensitivity analysis gives new insight when interpreting random black box testing results. Although sensitivity analysis is computationally intensive, it requires no oracle and no human intervention.

Interventions for the Reduction of Dental Anxiety and Corresponding Behavioral Deficits in Children with Autism Spectrum Disorder.

PubMed

Elmore, Jessica L; Bruhn, Ann M; Bobzien, Jonna L

2016-04-01

Autism Spectrum Disorder (ASD) can greatly inhibit a child's communication and social interaction skills, impacting their comfort during dental hygiene treatment and services. Children with ASD may exhibit sensory sensitivities, fear of the unfamiliar and lack of socio-cognitive understanding, leading to anxiety and corresponding behavioral deficits. Since the prevalence rates for ASD have risen significantly in the past decade, increased emphasis has been placed on educational and behavior guidance techniques, which can be helpful for children with ASD because of their increased capabilities in visual-processing. The purpose of this literature review is to summarize the interventions available to reduce dental anxiety in children with ASD, and to determine which strategies are best suited for implementation by the dental hygienist. Advancements in technology and socio-behavioral interventions were assessed for appropriate use, efficacy and engagement in the target population. Interventions were categorized into the following groups: picture cards, video technologies and mobile applications. Copyright © 2016 The American Dental Hygienists’ Association.

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

ERIC Educational Resources Information Center

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

2006-01-01

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

Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: based on parental report.

PubMed

Pennesi, Christine M; Klein, Laura Cousino

2012-03-01

Studies on the gluten-free and/or casein-free (GFCF) dietary intervention for children with autism spectrum disorders (ASDs) suggest that some children may positively respond to implementation of the dietary intervention. Other research suggests that children diagnosed with ASD can be classified into subpopulations based on various factors, including gastrointestinal (GI) abnormalities and immune function. This study analyzes parental report data collected using a 90-item online questionnaire from 387 parents or primary caregivers of children diagnosed with ASD on the efficacy of the GFCF diet. Parents reported on their child's GI symptoms, food allergy diagnoses, and suspected food sensitivities, as well as the degree and length of their diet implementation. Overall, diet efficacy among children whose parents reported the presence of GI symptoms, food allergy diagnoses, and suspected food sensitivities included greater improvement in ASD behaviors, physiological symptoms, and social behaviors compared with children whose parents reported none of these symptoms, diagnoses, or sensitivities (P < 0.05). Parental report of strict diet implementation, indicated by complete gluten/casein elimination and infrequent diet errors during and outside of parental care, also corresponded to improvement in ASD behaviors, physiological symptoms, and social behaviors (P < 0.05). These findings suggest that various intricacies related to diet implementation and GI and immune factors may play a role in differentiating diet responders from diet non-responders and substantiate the importance of further investigations into the various, nuanced factors that influence efficacy of the intervention among children with ASDs.

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

PubMed Central

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

2014-01-01

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

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective.

PubMed

Thibodeau, Eric L; August, Gerald J; Cicchetti, Dante; Symons, Frank J

2016-03-01

Preventive interventions that target high-risk youth, via one-size-fits-all approaches, have demonstrated modest effects in reducing rates of substance use. Recently, substance use researchers have recommended personalized intervention strategies. Central to these approaches is matching preventatives to characteristics of an individual that have been shown to predict outcomes. One compelling body of literature on person × environment interactions is that of environmental sensitivity theories, including differential susceptibility theory and vantage sensitivity. Recent experimental evidence has demonstrated that environmental sensitivity (ES) factors moderate substance abuse outcomes. We propose that ES factors may augment current personalization strategies such as matching based on risk factors/severity of problem behaviors (risk severity (RS)). Specifically, individuals most sensitive to environmental influence may be those most responsive to intervention in general and thus need only a brief-type or lower-intensity program to show gains, while those least sensitive may require more comprehensive or intensive programming for optimal responsiveness. We provide an example from ongoing research to illustrate how ES factors can be incorporated into prevention trials aimed at high-risk adolescents.

Hispanic Male’s Perspectives of Health Behaviors Related to Weight Management

PubMed Central

Garcia, David O.; Valdez, Luis A.; Hooker, Steven P.

2015-01-01

Hispanic males have the highest prevalence of overweight and obesity among men in the United States; yet are significantly underrepresented in weight loss research. The purpose of the current study was to examine Hispanic male’s perspectives of health behaviors related to weight management to refine the methodologies to deliver a gender-sensitive and culturally sensitive weight loss intervention. From October 2014 to April 2015, semistructured interviews were conducted with 14 overweight Hispanic men of ages 18 to 64 years. The interviews lasted approximately 60 minutes. Participants also completed a brief questionnaire and body weight/height were measured. Grounded in a deductive process, a preliminary codebook was developed based on the topics included in the interview guides. A thematic analysis facilitated the identification of inductive themes and the finalization of the codebook used for transcript analysis. Four overarching themes were identified: (a) general health beliefs of how diet and physical activity behaviors affect health outcomes, (b) barriers to healthy eating and physical activity, (c) motivators for change, and (d) viable recruitment and intervention approaches. Future research should examine feasible and appropriate recruitment and intervention strategies identified by Hispanic males to improve weight management in this vulnerable group. PMID:26634854

Intervention in the First Weeks of Life for Infants Born Late Preterm: A Case Series

PubMed Central

Dusing, Stacey C.; Lobo, Michele A.; Lee, Hui-Min; Galloway, James Cole

2013-01-01

Infants born late preterm (34–36 weeks of gestation) account for 350,000 US births per year, are at risk for developmental delays, and are rarely included in intervention studies. Purpose To describe a novel parent delivered movement intervention program for very young infants and outcomes following intervention and to evaluate the feasibility of using a comprehensive set of outcome measures. Summary of Key Points Two infants born late preterm received intervention from 0.5 to 2.0 months of adjusted age. Development, postural control, reaching, and object exploration assessments were completed at 3 time points. The intervention was well tolerated by the family. Improvements in developmental outcomes, postural control, and object exploration are presented. Statement of Conclusion Very early movement experience provided daily by parents may improve development. In combination, norm-referenced and behavioral measures appear sensitive to changes in infant behaviors. PMID:23542201

Sensitivity and Specificity of Proposed DSM-5 Criteria for Autism Spectrum Disorder in Toddlers

ERIC Educational Resources Information Center

Barton, Marianne L.; Robins, Diana L.; Jashar, Dasal; Brennan, Laura; Fein, Deborah

2013-01-01

Autism spectrum disorder (ASD) diagnosis is based on behavioral presentation; changes in conceptual models or defining behaviors may significantly impact diagnosis and uptake of ASD-specific interventions. The literature examining impact of DSM-5 criteria is equivocal. Toddlers may be especially vulnerable to the stringent requirements of…

The effects of macro-level interventions on addictive behavior.

PubMed

Pacula, R L; Chaloupka, F J

2001-12-01

Drug addictions are often viewed as compulsive behaviors, not sensitive to the typical rules of self-discipline or market forces. Nonetheless, many governments try to discourage consumption of addictive substances through macro policy tools, such as taxation, regulation and prohibition, in an effort to reduce the harmful consequences that result from their consumption. The government's ability to discourage this type of behavior through these macro policies depends critically on the responsiveness of addictive consumption to market interventions. This paper reviews the growing literature that applies economic principles to the analysis of "substance abuse." Specifically, we review the impact of prices and public policies on the demands for tobacco, alcohol, and illicit drugs. The findings from these studies clearly demonstrate that even addictive behaviors are sensitive to changes in the price of substances being abused. When the full price of the addictive good rises, consumption of that good falls, even among abusers. Therefore, public policies that raise the full price of a drug to a consumer, particularly youth, are likely to result in long run reductions in rates of addiction.

Sexual Health Behavior Interventions for U.S. Latino Adolescents: A Systematic Review of the Literature

PubMed Central

Cardoza, Vicky J.; Documét, Patricia I.; Fryer, Craig S.; Gold, Melanie A.; Butler, James

2012-01-01

Study Objective To identify sexual health behavior interventions targeting U.S. Latino adolescents. Design A systematic literature review. Setting Peer-reviewed articles published between 1993 and 2011, conducted in any type of setting. Participants Male and female Latino adolescents ages 11–21 years. Interventions Interventions promoting sexual abstinence, pregnancy prevention, sexually transmitted infection (STI) prevention, and/or HIV/AIDS prevention. Main Outcome Measures Changes in knowledge, attitudes, engagement in risky sexual behaviors, rates of STIs, and/or pregnancy. Results Sixty-eight articles were identified. Fifteen were included in this review that specifically addressed Latino adolescent sexual health behavior. Among the reviewed interventions, most aimed to prevent or reduce STI and HIV/AIDS incidence by focusing on behavior change at two levels of the social ecological model: individual and interpersonal. Major strengths of the articles included addressing the most critical issues of sexual health; using social ecological approaches; employing different strategies to deliver sexual health messages; and employing different intervention designs in diverse geographical locations with the largest population of Latino communities. Most of the interventions targeted female adolescents, stressing the need for additional interventions that target Latino adolescent males. Conclusions Latino adolescent sexual health is a new research field with gaps that need to be addressed in reducing negative sexual health outcomes among this population. More research is needed to produce new or validate existing, age-specific, and culturally-sensitive sexual health interventions for Latino male and female adolescents. Further, this research should also be conducted in areas of the U.S. with the newest Latino migration (e.g., North Carolina). PMID:22206687

Ecological Momentary Interventions: Incorporating Mobile Technology Into Psychosocial and Health Behavior Treatments

PubMed Central

Heron, Kristin E.; Smyth, Joshua M.

2009-01-01

Purpose Psychosocial and health behavior treatments and therapies can be extended beyond traditional research or clinical settings by using mobile technology to deliver interventions to individuals as they go about their daily lives. These Ecological Momentary Interventions [EMI] are treatments that are provided to people during their everyday lives (i.e., in real time) and in natural settings (i.e., real world). The goal of the present review is to synthesize and critique mobile technology-based EMI aimed at improving health behaviors and psychological and physical symptoms. Methods Twenty-seven interventions using palmtop computers or mobile phones to deliver ambulatory treatment for smoking cessation, weight loss, anxiety, diabetes management, eating disorders, alcohol use, and healthy eating and physical activity were identified. Results There is evidence that EMI can be successfully delivered, are accepted by patients, and are efficacious for treating a variety of health behaviors and physical and psychological symptoms. Limitations of the existing literature were identified and recommendations and considerations for research design, sample characteristics, measurement, statistical analyses, and clinical implementation are discussed. Conclusions Mobile technology-based EMI can be effectively implemented as interventions for a variety of health behaviors and psychological and physical symptoms. Future research should integrate the assessment and intervention capabilities of mobile technology to create dynamically and individually tailored EMI that are ecologically sensitive. PMID:19646331

A behavioral economic measure of demand for alcohol predicts brief intervention outcomes.

PubMed

MacKillop, James; Murphy, James G

2007-07-10

Considerable basic and clinical research supports a behavioral economic conceptualization of alcohol and drug dependence. One behavioral economic approach to assess motivation for a drug is the use of demand curves, or quantitative representations of drug consumption and drug-reinforced responding across a range of prices. This study used a hypothetical alcohol purchase task to generate demand curves, and examined whether the resulting demand curve parameters predicted drinking outcomes following a brief intervention. Participants were 51 college student drinkers (67% female; 94% Caucasian; drinks/week: M=24.57, S.D.=8.77) who completed a brief alcohol intervention. Consistent with predictions, a number of demand curve indices significantly predicted post-intervention alcohol use and frequency of heavy drinking episodes, even after controlling for baseline drinking and other pertinent covariates. Most prominently, O(max) (i.e., maximum alcohol expenditure) and breakpoint (i.e., sensitivity of consumption to increasing price) predicted greater drinking at 6-month post-intervention follow-up. These results indicate that a behavioral economic measure of alcohol demand may have utility in characterizing the malleability of alcohol consumption. Moreover, these results support the utility of translating experimental assays of reinforcement into clinical research.

What Drives Parents? A Case Sensitive Inquiry into Parents' Mode Preferences for the Journey to School

ERIC Educational Resources Information Center

Zuniga, Kelly Draper

2010-01-01

This dissertation uses a case-sensitive approach to examine an active travel intervention's diverse target population. It builds on a series of travel choice models, and draws key conceptual themes from Chapin's (1974) human activity model, which highlights opportunity-related and propensity-related factors associated with behaviors. The research…

Influence of environmental factors on college alcohol drinking patterns.

PubMed

Bani, Ridouan; Hameed, Rasheed; Szymanowski, Steve; Greenwood, Priscilla; Kribs-Zaleta, Christopher M; Mubayi, Anuj

2013-01-01

Alcohol abuse is a major problem, especially among students on and around college campuses. We use the mathematical framework of [16] and study the role of environmental factors on the long term dynamics of an alcohol drinking population. Sensitivity and uncertainty analyses are carried out on the relevant functions (for example, on the drinking reproduction number and the extinction time of moderate and heavy drinking because of interventions) to understand the impact of environmental interventions on the distributions of drinkers. The reproduction number helps determine whether or not the high-risk alcohol drinking behavior will spread and become persistent in the population, whereas extinction time of high-risk drinking measures the effectiveness of control programs. We found that the reproduction number is most sensitive to social interactions, while the time to extinction of high-risk drinkers is significantly sensitive to the intervention programs that reduce initiation, and the college drop-out rate. The results also suggest that in a population, higher rates of intervention programs in low-risk environments (more than intervention rates in high-risk environments) are needed to reduce heavy drinking in the population.

Cultural Adaptations of Cognitive Behavioral Therapy.

PubMed

Hinton, Devon E; Patel, Anushka

2017-12-01

In increasingly multicultural societies, cognitive behavioral therapy (CBT) must be made appropriate for diverse groups. This article examines cultural adaptations of CBT, focusing on anxiety and depressive disorders. The article presents a culturally informed, transdiagnostic model of how anxious-depressive distress is generated and culturally shaped. Guided by this model, it discusses how interventions can be designed to decrease anxiety-type and depressive-type psychopathology in a culturally sensitive way. It describes such concepts as explanatory model bridging, cultural grounding, and contextual sensitivity. Copyright © 2017 Elsevier Inc. All rights reserved.

Driving Green: Toward the Prediction and Influence of Efficient Driving Behavior

NASA Astrophysics Data System (ADS)

Newsome, William D.

Sub-optimal efficiency in activities involving the consumption of fossil fuels, such as driving, contribute to a miscellany of negative environmental, political, economic and social externalities. Demonstrations of the effectiveness of feedback interventions can be found in countless organizational settings, as can demonstrations of individual differences in sensitivity to feedback interventions. Mechanisms providing feedback to drivers about fuel economy are becoming standard equipment in most new vehicles, but vary considerably in their constitution. A keystone of Radical Behaviorism is the acknowledgement that verbal behavior appears to play a role in mediating apparent susceptibility to influence by contingencies of varying delay. In the current study, samples of verbal behavior (rules) were collected in the context of a feedback intervention to improve driving efficiency. In an analysis of differences in individual responsiveness to the feedback intervention, the rate of novel rules per week generated by drivers is revealed to account for a substantial proportion of the variability in relative efficiency gains across participants. The predictive utility of conceptual tools, such as the basic distinction among contingency-shaped and rule governed behavior, the elaboration of direct-acting and indirect-acting contingencies, and the psychological flexibility model, is bolstered by these findings.

Overview of methods in economic analyses of behavioral interventions to promote oral health

PubMed Central

O’Connell, Joan M.; Griffin, Susan

2016-01-01

Background Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. Objective To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. Methods We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Discussion Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly. PMID:21656966

Overview of methods in economic analyses of behavioral interventions to promote oral health.

PubMed

O'Connell, Joan M; Griffin, Susan

2011-01-01

Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly.

Multidimensionality of Teachers' Graded Responses for Preschoolers' Stylistic Learning Behavior: The Learning-to-Learn Scales

ERIC Educational Resources Information Center

McDermott, Paul A.; Fantuzzo, John W.; Warley, Heather P.; Waterman, Clare; Angelo, Lauren E.; Gadsden, Vivian L.; Sekino, Yumiko

2011-01-01

Assessment of preschool learning behavior has become very popular as a mechanism to inform cognitive development and promote successful interventions. The most widely used measures offer sound predictions but distinguish only a few types of stylistic learning and lack sensitive growth detection. The Learning-to-Learn Scales was designed to…

Child- And Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: Development and Preliminary Results.

ERIC Educational Resources Information Center

Pavuluri, Mani N.; Graczyk, Patricia A.; Henry, David B.; Carbray, Julie A.; Heidenreich, Jodi; Miklowitz, David J.

2004-01-01

Objective: To describe child- and family-focused cognitive-behavioral therapy (CFF-CBT), a new developmentally sensitive psychosocial intervention for pediatric bipolar disorder (PBD) that is intended for use along with medication. CFF-CBT integrates principles of family-focused therapy with those of CBT. The theoretical framework is based on (1)…

Educational Intervention to Modify Bottle-Feeding Behaviors among Formula-Feeding Mothers in the WIC Program: Impact on Infant Formula Intake and Weight Gain

ERIC Educational Resources Information Center

Kavanagh, Katherine F.; Cohen, Roberta J.; Heinig, M. Jane; Dewey, Kathryn G.

2008-01-01

Objective: Formula-fed infants gain weight faster than breastfed infants. This study evaluated whether encouraging formula-feeding caregivers to be sensitive to infant satiety cues would alter feeding practices and reduce infant formula intake and weight gain. Design: Double-blind, randomized educational intervention, with intake and growth…

Early intervention and recovery among children with failure to thrive: follow-up at age 8.

PubMed

Black, Maureen M; Dubowitz, Howard; Krishnakumar, Ambika; Starr, Raymond H

2007-07-01

We sought to examine the impact of a randomized, controlled trial of home visiting among infants with failure to thrive on growth, academic/cognitive performance, and home/classroom behavior at age 8. Infants with failure to thrive (N = 130) or adequate growth (N = 119) were recruited from pediatric primary care clinics serving low-income, urban communities. Eligibility criteria included age <25 months, gestational age >36 weeks, birth weight >2500 g, and no significant medical conditions. Evaluation included anthropometries, Bayley scales, maternal anthropometries, demographics, negative affect, IQ, and the Home Observation for Measurement of the Environment scale. Infants with failure to thrive were treated in an interdisciplinary growth and nutrition clinic and randomized into clinical-intervention-plus-home-intervention or clinical-care-only groups. The home-visiting curriculum promoted maternal sensitivity, parent-infant relationships, and child development. Follow-up visits were conducted by evaluators who were unaware of the children's growth or intervention history. At age 8, the evaluation included anthropometries, the Wechsler Intelligence Scale for Children III, and the Wide Range Achievement Test, Revised. Mothers completed the Child Behavior Checklist and teachers completed the Teacher Report Form. Multivariate analyses of variance were used to examine differences in growth, cognitive/academic performance, and home/school behavior, adjusted by maternal education, public assistance, and, when appropriate, infant Bayley score, maternal BMI, height, negative affect, IQ, and Home Observation for Measurement of the Environment scores. Retention was 74% to 78%. Children in the adequate-growth group were significantly taller, heavier, and had better arithmetic scores than the clinical-intervention-only group, with the clinical-intervention-plus-home-intervention group intermediate. There were no group differences in IQ, reading, or mother-reported behavior problems. Children in the clinical-intervention-plus-home-intervention group had fewer teacher-reported internalizing problems and better work habits than the clinical-intervention-only group. Early failure to thrive increased children's vulnerability to short stature, poor arithmetic performance, and poor work habits. Home visiting attenuated some of the negative effects of early failure to thrive, possibly by promoting maternal sensitivity and helping children build strong work habits that enabled them to benefit from school. Findings provide evidence for early intervention programs for vulnerable infants.

Efficacy of a Sun Protection Workbook for Kidney Transplant Recipients: A Randomized Controlled Trial of a Culturally Sensitive Educational Intervention

PubMed Central

Robinson, June K.; Guevara, Yanina; Gaber, Rikki; Clayman, Marla L.; Kwasny, Mary J.; Friedewald, John J.; Gordon, Elisa J.

2014-01-01

A culturally sensitive educational intervention that encouraged sun protection behaviors among kidney transplant recipients was developed and the short-term efficacy was evaluated. Non-Hispanic White, Hispanic/Latino, and non-Hispanic Black patients, who received a transplant 2–24 months prior to the study, were randomized into two study groups: intervention versus standard of care. Electronic reminders tailored to the weather conditions were sent every two weeks by text message or email. Self-reported surveys and biologic measurements were obtained prior to the intervention and six weeks later. Among the 101 study participants, there was a statistically significant increase in knowledge, recognition of personal risk of developing skin cancer, willingness to change sun protection behavior, and self-reported performance of sun protection in participants receiving the intervention in comparison with those receiving standard of care (p <0.05). The pigment darkening of the sun–exposed forearm and sun damage of the forearm and sunburns/ skin irritation from the sun were significantly less in participants receiving the intervention (p <0.05). Providing sun protection education at the beginning of summer with reminders tailored to weather conditions helped KTRs adopt sun protection practices. This sun protection program for KTRs may be incorporated into the care provided by the nephrologist or transplant surgeon. PMID:25395386

From observational to dynamic genetics

PubMed Central

Haworth, Claire M. A.; Davis, Oliver S. P.

2014-01-01

Twin and family studies have shown that most traits are at least moderately heritable. But what are the implications of finding genetic influence for the design of intervention and prevention programs? For complex traits, heritability does not mean immutability, and research has shown that genetic influences can change with age, context, and in response to behavioral and drug interventions. The most significant implications for intervention will come when we move from observational genetics to investigating dynamic genetics, including genetically sensitive interventions. Future interventions should be designed to overcome genetic risk and draw upon genetic strengths by changing the environment. PMID:24478793

Hippocampal volume and sensitivity to maternal aggressive behavior: a prospective study of adolescent depressive symptoms.

PubMed

Whittle, Sarah; Yap, Marie B H; Sheeber, Lisa; Dudgeon, Paul; Yücel, Murat; Pantelis, Christos; Simmons, Julian G; Allen, Nicholas B

2011-02-01

It has been suggested that biological factors confer increased sensitivity to environmental influences on depressive symptoms during adolescence, a crucial time for the onset of depressive disorders. Given the critical role of the hippocampus in sensitivity to stress and processing of contextual aspects of the environment, investigation of its role in determining sensitivity to environmental context seems warranted. This study prospectively examined hippocampal volume as a measure of sensitivity to the influence of aggressive maternal behavior on change in depressive symptoms from early to midadolescence. The interaction between aggressive maternal behavior and hippocampal volume was found to predict change in depressive symptoms. Significant sex differences also emerged, whereby only for girls were larger bilateral hippocampal volumes more sensitive to the effects of maternal aggressive behavior, particularly with respect to experiencing the protective effects of low levels of maternal aggressiveness. These findings help elucidate the complex relationships between brain structure, environmental factors such as maternal parenting style, and sensitivity to (i.e., risk for, and protection from) the emergence of depression during this life stage. Given that family context risk factors are modifiable, our findings suggest the potential utility of targeted parenting interventions for the prevention and treatment of adolescent depressive disorder.

The Community-based Participatory Intervention Effect of “HIV-RAAP”

PubMed Central

Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

2012-01-01

Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

The community-based participatory intervention effect of "HIV-RAAP".

PubMed

Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

2012-07-01

To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

A randomized clinical trial of an HIV-risk-reduction intervention among low-income Latina women.

PubMed

Peragallo, Nilda; Deforge, Bruce; O'Campo, Patricia; Lee, Sun Mi; Kim, Young Ju; Cianelli, Rosina; Ferrer, Lilian

2005-01-01

HIV infection has increased within the Latina community more than in any other ethnic or racial group within the United States. Latinas comprise only 13% of the U.S. population, yet they account for 20% of the cumulative reported cases of AIDS. The purpose of the study was to evaluate a randomized culturally tailored intervention to prevent high-HIV-risk sexual behaviors for Latina women residing in urban areas. Mexican and Puerto Rican women (18-44 years of age; N = 657) who were sexually active during the previous 3 months were recruited and randomized into intervention and control groups. The intervention, facilitated by bilingual, bicultural, trained Latina women, consisted of culturally tailored sessions on understanding their bodies, HIV/AIDS and sexually transmitted diseases, condoms (myths and use), negotiating safer sex practices, violence prevention, and partner communication. Bivariate and multivariate analyses assessed changes from baseline. The intervention improved HIV knowledge, partner communication, risk-reduction behavioral intentions, and condom use, and decreased perceived barriers to condom use. The efficacy of a culturally-sensitive intervention to reduce HIV/AIDS-risk behaviors in Latina women was demonstrated in the current study.

Patterns of Sensitivity to Parenting and Peer Environments: Early Temperament and Adolescent Externalizing Behavior.

PubMed

Tung, Irene; Noroña, Amanda N; Morgan, Julia E; Caplan, Barbara; Lee, Steve S; Baker, Bruce L

2018-03-14

Although parenting behavior and friendship quality predict adolescent externalizing behaviors (EBs), individual differences in temperament may differentially affect susceptibility to these factors over time. In a multi-method and multi-informant study of 141 children followed prospectively from toddlerhood to adolescence, we tested the independent and interactive associations of age 3 reactive temperament (e.g., negative emotionality) and age 13 observed parenting (i.e., positive and negative behavior) and friendship (i.e., conflict and warmth), with multi-informant ratings of age 15 aggression and rule-breaking behavior. Negative parenting predicted growth in parent-rated EB, but only for adolescents with early reactive temperament. Temperament did not affect sensitivity to positive parenting or friendship. Results are discussed in the context of differential susceptibility theory and intervention implications for adolescents. © 2018 Society for Research on Adolescence.

The Triandis model for the study of health and illness behavior: a social behavior theory with sensitivity to diversity.

PubMed

Facione, N C

1993-03-01

The Triandis model of social behavior offers exceptional promise to nurse researchers whose goal is to achieve cultural sensitivity in their research investigations. The model includes six components: consequential beliefs, affect, social influences, previous behavioral habits, physiologic arousal, and facilitating environmental resources. A directed methodology to include culture-relevant items in the measurement of each of these model components allows researchers to capture the diverse explanations of health and illness behavior that might pertain in diverse populations. Researchers utilizing the model can achieve theory-based explanations of differences they observe by gender, race/ethnicity, social class, and sexual orientation. The Triandis model can provide studies to target variables for future intervention studies, as well as highlight areas for needed political action to equalize access to and delivery of nursing care.

Cost of Behavioral Interventions Utilizing Electronic Drug Monitoring for Antiretroviral Therapy Adherence

PubMed Central

Rasu, Rafia S.; Malewski, David F.; Banderas, Julie W.; Thomson, Domonique Malomo; Goggin, Kathy

2013-01-01

Objective To provide data on the actual costs associated with behavioral ART adherence interventions and electronic drug monitoring used in a clinical trial to inform their implementation in future studies and real-world practice. Methods Direct and time costs were calculated from a multi-site three-arm randomized controlled ART adherence trial. HIV positive participants (n = 204) were randomized to standard care (SC), enhanced counseling (EC), or EC and modified directly observed therapy (mDOT) interventions. Electronic drug monitoring (EDM) was used. Costs were calculated for various components of the 24-week adherence intervention. This economic evaluation was conducted from the perspective of an agency that may wish to implement these strategies. Sensitivity analyses were conducted to examine costs and savings associated with different scenarios. Results Total direct costs were $126,068 ($618/patient). Initial time costs were $53,590 ($262/patient). Base cost of labor was $0.36/minute. EC costs for 134 patients were $18,427 ($137/patient) and mDOT for 64 patients cost $18,638 ($291/patient). Total per patient costs were: SC=$880, EC=$1,018, EC/mDOT=$1,309. Removing driving costs evidenced the most variable impact on savings between the three study arms. The tornado diagram (sensitivity analysis) showed a graphical representation of how each sensitivity assumption reduced costs compared to each other and the resulting comparative costs for each group. Conclusion This novel economic analysis provides valuable cost information to guide treatment implementation and research design decisions. PMID:23337364

The promise of multimedia technology for STI/HIV prevention: frameworks for understanding improved facilitator delivery and participant learning.

PubMed

Khan, Maria R; Epperson, Matthew W; Gilbert, Louisa; Goddard, Dawn; Hunt, Timothy; Sarfo, Bright; El-Bassel, Nabila

2012-10-01

There is increasing excitement about multimedia sexually transmitted infection (STI) and HIV prevention interventions, yet there has been limited discussion of how use of multimedia technology may improve STI/HIV prevention efforts. The purpose of this paper is to describe the mechanisms through which multimedia technology may work to improve the delivery and uptake of intervention material. We present conceptual frameworks describing how multimedia technology may improve intervention delivery by increasing standardization and fidelity to the intervention material and the participant's ability to learn by improving attention, cognition, emotional engagement, skills-building, and uptake of sensitive material about sexual and drug risks. In addition, we describe how the non-multimedia behavioral STI/HIV prevention intervention, Project WORTH, was adapted into a multimedia format for women involved in the criminal justice system and provide examples of how multimedia activities can more effectively target key mediators of behavioral change in this intervention.

The Promise of Multimedia Technology for STI/HIV Prevention: Frameworks for Understanding Improved Facilitator Delivery and Participant Learning

PubMed Central

Epperson, Matthew W.; Gilbert, Louisa; Goddard, Dawn; Hunt, Timothy; Sarfo, Bright; El-Bassel, Nabila

2018-01-01

There is increasing excitement about multi-media sexually transmitted infection (STI) and HIV prevention interventions, yet there has been limited discussion of how use of multimedia technology may improve STI/HIV prevention efforts. The purpose of this paper is to describe the mechanisms through which multimedia technology may work to improve the delivery and uptake of intervention material. We present conceptual frameworks describing how multimedia technology may improve intervention delivery by increasing standardization and fidelity to the intervention material and the participant’s ability to learn by improving attention, cognition, emotional engagement, skills-building, and uptake of sensitive material about sexual and drug risks. In addition, we describe how the non-multimedia behavioral STI/HIV prevention intervention, Project WORTH, was adapted into a multimedia format for women involved in the criminal justice system and provide examples of how multimedia activities can more effectively target key mediators of behavioral change in this intervention. PMID:22223296

Cost-utility of a cardiovascular prevention program in highly educated adults: intermediate results of a randomized controlled trial.

PubMed

Jacobs, Nele; Evers, Silvia; Ament, Andre; Claes, Neree

2010-01-01

Little is known about the costs and the effects of cardiovascular prevention programs targeted at medical and behavioral risk factors. The aim was to evaluate the cost-utility of a cardiovascular prevention program in a general sample of highly educated adults after 1 year of intervention. The participants were randomly assigned to intervention (n = 208) and usual care conditions (n = 106). The intervention consisted of medical interventions and optional behavior-change interventions (e.g., a tailored Web site). Cost data were registered from a healthcare perspective, and questionnaires were used to determine effectiveness (e.g., quality-adjusted life-years [QALYs]). A cost-utility analysis and sensitivity analyses using bootstrapping were performed on the intermediate results. When adjusting for baseline utility differences, the incremental cost was 433 euros and the incremental effectiveness was 0.016 QALYs. The incremental cost-effectiveness ratio was 26,910 euros per QALY. The intervention was cost-effective compared with usual care in this sample of highly educated adults after 1 year of intervention. Increased participation would make this intervention highly cost-effective.

Reinforcement Sensitivity Underlying Treatment-Seeking Smokers’ Affect, Smoking Reinforcement Motives, and Affective Responses

PubMed Central

Cui, Yong; Robinson, Jason D.; Engelmann, Jeffrey M.; Lam, Cho Y.; Minnix, Jennifer A.; Karam-Hage, Maher; Wetter, David W.; Dani, John A.; Kosten, Thomas R.; Cinciripini, Paul M.

2014-01-01

Nicotine dependence has been suggested to be related to reinforcement sensitivity, which encompasses behavioral predispositions either to avoid aversive (behavioral inhibition) or to approach appetitive (behavioral activation) stimuli. Reinforcement sensitivity may shape motives for nicotine use and offer potential targets for personalized smoking cessation therapy. However, little is known regarding how reinforcement sensitivity is related to motivational processes implicated in the maintenance of smoking. Additionally, women and men differ in reinforcement sensitivity, and such difference may cause distinct relationships between reinforcement sensitivity and motivational processes for female and male smokers. In this study, we characterized reinforcement sensitivity in relation to affect, smoking-related reinforcement motives, and affective responses, using self-report and psychophysiological measures, in over 200 smokers before treating them. The Behavioral Inhibition/Activation Scales (BIS/BAS; Carver & White, 1994) was used to measure reinforcement sensitivity. In female and male smokers, BIS was similarly associated with negative affect and negative reinforcement of smoking. But positive affect was positively associated with BAS Drive scores in male smokers, and this association was reversed in female smokers. BIS was positively associated with corrugator electromyographic reactivity towards negative stimuli and left frontal electroencephalogram alpha asymmetry. Female and male smokers showed similar relationships for these physiological measures. These findings suggest that reinforcement sensitivity underpins important motivational processes (e.g., affect), and gender is a moderating factor for these relationships. Future personalized smoking intervention, particularly among more dependent treatment-seeking smokers, may experiment to target individual differences in reinforcement sensitivity. PMID:25621416

Change in children's externalizing and internalizing behavior problems: the role of defense mechanisms.

PubMed

Cramer, Phebe

2015-03-01

This study investigates the relation of defense mechanism to children's externalizing and internalizing behavior problems, as assessed from mothers' report at age 9 and 12 years, based on archival data. The defense mechanisms of denial, projection, and identification were assessed from Thematic Apperception Test stories told by the children at age 9 years, using the Defense Mechanism Manual (Cramer, The development of defense mechanisms: Theory, research and assessment. New York: Springer-Verlag, 1991a; Protecting the self: Defense mechanisms in action. New York: Guilford Press, 2006). The results showed that the use of identification predicted a decrease in externalizing behaviors between age 9 and 12 years. In contrast, change in internalizing behaviors was not predicted by defense use, but the use of projection was related to fewer internalizing behaviors at both ages. These findings are consistent with the idea that behavioral intervention stressing self-regulation can be effective in reducing externalizing problems, but internalizing problems require an intervention that is sensitive to the underlying behavioral inhibition in these children.

Sexual health behavior interventions for U.S. Latino adolescents: a systematic review of the literature.

PubMed

Cardoza, Vicky J; Documét, Patricia I; Fryer, Craig S; Gold, Melanie A; Butler, James

2012-04-01

To identify sexual health behavior interventions targeting U.S. Latino adolescents. A systematic literature review. Peer-reviewed articles published between 1993 and 2011, conducted in any type of setting. Male and female Latino adolescents ages 11-21 years. Interventions promoting sexual abstinence, pregnancy prevention, sexually transmitted infection (STI) prevention, and/or HIV/AIDS prevention. Changes in knowledge, attitudes, engagement in risky sexual behaviors, rates of STIs, and/or pregnancy. Sixty-eight articles were identified. Fifteen were included in this review that specifically addressed Latino adolescent sexual health behavior. Among the reviewed interventions, most aimed to prevent or reduce STI and HIV/AIDS incidence by focusing on behavior change at two levels of the social ecological model: individual and interpersonal. Major strengths of the articles included addressing the most critical issues of sexual health; using social ecological approaches; employing different strategies to deliver sexual health messages; and employing different intervention designs in diverse geographical locations with the largest population of Latino communities. Most of the interventions targeted female adolescents, stressing the need for additional interventions that target Latino adolescent males. Latino adolescent sexual health is a new research field with gaps that need to be addressed in reducing negative sexual health outcomes among this population. More research is needed to produce new or validate existing, age-specific, and culturally-sensitive sexual health interventions for Latino male and female adolescents. Further, this research should also be conducted in areas of the U.S. with the newest Latino migration (e.g., North Carolina). Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Preschoolers’ Genetic, Physiological, and Behavioral Sensitivity Factors Moderate Links Between Parenting Stress and Child Internalizing, Externalizing, and Sleep Problems

PubMed Central

Davis, Molly; Thomassin, Kristel; Bilms, Joanie; Suveg, Cynthia; Shaffer, Anne; Beach, Steven R. H.

2017-01-01

This study examined three potential moderators of the relations between maternal parenting stress and preschoolers’ adjustment problems: a genetic polymorphism - the short allele of the serotonin transporter (5-HTTLPR, ss/sl allele) gene, a physiological indicator - children’s baseline respiratory sinus arrhythmia (RSA), and a behavioral indicator - mothers’ reports of children’s negative emotionality. A total of 108 mothers (Mage = 30.68 years, SDage = 6.06) reported on their parenting stress as well as their preschoolers’ (Mage = 3.50 years, SDage = .51, 61% boys) negative emotionality and internalizing, externalizing, and sleep problems. Results indicated that the genetic sensitivity variable functioned according to a differential susceptibility model; however, the results involving physiological and behavioral sensitivity factors were most consistent with a diathesis-stress framework. Implications for prevention and intervention efforts to counter the effects of parenting stress are discussed. PMID:28295263

Evaluate, Assess, Treat: Development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues

PubMed Central

DeBate, Rita D.; Cragun, Deborah; Gallentine, Ashley A.; Severson, Herbert H.; Shaw, Tracey; Cantwell, Carley; Christiansen, Steve; Koerber, Anne; Hendricson, William; Tomar, Scott L.; Brown, Kelli McCormack; Tedesco, Lisa A.

2012-01-01

Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues while interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e., early detection of oral manifestations of disordered eating behaviors, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviors. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and 7 dental (D) classes from 8 institutions were randomized to either the intervention or control conditions. Both groups completed preand post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention while controlling for baseline levels. Statistically significant improvements from pre-to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all p < .01). Effect sizes ranged from .57–.95. No statistically significant differences in outcomes were observed by type of student. Although the EAT Framework was developed as part of a larger study on secondary prevention of eating disorders, the procedures and skills presented can be applied to other sensitive oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication. PMID:23050505

Evaluating a cognitive/ecological program for the prevention of aggression among urban children.

PubMed

Huesmann, L R; Maxwell, C D; Eron, L; Dahlberg, L L; Guerra, N G; Tolan, P H; VanAcker, R; Henry, D

1996-01-01

The Metropolitan Area Child Study (MACS) is a multifaceted school- and family-based intervention and evaluation study designed to prevent and understand the development of aggressive behavior. The multifaceted interventions are grounded in combined social-cognitive and ecologic theories. Social-cognitive theories contend that cognitive scripts, attributions, and beliefs acquired early in life mediate the effects of ecological factors that influence the development of antisocial behavior. Prevention programs aimed at these cognitions must address multiple dimensions of the child's environment including family, peer, school, and community. The program has three levels of intervention delivered in two-year segments: (1) Level 1: a general enhancement classroom intervention that stresses culturally sensitive student and teacher interaction involving instructional and classroom management strategies and a social-cognitive curriculum that mitigates aggressive development; (2) Level 2: intensive small-group sessions designed to change children's cognitions and enhance peer relationship skills for at-risk children added to the general classroom enhancement program; and (3) Level 3: a one-year family relationship intervention that stresses parenting skill building and emotional responsiveness in family interactions added to the general enhancement and small-group training conditions. Sixteen Chicago-area schools are randomly assigned (four each) to a control group or one of the three intervention levels. Individual child assessment, peer assessments, classroom behavioral observations, and archival data are collected before the interventions begin, during the interventions, at the end of each intervention, and at a follow-up point. The pretests indicate that the children on average have higher levels of aggression than found nationally and elevated clinical levels of other psychopathologies. Across the four intervention levels there are no significant differences in ethnic composition, socio-economic status (SES), aggressive behavior, and normative beliefs about aggression.

Task-shifting alcohol interventions for HIV+ persons in Kenya: a cost-benefit analysis.

PubMed

Galárraga, Omar; Gao, Burke; Gakinya, Benson N; Klein, Debra A; Wamai, Richard G; Sidle, John E; Papas, Rebecca K

2017-03-28

Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms. We conducted a cost-benefit analysis, measuring economic return on investment, of a task-shifted cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use in a modeled cohort of 13,440 outpatients in Kenya. In our base-case, we estimated the costs and economic benefits from a societal perspective across a six-year time horizon, with a 3% annual discount rate. Costs included all costs associated with training and administering task-shifted CBT therapy. Benefits included the economic impact of lowered HIV incidence as well as the improvements in household and labor-force productivity. We conducted univariate and multivariate probabilistic sensitivity analyses to test the robustness of our results. Under the base case, total costs for CBT rollout was $554,000, the value of benefits were $628,000, and the benefit-to-cost ratio was 1.13. Sensitivity analyses showed that under most assumptions, the benefit-to-cost ratio remained above unity indicating that the intervention was cost-saving (i.e., had positive return on investment). The duration of the treatment effect most effected the results in sensitivity analyses. CBT can be effectively and economically task-shifted to paraprofessionals in Kenya. The intervention can generate not only reductions in morbidity and mortality, but also economic savings for the health system in the medium and long term. The findings have implications for other countries with generalized HIV epidemics, high prevalence of alcohol consumption, and shortages of mental health professionals. This paper uses data derived from "Cognitive Behavioral Treatment to Reduce Alcohol Use Among HIV-Infected Kenyans (KHBS)" with ClinicalTrials.gov registration NCT00792519 on 11/17/2008; and preliminary data from "A Stage 2 Cognitive-behavioral Trial: Reduce Alcohol First in Kenya Intervention" ( NCT01503255 , registered on 12/16/2011).

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

PubMed

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

2015-02-12

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

Moderate social sensitivity in a risky context supports adaptive decision making in adolescence: evidence from brain and behavior.

PubMed

van Hoorn, Jorien; McCormick, Ethan M; Telzer, Eva H

2018-05-01

Adolescence is a time of increased social-affective sensitivity, which is often related to heightened health-risk behaviors. However, moderate levels of social sensitivity, relative to either low (social vacuum) or high levels (exceptionally attuned), may confer benefits as it facilitates effective navigation of the social world. The present fMRI study tested a curvilinear relationship between social sensitivity and adaptive decision-making. Participants (ages 12-16; N = 35) played the Social Analogue Risk Task, which measures participants' willingness to knock on doors in order to earn points. With each knock, the facial expression of the house's resident shifted from happy to somewhat angrier. If the resident became too angry, the door slammed and participants lost points. Social sensitivity was defined as the extent to which adolescents adjusted their risky choices based on shifting facial expressions. Results confirmed a curvilinear relationship between social sensitivity and self-reported adaptive decision-making at the behavioral and neural level. Moderate adolescent social sensitivity was modulated via heightened tracking of social cues in the temporoparietal junction, insula and dorsolateral prefrontal cortex and related to adaptive decision-making. These findings suggest that social-affective sensitivity may positively impact outcomes in adolescence and have implications for interventions to help adolescents reach mature social goals into adulthood.

Parenting Supports for Early Vocabulary Development: Specific Effects of Sensitivity and Stimulation through Infancy

PubMed Central

Vallotton, Claire; Mastergeorge, Ann; Foster, Tricia; Decker, Kalli B.; Ayoub, Catherine

2016-01-01

Growing recognition of disparities in early childhood language environments prompt examination of parent-child interactions which support vocabulary. Research links parental sensitivity and cognitive stimulation to child language, but has not explicitly contrasted their effects, nor examined how effects may change over time. We examined maternal sensitivity and stimulation throughout infancy using two observational methods – ratings of parents’ interaction qualities, and coding of discrete parenting behaviors - to assess the relative importance of these qualities to child vocabulary over time, and determine whether mothers make related changes in response to children’s development. Participants were 146 infants and mothers, assessed when infants were 14, 24, and 36 months. At 14 months, sensitivity had a stronger effect on vocabulary than did stimulation, but the effect of stimulation grew throughout toddlerhood. Mothers’ cognitive stimulation grew over time, whereas sensitivity remained stable. While discrete parenting behaviors changed with child age, there was no evidence of trade-offs between sensitive and stimulating behaviors, and no evidence that sensitivity moderated the effect of stimulation on child vocabulary. Findings demonstrate specificity of timing in the link between parenting qualities and child vocabulary which could inform early parent interventions, and supports a reconceptualization of the nature and measurement of parental sensitivity. PMID:28111526

Dietary factors and cancers of breast, endometrium, and ovary: strategies for modifying fat intake in African American women.

PubMed

Hargreaves, M K; Buchowski, M S; Hardy, R E; Rossi, S R; Rossi, J S

1997-06-01

Modification of dietary fat and fiber could help prevent cancers of the breast, endometrium, and ovary that are prevalent in African-American women. Dietary intervention programs aimed at reducing fat intake have had mixed results in this population. The transtheoretic model is proposed for achieving dietary change. Strategies for changing health behaviors in African-American women include heightening sensitivity to cultural values among health educators and the use of multiple strategies to reinforce messages. To stimulate healthier eating, it is important to incorporate the distinct habitual eating patterns into innovative intervention methods, using effective behavioral change methods.

Teaching guatemala midwives about postpartum hemorrhage.

PubMed

Garcia, Kimberly; Morrison, Fellow Barbara; Savrin, Carol

2012-01-01

To evaluate the effect of a culturally sensitive teaching unit on traditional midwives' knowledge of nursing interventions to prevent and treat postpartum hemorrhage (PPH). Sixteen midwives participated in a 1-day training program at a Refuge International Health Clinic in the remote town of Sarstun, Guatemala. The quasi experimental study used a one-group, pretest-posttest design. Researchers used a PPH Behavioral Checklist from the American College of Nurse Midwives (ACNM) to assess and compare knowledge of PPH interventions before and after the PPH teaching. The final analysis included 13 traditional midwives as the subjects. The culturally sensitive teaching improved traditional midwives' knowledge and skills about nursing interventions to manage PPH (pretest M = 1.385/8, posttest M = 4.846/8). Results of this pilot project suggest a culturally sensitive oral teaching in the primary language of the participants positively affects traditional midwives' knowledge and skills to manage PPH. Future training should be presented in a similar format to meet the needs of illiterate audiences in resource-poor settings.

Reinforcement sensitivity underlying treatment-seeking smokers' affect, smoking reinforcement motives, and affective responses.

PubMed

Cui, Yong; Robinson, Jason D; Engelmann, Jeffrey M; Lam, Cho Y; Minnix, Jennifer A; Karam-Hage, Maher; Wetter, David W; Dani, John A; Kosten, Thomas R; Cinciripini, Paul M

2015-06-01

Nicotine dependence has been suggested to be related to reinforcement sensitivity, which encompasses behavioral predispositions either to avoid aversive (behavioral inhibition) or to approach appetitive (behavioral activation) stimuli. Reinforcement sensitivity may shape motives for nicotine use and offer potential targets for personalized smoking cessation therapy. However, little is known regarding how reinforcement sensitivity is related to motivational processes implicated in the maintenance of smoking. Additionally, women and men differ in reinforcement sensitivity, and such difference may cause distinct relationships between reinforcement sensitivity and motivational processes for female and male smokers. In this study, the authors characterized reinforcement sensitivity in relation to affect, smoking-related reinforcement motives, and affective responses, using self-report and psychophysiological measures, in over 200 smokers before treating them. The Behavioral Inhibition/Activation Scales (BIS/BAS; Carver & White, 1994) was used to measure reinforcement sensitivity. In female and male smokers, BIS was similarly associated with negative affect and negative reinforcement of smoking. However, positive affect was positively associated with BAS Drive scores in male smokers, and this association was reversed in female smokers. BIS was positively associated with corrugator electromyographic reactivity toward negative stimuli and left frontal electroencephalogram alpha asymmetry. Female and male smokers showed similar relationships for these physiological measures. These findings suggest that reinforcement sensitivity underpins important motivational processes (e.g., affect), and gender is a moderating factor for these relationships. Future personalized smoking intervention, particularly among more dependent treatment-seeking smokers, may experiment to target individual differences in reinforcement sensitivity. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Children's Reward and Punishment Sensitivity Moderates the Association of Negative and Positive Parenting Behaviors in Child ADHD Symptoms.

PubMed

Li, James J

2018-03-20

Atypical reward processing, including abnormal reward responsivity and sensitivity to punishment, has long been implicated in the etiology of ADHD. However, little is known about how these facets of behavior interact with positive (e.g., warmth, praise) and negative (e.g., hostility, harsh discipline) parenting behavior in the early expression of ADHD symptoms in young children. Understanding the interplay between children's reward processing and parenting may be crucial for identifying specific treatment targets in psychosocial interventions for ADHD, especially given that not all children benefit from contingency-based treatments (e.g., parent management training). The study consisted of a sample of kindergarten children (N = 201, 55% male) and their parents, who completed questionnaires about their parenting practices, their child's behaviors and participated in an observed parent-child play task in the laboratory. Children's reward responsivity and sensitivity to punishment were positively associated with child ADHD symptoms. However, children with high reward responsivity had more symptoms of ADHD but only under conditions of low negative parenting (self-reported and observed) and high self-reported positive parenting, compared to children with low reward responsivity. Children with high sensitivity to punishment had more ADHD symptoms relative to children with low sensitivity to punishment, but only under conditions in which observed praise was infrequent. Results provide evidence that individual differences in sensitivity to reward/punishment may be an important of marker of risk for ADHD, but also highlights how children's responses to positive and negative parenting behavior may vary by children's sensitivities. Clinical and treatment implications are discussed.

Cognitive behavior therapy in the treatment of panic disorder

PubMed Central

Manjula, M.; Kumariah, V.; Prasadarao, P. S. D. V.; Raguram, R.

2009-01-01

Background: Comprehensive cognitive behavior therapies have been proved to be more effective than behavioral interventions. However, the efficacy of CBT is not studied in the Indian context and also, the amount of change brought about by CBT is not known. Aims: This study aims to examine the efficacy of cognitive behavioral intervention (CBI) in the treatment of panic disorder. Our specific objectives were to assess the effectiveness of CBI in reducing symptom severity as well as cognitions related to panic and panic-related behaviors. Design: The study adopted a two-group comparison with pre- and postassessments design. Materials and Methods: The sample consisted of 30 patients sequentially allotted to the CBI (n = 15) and behavioral intervention (BI, n = 15) groups. Assessment was done using a semistructured interview schedule, panic disorder severity scale, Texas panic attack record form, Anxiety Sensitivity Index, Agoraphobic cognitions questionnaire, Behavioral avoidance checklist, and Panic appraisal inventory. The CBI group was provided with comprehensive cognitive behavior therapy and the BI group with psycho-education and applied relaxation. Results: CBI was found to be superior to BI in the reduction of panic symptoms, behavioral avoidance, safety behaviors, and cognitions. A large percentage of the CBI group patients met the criteria for clinically significant change with a large magnitude of change. Conclusion: Multicomponent CBI is superior to BI in terms of the amount of change it brings about with respect to panic symptoms, avoidance, safety behaviors, and cognitions. PMID:19823629

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

PubMed

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

2018-07-01

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

Impact of a nurse-directed, coordinated school health program to enhance physical activity behaviors and reduce body mass index among minority children: A parallel-group, randomized control trial

PubMed Central

Wright, Kynna; Giger, Joyce Newman; Norris, Keth; Suro, Zulma

2013-01-01

Background Underserved children, particularly girls and those in urban communities, do not meet the recommended physical activity guidelines (>60 min of daily physical activity), and this behavior can lead to obesity. The school years are known to be a critical period in the life course for shaping attitudes and behaviors. Children look to schools for much of their access to physical activity. Thus, through the provision of appropriate physical activity programs, schools have the power to influence apt physical activity choices, especially for underserved children where disparities in obesity-related outcomes exist. Objectives To evaluate the impact of a nurse directed, coordinated, culturally sensitive, school-based, family-centered lifestyle program on activity behaviors and body mass index. Design, settings and participants: This was a parallel group, randomized controlled trial utilizing a community-based participatory research approach, through a partnership with a University and 5 community schools. Participants included 251 children ages 8–12 from elementary schools in urban, low-income neighborhoods in Los Angeles, USA. Methods The intervention included Kids N Fitness©, a 6-week program which met weekly to provide 45 min of structured physical activity and a 45 min nutrition education class for parents and children. Intervention sites also participated in school-wide wellness activities, including health and counseling services, staff professional development in health promotion, parental education newsletters, and wellness policies for the provision of healthy foods at the school. The Child and Adolescent Trial for Cardiovascular Health School Physical Activity and Nutrition Student Questionnaire measured physical activity behavior, including: daily physical activity, participation in team sports, attending physical education class, and TV viewing/computer game playing. Anthropometric measures included height, weight, body mass index, resting blood pressure, and waist circumference. Measures were collected at baseline, completion of the intervention phase (4 months), and 12 months post-intervention. Results Significant results for students in the intervention, included for boys decreases in TV viewing; and girls increases in daily physical activity, physical education class attendance, and decreases in body mass index z-scores from baseline to the 12 month follow-up. Conclusions Our study shows the value of utilizing nurses to implement a culturally sensitive, coordinated, intervention to decrease disparities in activity and TV viewing among underserved girls and boys. PMID:23021318

Genetic sensitivity to the caregiving context: The influence of 5httlpr and BDNF val66met on indiscriminate social behavior

PubMed Central

Drury, Stacy S; Gleason, Mary Margaret; Theall, Katherine; Smyke, Anna T; Nelson, Charles A; Fox, Nathan A; Zeanah, Charles H

2014-01-01

Evidence that gene x environment interactions can reflect differential sensitivity to the environmental context, rather than risk or resilience, is increasing. To test this model, we examined the genetic contribution to indiscriminate social behavior, in the setting of a randomized controlled trial of foster care compared to institutional rearing. Children enrolled in the Bucharest Early Intervention Project (BEIP) were assessed comprehensively before the age of 30 months and subsequently randomized to either care as usual (CAUG) or high quality foster care (FCG). Indiscriminate social behavior was assessed at four time points, baseline, 30 months, 42 months and 54 months of age, using caregiver report with the Disturbances of Attachment Interview (DAI). General linear mixed-effects models were used to examine the effect of the interaction between group status and functional polymorphisms in Brain Derived Neurotrophic Factor (BDNF) and the Serotonin Transporter (5htt) on levels of indiscriminate behavior over time. Differential susceptibility, relative to levels of indiscriminate behavior, was demonstrated in children with either the s/s 5httlpr genotype or met 66 BDNF allele carriers. Specifically children with either the s/s 5httlpr genotype or met66 carriers in BDNF demonstrated the lowest levels of indiscriminate behavior in the FCG and the highest levels in the CAUG. Children with either the long allele of the 5httlpr or val/val genotype of BDNF demonstrated little difference in levels of indiscriminate behaviors over time and no group x genotype interaction. Children with both plasticity genotypes had the most signs of indiscriminate behavior at 54 months if they were randomized to the CAUG in the institution, while those with both plasticity genotypes randomized to the FCG intervention had the fewest signs at 54 months. Strikingly children with no plasticity alleles demonstrated no intervention effect on levels of indiscriminate behavior at 54 months. These findings represent the first genetic associations reported with Indiscriminate social behavior, replicate previous gene x gene x environment findings with these polymorphisms, and add to the growing body of literature supporting a differential susceptibility model of gene x environment interactions in developmental psychopathology. PMID:22133521

Decreasing Substance Use Risk Among African American Youth: Parent-based Mechanisms of Change

PubMed Central

Beach, Steven R. H.; Barton, Allen W.; Lei, Man Kit; Mandara, Jelani; Wells, Ashley C.; Kogan, Steven M.; Brody, Gene H.

2017-01-01

African American couples (N = 139; 67.7% married; with children between the ages of 9 and 14) were randomly assigned to (a) a culturally sensitive, couple- and parenting-focused program designed to prevent stress-spillover (n = 70) or (b) an information-only control condition in which couples received self-help materials (n = 69). Eight months after baseline, youth whose parents participated in the program, compared with control youth, reported increased parental monitoring, positive racial socialization, and positive self-concept, as well as decreased conduct problems and self-reported substance use. Changes in youth-reported parenting behavior partially mediated the effect of the intervention on conduct problems and fully mediated its impact on positive self-concept, but did not mediate effects on lifetime substance use initiation. Results suggest the potential for a culturally sensitive family-based intervention targeting adults’ couple and parenting processes to enhance multiple parenting behaviors as well as decrease youths’ substance use onset and vulnerability. PMID:27129477

Early-Life Obesity Prevention: Critique of Intervention Trials During the First One Thousand Days.

PubMed

Reilly, John J; Martin, Anne; Hughes, Adrienne R

2017-06-01

To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make suggestions for more informative future intervention trials. Completed and ongoing intervention trials have had fairly modest effects, have been limited largely to high-income countries, and have used relatively short-term interventions and outcomes. Comparison of the evidence from completed prevention trials with the evidence from systematic reviews of behavioral risk factors shows that some life-course stages have been neglected (pre-conception and toddlerhood), and that interventions have neglected to target some important behavioral risk factors (maternal smoking during pregnancy, infant and child sleep). Finally, while obesity prevention interventions aim to modify body composition, few intervention trials have used body composition measures as outcomes, and this has limited their sensitivity to detect intervention effects. The new WHO Healthy Lifestyles Trajectory (HeLTI) initiative should address some of these weaknesses. Future early obesity prevention trials should be much more ambitious. They should, ideally: extend their interventions over the first 1000 days; have longer-term (childhood) outcomes, and improved outcome measures (body composition measures in addition to proxies for body composition such as the BMI for age); have greater emphasis on maternal smoking and child sleep; be global.

Promoting smoke-free homes: a novel behavioral intervention using real-time audio-visual feedback on airborne particle levels.

PubMed

Klepeis, Neil E; Hughes, Suzanne C; Edwards, Rufus D; Allen, Tracy; Johnson, Michael; Chowdhury, Zohir; Smith, Kirk R; Boman-Davis, Marie; Bellettiere, John; Hovell, Melbourne F

2013-01-01

Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m(3), and low noise. A linear relationship (R(2) = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m(3). Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches.

Promoting Smoke-Free Homes: A Novel Behavioral Intervention Using Real-Time Audio-Visual Feedback on Airborne Particle Levels

PubMed Central

Klepeis, Neil E.; Hughes, Suzanne C.; Edwards, Rufus D.; Allen, Tracy; Johnson, Michael; Chowdhury, Zohir; Smith, Kirk R.; Boman-Davis, Marie; Bellettiere, John; Hovell, Melbourne F.

2013-01-01

Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m3, and low noise. A linear relationship (R2 = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m3. Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches. PMID:24009742

Increasing the Understanding and Demonstration of Appropriate Affection in Children with Asperger Syndrome: A Pilot Trial

PubMed Central

Sofronoff, Kate; Eloff, Johann; Sheffield, Jeanie; Attwood, Tony

2011-01-01

The study was conducted to examine relationships between affectionate behavior in children with Asperger syndrome and variables likely to influence its expression (e.g., tactile sensitivity, social ability). It also evaluated the impact of a cognitive behavioral intervention that aimed to improve a child's understanding and expression of affection. Twenty-one children, aged 7 to 12 years, participated in the trial. The results showed significant correlations between measures of affection and tactile sensitivity and social ability. After attending the 5-week program, parents identified significant increases in the appropriateness of children's affectionate behavior both towards immediate family and people outside the immediate family, despite reporting no significant changes in their child's general difficulties with affectionate behavior. There was a significant improvement in children's understanding of the purpose of affection. The findings are discussed as well as the limitations of the study. PMID:22937243

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

PubMed

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

2015-10-01

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

Preschoolers' genetic, physiological, and behavioral sensitivity factors moderate links between parenting stress and child internalizing, externalizing, and sleep problems.

PubMed

Davis, Molly; Thomassin, Kristel; Bilms, Joanie; Suveg, Cynthia; Shaffer, Anne; Beach, Steven R H

2017-05-01

This study examined three potential moderators of the relations between maternal parenting stress and preschoolers' adjustment problems: a genetic polymorphism-the short allele of the serotonin transporter (5-HTTLPR, ss/sl allele) gene, a physiological indicator-children's baseline respiratory sinus arrhythmia (RSA), and a behavioral indicator-mothers' reports of children's negative emotionality. A total of 108 mothers (M age  = 30.68 years, SD age  = 6.06) reported on their parenting stress as well as their preschoolers' (M age  = 3.50 years, SD age  = 0.51, 61% boys) negative emotionality and internalizing, externalizing, and sleep problems. Results indicated that the genetic sensitivity variable functioned according to a differential susceptibility model; however, the results involving physiological and behavioral sensitivity factors were most consistent with a diathesis-stress framework. Implications for prevention and intervention efforts to counter the effects of parenting stress are discussed. © 2017 Wiley Periodicals, Inc.

The economics of improving medication adherence in osteoporosis: validation and application of a simulation model.

PubMed

Patrick, Amanda R; Schousboe, John T; Losina, Elena; Solomon, Daniel H

2011-09-01

Adherence to osteoporosis treatment is low. Although new therapies and behavioral interventions may improve medication adherence, questions are likely to arise regarding their cost-effectiveness. Our objectives were to develop and validate a model to simulate the clinical outcomes and costs arising from various osteoporosis medication adherence patterns among women initiating bisphosphonate treatment and to estimate the cost-effectiveness of a hypothetical intervention to improve medication adherence. We constructed a computer simulation using estimates of fracture rates, bisphosphonate treatment effects, costs, and utilities for health states drawn from the published literature. Probabilities of transitioning on and off treatment were estimated from administrative claims data. Patients were women initiating bisphosphonate therapy from the general community. We evaluated a hypothetical behavioral intervention to improve medication adherence. Changes in 10-yr fracture rates and incremental cost-effectiveness ratios were evaluated. A hypothetical intervention with a one-time cost of $250 and reducing bisphosphonate discontinuation by 30% had an incremental cost-effectiveness ratio (ICER) of $29,571 per quality-adjusted life year in 65-yr-old women initiating bisphosphonates. Although the ICER depended on patient age, intervention effectiveness, and intervention cost, the ICERs were less than $50,000 per quality-adjusted life year for the majority of intervention cost and effectiveness scenarios evaluated. Results were sensitive to bisphosphonate cost and effectiveness and assumptions about the rate at which intervention and treatment effects decline over time. Our results suggests that behavioral interventions to improve osteoporosis medication adherence will likely have favorable ICERs if their efficacy can be sustained.

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

PubMed Central

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

2006-01-01

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

Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: a Cost-Effectiveness Analysis.

PubMed

Gong, Cynthia L; Zangwill, Kenneth M; Hay, Joel W; Meeker, Daniella; Doctor, Jason N

2018-05-08

Behavioral economics interventions have been shown to effectively reduce the rates of inappropriate antibiotic prescriptions for acute respiratory infections (ARIs). To determine the cost-effectiveness of three behavioral economic interventions designed to reduce inappropriate antibiotic prescriptions for ARIs. Thirty-year Markov model from the US societal perspective with inputs derived from the literature and CDC surveillance data. Forty-five-year-old adults with signs and symptoms of ARI presenting to a healthcare provider. (1) Provider education on guidelines for the appropriate treatment of ARIs; (2) Suggested Alternatives, which utilizes computerized clinical decision support to suggest non-antibiotic treatment choices in lieu of antibiotics; (3) Accountable Justification, which mandates free-text justification into the patient's electronic health record when antibiotics are prescribed; and (4) Peer Comparison, which sends a periodic email to prescribers about his/her rate of inappropriate antibiotic prescribing relative to clinician colleagues. Discounted costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios. Each intervention has lower costs but higher QALYs compared to provider education. Total costs for each intervention were $178.21, $173.22, $172.82, and $172.52, and total QALYs were 14.68, 14.73, 14.74, and 14.74 for the control, Suggested Alternatives, Accountable Justification, and Peer Comparison groups, respectively. Results were most sensitive to the quality-of-life of the uninfected state, and the likelihood and costs for antibiotic-associated adverse events. Behavioral economics interventions can be cost-effective strategies for reducing inappropriate antibiotic prescriptions by reducing healthcare resource utilization.

Developing Clinically Practicable Biomarkers for Autism Spectrum Disorder

ERIC Educational Resources Information Center

McPartland, James C.

2017-01-01

Despite significant advances in understanding the biological bases of autism spectrum disorder (ASD), the field remains primarily reliant on observational and parent report measures of behavior to guide clinical practice, conduct research, and evaluate intervention outcomes. There is a critical need for objective measures to more sensitively and…

Capoeira as a Clinical Intervention: Addressing Adolescent Aggression with Brazilian Martial Arts

ERIC Educational Resources Information Center

Burt, Isaac; Butler, S. Kent

2011-01-01

Aggression in adolescents is harmful and emotionally devastating to youth and surrounding communities. This article integrates martial arts and therapeutic principles into a culturally sensitive model that cultivates change in the aggressive behaviors of disenfranchised adolescents. The art form of Capoeira is proposed for promoting positive…

Emotional availability in mothers with borderline personality disorder and mothers with remitted major depression is differently associated with psychopathology among school-aged children.

PubMed

Kluczniok, Dorothea; Boedeker, Katja; Hindi Attar, Catherine; Jaite, Charlotte; Bierbaum, Anna-Lena; Fuehrer, Daniel; Paetz, Luisa; Dittrich, Katja; Herpertz, Sabine C; Brunner, Romuald; Winter, Sibylle; Heinz, Andreas; Roepke, Stefan; Heim, Christine; Bermpohl, Felix

2018-04-15

Both, maternal borderline personality disorder (BPD) and maternal major depressive disorder (MDD) are often associated with adverse consequences for children, including increased risk for child behavior problems. Reduced maternal emotional availability might play a critical role in transmitting maternal psychopathology on the child. Our aim was to investigate the association between emotional availability and maternal BPD and MDD in remission (rMDD), and if this interrelatedness mediates the association between maternal mental disorders and child behavior problems. The interaction of 178 mother-child dyads was assessed during a play situation using the Emotional Availability Scales. Children were between 5 and 12 years old. Regression analyses were used to investigate the impact of maternal BPD and maternal rMDD on emotional availability. Ordinary least squares regression analyses using bootstrapping were conducted to investigate the mediating effect of emotional availability on the association between maternal mental disorders and child behavior problems. Mothers with BPD showed increased hostility during mother-child interaction, whereas history of MDD was associated with reduced sensitivity. Maternal hostility was a mediator between maternal BPD and number of child psychiatric disorders, as well as externalizing and internalizing behavior. Maternal sensitivity mediated the association between maternal rMDD and number of child psychiatric disorders, as well as internalizing child behavior. Our data suggest that mothers with BPD show a qualitatively different pattern of emotional availability compared to mothers with rMDD. These patterns might reflect two separate pathways of transgenerational transmission of aspects of maternal mental disorders, where intervention and training programs could start: maternal rMDD impacts on child behavior problems via reduced sensitivity, and maternal BPD via increased hostility, which could both be addressed with specific therapeutic interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

Cortisol Patterns for Young Children Displaying Disruptive Behavior: Links to a Teacher-Child, Relationship-Focused Intervention.

PubMed

Hatfield, Bridget E; Williford, Amanda P

2017-01-01

Supportive and close relationships that young children have with teachers have lasting effects on children's behavior and academic success, and this is particularly true for children with challenging behaviors. These relationships are also important for children's developing stress response system, and children in child care may be more likely to display atypical cortisol patterns at child care. However, warm, supportive relationships with teachers may buffer these negative effects of child care. While many relationship-focused early childhood interventions demonstrate changes in child behavior, associations with children's stress response system are unknown. This study assessed children's activity in the hypothalamic-pituitary-adrenal axis via salivary cortisol as a function of their participation in a dyadic intervention intended to improve a teacher's interaction quality with a particular child. Seventy teachers and 113 preschool children participated who were part of a larger study of teachers and children were randomly assigned at the classroom level across three intervention conditions: Banking Time, Time-Control Comparison (Child Time), and Business-as-Usual. At the end of the school year, children in the Banking Time condition displayed a significantly greater decline in cortisol across the morning during preschool compared to children in Business-as-Usual condition. These pilot results are among the first to provide preliminary evidence that school-based interventions that promote sensitive and responsive interactions may improve young children's activity in the stress response system within the child care/early education context.

Culturally Sensitive Education Can Decrease Hispanic Workers' Risk of Metabolic Syndrome.

PubMed

Marks, Steven

2016-04-08

Metabolic syndrome is a continuing problem in the United States, and the Hispanic population is at increased risk of developing complications from this disease process. Many of the workers at a South Jersey yacht-building company are Hispanic, and a culturally sensitive education program was implemented to improve their overall health. Program assessments included the Latino Dietary Behavior Questionnaire (LDBQ), anthropomorphic measurements, and laboratory studies both pre and post intervention. The intervention included a Spanish-language lecture on metabolic syndrome and healthy nutrition, followed by an interactive culturally appropriate cooking demonstration for the participants and their significant others. Program participants showed reductions in body mass index, blood pressure, lipid levels, and hemoglobin A1c, and more knowledge of healthy nutrition as measured by the LDBQ. This finding supports culturally sensitive education programs to improve the health of Hispanic populations. © 2016 The Author(s).

The roles of trauma exposure, rejection sensitivity, and callous-unemotional traits in the aggressive behavior of justice-involved youth: A moderated mediation model.

PubMed

Mozley, Michaela M; Modrowski, Crosby A; Kerig, Patricia K

2018-05-01

Research has demonstrated an association between childhood trauma exposure and adolescent aggression. This association may be explained by rejection sensitivity, defined as anger, or anxiety in the anticipation of rejection, which can be a consequence of trauma exposure. Callous-unemotional (CU) traits also are associated with trauma exposure and aggressive behavior; however, research has not yet investigated the interactive roles that rejection sensitivity and CU traits play in the relation between trauma exposure and aggression. Therefore, this study sought to investigate the role of rejection sensitivity in the association between trauma exposure and aggression, and whether this indirect effect was moderated by CU traits. Participants included 380 detained youth (98 girls, 282 boys) who completed self-report measures of trauma exposure, angry, and anxious rejection sensitivity, CU traits, and aggression. Results of moderated mediation demonstrated that the relation between trauma exposure and aggression exhibited an indirect effect through angry rejection sensitivity, but only at moderate or high levels of CU traits. This pattern was not found for anxious rejection sensitivity. Results suggest that interventions aimed to decrease aggressive behavior in traumatized adolescents may benefit from considering how youth respond to rejection, as well as whether youth endorse CU traits, as this may help to limit further involvement in the juvenile justice system after release. © 2018 Wiley Periodicals, Inc.

Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples.

PubMed

Martinez, Omar; Wu, Elwin; Levine, Ethan C; Muñoz-Laboy, Miguel; Fernandez, M Isabel; Bass, Sarah Bauerle; Moya, Eva M; Frasca, Timothy; Chavez-Baray, Silvia; Icard, Larry D; Ovejero, Hugo; Carballo-Diéguez, Alex; Rhodes, Scott D

2016-01-01

Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. We collaborated with Latino male couples and providers to adapt Connect 'n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be offered after providing information about these tools. Regarding culturally sensitive and responsive approaches, participants identified stigma and discrimination associated with HIV and sexual identity as barriers to care, language barriers and documentation status as further barriers to care, the couple-based approach as ideal to health promotion, and the need to include family topics in the intervention. We successfully adapted an evidence-based behavioral HIV prevention intervention for Latino male couples. The adapted intervention, called Conectando Latinos en Pareja, integrates social, cultural, behavioral and biomedical strategies to address the HIV epidemic among Latino MSM. The study highlights the promise regarding the feasibility of implementing a combination approach to HIV prevention in this population.

Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples

PubMed Central

Martinez, Omar; Wu, Elwin; Levine, Ethan C.; Muñoz-Laboy, Miguel; Fernandez, M. Isabel; Bass, Sarah Bauerle; Moya, Eva M.; Frasca, Timothy; Chavez-Baray, Silvia; Icard, Larry D.; Ovejero, Hugo; Carballo-Diéguez, Alex; Rhodes, Scott D.

2016-01-01

Introduction Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. Materials and Methods We collaborated with Latino male couples and providers to adapt Connect ‘n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. Results The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be offered after providing information about these tools. Regarding culturally sensitive and responsive approaches, participants identified stigma and discrimination associated with HIV and sexual identity as barriers to care, language barriers and documentation status as further barriers to care, the couple-based approach as ideal to health promotion, and the need to include family topics in the intervention. Discussion We successfully adapted an evidence-based behavioral HIV prevention intervention for Latino male couples. The adapted intervention, called Conectando Latinos en Pareja, integrates social, cultural, behavioral and biomedical strategies to address the HIV epidemic among Latino MSM. The study highlights the promise regarding the feasibility of implementing a combination approach to HIV prevention in this population. PMID:27028873

A mother-child intervention program in adolescent mothers and their children to improve maternal sensitivity, child responsiveness and child development (the TeeMo study): study protocol for a randomized controlled trial.

PubMed

Firk, Christine; Dahmen, Brigitte; Lehmann, Christin; Niessen, Anke; Koslowski, Julia; Rauch, Geraldine; Schwarte, Reinhild; Stich, Kerstin; Konrad, Kerstin; Herpertz-Dahlmann, Beate

2015-05-27

Children of adolescent mothers present a high-risk group for child neglect and maltreatment. Previous findings suggest that early interventions can reduce maltreatment by improving the quality of mother-child interaction, particularly maternal sensitivity. The aim of the current study is to evaluate the effects of a mother-child intervention program using home visits and video-feedback regarding mother-child interaction (STEEP-b) plus psychiatric treatment of the mother in cases where mental illness is present compared with TAU (treatment as usual, that is, standardized support by the child welfare system) on enhancing maternal sensitivity and child responsiveness in adolescent, high-risk mothers. The second aim of the current project is to investigate behavioral and neural differences between adolescent and adult mothers at baseline and postintervention. This is a randomized controlled trial (RCT) with 120 high-risk adolescent mothers (<21 years old) and their 3- to 6-month-old children. Half of the participants will be randomized to receive STEEP-b in addition to their standard treatment for up to 12 to 18 sessions over 9 months. The other half will continue with treatment as usual. For further comparisons, 40 adult mothers with positive and negative rearing experiences (>25 years) will additionally be recruited to investigate behavioral and neural differences between the adolescent and adult group. Blind assessments will take place at T1 (pre-intervention), at the end of the 9-month intervention (T2, postintervention) and 6 months postintervention (T3, follow-up). Moderators of treatment outcomes and sociodemographic data will be assessed at T1. The primary outcome hypothesis is that STEEP-b added to treatment as usual will improve maternal sensitivity and child responsiveness compared with treatment as usual alone in high-risk adolescent mothers. The primary hypothesis will be evaluated at the end of the 9-month follow-up assessment based on the intention-to-treat principle. The trial is funded by the German Ministry for Research and Education (BMBF). Data collection started in October 2012. This is a randomized controlled trial that evaluates the effects of an early intervention program (STEEP-b) on the quality of mother-child interaction and child development in adolescent, high-risk mothers. DRKS00004409 (27 September 2012).

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

PubMed Central

2014-01-01

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

Childhood obesity and insulin resistance: how should it be managed?

PubMed

Ho, Mandy; Garnett, Sarah P; Baur, Louise A

2014-12-01

Concomitant with the rise in global pediatric obesity in the past decades, there has been a significant increase in the number of children and adolescents with clinical signs of insulin resistance. Given insulin resistance is the important link between obesity and the associated metabolic abnormalities and cardiovascular risk, clinicians should be aware of high risk groups and treatment options. As there is no universally accepted biochemical definition of insulin resistance in children and adolescents, identification and diagnosis of insulin resistance usually relies on clinical features such as acanthosis nigricans, polycystic ovary syndrome, hypertension, dyslipidemia, and nonalcoholic fatty liver disease. Treatment for reducing insulin resistance and other obesity-associated comorbidities should focus on changes in health behaviors to achieve effective weight management. Lifestyle interventions incorporating dietary change, increased physical activity, and decreased sedentary behaviors, with the involvement of family and adoption of a developmentally appropriate approach, should be used as the first line treatment. Current evidence suggests that the primary objective of dietary interventions should be to reduce total energy intake and a combination of aerobic and resistance training should be encouraged. Metformin can be used in conjunction with a lifestyle intervention program in obese adolescents with clinical insulin resistance to achieve weight loss and to improve insulin sensitivity. Ongoing evaluation and research are required to explore optimal protocol and long-term effectiveness of lifestyle interventions, as well as to determine whether the improvements in insulin sensitivity induced by lifestyle interventions and weight loss will lead to a clinical benefit including reduced cardiovascular morbidity and mortality.

Systematic review and meta-analysis of remotely delivered interventions using self-monitoring or tailored feedback to change dietary behavior.

PubMed

Teasdale, Natalie; Elhussein, Ahmed; Butcher, Frances; Piernas, Carmen; Cowburn, Gill; Hartmann-Boyce, Jamie; Saksena, Rhea; Scarborough, Peter

2018-02-01

Self-monitoring (SM) of diet and tailored feedback (TF) have been suggested as tools for changing dietary behavior. New technologies allow users to monitor behavior remotely, potentially improving reach, adherence, and outcomes. We conducted a systematic literature review and meta-analysis to address the following question: are remotely delivered standalone (i.e., no human contact) interventions that use SM or TF effective in changing eating behaviors? Five databases were searched in October 2016 (updated in September 2017). Only randomized controlled trials published after 1990 were included. Trials could include any adult population with no history of disordered eating which delivered an SM or TF intervention without direct contact and recorded actual dietary consumption as an outcome. Three assessors independently screened the search results. Two reviewers extracted the study characteristics, intervention details, and outcomes, and assessed risk of bias using the Cochrane tool. Results were converted to standardized mean differences and incorporated into a 3-level (individuals and outcomes nested in studies) random effects meta-analysis. Twenty-six studies containing 21,262 participants were identified. The majority of the studies were judged to be unclear or at high risk of bias. The meta-analysis showed dietary improvement in the intervention group compared to the control group with a standardized mean difference of 0.17 (95% CI: 0.10, 0.24; P < 0.0001). The I2 statistic for the meta-analysis was 0.77, indicating substantial heterogeneity in results. A "one study removed" sensitivity analysis showed that no single study excessively influenced the results. Standalone interventions containing self-regulatory methods have a small but significant effect on dietary behavior, and integrating these elements could be important in future interventions. However, there was substantial variation in study results that could not be explained by the characteristics we explored, and there were risk-of-bias concerns with the majority of studies.

Reducing sexual risk behavior among high-risk couples in Northern India.

PubMed

Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M

2013-09-01

With a population of 1.1 billion, India is considered to be a country in which effective prevention interventions could contain the development of a human immunodeficiency virus (HIV) epidemic. Heterosexual transmission accounts for 85 % of the extant HIV infections. This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self-efficacy, knowledge, conflict resolution, and coping among high-risk heterosexual couples in Northern India. This pilot study was conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high-risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in 1 month of three weekly gender-concordant behavioral intervention groups and were individually administered assessments preintervention and post-intervention. The intervention was tailored to the Northern Indian context and addressed sexual barrier use, human immunodeficiency virus (HIV)/sexually transmitted infection transmission, and cognitive behavioral skill building focusing on sexual negotiation and communication. The participants had a mean age of 32 years (men) and 29 years (women), and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (<100 % of the time; 64 % of women, 59 % of men). Post-intervention, nearly all participants reported consistent condom use (100 % of the time; 100 % of men, 97 % of women). Participants also reported decreased verbal aggression, increased self-efficacy, and increased HIV-related knowledge, and women increased their use of positive coping tactics. The results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high-risk couples may be an important adjunct to preventing the development of a generalized epidemic in India.

Systematic review and meta-analysis of remotely delivered interventions using self-monitoring or tailored feedback to change dietary behavior

PubMed Central

Teasdale, Natalie; Elhussein, Ahmed; Butcher, Frances; Piernas, Carmen; Cowburn, Gill; Hartmann-Boyce, Jamie; Saksena, Rhea; Scarborough, Peter

2018-01-01

ABSTRACT Background Self-monitoring (SM) of diet and tailored feedback (TF) have been suggested as tools for changing dietary behavior. New technologies allow users to monitor behavior remotely, potentially improving reach, adherence, and outcomes. Objective We conducted a systematic literature review and meta-analysis to address the following question: are remotely delivered standalone (i.e., no human contact) interventions that use SM or TF effective in changing eating behaviors? Design Five databases were searched in October 2016 (updated in September 2017). Only randomized controlled trials published after 1990 were included. Trials could include any adult population with no history of disordered eating which delivered an SM or TF intervention without direct contact and recorded actual dietary consumption as an outcome. Three assessors independently screened the search results. Two reviewers extracted the study characteristics, intervention details, and outcomes, and assessed risk of bias using the Cochrane tool. Results were converted to standardized mean differences and incorporated into a 3-level (individuals and outcomes nested in studies) random effects meta-analysis. Results Twenty-six studies containing 21,262 participants were identified. The majority of the studies were judged to be unclear or at high risk of bias. The meta-analysis showed dietary improvement in the intervention group compared to the control group with a standardized mean difference of 0.17 (95% CI: 0.10, 0.24; P < 0.0001). The I2 statistic for the meta-analysis was 0.77, indicating substantial heterogeneity in results. A “one study removed” sensitivity analysis showed that no single study excessively influenced the results. Conclusions Standalone interventions containing self-regulatory methods have a small but significant effect on dietary behavior, and integrating these elements could be important in future interventions. However, there was substantial variation in study results that could not be explained by the characteristics we explored, and there were risk-of-bias concerns with the majority of studies. PMID:29529158

The effect of prevention messages and self-efficacy skill building with inner-city women at risk for HIV infection.

PubMed

DeMarco, Rosanna F; Kendricks, Malkia; Dolmo, Yolani; Looby, Sara E Dolan; Rinne, Kirsti

2009-01-01

The purpose of this study was to examine the effect of gender-sensitive and culturally relevant HIV prevention film messages combined with self-efficacy and skill building exercises on self-reported safe sex behaviors, intentions, attitudes, and self-advocacy over time. A sample of 131 women of mixed ethnicity from inner-city Boston who were living in transitional housing participated in a 4-week pre/postmeasurement design. Results showed that, despite the short duration of the intervention, participants self-reported significantly more use of safe sex behaviors and being prepared for sexual intimacy after the intervention. The study validated use of an approach originally intended for African American women with other women at risk for HIV.

Self-perceived healthcare needs for African American women in street-level prostitution: strategies for interventions.

PubMed

Prince, Lola M

2013-01-01

Prostituted women have a unique combination of overall healthcare needs. This qualitative study explored the general health and perceived healthcare needs for eleven women. Lack of access to affordable culturally sensitive health clinics, individual mental health counseling, and healthy nutrition were unmet needs. Cultural sensitivity training and formation of partnerships among health care providers at Federally Qualified Health Centers with those in the social service and behavioral health fields could facilitate the provision of integrated healthcare services.

Carotid interventions and blood pressure.

PubMed

Hirschl, Mirko; Kundi, Michael

2014-12-01

Arterial baroreceptors are pressure sensors found in the carotid sinus near the bifurcation of the carotid artery and in the aortic arch. Carotid interventions, whether endovascular or surgical, affect this complicated control system and the post-interventional blood pressure behavior. Comparisons between the intervention techniques, however, are challenging due to the varying measurement methods, duration of observation, and patient populations. The question as to which interventional method is preferable, if undisturbed regulation of blood pressure is concerned, still remains unanswered. The fact that blood pressure events (i.e., hemodynamic instability, hypertension, unstable blood pressure) frequently occur both immediately after intervention and in the long term, mandates a particularly careful cardiopulmonary and blood pressure monitoring. Direct and indirect measurements of baroreceptor sensitivity can be helpful in identifying high-risk patients, although the association to hard clinical endpoints is rarely documented for methodological reasons.

Blast-induced Mild Traumatic Brain Injury

DTIC Science & Technology

2010-01-01

concentration with agents such as psychostimulants, or improving compensatory strategies through cognitive- behavioral therapies. Pharmacological interventions...participate in educational activities and support groups. Some examples of general educational content include (1) compensatory strategies for impaired...or simple, ranging from electronic transmitters to trip wires, tilt switches, motion detectors, or thermal or pressure-sensitive switches. lEOs are

Operant Conditioning in Older Adults with Alzheimer's Disease

ERIC Educational Resources Information Center

Spira, Adam P.; Edelstein, Barry A.

2007-01-01

Behavioral interventions based on operant principles are commonly attempted to manage agitation in older adults with dementia. The extent to which operant conditioning can occur in persons with particular dementias, however, is unclear. The present study involved use of a button-pressing task to evaluate the sensitivity of the responding of older…

Mechanisms of impulsive choice: III. The role of reward processes

PubMed Central

Marshall, Andrew T.

2015-01-01

Two experiments examined the relationship between reward processing and impulsive choice. In Experiment 1, rats chose between a smaller-sooner (SS) reward (1 pellet, 10 s) and a larger-later (LL) reward (1, 2, and 4 pellets, 30 s). The rats then experienced concurrent variable-interval 30-s schedules with variations in reward magnitude to evaluate reward magnitude discrimination. LL choice behavior positively correlated with reward magnitude discrimination. In Experiment 2, rats chose between an SS reward (1 pellet, 10 s) and an LL reward (2 and 4 pellets, 30 s). The rats then received either a reward intervention which consisted of concurrent fixed-ratio schedules associated with different magnitudes to improve their reward magnitude discrimination, or a control task. All rats then experienced a post-intervention impulsive choice task followed by a reward magnitude discrimination task to assess intervention efficacy. The rats that received the intervention exhibited increases in post-intervention LL choice behavior, and made more responses for larger-reward magnitudes in the reward magnitude discrimination task, suggesting that the intervention heightened sensitivities to reward magnitude. The results suggest that reward magnitude discrimination plays a key role in individual differences in impulsive choice, and could be a potential target for further intervention developments. PMID:26506254

Unique contributions of emotion regulation and executive functions in predicting the quality of parent-child interaction behaviors.

PubMed

Shaffer, Anne; Obradović, Jelena

2017-03-01

Parenting is a cognitive, emotional, and behavioral endeavor, yet limited research investigates parents' executive functions and emotion regulation as predictors of how parents interact with their children. The current study is a multimethod investigation of parental self-regulation in relation to the quality of parenting behavior and parent-child interactions in a diverse sample of parents and kindergarten-age children. Using path analyses, we tested how parent executive functions (inhibitory control) and lack of emotion regulation strategies uniquely relate to both sensitive/responsive behaviors and positive/collaborative behaviors during observed interaction tasks. In our analyses, we accounted for parent education, financial stress, and social support as socioeconomic factors that likely relate to parent executive function and emotion regulation skills. In a diverse sample of primary caregivers (N = 102), we found that direct assessment of parent inhibitory control was positively associated with sensitive/responsive behaviors, whereas parent self-reported difficulties in using emotion regulation strategies were associated with lower levels of positive and collaborative dyadic behaviors. Parent education and financial stress predicted inhibitory control, and social support predicted emotion regulation difficulties; parent education was also a significant predictor of sensitive/responsive behaviors. Greater inhibitory control skills and fewer difficulties identifying effective emotion regulation strategies were not significantly related in our final path model. We discuss our findings in the context of current and emerging parenting interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Effect of Education Based on Health Belief Model on the Behavior of Breast Cancer Screening in Women.

PubMed

Masoudiyekta, Leila; Rezaei-Bayatiyani, Hojat; Dashtbozorgi, Bahman; Gheibizadeh, Mahin; Malehi, Amal Saki; Moradi, Mehrnaz

2018-01-01

The purpose of this study was to determine the effect of education based on health belief model (HBM) on the behavior of breast cancer screening (bCS) in women. This quasi-experimental study was conducted on 226 women who were selected with cluster sampling method from those referred to Dezful health centers. Data collection tool was a researcher-made questionnaire. Demographic questionnaire bCS- scale, and the Knowledge about questionnaire, all given before and 3 months after the intervention. According to the findings of the study, there was a significant relationship between women's performance and variables of knowledge, perceived sensitivity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Poor knowledge of women indicates a crucial need for formal educational programs to sensitize women regarding the importance of bCS. These educational programs should consider factors affecting bCS behaviors.

A behavioral strategy to minimize air pollution exposure in pregnant women: a randomized controlled trial.

PubMed

Araban, Marzieh; Tavafian, Sedigheh Sadat; Zarandi, Saeed Motesaddi; Hidarnia, Ali Reza; Burri, Andrea; Montazeri, Ali

2017-04-04

Pregnant women and their fetus belong to a sensitive group in response to air pollution hazards. The aim of this study was to evaluate the effectiveness of a theory-based educational program to change pollution exposure behavior in pregnant women. In this randomized controlled trial, pregnant women attending a prenatal clinic in Tehran, Iran were selected and randomized into the experimental and control groups. The inclusion criteria were age between 18 and 35 years, having a history of pregnancies without adverse outcomes and not suffering from chronic diseases. Data collected at baseline and 2-month follow-up. At baseline face-to-face interviews were conducted using a valid and reliable questionnaire including items on demographic characteristics, stages of change, self-efficacy, decisional balance and practice regarding air pollution preventive behaviors. The intervention composed of three parts: motivational interviewing, a booklet and daily small message service (SMS). The control group received no intervention except receiving usual care. Follow-up data were collected after the intervention. Data were analyzed performing t-test, Mann-Whitney U test, and chi-squared. In all the data for 104 pregnant women (53 in the intervention and 51 in the control group) were analyzed. The mean age of participants was 27.2 (SD = 4.11) years and it was 22.89 (SD = 8.75) weeks for gestational age. At baseline there were no significant statistical differences between intervention and control groups on the study measures while we found significant group differences in terms of stages of change, self-efficacy, perceived benefits and practice regarding air pollution preventive behaviors at follow-up assessment (P < 0.05). The findings indicated that the TTM-based intervention was effective in increasing air pollution preventive behaviors among pregnant women. This study provided a framework to modify some psychosocial determinants of air pollution preventive behavior other than knowledge using constructs of Transtheoretical model of behavior change, additionally results suggests the importance of education and makes enlightenment of the air pollution risk knowledge accelerate. IRCT2012091010804N1.

Pilot test of a home-based program to prevent perceived insufficient milk.

PubMed

Wood, Natsuko K; Sanders, Elizabeth A; Lewis, Frances M; Woods, Nancy F; Blackburn, Susan T

2017-12-01

Although the World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for the first six months, only 22% of U.S. mothers do so. Mothers' perceived insufficient milk (PIM) is the primary reason for breastfeeding discontinuation globally. There are two changeable causes of PIM: (1) mothers' misinterpretation of their infant's behavior, and (2) mothers' lack of confidence in their ability to breastfeed. The purpose of this study was to evaluate the short-term effect of a home-based intervention designed to prevent and/or reduce PIM. A mixed-methods, single-group, pretest-midtest-posttest design was used for evaluating a home-based breastfeeding program. The program was implemented during three 1.0- to 1.5-h home intervention sessions at 6, 13, and 27 days postpartum, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. We found significant increases over time in mothers' sensitivity to infant behavior and breastfeeding self-efficacy as well as significant decreased attribution of infant crying to PIM. Exit interviews indicated that the program was accepted by participating mothers. This is the first intervention study that has directly targeted the causes of PIM. The home-based intervention has the potential to add to maternal competencies both in correctly assessing their infants' behavior, thereby preventing erroneous attribution of infant behavior to PIM, as well as simultaneously bolstering maternal confidence in breastfeeding skills. By building maternal competencies, the home-based intervention has a longer-range potential to prevent breastfeeding discontinuation. Further evaluation is warranted. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Patterns of sun protective behaviors among Hispanic children in a skin cancer prevention intervention.

PubMed

Miller, Kimberly A; Huh, Jimi; Unger, Jennifer B; Richardson, Jean L; Allen, Martin W; Peng, David H; Cockburn, Myles G

2015-12-01

Invasive melanoma is becoming more common in U.S. Hispanics, yet little is known about the sun protection behaviors in this population, particularly children and adolescents who incur high ultraviolet (UV) exposures. We used latent class analysis to examine patterns of sun protective behaviors in a cross-sectional survey of Hispanic elementary students participating in a sun safety intervention in Los Angeles from 2013- to 2014 (N=972). Five behavior indicators in two environments (school and home) representing multiple methods of sun protection were selected for the model. Results suggested a four-class model best fit the data. Classes were labeled in order of increasing risk as multiple protective behaviors (28%), clothing and shade (32%), pants only (15%), and low/inconsistent protective behaviors (25%). Children who reported high parental engagement with sun protection were significantly more likely to be classified in high overall protective categories (odds ratio (OR)=4.77). Girls were more likely than boys to be classified in the highest protecting class (OR=3.46), but were also more likely to be in the "pants only" class (OR=2.65). Sensitivity to sunburn was associated with less likelihood of being in the "clothing and shade" class (OR=0.53). The differences among these classes and their predictors reveal the heterogeneity and complexity of Hispanic children's sun protective behaviors. These findings have implications for the design and delivery of future sun protection interventions targeting Hispanic children, as strategies tailored to specific subgroups may be more effective in achieving meaningful behavioral changes. Copyright © 2015 Elsevier Inc. All rights reserved.

The case for treatment fidelity in active music interventions: why and how.

PubMed

Wiens, Natalie; Gordon, Reyna L

2018-05-04

As the volume of studies testing the benefits of active music-making interventions increases exponentially, it is important to document what exactly is happening during music treatment sessions in order to provide evidence for the mechanisms through which music training affects other domains. Thus, to complement systematic and rigorous attention to outcomes of the treatment, we outline four vital components of treatment fidelity and discuss their implementation in nonmusic- and music-based interventions. We then describe the design of Music Impacting Language Expertise (MILEStone), a new intervention that aims to improve grammar skills in children with specific language impairment by increasing sensitivity to rhythmic structure, which may enhance general temporal processing and sensitivity to syntactic structure. We describe the approach to addressing treatment fidelity in MILEStone adapted from intervention research from other fields, including a behavioral coding system to track instructional episodes and child participation, a treatment manual, activity checklists, provider training and monitoring, a home practice log, and teacher ratings of participant engagement. This approach takes an important first step in modeling a formalized procedure for assessing treatment fidelity in active music-making intervention research, as a means of increasing methodological rigor in support of evidence-based practice in clinical and educational settings. © 2018 New York Academy of Sciences.

Impaired neurocognitive functions affect social learning processes in oppositional defiant disorder and conduct disorder: implications for interventions.

PubMed

Matthys, Walter; Vanderschuren, Louk J M J; Schutter, Dennis J L G; Lochman, John E

2012-09-01

In this review, a conceptualization of oppositional defiant (ODD) and conduct disorder (CD) is presented according to which social learning processes in these disorders are affected by neurocognitive dysfunctions. Neurobiological studies in ODD and CD suggest that the ability to make associations between behaviors and negative and positive consequences is compromised in children and adolescents with these disorders due to reduced sensitivity to punishment and to reward. As a result, both learning of appropriate behavior and learning to refrain from inappropriate behavior may be affected. Likewise, problem solving is impaired due to deficiencies in inhibition, attention, cognitive flexibility, and decision making. Consequently, children and adolescents with ODD and CD may have difficulty learning to optimize their behavior in changeable environments. This conceptualization of ODD and CD is relevant for the improvement of the effect of psychological treatments. Behavioral and cognitive-behavioral interventions that have been shown to be modestly effective in ODD and CD are based on social learning. Limited effectiveness of these interventions may be caused by difficulties in social learning in children and adolescents with ODD and CD. However, although these impairments have been observed at a group level, the deficits in reward processing, punishment processing, and cognitive control mentioned above may not be present to the same extent in each individual with ODD and CD. Therefore, the neurocognitive characteristics in children and adolescents with ODD and CD should be assessed individually. Thus, instead of delivering interventions in a standardized way, these programs may benefit from an individualized approach that depends on the weaknesses and strengths of the neurocognitive characteristics of the child and the adolescent.

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

PubMed

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

2017-01-01

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

Military Suicide Research Consortium

DTIC Science & Technology

2013-10-01

In S . C. Horswill (Chr.), Identifying and treating predispositional variables in the development of PTSD. Symposium submitted for the Annual meeting...of a Targeted Computerized Intervention for Anxiety Sensitivity Cognitive Concerns for use with at-risk Military Populations. Individual oral...Zvolensky, M.J. (2012). Daily marijuana use and suicidality: The unique impact of social anxiety . Addictive Behaviors, 37, 387-392. 8. Capron, D

Enhancing early child care quality and learning for toddlers at risk: the responsive early childhood program.

PubMed

Landry, Susan H; Zucker, Tricia A; Taylor, Heather B; Swank, Paul R; Williams, Jeffrey M; Assel, Michael; Crawford, April; Huang, Weihua; Clancy-Menchetti, Jeanine; Lonigan, Christopher J; Phillips, Beth M; Eisenberg, Nancy; Spinrad, Tracy L; de Villiers, Jill; de Villiers, Peter; Barnes, Marcia; Starkey, Prentice; Klein, Alice

2014-02-01

Despite reports of positive effects of high-quality child care, few experimental studies have examined the process of improving low-quality center-based care for toddler-age children. In this article, we report intervention effects on child care teachers' behaviors and children's social, emotional, behavioral, early literacy, language, and math outcomes as well as the teacher-child relationship. The intervention targeted the use of a set of responsive teacher practices, derived from attachment and sociocultural theories, and a comprehensive curriculum. Sixty-five childcare classrooms serving low-income 2- and 3-year-old children were randomized into 3 conditions: business-as-usual control, Responsive Early Childhood Curriculum (RECC), and RECC plus explicit social-emotional classroom activities (RECC+). Classroom observations showed greater gains for RECC and RECC+ teachers' responsive practices including helping children manage their behavior, establishing a predictable schedule, and use of cognitively stimulating activities (e.g., shared book reading) compared with controls; however, teacher behaviors did not differ for focal areas such as sensitivity and positive discipline supports. Child assessments demonstrated that children in the interventions outperformed controls in areas of social and emotional development, although children's performance in control and intervention groups was similar for cognitive skills (language, literacy, and math). Results support the positive impact of responsive teachers and environments providing appropriate support for toddlers' social and emotional development. Possible explanations for the absence of systematic differences in children's cognitive skills are considered, including implications for practice and future research targeting low-income toddlers.

Effects of a web-based tailored multiple-lifestyle intervention for adults: a two-year randomized controlled trial comparing sequential and simultaneous delivery modes.

PubMed

Schulz, Daniela N; Kremers, Stef P J; Vandelanotte, Corneel; van Adrichem, Mathieu J G; Schneider, Francine; Candel, Math J J M; de Vries, Hein

2014-01-27

Web-based computer-tailored interventions for multiple health behaviors can have a significant public health impact. Yet, few randomized controlled trials have tested this assumption. The objective of this paper was to test the effects of a sequential and simultaneous Web-based tailored intervention on multiple lifestyle behaviors. A randomized controlled trial was conducted with 3 tailoring conditions (ie, sequential, simultaneous, and control conditions) in the Netherlands in 2009-2012. Follow-up measurements took place after 12 and 24 months. The intervention content was based on the I-Change model. In a health risk appraisal, all respondents (N=5055) received feedback on their lifestyle behaviors that indicated whether they complied with the Dutch guidelines for physical activity, vegetable consumption, fruit consumption, alcohol intake, and smoking. Participants in the sequential (n=1736) and simultaneous (n=1638) conditions received tailored motivational feedback to change unhealthy behaviors one at a time (sequential) or all at the same time (simultaneous). Mixed model analyses were performed as primary analyses; regression analyses were done as sensitivity analyses. An overall risk score was used as outcome measure, then effects on the 5 individual lifestyle behaviors were assessed and a process evaluation was performed regarding exposure to and appreciation of the intervention. Both tailoring strategies were associated with small self-reported behavioral changes. The sequential condition had the most significant effects compared to the control condition after 12 months (T1, effect size=0.28). After 24 months (T2), the simultaneous condition was most effective (effect size=0.18). All 5 individual lifestyle behaviors changed over time, but few effects differed significantly between the conditions. At both follow-ups, the sequential condition had significant changes in smoking abstinence compared to the simultaneous condition (T1 effect size=0.31; T2 effect size=0.41). The sequential condition was more effective in decreasing alcohol consumption than the control condition at 24 months (effect size=0.27). Change was predicted by the amount of exposure to the intervention (total visiting time: beta=-.06; P=.01; total number of visits: beta=-.11; P<.001). Both interventions were appreciated well by respondents without significant differences between conditions. Although evidence was found for the effectiveness of both programs, no simple conclusive finding could be drawn about which intervention mode was more effective. The best kind of intervention may depend on the behavior that is targeted or on personal preferences and motivation. Further research is needed to identify moderators of intervention effectiveness. The results need to be interpreted in view of the high and selective dropout rates, multiple comparisons, and modest effect sizes. However, a large number of people were reached at low cost and behavioral change was achieved after 2 years. Nederlands Trial Register: NTR 2168; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2168 (Archived by WebCite at http://www.webcitation.org/6MbUqttYB).

Mixed housing with DBA/2 mice induces stress in C57BL/6 mice: implications for interventions based on social enrichment

PubMed Central

Kulesskaya, Natalia; Karpova, Nina N.; Ma, Li; Tian, Li; Voikar, Vootele

2014-01-01

Several behavioral interventions, based on social enrichment and observational learning are applied in treatment of neuropsychiatric disorders. However, the mechanism of such modulatory effect and the safety of applied methods on individuals involved in social support need further investigation. We took advantage of known differences between inbred mouse strains to reveal the effect of social enrichment on behavior and neurobiology of animals with different behavioral phenotypes. C57BL/6 and DBA/2 female mice displaying multiple differences in cognitive, social, and emotional behavior were group-housed either in same-strain or in mixed-strain conditions. Comprehensive behavioral phenotyping and analysis of expression of several plasticity- and stress-related genes were done to measure the reciprocal effects of social interaction between the strains. Contrary to our expectation, mixed housing did not change the behavior of DBA/2 mice. Nevertheless, the level of serum corticosterone and the expression of glucocorticoid receptor Nr3c1 in the brain were increased in mixed housed DBA/2 as compared with those of separately housed DBA/2 mice. In contrast, socially active C57BL/6 animals were more sensitive to the mixed housing, displaying several signs of stress: alterations in learning, social, and anxiety-like behavior and anhedonia. These behavioral impairments were accompanied by the elevated serum corticosterone and the reduced expression of Nr3c1, as well as the elevated Bdnf levels in the cortex and hippocampus. Our results demonstrate the importance of social factors in modulation of both behavior and the underlying neurobiological mechanisms in stress response, and draw attention to the potential negative impact of social interventions for individuals involved in social support. PMID:25147512

A Systematic Review of the Literature on Parenting of Young Children with Visual Impairments and the Adaptions for Video-Feedback Intervention to Promote Positive Parenting (VIPP).

PubMed

van den Broek, Ellen G C; van Eijden, Ans J P M; Overbeek, Mathilde M; Kef, Sabina; Sterkenburg, Paula S; Schuengel, Carlo

2017-01-01

Secure parent-child attachment may help children to overcome the challenges of growing up with a visual or visual-and-intellectual impairment. A large literature exists that provides a blueprint for interventions that promote parental sensitivity and secure attachment. The Video-feedback Intervention to promote Positive Parenting (VIPP) is based on that blueprint. While it has been adapted to several specific at risk populations, children with visual impairment may require additional adjustments. This study aimed to identify the themes that should be addressed in adapting VIPP and similar interventions. A Delphi-consultation was conducted with 13 professionals in the field of visual impairment to select the themes for relationship-focused intervention. These themes informed a systematic literature search. Interaction, intersubjectivity, joint attention, exploration, play and specific behavior were the themes mentioned in the Delphi-group. Paired with visual impairment or vision disorders, infants or young children (and their parents) the search yielded 74 articles, making the six themes for intervention adaptation more specific and concrete. The rich literature on six visual impairment specific themes was dominated by the themes interaction, intersubjectivity, and joint attention. These themes need to be addressed in adapting intervention programs developed for other populations, such as VIPP which currently focuses on higher order constructs of sensitivity and attachment.

Identifying eating behavior phenotypes and their correlates: a novel direction toward improving weight management interventions

PubMed Central

Bouhlal, Sofia; McBride, Colleen M.; Trivedi, Niraj S.; Agurs-Collins, Tanya; Persky, Susan

2017-01-01

Common reports of over-response to food cues, difficulties with calorie restriction, and difficulty adhering to dietary guidelines suggest that eating behaviors could be interrelated in ways that influence weight management efforts. The feasibility of identifying robust eating phenotypes (showing face, content, and criterion validity) was explored based on well-validated individual eating behavior assessments. Adults (n=260; mean age 34 years) completed online questionnaires with measurements of nine eating behaviors including: appetite for palatable foods, binge eating, bitter taste sensitivity, disinhibition, food neophobia, pickiness and satiety responsiveness. Discovery-based visualization procedures that have the combined strengths of heatmaps and hierarchical clustering were used to investigate: 1) how eating behaviors cluster, 2) how participants can be grouped within eating behavior clusters, and 3) whether group clustering is associated with body mass index (BMI) and dietary self-efficacy levels. Two distinct eating behavior clusters and participant groups that aligned within these clusters were identified: one with higher drive to eat and another with food avoidance behaviors. Participants’ BMI (p=.0002) and dietary self-efficacy (p<.0001) were associated with cluster membership. Eating behavior clusters showed content and criterion validity based on their association with BMI (associated, but not entirely overlapping) and dietary self-efficacy. Identifying eating behavior phenotypes appears viable. These efforts could be expanded and ultimately inform tailored weight management interventions. PMID:28043857

Effects of a Culturally Informed Intervention on Abused, Suicidal African American Women

PubMed Central

Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D.; Blackmon, Brittane; Bryant, Rachel J.; Siegelman, Asher E.; Kaslow, Nadine J.

2014-01-01

Background This study examined 1) the relative efficacy of a culturally-sensitive empowerment group intervention (Nia) aimed at increasing three protective factors—self-esteem, hopefulness, and effectiveness of obtaining resources—versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and 2) the impact of participants’ readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the two conditions. Methods The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Results Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants that were “less ready to change” (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Conclusion Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally-informed intervention. PMID:25403027

Effects of a culturally informed intervention on abused, suicidal African American women.

PubMed

Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D; Blackmon, Brittane; Bryant, Rachel J; Siegelman, Asher E; Kaslow, Nadine J

2015-10-01

This study examined (a) the relative efficacy of a culturally sensitive empowerment group intervention (Nia) aimed at increasing 3 protective factors-self-esteem, hopefulness, and effectiveness of obtaining resources-versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and (b) the impact of participants' readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the 2 conditions. The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants who were "less ready to change" (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally informed intervention. (c) 2015 APA, all rights reserved).

Effects of a behavioral intervention that emphasizes spices and herbs on adherence to recommended sodium intake: results of the SPICE randomized clinical trial.

PubMed

Anderson, Cheryl A M; Cobb, Laura K; Miller, Edgar R; Woodward, Mark; Hottenstein, Annette; Chang, Alex R; Mongraw-Chaffin, Morgana; White, Karen; Charleston, Jeanne; Tanaka, Toshiko; Thomas, Letitia; Appel, Lawrence J

2015-09-01

For decades, dietary sodium intake in the United States has remained high, and few studies have examined strategies for maintaining recommended intakes. We examined the effects of a behavioral intervention, which emphasized spices and herbs, on the maintenance of sodium intake at the recommended intake of 1500 mg/d in individuals to whom the US Dietary Guidelines for Americans apply. We conducted a 2-phase study that included adults ≥18 y of age for whom Dietary Guidelines for Americans recommends 1500 mg Na/d. The study was conducted in Baltimore, Maryland, from 2012 to 2014. In phase 1, 55 individuals consumed a low-sodium diet for 4 wk. Participants were provided all foods, snacks, and calorie-containing drinks. In phase 2, 40 participants from phase 1 were randomly assigned to either a behavioral intervention to reduce sodium intake (n = 20) or a self-directed control group (n = 20) for 20 wk. The primary study outcome was the change in mean 24-h urinary sodium excretion during phase 2. Linear regression analyses were used to determine intervention effects on urinary sodium excretion. Participant characteristics were as follows: women: 65%; African American: 88%; hypertension: 63%; diabetes: 18%; mean age: 61 y; and mean body mass index (in kg/m(2)): 30. At the end of phase 2, mean 24-h sodium excretion was lower in the behavioral intervention than in the self-directed group (mean difference: -956.8 mg/d; 95% CI: -1538.7, -374.9 mg/d) after sodium intake at screening was controlled for (P = 0.002). These findings persisted in sensitivity analyses that excluded potentially incomplete urine collections [Mage's equation mean difference: -1090 mg/d (P = 0.001); Joosens' equation mean difference: -796 mg/d (P = 0.04)]. A multifactorial behavioral intervention emphasizing spices and herbs significantly reduced sodium intake. Because of the ubiquity of sodium in the US food supply, multilevel strategies addressing individual behaviors and the food supply are needed to improve adherence to recommendations. This trial was registered at clinicaltrials.gov as NCT01615159. © 2015 American Society for Nutrition.

Parenting in an Individualistic Culture with a Collectivistic Cultural Background: The Case of Turkish Immigrant Families with Toddlers in the Netherlands

PubMed Central

Yaman, Ayşe; van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.; Linting, Mariëlle

2010-01-01

Expanding our knowledge on parenting practices of immigrant families is crucial for designing culturally sensitive parenting intervention programs in countries with high immigration rates. We investigated differences in patterns of parenting between second-generation immigrant and native families with young children. Authoritarian and authoritative control and sensitivity of second-generation Turkish immigrant mothers of 2-year-old children (n = 70) and native Dutch mothers (n = 70) were observed in the home and in the laboratory. Controlling for maternal age and education, Turkish immigrant mothers were less supportive, gave less clear instructions to their children, were more intrusive and were less authoritative in their control strategies than native Dutch mothers. No differences were found in authoritarian control. In both ethnic groups supportive presence, clarity of instruction, authoritative control, and low intrusiveness loaded on one factor. No differences between ethnic groups were found in gender-differentiated parenting. Maternal emotional connectedness to the Turkish culture was associated with less authoritative control, whereas more use of the Turkish language was related to more sensitivity. Even though mean level differences in parenting behaviors still exist between second-generation Turkish immigrant and native Dutch mothers, the patterns of associations between parenting behaviors were comparable for both groups. This suggests that existing parenting interventions for native families may be applicable to second-generation Turkish immigrants as well. PMID:20835387

Parenting in an Individualistic Culture with a Collectivistic Cultural Background: The Case of Turkish Immigrant Families with Toddlers in the Netherlands.

PubMed

Yaman, Ayşe; Mesman, Judi; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; Linting, Mariëlle

2010-10-01

Expanding our knowledge on parenting practices of immigrant families is crucial for designing culturally sensitive parenting intervention programs in countries with high immigration rates. We investigated differences in patterns of parenting between second-generation immigrant and native families with young children. Authoritarian and authoritative control and sensitivity of second-generation Turkish immigrant mothers of 2-year-old children (n = 70) and native Dutch mothers (n = 70) were observed in the home and in the laboratory. Controlling for maternal age and education, Turkish immigrant mothers were less supportive, gave less clear instructions to their children, were more intrusive and were less authoritative in their control strategies than native Dutch mothers. No differences were found in authoritarian control. In both ethnic groups supportive presence, clarity of instruction, authoritative control, and low intrusiveness loaded on one factor. No differences between ethnic groups were found in gender-differentiated parenting. Maternal emotional connectedness to the Turkish culture was associated with less authoritative control, whereas more use of the Turkish language was related to more sensitivity. Even though mean level differences in parenting behaviors still exist between second-generation Turkish immigrant and native Dutch mothers, the patterns of associations between parenting behaviors were comparable for both groups. This suggests that existing parenting interventions for native families may be applicable to second-generation Turkish immigrants as well.

Children's parasympathetic reactivity to specific emotions moderates response to intervention for early-onset aggression.

PubMed

Gatzke-Kopp, Lisa M; Greenberg, Mark; Bierman, Karen

2015-01-01

Following theories that individual differences in respiratory sinus arrhythmia (RSA) denote differential sensitivity to environmental influences, this study examines whether differences in RSA reactivity to specific emotional challenges predict differential response to intervention. We present data from a randomized clinical trial of a targeted intervention for early onset aggression. In collaboration with a high-risk urban school district, 207 kindergarten children (73% African American, 66% male), identified by their teachers as having high levels of aggressive and disruptive behavior, were recruited. All children received a universal social-emotional curriculum. One hundred children were randomly assigned to an additional intervention consisting of weekly peer-based social skills training. Complete RSA data were available for 139 of the children. Teacher-reported externalizing symptoms and emotion regulation in 1st grade (post intervention) were examined controlling for baseline levels. First-grade peer nominations of aggressive behavior, controlling for baseline nominations, were also examined as outcomes. No effect of resting RSA was found. However, greater reactivity to anger was associated with higher externalizing symptoms and lower emotion regulation skills in 1st grade relative to low reactive children. Lower reactivity to fear was associated with greater improvement over time, an effect that was enhanced in the targeted intervention condition. Results suggest that measures of affective reactivity may provide insight into children's capacity to benefit from different types of interventions.

A comparison of maternal sensitivity and verbal stimulation as unique predictors of infant social-emotional and cognitive development.

PubMed

Page, Melissa; Wilhelm, Mari S; Gamble, Wendy C; Card, Noel A

2010-02-01

Although maternal sensitivity has been shown to influence social-emotional development, the role of verbal stimulation on infant developmental outcomes has received less exploration. Recent research has focused on intentional behaviors within the context of a mother-infant interaction as a critical influence and as distinct from sensitivity. In this investigation 6377 mother-infant dyads participated in a teaching task as part of the sample from the Early Childhood Longitudinal Study Birth Cohort (ECLS-B). Analyses focused in deciphering the role of maternal sensitivity and verbal stimulation as contributors to the infant's social-emotional (S-E) and cognitive (Cog) development. We further hypothesized that inclusion of infant age as a moderator of maternal behaviors would illuminate any differences between younger and older infants. For the infant's S-E development, our hypothesis that maternal sensitivity would be a stronger predictor than verbal stimulation was not supported; nor did we find support for our hypothesis that the association would be moderated by age. For Cog development, only verbal stimulation had a direct positive effect on the infant's cognitive ability; our findings for moderation showed that mothers spoke more to older infants than younger infants. Identification of specific maternal behaviors associated with infant outcomes informs the child development field, and also provides strategies for early intervention to assist mothers with developing or maintaining a consistent relationship that includes sensitivity and verbal stimulation. Published by Elsevier Inc.

Adaptation and psychometric properties of the ISPCAN Child Abuse Screening Tool for use in trials (ICAST-Trial) among South African adolescents and their primary caregivers.

PubMed

Meinck, Franziska; Boyes, Mark E; Cluver, Lucie; Ward, Catherine L; Schmidt, Peter; DeStone, Sachin; Dunne, Michael P

2018-05-31

Child abuse prevention research has been hampered by a lack of validated multi-dimensional non-proprietary instruments, sensitive enough to measure change in abuse victimization or behavior. This study aimed to adapt the ICAST child abuse self-report measure (parent and child) for use in intervention studies and to investigate the psychometric properties of this substantially modified tool in a South African sample. First, cross-cultural and sensitivity adaptation of the original ICAST tools resulted in two preliminary measures (ICAST-Trial adolescents: 27 items, ICAST-Trial caregivers: 19 items). Second, ICAST-Trial data from a cluster randomized trial of a parenting intervention for families with adolescents (N = 1104, 552 caregiver-adolescent dyads) was analyzed. Confirmatory factor analysis established the hypothesized 6-factor (adolescents) and 4-factor (caregivers) structure. Removal of two items for adolescents and five for caregivers resulted in adequate model fit. Concurrent criterion validity analysis confirmed hypothesized relationships between child abuse and adolescent and caregiver mental health, adolescent behavior, discipline techniques and caregiver childhood abuse history. The resulting ICAST-Trial measures have 25 (adolescent) and 14 (caregiver) items respectively and measure physical, emotional and contact sexual abuse, neglect (both versions), and witnessing intimate partner violence and sexual harassment (adolescent version). The study established that both tools are sensitive to measuring change over time in response to a parenting intervention. The ICAST-Trial should have utility for evaluating the effectiveness of child abuse prevention efforts in similar socioeconomic contexts. Further research is needed to replicate these findings and examine cultural appropriateness, barriers for disclosure, and willingness to engage in child abuse research. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Diagnosis and Management of Behavioral Issues in Frontotemporal Dementia

PubMed Central

Manoochehri, Masood; Huey, Edward D.

2012-01-01

Frontotemporal lobar degeneration (FTLD) is an umbrella term for several different disorders. In behavioral variant frontotemporal dementia (bvFTD), patients show deterioration in cognition and social behavior. New diagnostic criteria proposed by the International Behavioral Variant FTD Consortium provide greater sensitivity in diagnosing bvFTD. Current pharmacological management of symptoms relies on medications borrowed from treating Alzheimer’s Disease (AD) and psychiatric disorders. The evidence for using AD medications such as acetylcholinesterase inhibitors is questionable. Psychiatric medications can be helpful. Trazodone or SSRIs can have some efficacy in reducing disinhibition, repetitive behaviors, sexually inappropriate behaviors, and hyperorality. Small doses of atypical antipsychotics may be helpful in decreasing agitation and verbal outbursts. Non-pharmacological management includes caregiver education and support and behavioral interventions. While symptomatic treatments are likely to remain important behavior management tools, targeting the underlying pathology of bvFTD with disease-modifying agents will hopefully be the future of treatment. PMID:22847063

Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional, and behavioral problems: 18-month predictive validity of the Substance Use Risk Profile Scale.

PubMed

Castellanos-Ryan, Natalie; O'Leary-Barrett, Maeve; Sully, Laura; Conrod, Patricia

2013-01-01

This study assessed the validity, sensitivity, and specificity of the Substance Use Risk Profile Scale (SURPS), a measure of personality risk factors for substance use and other behavioral problems in adolescence. The concurrent and predictive validity of the SURPS was tested in a sample of 1,162 adolescents (mean age: 13.7 years) using linear and logistic regressions, while its sensitivity and specificity were examined using the receiver operating characteristics curve analyses. Concurrent and predictive validity tests showed that all 4 brief scales-hopelessness (H), anxiety sensitivity (AS), impulsivity (IMP), and sensation seeking (SS)-were related, in theoretically expected ways, to measures of substance use and other behavioral and emotional problems. Results also showed that when using the 4 SURPS subscales to identify adolescents "at risk," one can identify a high number of those who developed problems (high sensitivity scores ranging from 72 to 91%). And, as predicted, because each scale is related to specific substance and mental health problems, good specificity was obtained when using the individual personality subscales (e.g., most adolescents identified at high risk by the IMP scale developed conduct or drug use problems within the next 18 months [a high specificity score of 70 to 80%]). The SURPS is a valuable tool for identifying adolescents at high risk for substance misuse and other emotional and behavioral problems. Implications of findings for the use of this measure in future research and prevention interventions are discussed. Copyright © 2012 by the Research Society on Alcoholism.

Emotional, behavioral, and developmental features indicative of neglect or emotional abuse in preschool children: a systematic review.

PubMed

Naughton, Aideen Mary; Maguire, Sabine Ann; Mann, Mala Kanthi; Lumb, Rebecca Caroline; Tempest, Vanessa; Gracias, Shirley; Kemp, Alison Mary

2013-08-01

Early intervention for neglect or emotional abuse in preschoolers may mitigate lifelong consequences, yet practitioners lack confidence in recognizing these children. To define the emotional, behavioral, and developmental features of neglect or emotional abuse in preschoolers. A literature search of 18 databases, 6 websites, and supplementary searching performed from January 1, 1960, to February 1, 2011, identified 22 669 abstracts. Standardized critical appraisal of 164 articles was conducted by 2 independent, trained reviewers. Inclusion criteria were children aged 0 to 6 years with confirmed neglect or emotional abuse who had emotional, behavioral, and developmental features recorded or for whom the carer-child interaction was documented. Twenty-eight case-control (matched for socioeconomic, educational level, and ethnicity), 1 cross-sectional, and 13 cohort studies were included. Key features in the child included the following: aggression (11 studies) exhibited as angry, disruptive behavior, conduct problems, oppositional behavior, and low ego control; withdrawal or passivity (12 studies), including negative self-esteem, anxious or avoidant behavior, poor emotional knowledge, and difficulties in interpreting emotional expressions in others; developmental delay (17 studies), particularly delayed language, cognitive function, and overall development quotient; poor peer interaction (5 studies), showing poor social interactions, unlikely to act to relieve distress in others; and transition (6 studies) from ambivalent to avoidant insecure attachment pattern and from passive to increasingly aggressive behavior and negative self-representation. Emotional knowledge, cognitive function, and language deteriorate without intervention. Poor sensitivity, hostility, criticism, or disinterest characterize maternal-child interactions. Preschool children who have been neglected or emotionally abused exhibit a range of serious emotional and behavioral difficulties and adverse mother-child interactions that indicate that these children require prompt evaluation and interventions.

The Sensitivity to Change and Responsiveness of the Adult Responses to Children’s Symptoms in Children and Adolescents With Chronic Pain

PubMed Central

Alberts, Nicole; Langer, Shelby L.; Levy, Rona L.; Walker, Lynn S.; Palermo, Tonya M.

2016-01-01

Abstract Objective  To examine the sensitivity to change and responsiveness of the Adult Responses to Children’s Symptoms (ARCS) among parents of youth with chronic pain.  Methods  Participants included 330 youth (89 children aged 7–11 years, 241 children aged 12–17 years) and their parents who participated in randomized controlled trials of family-based cognitive-behavioral therapy for chronic pain. Child pain and disability, parental emotional functioning, and parental responses to child pain were assessed at baseline and posttreatment.  Results  The Protect and Monitor scales of the ARCS were sensitive to change following intervention for both developmental groups, with clinically meaningful reductions in these behaviors, thereby demonstrating responsiveness. Among the adolescent sample, greater change on some ARCS scales was associated with better parental emotional functioning and lower child pain at posttreatment.  Conclusions  Findings support the sensitivity to change and responsiveness of the Protect and Monitor scales among parents of youth with chronic pain. PMID:26493601

Conceptualizing the Influence of Social Agents of Behavior Change: A Meta-Analysis of the Effectiveness of HIV-Prevention Interventionists for Different Groups

PubMed Central

Durantini, Marta R.; Albarracín, Dolores; Mitchell, Amy L.; Earl, Allison N.; Gillette, Jeffrey C.

2016-01-01

A meta-analysis of 166 HIV-prevention interventions tested theoretical predictions about the effects of experts, lay community members, and similar and dissimilar others, as agents of change. In general, expert interventionists produced greater behavior change than lay community members, and the demographic and behavioral similarity between the interventionist and the recipients facilitated behavioral change. Equally importantly, there were differences across groups in the efficacy of various sources, especially among populations of low status and/or power. These findings support the hypothesis that unempowered populations are more sensitive to characteristics of the interventionists who can facilitate access to various resources. In addition, they suggest the need to ensure the availability of health professionals from diverse demographic and behavioral backgrounds. PMID:16536642

Longitudinal assessment of stereotypic, proto-injurious, and self-injurious behavior exhibited by young children with developmental delays.

PubMed

Richman, David M; Lindauer, Steven E

2005-11-01

Twelve children (CA, 12 to 32 months) with developmental delay were observed in their homes during monthly analogue functional analysis probes to document patterns of emerging self-injurious behavior. Two patterns of emerging self-injury were observed for 5 participants: (a) The topography and functional analysis pattern remained the same, but the behavior eventually caused tissue damage; or (b) a new topography emerged that was similar to an established stereotypic motor behavior. Functional analysis results were inconclusive for the majority of target behaviors across participants due to undifferentiated responding across conditions. One participant exhibited two topographies that appeared to become sensitive to positive reinforcement over time. Results are discussed in terms of implications for future research on early intervention and prevention of self-injury.

Cost-effectiveness of environmental-structural communication interventions for HIV prevention in the female sex industry in the Dominican Republic.

PubMed

Sweat, Michael; Kerrigan, Deanna; Moreno, Luis; Rosario, Santo; Gomez, Bayardo; Jerez, Hector; Weiss, Ellen; Barrington, Clare

2006-01-01

Behavior change communication often focuses on individual-level variables such as knowledge, perceived risk, self-efficacy, and behavior. A growing body of evidence suggests, however, that structural interventions to change the policy environment and environmental interventions designed to modify the physical and social environment further bolster impact. Little is known about the cost-effectiveness of such comprehensive intervention programs. In this study we use standard cost analysis methods to examine the incremental cost-effectiveness of two such interventions conducted in the Dominican Republic in sex establishments. In Santo Domingo the intervention was environmental; in Puerto Plata it was both environmental and structural (levying financial sanctions on sex establishment owners who failed to follow the intervention). The interventions in both sites included elements found in more conventional behavior change communication (BCC) programs (e.g., community mobilization, peer education, educational materials, promotional stickers). One key aim was to examine whether the addition of policy regulation was cost-effective. Data for the analysis were gleaned from structured behavioral questionnaires administered to female sex workers and their male regular paying partners in 41 sex establishments conducted pre- and post-intervention (1 year follow-up); data from HIV sentinel surveillance, STI screening results conducted for the intervention; and detailed cost data we collected. We estimated the number of HIV infections averted from each of the two intervention models and converted these estimates to the number of disability life years saved as compared with no intervention. One-way, two-way, three-way, and multivariate sensitivity analysis were conducted on model parameters. We examine a discount rate of 0%, 3% (base case), and 6% for future costs and benefits. The intervention conducted in Santo Domingo (community mobilization, promotional media, and interpersonal communication) was estimated to avert 64 HIV infections per 10,000 clients reached, and resulted in a cost per disability-adjusted life year (DALY) saved of $1,186. In Puerto Plata a policy/regulatory intervention was added, which resulted in 162 HIV infections averted per 10,000 clients reached, and yielded a cost per DALY saved of $457. Cost-effectiveness estimates were most correlated to the discount rate used and base rates of sexually transmitted infection (which affects the HIV transmission rate). Both intervention models resulted in cost-effective outcomes; however, the intervention that included policy regulation resulted in a substantially more cost-effective outcome.

Creating Abbreviated Rating Scales to Monitor Classroom Inattention-Overactivity, Aggression, and Peer Conflict: Reliability, Validity, and Treatment Sensitivity

ERIC Educational Resources Information Center

Volpe, Robert J.; Gadow, Kenneth D.

2010-01-01

Rating scales developed to measure child emotional and behavioral problems typically are so long as to make their use in progress monitoring impractical in typical school settings. This study examined two methods of selecting items from existing rating scales to create shorter instruments for use in assessing response to intervention. The…

Leveraging family values to decrease unhealthy alcohol use in aging Latino day laborers.

PubMed

del Pino, Homero E; Méndez-Luck, Carolyn; Bostean, Georgiana; Ramírez, Karina; Portillo, Marlom; Moore, Alison A

2013-10-01

In one Los Angeles study, 20 % of day laborers reported excessive drinking. Older adults are more sensitive to alcohol's effects, yet heavy drinking persists among Latinos until they are in their 60s. No interventions to reduce heavy drinking exist for aging day laborers. We recruited 14 day laborers aged 50 and older in Los Angeles. We identified their unhealthy alcohol use behaviors and comorbidities and conducted semi-structured interviews to understand their perceptions of unhealthy alcohol use. We found social disadvantages and conditions exacerbated by alcohol use, like depression. Participants were concerned with dying and premature aging, and reported that family could influence behavior change. An intervention should consider (1) integrating family values and (2) increasing knowledge about alcohol use and comorbidities. Further studies are needed to explore family influence on aging Latino day laborers.

Cost-Effectiveness of an Intervention to Reduce HIV/STI Incidence and Promote Condom Use among Female Sex Workers in the Mexico–US Border Region

PubMed Central

Burgos, José L.; Gaebler, Julia A.; Strathdee, Steffanie A.; Lozada, Remedios; Staines, Hugo; Patterson, Thomas L.

2010-01-01

Background Previous research demonstrated efficacy of a brief behavioral intervention to reduce incidence of HIV and sexually transmitted infections (STIs) among female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico, cities on Mexico's border with the US. We assessed this intervention's cost-effectiveness. Methodology and Principal Findings A life-time Markov model was developed to estimate HIV cases prevented, changes in quality-adjusted life expectancy (QALE), and costs per additional quality-adjusted life year gained (QALY), comparing (in US$2,009) no intervention to a once-only and annual intervention. Future costs and health benefits were discounted annually at 3%. Sensitivity analyses evaluated model robustness. We found that for a hypothetical 1,000 FSWs receiving the once-only intervention, there were 33 HIV cases prevented and 5.7 months of QALE gained compared to no intervention. The additional cost per QALY gained was US$183. For FSWs receiving the intervention annually, there were 29 additional HIV cases prevented and 4.5 additional months of QALE compared to the once-only intervention. The additional cost per QALY was US$1,075. When highly active antiretroviral therapy (HAART) was included in the model, the annual intervention strategy resulted in net savings and dominated both once-only and no intervention strategies, and remained robust across extensive sensitivity analyses. Even when considering clinical benefits from HAART, ignoring added costs, the cost per QALY gained remained below three times the Mexican GDP per capita, and below established cost-effectiveness thresholds. Conclusions/Significance This brief intervention was shown to be cost-effective among FSWs in two Mexico-US border cities and may have application for FSWs in other resource-limited settings. Trial Registration ClinicalTrials.gov NCT00338845 PMID:20617193

Psychological Processes and Repeat Suicidal Behavior: A Four-Year Prospective Study

PubMed Central

2013-01-01

Objective: Although suicidal behavior is a major public health concern, understanding of individually sensitive suicide risk mechanisms is limited. In this study, the authors investigated, for the first time, the utility of defeat and entrapment in predicting repeat suicidal behavior in a sample of suicide attempters. Method: Seventy patients hospitalized after a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, defeat, and entrapment) while in hospital. Four years later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: Over 4 years, 24.6% of linked participants were readmitted to hospital after a suicidal attempt. In univariate logistic regression analyses, defeat and entrapment as well as depression, hopelessness, past suicide attempts, and suicidal ideation all predicted suicidal behavior over this interval. However, in the multivariate analysis, entrapment and past frequency of suicide attempts were the only significant predictors of suicidal behavior. Conclusions: This longitudinal study supports the utility of a new theoretical model in the prediction of suicidal behavior. Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt. PMID:23855989

The Driving Behavior Survey as a Measure of Behavioral Stress Responses to MVA-related PTSD

PubMed Central

Baker, Aaron S.; Litwack, Scott D.; Clapp, Joshua D.; Beck, J. Gayle; Sloan, Denise M.

2014-01-01

Numerous treatments are available that address the core symptoms of posttraumatic stress disorder (PTSD). However, there are a number of related behavioral stress responses that are not assessed with PTSD measures, yet these behavioral stress responses affect quality of life. The goal of the current study was to investigate whether a recently developed measure of behavioral stress response, the Driving Behavior Survey (DBS), was sensitive to change associated with treatment among a group of participants diagnosed with PTSD. The DBS indexes anxious driving behavior, which is frequently observed among individuals with motor vehicle accident-related PTSD. Participants (n = 40) were racially-diverse adults (M age =40.78, 63% women) who met diagnostic criteria for motor vehicle accident-related PTSD. Hierarchical linear modeling analyses indicated that participants who were assigned to a brief, exposure-based intervention displayed significant reductions on the DBS subscales relative to participants assigned to the waitlist control condition (r = .41-.43). Moreover, meditational analyses indicated that the observed reductions on the DBS subscales were not better accounted for by reductions in PTSD. Taken together, these findings suggest that the DBS subscales are sensitive to changes associated with PTSD treatment and can be used to augment outcome measures in PTSD treatment trials PMID:24491201

The Driving Behavior Survey as a Measure of Behavioral Stress Responses to MVA-Related PTSD

PubMed Central

Baker, Aaron S.; Litwack, Scott D.; Clapp, Joshua D.; Beck, J. Gayle; Sloan, Denise M.

2014-01-01

Numerous treatments are available that address the core symptoms of posttraumatic stress disorder (PTSD). However, there are a number of related behavioral stress responses that are not assessed with PTSD measures, yet these behavioral stress responses affect quality of life. The goal of the current study was to investigate whether a recently developed measure of behavioral stress response, the Driving Behavior Survey (DBS), was sensitive to change associated with treatment among a group of participants diagnosed with PTSD. The DBS indexes anxious driving behavior, which is frequently observed among individuals with motor vehicle accident-related PTSD. Participants (n = 40) were racially diverse adults (M age = 40.78, 63% women) who met diagnostic criteria for motor vehicle accident-related PTSD. Hierarchical linear modeling analyses indicated that participants who were assigned to a brief, exposure-based intervention displayed significant reductions on the DBS subscales relative to participants assigned to the wait-list control condition (r = .41–.43). Moreover, mediational analyses indicated that the observed reductions on the DBS subscales were not better accounted for by reductions in PTSD. Taken together, these findings suggest that the DBS subscales are sensitive to changes associated with PTSD treatment and can be used to augment outcome assessment in PTSD treatment trials. PMID:24800313

Foundations to the unified psycho-cognitive engine.

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

Bernard, Michael Lewis; Bier, Asmeret Brooke; Backus, George A.

This document outlines the key features of the SNL psychological engine. The engine is designed to be a generic presentation of cognitive entities interacting among themselves and with the external world. The engine combines the most accepted theories of behavioral psychology with those of behavioral economics to produce a unified simulation of human response from stimuli through executed behavior. The engine explicitly recognizes emotive and reasoned contributions to behavior and simulates the dynamics associated with cue processing, learning, and choice selection. Most importantly, the model parameterization can come from available media or survey information, as well subject-matter-expert information. The frameworkmore » design allows the use of uncertainty quantification and sensitivity analysis to manage confidence in using the analysis results for intervention decisions.« less

Behavioral interventions to promote adequate sleep among women: protocol for a systematic review and meta-analysis.

PubMed

Vézina-Im, Lydi-Anne; Moreno, Jennette Palcic; Nicklas, Theresa A; Baranowski, Tom

2017-05-11

Short and poor sleep have been associated with adverse health outcomes in adults, such as overweight/obesity and type 2 diabetes, especially among women. Women therefore represent an important target for interventions aimed at improving sleep and such interventions have been advocated to enhance maternal, fetal, and infant health. This systematic review will assess the efficacy or effectiveness of behavioral interventions aimed at promoting adequate sleep among women. The primary outcomes will be changes in sleep duration and/or sleep quality from baseline to post-intervention and to the last available follow-up measured either through self-reports or objectively. Secondary outcomes will be assessing the behavior change techniques that are responsible for the changes in sleep duration and quality among women. Behavioral interventions that are non-pharmacological and target either sleep directly or sleep hygiene behaviors will be included. Randomized controlled trials, quasi-experimental, and one-group pre-post studies will be included, but treated separately in the analyses, given that a limited number of studies on the topic of sleep is expected. MEDLINE/PubMed, PsycINFO, CINAHL, EMBASE, and Proquest Dissertations and Theses will be investigated. There will be no restriction on the year of publication of the articles, but we will include only the ones written in English or French. Two authors will independently assess articles for eligibility and will extract data using a standardized data extraction form that will have been previously pilot-tested. The quality of the studies will be assessed using the Effective Public Health Practice Project tool for quantitative study designs. The intervention procedures will be classified according to the latest validated taxonomy of behavior change techniques. If there is a sufficient number of studies (k > 5), a meta-analysis of the results will be performed with a random-effect model. If the heterogeneity is high (I 2  ≥ 75%), it will be investigated through sensitivity analyses and meta-regression. This review will provide valuable information to those interested in promoting adequate sleep among women and, hopefully, encourage additional research in this important field to promote maternal, fetal, and infant health. The study protocol was registered in PROSPERO in October 2016 (CRD42016049538).

Vectorial capacity and vector control: reconsidering sensitivity to parameters for malaria elimination

PubMed Central

Brady, Oliver J.; Godfray, H. Charles J.; Tatem, Andrew J.; Gething, Peter W.; Cohen, Justin M.; McKenzie, F. Ellis; Perkins, T. Alex; Reiner, Robert C.; Tusting, Lucy S.; Sinka, Marianne E.; Moyes, Catherine L.; Eckhoff, Philip A.; Scott, Thomas W.; Lindsay, Steven W.; Hay, Simon I.; Smith, David L.

2016-01-01

Background Major gains have been made in reducing malaria transmission in many parts of the world, principally by scaling-up coverage with long-lasting insecticidal nets and indoor residual spraying. Historically, choice of vector control intervention has been largely guided by a parameter sensitivity analysis of George Macdonald's theory of vectorial capacity that suggested prioritizing methods that kill adult mosquitoes. While this advice has been highly successful for transmission suppression, there is a need to revisit these arguments as policymakers in certain areas consider which combinations of interventions are required to eliminate malaria. Methods and Results Using analytical solutions to updated equations for vectorial capacity we build on previous work to show that, while adult killing methods can be highly effective under many circumstances, other vector control methods are frequently required to fill effective coverage gaps. These can arise due to pre-existing or developing mosquito physiological and behavioral refractoriness but also due to additive changes in the relative importance of different vector species for transmission. Furthermore, the optimal combination of interventions will depend on the operational constraints and costs associated with reaching high coverage levels with each intervention. Conclusions Reaching specific policy goals, such as elimination, in defined contexts requires increasingly non-generic advice from modelling. Our results emphasize the importance of measuring baseline epidemiology, intervention coverage, vector ecology and program operational constraints in predicting expected outcomes with different combinations of interventions. PMID:26822603

Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls.

PubMed

Balantekin, Katherine N; Birch, Leann L; Savage, Jennifer S

2018-04-01

To examine the relationship of family, friend, and media factors on weight-control group membership at 15 years separately and in a combined model. Subjects included 166 15 year girls. Latent class analysis identified four patterns of weight-control behaviors: non-dieters, lifestyle, dieters, and extreme dieters. Family (family functioning, priority of the family meals, maternal/paternal weight-teasing, and mother's/father's dieting), friend (weight-teasing and dieting), and media variables (media sensitivity and weekly TV time) were included as predictors of weight-control group membership. Family functioning and priority of family meals predicted membership in the Extreme Dieters group, and maternal weight-teasing predicted membership in both dieters and extreme dieters. Friend's dieting and weight-teasing predicted membership in both dieters and extreme dieters. Media sensitivity was significantly associated with membership in lifestyle, dieters, and extreme dieters. In a combined influence model with family, friend, and media factors included, the following remained significantly associated with weight-control group membership: family functioning, friends' dieting, and media sensitivity. Family, friends, and the media are three sources of sociocultural influence, which play a role in adolescent girls' use of patterns of weight-control behaviors; family functioning was a protective factor, whereas friend's dieting and media sensitivity were risk factors. These findings emphasize the need for multidimensional interventions, addressing risk factors for dieting and use of unhealthy weight-control behaviors at the family, peer, and community (e.g., media) levels.

Effects of behavioral changes in a smallpox attack model.

PubMed

Del Valle, S; Hethcote, H; Hyman, J M; Castillo-Chavez, C

2005-06-01

The impact of individual and community behavioral changes in response to an outbreak of a disease with high mortality is often not appreciated. Response strategies to a smallpox bioterrorist attack have focused on interventions such as isolation of infectives, contact tracing, quarantine of contacts, ring vaccination, and mass vaccination. We formulate and analyze a mathematical model in which some individuals lower their daily contact activity rates once an epidemic has been identified in a community. Transmission parameters are estimated from data and an expression is derived for the effective reproduction number. We use computer simulations to analyze the effects of behavior change alone and in combination with other control measures. We demonstrate that the spread of the disease is highly sensitive to how rapidly people reduce their contact activity rates and to the precautions that the population takes to reduce the transmission of the disease. Even gradual and mild behavioral changes can have a dramatic impact in slowing an epidemic. When behavioral changes are combined with other interventions, the epidemic is shortened and the number of smallpox cases is reduced. We conclude that for simulations of a smallpox outbreak to be useful, they must consider the impact of behavioral changes. This is especially true if the model predictions are being used to guide public health policy.

A Community Intervention to Decrease Antibiotics Used for Self-Medication Among Latino Adults

PubMed Central

Mainous, Arch G.; Diaz, Vanessa A.; Carnemolla, Mark

2009-01-01

PURPOSE Recent evidence in Latino communities indicates substantial self-medication with antibiotics obtained without a prescription (WORx). We implemented and evaluated a culturally sensitive educational intervention to decrease antibiotic self-medication. METHODS We conducted a community-based intervention with preintervention and postintervention measures in the intervention community (Charleston, South Carolina) as well as a postintervention measure in a control community (Greenville, South Carolina) 200 miles away. The 9-month culturally sensitive intervention included multiple media sources (pamphlets, radio, newspapers). We evaluated the use of antibiotics WORx in the United States, as well as the likelihood of importing antibiotics, by surveying Latino adults in the intervention (n = 250) and in the control community (n = 250). RESULTS Most adults in the intervention community (69%) and the control community (60%) reported some exposure to messages about the inappropriate use of antibiotics, and 25.9% in the intervention community and 8.6% in the control community reported seeing our patient education pamphlets. A substantial proportion of Latino adults in both the intervention (31%) and control communities (20%) have obtained antibiotics WORx in the United States. In multivariate analyses, exposure to an educational message was not a significant predictor of having acquired antibiotics WORx in the United States in past 12 months. The primary predictor of respondents’ having acquired antibiotics WORx in the United States was whether they had bought antibiotics WORx outside the United States. CONCLUSIONS Novel approaches are needed to decrease the use of antibiotics WORx in Latino communities, as focusing only on education may not be sufficient to change behaviors common in their home countries. PMID:19901311

Integrating Men’s Health and Masculinity Theories to Explain Colorectal Cancer Screening Behavior

PubMed Central

Christy, Shannon M.; Mosher, Catherine E.; Rawl, Susan M.

2013-01-01

Colorectal cancer (CRC) is the third most common cause of cancer deaths among men in the United States. Although CRC screening has been found to reduce CRC incidence and mortality, current screening rates among men are suboptimal due to various practical and psychosocial barriers. One potential barrier to CRC screening identified in qualitative studies with men is the threat to masculinity that endoscopic screening methods pose. Indeed, beliefs about masculinity have been predictive of other preventive health behaviors among men. In this review paper, we propose a novel conceptual framework to explain men’s CRC screening behavior that integrates masculinity norms, gender role conflict, men’s health care experiences, behaviors, and beliefs, and social and background variables. This framework has the potential to guide future research on men’s CRC screening behaviors and other health behaviors and may inform gender-sensitive interventions which target masculinity beliefs to increase preventive health behaviors. PMID:23813927

Integrating men's health and masculinity theories to explain colorectal cancer screening behavior.

PubMed

Christy, Shannon M; Mosher, Catherine E; Rawl, Susan M

2014-01-01

Colorectal cancer (CRC) is the third most common cause of cancer deaths among men in the United States. Although CRC screening has been found to reduce CRC incidence and mortality, current screening rates among men are suboptimal due to various practical and psychosocial barriers. One potential barrier to CRC screening identified in qualitative studies with men is the threat to masculinity that endoscopic screening methods pose. Indeed, beliefs about masculinity have been predictive of other preventive health behaviors among men. In this review article, we propose a novel conceptual framework to explain men's CRC screening behavior that integrates masculinity norms, gender role conflict, men's health care experiences, behaviors, and beliefs, and social and background variables. This framework has the potential to guide future research on men's CRC screening behaviors and other health behaviors and may inform gender-sensitive interventions that target masculinity beliefs to increase preventive health behaviors.

Secondary prevention of work-related disability in nonspecific low back pain: does problem-solving therapy help? A randomized clinical trial.

PubMed

van den Hout, Johanna H C; Vlaeyen, Johan W S; Heuts, Peter H T G; Zijlema, Johan H L; Wijnen, Joseph A G

2003-01-01

Given the individual and economic burden of chronic work disability in low back pain patients, there is a need for effective preventive interventions. The aim of the present study was to investigate whether problem-solving therapy had a supplemental value when added to behavioral graded activity, regarding days of sick leave and work status. Randomized controlled trial. Employees who were recently on sick leave as a result of nonspecific low back pain were referred to the rehabilitation center by general practitioner, occupational physician, or rehabilitation physician. Forty-five employees had been randomly assigned to the experimental treatment condition that included behavioral graded activity and problem-solving therapy (GAPS), and 39 employees had been randomly assigned to behavioral graded activity and group education (GAGE). Days of sick leave and work status. Data were retrieved from occupational health services. Data analyses showed that employees in the GAPS group had significantly fewer days of sick leave in the second half-year after the intervention. Moreover, work status was more favorable for employees in this condition, in that more employees had a 100% return-to-work and fewer patients ended up receiving disability pensions one year after the intervention. Sensitivity analyses confirmed these results. The addition of problem-solving therapy to behavioral graded activity had supplemental value in employees with nonspecific low back pain.

Effects of a Web-Based Tailored Multiple-Lifestyle Intervention for Adults: A Two-Year Randomized Controlled Trial Comparing Sequential and Simultaneous Delivery Modes

PubMed Central

Kremers, Stef PJ; Vandelanotte, Corneel; van Adrichem, Mathieu JG; Schneider, Francine; Candel, Math JJM; de Vries, Hein

2014-01-01

Background Web-based computer-tailored interventions for multiple health behaviors can have a significant public health impact. Yet, few randomized controlled trials have tested this assumption. Objective The objective of this paper was to test the effects of a sequential and simultaneous Web-based tailored intervention on multiple lifestyle behaviors. Methods A randomized controlled trial was conducted with 3 tailoring conditions (ie, sequential, simultaneous, and control conditions) in the Netherlands in 2009-2012. Follow-up measurements took place after 12 and 24 months. The intervention content was based on the I-Change model. In a health risk appraisal, all respondents (N=5055) received feedback on their lifestyle behaviors that indicated whether they complied with the Dutch guidelines for physical activity, vegetable consumption, fruit consumption, alcohol intake, and smoking. Participants in the sequential (n=1736) and simultaneous (n=1638) conditions received tailored motivational feedback to change unhealthy behaviors one at a time (sequential) or all at the same time (simultaneous). Mixed model analyses were performed as primary analyses; regression analyses were done as sensitivity analyses. An overall risk score was used as outcome measure, then effects on the 5 individual lifestyle behaviors were assessed and a process evaluation was performed regarding exposure to and appreciation of the intervention. Results Both tailoring strategies were associated with small self-reported behavioral changes. The sequential condition had the most significant effects compared to the control condition after 12 months (T1, effect size=0.28). After 24 months (T2), the simultaneous condition was most effective (effect size=0.18). All 5 individual lifestyle behaviors changed over time, but few effects differed significantly between the conditions. At both follow-ups, the sequential condition had significant changes in smoking abstinence compared to the simultaneous condition (T1 effect size=0.31; T2 effect size=0.41). The sequential condition was more effective in decreasing alcohol consumption than the control condition at 24 months (effect size=0.27). Change was predicted by the amount of exposure to the intervention (total visiting time: beta=–.06; P=.01; total number of visits: beta=–.11; P<.001). Both interventions were appreciated well by respondents without significant differences between conditions. Conclusions Although evidence was found for the effectiveness of both programs, no simple conclusive finding could be drawn about which intervention mode was more effective. The best kind of intervention may depend on the behavior that is targeted or on personal preferences and motivation. Further research is needed to identify moderators of intervention effectiveness. The results need to be interpreted in view of the high and selective dropout rates, multiple comparisons, and modest effect sizes. However, a large number of people were reached at low cost and behavioral change was achieved after 2 years. Trial Registration Nederlands Trial Register: NTR 2168; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2168 (Archived by WebCite at http://www.webcitation.org/6MbUqttYB). PMID:24472854

Primary Care Interventions to Reduce Childhood Obesity in Latino Families.

PubMed

Gonzalez, Giulliana

2016-01-01

Increasing rates of obesity in Latino children call for culturally sensitive primary care interventions. Despite recent efforts to address this growing disparity, little is known about cultural variables that influence obesity management programs in Latino children. A literature search was conducted using CINHAL, Scopus, PubMed, and PsycINFO to review the state of the science regarding primary care interventions to decrease obesity in Latino children. The author analyzed the effects of several cultural practices on obesity and made recommendations based on their clinical implications for weight reduction management programs. Obesity in Latino children is a multifactorial problem influenced by family behaviors, cultural perceptions of weight and health, traditional dietary norms, and socioeconomic status. Current practice lags behind national obesity management recommendations and is further hindered by a lack of consideration of the roles of key cultural differences in Latino families. It is imperative to recognize the importance of family preferences and culture when developing weight reduction programs so as to foster long-term behavior changes. More research assessing the efficacy of culturally competent interventions is necessary to guide national efforts to address this increasing disparity. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Identifying eating behavior phenotypes and their correlates: A novel direction toward improving weight management interventions.

PubMed

Bouhlal, Sofia; McBride, Colleen M; Trivedi, Niraj S; Agurs-Collins, Tanya; Persky, Susan

2017-04-01

Common reports of over-response to food cues, difficulties with calorie restriction, and difficulty adhering to dietary guidelines suggest that eating behaviors could be interrelated in ways that influence weight management efforts. The feasibility of identifying robust eating phenotypes (showing face, content, and criterion validity) was explored based on well-validated individual eating behavior assessments. Adults (n = 260; mean age 34 years) completed online questionnaires with measurements of nine eating behaviors including: appetite for palatable foods, binge eating, bitter taste sensitivity, disinhibition, food neophobia, pickiness and satiety responsiveness. Discovery-based visualization procedures that have the combined strengths of heatmaps and hierarchical clustering were used to investigate: 1) how eating behaviors cluster, 2) how participants can be grouped within eating behavior clusters, and 3) whether group clustering is associated with body mass index (BMI) and dietary self-efficacy levels. Two distinct eating behavior clusters and participant groups that aligned within these clusters were identified: one with higher drive to eat and another with food avoidance behaviors. Participants' BMI (p = 0.0002) and dietary self-efficacy (p < 0.0001) were associated with cluster membership. Eating behavior clusters showed content and criterion validity based on their association with BMI (associated, but not entirely overlapping) and dietary self-efficacy. Identifying eating behavior phenotypes appears viable. These efforts could be expanded and ultimately inform tailored weight management interventions. Published by Elsevier Ltd.

Economic evaluation of a web-based tailored lifestyle intervention for adults: findings regarding cost-effectiveness and cost-utility from a randomized controlled trial.

PubMed

Schulz, Daniela N; Smit, Eline S; Stanczyk, Nicola E; Kremers, Stef P J; de Vries, Hein; Evers, Silvia M A A

2014-03-20

Different studies have reported the effectiveness of Web-based computer-tailored lifestyle interventions, but economic evaluations of these interventions are scarce. The objective was to assess the cost-effectiveness and cost-utility of a sequential and a simultaneous Web-based computer-tailored lifestyle intervention for adults compared to a control group. The economic evaluation, conducted from a societal perspective, was part of a 2-year randomized controlled trial including 3 study groups. All groups received personalized health risk appraisals based on the guidelines for physical activity, fruit intake, vegetable intake, alcohol consumption, and smoking. Additionally, respondents in the sequential condition received personal advice about one lifestyle behavior in the first year and a second behavior in the second year; respondents in the simultaneous condition received personal advice about all unhealthy behaviors in both years. During a period of 24 months, health care use, medication use, absenteeism from work, and quality of life (EQ-5D-3L) were assessed every 3 months using Web-based questionnaires. Demographics were assessed at baseline, and lifestyle behaviors were assessed at both baseline and after 24 months. Cost-effectiveness and cost-utility analyses were performed based on the outcome measures lifestyle factor (the number of guidelines respondents adhered to) and quality of life, respectively. We accounted for uncertainty by using bootstrapping techniques and sensitivity analyses. A total of 1733 respondents were included in the analyses. From a willingness to pay of €4594 per additional guideline met, the sequential intervention (n=552) was likely to be the most cost-effective, whereas from a willingness to pay of €10,850, the simultaneous intervention (n=517) was likely to be most cost-effective. The control condition (n=664) appeared to be preferred with regard to quality of life. Both the sequential and the simultaneous lifestyle interventions were likely to be cost-effective when it concerned the lifestyle factor, whereas the control condition was when it concerned quality of life. However, there is no accepted cutoff point for the willingness to pay per gain in lifestyle behaviors, making it impossible to draw firm conclusions. Further economic evaluations of lifestyle interventions are needed. Dutch Trial Register NTR2168; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2168 (Archived by WebCite at http://www.webcitation.org/6MbUqttYB).

Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study

PubMed Central

Reyes-Rodríguez, Mae Lynn; Baucom, Donald H.; Bulik, Cynthia M.

2014-01-01

Objective We describe cognitive-behavioral therapy for bulimia nervosa (CBT-BN) with a Latina woman that incorporates culturally relevant topics. Method A single case report of a 31-year-old monolingual Latina woman with BN describes the application of a couple-based intervention adjunctive to CBT-BN. Results The patient reported no binge and purge episodes by session 20 and remained symptom free until the end of treatment (session 26). Improvement was observed in the Eating Disorders Examination (EDE) comparing baseline (EDE=5.74) with post treatment (EDE=1.25). Conclusions The case illustrates how cultural adaptations such as including a family member, being flexible on topics and scheduling, and providing culturally relevant interventions can lead to successful completion of a course of therapy and facilitate ongoing interventions to ensure continued recovery. PMID:25598951

Promoting healthy weight among elementary school children via a health report card approach.

PubMed

Chomitz, Virginia R; Collins, Jessica; Kim, Juhee; Kramer, Ellen; McGowan, Robert

2003-08-01

As overweight continues to rise among children, schools seek effective and sensitive ways to engage parents in promoting healthy weight. To evaluate a school-based health report card on the family awareness of and concern about the child weight status, plans for weight control, and preventive behaviors. Quasi-experimental field trial with a personalized weight and fitness health report card intervention (PI), a general-information intervention (GI), and a control group (CG). Outcomes were assessed using a postintervention telephone survey, including process and outcome measures. The intervention included 1396 ethnically diverse students at 4 elementary schools in an urban area. Telephone surveys were completed by 399 families from an evaluation sample of 793. Intervention Families were randomly assigned to the PI, GI, or CG and mailed intervention materials. The CG was mailed GI materials after the survey. Parent awareness of child weight status, concerns, weight-control plans, and preventive behaviors. Group effects were significantly different by the child's weight status, so results were stratified. Among overweight students, intervention parents were more likely to know their child's weight status (PI, 44%; GI, 41%; CG, 23%) (P =.02). The PI parents planned medical help (PI, 25%; GI, 7%; CG, 9%) (P =.004), dieting activities (PI, 19%; GI and CG, <5 cases) (P =.02) and physical activities (PI, 42%; GI, 27%; CG, 13%) (P<.001) for their overweight children. No group effect on concern or preventive behaviors was detected. Most parents of overweight children who read materials requested annual weight and health information on their child (PI, 91%; GI, 67%). Among overweight children, the PI was associated with increased parental awareness of their child's weight status. Although parents wanted PI for their children, more research is needed to test this approach on children's self-esteem and plans for weight control.

Feasibility and initial efficacy of a culturally sensitive women-centered substance use intervention in Georgia: Sex risk outcomes.

PubMed

Jones, Hendrée E; Kirtadze, Irma; Otiashvili, David; Murphy, Keryn; O'Grady, Kevin E; Zule, William; Krupitsky, Evgeny; Wechsberg, Wendee M

2015-12-08

This paper reports on the feasibility and initial efficacy of a culturally sensitive, comprehensive women-centered substance use intervention for women who inject drugs in Georgia in terms of the primary and secondary sex risk outcomes. The hypothesis under examination was that, relative to case management participants, participants in a culturally sensitive, comprehensive women-specific and -centered intervention would, on average, show significant decreases in past-30-day frequency of unprotected sex, unprotected sex at the last sexual encounter, and increases in condom use and safer sex actions. The study was a two-arm randomized trial, in which 173 potentially eligible women were screened, and those 128 women determined to be eligible were assigned at random to either Reinforcement-based Treatment plus Women's Co-Op (RBT + WC) or case management (CM). RBT + WC participants received 12 sessions of a structured intervention with the goal of reducing risky sex and substance use and improving physical and mental health. CM participants received 12 sessions of case management and informational brochures that focused on the same issues on which RBT + WC focused. Participants were assessed at baseline, post-treatment, and 3 months following treatment enrollment. Analyses revealed case management having significantly overall higher Safer Sex action scores than RBT + WC, and a significant decrease over time for past 30-day number of unprotected sex acts. Unprotected sex at the last encounter and Condom Use action scores were nonsignificant. Women who inject drugs in Georgia are engaging in risky sexual practices, and are in need of an intervention that addresses these risky behaviors. Reasons for the failure to find differences between a culturally sensitive, comprehensive women-centered intervention and case management tailored to the needs of women who inject drugs in Georgia may have been the result of inadequate power to detect an effect in a sample whose drug use was not as serious as warranted by the intervention. (ClinicalTrials.gov Identifier: NCT01331460 ).

Neural markers of errors as endophenotypes in neuropsychiatric disorders

PubMed Central

Manoach, Dara S.; Agam, Yigal

2013-01-01

Learning from errors is fundamental to adaptive human behavior. It requires detecting errors, evaluating what went wrong, and adjusting behavior accordingly. These dynamic adjustments are at the heart of behavioral flexibility and accumulating evidence suggests that deficient error processing contributes to maladaptively rigid and repetitive behavior in a range of neuropsychiatric disorders. Neuroimaging and electrophysiological studies reveal highly reliable neural markers of error processing. In this review, we evaluate the evidence that abnormalities in these neural markers can serve as sensitive endophenotypes of neuropsychiatric disorders. We describe the behavioral and neural hallmarks of error processing, their mediation by common genetic polymorphisms, and impairments in schizophrenia, obsessive-compulsive disorder, and autism spectrum disorders. We conclude that neural markers of errors meet several important criteria as endophenotypes including heritability, established neuroanatomical and neurochemical substrates, association with neuropsychiatric disorders, presence in syndromally-unaffected family members, and evidence of genetic mediation. Understanding the mechanisms of error processing deficits in neuropsychiatric disorders may provide novel neural and behavioral targets for treatment and sensitive surrogate markers of treatment response. Treating error processing deficits may improve functional outcome since error signals provide crucial information for flexible adaptation to changing environments. Given the dearth of effective interventions for cognitive deficits in neuropsychiatric disorders, this represents a potentially promising approach. PMID:23882201

Neural markers of errors as endophenotypes in neuropsychiatric disorders.

PubMed

Manoach, Dara S; Agam, Yigal

2013-01-01

Learning from errors is fundamental to adaptive human behavior. It requires detecting errors, evaluating what went wrong, and adjusting behavior accordingly. These dynamic adjustments are at the heart of behavioral flexibility and accumulating evidence suggests that deficient error processing contributes to maladaptively rigid and repetitive behavior in a range of neuropsychiatric disorders. Neuroimaging and electrophysiological studies reveal highly reliable neural markers of error processing. In this review, we evaluate the evidence that abnormalities in these neural markers can serve as sensitive endophenotypes of neuropsychiatric disorders. We describe the behavioral and neural hallmarks of error processing, their mediation by common genetic polymorphisms, and impairments in schizophrenia, obsessive-compulsive disorder, and autism spectrum disorders. We conclude that neural markers of errors meet several important criteria as endophenotypes including heritability, established neuroanatomical and neurochemical substrates, association with neuropsychiatric disorders, presence in syndromally-unaffected family members, and evidence of genetic mediation. Understanding the mechanisms of error processing deficits in neuropsychiatric disorders may provide novel neural and behavioral targets for treatment and sensitive surrogate markers of treatment response. Treating error processing deficits may improve functional outcome since error signals provide crucial information for flexible adaptation to changing environments. Given the dearth of effective interventions for cognitive deficits in neuropsychiatric disorders, this represents a potentially promising approach.

ORCHIDS: an observational randomized controlled trial on childhood differential susceptibility.

PubMed

Chhangur, Rabia R; Weeland, Joyce; Overbeek, Geertjan; Matthys, Walterchj; Orobio de Castro, Bram

2012-10-29

A central tenet in developmental psychopathology is that childhood rearing experiences have a major impact on children's development. Recently, candidate genes have been identified that may cause children to be differentially susceptible to these experiences (i.e., susceptibility genes). However, our understanding of the differential impact of parenting is limited at best. Specifically, more experimental research is needed. The ORCHIDS study will investigate gene-(gene-)environment interactions to obtain more insight into a) moderating effects of polymorphisms on the link between parenting and child behavior, and b) behavioral mechanisms that underlie these gene-(gene-)environment interactions in an experimental design. The ORCHIDS study is a randomized controlled trial, in which the environment will be manipulated with an intervention (i.e., Incredible Years parent training). In a screening, families with children aged 4-8 who show mild to (sub)clinical behavior problems will be targeted through community records via two Dutch regional healthcare organizations. Assessments in both the intervention and control condition will be conducted at baseline (i.e., pretest), after 6 months (i.e., posttest), and after 10 months (i.e., follow-up). This study protocol describes the design of a randomized controlled trial that investigates gene-(gene-)environment interactions in the development of child behavior. Two hypotheses will be tested. First, we expect that children in the intervention condition who carry one or more susceptibility genes will show significantly lower levels of problem behavior and higher levels of prosocial behavior after their parent(s) received the Incredible Years training, compared to children without these genes, or children in the control group. Second, we expect that children carrying one or more susceptibility genes will show a heightened sensitivity to changes in parenting behaviors, and will manifest higher emotional synchronization in dyadic interchanges with their parents. This may lead to either more prosocial behavior or antisocial behavior depending on their parents' behavior. Dutch Trial Register (NTR3594).

The cost-effectiveness of cognitive behavioral therapy for bulimia nervosa in the Australian context.

PubMed

Le, Long Khanh-Dao; Hay, Phillipa; Wade, Tracey; Touyz, Stephen; Mihalopoulos, Cathrine

2017-12-01

This study was to model the cost-effectiveness of specialist-delivered cognitive behavioral therapy for bulimia nervosa (CBT-BN) compared to no intervention within the Australian context. An illness-death model was developed to estimate the cost per disability-adjusted life-year (DALY) averted of CBT-BN over 2 years from the healthcare perspective. Target population was adults aged 18-65 years with BN. Results are reported as incremental cost-effectiveness ratios (ICER) in 2013 Australian dollars per DALY averted. Uncertainty and sensitivity analyses were conducted to test the robustness of results. Primary analysis indicated that CBT-BN was associated with greater DALY averted (0.10 DALY per person) and higher costs ($1,435 per person) than no intervention, resulting the mean ICER of $14,451 per DALY averted (95% uncertainty interval [UI]: $8,762 to $35,650). Uncertainty analysis indicated CBT-BN is 99% likely to be cost-effective at a threshold of $50,000 per DALY averted. Including the patients' time and travel costs resulted in the mean ICER of $18,858 per DALY averted (95% UI: $11,235 to $46,026). Sensitivity analysis indicated the intervention was not cost-effective if over 80% people discontinued treatment. Other analyses including a reduced time horizon, increased remission rates, and 4-month effect size of CBT-BN increases the ICERs but these ICERs remained well below under a threshold of $50,000 per DALY averted. This study has demonstrated that CBT-BN for adults with BN is a cost-effective treatment intervention. Further research is required to investigate the practicability of CBT-ED and the cost-effectiveness of other formats of CBT-BN delivery. © 2017 Wiley Periodicals, Inc.

Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods.

PubMed

Williams, Allison N; Konopken, Yolanda P; Keller, Colleen S; Castro, Felipe Gonzalez; Arcoleo, Kimberly J; Barraza, Estela; Patrick, Donald L; Olson, Micah L; Shaibi, Gabriel Q

2017-03-01

Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14-16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods

PubMed Central

Williams, AN; Konopken, YP; Keller, CS; Castro, FG; Arcoleo, K; Barraza, E; Patrick, DL; Olson, ML; Shaibi, GQ

2017-01-01

Background Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. Objectives To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14–16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. Conclusions The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations. PMID:28104469

Comparing top-down and bottom-up costing approaches for economic evaluation within social welfare.

PubMed

Olsson, Tina M

2011-10-01

This study compares two approaches to the estimation of social welfare intervention costs: one "top-down" and the other "bottom-up" for a group of social welfare clients with severe problem behavior participating in a randomized trial. Intervention costs ranging over a two-year period were compared by intervention category (foster care placement, institutional placement, mentorship services, individual support services and structured support services), estimation method (price, micro costing, average cost) and treatment group (intervention, control). Analyses are based upon 2007 costs for 156 individuals receiving 404 interventions. Overall, both approaches were found to produce reliable estimates of intervention costs at the group level but not at the individual level. As choice of approach can greatly impact the estimate of mean difference, adjustment based on estimation approach should be incorporated into sensitivity analyses. Analysts must take care in assessing the purpose and perspective of the analysis when choosing a costing approach for use within economic evaluation.

[Clustering patterns of behavioral risk factors linked to chronic disease among young adults in two localities in Bogota, Colombia: importance of sex differences].

PubMed

Gómez Gutiérrez, Luis Fernando; Lucumí Cuesta, Diego Iván; Girón Vargas, Sandra Lorena; Espinosa García, Gladys

2004-01-01

The characterization of clustering behavioral risk factors may be used as a guideline for interventions aimed at preventing chronic diseases. This study determined the clustering patterns of some behavioral risk factors in young adults aged 18 to 29 years and established the factors associated with having two or more of them. Patterns of clustering by gender were established in four behavioral risk factors (low consumption of fruits and vegetables, physical inactivity in leisure time, current tobacco consumption and acute alcohol consumption), in 1465 young adults participants through a multistage probabilistic sample. Regression models identified the sociodemografic variables associated with having two or more of the aforementioned behavioral risk factors. Having one, 32.9% two and 17.7% three or four. Acute alcohol consumption was the risk factor most frequent in the combined risk factor patterns among males; physical inactivity during leisure time being the most frequent among females. Among the females, having two or more behavioral risk factors was linked to be separated or divorced, this having been linked to work having been the main activity over the past 30 days among males. The combinations of behavioral risk factors studied and the factors associated with clustering show different patterns among males and females. These findings stressed the need of designing interventions sensitive to gender differences.

Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities.

PubMed

Burgos, Jose L; Patterson, Thomas L; Graff-Zivin, Joshua S; Kahn, James G; Rangel, M Gudelia; Lozada, M Remedios; Staines, Hugo; Strathdee, Steffanie A

2016-01-01

We evaluated the cost-effectiveness of combined single session brief behavioral intervention, either didactic or interactive (Mujer Mas Segura, MMS) to promote safer-sex and safer-injection practices among female sex workers who inject drugs (FSW-IDUs) in Tijuana (TJ) and Ciudad-Juarez (CJ) Mexico. Data for this analysis was obtained from a factorial RCT in 2008-2010 coinciding with expansion of needle exchange programs (NEP) in TJ, but not in CJ. A Markov model was developed to estimate the incremental cost per quality adjusted life year gained (QALY) over a lifetime time frame among a hypothetical cohort of 1,000 FSW-IDUs comparing a less intensive didactic vs. a more intensive interactive format of the MMS, separately for safer sex and safer injection combined behavioral interventions. The costs for antiretroviral therapy was not included in the model. We applied a societal perspective, a discount rate of 3% per year and currency adjusted to US$2014. A multivariate sensitivity analysis was performed. The combined and individual components of the MMS interactive behavioral intervention were compared with the didactic formats by calculating the incremental cost-effectiveness ratios (ICER), defined as incremental unit of cost per additional health benefit (e.g., HIV/STI cases averted, QALYs) compared to the next least costly strategy. Following guidelines from the World Health Organization, a combined strategy was considered highly cost-effective if the incremental cost per QALY gained fell below the gross domestic product per capita (GDP) in Mexico (equivalent to US$10,300). For CJ, the mixed intervention approach of interactive safer sex/didactic safer injection had an incremental cost-effectiveness ratio (ICER) of US$4,360 ($310-$7,200) per QALY gained compared with a dually didactic strategy. Using the dually interactive strategy had an ICER of US$5,874 ($310-$7,200) compared with the mixed approach. For TJ, the combination of interactive safer sex/didactic safer injection had an ICER of US$5,921 ($104-$9,500) per QALY compared with dually didactic. Strategies using the interactive safe injection intervention were dominated due to lack of efficacy advantage. The multivariate sensitivity analysis showed a 95% certainty that in both CJ and TJ the ICER for the mixed approach (interactive safer sex didactic safer injection intervention) was less than the GDP per capita for Mexico. The dual interactive approach met this threshold consistently in CJ, but not in TJ. In the absence of an expanded NEP in CJ, the combined-interactive formats of the MMS behavioral intervention is highly cost-effective. In contrast, in TJ where NEP expansion suggests that improved access to sterile syringes significantly reduced injection-related risks, the interactive safer-sex combined didactic safer-injection was highly cost-effective compared with the combined didactic versions of the safer-sex and safer-injection formats of the MMS, with no added benefit from the interactive safer-injection component.

LIBER8 design and methods: an integrative intervention for loss of control eating among African American and White adolescent girls.

PubMed

Mazzeo, Suzanne E; Kelly, Nichole R; Stern, Marilyn; Palmberg, Allison A; Belgrave, Faye Z; Tanofsky-Kraff, Marian; Latzer, Yael; Bulik, Cynthia M

2013-01-01

Loss of control (LOC) eating affects a significant number of adolescents of all racial and ethnic backgrounds and is associated with numerous psychosocial problems, including depression, anxiety, low self-esteem, body dissatisfaction, and weight concerns. However, empirically validated, culturally sensitive treatments for adolescents with these disordered eating behaviors are not available. This pilot project involved designing a developmentally and culturally appropriate treatment for LOC eating for adolescent girls. We intend to conduct multiple focus groups with adolescent girls who engage in LOC eating, and their primary caregivers. Data from these groups will inform the subsequent creation of a manualized treatment protocol. We will then evaluate the efficacy of this intervention (LIBER8-Linking Individuals Being Emotionally Real) to reduce LOC eating. This intervention will integrate components of dialectical behavior therapy, such as mindfulness and distress tolerance skills training, and cognitive-behavioral therapy. We will also integrate text-messaging, a key adolescent communication strategy, as a means of self-monitoring. Participants meeting study criteria will be offered participation in this 12-week randomized controlled trial comparing LIBER8 to a weight management control condition (2BFit). We hypothesize that this intervention will serve to reduce LOC eating, as well as improve psychosocial functioning as evidenced by decreased depression, anxiety, eating disorder cognitions, emotional eating, impulsivity, and improved quality of life. The feasibility and acceptability of this intervention will be extensively evaluated with the explicit intent of informing a subsequent larger randomized controlled trial. Copyright © 2012 Elsevier Inc. All rights reserved.

LIBER8 Design and Methods: An Integrative Intervention for Loss of Control Eating among African American and White Adolescent Girls

PubMed Central

Mazzeo, Suzanne E.; Kelly, Nichole R.; Stern, Marilyn; Palmberg, Allison A.; Belgrave, Faye Z.; Tanofsky-Kraff, Marian; Latzer, Yael; Bulik, Cynthia M.

2013-01-01

Loss of control (LOC) eating affects a significant number of adolescents of all racial and ethnic backgrounds and is associated with numerous psychosocial problems, including depression, anxiety, low self-esteem, body dissatisfaction, and weight concerns. However, empirically validated, culturally sensitive treatments for adolescents with these disordered eating behaviors are not available. This pilot project involved designing a developmentally and culturally appropriate treatment for LOC eating for adolescent girls. We intend to conduct multiple focus groups with adolescent girls who engage in LOC eating, and their primary caregivers. Data from these groups will inform the subsequent creation of a manualized treatment protocol. We will then evaluate the efficacy of this intervention (LIBER8—Linking Individuals Being Emotionally Real) to reduce LOC eating. This intervention will integrate components of dialectical behavior therapy, such as mindfulness and distress tolerance skills training, and cognitive-behavioral therapy. We will also integrate text-messaging, a key adolescent communication strategy, as a means of self-monitoring. Participants meeting study criteria will be offered participation in this 12-week randomized controlled trial comparing LIBER8 to a weight management control condition (2BFit). We hypothesize that this intervention will serve to reduce LOC eating, as well as improve psychosocial functioning as evidenced by decreased depression, anxiety, eating disorder cognitions, emotional eating, impulsivity, and improved quality of life. The feasibility and acceptability of this intervention will be extensively evaluated with the explicit intent of informing a subsequent larger randomized controlled trial. PMID:23142669

Pain sensitivity and temperament in extremely low-birth-weight premature toddlers and preterm and full-term controls.

PubMed

Grunau, R V; Whitfield, M F; Petrie, J H

1994-09-01

High-technology medical care of extremely low-birth-weight (ELBW) infants (< 1001 g) involves repeated medical interventions which are potentially painful and may later affect reaction to pain. At 18 months corrected age (CCA), we examined parent ratings of pain sensitivity and how pain sensitivity ratings related to child temperament and parenting style in 2 groups of ELBW children (49 with a birth weight of 480-800 g and 75 with a birth weight of 801-1000 g) and 2 control groups (42 heavier preterm (1500-2499 g) and 29 full-birth-weight (FBW) children (> 2500 g). Both groups of ELBW toddlers were rated by parents as significantly lower in pain sensitivity compared with both control groups. The relationships between child temperament and pain sensitivity rating varied systematically across the groups. Temperament was strongly related to rated pain sensitivity in the FBW group, moderately related in the heavier preterm and ELBW 801-1000 g groups, and not related in the lowest birth-weight group (< 801 g). Parental style did not mediate ratings of pain sensitivity. The results suggest that parents perceive differences in pain behavior of ELBW toddlers compared with heavier preterm and FBW toddlers, especially for those less than 801 g. Longitudinal research into the development of pain behavior for infants who experience lengthy hospitalization is warranted.

Origins and outlook of interoceptive exposure.

PubMed

Boettcher, Hannah; Brake, C Alex; Barlow, David H

2016-12-01

Interoceptive exposure (IE) is a behavioral intervention that reduces anxiety sensitivity and distress associated with somatic sensations. In this discussion, we describe the history, current applications and additional clinical potential of IE. We review the origins of IE and its historical application to panic disorder, as well as the accumulating evidence for transdiagnostic application to other disorders including post-traumatic stress disorder, social anxiety disorder, specific phobias and physical disorders. Then, we discuss ways in which IE could contribute to the treatment of additional disorders. IE is well-established in the treatment of panic disorder and increasingly used to target anxiety-provoking physical sensations in other disorders. Research and clinical evidence suggests that anxiety sensitivity is present across a range of disorders, and may actually be one variation on a broader phenomenon of interoceptive sensitivity, or anxiety focused on physical sensations that have been conditioned to unpleasant emotional states. Moreover, somatic symptoms are central to the experience of most emotions and may contribute to avoidant coping, a maintenance factor for disorders of emotion. IE has potential as a transdiagnostic intervention targeting interoceptive sensitivity in disorders such as depression and eating disorders. Nevertheless, IE is underutilized by clinicians in practice. Recent research in inhibitory learning and extinction suggests strategies for maximizing the effectiveness of IE. This review is not exhaustive in nature, and systematic research on transdiagnostic applications of IE remains scarce. IE is a potentially powerful yet understudied transdiagnostic intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quantifying Phishing Susceptibility for Detection and Behavior Decisions.

PubMed

Canfield, Casey Inez; Fischhoff, Baruch; Davis, Alex

2016-12-01

We use signal detection theory to measure vulnerability to phishing attacks, including variation in performance across task conditions. Phishing attacks are difficult to prevent with technology alone, as long as technology is operated by people. Those responsible for managing security risks must understand user decision making in order to create and evaluate potential solutions. Using a scenario-based online task, we performed two experiments comparing performance on two tasks: detection, deciding whether an e-mail is phishing, and behavior, deciding what to do with an e-mail. In Experiment 1, we manipulated the order of the tasks and notification of the phishing base rate. In Experiment 2, we varied which task participants performed. In both experiments, despite exhibiting cautious behavior, participants' limited detection ability left them vulnerable to phishing attacks. Greater sensitivity was positively correlated with confidence. Greater willingness to treat e-mails as legitimate was negatively correlated with perceived consequences from their actions and positively correlated with confidence. These patterns were robust across experimental conditions. Phishing-related decisions are sensitive to individuals' detection ability, response bias, confidence, and perception of consequences. Performance differs when people evaluate messages or respond to them but not when their task varies in other ways. Based on these results, potential interventions include providing users with feedback on their abilities and information about the consequences of phishing, perhaps targeting those with the worst performance. Signal detection methods offer system operators quantitative assessments of the impacts of interventions and their residual vulnerability. © 2016, Human Factors and Ergonomics Society.

An intervention fidelity framework for technology-based behavioral interventions.

PubMed

Devito Dabbs, Annette; Song, Mi-Kyung; Hawkins, Robert; Aubrecht, Jill; Kovach, Karen; Terhorst, Lauren; Connolly, Mary; McNulty, Mary; Callan, Judith

2011-01-01

Despite the proliferation of health technologies, descriptions of the unique considerations and practical guidance for evaluating the intervention fidelity of technology-based behavioral interventions are lacking. The aims of this study were to (a) discuss how technology-based behavioral interventions challenge conventions about how intervention fidelity is conceptualized and evaluated, (b) propose an intervention fidelity framework that may be more appropriate for technology-based behavioral interventions, and (c) present a plan for operationalizing each concept in the framework using the intervention fidelity monitoring plan for Pocket PATH (Personal Assistant for Tracking Health), a mobile health technology designed to promote self-care behaviors after lung transplantation, as an exemplar. The literature related to intervention fidelity and technology acceptance was used to identify the issues that are unique to the fidelity of technology-based behavioral interventions and thus important to include in a proposed intervention fidelity framework. An intervention fidelity monitoring plan for technology-based behavioral interventions was developed as an example. The intervention fidelity monitoring plan was deemed feasible and practical to implement and showed utility in operationalizing the concepts such as assessing interventionists' delivery and participants' acceptance of the technology-based behavioral intervention. The framework has the potential to guide the development of implementation fidelity monitoring tools for other technology-based behavioral interventions. Further application and testing of this framework will allow for a better understanding of the role that technology acceptance plays in the adoption and enactment of the behaviors that technology-based behavioral interventions are intended to promote.

Variation in the oxytocin receptor gene moderates the protective effects of a family-based prevention program on telomere length.

PubMed

Smearman, Erica L; Yu, Tianyi; Brody, Gene H

2016-02-01

Parent-child relationships with high conflict and low warmth and support are associated with later adverse behavioral and physiological child outcomes. These outcomes include shorter telomere lengths, the repetitive sequences at the ends of chromosomes that have been utilized as a biomarker for chronic stress. Our research group furthered this by exploring telomere length outcomes following a family-based prevention program and identified reduced telomere shortening 5 years post intervention among those originally exposed to nonsupportive parenting and randomized to the intervention condition. However, not all individuals respond equally, and a growing literature suggests genetic sensitivity to one's environment, with variations in the oxytocin receptor gene (OXTR) potentially influencing this sensitivity. We utilized data from African American youths (mean age 17) randomized to intervention (n = 100) or control condition (n = 91) with baseline assessments of genetic status and nonsupportive parenting, and 5-year follow-up assessments of telomere length. We found a significant three-way interaction between nonsupportive parenting, intervention condition, and OXTR rs53576 genotype. OXTR GG individuals, who are suggested to be more sensitive to their social environment, exhibited significantly more variability, evidencing the shortest telomeres when exposed to nonsupportive parenting and randomized to the control condition, and similar telomere lengths to non at-risk groups when randomized to the intervention. In contrast, those with the A allele showed no statistical difference in telomere lengths across parental and intervention conditions. Subsequent analyses suggest that these findings may be mediated through chronic anger, whereby GG individuals exposed to nonsupportive parenting and randomized to the control condition had a greater increase in chronic anger by study follow-up, compared to those in the intervention, and this change associated with greater telomere shortening. These findings highlight the importance of individual differences and potential role of genetic status in moderating the relationship between environmental contexts and biological outcomes.

Effects of a behavioral intervention that emphasizes spices and herbs on adherence to recommended sodium intake: results of the SPICE randomized clinical trial12

PubMed Central

Anderson, Cheryl AM; Cobb, Laura K; Miller, Edgar R; Woodward, Mark; Hottenstein, Annette; Chang, Alex R; Mongraw-Chaffin, Morgana; White, Karen; Charleston, Jeanne; Tanaka, Toshiko; Thomas, Letitia; Appel, Lawrence J

2015-01-01

Background: For decades, dietary sodium intake in the United States has remained high, and few studies have examined strategies for maintaining recommended intakes. Objective: We examined the effects of a behavioral intervention, which emphasized spices and herbs, on the maintenance of sodium intake at the recommended intake of 1500 mg/d in individuals to whom the US Dietary Guidelines for Americans apply. Design: We conducted a 2-phase study that included adults ≥18 y of age for whom Dietary Guidelines for Americans recommends 1500 mg Na/d. The study was conducted in Baltimore, Maryland, from 2012 to 2014. In phase 1, 55 individuals consumed a low-sodium diet for 4 wk. Participants were provided all foods, snacks, and calorie-containing drinks. In phase 2, 40 participants from phase 1 were randomly assigned to either a behavioral intervention to reduce sodium intake (n = 20) or a self-directed control group (n = 20) for 20 wk. The primary study outcome was the change in mean 24-h urinary sodium excretion during phase 2. Linear regression analyses were used to determine intervention effects on urinary sodium excretion. Results: Participant characteristics were as follows: women: 65%; African American: 88%; hypertension: 63%; diabetes: 18%; mean age: 61 y; and mean body mass index (in kg/m2): 30. At the end of phase 2, mean 24-h sodium excretion was lower in the behavioral intervention than in the self-directed group (mean difference: −956.8 mg/d; 95% CI: −1538.7, −374.9 mg/d) after sodium intake at screening was controlled for (P = 0.002). These findings persisted in sensitivity analyses that excluded potentially incomplete urine collections [Mage’s equation mean difference: −1090 mg/d (P = 0.001); Joosens’ equation mean difference: −796 mg/d (P = 0.04)]. Conclusions: A multifactorial behavioral intervention emphasizing spices and herbs significantly reduced sodium intake. Because of the ubiquity of sodium in the US food supply, multilevel strategies addressing individual behaviors and the food supply are needed to improve adherence to recommendations. This trial was registered at clinicaltrials.gov as NCT01615159. PMID:26269371

Meta-synthesis of health behavior change meta-analyses.

PubMed

Johnson, Blair T; Scott-Sheldon, Lori A J; Carey, Michael P

2010-11-01

We integrated and compared meta-analytic findings across diverse behavioral interventions to characterize how well they have achieved change in health behavior. Outcomes from 62 meta-analyses of interventions for change in health behavior were quantitatively synthesized, including 1011 primary-level investigations with 599,559 participants. Content coding suggested 6 behavioral domains: eating and physical activity, sexual behavior, addictive behaviors, stress management, female-specific screening and intervention behaviors, and behaviors involving use of health services. Behavior change interventions were efficacious (mean effect sizes = 0.08-0.45). Behavior change was more evident in more recent meta-analyses; those that sampled older interventions and literatures or sampled more published articles; those that included studies that relied on self-report, used briefer interventions, or sampled fewer, older, or female participants; and in some domains (e.g., stress management) more than others (e.g., sexual behaviors). Interventions improved health-related behaviors; however, efficacy varied as a function of participant and intervention characteristics. This meta-synthesis provides information about the efficacy of behavioral change interventions across health domains and populations; this knowledge can inform the design and development of public health interventions and future meta-analyses of these studies.

Appetitive traits from infancy to adolescence: Using behavioral and neural measures to investigate obesity risk

PubMed Central

Carnell, Susan; Benson, Leora; Pryor, Katherine; Driggin, Elissa

2013-01-01

We come into the world with enduring predispositions towards food, which interact with environmental factors to influence our eating behaviors and weight trajectories. But our fates are not sealed – by learning more about this process we can identify ways to intervene. To advance this goal this we need to be able to assess appetitive traits such as food cue responsiveness and satiety sensitivity at different developmental stages. Assessment methods might include behavioral measures (e.g. eating behavior tests, psychometric questionnaires), but also biomarkers such as brain responses to food cues measured using fMRI. Evidence from infants, children and adolescents suggests that these indices of appetite differ not only with body weight, but also with familial obesity risk as assessed by parent weight, which reflects both genetic and environmental influences, and may provide a useful predictor of obesity development. Behavioral and neural approaches have great potential to inform each other: examining eating behavior can help us identify meaningful appetitive endophenotypes whose neural bases can be probed, while increasing knowledge of the shared neurobiology underlying appetite, obesity, and related behaviors and disorders may ultimately lead to innovative generalized interventions. Another challenge will be to combine comprehensive behavioral and neural assessments of appetitive traits with measures of relevant genetic and environmental factors within long-term prospective studies. This approach may help to identify the biobehavioral precursors of obesity, and lay the foundations for targeted neurobehavioral interventions that can interrupt the pathway to excess weight. PMID:23458627

Vectorial capacity and vector control: reconsidering sensitivity to parameters for malaria elimination.

PubMed

Brady, Oliver J; Godfray, H Charles J; Tatem, Andrew J; Gething, Peter W; Cohen, Justin M; McKenzie, F Ellis; Perkins, T Alex; Reiner, Robert C; Tusting, Lucy S; Sinka, Marianne E; Moyes, Catherine L; Eckhoff, Philip A; Scott, Thomas W; Lindsay, Steven W; Hay, Simon I; Smith, David L

2016-02-01

Major gains have been made in reducing malaria transmission in many parts of the world, principally by scaling-up coverage with long-lasting insecticidal nets and indoor residual spraying. Historically, choice of vector control intervention has been largely guided by a parameter sensitivity analysis of George Macdonald's theory of vectorial capacity that suggested prioritizing methods that kill adult mosquitoes. While this advice has been highly successful for transmission suppression, there is a need to revisit these arguments as policymakers in certain areas consider which combinations of interventions are required to eliminate malaria. Using analytical solutions to updated equations for vectorial capacity we build on previous work to show that, while adult killing methods can be highly effective under many circumstances, other vector control methods are frequently required to fill effective coverage gaps. These can arise due to pre-existing or developing mosquito physiological and behavioral refractoriness but also due to additive changes in the relative importance of different vector species for transmission. Furthermore, the optimal combination of interventions will depend on the operational constraints and costs associated with reaching high coverage levels with each intervention. Reaching specific policy goals, such as elimination, in defined contexts requires increasingly non-generic advice from modelling. Our results emphasize the importance of measuring baseline epidemiology, intervention coverage, vector ecology and program operational constraints in predicting expected outcomes with different combinations of interventions. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Videotaped assessment of parenting practices: a preliminary report.

PubMed

Frankel, F

1998-04-01

Assessment of parenting skills was based upon a standardized videotape of vignettes of parents reading a magazine while their children were playing, playing with their children, or trying to get them to clean up. Parents who viewed this videotape came from 40, 2-parent families referred to an outpatient clinic for behavior problems (Behavior Problem group) or 20 nonreferred 2-parent families (Nonclinic group). They were compared on the degree to which they selected: (1) positive responses to children's prosocial behavior (praise), (2) ignoring children's inappropriate behavior (ignore), and (3) punishing children's aversive behavior (punish). The Nonclinic group was more accurate than the Behavior Problem Group and mothers were more accurate than fathers in their selection of praise to children's prosocial behavior. Nonclinic mothers were more accurate than all other combinations of Group and Parent Sex in their selection of ignore for children's inappropriate behavior. Sensitivity calculations suggested that this instrument could potentially be useful as a screening tool in clinical pediatric practice and early intervention. Implications for nursing research and practice were discussed.

Tinnitus sensitization: a neurophysiological pathway of chronic complex tinnitus.

PubMed

Zenner, Hans P

2006-01-01

A novel neuro- and psychophysiological pathway for central cognition of tinnitus, i.e. tinnitus sensitization, is presented here. As a complement to the neurophysiological pathway for the conditioned reflex according to Jastreboff, which permits therapeutic procedures to bring about an extinction of the tinnitus (e.g. by the acoustic tinnitus retraining therapy), sensitization can be treated with procedures that act at the cognitive level. Since on the one hand therapeutic extinction procedures (e.g. the therapeutic application of sound) are still to be proven effective in controlled studies, while on the other cognitive interventions such as cognitive behavioral therapies have in fact acquired evidence level IIa in prospective studies, it is indeed appropriate to discuss whether the earlier neurophysiological model of a conditioned reflex is sufficient on its own, and whether in fact it needs to be complemented with the sensitization model.

A Systematic Review of Behavioral Interventions to Reduce Condomless Sex and Increase HIV Testing for Latino MSM.

PubMed

Pérez, Ashley; Santamaria, E Karina; Operario, Don

2017-12-15

Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV, and there have been calls to improve availability of culturally sensitive HIV prevention programs for this population. This article provides a systematic review of intervention programs to reduce condomless sex and/or increase HIV testing among Latino MSM. We searched four electronic databases using a systematic review protocol, screened 1777 unique records, and identified ten interventions analyzing data from 2871 Latino MSM. Four studies reported reductions in condomless anal intercourse, and one reported reductions in number of sexual partners. All studies incorporated surface structure cultural features such as bilingual study recruitment, but the incorporation of deep structure cultural features, such as machismo and sexual silence, was lacking. There is a need for rigorously designed interventions that incorporate deep structure cultural features in order to reduce HIV among Latino MSM.

Risk Reduction for HIV-Positive African American and Latino Men with Histories of Childhood Sexual Abuse

PubMed Central

Wyatt, Gail E.; Rivkin, Inna; Ramamurthi, Hema Codathi; Li, Xiaomin; Liu, Honghu

2014-01-01

While the HIV epidemic has disproportionately affected African American and Latino men who have sex with men (MSM), few HIV prevention interventions have focused on African American and Latino men who have sex with both men and women (MSMW). Even fewer interventions target HIV-positive African American and Latino MSM and MSMW with histories of childhood sexual abuse (CSA), a population that may be vulnerable to high-risk sexual behaviors, having multiple sexual partners, and depression. The Men’s Health Project, a small randomized clinical trial, compared the effects of two 6-session interventions, the Sexual Health Intervention for Men (S-HIM), guided by social learning theory and aimed at decreasing high-risk sexual behaviors, number of sexual partners, and depressive symptoms, and a standard health promotion control (SHP).A community sample of 137 HIV-positive gay and non-gay identifying African American and Latino MSM and MSMW with histories of CSA was recruited. Results were based on an “intent to treat” analyses of baseline to post, 3 and 6 month follow-ups. The sample as a whole reported reductions in sexual risk behaviors and number of sexual partners from baseline to post-test, and from the 3 to 6 month follow-ups, although the decrease in sexual risk behavior from baseline to post-test was significant only for S-HIM participants. No significant differences between conditions were reported for depressive symptoms, but the total sample reported a significant decrease at 6 months. These findings highlight the importance of addressing sexual decision-making and psychological adjustment for ethnic men, while being sensitive to CSA histories and sexual minority status, and suggest the need to develop additional strategies to heighten HIV risk reduction over time. PMID:18506611

Assessing fears of preschool children with nighttime fears by a parent version of the fear survey schedule for preschool children.

PubMed

Kushnir, Jonathan; Gothelf, Doron; Sadeh, Avi

2015-01-01

Although excessive fears are common in preschool children, validated assessment tools for this age are lacking. Our aim was to modify and provide preliminary evidence of the utility of a preschoolers' fear screening tool, a parent-reported Fear Survey Schedule for Preschool Children (FSS-PC). 109 Israeli preschool children (aged 4-6 years) with chronic night time fears (NF) and 30 healthy children (controls) participated. The FSS-PC analysis included: 1) internal reliability, 2) correlations between FSS-PC scores and Child Behavior Checklist (CBCL) measures, 3) differences between NF and a comparison sample of FSS-PC scores, and 4) FSS-PC sensitivity in detecting change in NF following an intervention for NF. There were low-to-medium positive correlations between the FSS-PC scores and several internalizing scales of the CBCL measures. FSS-PC scores in the NF group were significantly higher than the control children's score. FSS-PC scores had adequate internal reliability and were also sensitive for detecting significant changes in fear levels following behavioral interventions. Unique cultural and environmental circumstances and specific study group. This new version of the FSS-PC may provide clinicians with a novel and useful screening tool for early assessment of fear- and anxiety-related phenomena of preschool children.

The role of tobacco outlet density in a smoking cessation intervention for urban youth.

PubMed

Mennis, Jeremy; Mason, Michael; Way, Thomas; Zaharakis, Nikola

2016-03-01

This study investigates the role of tobacco outlet density in a randomized controlled trial of a text messaging-based smoking cessation intervention conducted among a sample of 187 primarily African American youth in a midsize U.S. city. A moderated mediation model was used to test whether the indirect effect of residential tobacco outlet density on future smoking was mediated by the intention to smoke, and whether this indirect effect differed between adolescents who received the intervention and those who did not. Results indicated that tobacco outlet density is associated with intention to smoke, which predicts future smoking, and that the indirect effect of tobacco outlet density on future smoking is moderated by the intervention. Tobacco outlet density and the intervention can be viewed as competing forces on future smoking behavior, where higher tobacco outlet density acts to mitigate the sensitivity of an adolescent to the intervention's intended effect. Smoking cessation interventions applied to youth should consider tobacco outlet density as a contextual condition that can influence treatment outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study

PubMed Central

2014-01-01

Background While there is strong support for the benefits of working in multi-professional teams in health care, the implementation of multi-professional teamwork is reported to be complex and challenging. Implementation strategies combining multiple behavior change interventions are recommended, but the understanding of how and why the behavior change interventions influence staff behavior is limited. There is a lack of studies focusing on the functions of different behavior change interventions and the mechanisms driving behavior change. In this study, applied behavior analysis is used to analyze the function and impact of different behavior change interventions when implementing multi-professional teamwork. Methods A comparative case study design was applied. Two sections of an emergency department implemented multi-professional teamwork involving changes in work processes, aimed at increasing inter-professional collaboration. Behavior change interventions and staff behavior change were studied using observations, interviews and document analysis. Using a hybrid thematic analysis, the behavior change interventions were categorized according to the DCOM® model. The functions of the behavior change interventions were then analyzed using applied behavior analysis. Results The two sections used different behavior change interventions, resulting in a large difference in the degree of staff behavior change. The successful section enabled staff performance of teamwork behaviors with a strategy based on ongoing problem-solving and frequent clarification of directions. Managerial feedback initially played an important role in motivating teamwork behaviors. Gradually, as staff started to experience positive outcomes of the intervention, motivation for teamwork behaviors was replaced by positive task-generated feedback. Conclusions The functional perspective of applied behavior analysis offers insight into the behavioral mechanisms that describe how and why behavior change interventions influence staff behavior. The analysis demonstrates how enabling behavior change interventions, managerial feedback and task-related feedback interact in their influence on behavior and have complementary functions during different stages of implementation. PMID:24885212

The Design of a Multi-component Intervention to Promote Screening Mammography in an American Indian Community: The Native Women's Health Project

PubMed Central

Tolma, Eleni L.; Engelman, Kimberly; Stoner, Julie A.; Thomas, Cara; Joseph, Stephanie; Li, Ji; Blackwater, Cecily; Henderson, J. Neil; Carson, L. D.; Neely, Norma; Edwards, Tewanna

2016-01-01

Background Breast cancer is an important public health issue among American Indian/Alaska Native (AI/AN) women in the US. This article describes the design and implementation of a culturally sensitive intervention to promote breast health among AI/AN women through a hybrid model that incorporates clinical and community-based approaches. This is one of the first studies using this model addressing breast cancer disparities among AI/AN populations in the US. Methods The Theory of Planned Behavior was used as the guiding framework of the intervention and Community Based Participatory Research was the primary vehicle for the intervention planning and implementation. Three preliminary studies took place that aimed to identify qualitatively and quantitatively what deterred or encouraged AI women to get past or future mammograms. The research results were shared with community members who, through a prioritization process, identified the theoretical focus of the intervention and its corresponding activities. The priority population consisted of AI women ages 40–74, with no recent mammogram, and no breast cancer history. Results The intervention centered on the promotion of social modeling and physician recommendation. The main corresponding activities included enhancing patient-physician communication about screening mammography through a structured dialogue, receipt of a breast cancer brochure, participation in an inter-generational discussion group, and a congratulatory bracelet upon receipt of a mammogram. Environmental and policy related changes also were developed. Conclusion Creating a theory-based, culturally-sensitive intervention through tribal participatory research is a challenging approach towards eliminating breast cancer disparities among hard-to-reach populations. PMID:29546205

Memory, Executive Skills, and Psychosocial Phenotype in Children with Pharmacoresponsive Epilepsy: Reactivity to Intervention.

PubMed

Schaffer, Yael; Ben Zeev, Bruria; Cohen, Roni; Shufer, Avinoam; Geva, Ronny

2017-01-01

Recent studies on pharmacoresponsive epilepsies demonstrate specific memory, executive functions (EF), and psychosocial deficits in this group. These deficits are often undertreated, and little is known about the neuropsychological factors that may support moderation of the deficits through intervention. The aim of this study was to explore the effects of a structured cognitive behavioral group intervention on both memory and emotional domains and to evaluate the factors influencing its efficacy. The feasibility study implemented a newly designed intervention for children with pharmacoresponsive epilepsies ( N  = 33, aged 9-14 years, 51% girls), hypothesizing that memory and psychosocial symptoms in children with pharmacoresponsive epilepsies are sensitive to intervention using structured memory and psychosocial modules in a weekly group session setting. Comparable memory and psychosocial assessments were used to evaluate performance at baseline and post-intervention. Results were compared to age- and education-matched healthy controls ( N  = 27, aged 9-14 years). Pre-post-intervention comparisons show improvements in STM ( p  < 0.01, η 2 = 0.358), optimism ( p  < 0.05, η 2 = 0.245), and self-efficacy ( p  < 0.05, η 2 = 0.164). Unique negative relations between memory deficits and psychosocial phenotype were seen in epilepsy patients and not in controls in response to the intervention. EF moderated this intervention effect ( p  < 0.05, η 2 = 0.252), whereas psychosocial status and pharmacological profile did not. Cognitive behavioral therapy focusing on memory and psychosocial perceptions for children with pharmacoresponsive epilepsies seems promising, with greater improvement in memory and psychosocial functioning in children with more affected EF.

A School-Based, Peer-Led, Social Marketing Intervention To Engage Spanish Adolescents in a Healthy Lifestyle ("We Are Cool"-Som la Pera Study): A Parallel-Cluster Randomized Controlled Study.

PubMed

Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Moriña, David; Papell-Garcia, Ignasi; Prades-Tena, Jordi; Kettner-Høeberg, Helle; Puiggròs, Francesc; Arola, Lluís; Davies, Amy; Giralt, Montse; Solà, Rosa

2017-08-01

Encouraging adolescents to adopt healthy lifestyles can be challenging. The aim of the "Som la Pera" study was to engage adolescents by applying new strategies to increase both their fruit and vegetable consumption and their physical activity (PA) while reducing their sedentary behavior. In disadvantaged neighborhoods of Reus (Spain), two high schools were randomly assigned to the intervention (n = 170 adolescents 13- to 16-year-olds) and two were assigned to the control group (n = 223 adolescents 13- to 16-year-olds). The intervention, which lasted 12 months and spanned 2 academic years (2013-2015), used social marketing (SM) to improve healthy choices. The peer-led strategy involved 5 adolescents who designed and implemented 10 activities as challenges for their 165 school-aged peers. The control group received no intervention. To assess self-reported lifestyles in both groups, the Health Behavior in School-Aged Children Survey was used at baseline and end of study. After 12 months, intervention adolescents showed an increase of 28.9% in ≥1 fruit/day (p < 0.01) and of 18.5% in ≥6 hours/week of PA (p < 0.01) compared with controls. Additionally, intervention group males had an increase of 28.8% in ≥1 vegetable/day (p < 0.01) and of 15.6% in ≤2 hours/day of sedentary activity (p = 0.01) compared with controls. A school-based, peer-led, SM intervention developed by adolescents attending high schools in low-income neighborhoods effectively improved the healthy choices of their school-aged peers, leading to increased fruit consumption and PA in adolescents of both genders. Furthermore, adolescent males were more sensitive to improvements in healthy choices, showing increased vegetable consumption and decreased sedentary behavior.

Evaluating the effectiveness of behavior change techniques in health-related behavior: a scoping review of methods used.

PubMed

Michie, Susan; West, Robert; Sheals, Kate; Godinho, Cristina A

2018-03-01

Behavior change interventions typically contain multiple potentially active components: behavior change techniques (BCTs). Identifying which specific BCTs or BCT combinations have the potential to be effective for a given behavior in a given context presents a major challenge. The aim of this study was to review the methods that have been used to identify effective BCTs for given behaviors in given contexts and evaluate their strengths and limitations. A scoping review was conducted of studies that had sought to identify effective BCTs. Articles referring to "behavio(u)r change technique(s)" in the abstract/text were located, and ones that involved identification of effective BCTs were selected. The methods reported were coded. The methods were analyzed in general terms using "PASS" criteria: Practicability (facility to apply the method appropriately), Applicability (facility to generalize from findings to contexts and populations of interest), Sensitivity (facility to identify effective BCTs), and Specificity (facility to rule out ineffective BCTs). A sample of 10% of the studies reviewed was then evaluated using these criteria to assess how far the strengths and limitations identified in principle were borne out in practice. One hundred and thirty-five studies were identified. The methods used in those studies were experimental manipulation of BCTs, observational studies comparing outcomes in the presence or absence of BCTs, meta-analyses of BCT comparisons, meta-regressions evaluating effect sizes with and without specific BCTs, reviews of BCTs found in effective interventions, and meta-classification and regression trees. The limitations of each method meant that only weak conclusions could be drawn regarding the effectiveness of specific BCTs or BCT combinations. Methods for identifying effective BCTs linked to target behavior and context all have important inherent limitations. A strategy needs to be developed that can systematically combine the strengths of the different methods and that can link these constructs in an ontology of behavior change interventions.

Treadmill Intervention Attenuates the Cafeteria Diet-Induced Impairment of Stress-Coping Strategies in Young Adult Female Rats

PubMed Central

Cigarroa, Igor; Lalanza, Jaume F.; Caimari, Antoni; del Bas, Josep M.; Capdevila, Lluís; Arola, Lluís; Escorihuela, Rosa M.

2016-01-01

The current prevalence of diet-induced overweight and obesity in adolescents and adults is continuously growing. Although the detrimental biochemical and metabolic consequences of obesity are widely studied, its impact on stress-coping behavior and its interaction with specific exercise doses (in terms of intensity, duration and frequency) need further investigation. To this aim, we fed adolescent rats either an obesogenic diet (cafeteria diet, CAF) or standard chow (ST). Each group was subdivided into four subgroups according to the type of treadmill intervention as follows: a sedentary group receiving no manipulation; a control group exposed to a stationary treadmill; a low-intensity treadmill group trained at 12 m/min; and a higher intensity treadmill group trained at 17 m/min. Both the diet and treadmill interventions started at weaning and lasted for 8 weeks. Subjects were tested for anxiety-like behavior in the open field test and for coping strategies in the two-way active avoidance paradigm at week 7 and were sacrificed at week 8 for biometric and metabolic characterization. CAF feeding increased the weight gain, relative retroperitoneal white adipose tissue (RWAT %), and plasma levels of glucose, insulin, triglycerides and leptin and decreased the insulin sensitivity. Treadmill intervention partially reversed the RWAT% and triglyceride alterations; at higher intensity, it decreased the leptin levels of CAF-fed animals. CAF feeding decreased the motor activity and impaired the performance in a two-way active avoidance assessment. Treadmill intervention reduced defecation in the shuttle box, suggesting diminished anxiety. CAF feeding combined with treadmill training at 17 m/min increased the time spent in the center of the open field and more importantly, partially reversed the two-way active avoidance deficit. In conclusion, this study demonstrates that at doses that decreased anxiety-like behavior, treadmill exercise partially improved the coping strategy in terms of active avoidance behavior in the CAF-fed animals. This effect was not observed at lower doses of treadmill training. PMID:27099927

Treadmill Intervention Attenuates the Cafeteria Diet-Induced Impairment of Stress-Coping Strategies in Young Adult Female Rats.

PubMed

Cigarroa, Igor; Lalanza, Jaume F; Caimari, Antoni; del Bas, Josep M; Capdevila, Lluís; Arola, Lluís; Escorihuela, Rosa M

2016-01-01

The current prevalence of diet-induced overweight and obesity in adolescents and adults is continuously growing. Although the detrimental biochemical and metabolic consequences of obesity are widely studied, its impact on stress-coping behavior and its interaction with specific exercise doses (in terms of intensity, duration and frequency) need further investigation. To this aim, we fed adolescent rats either an obesogenic diet (cafeteria diet, CAF) or standard chow (ST). Each group was subdivided into four subgroups according to the type of treadmill intervention as follows: a sedentary group receiving no manipulation; a control group exposed to a stationary treadmill; a low-intensity treadmill group trained at 12 m/min; and a higher intensity treadmill group trained at 17 m/min. Both the diet and treadmill interventions started at weaning and lasted for 8 weeks. Subjects were tested for anxiety-like behavior in the open field test and for coping strategies in the two-way active avoidance paradigm at week 7 and were sacrificed at week 8 for biometric and metabolic characterization. CAF feeding increased the weight gain, relative retroperitoneal white adipose tissue (RWAT %), and plasma levels of glucose, insulin, triglycerides and leptin and decreased the insulin sensitivity. Treadmill intervention partially reversed the RWAT% and triglyceride alterations; at higher intensity, it decreased the leptin levels of CAF-fed animals. CAF feeding decreased the motor activity and impaired the performance in a two-way active avoidance assessment. Treadmill intervention reduced defecation in the shuttle box, suggesting diminished anxiety. CAF feeding combined with treadmill training at 17 m/min increased the time spent in the center of the open field and more importantly, partially reversed the two-way active avoidance deficit. In conclusion, this study demonstrates that at doses that decreased anxiety-like behavior, treadmill exercise partially improved the coping strategy in terms of active avoidance behavior in the CAF-fed animals. This effect was not observed at lower doses of treadmill training.

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

PubMed

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

2011-01-01

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

Stroke Health and Risk Education (SHARE): Design, methods, and theoretical basis

PubMed Central

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

2012-01-01

Background Stroke is a disease with tremendous individual, family, and societal impact across all race/ethnic groups. Mexican Americans, the largest subgroup of Hispanic Americans, are at even higher risk of stroke than European Americans. Aim To test the effectiveness of a culturally sensitive, church-based, multicomponent, motivational enhancement intervention for Mexican Americans and European Americans in reducing stroke risk factors. Methods Participants enroll in family or friendship pairs, from the same Catholic church in the Corpus Christi Texas area, and are encouraged to change diet and physical activity behaviors and provide support for behavior change to their partners. Churches are randomized to either the intervention or control group. Goal enrollment for each of the 10 participating churches is 40 participant pairs. The intervention consists of self-help materials (including a motivational short film, cookbook/healthy eating guide, physical activity guide with pedometer, and photonovella), five motivational interviewing calls, two tailored newsletters, parish health promotion activities and environmental changes, and a peer support workshop where participants learn to provide autonomy supportive counseling to their partner. SHARE’s three primary outcomes are self-reported sodium intake, fruit and vegetable intake, and level of physical activity. Participants complete questionnaires and have measurements at baseline, six months, and twelve months. Persistence testing is performed at 18 months in the intervention group. PMID:22421317

Maternal Responsiveness and Sensitivity Re-Considered: Some Is More

PubMed Central

Bornstein, Marc H.; Manian, Nanmathi

2013-01-01

Is it always or necessarily the case that common and important parenting practices are better insofar as they occur more often, or worse because they occur less often? Perhaps, less is more, or some is more. To address this question, we studied mothers’ microcoded contingent responsiveness to their infants (M = 5.4 months, SD = 0.2) in relation to independent global judgments of the same mothers’ parenting sensitivity. In a community sample of 335 European American dyads, videorecorded infant and maternal behaviors were timed microanalytically throughout an extended home observation; separately and independently, global maternal sensitivity was rated macroanalytically. Sequential analysis and spline regression showed that, as maternal contingent responsiveness increased, judged maternal sensitivity increased to significance on the contingency continuum, after which mothers who were even more contingent were judged less sensitive. Just significant levels of maternal responsiveness are deemed optimally sensitive. Implications of these findings for typical and atypical parenting, child development, and intervention science are discussed. PMID:24229542

The cost of a primary care-based childhood obesity prevention intervention

PubMed Central

2014-01-01

Background United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. Methods High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children’s nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n = 192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. Results The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95% CI [$64,522, $66,842]) and $12,192 (95% CI [$11,393, $13,174]). The mean costs for the intervention and usual care groups were $259 (95% CI [$255, $264]) and $63 (95% CI [$59, $69]) per child, respectively, for a incremental difference of $196 (95% CI [$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. Conclusions High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions. Trial registration ClinicalTrials.gov Identifier: NCT00377767. PMID:24472122

The cost of a primary care-based childhood obesity prevention intervention.

PubMed

Wright, Davene R; Taveras, Elsie M; Gillman, Matthew W; Horan, Christine M; Hohman, Katherine H; Gortmaker, Steven L; Prosser, Lisa A

2014-01-29

United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children's nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n =192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95% CI [$64,522, $66,842]) and $12,192 (95% CI [$11,393, $13,174]). The mean costs for the intervention and usual care groups were $259 (95% CI [$255, $264]) and $63 (95% CI [$59, $69]) per child, respectively, for a incremental difference of $196 (95% CI [$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions.

Maternal Childhood Sexual Trauma, Child Directed Aggression, Parenting Behavior, and the Moderating Role of Child Sex

PubMed Central

Zvara, B.J.; Mills-Koonce, R.; Cox, M.

2016-01-01

Using propensity-matched controls, the present study examines the associations between maternal report of child-directed aggression and observed parenting behavior across early childhood for women with and without childhood sexual trauma histories. The moderating role of child sex was also examined. The sample (n=204) is from a longitudinal study of rural poverty exploring the ways in which child, family, and contextual factors shape development over time. After controlling for numerous factors including child and primary caregiver covariates, findings reveal that childhood sexual trauma is related to sensitive parenting behavior and child-directed aggression. Findings further revealed that child sex moderates the relation between sexual trauma history and maternal behavior towards children. Implications for interventions for mothers with childhood sexual trauma histories and directions for future study are proposed. PMID:28450762

Treatment Integrity of Interventions with Children in the "Journal of Positive Behavior Interventions" from 1999 to 2009

ERIC Educational Resources Information Center

Sanetti, Lisa M. Hagermoser; Dobey, Lisa M.; Gritter, Katie L.

2012-01-01

For more than 10 years, the "Journal of Positive Behavior Interventions" has published, among other types of articles, behavioral intervention outcome studies related to positive behavior support. Operationally defining interventions is important to facilitating replication studies and adoption of intervention in applied settings. Furthermore,…

Mediation and Moderation of Divorce Effects on Children’s Behavior Problems

PubMed Central

Weaver, Jennifer; Schofield, Thomas

2016-01-01

Using data from the NICHD Study of Early Child Care and Youth Development, we examined children’s internalizing and externalizing behavior problems from age 5 to age 15 in relation to whether they had experienced a parental divorce. Children from divorced families had more behavior problems compared with a propensity score-matched sample of children from intact families according to both teachers and mothers. They exhibited more internalizing and externalizing problems at the first assessment after the parents’ separation and at the last available assessment (age 11 for teacher reports, or age 15 for mother reports). Divorce also predicted both short-term and long-term rank-order increases in behavior problems. Associations between divorce and child behavior problems were moderated by family income (assessed before the divorce) such that children from families with higher incomes prior to the separation had fewer internalizing problems than children from families with lower incomes prior to the separation. Higher levels of pre-divorce maternal sensitivity and child IQ also functioned as protective factors for children of divorce. Mediation analyses showed that children were more likely to exhibit behavior problems after the divorce if their post-divorce home environment was less supportive and stimulating, their mother was less sensitive and more depressed, and their household income was lower. We discuss avenues for intervention, particularly efforts to improve the quality of home environments in divorced families. PMID:25419913

Economic Analysis of a Multi-Site Prevention Program: Assessment of Program Costs and Characterizing Site-level Variability

PubMed Central

Corso, Phaedra S.; Ingels, Justin B.; Kogan, Steven M.; Foster, E. Michael; Chen, Yi-Fu; Brody, Gene H.

2013-01-01

Programmatic cost analyses of preventive interventions commonly have a number of methodological difficulties. To determine the mean total costs and properly characterize variability, one often has to deal with small sample sizes, skewed distributions, and especially missing data. Standard approaches for dealing with missing data such as multiple imputation may suffer from a small sample size, a lack of appropriate covariates, or too few details around the method used to handle the missing data. In this study, we estimate total programmatic costs for a prevention trial evaluating the Strong African American Families-Teen program. This intervention focuses on the prevention of substance abuse and risky sexual behavior. To account for missing data in the assessment of programmatic costs we compare multiple imputation to probabilistic sensitivity analysis. The latter approach uses collected cost data to create a distribution around each input parameter. We found that with the multiple imputation approach, the mean (95% confidence interval) incremental difference was $2149 ($397, $3901). With the probabilistic sensitivity analysis approach, the incremental difference was $2583 ($778, $4346). Although the true cost of the program is unknown, probabilistic sensitivity analysis may be a more viable alternative for capturing variability in estimates of programmatic costs when dealing with missing data, particularly with small sample sizes and the lack of strong predictor variables. Further, the larger standard errors produced by the probabilistic sensitivity analysis method may signal its ability to capture more of the variability in the data, thus better informing policymakers on the potentially true cost of the intervention. PMID:23299559

Economic analysis of a multi-site prevention program: assessment of program costs and characterizing site-level variability.

PubMed

Corso, Phaedra S; Ingels, Justin B; Kogan, Steven M; Foster, E Michael; Chen, Yi-Fu; Brody, Gene H

2013-10-01

Programmatic cost analyses of preventive interventions commonly have a number of methodological difficulties. To determine the mean total costs and properly characterize variability, one often has to deal with small sample sizes, skewed distributions, and especially missing data. Standard approaches for dealing with missing data such as multiple imputation may suffer from a small sample size, a lack of appropriate covariates, or too few details around the method used to handle the missing data. In this study, we estimate total programmatic costs for a prevention trial evaluating the Strong African American Families-Teen program. This intervention focuses on the prevention of substance abuse and risky sexual behavior. To account for missing data in the assessment of programmatic costs we compare multiple imputation to probabilistic sensitivity analysis. The latter approach uses collected cost data to create a distribution around each input parameter. We found that with the multiple imputation approach, the mean (95 % confidence interval) incremental difference was $2,149 ($397, $3,901). With the probabilistic sensitivity analysis approach, the incremental difference was $2,583 ($778, $4,346). Although the true cost of the program is unknown, probabilistic sensitivity analysis may be a more viable alternative for capturing variability in estimates of programmatic costs when dealing with missing data, particularly with small sample sizes and the lack of strong predictor variables. Further, the larger standard errors produced by the probabilistic sensitivity analysis method may signal its ability to capture more of the variability in the data, thus better informing policymakers on the potentially true cost of the intervention.

The Efficacy of Vigorous-Intensity Exercise as an Aid to Smoking Cessation in Adults With High Anxiety Sensitivity: A Randomized Controlled Trial.

PubMed

Smits, Jasper A J; Zvolensky, Michael J; Davis, Michelle L; Rosenfield, David; Marcus, Bess H; Church, Timothy S; Powers, Mark B; Frierson, Georita M; Otto, Michael W; Hopkins, Lindsey B; Brown, Richard A; Baird, Scarlett O

2016-04-01

High anxiety sensitivity predicts poor smoking cessation outcomes. Aerobic exercise reduces anxiety sensitivity and aspects of the risk conferred by anxiety sensitivity. In the current study, we examined whether exercise can aid smoking cessation in adults with high anxiety sensitivity. Participants were sedentary and low-activity adult daily smokers (n = 136) with elevated prescreen anxiety sensitivity. Participants received 15 weeks of standard smoking cessation treatment (ST; cognitive behavioral therapy plus nicotine replacement therapy). In addition, participants were simultaneously randomized to 15 weeks of either an exercise intervention (ST + EX; n = 72) or a wellness education control condition (ST + CTRL; n = 64). Self-reported smoking abstinence was assessed weekly during the intervention, at the end of treatment (10 weeks after the target quit date), and at 4 and 6 months after the target quit date. Abstinence was verified by expired carbon monoxide readings and saliva cotinine. Results indicated that point prevalence abstinence (PPA) and prolonged abstinence (PA) rates were significantly higher for ST + EX than for ST + CTRL at each of the major end points among persons with high anxiety sensitivity (PPA: b = -0.91, standard error [SE] = 0.393, t(1171) = -2.33, p = .020; PA: b = -0.98, SE = 0.346, t(132) = -2.84, p = .005), but not among those with low anxiety sensitivity (PPA: b = -0.23, SE = 0.218, t(1171) = -1.06, p = .29; PA: b = -0.31, SE = 0.306, t(132) = -1.01, p = .32). The present results suggest that exercise facilitates the odds of quit success for smokers with high levels of anxiety sensitivity and therefore may be a useful therapeutic tactic for this high-risk segment of the smoking population. ClinicalTrials.gov, NCT01065506.

The Efficacy of Vigorous-Intensity Exercise as an Aid to Smoking Cessation in Adults with High Anxiety Sensitivity: A Randomized Controlled Trial

PubMed Central

Smits, Jasper A. J.; Zvolensky, Michael J.; Davis, Michelle L.; Rosenfield, David; Marcus, Bess H.; Church, Timothy S.; Powers, Mark B.; Frierson, Georita M.; Otto, Michael W.; Hopkins, Lindsey B.; Brown, Richard A.; Baird, Scarlett O.

2015-01-01

Objective High anxiety sensitivity predicts poor smoking cessation outcomes. Aerobic exercise reduces anxiety sensitivity and aspects of the risk conferred by anxiety sensitivity. In the current study, we examined whether exercise can aid smoking cessation in adults with high anxiety sensitivity. Method Participants were sedentary and low activity adult daily smokers (N = 136) with elevated prescreen anxiety sensitivity. Participants received 15 weeks of standard smoking cessation treatment (ST: cognitive behavioral therapy plus nicotine replacement therapy). Additionally, participants were simultaneously randomized to 15 weeks of either an exercise intervention (ST+EX; n = 72) or a wellness education control condition (ST+CTRL; n = 64). Self-reported smoking abstinence was assessed weekly during the intervention, at the end of treatment (10 weeks following the target quit date), and at 4 and 6 months following the target quit date. Abstinence was verified by expired carbon monoxide readings and saliva cotinine. Results Results indicated that point prevalence abstinence (PPA) and prolonged abstinence (PA) rates were significantly higher for ST+EX than for ST+CTRL at each of the major end points among persons with high anxiety sensitivity (PPA: b=−.91, SE=.393, t(1171)=−2.33, p=.020; PA: b=−.98, SE=.346, t(132)=−2.84, p=.005), but not among those with low anxiety sensitivity (PPA: b=−.23, SE=.218, t(1171)=−1.06, p=..29; PA: b=−.31, SE=.306, t(132)=−1.01, p=.32) Conclusions The present results suggest that exercise faciliates the odds of quit success for smokers with high levels of anxiety sensitivity, and therefore, may be a useful therapeutic tactic for this high-risk segment of the smoking population. PMID:26513517

Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities.

PubMed Central

Burgos, Jose L.; Patterson, Thomas L.; Graff-Zivin, Joshua S.; Kahn, James G.; Rangel, M. Gudelia; Lozada, M. Remedios; Staines, Hugo; Strathdee, Steffanie A.

2016-01-01

Background We evaluated the cost-effectiveness of combined single session brief behavioral intervention, either didactic or interactive (Mujer Mas Segura, MMS) to promote safer-sex and safer-injection practices among female sex workers who inject drugs (FSW-IDUs) in Tijuana (TJ) and Ciudad-Juarez (CJ) Mexico. Data for this analysis was obtained from a factorial RCT in 2008–2010 coinciding with expansion of needle exchange programs (NEP) in TJ, but not in CJ. Methods A Markov model was developed to estimate the incremental cost per quality adjusted life year gained (QALY) over a lifetime time frame among a hypothetical cohort of 1,000 FSW-IDUs comparing a less intensive didactic vs. a more intensive interactive format of the MMS, separately for safer sex and safer injection combined behavioral interventions. The costs for antiretroviral therapy was not included in the model. We applied a societal perspective, a discount rate of 3% per year and currency adjusted to US$2014. A multivariate sensitivity analysis was performed. The combined and individual components of the MMS interactive behavioral intervention were compared with the didactic formats by calculating the incremental cost-effectiveness ratios (ICER), defined as incremental unit of cost per additional health benefit (e.g., HIV/STI cases averted, QALYs) compared to the next least costly strategy. Following guidelines from the World Health Organization, a combined strategy was considered highly cost-effective if the incremental cost per QALY gained fell below the gross domestic product per capita (GDP) in Mexico (equivalent to US$10,300). Findings For CJ, the mixed intervention approach of interactive safer sex/didactic safer injection had an incremental cost-effectiveness ratio (ICER) of US$4,360 ($310–$7,200) per QALY gained compared with a dually didactic strategy. Using the dually interactive strategy had an ICER of US$5,874 ($310–$7,200) compared with the mixed approach. For TJ, the combination of interactive safer sex/didactic safer injection had an ICER of US$5,921 ($104–$9,500) per QALY compared with dually didactic. Strategies using the interactive safe injection intervention were dominated due to lack of efficacy advantage. The multivariate sensitivity analysis showed a 95% certainty that in both CJ and TJ the ICER for the mixed approach (interactive safer sex didactic safer injection intervention) was less than the GDP per capita for Mexico. The dual interactive approach met this threshold consistently in CJ, but not in TJ. Interpretation In the absence of an expanded NEP in CJ, the combined-interactive formats of the MMS behavioral intervention is highly cost-effective. In contrast, in TJ where NEP expansion suggests that improved access to sterile syringes significantly reduced injection-related risks, the interactive safer-sex combined didactic safer-injection was highly cost-effective compared with the combined didactic versions of the safer-sex and safer-injection formats of the MMS, with no added benefit from the interactive safer-injection component. PMID:26890001

Behavioral medicine interventions for adult primary care settings: A review.

PubMed

Funderburk, Jennifer S; Shepardson, Robyn L; Wray, Jennifer; Acker, John; Beehler, Gregory P; Possemato, Kyle; Wray, Laura O; Maisto, Stephen A

2018-06-07

Health care organizations are embracing integrated primary care (IPC), in which mental health and behavioral health are addressed as part of routine care within primary care settings. Behavioral medicine concerns, which include health behavior change and coping with medical conditions, are common in primary care populations. Although there are evidence-based behavioral interventions that target a variety of behavioral medicine concerns, integrated behavioral health providers need interventions that are sufficiently brief (i.e., ≤6 appointments) to be compatible with IPC. We conducted a literature review of published studies examining behavioral interventions that target prevalent behavioral medicine concerns and can feasibly be employed by IPC providers in adult primary care settings. A total of 67 published articles representing 63 original studies met eligibility criteria. We extracted data on the behavioral interventions employed, results comparing the active intervention to a comparison group, general fit with IPC, and methodological quality. The vast majority of studies examined brief interventions targeting sleep difficulties and physical activity. The most commonly employed interventions were derived from cognitive-behavioral therapy and motivational interviewing. Outcomes were generally statistically significantly in favor of the active intervention relative to comparison, with highly variable methodological quality ratings (range = 0-5; M = 2.0). Results are discussed in relation to the need for further evidence for brief behavioral interventions targeting other behavioral medicine concerns beyond sleep and physical activity, as well as for more specificity regarding the compatibility of such interventions with IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Advances in family-based interventions in the neonatal ICU.

PubMed

Welch, Martha G; Myers, Michael M

2016-04-01

Despite advances in medical care, preterm infants remain at risk for many adverse outcomes. This article reviews findings from several recent neonatal ICU (NICU) interventions and a trial of a novel nurture-based approach, Family Nurture Intervention (FNI). Recent trials reviewed here find positive effects of a variety of family-related interventions focused on parental guidance. These interventions target prescribed physical activities with infants, parents' stress, and the parents' ability to recognize their positive and negative behaviors with their infants. Beneficial effects include reductions in parenting stress, maternal anxiety, and depression. A different approach, FNI, is aimed at establishing mother-infant emotional connection. As in other trials, FNI also decreased maternal symptoms of anxiety and depression, and increased maternal sensitivity. Additionally, FNI led to positive short and long-term effects on infant neurobehavioral outcomes at term and 18 months. A number of recent parent-based NICU interventions have been effective at reducing preterm parent stress. Another, FNI, has positive effects on both maternal and infant outcomes and promises to be cost-effective. Future decreases in long-term morbidity in preterm infants will increasingly rely on nonmedical interventions. Therefore, the rigorous development and testing of such interventions should be a high priority in perinatology research.

Parent-child interaction in motor speech therapy.

PubMed

Namasivayam, Aravind Kumar; Jethava, Vibhuti; Pukonen, Margit; Huynh, Anna; Goshulak, Debra; Kroll, Robert; van Lieshout, Pascal

2018-01-01

This study measures the reliability and sensitivity of a modified Parent-Child Interaction Observation scale (PCIOs) used to monitor the quality of parent-child interaction. The scale is part of a home-training program employed with direct motor speech intervention for children with speech sound disorders. Eighty-four preschool age children with speech sound disorders were provided either high- (2×/week/10 weeks) or low-intensity (1×/week/10 weeks) motor speech intervention. Clinicians completed the PCIOs at the beginning, middle, and end of treatment. Inter-rater reliability (Kappa scores) was determined by an independent speech-language pathologist who assessed videotaped sessions at the midpoint of the treatment block. Intervention sensitivity of the scale was evaluated using a Friedman test for each item and then followed up with Wilcoxon pairwise comparisons where appropriate. We obtained fair-to-good inter-rater reliability (Kappa = 0.33-0.64) for the PCIOs using only video-based scoring. Child-related items were more strongly influenced by differences in treatment intensity than parent-related items, where a greater number of sessions positively influenced parent learning of treatment skills and child behaviors. The adapted PCIOs is reliable and sensitive to monitor the quality of parent-child interactions in a 10-week block of motor speech intervention with adjunct home therapy. Implications for rehabilitation Parent-centered therapy is considered a cost effective method of speech and language service delivery. However, parent-centered models may be difficult to implement for treatments such as developmental motor speech interventions that require a high degree of skill and training. For children with speech sound disorders and motor speech difficulties, a translated and adapted version of the parent-child observation scale was found to be sufficiently reliable and sensitive to assess changes in the quality of the parent-child interactions during intervention. In developmental motor speech interventions, high-intensity treatment (2×/week/10 weeks) facilitates greater changes in the parent-child interactions than low intensity treatment (1×/week/10 weeks). On one hand, parents may need to attend more than five sessions with the clinician to learn how to observe and address their child's speech difficulties. On the other hand, children with speech sound disorders may need more than 10 sessions to adapt to structured play settings even when activities and therapy materials are age-appropriate.

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

PubMed

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

2018-06-01

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

An Economic Evaluation of Food Safety Education Interventions: Estimates and Critical Data Gaps.

PubMed

Zan, Hua; Lambea, Maria; McDowell, Joyce; Scharff, Robert L

2017-08-01

The economic evaluation of food safety interventions is an important tool that practitioners and policy makers use to assess the efficacy of their efforts. These evaluations are built on models that are dependent on accurate estimation of numerous input variables. In many cases, however, there is no data available to determine input values and expert opinion is used to generate estimates. This study uses a benefit-cost analysis of the food safety component of the adult Expanded Food and Nutrition Education Program (EFNEP) in Ohio as a vehicle for demonstrating how results based on variable values that are not objectively determined may be sensitive to alternative assumptions. In particular, the focus here is on how reported behavioral change is translated into economic benefits. Current gaps in the literature make it impossible to know with certainty how many people are protected by the education (what are the spillover effects?), the length of time education remains effective, and the level of risk reduction from change in behavior. Based on EFNEP survey data, food safety education led 37.4% of participants to improve their food safety behaviors. Under reasonable default assumptions, benefits from this improvement significantly outweigh costs, yielding a benefit-cost ratio of between 6.2 and 10.0. Incorporation of a sensitivity analysis using alternative estimates yields a greater range of estimates (0.2 to 56.3), which highlights the importance of future research aimed at filling these research gaps. Nevertheless, most reasonable assumptions lead to estimates of benefits that justify their costs.

The role of grandparents in preventing aggressive and other externalizing behavior problems in children from rural, methamphetamine-involved families

PubMed Central

Sheridan, Kathryn; Haight, Wendy L.; Cleeland, Leah

2011-01-01

Preventive interventions are urgently needed for children from rural, methamphetamine-involved families, who are at risk for the development of aggressive and other externalizing behavioral problems. This mixed method study explored naturally occurring sources of protection and considers the implications for targeted interventions. Participants were 41 children aged six to 14 years from rural families involved with methamphetamine and the public child welfare system, their primary caregivers, and 19 parents recovering from methamphetamine addiction. When invited during semi-structured interviews to talk about their families, 48% of children spontaneously described socially and emotionally supportive relationships with healthy grandparents. Children’s reports of support from grandparents were associated with lower scores on CBCL Social Problems, [t(37)= 2.23, p<.05 ]; externalizing behaviors, [t(37)= 2.07, p<.05]; and aggressive behaviors, [t(37)= 2.75, p<.01]. When asked to talk about their families, 58% of parents spontaneously described the support their children received from grandparents, and 26% also described the support that they had received from their own grandparents. Children’s and parents’ descriptions of grandparent support suggest how grandparents may protect children from the development of aggressive and other externalizing behavior problems. First, grandparents may prevent obstacles to healthy development by providing their grandchildren with safe shelter and basic child care when parents are incapacitated from substance misuse. Second, they may promote their grandchildren’s positive social-emotional development through supportive relationships. Third, they may promote social competence through enjoyable leisure activities with healthy adults and non-delinquent peers. Understanding naturally occurring sources of protection for children can inform the development of interventions by identifying strengths on which to build, and suggesting culturally sensitive approaches when children are struggling. PMID:21804680

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

PubMed

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

2015-10-01

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

Experimental research on the relation between food price changes and food-purchasing patterns: a targeted review.

PubMed

Epstein, Leonard H; Jankowiak, Noelle; Nederkoorn, Chantal; Raynor, Hollie A; French, Simone A; Finkelstein, Eric

2012-04-01

One way in which to modify food purchases is to change prices through tax policy, subsidy policy, or both. We reviewed the growing body of experimental research conducted in the laboratory and in the field that investigates the following: the extent to which price changes influence purchases of targeted and nontargeted foods, total energy, or macronutrients purchased; the interaction of price changes with adjunctive interventions; and moderators of sensitivity to price changes. After a brief overview of economic principles and observational research that addresses these issues, we present a targeted review of experimental research. Experimental research suggests that price changes modify purchases of targeted foods, but research on the overall nutritional quality of purchases is mixed because of substitution effects. There is mixed support for combining price changes with adjunctive interventions, and there are no replicated findings on moderators to price sensitivity in experiments. Additional focused research is needed to better inform food policy development with the aim of improving eating behavior and preventing obesity.

Structure to utilize interventionists' implementation experiences of a family-based behavioral weight management program to enhance the dissemination of the standardized intervention: The TODAY study.

PubMed

Chadwick, Jennifer Q; Van Buren, Dorothy J; Morales, Elisa; Timpson, Alexandra; Abrams, Ericka L; Syme, Amy; Preske, Jeff; Mireles, Gerardo; Anderson, Barbara; Grover, Nisha; Laffel, Lori

2017-08-01

Background For a 2- to 6-year period, interventionists for the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) randomized clinical trial delivered a family-based, behavioral weight-loss program (the TODAY Lifestyle Program) to 234 youth with type 2 diabetes. Interventionists held at least a bachelor's degree in psychology, social work, education, or health-related field and had experience working with children and families, especially from diverse ethnic and socioeconomic backgrounds. This article describes the administrative and organizational structure of the lifestyle program and how the structure facilitated collaboration among study leadership and lifestyle interventionists on the tailoring of the program to best suit the needs of the trial's diverse patient population. Methods During the pilot phase and throughout the duration of the trial, the interventionists' experiences in delivering the intervention were collected in a variety of ways including membership on study committees, survey responses, session audio recordings, and feedback during in-person trainings. Results The experiences of interventionists conveyed to study leadership through these channels resulted in decisions to tailor the lifestyle intervention's delivery location and ways to supplement the standardized educational materials to better address the needs of a diverse patient population. Conclusion The methods used within the TODAY study to encourage and utilize interventionists' experiences while implementing the lifestyle program may be useful to the design of future multi-site, clinical trials seeking to tailor behavioral interventions in a standardized, and culturally and developmentally sensitive manner.

Technical and Applied Features of Functional Behavioral Assessments and Behavior Intervention Plans

ERIC Educational Resources Information Center

Hawkins, Shannon M.

2012-01-01

When conducted correctly, functional behavior assessments (FBAs) can help professionals intervene with problem behavior using function-based interventions. Despite the fact that researchers have shown that effective interventions are based on function, recent investigators have found that most behavioral intervention plans (BIPs) are written…

Serotonin Transporter Genotype (5HTTLPR) Moderates the Longitudinal Impact of Atypical Attachment on Externalizing Behavior.

PubMed

Humphreys, Kathryn L; Zeanah, Charles H; Nelson, Charles A; Fox, Nathan A; Drury, Stacy S

2015-01-01

To test whether genotype of the serotonin transporter-linked polymorphic region (5HTTLPR) and atypical attachment interact to predict externalizing psychopathology prospectively in a sample of children with a history of early institutional care. Caregiver report of externalizing behavior at 54 months was examined in 105 children initially reared in institutional care and enrolled in the Bucharest Early Intervention Project, a randomized controlled trial of high quality foster care. 5HTTLPR genotype, attachment status at 42 months of age (typical [secure, avoidant, or ambivalent] or atypical [disorganized-controlling, insecure-other]), and their interaction were examined as predictors of externalizing behavior at age 54 months. 5HTTLPR genotype and atypical attachment at age 42 months interacted to predict externalizing behavior at age 54 months. Specifically, children with the s/s genotype with an atypical attachment had the highest externalizing scores. However, s/s children with a typical attachment demonstrated the lowest externalizing scores, even after controlling for intervention group status. There was no association between attachment status and externalizing behavior among children carrying at least 1 copy of the l allele. These findings indicate that genetic variation in the serotonergic system moderates the association between atypical attachment status and externalizing in young children. Our findings suggest that children, as a result of genetic variability in the serotonergic system, demonstrate differential sensitivity to the attachment relationship.

Serotonin Transporter Genotype (5HTTLPR) Moderates the Longitudinal Impact of Atypical Attachment on Externalizing Behavior

PubMed Central

Humphreys, Kathryn L.; Zeanah, Charles H.; Nelson, Charles A.; Fox, Nathan A.; Drury, Stacy S.

2015-01-01

Objective To test whether genotype of the serotonin transporter-linked polymorphic region (5HTTLPR) and atypical attachment interact to predict externalizing psychopathology prospectively in a sample of children with a history of early institutional care. Methods Caregiver report of externalizing behavior at 54 months was examined in 105 children initially reared in institutional care and enrolled in the Bucharest Early Intervention Project, a randomized controlled trial of high quality foster care. 5HTTLPR genotype, attachment status at 42 months of age (typical [secure, avoidant, or ambivalent] or atypical [disorganized-controlling, insecure-other]), as well as their interaction, were examined as predictors of externalizing behavior at age 54 months. Results 5HTTLPR genotype and atypical attachment at age 42 months interacted to predict externalizing behavior at age 54 months. Specifically, children with the s/s genotype with an atypical attachment had the highest externalizing scores. However, s/s children with a typical attachment demonstrated the lowest externalizing scores, even after controlling for intervention group status. There was no association between attachment status and externalizing behavior among children carrying at least one copy of the l allele. Discussion These findings indicate that genetic variation in the serotonergic system moderates the association between atypical attachment status and externalizing in young children. Our findings suggest that children, as a result of genetic variability in the serotonergic system, demonstrate differential sensitivity to the attachment relationship. PMID:25933228

Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism.

PubMed

MacDonald, Rebecca; Parry-Cruwys, Diana; Dupere, Sally; Ahearn, William

2014-12-01

Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing overall functioning level rather than via repeated observational measures of autism-specific deficits (i.e., social behavior). In the current study, 83 children with autism (CWA), aged 1, 2 and 3 years, and 58 same-aged typically developing children (TDC) were directly observed in the areas of cognitive skills, joint attention (JA), play, and stereotypic behavior using a measure called the Early Skills Assessment Tool (ESAT; MacDonald et al., 2006). CWA were assessed at entry into an EIBI program and again after 1 year of treatment. Changes in performance were compared pre- and post-treatment as well as to the normative data by age. Results indicate significant gains on the ESAT across all age groups with the greatest gains seen in the children who entered treatment prior to their second birthday. Increases were seen on direct measures of JA, play, imitation and language while decreases were seen in stereotypy regardless of level of performance at entry into EIBI. The ESAT, a direct measurement tool, served as a sensitive tool to measure changes in autism symptomatology following EIBI treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluating Teach One Reach One-An STI/HIV Risk-Reduction Intervention to Enhance Adult-Youth Communication About Sex and Reduce the Burden of HIV/STI.

PubMed

Dave, Gaurav; Ritchwood, Tiarney; Young, Tiffany L; Isler, Malika Roman; Black, Adina; Akers, Aletha Y; Gizlice, Ziya; Blumenthal, Connie; Atley, Leslie; Wynn, Mysha; Stith, Doris; Cene, Crystal; Ellis, Danny; Corbie-Smith, Giselle

2017-11-01

Parents and caregivers play an important role in sexual socialization of youth, often serving as the primary source of information about sex. For African American rural youth who experience disparate rates of HIV/sexually transmitted infection, improving caregiver-youth communication about sexual topics may help to reduce risky behaviors. This study assessed the impact of an intervention to improve sexual topic communication. A Preintervention-postintervention, quasi-experimental, controlled, and community-based trial. Intervention was in 2 rural North Carolina counties with comparison group in 3 adjacent counties. Participants (n = 249) were parents, caregivers, or parental figures for African American youth aged 10 to 14. Twelve-session curriculum for participating dyads. Audio computer-assisted self-interview to assess changes at 9 months from baseline in communication about general and sensitive sex topics and overall communication about sex. Multivariable models were used to examine the differences between the changes in mean of scores for intervention and comparison groups. Statistically significant differences in changes in mean scores for communication about general sex topics ( P < .0001), communication about sensitive sex topics ( P < .0001), and overall communication about sex ( P < .0001) existed. Differences in change in mean scores remained significant after adjusting baseline scores and other variables in the multivariate models. In Teach One Reach One intervention, adult participants reported improved communication about sex, an important element to support risk reduction among youth in high-prevalence areas.

Ten good reasons to consider biological processes in prevention and intervention research

PubMed Central

BEAUCHAINE, THEODORE P.; NEUHAUS, EMILY; BRENNER, SHARON L.; GATZKE-KOPP, LISA

2009-01-01

Most contemporary accounts of psychopathology acknowledge the importance of both biological and environmental influences on behavior. In developmental psychopathology, multiple etiological mechanisms for psychiatric disturbance are well recognized, including those operating at genetic, neurobiological, and environmental levels of analysis. However, neuroscientific principles are rarely considered in current approaches to prevention or intervention. In this article, we explain why a deeper understanding of the genetic and neural substrates of behavior is essential for the next generation of preventive interventions, and we outline 10 specific reasons why considering biological processes can improve treatment efficacy. Among these, we discuss (a) the role of biomarkers and endophenotypes in identifying those most in need of prevention; (b) implications for treatment of genetic and neural mechanisms of homotypic comorbidity, heterotypic comorbidity, and heterotypic continuity; (c) ways in which biological vulnerabilities moderate the effects of environmental experience; (d) situations in which Biology×Environment interactions account for more variance in key outcomes than main effects; and (e) sensitivity of neural systems, via epigenesis, programming, and neural plasticity, to environmental moderation across the life span. For each of the 10 reasons outlined we present an example from current literature and discuss critical implications for prevention. PMID:18606030

Research Ethics in Behavioral Interventions Among Special Populations: Lessons From the Peer Approaches to Lupus Self-Management Study.

PubMed

Faith, Trevor D; Egede, Leonard; Williams, Edith M

2018-02-01

Research involving a homogenous cohort of participants belonging to a special population must make considerations to recruit and protect the subjects. This study analyses the ethical considerations made in the peer approaches to lupus self-management project which pilot tested a peer mentoring intervention for African American women with systemic lupus erythematosus. Considerations made at the outset of the project are described and their justifications and reasoning are given. Through analysis of feedback from a postintervention focus group and mentors' logs, implications on program outcomes and participant satisfaction are discussed. Feedback indicated the importance of recruiting and training capable mentors, consistent contact from study staff to avert adverse events and avert fear or mistrust and careful consideration that must go into the pairing of mentors and mentees. Participant feedback also indicated that sensitive topics must be addressed carefully to prevent distress and dissatisfaction. Applying the lessons learned from this work as well as the considerations that proved successful may improve the contextualization and ethical conduct of behavioral interventions in special populations resulting in improved tailoring and acceptability toward historically underserved individuals. Published by Elsevier Inc.

Ten good reasons to consider biological processes in prevention and intervention research.

PubMed

Beauchaine, Theodore P; Neuhaus, Emily; Brenner, Sharon L; Gatzke-Kopp, Lisa

2008-01-01

Most contemporary accounts of psychopathology acknowledge the importance of both biological and environmental influences on behavior. In developmental psychopathology, multiple etiological mechanisms for psychiatric disturbance are well recognized, including those operating at genetic, neurobiological, and environmental levels of analysis. However, neuroscientific principles are rarely considered in current approaches to prevention or intervention. In this article, we explain why a deeper understanding of the genetic and neural substrates of behavior is essential for the next generation of preventive interventions, and we outline 10 specific reasons why considering biological processes can improve treatment efficacy. Among these, we discuss (a) the role of biomarkers and endophenotypes in identifying those most in need of prevention; (b) implications for treatment of genetic and neural mechanisms of homotypic comorbidity, heterotypic comorbidity, and heterotypic continuity; (c) ways in which biological vulnerabilities moderate the effects of environmental experience; (d) situations in which Biology x Environment interactions account for more variance in key outcomes than main effects; and (e) sensitivity of neural systems, via epigenesis, programming, and neural plasticity, to environmental moderation across the life span. For each of the 10 reasons outlined we present an example from current literature and discuss critical implications for prevention.

Behavioral intervention reduces unhealthy eating behaviors in preschool children via a behavior card approach.

PubMed

Lin, Ming; Pan, Li-Ping; Han, Juan; Li, Li; Jiang, Jing-Xiong; Jin, Run-Ming

2016-12-01

Many eating behaviors form in childhood, and some unhealthy behaviors may persist into adulthood and have potential impacts on people's health. This study evaluated the effectiveness of behavioral intervention in reducing consumption of Western fast food, sweetened beverages, fried food in preschool children, and changing parents' rewarding behaviors that encourage the consumption of the unhealthy foods. The research was a cluster randomized trial of seven kindergartens, involving 1138 children aged 3-6 years and their parents in Beijing, China. Parents and children allocated to the intervention group received two lectures and printed resources, including behavior cards, educational sheets. Children's behavior cards, applied with behavior-changing techniques, were used to intervene, and monitor behavior changes over time. Children in the control group just followed their usual health education curriculum in kindergartens. Intervention effects on food consumption behaviors were assessed by examining pre- and post-questionnaires. Of the 1138 children screened at baseline, 880 (77.3%) were measured at the end of the intervention period. The intervention lasted from March to June in 2010. The results showed that consumption of Western fast food, sweetened beverages, and fried food was decreased among the intervention group (P<0.001). Proportions of parents using Western fast food as rewards for their children were decreased (P=0.002). From March to June 2010, the frequency of each target behavior in children tended to decrease over the intervention period (P<0.001). Most parents favored regularly-delivered behavior cards or materials for behavioral intervention. In conclusion, the behavioral intervention encourages the healthier eating behaviors of children and reduces the parents' practice of using unhealthy foods as reward.

Managing Student Behavior with Class-Wide Function-Related Intervention Teams: An Observational Study in Early Elementary Classrooms

ERIC Educational Resources Information Center

Caldarella, Paul; Williams, Leslie; Hansen, Blake D.; Wills, Howard

2015-01-01

Comprehensive evidence-based interventions are needed to help early childhood educators manage challenging student behaviors. One such intervention, class-wide function-related intervention teams (CW-FIT), is a multi-tiered behavioral intervention program based on positive behavior support principles, including four main elements: (a) teaching…

Symptom Presentation and Symptom Meaning Among Traumatized Cambodian Refugees: Relevance to a Somatically Focused Cognitive-Behavior Therapy

PubMed Central

Hinton, Devon E.; Otto, Michael W.

2009-01-01

Among psychologically distressed Cambodian refugees, somatic complaints are particularly prominent. Cambodians interpret anxiety-related somatic sensations in terms of “Wind” (khyâl), an ethnophysiology that gives rise to multiple catastrophic interpretations; and they have prominent trauma-memory associations to anxiety-related somatic symptoms. In this article, we detail some of the common sensation-related dysphoric networks of Cambodian refugees, focusing on catastrophic cognitions and trauma associations. We argue that delineating symptom-related dysphoric networks is crucial to successfully adapt cognitive-behavioral interventions to treat panic disorder and posttraumatic stress disorder among Cambodian refugees, and that such an approach may be useful for the culturally sensitive adaptation of cognitive-behavior therapy for other traumatized non-Western groups. PMID:19823603

Multiple Behavior Change Intervention to Improve Detection of Unmet Social Needs and Resulting Resource Referrals

PubMed Central

Colvin, Jeffrey D.; Bettenhausen, Jessica L.; Anderson-Carpenter, Kaston D.; Collie-Akers, Vicki; Plencner, Laura; Krager, Molly; Nelson, Brooke; Donnelly, Sara; Simmons, Julia; Higinio, Valeria; Chung, Paul J.

2015-01-01

Objective It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (i.e., negative social determinants of health.) We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. Methods During an 18-month period, interns rotating on one of two otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month post-intervention period, every third H&P was reviewed to determine median duration of continued IHELP use. Results 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P<0.001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% CI 0.87–0.99) and sensitivity was 0.63 (95% CI 0.50–0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (IQR 1–10 months) Conclusions A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs. PMID:26183003

Dietary change through African American churches: baseline results and program description of the eat for life trial.

PubMed

Resnicow, K; Wallace, D C; Jackson, A; Digirolamo, A; Odom, E; Wang, T; Dudley, W N; Davis, M; Mitchell, D; Baranowski, T

2000-01-01

Eat for Life, a multicomponent intervention to increase fruit and vegetable (F & V) consumption among African Americans, is delivered through African American churches. Fourteen churches were randomly assigned to one of three treatment conditions: 1) comparison; 2) culturally-sensitive multicomponent intervention with one phone call; and 3) culturally-sensitive multicomponent intervention with four phone calls. The intervention included an 18-minute video, a project cookbook, printed health education materials, and several "cues" imprinted with the project logo and a 5 A Day message. A key element of the telephone intervention was the use of motivational interviewing, a counseling technique originally developed for addictive behaviors. Major outcomes for the trial included total F & V intake, assessed by food-frequency questionnaires (FFQs) and 24-hour recalls, and serum carotenoids. Psychosocial variables assessed included outcome expectations, barriers to F & V intake, preference for meat meals, neophobia, social support to eat more F & V, self-efficacy to eat more F & V, and nutrition knowledge. Baseline mean F & V intakes across the three FFQs ranged from 3.45 to 4.28 servings per day. Intake based on a single 24-hour recall was 3.0 servings. Variables positively correlated with F & V intake included self-efficacy, outcome expectations, and a belief that F & V contain vitamins. Factors negatively correlated with intake include perceived barriers, meat preference, neophobia, and high-fat cooking practices. The completion rate for the first telephone counseling call was 90%. Completion rates for the remaining three calls ranged from 79% to 86%. The recruitment and intervention methods of the Eat for Life study appear promising. The telephone intervention based on motivational interviewing is potentially useful for delivering dietary counseling.

Parental childhood adversity, depressive symptoms, and parenting quality: Effects on toddler self-regulation in Child Welfare Services-involved families

PubMed Central

Spieker, Susan J.; Oxford, Monica L.; Fleming, Charles B.; Lohr, Mary Jane

2018-01-01

Parents who are child welfare services-involved (CWSI) often have a history of childhood adversity and depressive symptoms. Both affect parenting quality, which in turn influences child adaptive functioning. We tested a model of the relations between parental depression and child regulatory outcomes first proposed by Lyons-Ruth and colleagues (2002). We hypothesized that both parental depression and parenting quality mediate the effects of parental early adversity on offspring regulatory outcomes. Participants were 123 CWSI parents and their toddlers who were assessed three times over a period of six months. At T1, parents reported on their childhood adversity and current depressive symptoms. At T2, parents’ sensitivity to their child’s distress and non-distress cues were rated from a videotaped teaching task. At T3, observers rated children’s emotional regulation, orientation/engagement, and secure base behavior. The results of a path model partly supported hypotheses. Parent childhood adversity was associated with current depressive symptoms, which in turn was related to parent sensitivity to child distress but not non-distress. Sensitivity to distress also predicted secure base behavior. Depression directly predicted orientation/engagement, also predicted by sensitivity to non-distress. Sensitivity to distress predicted emotion regulation and orientation/engagement. Results are discussed in terms of intervention approaches for CWSI families. PMID:29266280

PARENTAL CHILDHOOD ADVERSITY, DEPRESSIVE SYMPTOMS, AND PARENTING QUALITY: EFFECTS ON TODDLER SELF-REGULATION IN CHILD WELFARE SERVICES INVOLVED FAMILIES.

PubMed

Spieker, Susan J; Oxford, Monica L; Fleming, Charles B; Lohr, Mary Jane

2018-01-01

Parents who are involved with child welfare services (CWSI) often have a history of childhood adversity and depressive symptoms. Both affect parenting quality, which in turn influences child adaptive functioning. We tested a model of the relations between parental depression and child regulatory outcomes first proposed by K. Lyons-Ruth, R. Wolfe, A. Lyubchik, and R. Steingard (2002). We hypothesized that both parental depression and parenting quality mediate the effects of parental early adversity on offspring regulatory outcomes. Participants were 123 CWSI parents and their toddlers assessed three times over a period of 6 months. At Time 1, parents reported on their childhood adversity and current depressive symptoms. At Time 2, parents' sensitivity to their child's distress and nondistress cues was rated from a videotaped teaching task. At Time 3, observers rated children's emotional regulation, orientation/engagement, and secure base behavior. The results of a path model partly supported the hypotheses. Parent childhood adversity was associated with current depressive symptoms, which in turn related to parent sensitivity to child distress, but not nondistress. Sensitivity to distress also predicted secure base behavior. Depression directly predicted orientation/engagement, also predicted by sensitivity to nondistress. Sensitivity to distress predicted emotion regulation and orientation/engagement. Results are discussed in terms of intervention approaches for CWSI families. © 2017 Michigan Association for Infant Mental Health.

Computer-Delivered Interventions for Health Promotion and Behavioral Risk Reduction: A Meta-Analysis of 75 Randomized Controlled Trials, 1988 – 2007

PubMed Central

Portnoy, David B.; Scott-Sheldon, Lori A. J.; Johnson, Blair T.; Carey, Michael P.

2008-01-01

Objective Use of computers to promote healthy behavior is increasing. To evaluate the efficacy of these computer-delivered interventions, we conducted a meta-analysis of the published literature. Method Studies examining health domains related to the leading health indicators outlined in Healthy People 2010 were selected. Data from 75 randomized controlled trials, published between 1988 and 2007, with 35,685 participants and 82 separate interventions were included. All studies were coded independently by two raters for study and participant characteristics, design and methodology, and intervention content. We calculated weighted mean effect sizes for theoretically-meaningful psychosocial and behavioral outcomes; moderator analyses determined the relation between study characteristics and the magnitude of effect sizes for heterogeneous outcomes. Results Compared with controls, participants who received a computer-delivered intervention improved several hypothesized antecedents of health behavior (knowledge, attitudes, intentions); intervention recipients also improved health behaviors (nutrition, tobacco use, substance use, safer sexual behavior, binge/purge behaviors) and general health maintenance. Several sample, study and intervention characteristics moderated the psychosocial and behavioral outcomes. Conclusion Computer-delivered interventions can lead to improved behavioral health outcomes at first post-intervention assessment. Interventions evaluating outcomes at extended assessment periods are needed to evaluate the longer-term efficacy of computer-delivered interventions. PMID:18403003

Effect of Retraining Approach-Avoidance Tendencies on an Exercise Task: A Randomized Controlled Trial.

PubMed

Cheval, Boris; Sarrazin, Philippe; Pelletier, Luc; Friese, Malte

2016-12-01

Promoting regular physical activity (PA) and lessening sedentary behaviors (SB) constitute a public health priority. Recent evidence suggests that PA and SB are not only related to reflective processes (eg, behavioral intentions), but also to impulsive approach-avoidance tendencies (IAAT). This study aims to test the effect of a computerized IAAT intervention on an exercise task. Participants (N = 115) were randomly assigned to 1 of 3 experimental conditions, in which they were either trained to approach PA and avoid SB (ApPA-AvSB condition), to approach SB and avoid PA (ApSB-AvPA condition), or to approach and avoid PA and SB equally often (active control condition). The main outcome variable was the time spent carrying out a moderate intensity exercise task. IAAT toward PA decreased in the ApSB-AvPA condition, tended to increase in the ApPA-AvSB condition, and remained stable in the control condition. Most importantly, the ApPA-AvSB manipulation led to more time spent exercising than the ApSB-AvPA condition. Sensitivity analyses excluding individuals who were highly physically active further revealed that participants in the ApPA-AvSB condition spent more time exercising than participants in the control condition. These findings provide preliminary evidence that a single intervention session can successfully change impulsive approach tendencies toward PA and can increase the time devoted to an exercise task, especially among individuals who need to be more physically active. Potential implications for health behavior theories and behavior change interventions are outlined.

Identity-based motivation: Implications for intervention

PubMed Central

Oyserman, Daphna; Destin, Mesmin

2010-01-01

Children want to succeed academically and attend college, but their actual attainment often lags behind; some groups (e.g., boys, low-income children) are particularly likely to experience this gap. Social structural factors matter, influencing this gap in part by affecting children's perceptions of what is possible for them and people like them in the future. Interventions that focus on this macro-micro interface can boost children's attainment. We articulate the processes underlying these effects using an integrative culturally sensitive framework entitled identity-based motivation (IBM, Oyserman, 2007, 2009a, 2009b). The IBM model assumes that identities are dynamically constructed in context. People interpret situations and difficulties in ways that are congruent with currently active identities and prefer identity-congruent to identity-incongruent actions. When action feels identity-congruent, experienced difficulty highlights that the behavior is important and meaningful. When action feels identity-incongruent, the same difficulty suggests that the behavior is pointless and “not for people like me.” PMID:21516204

Empathy and motivation for justice: Cognitive empathy and concern, but not emotional empathy, predict sensitivity to injustice for others

PubMed Central

Decety, Jean; Yoder, Keith J.

2015-01-01

Why do people tend to care for upholding principles of justice? This study examined the association between individual differences in the affective, motivational and cognitive components of empathy, sensitivity to justice, and psychopathy in participants (N 265) who were also asked to rate the permissibility of everyday moral situations that pit personal benefit against moral standards of justice. Counter to commonsense, emotional empathy was not associated with sensitivity to injustice for others. Rather, individual differences in cognitive empathy and empathic concern predicted sensitivity to justice for others, as well as the endorsement of moral rules. Psychopathy coldheartedness scores were inversely associated with motivation for justice. Moreover, hierarchical multiple linear regression analysis revealed that self-focused and other-focused orientations toward justice had opposing influences on the permissibility of moral judgments. High scores on psychopathy were associated with less moral condemnation of immoral behavior. Together, these results contribute to a better understanding of the information processing mechanisms underlying justice motivation, and may guide interventions designed to foster justice and moral behavior. In order to promote justice motivation, it may be more effective to encourage perspective taking and reasoning to induce concern for others than emphasizing emotional sharing with the misfortune of others. PMID:25768232

Attachment quality of children with ID and its link to maternal sensitivity and structuring.

PubMed

Feniger-Schaal, Rinat; Joels, Tirtsa

2018-05-01

Attachment theory produced a fertile field of research and clinical application. Although the topic of attachment of children with intellectual disability (ID) has received increasing research attention over the past 15 years, the empirical evidence is still limited. We applied theoretical and empirical knowledge of parenting typically developing children to examine the mother-child relationship in the ID population. The aim was to examine maternal sensitivity and structuring and its association with children's attachment classification and their disability. Forty preschool children (mean age 47.25, range 26-75 months) with non-specific ID and their mothers participated in the study. The mean developmental age was 25.92 months (SD = 10.89), The DQ mean score was 55.45 (SD = 17.28). We assessed children's quality of attachment using the SSP and maternal interactive behavior using the Emotional Availability Scales. Forty percent of children showed secure attachment, and 32.5% showed disorganized attachment. Attachment classifications correlated significantly with maternal sensitivity and maternal structuring but not with the child's cognitive disability. The results point to the importance of maternal interactive behavior for children with ID. Clinical implication may consider interventions aiming to enhance maternal sensitivity and structuring to improve children's quality of attachment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Empathy and motivation for justice: Cognitive empathy and concern, but not emotional empathy, predict sensitivity to injustice for others.

PubMed

Decety, Jean; Yoder, Keith J

2016-01-01

Why do people tend to care for upholding principles of justice? This study examined the association between individual differences in the affective, motivational and cognitive components of empathy, sensitivity to justice, and psychopathy in participants (N 265) who were also asked to rate the permissibility of everyday moral situations that pit personal benefit against moral standards of justice. Counter to common sense, emotional empathy was not associated with sensitivity to injustice for others. Rather, individual differences in cognitive empathy and empathic concern predicted sensitivity to justice for others, as well as the endorsement of moral rules. Psychopathy coldheartedness scores were inversely associated with motivation for justice. Moreover, hierarchical multiple linear regression analysis revealed that self-focused and other-focused orientations toward justice had opposing influences on the permissibility of moral judgments. High scores on psychopathy were associated with less moral condemnation of immoral behavior. Together, these results contribute to a better understanding of the information processing mechanisms underlying justice motivation, and may guide interventions designed to foster justice and moral behavior. In order to promote justice motivation, it may be more effective to encourage perspective taking and reasoning than emphasizing emotional sharing with the misfortune of others.

Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal

PubMed Central

Gautam, Om Prasad; Schmidt, Wolf-Peter; Cairncross, Sandy; Cavill, Sue; Curtis, Valerie

2017-01-01

In this study, we report on the results of a trial of an intervention to improve five food hygiene behaviors among mothers of young children in rural Nepal. This novel intervention targeted five behaviors; cleanliness of serving utensils, handwashing with soap before feeding, proper storage of cooked food, and thorough reheating and water treatment. Based on formative research and a creative process using the Behavior-Centered Design approach, an innovative intervention package was designed and delivered over a period of 3 months. The intervention activities included local rallies, games, rewards, storytelling, drama, competitions linking with emotional drivers of behavior, and “kitchen makeovers” to disrupt behavior settings. The effect of the package on behavior was evaluated via a cluster-randomized before–after study in four villages with four villages serving as controls. The primary outcome was the difference in the mean cluster level proportions of mothers directly observed practicing all five food hygiene behaviors. The five targeted food hygiene behaviors were rare at baseline (composite performance of all five behaviors in intervention 1% [standard deviation (SD) = 2%] and in control groups 2% [SD = 2%]). Six weeks after the intervention, the target behaviors were more common in the intervention than in the control group (43% [SD = 14%] versus 2% [SD = 2%], P = 0.02) during follow-up. The intervention appeared to be equally effective in improving all five behaviors in all intervention clusters. This study shows that a theory-driven, systematic approach employing emotional motivators and modifying behavior settings was capable of substantially improving multiple food hygiene behaviors in Nepal. PMID:28719285

Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal.

PubMed

Gautam, Om Prasad; Schmidt, Wolf-Peter; Cairncross, Sandy; Cavill, Sue; Curtis, Valerie

2017-06-01

AbstractIn this study, we report on the results of a trial of an intervention to improve five food hygiene behaviors among mothers of young children in rural Nepal. This novel intervention targeted five behaviors; cleanliness of serving utensils, handwashing with soap before feeding, proper storage of cooked food, and thorough reheating and water treatment. Based on formative research and a creative process using the Behavior-Centered Design approach, an innovative intervention package was designed and delivered over a period of 3 months. The intervention activities included local rallies, games, rewards, storytelling, drama, competitions linking with emotional drivers of behavior, and "kitchen makeovers" to disrupt behavior settings. The effect of the package on behavior was evaluated via a cluster-randomized before-after study in four villages with four villages serving as controls. The primary outcome was the difference in the mean cluster level proportions of mothers directly observed practicing all five food hygiene behaviors. The five targeted food hygiene behaviors were rare at baseline (composite performance of all five behaviors in intervention 1% [standard deviation (SD) = 2%] and in control groups 2% [SD = 2%]). Six weeks after the intervention, the target behaviors were more common in the intervention than in the control group (43% [SD = 14%] versus 2% [SD = 2%], P = 0.02) during follow-up. The intervention appeared to be equally effective in improving all five behaviors in all intervention clusters. This study shows that a theory-driven, systematic approach employing emotional motivators and modifying behavior settings was capable of substantially improving multiple food hygiene behaviors in Nepal.

Using Participant Data to Extend the Evidence Base for Intensive Behavioral Intervention for Children with Autism

ERIC Educational Resources Information Center

Eldevik, Sigmund; Hastings, Richard P.; Hughes, J. Carl; Jahr, Erik; Eikeseth, Svein; Cross, Scott

2010-01-01

We gathered individual participant data from 16 group design studies on behavioral intervention for children with autism. In these studies, 309 children received behavioral intervention, 39 received comparison interventions, and 105 were in a control group. More children who underwent behavioral intervention achieved reliable change in IQ (29.8%)…

Parent-child attachment: meta-analysis of associations with parenting behaviors in middle childhood and adolescence.

PubMed

Koehn, Amanda J; Kerns, Kathryn A

2018-08-01

Maternal sensitivity predicts mother-child attachment in young children, but no meta-analysis has investigated the link between parenting and parent-child attachment in older children. This study examined the relationship between parent-child attachment and multiple components of parenting in children 5-18 years of age. A series of meta-analyses showed that parents of children with more secure attachment are more responsive, more supportive of the child's autonomy, use more behavioral control strategies, and use less harsh control strategies. Parents of children with more avoidant attachment were less responsive and used less behavioral control strategies. Ambivalent attachment was not significantly related to any of the parenting behaviors, and there were not enough studies to reliably test the relationship between disorganized attachment and parenting. There were few significant moderators. The findings inform new areas for future research, as well as family interventions for at-risk youth.

Cognitive-behavioral play therapy.

PubMed

Knell, S M

1998-03-01

Discusses cognitive-behavioral play therapy (CBPT), a developmentally sensitive treatment for young children that relies on flexibility, decreased expectation for verbalizations by the child, and increased reliance on experiential approaches. The development of CBPT for preschool-age children provides a relatively unique adaptation of cognitive therapy as it was originally developed for adults. CBPT typically contains a modeling component through which adaptive coping skills are demonstrated. Through the use of play, cognitive change is communicated indirectly, and more adaptive behaviors can be introduced to the child. Modeling is tailored for use with many specific cognitive and behavioral interventions. Generalization and response prevention are important features of CBPT. With minor modifications, many of the principles of cognitive therapy, as delineated for use with adults, are applicable to young children. Case examples are presented to highlight the application of CBPT. Although CBPT has a sound therapeutic base and utilizes proven techniques, more rigorous empirical scrutiny is needed.

Integrating Universal Behavioral Screening within Program-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Burke, Mack D.; Rispoli, Mandy; Clemens, Nathan H.; Lee, Yuan-Hsuan; Sanchez, Lisa; Hatton, Heather

2016-01-01

Universal behavioral screening is a major part of positive behavioral support and response to intervention systems. Program-wide positive behavioral interventions and supports (PBIS) focuses on establishing social, emotional, and behavioral competence through promotion of a small set of behavioral expectations that are agreed upon, taught, and…

Addressing Literacy and Numeracy to Improve Diabetes Care

PubMed Central

Cavanaugh, Kerri; Wallston, Kenneth A.; Gebretsadik, Tebeb; Shintani, Ayumi; Huizinga, Mary Margaret; Davis, Dianne; Gregory, Rebecca Pratt; Malone, Robb; Pignone, Michael; DeWalt, Darren; Elasy, Tom A.; Rothman, Russell L.

2009-01-01

OBJECTIVE Diabetic patients with lower literacy or numeracy skills are at greater risk for poor diabetes outcomes. This study evaluated the impact of providing literacy- and numeracy-sensitive diabetes care within an enhanced diabetes care program on A1C and other diabetes outcomes. RESEARCH DESIGN AND METHODS In two randomized controlled trials, we enrolled 198 adult diabetic patients with most recent A1C ≥7.0%, referred for participation in an enhanced diabetes care program. For 3 months, control patients received care from existing enhanced diabetes care programs, whereas intervention patients received enhanced programs that also addressed literacy and numeracy at each institution. Intervention providers received health communication training and used the interactive Diabetes Literacy and Numeracy Education Toolkit with patients. A1C was measured at 3 and 6 months follow-up. Secondary outcomes included self-efficacy, self-management behaviors, and treatment satisfaction. RESULTS At 3 months, both intervention and control patients had significant improvements in A1C from baseline (intervention −1.50 [95% CI −1.80 to −1.02]; control −0.80 [−1.10 to −0.30]). In adjusted analysis, there was greater improvement in A1C in the intervention group than in the control group (P = 0.03). At 6 months, there were no differences in A1C between intervention and control groups. Self-efficacy improved from baseline for both groups. No significant differences were found for self-management behaviors or satisfaction. CONCLUSIONS A literacy- and numeracy-focused diabetes care program modestly improved self-efficacy and glycemic control compared with standard enhanced diabetes care, but the difference attenuated after conclusion of the intervention. PMID:19741187

Vantage sensitivity: a framework for individual differences in response to psychological intervention.

PubMed

de Villiers, Bernadette; Lionetti, Francesca; Pluess, Michael

2018-06-01

People differ significantly in their response to psychological intervention, with some benefitting more from treatment than others. According to the recently proposed theoretical framework of vantage sensitivity, some of this variability may be due to individual differences in environmental sensitivity, the inherent ability to register, and process external stimuli. In this paper, we apply the vantage sensitivity framework to the field of psychiatry and clinical psychology, proposing that some people are more responsive to the positive effects of psychological intervention due to heightened sensitivity. After presenting theoretical frameworks related to environmental sensitivity, we review a selection of recent studies reporting individual differences in the positive response to psychological intervention. A growing number of studies report that some people benefit more from psychological intervention than others as a function of genetic, physiological, and psychological characteristics. These studies support the vantage sensitivity proposition that treatment response is influenced by factors associated with heightened sensitivity to environmental influences. More recently, studies have also shown that sensitivity can be measured with a short questionnaire which appears to predict the response to psychological intervention. Vantage sensitivity is a framework with significant relevance for our understanding of widely observed heterogeneity in treatment response. It suggests that variability in response to treatment is partly influenced by people's differing capacity for environmental sensitivity, which can be measured with a short questionnaire. Application of the vantage sensitivity framework to psychiatry and clinical psychology may improve our knowledge regarding when, how, and for whom interventions work.

Measuring the quality of life of the elderly in health promotion intervention clinical trials.

PubMed Central

Kutner, N G; Ory, M G; Baker, D I; Schechtman, K B; Hornbrook, M C; Mulrow, C D

1992-01-01

The Multicenter Trials of Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) is a series of clinical trials of biomedical, behavioral, and environmental interventions to reduce the risks of frailty and injury among the elderly. Reliable assessment of the quality of life reported by the subjects is a central issue in evaluating the interventions. An intervention may have a significant impact on an elderly person's sense of well-being, even though significant improvement is not observed in selected physical outcome measures. Elderly persons' compliance with particular intervention regimens may be influenced by the quality of life effects that they perceive in relation to the intervention. The researchers review the definition and measurement of quality of life in the trials, with particular attention to issues in determining common measures used at all study locations. Practical considerations in the selection and use of quality of life measures in both community and institutional populations are addressed. Topics discussed include the interrelation of aging, functional capacities, and quality of life; the multi-dimensionality of quality of life in relation to differential intervention effects; and age-related issues in the collection of quality of life data. Preliminary observations are reviewed, and potential contributions of FICSIT to intervention-sensitive quality of life assessments among the elderly are noted. PMID:1410233

Effect of local cultural context on the success of community-based conservation interventions.

PubMed

Waylen, Kerry A; Fischer, Anke; McGowan, Philip J K; Thirgood, Simon J; Milner-Gulland, E J

2010-08-01

Conservation interventions require evaluation to understand what factors predict success or failure. To date, there has been little systematic investigation of the effect of social and cultural context on conservation success, although a large body of literature argues it is important. We investigated whether local cultural context, particularly local institutions and the efforts of interventions to engage with this culture significantly influence conservation outcomes. We also tested the effects of community participation, conservation education, benefit provision, and market integration. We systematically reviewed the literature on community-based conservation and identified 68 interventions suitable for inclusion. We used a protocol to extract and code information and evaluated a range of measures of outcome success (attitudinal, behavioral, ecological, and economic). We also examined the association of each predictor with each outcome measure and the structure of predictor covariance. Local institutional context influenced intervention outcomes, and interventions that engaged with local institutions were more likely to succeed. Nevertheless, there was limited support for the role of community participation, conservation education, benefit provision, and market integration on intervention success. We recommend that conservation interventions seek to understand the societies they work with and tailor their activities accordingly. Systematic reviews are a valuable approach for assessing conservation evidence, although sensitive to the continuing lack of high-quality reporting on conservation interventions.

A Two-Factor Model of Relapse/Recurrence Vulnerability in Unipolar Depression

PubMed Central

Farb, Norman A. S.; Irving, Julie A.; Anderson, Adam K.; Segal, Zindel V.

2015-01-01

The substantial health burden associated with Major Depressive Disorder is a product of both its high prevalence and the significant risk of relapse, recurrence and chronicity. Establishing recurrence vulnerability factors (VFs) could improve the long-term management of MDD by identifying the need for further intervention in seemingly recovered patients. We present a model of sensitization in depression vulnerability, with an emphasis on the integration of behavioral and neural systems accounts. Evidence suggests that VFs fall into two categories: dysphoric attention and dysphoric elaboration. Dysphoric attention is driven by fixation on negative life events, and is characterized behaviorally by reduced executive control, and neurally by elevated activity in the brain’s salience network. Dysphoric elaboration is driven by rumination that promotes over-general self and contextual appraisals, and is characterized behaviorally by dysfunctional attitudes, and neurally by elevated connectivity within normally-distinct prefrontal brain networks. While, at present, few prospective VF studies exist from which to catalogue a definitive neurobehavioral account, extant data support the value of the proposed two-factor model. Measuring the continued presence of these two VFs during recovery may more accurately identify remitted patients who would benefit from targeted prophylactic intervention. PMID:25688431

Effects of 2 Prevention Programs on High-Risk Behaviors Among African American Youth

PubMed Central

Flay, Brian R.; Graumlich, Sally; Segawa, Eisuke; Burns, James L.; Holliday, Michelle Y.

2008-01-01

Objective To test the efficacy of 2 programs designed to reduce high-risk behaviors among inner-city African American youth. Design Cluster randomized trial. Setting Twelve metropolitan Chicago, Ill, schools and the communities they serve, 1994 through 1998. Participants Students in grades 5 through 8 and their parents and teachers. Interventions The social development curriculum (SDC) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur. The school/community intervention (SCI) consisted of SDC and school-wide climate and parent and community components. The control group received an attention-placebo health enhancement curriculum (HEC) of equal intensity to the SDC focusing on nutrition, physical activity, and general health care. Main Outcome Measures Student self-reports of violence, provocative behavior, school delinquency, substance use, and sexual behaviors (intercourse and condom use). Results For boys, the SDC and SCI significantly reduced the rate of increase in violent behavior (by 35% and 47% compared with HEC, respectively), provoking behavior (41% and 59%), school delinquency (31% and 66%), drug use (32% and 34%), and recent sexual intercourse (44% and 65%), and improved the rate of increase in condom use (95% and 165%). The SCI was significantly more effective than the SDC for a combined behavioral measure (79% improvement vs 51%). There were no significant effects for girls. Conclusions Theoretically derived social-emotional programs that are culturally sensitive, developmentally appropriate, and offered in multiple grades can reduce multiple risk behaviors for inner-city African American boys in grades 5 through 8. The lack of effects for girls deserves further research. PMID:15066879

Sensitivity to change and concurrent validity of direct behavior ratings for academic anxiety.

PubMed

von der Embse, Nathaniel P; Scott, Emma-Catherine; Kilgus, Stephen P

2015-06-01

Multitiered frameworks of service delivery have traditionally underserved students with mental health needs. Whereas research has supported the assessment and intervention of social and academic behavior across tiers, evidence is limited with regard to mental health concerns including internalizing behaviors (e.g., anxiety and depression). In particular, there is a notable shortage of brief anxiety assessment tools to be used for progress monitoring purposes. Moreover, traditional omnibus rating scale approaches may fail to capture contextually dependent anxiety. The purpose of the present investigation is to examine the sensitivity to change and concurrent validity of Direct Behavior Ratings (DBR; Chafouleas, Riley-Tillman, & Christ, 2009; Chafouleas, Riley-Tillman, & Sugai, 2007) of anxiety and traditional rating scales in measuring academic anxiety directly before, during, and after a potentially anxiety provoking stimulus. Research was conducted with 115 undergraduate students in a Southeastern university. Results indicated significant relationships between DBRs and pre- and postmeasures of anxiety. Change metrics suggested an overall lack of correspondence between DBR and the criterion measure, with DBR scales detecting greater change both across the testing situation and participants. The use of DBR for anxiety is considered within a multitiered, problem-solving framework. Feasibility and limitations associated with implementation are discussed. (c) 2015 APA, all rights reserved).

Behavior change is not one size fits all: psychosocial phenotypes of childhood obesity prevention intervention participants.

PubMed

Burgermaster, Marissa; Contento, Isobel; Koch, Pamela; Mamykina, Lena

2018-01-17

Variability in individuals' responses to interventions may contribute to small average treatment effects of childhood obesity prevention interventions. But, neither the causes of this individual variability nor the mechanism by which it influences behavior are clear. We used qualitative methods to characterize variability in students' responses to participating in a childhood obesity prevention intervention and psychosocial characteristics related to the behavior change process. We interviewed 18 students participating in a school-based curriculum and policy behavior change intervention. Descriptive coding, summary, and case-ordered descriptive meta-matrices were used to group participants by their psychosocial responses to the intervention and associated behavior changes. Four psychosocial phenotypes of responses emerged: (a) Activated-successful behavior-changers with strong internal supports; (b) Inspired-motivated, but not fully successful behavior-changers with some internal supports, whose taste preferences and food environment overwhelmed their motivation; (c) Reinforced-already practiced target behaviors, were motivated, and had strong family support; and (d) Indifferent-uninterested in behavior change and only did target behaviors if family insisted. Our findings contribute to the field of behavioral medicine by suggesting the presence of specific subgroups of participants who respond differently to behavior change interventions and salient psychosocial characteristics that differentiate among these phenotypes. Future research should examine the utility of prospectively identifying psychosocial phenotypes for improving the tailoring of nutrition behavior change interventions. © Society of Behavioral Medicine 2018.

Behavioral Intervention Materials Compendium. OPRE Report 2018-08

ERIC Educational Resources Information Center

Anzelone, Caitlin, Ed.; Dechausay, Nadine, Ed.; Alemany, Xavier, Ed.

2018-01-01

The Behavioral Interventions to Advance Self-Sufficiency (BIAS) project conducted 15 randomized controlled trials of behavioral interventions across eight states, in the domains of work support, child support, and child care. BIAS used a systematic approach called "behavioral diagnosis and design" to develop the interventions and their…

Using an evidence-based online module to improve parents' ability to support their child with Developmental Coordination Disorder.

PubMed

Camden, Chantal; Foley, Véronique; Anaby, Dana; Shikako-Thomas, Keiko; Gauthier-Boudreault, Camille; Berbari, Jade; Missiuna, Cheryl

2016-07-01

Developmental Coordination Disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents' awareness and building capacity but few interventions incorporating these best practices are documented. To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioral changes when managing their child's health condition. A mixed-methods, before-after design guided by the Theory of Planned Behavior was employed. Data about the knowledge, skills and behaviors of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. Paired T-tests, sensitivity analyses and thematic analyses were performed on data as appropriate. One hundred-sixteen, 81 and 58 participants respectively completed the three questionnaires. For knowledge and skills, post- and follow-up scores were significantly higher than baseline scores (p < 0.01). Fifty-two (64%) participants reported an intention to change behavior post-intervention and 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents' behavioral change: sharing information, trialing strategies and changing attitudes. Factors influencing parents' ability to implement these behavioral changes included clear recommendations, time, and 'right' attitude. Perceived outcomes associated with the parental behavioral changes involved improvement in well-being for the children at school, at home, and for the family as a whole. The online module increased parents' self-reported knowledge and skills in DCD management. Future research should explore its impacts on children's long-term outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Selecting Behavioral Interventions for Individualized Intervention Plans.

ERIC Educational Resources Information Center

Center, David B.

This paper cites ethical provisions and professional standards that affect the selection of behavioral interventions that will benefit exceptional individuals without undermining their dignity. A three-category system that classifies behavioral interventions on the basis of their intrusiveness or restrictiveness is presented. Interventions are…

Stroke Health and Risk Education (SHARE): design, methods, and theoretical basis.

PubMed

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

2012-07-01

Stroke is a disease with tremendous individual, family, and societal impact across all race/ethnic groups. Mexican Americans, the largest subgroup of Hispanic Americans, are at even higher risk of stroke than European Americans. To test the effectiveness of a culturally sensitive, church-based, multi-component, motivational enhancement intervention for Mexican Americans and European Americans in reducing stroke risk factors. Participants enroll in family or friendship pairs, from the same Catholic church in the Corpus Christi Texas area, and are encouraged to change diet and physical activity behaviors and provide support for behavior change to their partners. Churches are randomized to either the intervention or control group. Goal enrollment for each of the 10 participating churches is 40 participant pairs. The intervention consists of self-help materials (including a motivational short film, cookbook/healthy eating guide, physical activity guide with pedometer, and photonovella), five motivational interviewing calls, two tailored newsletters, parish health promotion activities and environmental changes, and a peer support workshop where participants learn to provide autonomy supportive counseling to their partner. SHARE's three primary outcomes are self-reported sodium intake, fruit and vegetable intake, and level of physical activity. Participants complete questionnaires and have measurements at baseline, six months, and twelve months. Persistence testing is performed at 18 months in the intervention group. The trial is registered with clinicaltrials.gov (NCT01378780). Copyright © 2012 Elsevier Inc. All rights reserved.

Parenting begets parenting: A neurobiological perspective on early adversity and the transmission of parenting styles across generations.

PubMed

Lomanowska, A M; Boivin, M; Hertzman, C; Fleming, A S

2017-02-07

The developing brains of young children are highly sensitive to input from their social environment. Nurturing social experience during this time promotes the acquisition of social and cognitive skills and emotional competencies. However, many young children are confronted with obstacles to healthy development, including poverty, inappropriate care, and violence, and their enhanced sensitivity to the social environment means that they are highly susceptible to these adverse childhood experiences. One source of social adversity in early life can stem from parenting that is harsh, inconsistent, non-sensitive or hostile. Parenting is considered to be the cornerstone of early socio-emotional development and an adverse parenting style is associated with adjustment problems and a higher risk of developing mood and behavioral disorders. Importantly, there is a growing literature showing that an important predictor of parenting behavior is how parents, especially mothers, were parented themselves. In this review, we examine how adversity in early-life affects mothering behavior in later-life and how these effects may be perpetuated inter-generationally. Relying on studies in humans and animal models, we consider evidence for the intergenerational transmission of mothering styles. We then describe the psychological underpinnings of mothering, including responsiveness to young, executive function and affect, as well as the physiological mediators of mothering behavior, including hormones, brain regions and neurotransmitters, and we consider how development in these relevant domains may be affected by adversity experienced in early life. Finally, we explore how genes and early experience interact to predict mothering behavior, including the involvement of epigenetic mechanisms. Understanding how adverse parenting begets adverse parenting in the next generation is critical for designing interventions aimed at preventing this intergenerational cycle of early adversity. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

A Mother's Borderline Personality Disorder and Her Sensitivity, Autonomy Support, Hostility, Fearful/Disoriented Behavior, and Role Reversal With Her Young Child.

PubMed

Macfie, Jenny; Kurdziel, Gretchen; Mahan, Rebecca M; Kors, Stephanie

2017-12-01

There is some evidence that maternal borderline personality disorder (BPD) adversely affects parenting in infancy, resulting in disorganized attachment, which longitudinally predicts BPD symptoms in adulthood. We examined parenting related to disorganized attachment beyond infancy in offspring of mothers with BPD, when parenting becomes a goal-corrected partnership. We observed puzzle solving in a low socioeconomic status (SES) sample of mothers with BPD and their children ages 4-7, n = 36, and normative comparisons, n = 34. Compared with normative mothers and controlling for maternal mood disorders, mothers with BPD were less likely to be sensitive and provide autonomy support, and were more likely to be hostile and display fearful/disoriented behavior and higher levels of parent-child role reversal. We additionally found correlations between parenting and self-reported maternal borderline features. We discuss implications for child development, including possible transmission of BPD from mothers to children via representational models, and developmentally appropriate preventive interventions.

Making the case for change: What researchers need to consider when designing behavior change interventions aimed at improving medication dispensing.

PubMed

Cadogan, Cathal A; Ryan, Cristín; Hughes, Carmel

2016-01-01

There is a growing emphasis on behavior change in intervention development programmes aimed at improving public health and healthcare professionals' practice. A number of frameworks and methodological tools have been established to assist researchers in developing interventions seeking to change healthcare professionals' behaviors. The key features of behavior change intervention design involve specifying the target group (i.e. healthcare professional or patient cohort), the target behavior and identifying mediators (i.e. barriers and facilitators) of behavior change. Once the target behavior is clearly specified and understood, specific behavior change techniques can then be used as the basis of the intervention to target identified mediators of behavior change. This commentary outlines the challenges for pharmacy practice-based researchers in targeting dispensing as a behavior when developing behavior change interventions aimed at pharmacists and proposes a definition of dispensing to consider in future research. Copyright © 2016 Elsevier Inc. All rights reserved.

Mediation and moderation of divorce effects on children's behavior problems.

PubMed

Weaver, Jennifer M; Schofield, Thomas J

2015-02-01

Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, we examined children's internalizing and externalizing behavior problems from age 5 to 15 years in relation to whether they had experienced a parental divorce. Children from divorced families had more behavior problems compared with a propensity-score-matched sample of children from intact families, according to both teachers and mothers. They exhibited more internalizing and externalizing problems at the first assessment after the parents' separation and at the last available assessment (age 11 years for teacher reports, or 15 years for mother reports). Divorce also predicted both short-term and long-term rank-order increases in behavior problems. Associations between divorce and child behavior problems were moderated by family income (assessed before the divorce) such that children from families with higher incomes prior to the separation had fewer internalizing problems than children from families with lower incomes prior to the separation. Higher levels of predivorce maternal sensitivity and child IQ also functioned as protective factors for children of divorce. Mediation analyses showed that children were more likely to exhibit behavior problems after the divorce if their postdivorce home environment was less supportive and stimulating, their mother was less sensitive and more depressed, and their household income was lower. We discuss avenues for intervention, particularly efforts to improve the quality of home environments in divorced families. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Childhood exposure to violence and lifelong health: clinical intervention science and stress-biology research join forces.

PubMed

Moffitt, Terrie E

2013-11-01

Many young people who are mistreated by an adult, victimized by bullies, criminally assaulted, or who witness domestic violence react to this violence exposure by developing behavioral, emotional, or learning problems. What is less well known is that adverse experiences like violence exposure can lead to hidden physical alterations inside a child's body, alterations that may have adverse effects on life-long health. We discuss why this is important for the field of developmental psychopathology and for society, and we recommend that stress-biology research and intervention science join forces to tackle the problem. We examine the evidence base in relation to stress-sensitive measures for the body (inflammatory reactions, telomere erosion, epigenetic methylation, and gene expression) and brain (mental disorders, neuroimaging, and neuropsychological testing). We also review promising interventions for families, couples, and children that have been designed to reduce the effects of childhood violence exposure. We invite intervention scientists and stress-biology researchers to collaborate in adding stress-biology measures to randomized clinical trials of interventions intended to reduce effects of violence exposure and other traumas on young people.

Behavior Intervention for Students with Externalizing Behavior Problems: Primary-Level Standard Protocol

ERIC Educational Resources Information Center

Benner, Gregory J.; Nelson, J. Ron; Sanders, Elizabeth A.; Ralston, Nicole C.

2012-01-01

This article examined the efficacy of a primary-level, standard-protocol behavior intervention for students with externalizing behavioral disorders. Elementary schools were randomly assigned to treatment (behavior intervention) or control (business as usual) conditions, and K-3 students were screened for externalizing behavior risk status. The…

How did formative research inform the development of a home-based neonatal care intervention in rural Ghana?

PubMed

Hill, Z; Manu, A; Tawiah-Agyemang, C; Gyan, T; Turner, K; Weobong, B; Ten Asbroek, A H A; Kirkwood, B R

2008-12-01

Formative research is often used to inform intervention design, but the design process is rarely reported. This study describes how an integrated home visit intervention for newborns in Ghana was designed. As a first step in the design process, the known intervention parameters were listed, information required to refine the intervention was then identified and a formative research strategy designed. The strategy included synthesizing available data, collecting data on newborn care practices in homes and facilities, on barriers and facilitators to adopting desired behaviors and on practical issues such as whom to include in the intervention. The data were used to develop an intervention plan through workshops with national and international stakeholders and experts. The intervention plan was operationalized by district level committees. This included developing work plans, a creative brief for the materials and completing a community volunteer inventory. The intervention was then piloted and the intervention materials were finalized. The design process took over a year and was iterative. Throughout the process, literature was reviewed to identify the best practice. The intervention focuses on birth preparedness, using treated bednets in pregnancy, early and exclusive breastfeeding, thermal care, special care for small babies and prompt care seeking for newborns with danger signs. The need for a problem-solving approach was identified to help ensure behavior change. A subset of behaviors were already being performed adequately, or were the focus of other interventions, but were important to reinforce in the visits. These include attending antenatal care and care seeking for danger signs in pregnancy. On the basis of the intervention content, the timing of newborn deaths and the acceptability of visits, two antenatal and three visits in the first week of life (days 1, 3 and 7) were planned. Several household members were identified to include in the visits as they were involved in newborn care or they made financial decisions. Birth attendants and health workers were often the locus of control for immediate newborn care, and sensitization activities were designed to improve their practices and to help ensure that families received consistent messages. An existing cadre of community volunteers was identified to deliver the intervention-these volunteers were already trusted and accepted by the community, already visited pregnant women at home and had the time and commitment to deliver the intervention. A supervision and remuneration system was developed through discussions with the volunteers and at the planning workshops. The need for community entry activities was identified to garner community support for the intervention, to encourage self-identification of pregnant and delivered women and to motivate the volunteer through community recognition. Formative research is an essential step in helping to ensure the development of an effective, appropriate and sustainable intervention.

Development of a music therapy assessment tool for patients in low awareness states.

PubMed

Magee, Wendy L

2007-01-01

People in low awareness states following profound brain injury typically demonstrate subtle changes in functional behaviors which challenge the sensitivity of measurement tools. Failure to identify and measure changes in functioning can lead to misdiagnosis and withdrawal of treatment with this population. Thus, the development of tools which are sensitive to responsiveness is of central concern. As the auditory modality has been found to be particularly sensitive in identifying responses indicating awareness, a convincing case can be made for music therapy as a treatment medium. However, little has been recommended about protocols for intervention or tools for measuring patient responses within the music therapy setting. This paper presents the rationale for an assessment tool specifically designed to measure responses in the music therapy setting with patients who are diagnosed as minimally conscious or in a vegetative state. Developed over fourteen years as part of interdisciplinary assessment and treatment, the music therapy assessment tool for low awareness states (MATLAS) contains fourteen items which rate behavioral responses across a number of domains. The tool can provide important information for interdisciplinary assessment and treatment particularly in the auditory and communication domains. Recommendations are made for testing its reliability and validity through research.

Effect of a group adherence intervention for Mexican-American older adults with type 2 diabetes.

PubMed

Haltiwanger, Emily Piven

2012-01-01

I evaluated the effect of a culturally tailored, peer-led support group intervention on improvement in adherence behaviors of Mexican-American older adults with type 2 diabetes mellitus and obtained feedback on the cultural relevance of the manual that structured the intervention. The one-group pretest-posttest design used five self-report questionnaires and blood testing to measure change among 4 men and 12 women, ages 60-85. Empowerment, self-efficacy, and attitude were highly significant at 2-, 4-, and 6-mo posttests. Glycosylated hemoglobin test results were significant at p < .05 between pretest and 2-mo posttest with a stabilizing effect on the 6-mo posttest. Mexican-American older adults' adherence may improve with a culturally sensitive, structured peer-led program with indirect consultation from an occupational therapist. Copyright © 2012 by the American Occupational Therapy Association, Inc.

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

PubMed Central

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

2010-01-01

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

Promotion of Influenza Prevention Beliefs and Behaviors through Primary School Science Education

PubMed Central

Koep, TH; Jenkins, S; M Hammerlund, ME; Clemens, C; Fracica, E; Ekker, SC; Enders, FT; Huskins, WC; Pierret, C

2016-01-01

Background School-based campaigns to improve student health have demonstrated short-term success across various health topics. However, evidence of the effectiveness of programs in promoting healthy beliefs and behaviors is limited. We hypothesized that educational curricula teaching the science behind health promotion would increase student knowledge, beliefs and adherence to healthy behaviors, in this case related to influenza. Methods Integrated Science Education Outreach is a successful education intervention in Rochester, Minnesota public schools that has demonstrated improvements in student learning. Within this program, we designed novel curricula and assessments to determine if gains in knowledge extended to influenza prevention. Further, we coupled InSciEd Out programming with a clinical intervention, Influenza Prevention Prescription Education (IPPE), to compare students' attitudes, intentions and healthy behaviors utilizing surveys and hand hygiene monitoring equipment. Results 95 students participated in (IPPE) in the intervention school. Talking drawings captured improvement in influenza prevention understanding related to hand washing [pre n=17(43%); post n=30(77%)] and vaccination [pre n=2(5%); post n=15(38%)]. Findings from 1024 surveys from 566 students revealed strong baseline understanding and attitudes related to hand washing and cough etiquette (74% or greater positive responses). Automated hand hygiene monitoring in school bathrooms and classrooms estimated compliance for both soap (overall median 63%, IQR 38% to 100%) and hand sanitizer use (0.04 to 0.24 uses per student per day) but did not show significant pre/ post IPPE differences. Conclusions Student understanding of principles of influenza prevention was reasonably high. Even with this baseline, InSciEd Out and IPPE improved students’ unprompted knowledge of behaviors to prevent influenza, as reflected by talking drawings. This novel metric may be more sensitive in capturing knowledge among students than traditional assessment methods. However, IPPE did not produce further significant differences in student attitudes and behaviors regarding the flu. PMID:27525193

Promotion of Influenza Prevention Beliefs and Behaviors through Primary School Science Education.

PubMed

Koep, T H; Jenkins, S; M Hammerlund, M E; Clemens, C; Fracica, E; Ekker, S C; Enders, F T; Huskins, W C; Pierret, C

2016-06-01

School-based campaigns to improve student health have demonstrated short-term success across various health topics. However, evidence of the effectiveness of programs in promoting healthy beliefs and behaviors is limited. We hypothesized that educational curricula teaching the science behind health promotion would increase student knowledge, beliefs and adherence to healthy behaviors, in this case related to influenza. Integrated Science Education Outreach is a successful education intervention in Rochester, Minnesota public schools that has demonstrated improvements in student learning. Within this program, we designed novel curricula and assessments to determine if gains in knowledge extended to influenza prevention. Further, we coupled InSciEd Out programming with a clinical intervention, Influenza Prevention Prescription Education (IPPE), to compare students' attitudes, intentions and healthy behaviors utilizing surveys and hand hygiene monitoring equipment. 95 students participated in (IPPE) in the intervention school. Talking drawings captured improvement in influenza prevention understanding related to hand washing [pre n=17(43%); post n=30(77%)] and vaccination [pre n=2(5%); post n=15(38%)]. Findings from 1024 surveys from 566 students revealed strong baseline understanding and attitudes related to hand washing and cough etiquette (74% or greater positive responses). Automated hand hygiene monitoring in school bathrooms and classrooms estimated compliance for both soap (overall median 63%, IQR 38% to 100%) and hand sanitizer use (0.04 to 0.24 uses per student per day) but did not show significant pre/ post IPPE differences. Student understanding of principles of influenza prevention was reasonably high. Even with this baseline, InSciEd Out and IPPE improved students' unprompted knowledge of behaviors to prevent influenza, as reflected by talking drawings. This novel metric may be more sensitive in capturing knowledge among students than traditional assessment methods. However, IPPE did not produce further significant differences in student attitudes and behaviors regarding the flu.

Quantifying Reinforcement Value and Demand for Psychoactive Substances in Humans

PubMed Central

Heinz, Adrienne J.; Lilje, Todd C.; Kassel, Jon D.; de Wit, Harriet

2013-01-01

Behavioral economics is an emerging cross-disciplinary field that is providing an exciting new contextual framework for researchers to study addictive processes. New initiatives to study addiction under a behavioral economic rubric have yielded variable terminology and differing methods and theoretical approaches that are consistent with the multidimensional nature of addiction. The present article is intended to provide an integrative overview of the behavioral economic nomenclature and to describe relevant theoretical models, principles and concepts. Additionally, we present measures derived from behavioral economic theories that quantify demand for substances and assess decision making processes surrounding substance use. The sensitivity of these measures to different contextual elements (e.g., drug use status, acute drug effects, deprivation) is also addressed. The review concludes with discussion of the validity of these approaches and their potential for clinical application and highlights areas that warrant further research. Overall, behavioral economics offers a compelling framework to help explicate complex addictive processes and it is likely to provide a translational platform for clinical intervention. PMID:23062106

A technology to measure multiple driving behaviors without self-report or participant reactivity.

PubMed Central

Boyce, T E; Geller, E S

2001-01-01

An in-vehicle information system (IVIS) was used to videotape drivers (N = 61) without their knowledge while driving 22 miles in normal traffic. The drivers were told that they were participating in a study of direction following and map reading. Two data-coding procedures were used to analyze videotapes. Safety-related behaviors were counted during consecutive 15-s intervals of a driving trial, and the occurrence of certain safety-related behaviors was assessed under critical conditions. These two methods of data coding were assessed for practicality, reliability, and sensitivity. Interobserver agreement for the five different driving behaviors ranged from 85% to 95%. Within-subject variability in safe driving was more pronounced among younger drivers and decreased as a function of age. Contrary to previous research that has relied on self-reports, driver risk taking did not vary significantly as a function of gender. These results are used to illustrate the capabilities of the technology introduced here to design and evaluate behavior-analytic interventions to increase safe driving. PMID:11317986

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

PubMed

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

2017-06-01

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

Schoolwide Positive Behavioral Interventions and Support Practices: Review of Studies in the "Journal of Positive Behavior Interventions"

ERIC Educational Resources Information Center

Ögülmüs, Kürsat; Vuran, Sezgin

2016-01-01

Schoolwide Positive Behavioral Interventions and Support (SWPBIS) focuses on interventions in order to meet the social behavioral demands of schools with the help of a three-tiered model. The main aim in SWPBIS is to ensure behavioral success and academic achievement of students in schools. By analyzing the related studies it was seen that there…

The Optimal Ordering Strategy of Outsourcing Procurement of Health Education and Behavior Intervention Products

ERIC Educational Resources Information Center

Zhou, Kai-Ge; Wu, Zhi-Fan; Sun, Xiao-Sheng

2017-01-01

Health communication and behavior intervention are main measures adopted in health education. Behavior intervention among these measures is the direct one to affect individual and group behaviors. Patients demand more than health information communication, but rely on health intervention service and related products. This essay starts from…

Behavior Support Interventions Implemented by Families of Young Children: Examination of Contextual Fit

ERIC Educational Resources Information Center

McLaughlin, Tara W.; Denney, Maria K.; Snyder, Patricia A.; Welsh, Jill L.

2012-01-01

Families are increasingly involved in the implementation of behavior support interventions to promote positive behaviors of young children in everyday family settings. Contextual fit, described as congruence between the behavior support intervention and the values, skills, resources, and routines of those who will implement the intervention, has…

Behavioral intervention for problem behavior in children with fragile X syndrome.

PubMed

Moskowitz, Lauren J; Carr, Edward G; Durand, V Mark

2011-11-01

Parents and professionals typically report problem behavior as a significant concern for children with fragile X syndrome. In the present study, the authors explored whether behaviorally based interventions would result in a reduction in problem behavior and an improvement in quality of life for 3 children with fragile X syndrome and their families. A multiple baseline design was used to demonstrate intervention effects for specific high-priority contexts (i.e., bedtime, running errands, and toileting). A multicomponent intervention plan was developed to teach the parents and child to effectively cope with the particular context. After intervention, there were substantial improvements in problem behavior and family quality of life within the given contexts. Results of this study demonstrated the effectiveness of behavioral intervention for children with fragile X syndrome.

Anxiety sensitivity cognitive concerns predict suicide risk.

PubMed

Oglesby, Mary Elizabeth; Capron, Daniel William; Raines, Amanda Medley; Schmidt, Norman Bradley

2015-03-30

Anxiety sensitivity (AS) cognitive concerns, which reflects fears of mental incapacitation, have been previously associated with suicidal ideation and behavior. The first study aim was to replicate and extend upon previous research by investigating whether AS cognitive concerns can discriminate between those at low risk versus high risk for suicidal behavior. Secondly, we aimed to test the incremental predictive power of AS cognitive concerns above and beyond known suicide risk factors (i.e., thwarted belongingness and insomnia). The sample consisted of 106 individuals (75% meeting current criteria for an Axis I disorder) recruited from the community. Results revealed that AS cognitive concerns were a robust predictor of elevated suicide risk after covarying for negative affect, whereas AS social and physical concerns were not. Those with high, relative to low, AS cognitive scores were 3.67 times more likely to be in the high suicide risk group. Moreover, AS cognitive concerns significantly predicted elevated suicide risk above and beyond relevant suicide risk factors. Results of this study add to a growing body of the literature demonstrating a relationship between AS cognitive concerns and increased suicidality. Incorporating AS cognitive concerns amelioration protocols into existing interventions for suicidal behavior may be beneficial. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effects of the Cognitive-Behavioral Therapy for Stress Management on Executive Function Components.

PubMed

Santos-Ruiz, Ana; Robles-Ortega, Humbelina; Pérez-García, Miguel; Peralta-Ramírez, María Isabel

2017-02-13

This study aims to determine whether it is possible to modify executive function in stressed individuals by means of cognitive-behavioral therapy for stress management. Thirty-one people with high levels of perceived stress were recruited into the study (treatment group = 18; wait-list group = 13). The treatment group received 14 weeks of stress management program. Psychological and executive function variables were evaluated in both groups pre and post-intervention. The treatment group showed improved psychological variables of perceived stress (t = 5.492; p = .001), vulnerability to stress (t = 4.061; p = .001) and superstitious thinking (t = 2.961; p = .009). Likewise, the results showed statistically significant differences in personality variables related to executive function, positive urgency (t = 3.585; p = .002) and sensitivity to reward (t = -2.201; p = .042), which improved after the therapy. These variables showed a moderate to high effect size (oscillates between 1.30 for perceived stress and .566 for sensitivity to reward). The cognitive-behavioral therapy for stress management may be an appropriate strategy for improving personality construct components related to executive function, however effects of the therapy are not showed on performance on the tests of executive function applied, as presented studies previous.

Adapting Behavioral Interventions for Social Media Delivery

PubMed Central

Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L

2016-01-01

Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals—a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality. PMID:26825969

Adapting Behavioral Interventions for Social Media Delivery.

PubMed

Pagoto, Sherry; Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L

2016-01-29

Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals--a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality.

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

Changes in automatic threat processing precede and predict clinical changes with exposure-based cognitive-behavior therapy for panic disorder.

PubMed

Reinecke, Andrea; Waldenmaier, Lara; Cooper, Myra J; Harmer, Catherine J

2013-06-01

Cognitive behavioral therapy (CBT) is an effective treatment for emotional disorders such as anxiety or depression, but the mechanisms underlying successful intervention are far from understood. Although it has been a long-held view that psychopharmacological approaches work by directly targeting automatic emotional information processing in the brain, it is usually postulated that psychological treatments affect these processes only over time, through changes in more conscious thought cycles. This study explored the role of early changes in emotional information processing in CBT action. Twenty-eight untreated patients with panic disorder were randomized to a single session of exposure-based CBT or waiting group. Emotional information processing was measured on the day after intervention with an attentional visual probe task, and clinical symptoms were assessed on the day after intervention and at 4-week follow-up. Vigilance for threat information was decreased in the treated group, compared with the waiting group, the day after intervention, before reductions in clinical symptoms. The magnitude of this early effect on threat vigilance predicted therapeutic response after 4 weeks. Cognitive behavioral therapy rapidly affects automatic processing, and these early effects are predictive of later therapeutic change. Such results suggest very fast action on automatic processes mediating threat sensitivity, and they provide an early marker of treatment response. Furthermore, these findings challenge the notion that psychological treatments work directly on conscious thought processes before automatic information processing and imply a greater similarity between early effects of pharmacological and psychological treatments for anxiety than previously thought. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Insulin sensitivity deteriorates after short-term lifestyle intervention in the insulin sensitive phenotype of obesity.

PubMed

Gilardini, Luisa; Vallone, Luciana; Cottafava, Raffaella; Redaelli, Gabriella; Croci, Marina; Conti, Antonio; Pasqualinotto, Lucia; Invitti, Cecilia

2012-01-01

To investigate the effects of a 3-month lifestyle intervention on insulin sensitivity and its related cardiometabolic factors in obese patients. Anthropometry, body composition, oral glucose tolerance test, lipids, alanine aminotransferase, insulin sensitivity (insulinogenic index (ISI), homeostasis model assessment, β-cell performance (disposition index)) were evaluated in 263 obese women and 93 obese men before and after 3 months of hypocaloric low fat/high protein diet associated with physical activity 30 min/day. Patients were divided into 3 groups according to the intervention-induced ISI changes: group 1 (decrease), group 2 (stability) and group 3 (increase). Insulin sensitivity and the disposition index were significantly higher before the intervention in group 1 than in group 3. BMI, waist circumference, and fat mass significantly decreased in groups 1 and 3 in both sexes. β-cell performance decreased in group 1 and increased in group 3. Metabolic variables improved in group 3, whereas glucose levels increased in women of group 1. The post-intervention insulin sensitivity was lower in group 1 than in group 3. Lifestyle intervention induces changes in insulin sensitivity and metabolic factors that depend on the pre-intervention degree of insulin sensitivity. Weight loss leads to metabolic benefits in insulin-resistant, obese patients, whereas it may paradoxically worsen the metabolic conditions in the insulin-sensitive phenotype of obesity. Copyright © 2012 S. Karger GmbH, Freiburg.

Multiple Behavior Change Intervention to Improve Detection of Unmet Social Needs and Resulting Resource Referrals.

PubMed

Colvin, Jeffrey D; Bettenhausen, Jessica L; Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Plencner, Laura; Krager, Molly; Nelson, Brooke; Donnelly, Sara; Simmons, Julia; Higinio, Valeria; Chung, Paul J

2016-03-01

It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use. A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P < .001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% confidence interval 0.87-0.99) and sensitivity was 0.63 (95% confidence interval 0.50-0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months). A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Study adaptation, design, and methods of a web-based PTSD intervention for women Veterans.

PubMed

Lehavot, Keren; Litz, Brett; Millard, Steven P; Hamilton, Alison B; Sadler, Anne; Simpson, Tracy

2017-02-01

Women Veterans are a rapidly growing population with high risk of exposure to potentially traumatizing events and PTSD diagnoses. Despite the dissemination of evidence-based treatments for PTSD in the VA, most women Veteran VA users underutilize these treatments. Web-based PTSD treatment has the potential to reach and engage women Veterans with PTSD who do not receive treatment in VA settings. Our objective is to modify and evaluate Delivery of Self Training and Education for Stressful Situations (DESTRESSS), a web-based cognitive-behavioral intervention for PTSD, to target PTSD symptoms among women Veterans. The specific aims are to: (1) obtain feedback about DESTRESS, particularly on its relevance and sensitivity to women, using semi-structured interviews with expert clinicians and women Veterans with PTSD, and make modifications based on this feedback; (2) conduct a pilot study to finalize study procedures and make further refinements to the intervention; and (3) conduct a randomized clinical trial (RCT) evaluating a revised, telephone-assisted DESTRESS compared to telephone monitoring only. We describe the results from the first two aims, and the study design and procedures for the ongoing RCT. This line of research has the potential to result in a gender-sensitive, empirically-based, online treatment option for women Veterans with PTSD. Published by Elsevier Inc.

Communicative Alternatives to Challenging Behavior: Integrating Functional Assessment and Intervention Strategies. Volume 3. Communication and Language Intervention Series.

ERIC Educational Resources Information Center

Reichle, Joe, Ed.; Wacker, David P., Ed.

Emphasizing the use of communication training as the foundation for effective behavioral programming, this book explains how challenging behavior can be redirected into socially acceptable behavior through functional communication intervention. The book offers hands-on assessment and intervention strategies that can be used in school, home, work,…

Treatment Fidelity: Special Educators' Perceptions of Measures Used to Monitor the Implementation of Behavior Intervention Plans

ERIC Educational Resources Information Center

Thorne, Jennifer

2012-01-01

The Individuals with Disabilities Education Improvement Act of 2004 requires empirically based interventions to be used when treating chronic problem behaviors. The fundamental part of behavior modification is the ability to demonstrate that behavior change occurred due to the intervention. This can only be accomplished when the intervention is…

Teacher Perceptions of Using Positive Behavior Interventions and Supports as Behavioral Interventions in a Pre-K-5 Elementary School: A Phenomenological Study

ERIC Educational Resources Information Center

Roberts-Clawson, Meghann E.

2017-01-01

This qualitative study addresses teacher perceptions of using positive behavior interventions and supports (PBIS) as positive behavioral interventions. This phenomenological study was conducted within a Pre-K-5 elementary school in northwestern North Carolina. In order to collect qualitative data, personal individualized interviews were conducted…

A Randomized Controlled Trial of a Standardized Behavior Management Intervention for Students with Externalizing Behavior

ERIC Educational Resources Information Center

Forster, Martin; Sundell, Knut; Morris, Richard J.; Karlberg, Martin; Melin, Lennart

2012-01-01

This study reports the results from a Swedish randomized controlled trial of a standardized behavior management intervention. The intervention targeted students with externalizing behavior in a regular education setting. First- and second-grade students (N = 100) from 38 schools were randomly assigned to either the intervention or an active…

Behavior Intervention Planning and Implementation of Positive Behavioral Support Plans: An Examination of States' Adherence to Standards for Practice

ERIC Educational Resources Information Center

Killu, Kim; Weber, Kimberly P.; Derby, K. Mark; Barretto, Anjali

2006-01-01

To address the behavioral needs of students with disabilities in school settings, the Individuals with Disabilities Education Improvement Act of 2004 (IDEIA) requires the development and implementation of a behavior intervention plan/positive behavioral support plan (BIP/PBSP) based on positive behavioral interventions and supports (PBIS). Despite…

Understanding child sexual behavior problems: a developmental psychopathology framework.

PubMed

Elkovitch, Natasha; Latzman, Robert D; Hansen, David J; Flood, Mary Fran

2009-11-01

Children exhibiting sexual behavior have increasingly gained the attention of child welfare and mental health systems, as well as the scientific community. While a heterogeneous group, children with sexual behavior problems consistently demonstrate a number of problems related to adjustment and overall development. In order to appropriately intervene with these children, a comprehensive understanding of etiology is imperative. The overarching goal of the present paper is to review the extant research on mechanisms associated with the development of problematic sexual behavior in childhood within a developmental psychopathology framework. What is known about normative and nonnormative sexual behavior in childhood is reviewed, highlighting definitional challenges and age-related developmental differences. Further, the relationship between child sexual abuse and child sexual behavior problems is discussed, drawing attention to factors impacting this relationship. Risk factors for child sexual behavior problems, beyond that of sexual abuse, are also reviewed utilizing a transactional-ecological framework. Finally, we conclude with a discussion of implications of a developmental psychopathology perspective on problematic child sexual behaviors to inform future research and intervention efforts. Such implications include the need for attention to normative childhood sexual behavior, developmental sensitivity, and examinations of ecological domain in concert.

Addictive Behavior Interventions Among College Students.

PubMed

Jeffries, Emily R; Lemke, Austin W; Shah, Sonia M; Dean, Kimberlye E; Richter, Ashley A; Buckner, Julia D

2016-12-01

Addictive behaviors among college students are a significant public health concern. This manuscript reviews the past two years of literature on prevention and treatment approaches for college students who engage in addictive behaviors. In-person skills-based interventions and motivational interventions that incorporate personalized feedback are effective in the short-term but little support was found for long-term effects. Although web-based interventions reduced certain addictive behaviors (e.g., alcohol, problematic gambling), in-person interventions that include motivational interviewing components and personalized feedback appear to be more efficacious. Research has largely focused on alcohol and little is known about the utility of interventions for students who use tobacco or illicit substances or who engage in problematic gambling. Research on interventions for these high-risk behaviors is recommended.

Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis.

PubMed

Howlett, Neil; Trivedi, Daksha; Troop, Nicholas A; Chater, Angel Marie

2018-02-28

Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the "Template for Intervention Description and Replication" (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16-0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12-0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs "Biofeedback," "Demonstration of the behavior," "Behavior practice/rehearsal," and "Graded tasks." At follow-up, effectiveness was associated with using "Action planning," "Instruction on how to perform the behavior," "Prompts/cues," "Behavior practice/rehearsal," "Graded tasks," and "Self-reward." Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement.

Maternal sensitivity and social support protect against childhood atopic dermatitis.

PubMed

Letourneau, Nicole L; Kozyrskyj, Anita L; Cosic, Nela; Ntanda, Henry N; Anis, Lubna; Hart, Martha J; Campbell, Tavis S; Giesbrecht, Gerald F

2017-01-01

Many studies have identified associations between qualities of maternal-child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal-infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors. We conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrollment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age. Higher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD. Low maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal-infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.

Cognitive development in children of adolescent mothers: The impact of socioeconomic risk and maternal sensitivity.

PubMed

Firk, Christine; Konrad, Kerstin; Herpertz-Dahlmann, Beate; Scharke, Wolfgang; Dahmen, Brigitte

2018-02-01

Adolescent motherhood is accompanied by a constellation of risk factors that translate into developmental risk for the off-spring. Socioeconomic risk that is associated with adolescent motherhood as well as maternal interactive behaviors may contribute to the impact of adolescent motherhood on children's developmental outcome. Therefore, the aim of the current study was to investigate differences in children's cognitive development between children of adolescent and adult mothers in their first two years of life and to examine whether socioeconomic risk (e.g. such as educational and financial problems) and/or maternal sensitivity mediate developmental differences between children of adolescent and adult mothers. Adolescent mothers (<21 years; N = 64) and adult mothers (>25 years; N = 34) and their infants were included in the current study. Child cognitive development and maternal sensitivity were assessed at three different time points (T1: mean child age 5.26 months; T2: mean child age 14.69 months; T3: mean child age 21.16 months). Children of adult mothers showed better cognitive performance at T3 compared to children of adolescent mothers but not at T1 and T2. A multiple mediation model including socioeconomic risk and maternal sensitivity as serial mediators demonstrated that the effect of adolescent motherhood on cognitive development was mediated in a causal effect chain with socioeconomic risk negatively affecting maternal sensitivity and maternal sensitivity affecting children's cognitive development. The present findings demonstrate that maternal interactive behaviors are not only a simple predictor of cognitive development but may also act as a mediator of the association between more distal variables such as socioeconomic risk and cognitive development in adolescent mothers. This supports the need to promote prevention and intervention programs for adolescent mothers during the early postpartum period to reduce socioeconomic problems and enhance maternal interactive behaviors. Copyright © 2018 Elsevier Inc. All rights reserved.

Efficacy of smoking cessation therapy alone or integrated with prolonged exposure therapy for smokers with PTSD: Study protocol for a randomized controlled trial.

PubMed

Powers, Mark B; Kauffman, Brooke Y; Kleinsasser, Anne L; Lee-Furman, Eunjung; Smits, Jasper A J; Zvolensky, Michael J; Rosenfield, David

2016-09-01

Posttraumatic stress disorder (PTSD) is related to an increased risk of smoking cessation failure. In fact, the quit rate in smokers with PTSD (23.2%) is one of the lowest of all mental disorders. Features of PTSD that contribute to smokers' progression to nicotine dependence and cessation relapse include negative affect, fear, increased arousal, irritability, anger, distress intolerance, and anxiety sensitivity. Anxiety sensitivity is higher in people with PTSD than in any other anxiety disorder except for panic disorder. High anxiety sensitivity is uniquely associated with greater odds of lapse and relapse during quit attempts. Distress intolerance, a perceived or behavioral tendency to not tolerate distress, is related to both the maintenance of PTSD and problems in quitting smoking. Prolonged exposure (PE) and interoceptive exposure (IE) reduce PTSD symptoms, distress intolerance, and anxiety sensitivity. Thus, they emerge as promising candidates to augment standard smoking cessation interventions for individuals with PTSD. The present study tests a 12-session specialized treatment for smokers with PTSD. This Integrated PTSD and Smoking Treatment (IPST) combines cognitive-behavioral therapy and nicotine replacement treatment for smoking cessation (standard care; SC) with PE to target PTSD symptoms and IE to reduce anxiety sensitivity and distress intolerance. Adult smokers (N=80) with PTSD will be randomly assigned to either: (1) IPST or (2) SC. Primary outcomes are assessed at weeks 0, 6, 8, 10, 14, 16, 22, and 30. Copyright © 2016. Published by Elsevier Inc.

Addressing multilevel barriers to cervical cancer screening in Korean American women: A randomized trial of a community-based intervention.

PubMed

Fang, Carolyn Y; Ma, Grace X; Handorf, Elizabeth A; Feng, Ziding; Tan, Yin; Rhee, Joanne; Miller, Suzanne M; Kim, Charles; Koh, Han Seung

2017-05-15

Korean American women have among the lowest rates of cervical cancer screening in the United States. The authors evaluated a multicomponent intervention combining community education with navigation services to reduce access barriers and increase screening rates in this underserved population. It was hypothesized that cervical cancer screening rates would be higher among women who received the intervention program compared with those in the control program. Korean American women (N = 705) were recruited from 22 churches. In this matched-pair, group-randomized design, 347 women received the intervention, which consisted of a culturally relevant cancer education program combined with provision of navigation services. The control group (N = 358) received general health education, including information about cervical cancer risk and screening and where to obtain low-cost or no-cost screening. Screening behavior was assessed 12 months after the program. Screening behavior data were obtained from 588 women 12 months after the program. In both site-level and participant-level analyses, the intervention program contributed to significantly higher screening rates compared with the control program (odds ratio [OR], 25.9; 95% confidence interval [CI], 10.1-66.1; P < .001). In sensitivity analysis, the treatment effect remained highly significant (OR, 16.7; 95% CI, 8.1-34.4; P < .001). A multicomponent intervention combining community cancer education with navigation services yielded significant increases in cervical cancer screening rates among underscreened Korean American women. Community-accessible programs that incorporate cancer education with the delivery of key navigation services can be highly effective in increasing cervical cancer screening rates in this underserved population. Cancer 2017;123:1018-26. © 2016 American Cancer Society. © 2016 American Cancer Society.

Paraprofessional Support and Perceptions of a Function-Based Classroom Intervention

ERIC Educational Resources Information Center

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

2018-01-01

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

Psychological and behavioral interventions to reduce HIV risk: evidence from a randomized control trial among orphaned and vulnerable adolescents in South Africa

PubMed Central

Thurman, T. R.; Kidman, R.; Carton, T. W.; Chiroro, P.

2016-01-01

ABSTRACT Evidence-based approaches are needed to address the high levels of sexual risk behavior and associated HIV infection among orphaned and vulnerable adolescents. This study recruited adolescents from a support program for HIV-affected families and randomly assigned them by cluster to receive one of the following: (1) a structured group-based behavioral health intervention; (2) interpersonal psychotherapy group sessions; (3) both interventions; or (4) no new interventions. With 95% retention, 1014 adolescents were interviewed three times over a 22-month period. Intent-to-treat analyses, applying multivariate difference-in-difference probit regressions, were performed separately for boys and girls to assess intervention impacts on sexual risk behaviors. Exposure to a single intervention did not impact behaviors. Exposure to both interventions was associated with risk-reduction behaviors, but the outcomes varied by gender: boys reported fewer risky sexual partnerships (β = −.48, p = .05) and girls reported more consistent condom (β = 1.37, p = .02). There was no difference in the likelihood of sexual debut for either gender. Providing both psychological and behavioral interventions resulted in long-term changes in sexual behavior that were not present when either intervention was provided in isolation. Multifaceted approaches for reducing sexual risk behaviors among vulnerable adolescents hold significant promise for mitigating the HIV epidemic among this priority population. PMID:26886261

Suicide Risk, Stress Sensitivity, and Self-Esteem among Young Adults Reporting Auditory Hallucinations.

PubMed

DeVylder, Jordan E; Hilimire, Matthew R

2015-08-01

Individuals with subthreshold psychotic experiences are at increased risk for suicidal thoughts and behavior, similar to those with schizophrenia and other psychotic disorders. This may be explained by shared risk factors such as heightened stress sensitivity or low self-esteem. Understanding the nature of this relationship could inform suicide prevention in social work practice. In this study, authors examined the relationship between self-reported auditory hallucinations and suicidal thoughts, plans, and attempts, in a nonclinical sample of young adults, controlling for scores on the Psychological Stress Index and Rosenberg Self-Esteem Scale. Auditory hallucinations were associated with approximately double the odds of suicidal ideation and plans and four times the odds for suicide attempts. This relationship was not explained by stress sensitivity or self-esteem, which were independently related to hallucinations and suicidality, respectively. Subthreshold auditory hallucinations may be a useful indicator of suicide risk. This association may represent a clinically significant relationship that may be addressed through social work interventions intended to alleviate stress sensitivity or improve self-esteem.

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

Promoting exercise behavior among Chinese youth with hearing loss: a randomized controlled trial based on the transtheoretical model.

PubMed

Si, Qi; Yu, Kehong; Cardinal, Bradley J; Lee, Hyo; Yan, Zi; Loprinzi, Paul D; Li, Fuzhong; Liu, Haiqun

2011-12-01

The transtheoretical model proposes that behavior change is experienced as a series of stages. Interventions tailored to these stages are most likely to be effective in progressing people through the model's hypothesized behavior change continuum. In this study, a stage-tailored, 12-week, exercise behavior intervention based on the transtheoretical model was conducted among a sample of 150 Chinese youth with hearing loss. Participants were randomized into an intervention or control group with all the core transtheoretical model constructs assessed pre- and post-intervention. Participants in the intervention group showed greater advances in their stage of exercise behavior change, decisional balance, and processes of change use compared to those in the control group. The intervention, however, was insufficient for increasing participants' self-efficacy for exercise behavior. The findings partially support the utility of the theory-based intervention for improving the exercise behavior of Chinese youth with hearing loss, while simultaneously helping to identify areas in need of improvement for future applications.

Effectiveness of Mindfulness Intervention on Psychological Behaviors Among Adolescents With Parental HIV Infection: A Group-Randomized Controlled Trial.

PubMed

Mon, Myo-Myo; Liabsuetrakul, Tippawan; Htut, Kyaw-Min

2016-11-01

This study aims to identify the effectiveness of mindfulness intervention on the psychological behaviors of adolescents with parental HIV infection and its associated factors in Myanmar. A total of 80 adolescents from 2 intervention townships and 80 adolescents from 2 control townships were enrolled in a group randomized controlled trial with assessments at baseline and 6 months follow-up. The mindfulness intervention involved monthly group sessions for 3 consecutive months led by an experienced mindfulness trainer. Three domains of psychological behaviors-namely, emotional, conduct, and social behaviors-were assessed at baseline and compared after 6 months. Multilevel regression analysis was used to determine the effectiveness of the intervention and associated factors for psychological behaviors. The intervention significantly improved emotional and conduct behaviors at 6 months (P < .001) but had no effect on social behavior. The significant effect of the intervention existed after adjusting for gender, family type, child age, and orphan status. © 2016 APJPH.

The Efficacy of a Group Cognitive Behavioral Therapy for War-Affected Young Migrants Living in Australia: A Cluster Randomized Controlled Trial

PubMed Central

Ooi, Chew S.; Rooney, Rosanna M.; Roberts, Clare; Kane, Robert T.; Wright, Bernadette; Chatzisarantis, Nikos

2016-01-01

Background: Preventative and treatment programs for people at risk of developing psychological problems after exposure to war trauma have mushroomed in the last decade. However, there is still much contention about evidence-based and culturally sensitive interventions for children. The aim of this study was to examine the efficacy of the Teaching Recovery Techniques in improving the emotional and behavioral outcomes of war-affected children resettled in Australia. Methods and Findings: A cluster randomized controlled trial with pre-test, post-test, and 3-month follow-up design was employed. A total of 82 participants (aged 10–17 years) were randomized by school into the 8-week intervention (n = 45) or the waiting list (WL) control condition (n = 37). Study outcomes included symptoms of post-traumatic stress disorder, depression, internalizing and externalizing problems, as well as psychosocial functioning. A medium intervention effect was found for depression symptoms. Participants in the intervention condition experienced a greater symptom reduction than participants in the WL control condition, F(1, 155) = 5.20, p = 0.024, partial η2 = 0.07. This improvement was maintained at the 3-month follow-up, F(2, 122) = 7.24, p = 0.001, partial η2 = 0.20. Conclusions: These findings suggest the potential benefit of the school and group-based intervention on depression symptoms but not on other outcomes, when compared to a waiting list control group. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12611000 948998. PMID:27843435

Understanding Research Gaps and Priorities for Improving Behavioral Counseling Interventions: Lessons Learned From the U.S. Preventive Services Task Force.

PubMed

Kurth, Ann E; Miller, Therese L; Woo, Meghan; Davidson, Karina W

2015-09-01

Behavioral counseling interventions can address significant causes of preventable morbidity and mortality. However, despite a growing evidence base for behavioral counseling interventions, there remain significant research gaps that limit translating the evidence into clinical practice. Using U.S. Preventive Services Task Force (USPSTF) examples, we address how researchers and funders can move the research portfolio forward to achieve better application of behavioral counseling interventions to address substantial health burdens in the U.S. This paper describes the types of gaps that the USPSTF encounters across its behavioral counseling intervention topics and provides suggestions for opportunities to address these gaps to enhance the evidence base for primary care-based behavioral counseling recommendations. To accomplish this, we draw from both the USPSTF experience and issues identified by researchers and clinicians during the USPSTF-sponsored Behavioral Counseling Intervention Forum. We also discuss the dilemma posed by having "insufficient" evidence with which to make a behavioral counseling intervention-related recommendation, and describe two case examples (screening for alcohol misuse in adolescence and screening for child maltreatment), detailing the research gaps that remain. Recommendations are outlined for researchers, funders, and practice implementers to improve behavioral counseling intervention research and application. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Interpersonal sensitivity, coping ways and automatic thoughts of nursing students before and after a cognitive-behavioral group counseling program.

PubMed

Hiçdurmaz, Duygu; Öz, Fatma

2016-01-01

In order to provide optimal professional care to patients, nurses must possess a positive self-image and professional identity. High interpersonal sensitivity, coping problems and dysfunctional automatic thoughts can prevent nursing students to be self-confident and successful nurses. Helping nursing students experiencing interpersonal sensitivity problems via cognitive-behavioral counseling strategies can contribute to shape good nurses. This study aims to evaluate interpersonal sensitivity, ways of coping and automatic thoughts of nursing students before and after a cognitive behavioral group counseling program. An intervention study with 43 nursing students. Measurements were done before the counseling program, at the end of the program and 4.5months after the program. The students were chosen from a faculty of nursing in Turkey. 43 second and third year nursing students who were experiencing interpersonal sensitivity problems constituted the sample. Brief Symptom Inventory, Ways of Coping Inventory and Automatic Thoughts Questionnaire were used for data collection. The students' scores of "interpersonal sensitivity", "hopeless" and "submissive" copings and "automatic thoughts" were significantly lower at the end of and 4.5months after the program than the scores before the program (Interpersonal sensitivity F=52.903, p=0.001; hopeless approach F=19.213, p=0.001; submissive approach F=4.326, p=0.016; automatic thoughts F=45.471, p=0.001). Scores of "self-confident", "optimistic" and "seeking social support" copings were higher at the end of and 4.5months after the program than the scores before the program (Self confident F=11.640, p=0.001; optimistic F=10.860, p=0.001; seeking social support F=10.411, p=0.001). This program helped the students to have better results at interpersonal sensitivity, ways of coping and automatic thoughts at the end of and 4.5 months after the program. We have reached the aim of the study. We suggest that such counseling programs should be regular and integrated into the services provided for students. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cultural considerations in the treatment of mental illness among sexually abused children and adolescents: the case of Bali, Indonesia.

PubMed

Lesmana, Cokorda Bagus J; Suryani, Luh Ketut; Tiliopoulos, Niko

2015-01-01

Childhood and adolescence sexual abuse can have long-lasting and devastating effects on personal and interpersonal growth and development. Sexually abused children tend to exhibit higher rates of poor school performance, aggressive behavior, PTSD (posttraumatic stress disorder), or depressive symptomatology, as well as social and relational deficits (e.g., age-inappropriate sexual behaviors). The trauma following such abuse can further affect neurodevelopment and physiology, aggravating mental or physical problems in adulthood. Early symptom recognition and appropriate interventional applications are important factors in successfully treating or even preventing the development of mental disorders in such cohorts. A central element of effective treatment is the selection of treatment targets. Cultural considerations are rarely or peripherally considered in sexual abuse treatment strategies. Western-trained psychiatrists and clinical psychologists tend to overlook or underestimate such factors in cross-cultural settings, resulting in interventional efforts that may interfere with traditional approaches to healing, and potentially contributing to a transgenerational cycle of trauma. By using Bali (Indonesia) as a focal culture, in this article we discuss the effects of cultural elements and showcase their potential contribution and systematic implementation into a holistic and sensitive interventional model for the treatment of mental illness in childhood and adolescence sexual traumatization. © 2015 Wiley Periodicals, Inc.

The relevance of memory sensitivity for psychological well-being in aging.

PubMed

Toffalini, Enrico; Borella, Erika; Cornoldi, Cesare; De Beni, Rossana

2016-08-01

In the present study, we investigated the relationship between memory sensitivity, which describes a positive attitude to autobiographical memory and the presence of behaviors devoted to saving memories of the personal past, and psychological well-being; in particular, we tested whether their relationship would change across age groups. Three hundred eighteen participants, divided in four groups: young to middle-aged adults (20-55 years old), young-old adults (65-74 years old), old adults (75-84 years old), and old-old adults (85-97 years old), completed questionnaires on their memory sensitivity and psychological well-being. Memory sensitivity slightly decreased with age and had a positive relationship with psychological well-being that was critically moderated by age. Specifically, the relationship between memory sensitivity and psychological well-being became increasingly stronger as age increased. While memory sensitivity may have little or no particular relevance in the case of young to middle-aged adults, it has an increasingly important positive relationship with psychological well-being at later age. It is thus suggested that memory sensitivity represents a dimension that should be considered in the study and interventions on quality of life in the elderly population.

[The BASYS observation system for the analysis of aggressive behavior in classroom-settings].

PubMed

Wettstein, Alexander

2012-01-01

Educational or therapeutic measures of aggressive student behavior are often based on the judgments of teachers. However, empirical studies show that the objectivity of these judgments is generally low. In order to assess aggressive behavior in classroom settings, we developed a context-sensitive observational system. The observation system exists in a version for teachers in action as well as a version for the uninvolved observer. The teacher version allows categorizing aggressive behavior while teaching. The aim is to differentiate the perception and the judgments of teachers, so that the judgments can serve as trustable diagnostic information. The version for an independent observer, in addition, contains categories to collect information about the context in which aggressions take place. The behavior observation system was tested in four field-studies in regular and special classes. The empirical results show that, after training, teachers were able to make objective observations, and that aggressive behavior depends to a large extent on situational factors. The system allows identification of problematic people-environment relationships and the derivation of intervention measures.

The Columbia–Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults

PubMed Central

Posner, Kelly; Brown, Gregory K.; Stanley, Barbara; Brent, David A.; Yershova, Kseniya V.; Oquendo, Maria A.; Currier, Glenn W.; Melvin, Glenn A.; Greenhill, Laurence; Shen, Sa; Mann, J. John

2013-01-01

Objective Research on suicide prevention and interventions requires a standard method for assessing both suicidal ideation and behavior to identify those at risk and to track treatment response. The Columbia–Suicide Severity Rating Scale (C-SSRS) was designed to quantify the severity of suicidal ideation and behavior. The authors examined the psychometric properties of the scale. Method The C-SSRS’s validity relative to other measures of suicidal ideation and behavior and the internal consistency of its intensity of ideation subscale were analyzed in three multisite studies: a treatment study of adolescent suicide attempters (N=124); a medication efficacy trial with depressed adolescents (N=312); and a study of adults presenting to an emergency department for psychiatric reasons (N=237). Results The C-SSRS demonstrated good convergent and divergent validity with other multi-informant suicidal ideation and behavior scales and had high sensitivity and specificity for suicidal behavior classifications compared with another behavior scale and an independent suicide evaluation board. Both the ideation and behavior subscales were sensitive to change over time. The intensity of ideation subscale demonstrated moderate to strong internal consistency. In the adolescent suicide attempters study, worst-point lifetime suicidal ideation on the C-SSRS predicted suicide attempts during the study, whereas the Scale for Suicide Ideation did not. Participants with the two highest levels of ideation severity (intent or intent with plan) at baseline had higher odds for attempting suicide during the study. Conclusions These findings suggest that the C-SSRS is suitable for assessment of suicidal ideation and behavior in clinical and research settings. PMID:22193671

Impact of a community-based payment for environmental services intervention on forest use in Menabe, Madagascar.

PubMed

Sommerville, Matthew; Milner-Gulland, E J; Rahajaharison, Michael; Jones, Julia P G

2010-12-01

Despite the growing interest in conservation approaches that include payments for environmental services (PES), few evaluations of the influence of such interventions on behaviors of individuals have been conducted. We used self-reported changes in six legal and illegal forest-use behaviors to investigate the way in which a PES for biodiversity conservation intervention in Menabe, Madagascar, influenced behavior. Individuals (n =864) from eight intervention communities and five control communities answered questions on their forest-use behaviors before and after the intervention began, as well as on their reasons for changing and their attitudes to various institutions. The payments had little impact on individuals' reported decisions to change behaviors, but it had a strong impact on individuals' attitudes. Payments appeared to legitimize monitoring of behaviors by the implementing nongovernmental organization (NGO), but did not act as a behavioral driver in their own right. Although there were no clear differences between changes in behaviors in the intervention and control communities, the intervention did influence motivations for change. Fear of local forest associations and the implementing NGO were strong motivators for changing behavior in communities with the PES intervention, whereas fear of the national government was the main reason given for change in control communities. Behavioral changes were most stable where fear of local organizations motivated the change. Our results highlight the interactions between different incentives people face when making behavioral decisions and the importance of considering the full range of incentives when designing community-based PES interventions. © 2010 Society for Conservation Biology.

Bridging Behavioral Assessment and Behavioral Intervention: Finding Your Inner Behavior Analyst

ERIC Educational Resources Information Center

Johnson, LeAnne D.; Monn, Emily

2015-01-01

The persistence of challenging behaviors for some children highlights a need and an opportunity to explore several key principles of behavioral intervention that are necessary for effective decision- making when more personalized interventions must be layered on top of high-quality universal supports. In the absence of expert support,…

Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Schreibman, Laura; Dawson, Geraldine; Stahmer, Aubyn C.; Landa, Rebecca; Rogers, Sally J.; McGee, Gail G.; Kasari, Connie; Ingersoll, Brooke; Kaiser, Ann P.; Bruinsma, Yvonne; McNerney, Erin; Wetherby, Amy; Halladay, Alycia

2015-01-01

Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. "Naturalistic Developmental Behavioral Interventions…

A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among Housing First residents.

PubMed

Kennedy, David P; Hunter, Sarah B; Chan Osilla, Karen; Maksabedian, Ervant; Golinelli, Daniela; Tucker, Joan S

2016-03-15

Individuals transitioning from homelessness to housing face challenges to reducing alcohol, drug and HIV risk behaviors. To aid in this transition, this study developed and will test a computer-assisted intervention that delivers personalized social network feedback by an intervention facilitator trained in motivational interviewing (MI). The intervention goal is to enhance motivation to reduce high risk alcohol and other drug (AOD) use and reduce HIV risk behaviors. In this Stage 1b pilot trial, 60 individuals that are transitioning from homelessness to housing will be randomly assigned to the intervention or control condition. The intervention condition consists of four biweekly social network sessions conducted using MI. AOD use and HIV risk behaviors will be monitored prior to and immediately following the intervention and compared to control participants' behaviors to explore whether the intervention was associated with any systematic changes in AOD use or HIV risk behaviors. Social network health interventions are an innovative approach for reducing future AOD use and HIV risk problems, but little is known about their feasibility, acceptability, and efficacy. The current study develops and pilot-tests a computer-assisted intervention that incorporates social network visualizations and MI techniques to reduce high risk AOD use and HIV behaviors among the formerly homeless. CLINICALTRIALS. NCT02140359.

Non-Pharmacological Approaches to Reducing Negative Behavioral Symptoms: A Scoping Review

PubMed Central

Wong, Carin; Leland, Natalie E.

2017-01-01

Background The management of negative behavioral symptoms among residents with dementia is a challenge that nursing homes face in delivering quality care. Objective Examine evidence documenting non-pharmacological interventions that reduce negative behavioral symptoms among nursing home residents with dementia and the role occupational therapy practitioners have in this area. Method A scoping review was completed for intervention studies published from 1987 to 2014, targeting negative behavioral symptoms among nursing home residents over 60 years of age with dementia. Interventions were categorized based on the AOTA Occupational Therapy Practice Framework. Results Twenty-two studies met the inclusion criteria. Four types of interventions were identified: occupation-based interventions, context and environment interventions, exercise interventions, and daily routine-based interventions. Conclusion The non-pharmacological interventions were found to align with the scope of occupational therapy. This suggests that occupational therapy practitioners can contribute to the development and evaluation of non-pharmacological interventions aimed to reduce negative behavioral symptoms. PMID:27504691

The importance of cultural competency in general pediatrics.

PubMed

Brotanek, Jane M; Seeley, Christina E; Flores, Glenn

2008-12-01

There is a growing awareness of the importance of cultural competency in pediatrics. The authors review the most recent studies that examine the impact of cultural competency on general pediatric care, explore cultural beliefs and practices affecting clinical care, and describe culturally sensitive interventions designed to address racial/ethnic health disparities. The beneficial effects of cultural competency embrace health outcomes, quality of care, and patient satisfaction, while failure to consider language and culture can have serious adverse consequences for clinical care, including patient safety and healthcare access. A five-component model of cultural competency has been developed, and a growing literature details an array of normative cultural values, folk illnesses, parent beliefs/practices, and provider behaviors that can have a profound impact on pediatric care. Culturally sensitive interventions are being developed to lessen racial/ethnic health disparities. A goal for the pediatrician is to provide culturally competent healthcare by using trained medical interpreters with limited English-proficient families, being familiar with normative cultural values that affect the healthcare of commonly encountered racial/ethnic groups, and asking about folk illness beliefs and ethnomedical treatments.

Experimental research on the relation between food price changes and food-purchasing patterns: a targeted review1234

PubMed Central

Epstein, Leonard H; Jankowiak, Noelle; Nederkoorn, Chantal; Raynor, Hollie A; French, Simone A; Finkelstein, Eric

2012-01-01

One way in which to modify food purchases is to change prices through tax policy, subsidy policy, or both. We reviewed the growing body of experimental research conducted in the laboratory and in the field that investigates the following: the extent to which price changes influence purchases of targeted and nontargeted foods, total energy, or macronutrients purchased; the interaction of price changes with adjunctive interventions; and moderators of sensitivity to price changes. After a brief overview of economic principles and observational research that addresses these issues, we present a targeted review of experimental research. Experimental research suggests that price changes modify purchases of targeted foods, but research on the overall nutritional quality of purchases is mixed because of substitution effects. There is mixed support for combining price changes with adjunctive interventions, and there are no replicated findings on moderators to price sensitivity in experiments. Additional focused research is needed to better inform food policy development with the aim of improving eating behavior and preventing obesity. PMID:22378726

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

PubMed

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

2012-12-14

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

Iranian Women's Breast Health-Seeking Behaviors: Husband's Role.

PubMed

Mazloomy-Mahmoodabad, Seyed Saeed; Khodayarian, Mahsa; Morowatisharifabad, Mohammad Ali; Lamyian, Minoor; Tavangar, Hossein

2017-12-14

Breast cancer has become the most common cancer among Yazdi women in Iran. Thus, it is necessary to encourage these women to participate in breast health-seeking behaviors. In this regard, husbands can play an effective role. The aim of this study was to explore women's perceptions about the effect of their husband's role on breast health-seeking protection motivation. This study used a directed qualitative content analysis approach based on the Protection Motivation Theory. Participants were selected using purposive sampling; in-depth semistructured interviews with 14 Yazdi women were completed. One major category named "motivator role of husband" emerged from the analysis. The following subcategories underlying this category were "indifference and a lack of support as long as the women can continue with expected duties," "what women want for support," "facilitating and restrictive factors of husband's supportive role," "public health education needed," and "husband's agreement with preventive actions." Voluntary participation in breast health-seeking behaviors is a culturally sensitive topic. The qualitative methodology allowed this sensitive topic and its different aspects to be explored. The findings indicated that the major source of support for women was their husband's behavior toward breast health-seeking actions. Family cohesion and love among couples were identified as strong determinant factors pertaining to husband's supportive behaviors. The study findings provided deeper understanding about the effective factors related to a husband's role in motivating a wife to practice breast cancer prevention. These new findings are relevant for health educators and practitioners to develop culturally based interventions.

Enhancing survey data collection among youth and adults: use of handheld and laptop computers.

PubMed

Bobula, James A; Anderson, Lori S; Riesch, Susan K; Canty-Mitchell, Janie; Duncan, Angela; Kaiser-Krueger, Heather A; Brown, Roger L; Angresano, Nicole

2004-01-01

Tobacco use, alcohol and other drug use, early sexual behavior, dietary practices, physical inactivity, and activities that contribute to unintentional and intentional injuries are a significant threat to the health of young people. These behaviors have immediate and long-term consequences and contribute to diminished health, educational, and social outcomes. Research suggests that health risk behaviors exhibited during adolescence and adulthood have their origins earlier in childhood and preventive interventions are less successful after the risk behaviors have begun. Therefore, efforts to prevent health risk behaviors are best initiated in late childhood or early adolescence. However, to document the efficacy of these efforts, reliable, valid, and parent/child-friendly systems of data collection are required. Computerized data collection for research has been found to improve privacy, confidentiality, and portability over the paper-and-pencil method, which, in turn, enhances the reliability of sensitive data such as alcohol use or sexual activity. We developed programming tools for the personal computer and a handheld personal data assistant to offer a comprehensive set of user interface design elements, relational databases, and ample programming languages so that adults could answer 261 items and youth 346 items. The purpose of the article was to describe an innovative handheld computer-assisted survey interview method of collecting sensitive data with children aged 9 to 11. The method was developed as part of a large multisite, national study to prevent substance use.

The Mechanisms Linking Health Literacy to Behavior and Health Status

PubMed Central

Osborn, Chandra Y.; Paasche-Orlow, Michael K.; Bailey, Stacy Cooper; Wolf, Michael S.

2011-01-01

Objective To examine the mechanisms linking health literacy to physical activity and self-reported health. Methods From 2005–2007, patients (N=330) with hypertension were recruited from safety net clinics. Path analytic models tested the pathways linking health literacy to physical activity and self-reported health. Results There were significant paths from health literacy to knowledge (r=0.22, P<0.001), knowledge to self-efficacy (r=0.13, P<0.01), self-efficacy to physical activity (r=0.17, P<0.01), and physical activity to health status (r=0.17, P<0.01). Conclusions Health education interventions should be literacy sensitive and aim to enhance patient health knowledge and self-efficacy to promote self-care behavior and desirable health outcomes. PMID:20950164

Tier II Interventions within the Framework of School-Wide Positive Behavior Support: Essential Features for Design, Implementation, and Maintenance.

PubMed

Anderson, Cynthia M; Borgmeier, Chris

2010-01-01

To meet the complex social behavioral and academic needs of all students, schools benefit from having available multiple evidence-based interventions of varying intensity. School-wide positive behavior support provides a framework within which a continuum of evidence-based interventions can be implemented in a school. This framework includes three levels or tiers of intervention; Tier I (primary or universal), Tier II (secondary or targeted), and Tier III (tertiary or individualized) supports. In this paper we review the logic behind school-wide positive behavior support and then focus on Tier II interventions, as this level of support has received the least attention in the literature. We delineate the key features of Tier II interventions as implemented within school-wide positive behavior support, provide guidelines for matching Tier II interventions to school and student needs, and describe how schools plan for implementation and maintenance of selected interventions.

The influence of interpersonal aggression on maternal perceptions of infant emotions: Associations with early parenting quality.

PubMed

Dayton, Carolyn J; Huth-Bocks, Alissa C; Busuito, Alexandra

2016-06-01

The current study tested the hypothesis that mothers who have experienced child maltreatment and aggression within their adult relationships may be at particular risk for misinterpreting infant emotions, leading to less sensitive parenting behaviors. Participants were 120 pregnant women recruited for a larger, longitudinal study investigating the role of psychosocial and environmental risk on women and their young children. Data were collected during the third trimester of pregnancy, and when children were 1 and 2 years of age. Participants completed a projective test designed to elicit individual differences in perceptions of infant emotions and an observer-rated assessment of parenting behaviors was conducted in the family home. Using structural equation modeling, we tested associations between maternal interpersonal aggression exposure and perceptions of infant emotion and parenting behaviors. Results demonstrated that a history of child abuse and intimate partner conflict were associated with a maternal tendency to view ambiguous infant facial expressions as negative (i.e., negative attribution bias), and in turn, with less parenting sensitivity over time. Findings suggest that negative attributions of infant emotion may be 1 mechanism by which a history of trauma and violence exposure contributes to less sensitive parenting for some mothers. Implications for intervention include the need for trauma-informed clinical services and psychoeducational methods that help mothers more accurately read and respond to infant emotional expression and bids for connection. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The Effects of Positive Behavior Interventions and Support on Changing the Behavior of Red Zone Students

ERIC Educational Resources Information Center

Robinson, Fredrick

2012-01-01

In order to improve culture, safety, and climate, numerous schools nationwide are implementing Positive Behavior Interventions and Support (PBIS). The purpose of this study was to examine the effectiveness of the Positive Behavior Interventions and Support (PBIS) model for reducing high-risk behaviors of students identified as red zone. The…

Intensive Behavioral Intervention for School-Aged Children with Autism: Una Breccia nel Muro (UBM)--A Comprehensive Behavioral Model

ERIC Educational Resources Information Center

Fava, Leonardo; Vicari, Stefano; Valeri, Giovanni; D'Elia, Lidia; Arima, Serena; Strauss, Kristin

2012-01-01

Although, reviews and outcome research supports empirical evidence for Early Intensive Behavior Intervention in pre-scholars, intensive behavioral service provision for school-aged children with autism spectrum disorders (ASD) are less subject to research studies. In order to provide effective behavioral interventions for school-aged children it…

Case Study on the Implementation of School-Wide Positive Behavioral Interventions and Supports in an Alternative Educational Setting

ERIC Educational Resources Information Center

Gelbar, Nicholas W.; Jaffery, Rose; Stein, Ravit; Cymbala, Heather

2015-01-01

School-wide positive behavior interventions and supports (SW-PBIS) can effectively reduce problem behaviors and simultaneously increase pro-social behaviors in general education settings. SW-PBIS is not a "packaged" intervention, but a framework through which schools create systemic changes for promoting expected behaviors, while also…

Effects of the KEEP Foster Parent Intervention on Child and Sibling Behavior Problems and Parental Stress during a Randomized Implementation Trial

PubMed Central

Price, Joseph M.; Roesch, Scott; Walsh, Natalia E.; Landsverk, John

2014-01-01

Children in foster care are at risk for externalizing behavior problems, which can in turn increase the risk of changes in foster care placement. The KEEP (Keeping Foster Parents Trained and Supported) foster parent training intervention was designed to equip foster parents with strategies for managing externalizing behavior problems. The primary goals of this investigation were to (a) examine the effectiveness of the KEEP intervention in reducing child behavior problems, as delivered by a community agency, (b) determine if the effects of the KEEP intervention generalize to more than one child in the same home, and (c) examine the effectiveness of the KEEP intervention in reducing parental stress associated with child behavior problems. The data from 335 foster and kinship families with children between the ages of 5 and 12 years were analyzed to address these objectives. Families were randomly assigned to the intervention or control condition. The results indicated that the KEEP intervention was effective in reducing child behavior problems when delivered by a community agency. These results expanded prior research on the KEEP intervention, revealing that the intervention was effective in reducing behavior problems of more than one child in the same household and in reducing parental stress levels associated with the behavioral issues of the focal child. Thus, the KEEP intervention model holds promise for reducing the behavior problems of children in foster care and reducing stress levels of foster and kinship caregivers as it is disseminated and implemented within similar child welfare settings. PMID:25418812

Functional Behavioral Assessment-Based Interventions. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2016

2016-01-01

This intervention report presents findings from a systematic review of "functional behavioral assessment-based interventions" conducted using the WWC Procedures and Standards Handbook, version 3.0, and the Children Identified With or At Risk for an Emotional Disturbance review protocol, version 3.0. Functional behavioral assessment (FBA)…

Functional Assessment-Based Interventions: Focusing on the Environment and Considering Function

ERIC Educational Resources Information Center

Oakes, Wendy Peia; Lane, Kathleen Lynne; Hirsch, Shanna Eisner

2018-01-01

It can be challenging for educators to select intervention tactics based on the function of the student's behavior. In this article, authors offer practical information on behavioral function and environmental-focused intervention ideas for educators developing behavior intervention plans. Ideas are organized according to the hypothesized function…

Interest in Health Behavior Intervention Delivery Modalities Among Cancer Survivors: A Cross-Sectional Study

PubMed Central

Basen-Engquist, Karen; Cox, Matthew G; Lyons, Elizabeth J; Carmack, Cindy L; Blalock, Janice A; Demark-Wahnefried, Wendy

2016-01-01

Background Effective, broad-reaching channels are important for the delivery of health behavior interventions in order to meet the needs of the growing population of cancer survivors in the United States. New technology presents opportunities to increase the reach of health behavior change interventions and therefore their overall impact. However, evidence suggests that older adults may be slower in their adoption of these technologies than the general population. Survivors’ interest for more traditional channels of delivery (eg, clinic) versus new technology-based channels (eg, smartphones) may depend on a variety of factors, including demographics, current health status, and the behavior requiring intervention. Objective The aim of this study was to determine the factors that predict cancer survivors’ interest in new technology-based health behavior intervention modalities versus traditional modalities. Methods Surveys were mailed to 1871 survivors of breast, prostate, and colorectal cancer. Participants’ demographics, diet and physical activity behaviors, interest in health behavior interventions, and interest in intervention delivery modalities were collected. Using path analysis, we explored the relationship between four intervention modality variables (ie, clinic, telephone, computer, and smartphone) and potential predictors of modality interest. Results In total, 1053 respondents to the survey (56.3% response rate); 847 provided complete data for this analysis. Delivery channel interest was highest for computer-based interventions (236/847, 27.9% very/extremely interested) and lowest for smartphone–based interventions (73/847, 8.6%), with interest in clinic-based (147/847, 17.3%) and telephone-delivered (143/847, 16.9%) falling in between. Use of other technology platforms, such as Web cameras and social networking sites, was positively predictive of interest in technology-based delivery channels. Older survivors were less likely to report interest in smartphone–based diet interventions. Physical activity, fruit and vegetable consumption, weight status, and age moderated relationships between interest in targeted intervention behavior and modality. Conclusions This study identified several predictors of survivor interest in various health behavior intervention delivery modalities. Overall, computer-based interventions were found to be most acceptable, while smartphones were the least. Factors related to survivors’ current technology use and health status play a role in their interest for technology-based intervention versus more traditional delivery channels. Future health behavior change research in this population should consider participants’ demographic, clinical, and lifestyle characteristics when selecting a delivery channel. Furthermore, current health behavior interventions for older cancer survivors may be best delivered over the Internet. Smartphone interventions may be feasible in the future following further adoption and familiarization by this particular population. PMID:28410164

Cognitive-Behavioral and Pharmacologic Interventions for Children's Distress during Painful Medical Procedures.

ERIC Educational Resources Information Center

Jay, Susan M.; And Others

1987-01-01

Evaluated efficacy of cognitive-behavioral intervention package and low-risk pharmacologic intervention (oral Valium) as compared with minimal treatment-attention control condition, in reducing children leukemia patients' distress during bone marrow aspirations. The cognitive-behavioral therapy reduced behavioral distress, pain ratings and pulse…

Cognitive behavioral intervention in the Chinese cultural context: a case report.

PubMed

Ng, Petrus; Tsun, Angela; Su, Susan; Young, Daniel

2013-09-01

Depression is predicted to become the world's second leading cause of disability by 2020 according to the World Health Organization. Cognitive behavioral intervention (CBI), recognized as a viable and effective treatment for depression, is becoming more widely used among Chinese clients. However, information about the application of this Western approach in the Chinese population is very limited. This paper discusses adaptations of CBI protocols for Chinese patients, considering the major Chinese cultural characteristics of predestination, losing face, avoiding conflict, and Yin-Yang balance (PLAY) for persons with depression. Illustrated is the application of the PLAY protocol in the actual case of a 35-year-old woman with depression. Implications for integrating Chinese cultural characteristics with CBI are discussed. There is evidence for adaptations of CBI for enhancing its effectiveness among Chinese people within their cultural context. Since there are limited studies on cultural-sensitive CBI for Chinese people, the conclusions drawn from this study are only preliminary. Further studies that verify the findings reported in this paper are necessary. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Individual and Network Interventions With Injection Drug Users in 5 Ukraine Cities

PubMed Central

Lehman, Wayne E. K.; Latkin, Carl A.; Dvoryak, Sergey; Brewster, John T.; Royer, Mark S.; Sinitsyna, Larisa

2011-01-01

Objectives. We evaluated the effects of an individual intervention versus a network intervention on HIV-related injection and sexual risk behaviors among street-recruited opiate injection drug users in 5 Ukraine cities. Methods. Between 2004 and 2006, 722 opiate injection drug users were recruited to participate in interventions that were either individually based or based on a social network model in which peer educators intervened with their network members. Audio computer-assisted self-interview techniques were used to interview participants at baseline and follow-up. Results. Multiple logistic analyses controlling for baseline injection and sexual risks revealed that both peer educators and network members in the network intervention reduced injection-related risk behaviors significantly more than did those in the individually based intervention and that peer educators increased condom use significantly more than did those in the individual intervention. Individual intervention participants, however, showed significantly greater improvements than did network members with respect to reductions in sexual risk behaviors. Conclusions. Social network interventions may be more effective than individually based interventions in changing injection risk behaviors among both peer educators and network members. The effectiveness of network interventions in changing sexual risk behaviors is less clear, probably owing to network composition and inhibitions regarding discussing sexual risk behaviors. PMID:20395584

Chronic Osteoporotic Pain in Mice: Cutaneous and Deep Musculoskeletal Pain Are Partially Independent of Bone Resorption and Differentially Sensitive to Pharmacological Interventions

PubMed Central

Millecamps, Magali; Naso, Lina; Mori, Chisato

2017-01-01

Although the pathological changes in osteoporotic bones are well established, the characterization of the osteoporotic pain and its appropriate treatment are not fully elucidated. We investigated the behavioral signs of cutaneous and deep musculoskeletal pain and physical function; time-dependent changes in bone mineral density (BMD) and the emergence of the behavioral phenotype; and the effects of pharmacological interventions having different mechanisms of action (chronic intraperitoneal administration of pamidronate [0.25 mg/kg, 5x/week for 5 weeks] versus acute treatment with intraperitoneal morphine [10 mg/kg] and pregabalin [100 mg/kg]) in a mouse model of ovariectomized or sham-operated mice 6 months following surgery. We observed reduced BMD associated with weight gain, referred cutaneous hypersensitivity, and deep musculoskeletal pain that persisted for 6 months. Chronic bisphosphonate treatment, 6 months after ovariectomy, reversed bone loss and hypersensitivity to cold, but other behavioral indices of osteoporotic pain were unchanged. While the efficacy of acute morphine on cutaneous pain was weak, pregabalin was highly effective; deep musculoskeletal pain was intractable. In conclusion, the reversal of bone loss alone is insufficient to manage pain in chronic osteoporosis. Additional treatments, both pharmacological and nonpharmacological, should be implemented to improve quality of life for osteoporosis patients. PMID:28299231

Effects of a Teacher Professional Development Intervention on Peer Relationships in Secondary Classrooms

PubMed Central

Mikami, Amori Yee; Gregory, Anne; Allen, Joseph P.; Pianta, Robert C.; Lun, Janetta

2012-01-01

We investigated the effects of My Teaching Partner—Secondary (MTP-S), a teacher professional development intervention, on students’ peer relationships in middle and high school classrooms. MTP-S targets increasing teachers’ positive interactions with students and sensitive instructional practices and has demonstrated improvements in students’ academic achievement and motivation. The current study tested the prediction from systems theory that effects of MTP-S on students would extend beyond the academic domain—that is, the ecology of teachers’ behaviors towards students should also influence the ecology of students’ behaviors towards one another. Participants were 88 teachers (43 randomly assigned to MTP-S and 45 assigned to a control group that received the regular professional development offerings in their school) and 1423 students in their classrooms. Observations and student self-report of classroom peer interactions were collected at the start and at the end of the course. Results indicated that in MTP-S classrooms, students were observed to show improvement in positive peer interactions, although this pattern was not found in self-report data. However, moderation analyses suggested that for students with high disruptive behavior at the start of the course, teacher participation in MTP-S mitigated a typical decline towards poorer self-reported peer relationships. The relevance of findings for the social ecology of classrooms is discussed. PMID:22736890

Effects of a Teacher Professional Development Intervention on Peer Relationships in Secondary Classrooms.

PubMed

Mikami, Amori Yee; Gregory, Anne; Allen, Joseph P; Pianta, Robert C; Lun, Janetta

2011-01-01

We investigated the effects of My Teaching Partner-Secondary (MTP-S), a teacher professional development intervention, on students' peer relationships in middle and high school classrooms. MTP-S targets increasing teachers' positive interactions with students and sensitive instructional practices and has demonstrated improvements in students' academic achievement and motivation. The current study tested the prediction from systems theory that effects of MTP-S on students would extend beyond the academic domain-that is, the ecology of teachers' behaviors towards students should also influence the ecology of students' behaviors towards one another. Participants were 88 teachers (43 randomly assigned to MTP-S and 45 assigned to a control group that received the regular professional development offerings in their school) and 1423 students in their classrooms. Observations and student self-report of classroom peer interactions were collected at the start and at the end of the course. Results indicated that in MTP-S classrooms, students were observed to show improvement in positive peer interactions, although this pattern was not found in self-report data. However, moderation analyses suggested that for students with high disruptive behavior at the start of the course, teacher participation in MTP-S mitigated a typical decline towards poorer self-reported peer relationships. The relevance of findings for the social ecology of classrooms is discussed.

Children’s Sympathy for Peers Who Are the Targets of Peer Aggression

PubMed Central

Leff, Stephen S.

2014-01-01

Although a goal of many aggression intervention programs is to increase children’s concern (often termed sympathy or empathy) for their peers as a means of ultimately reducing aggressive behavior, there are no measures specifically of children’s concern for peers who are the targets of peer aggression. A participatory action research (PAR) model was used to create a culturally-sensitive measure of urban African American children’s sympathy for peers who are the targets of physical aggression, relational or social aggression, verbal aggression, and property damage. In Study 1, 40 children (Mage =9.71 years; 47.5 % female) were interviewed about the types of incidents that lead them to feel sympathy for a peer. Based upon these findings, the 15-item Peer Sympathy Scale (PSS) was developed. In Study 2, the PSS was administered to 517 children (Mage=9.82 years; 47.4 % female) to examine the psychometric properties of the measure and to explore the association between children’s sympathy for their peers and their social behavior. Greater sympathy was associated with less overt and relational aggression according to both peer and teacher reports as well as with less oppositional-defiant behavior according to teacher reports. The clinical utility of the PSS as an outcome assessment tool for social skills intervention programs is discussed. PMID:22556114

Decrease in Behavioral Problems and Trauma Symptoms Among At-Risk Adopted Children Following Web-Based Trauma-Informed Parent Training Intervention

PubMed Central

Razuri, Erin Becker; Hiles Howard, Amanda R.; Parris, Sheri R.; Call, Casey D.; DeLuna, Jamie Hurst; Hall, Jordan S.; Purvis, Karyn B.; Cross, David R.

2016-01-01

Children who have experienced early adversities are at risk for behavioral problems and trauma symptoms. Using a two-group, pre–post intervention design, the authors evaluated the effectiveness of an online parent training for Trust-Based Relational Intervention, a trauma-informed, attachment-based intervention, in reducing behavioral problems and trauma symptoms in at-risk adopted children. Children of parents in the treatment group (n = 48) demonstrated significant decreases in behavioral problems and trauma symptoms after intervention. Scores for children in a matched-sample control group did not change. Findings suggest this intervention can effectively reduce behavioral problems and trauma symptoms in children with histories of adversities. PMID:26072917

Contests versus Norms: Implications of Contest-Based and Norm-Based Intervention Techniques

PubMed Central

Bergquist, Magnus; Nilsson, Andreas; Hansla, André

2017-01-01

Interventions using either contests or norms can promote environmental behavioral change. Yet research on the implications of contest-based and norm-based interventions is lacking. Based on Goal-framing theory, we suggest that a contest-based intervention frames a gain goal promoting intensive but instrumental behavioral engagement. In contrast, the norm-based intervention was expected to frame a normative goal activating normative obligations for targeted and non-targeted behavior and motivation to engage in pro-environmental behaviors in the future. In two studies participants (n = 347) were randomly assigned to either a contest- or a norm-based intervention technique. Participants in the contest showed more intensive engagement in both studies. Participants in the norm-based intervention tended to report higher intentions for future energy conservation (Study 1) and higher personal norms for non-targeted pro-environmental behaviors (Study 2). These findings suggest that contest-based intervention technique frames a gain goal, while norm-based intervention frames a normative goal. PMID:29218026

Contests versus Norms: Implications of Contest-Based and Norm-Based Intervention Techniques.

PubMed

Bergquist, Magnus; Nilsson, Andreas; Hansla, André

2017-01-01

Interventions using either contests or norms can promote environmental behavioral change. Yet research on the implications of contest-based and norm-based interventions is lacking. Based on Goal-framing theory, we suggest that a contest-based intervention frames a gain goal promoting intensive but instrumental behavioral engagement. In contrast, the norm-based intervention was expected to frame a normative goal activating normative obligations for targeted and non-targeted behavior and motivation to engage in pro-environmental behaviors in the future. In two studies participants ( n = 347) were randomly assigned to either a contest- or a norm-based intervention technique. Participants in the contest showed more intensive engagement in both studies. Participants in the norm-based intervention tended to report higher intentions for future energy conservation (Study 1) and higher personal norms for non-targeted pro-environmental behaviors (Study 2). These findings suggest that contest-based intervention technique frames a gain goal, while norm-based intervention frames a normative goal.

Design of a randomized controlled trial for multiple cancer risk behaviors among Spanish-speaking Mexican-origin smokers.

PubMed

Castro, Yessenia; Basen-Engquist, Karen; Fernandez, Maria E; Strong, Larkin L; Eakin, Elizabeth G; Resnicow, Ken; Li, Yisheng; Wetter, David W

2013-03-18

Smoking, poor diet, and physical inactivity account for as much as 60% of cancer risk. Latinos experience profound disparities in health behaviors, as well as the cancers associated with them. Currently, there is a dearth of controlled trials addressing these health behaviors among Latinos. Further, to the best of our knowledge, no studies address all three behaviors simultaneously, are culturally sensitive, and are guided by formative work with the target population. Latinos represent 14% of the U.S. population and are the fastest growing minority group in the country. Efforts to intervene on these important lifestyle factors among Latinos may accelerate the elimination of cancer-related health disparities. The proposed study will evaluate the efficacy of an evidence-based and theoretically-driven Motivation And Problem Solving (MAPS) intervention, adapted and culturally-tailored for reducing cancer risk related to smoking, poor diet, and physical inactivity among high-risk Mexican-origin smokers who are overweight/obese (n = 400). Participants will be randomly assigned to one of two groups: Health Education (HE) or MAPS (HE + up to 18 MAPS counseling calls over 18 months). Primary outcomes are smoking status, servings of fruits and vegetables, and both self-reported and objectively measured physical activity. Outcome assessments will occur at baseline, 6 months, 12 months, and 18 months. The current study will contribute to a very limited evidence base on multiple risk factor intervention studies on Mexican-origin individuals and has the potential to inform both future research and practice related to reducing cancer risk disparities. An effective program targeting multiple cancer risk behaviors modeled after chronic care programs has the potential to make a large public health impact because of the dearth of evidence-based interventions for Latinos and the extended period of support that is provided in such a program. National Institutes of Health Clinical Trials Registry # NCT01504919.

Reading interventions with behavioral and social skill outcomes: a synthesis of research.

PubMed

Roberts, Garrett J; Solis, Michael; Ciullo, Stephen; McKenna, John W; Vaughn, Sharon

2015-01-01

Research findings have suggested that reading deficits and problem behaviors are positively related. This synthesis investigated how reading interventions impact behavioral/social skill outcomes by reviewing studies that included (a) a reading intervention without behavioral/social skill components, (b) behavioral/social skill dependent variables, and (c) students in Grades K-12. Fifteen articles were evaluated by the type of reading intervention, associations between positive reading effects and behavioral/social skill outcomes, and The What Works Clearinghouse (WWC) determinants of study ratings. Findings suggested that reading interventions tended to have positive reading outcomes, while behavioral/social skill outcomes were small or negative. Research did not suggest an association between improved reading and behavioral performance, regardless of the WWC study determinants rating. Implications include reading instruction may not be sufficient to improve behavioral and social skill outcomes. Additional research is warranted to investigate the long-term impact of reading on behavioral and social skill outcomes. © The Author(s) 2014.

Effective preventive interventions to support parents of young children: Illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD).

PubMed

Juffer, Femmie; Struis, Estelle; Werner, Claudia; Bakermans-Kranenburg, Marian J

2017-01-01

Secure attachment relationships are essential for children's current and later development. From attachment theory and research, it can be derived that sensitive parenting is the key to positive parent-child relationships. Is it possible to design effective interventions to enhance sensitive parenting? In this article, we review elements that are crucial for effective attachment-based interventions, and we proceed with illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). We describe how this intervention program was developed, how it has been implemented in practice in different types of families and in daycare settings, and how effective the program is. We conclude that intervention programs like the VIPP-SD could play an important role in the community by serving families in need of parenting support.

"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.

Risk and protection for HIV/AIDS in African-American, Hispanic, and White adolescents.

PubMed

Bartlett, Robin; Buck, Raymond; Shattell, Mona M

2008-07-01

African-Americans and Hispanics are disproportionately affected by HIV/AIDS in the United States. HIV infection is often acquired during adolescence, a time when risky sexual behaviors are at their peak. This study explored relationships among selected risk factors, protective factors, and risky sexual behaviors among African-American, Hispanic, and White adolescents, from a sample of adolescents from the National Longitudinal Study of Adolescent Health. African-Americans and Hispanics were more likely to have sexual intercourse without the use of birth control than were Whites. African-Americans were more likely to have sexual behavior with multiple sexual partners than either Hispanics or Whites were, and African-Americans had higher self-esteem than did Hispanics and Whites. In order to develop culturally sensitive, effective interventions to prevent HIV/AIDS in adolescents, racial differences in risk and protective factors must be examined.

Brain self-regulation in criminal psychopaths.

PubMed

Konicar, Lilian; Veit, Ralf; Eisenbarth, Hedwig; Barth, Beatrix; Tonin, Paolo; Strehl, Ute; Birbaumer, Niels

2015-03-24

Psychopathic individuals are characterized by impaired affective processing, impulsivity, sensation-seeking, poor planning skills and heightened aggressiveness with poor self-regulation. Based on brain self-regulation studies using neurofeedback of Slow Cortical Potentials (SCPs) in disorders associated with a dysregulation of cortical activity thresholds and evidence of deficient cortical functioning in psychopathy, a neurobiological approach seems to be promising in the treatment of psychopathy. The results of our intensive brain regulation intervention demonstrate, that psychopathic offenders are able to gain control of their brain excitability over fronto-central brain areas. After SCP self-regulation training, we observed reduced aggression, impulsivity and behavioral approach tendencies, as well as improvements in behavioral-inhibition and increased cortical sensitivity for error-processing. This study demonstrates improvements on the neurophysiological, behavioral and subjective level in severe psychopathic offenders after SCP-neurofeedback training and could constitute a novel neurobiologically-based treatment for a seemingly change-resistant group of criminal psychopaths.

Behavioral Interventions in the Treatment of Pathological Gambling: A Review of Activity Scheduling and Desensitization

ERIC Educational Resources Information Center

Dowling, Nicki; Jackson, Alun C.; Thomas, Shane A.

2008-01-01

Cognitive and behavioral interventions have been cautiously recommended as "best practice" in the treatment of pathological gambling. Behavioral interventions, using a range of techniques, have been the most commonly evaluated approach to the psychological treatment of pathological gambling. The recent literature evaluating behavioral treatments…

Functional Behavioral Assessments and Intervention Plans in Early Intervention Settings.

ERIC Educational Resources Information Center

LaRocque, Michelle; Brown, Sharan E.; Johnson, Kurt L.

2001-01-01

This article advocates the use of functional behavioral assessments (FBAs) and behavior intervention plans (BIPs) in the development of Individualized Family Service Plans for children with or at risk of developing behavioral disorders. It describes the FBA and BIP processes and proposes a parent collaborative model for assessment and…

Behavioral management in children with intellectual disabilities in a resource-poor setting in Barwani, India

PubMed Central

Lakhan, Ram

2014-01-01

Background: Management of behavioral problems in children with intellectual disabilities (ID) is a great concern in resource-poor areas in India. This study attempted to analyze the efficacy of behavioral intervention provided in resource-poor settings. Objective: This study was aimed to examine the outcome of behavioral management provided to children with ID in a poor rural region in India. Materials and Methods: We analyzed data from 104 children between 3 and 18 years old who received interventions for behavioral problems in a clinical or a community setting. The behavioral assessment scale for Indian children with mental retardation (BASIC-MR) was used to quantify the study subjects’ behavioral problems before and after we applied behavioral management techniques (baseline and post-intervention, respectively). The baseline and post-intervention scores were analyzed using the following statistical techniques: Wilcoxon matched-pairs signed-rank test for the efficacy of intervention; χ2 for group differences. Results: The study demonstrated behavioral improvements across all behavior domains (P < 0.05). Levels of improvement varied for children with different severities of ID (P = 0.001), between children who did and did not have multiple disabilities (P = 0.011). Conclusion: The outcome of this behavioral management study suggests that behavioral intervention can be effectively provided to children with ID in poor areas. PMID:24574557

Prevalence of Sun Protection Use and Sunburn and Association of Demographic and Behaviorial Characteristics With Sunburn Among US Adults.

PubMed

Holman, Dawn M; Ding, Helen; Guy, Gery P; Watson, Meg; Hartman, Anne M; Perna, Frank M

2018-05-01

Monitoring sun protection and sunburn over time at the population level can provide valuable information about progress toward skin cancer prevention goals and inform future intervention efforts. To examine the prevalence of sun protection use (shade, sunscreen, and clothing) and sunburn and the association between sunburn and individual characteristics and health behaviors in the US population. In this cross-sectional study using a nationally representative sample of 31 162 US adults from the 2015 National Health Interview Survey-Cancer Control Supplement, household interviews of civilian, noninstitutionalized US adults were conducted throughout 2015 in person and completed on the telephone when necessary. Data analysis was performed from August 16, 2016, to September 6, 2017. The prevalence of sunburn and use of sun protection and their association with demographic characteristics, sun sensitivity, and health-related behaviors and conditions using multivariable logistic regression modeling. A total of 31 162 respondents (mean [SD] age, 47.0 [0.36] years; 13 932 male [44.7%] and 17 230 female [55.3%]) were included in the analyses, with 34.2% experiencing sunburn in 2015. Sunburn prevalence was higher among younger age groups (51.2% in adults 18-29 years old; 95% CI, 48.8%-53.7%), non-Hispanic white individuals (42.5%; 95% CI, 41.2%-43.9%), and those with sun-sensitive skin (50.2%). However, sunburn was also prevalent among black (13.2%; 95% CI, 11.6%-15.1%) and Hispanic (29.7%; 95% CI, 27.6%-31.9%) individuals, demographic groups that are often considered to be at low risk of skin cancer. The most frequent sun protection behaviors were staying in the shade (37.1%; 95% CI, 36.3%-38.0%) and using sunscreen (31.5%; 95% CI, 30.7%-32.3%) followed by wearing long clothing to the ankles (28.4%; 95% CI, 27.6-29.1). Sun avoidance behaviors (seeking shade and not going in the sun) were significantly (39.5% vs 35.1%; P < .001) associated with a lower prevalence of sunburn. Those who used self-applied sunless tanning products (45.0% of users vs 36.1% of nonusers; P < .001), those who engaged in aerobic activity (37.9% of aerobic exercisers vs 32.8% of non-aerobic exercisers; P < .001), binge drinkers (45.1% of binge drinkers vs 35.0% of non-binge drinkers; P < .001), and overweight or obese individuals (37.9% of overweight or obese individuals vs 34.4% of non-overweight or obese individuals; P < .001) were more likely to experience sunburn compared with the respective comparison groups. Sun sensitivity was significantly associated with a higher sunburn prevalence, independent of race/ethnicity, suggesting a need to consider sun sensitivity when identifying target demographic groups for sun safety interventions. Efforts to improve vigilance and consistency with use of sun protection are needed. In addition, those who engage in physical activity, use sunless tanners, or use sunscreen for tanning purposes may require additional intervention strategies to address the unique barriers they face in staying adequately protected.

Costs and Effects of a Telephonic Diabetes Self-Management Support Intervention Using Health Educators

PubMed Central

Schechter, Clyde B.; Walker, Elizabeth A.; Ortega, Felix M.; Chamany, Shadi; Silver, Lynn D.

2015-01-01

Background Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Methods Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. Oneway sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. Results The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Conclusions Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. PMID:26750743

Costs and effects of a telephonic diabetes self-management support intervention using health educators.

PubMed

Schechter, Clyde B; Walker, Elizabeth A; Ortega, Felix M; Chamany, Shadi; Silver, Lynn D

2016-03-01

Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. One-way sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. Copyright © 2016 Elsevier Inc. All rights reserved.

Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

PubMed

Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

2017-02-01

The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

Maternal BIS Sensitivity, Overprotective Parenting, and Children’s Internalizing Behaviors

PubMed Central

Kiel, Elizabeth J.; Maack, Danielle J.

2012-01-01

Although sensitivity to the Behavioral Inhibition System within Gray’s (1970) reinforcement sensitivity theory relates to individuals’ own depressive and anxious symptomatology, less is known about how parental BIS sensitivity relates to early indicators of internalizing problems in young children. Moreover, the extent to which this parental characteristic relates to parenting behavior, and children’s internalizing problems above and beyond parenting, remains unknown. The current study assessed maternal BIS sensitivity, overprotective parenting, and toddlers’ internalizing behaviors in a sample of 91 mothers while controlling for mothers’ own internalizing symptomatology. Heightened BIS sensitivity related to both overprotective parenting and internalizing behaviors. Overprotective parenting partially mediated the relation between BIS sensitivity and children’s internalizing behaviors, although BIS sensitivity maintained a marginal relation to internalizing behaviors. Maternal BIS sensitivity and toddler internalizing behaviors may represent a shared disposition towards inhibition that is somewhat accounted for by overprotective parenting. PMID:22904590

A Review of Intervention Programs to Prevent and Treat Behavioral Problems in Young Children with Developmental Disabilities

PubMed Central

Petrenko, Christie L. M.

2013-01-01

Children with developmental disabilities are at higher risk for internalizing and externalizing behavioral problems than children in the general population. Effective prevention and treatment programs are necessary to reduce the burden of behavioral problems in this population. The current review identified 17 controlled trials of nine intervention programs for young children with developmental disabilities, with parent training the most common type of intervention in this population. Nearly all studies demonstrated medium to large intervention effects on child behavior post-intervention. Preliminary evidence suggests interventions developed for the general population can be effective for children with developmental disabilities and their families. A greater emphasis on the prevention of behavior problems in young children with developmental disabilities prior to the onset of significant symptoms or clinical disorders is needed. Multi-component interventions may be more efficacious for child behavior problems and yield greater benefits for parent and family adjustment. Recommendations for future research directions are provided. PMID:24222982

Improving diets and nutrition through an integrated poultry value chain and nutrition intervention (SELEVER) in Burkina Faso: study protocol for a randomized trial.

PubMed

Gelli, Aulo; Becquey, Elodie; Ganaba, Rasmane; Headey, Derek; Hidrobo, Melissa; Huybregts, Lieven; Verhoef, Hans; Kenfack, Romain; Zongouri, Sita; Guedenet, Hannah

2017-09-06

The SELEVER study is designed to evaluate the impact of an integrated agriculture-nutrition package of interventions (including poultry value chain development, women's empowerment activities, and a behavior change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso. This paper presents the rationale and study design. The impact evaluation involves a cluster randomized controlled trial design that will be implemented in 120 rural communities/villages within 60 communes supported by SELEVER in the Boucle de Mouhoun, Centre-Ouest, and Haut-Bassins regions of Burkina Faso. Communities will be randomly assigned to one of three treatment arms, including: (1) SELEVER intervention group; (2) SELEVER with an intensive WASH component; and (3) control group without intervention. Primary outcomes include the mean probability of adequacy of diets for women and children (aged 2-4 years at baseline), infant and young child feeding practices of caregivers of children aged 0-2 years, and household poultry production and sales. Intermediate outcomes along the agriculture and nutrition pathways will also be measured, including child nutrition status and development. The evaluation will follow a mixed-methods approach, including a panel of child-, household-, community-, and market-level surveys, and data collection points during post-harvest and lean seasons, as well as one year after implementation completion to examine sustainability. To our knowledge, this study is the first to rigorously examine from a food systems perspective, the simultaneous impact of scaling-up nutrition-specific and nutrition-sensitive interventions through a livestock value-chain and community-intervention platform, across nutrition, health, and agriculture domains. The findings of this evaluation will provide evidence to support the design of market-based nutrition-sensitive interventions. ISRCTN registry, ISRCTN16686478 . Registered on 2 December 2016.

Childhood exposure to violence and lifelong health: Clinical intervention science and stress biology research join forces

PubMed Central

Moffitt, Terrie E.

2013-01-01

Many young people who are mistreated by an adult, victimized by bullies, criminally assaulted, or who witness domestic violence react to this violence exposure by developing behavioral, emotional, or learning problems. What is less well known is that adverse experiences like violence exposure can lead to hidden physical alterations inside a child’s body, alterations which may have adverse effects on life-long health. We discuss why this is important for the field of developmental psychopathology and for society, and we recommend that stress-biology research and intervention science join forces to tackle the problem. We examine the evidence base in relation to stress-sensitive measures for the body (inflammatory reactions, telomere erosion, epigenetic methylation, and gene expression) and brain (mental disorders, neuroimaging, and neuropsychological testing). We also review promising interventions for families, couples, and children that have been designed to reduce the effects of childhood violence exposure. We invite intervention scientists and stress-biology researchers to collaborate in adding stress-biology measures to randomized clinical trials of interventions intended to reduce effects of violence exposure and other traumas on young people. PMID:24342859

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

PubMed Central

Lee, Myeong Soo; Lee, Jung-Sook

2010-01-01

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

A Web-Based Intervention for Health Professionals and Patients to Decrease Cardiovascular Risk Attributable to Physical Inactivity: Development Process

PubMed Central

2012-01-01

Background Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity. Objective In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the “black box” of Web-based intervention development and to support future Web-based intervention development. Methods The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables. Results The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk-reduction behavior of patients with cardiovascular risk factors. Conclusions The Intervention Mapping protocol provided a systematic method for developing the intervention and each intervention design choice was carefully thought-out and justified. Although it was not a rapid or an easy method for developing an intervention, the protocol guided and directed the development process. The application of evidence-based behavior change methods used in our intervention offers insight regarding how an intervention may change intention and health behavior. The Web-based intervention appeared feasible and was implemented. Further research will test the effectiveness of the PIB2 intervention. Trial Registration Dutch Trial Register, Trial ID: ECP-92 PMID:23612470

Web-Based Intervention to Change Perceived Norms of College Student Alcohol Use and Sexual Behavior on Spring Break

PubMed Central

Patrick, Megan E.; Lee, Christine M.; Neighbors, Clayton

2014-01-01

The purpose of the present study was to evaluate an adapted web-based multi-component personalized feedback intervention to reduce college student alcohol use and risky sexual behavior during Spring Break. This is one of the first interventions focused on Spring Break alcohol use and related sexual behavior. Personalized feedback intervention components addressed intentions, expected consequences, norms, motivations, protective behavioral strategies, and pacts with friends. Participants were college students (N=263; 55% women) between the ages of 18 and 21 who planned to go on a Spring Break trip with their friends. Effects were not significant in reducing alcohol use or sexual behavior during Spring Break or some of the proposed intervention mechanisms. However, consistent results showed that the intervention succeeded in reducing perceived social norms for Spring Break drinking and sexual behavior. Findings suggest that changing norms alone is not sufficient for changing risk behavior during this event and alternative strategies are needed to impact other putative mediators. PMID:24333038

Developmental history of care and control, depression and anger: Correlates of maternal sensitivity in toddlerhood.

PubMed

Burrous, C Emma; Crockenberg, Susan C; Leerkes, Esther M

2009-03-01

This study examined maternal sensitivity in response to toddler distress in relation to mothers' childhood care and control experiences with parents, maternal depression, and maternal anger. Fifty-two mothers and infants participated. Mothers reported childhood care and control experiences prenatally. At 2½ years, mothers reported depressive symptoms and anger on questionnaires, and reported maternal behavior in a daily diary for 1 week, yielding ratings of maternal sensitivity to fear and anger. Results were as follows: (a) Mothers' acceptance during childhood correlated negatively with both maternal depression and maternal anger, and positively with maternal sensitivity to fear at 2½ years; (b) maternal anger mediated the association between childhood care and maternal sensitivity to fear at 2½ years; and (c) the interaction of maternal and paternal control during childhood predicted maternal sensitivity to anger at 2½ years, controlling for maternal education. When maternal control was low, paternal control was positively associated with maternal sensitivity to anger whereas when maternal control was high, paternal control was negatively associated with maternal sensitivity to anger. Results are discussed in relation to prior studies, with particular emphasis on attachment theory. Implications for preventive intervention efforts are considered. Copyright © 2009 Michigan Association for Infant Mental Health.

Initial Design of Culturally Informed Behavioral Intervention Technologies: Developing an mHealth Intervention for Young Sexual Minority Men With Generalized Anxiety Disorder and Major Depression

PubMed Central

Montague, Enid; Mohr, David C

2013-01-01

Background To our knowledge, there is no well-articulated process for the design of culturally informed behavioral intervention technologies. Objective This paper describes the early stages of such a process, illustrated by the methodology for the ongoing development of a behavioral intervention technology targeting generalized anxiety disorder and major depression among young sexual minority men. Methods We integrated instructional design for Internet behavioral intervention technologies with greater detail on information sources that can identify user needs in understudied populations, as well as advances in the understanding of technology-specific behavioral intervention technology dimensions that may need to be culturally tailored. Results General psychological theory describing how to effect change in the clinical target is first integrated with theory describing potentially malleable factors that help explain the clinical problem within the population. Additional information sources are then used to (1) evaluate the theory, (2) identify population-specific factors that may affect users’ ability to relate to and benefit from the behavioral intervention technology, and (3) establish specific skills, attitudes, knowledge, etc, required to change malleable factors posited in the theory. User needs result from synthesis of this information. Product requirements are then generated through application of the user needs to specific behavioral intervention technology dimensions (eg, technology platform). We provide examples of considerations relevant to each stage of this process and how they were applied. Conclusions This process can guide the initial design of other culturally informed behavioral intervention technologies. This first attempt to create a systematic design process can spur development of guidelines for design of behavioral intervention technologies aimed to reduce health disparities. PMID:24311444

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

PubMed

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

2014-11-01

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

A Randomized Controlled Trial of a Mobile Medical App for Kidney Transplant Recipients: Effect on Use of Sun Protection.

PubMed

Robinson, June K; Friedewald, John J; Desai, Amishi; Gordon, Elisa J

2016-01-01

Perception of skin cancer risk, belief that sun protection prevents skin cancer, and having sun protection choices enhance sun protection behaviors by kidney transplant recipients, who are at greater risk of developing skin cancer than the general population. A randomized controlled trial used stratified recruitment of non-Hispanic White, non-Hispanic Black, and Hispanic/Latino kidney transplant recipients, who received a transplant 2-24 months prior to the study. The same culturally sensitive SunProtect™ program was delivered to all recipients with tablet personal computers in two urban ambulatory offices. Text messages reminders were provided at two week intervals. Self-reported surveys and skin pigmentation measured prior to the intervention and six weeks later were analyzed. Among 552 eligible participants, 170 participated (62 non-Hispanic Whites, 60Blacks, and 48 Hispanics). Among participants receiving the intervention with skin that burns after sun exposure and becomes tan or becomes irritated and gets darker, there was a statistically significant increase in self-reported knowledge, recognition of personal skin cancer risk, confidence in sun protection preventing skin cancer, and sun protection behaviors in participants compared to those receiving usual education (p<0.05). At the six week follow-up, participants in the intervention group with skin that burns or becomes irritated, had significantly less darkening of the sun-exposed forearm than control participants (p<0.05). Providing sun protection education with SunProtect™ in the springwith reminders during the summer facilitated adoption of sun protection behaviors among kidney transplant recipients with skin that burns or becomes irritated.

A Randomized Controlled Trial of a Mobile Medical App for Kidney Transplant Recipients: Effect on Use of Sun Protection

PubMed Central

Robinson, June K.; Friedewald, John J.; Desai, Amishi; Gordon, Elisa J.

2016-01-01

Background Perception of skin cancer risk, belief that sun protection prevents skin cancer, and having sun protection choices enhance sun protection behaviors by kidney transplant recipients, who are at greater risk of developing skin cancer than the general population. Methods A randomized controlled trial used stratified recruitment of non-Hispanic white, non-Hispanic black, and Hispanic/Latino kidney transplant recipients, who received a transplant 2 to 24 months before the study. The same culturally sensitive SunProtect program was delivered to all recipients with tablet personal computers in 2 urban ambulatory offices. Text messages reminders were provided at 2-week intervals. Self-reported surveys and skin pigmentation measured before the intervention and 6 weeks later were analyzed. Results Among 552 eligible participants, 170 participated (62 non-Hispanic whites, 60 blacks, and 48 Hispanics). Among participants receiving the intervention with skin that burns after sun exposure and becomes tan or becomes irritated and gets darker, there was a statistically significant increase in self-reported knowledge, recognition of personal skin cancer risk, confidence in sun protection preventing skin cancer, and sun protection behaviors in participants compared with those receiving usual education (P < 0.05). At the 6-week follow-up, participants in the intervention group with skin that burns or becomes irritated had significantly less darkening of the sun-exposed forearm than control participants (P < 0.05). Conclusions Providing sun protection education with SunProtect in the spring with reminders during the summer facilitated adoption of sun protection behaviors among kidney transplant recipients with skin that burns or becomes irritated. PMID:26900599

Behavioral neurocardiac training in hypertension: a randomized, controlled trial.

PubMed

Nolan, Robert P; Floras, John S; Harvey, Paula J; Kamath, Markad V; Picton, Peter E; Chessex, Caroline; Hiscock, Natalie; Powell, Jonathan; Catt, Michael; Hendrickx, Hilde; Talbot, Duncan; Chen, Maggie H

2010-04-01

It is not established whether behavioral interventions add benefit to pharmacological therapy for hypertension. We hypothesized that behavioral neurocardiac training (BNT) with heart rate variability biofeedback would reduce blood pressure further by modifying vagal heart rate modulation during reactivity and recovery from standardized cognitive tasks ("mental stress"). This randomized, controlled trial enrolled 65 patients with uncomplicated hypertension to BNT or active control (autogenic relaxation), with six 1-hour sessions over 2 months with home practice. Outcomes were analyzed with linear mixed models that adjusted for antihypertensive drugs. BNT reduced daytime and 24-hour systolic blood pressures (-2.4+/-0.9 mm Hg, P=0.009, and -2.1+/-0.9 mm Hg, P=0.03, respectively) and pulse pressures (-1.7+/-0.6 mm Hg, P=0.004, and -1.4+/-0.6 mm Hg, P=0.02, respectively). No effect was observed for controls (P>0.10 for all indices). BNT also increased RR-high-frequency power (0.15 to 0.40 Hz; P=0.01) and RR interval (P<0.001) during cognitive tasks. Among controls, high-frequency power was unchanged (P=0.29), and RR interval decreased (P=0.03). Neither intervention altered spontaneous baroreflex sensitivity (P>0.10). In contrast to relaxation therapy, BNT with heart rate variability biofeedback modestly lowers ambulatory blood pressure during wakefulness, and it augments tonic vagal heart rate modulation. It is unknown whether efficacy of this treatment can be improved with biofeedback of baroreflex gain. BNT, alone or as an adjunct to drug therapy, may represent a promising new intervention for hypertension.

Multiple Health Behavior Change Research: An Introduction and Overview

PubMed Central

Prochaska, Judith J.; Spring, Bonnie; Nigg, Claudio R.

2008-01-01

In 2002, the Society of Behavioral Medicine’s special interest group on Multiple Health Behavior Change was formed. The group focuses on the interrelationships among health behaviors and interventions designed to promote change in more than one health behavior at a time. Growing evidence suggests the potential for multiple-behavior interventions to have a greater impact on public health than single-behavior interventions. However, there exists surprisingly little understanding of some very basic principles concerning multiple health behavior change (MHBC) research. This paper presents the rationale and need for MHBC research and interventions, briefly reviews the research base, and identifies core conceptual and methodological issues unique to this growing area. The prospects of MHBC for the health of individuals and populations are considerable. PMID:18319098

CBT for high anxiety sensitivity: alcohol outcomes.

PubMed

Olthuis, Janine V; Watt, Margo C; Mackinnon, Sean P; Stewart, Sherry H

2015-07-01

High anxiety sensitivity (AS) has been associated with greater alcohol consumption and alcohol-related problems as well as greater sensitivity to the anxiety-reducing effects of alcohol and greater risky negative reinforcement motives for drinking. The present study reported on the alcohol-related outcomes of a telephone-delivered cognitive behavioral treatment (CBT) designed to reduce high AS. Eighty individuals with high AS (M age=36 years; 79% women; 76% Caucasian) seeking treatment for their AS-related concerns participated in the study and were randomly assigned to an eight week telephone CBT program or a waiting list control. Participants completed measures of drinking motives and problem drinking at pre- and post-treatment. Multilevel modeling showed that the treatment was successful in reducing AS. The treatment also resulted in specific reductions in drinking to cope with anxiety motives as well as physical alcohol-related problems. Mediated moderation analyses showed treatment-related changes in AS mediated changes in drinking to cope with anxiety motives. Changes in drinking to cope with anxiety motives mediated changes in physical alcohol-related problems. Results of the present study suggest that an AS-targeted intervention may have implications for reducing risky alcohol use cognitions and behaviors. Further research is needed in a sample of problem drinkers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Experiential Exposure to Texting and Walking in Virtual Reality: A Randomized Trial to Reduce Distracted Pedestrian Behavior

PubMed Central

Schwebel, David C.; McClure, Leslie A.; Porter, Bryan E.

2017-01-01

Background Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant. Objective Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms. Methods The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months. Results The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not exposed to the intervention. Discussion The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it. Further efforts to develop interventions that will yield a reduction in distracted pedestrian behavior are needed. PMID:28279843

Experiential exposure to texting and walking in virtual reality: A randomized trial to reduce distracted pedestrian behavior.

PubMed

Schwebel, David C; McClure, Leslie A; Porter, Bryan E

2017-05-01

Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant. Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms. The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months. The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not exposed to the intervention. The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it. Further efforts to develop interventions that will yield a reduction in distracted pedestrian behavior are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of teacher behavior management in the development of disruptive behaviors: an intervention study with the good behavior game.

PubMed

Leflot, Geertje; van Lier, Pol A C; Onghena, Patrick; Colpin, Hilde

2010-08-01

The role of teacher behavior management for children's disruptive behavior development (hyperactive and oppositional behavior) was investigated using a universal classroom preventive intervention study. Five-hundred seventy children were followed from second to third grade of elementary school. Observations of teacher behavior management and children's on-task and off-task classroom behavior and peer reports of hyperactive and oppositional behavior were available. Results showed that the reduced use of negative remarks of intervention teachers predicted children's increase in on-task behavior and decrease in talking-out behavior. These improved children's classroom behaviors in turn mediated the impact of the intervention on the development of hyperactive and oppositional behavior over the studied period. These results were similar for girls and boys. The results underscore the role of teachers' classroom management strategies in improving children's classroom behavior, which, in turn is an important component in the reduction of disruptive behavior development.

Using Simulation to Compare Established and Emerging Interventions to Reduce Cardiovascular Disease Risk in the United States

PubMed Central

Homer, Jack; Wile, Kristina; Trogdon, Justin G.; Hirsch, Gary; Cooper, Lawton; Soler, Robin; Orenstein, Diane

2014-01-01

Introduction Computer simulation offers the ability to compare diverse interventions for reducing cardiovascular disease risks in a controlled and systematic way that cannot be done in the real world. Methods We used the Prevention Impacts Simulation Model (PRISM) to analyze the effect of 50 intervention levers, grouped into 6 (2 x 3) clusters on the basis of whether they were established or emerging and whether they acted in the policy domains of care (clinical, mental health, and behavioral services), air (smoking, secondhand smoke, and air pollution), or lifestyle (nutrition and physical activity). Uncertainty ranges were established through probabilistic sensitivity analysis. Results Results indicate that by 2040, all 6 intervention clusters combined could result in cumulative reductions of 49% to 54% in the cardiovascular risk-related death rate and of 13% to 21% in risk factor-attributable costs. A majority of the death reduction would come from Established interventions, but Emerging interventions would also contribute strongly. A slim majority of the cost reduction would come from Emerging interventions. Conclusion PRISM allows public health officials to examine the potential influence of different types of interventions — both established and emerging — for reducing cardiovascular risks. Our modeling suggests that established interventions could still contribute much to reducing deaths and costs, especially through greater use of well-known approaches to preventive and acute clinical care, whereas emerging interventions have the potential to contribute significantly, especially through certain types of preventive care and improved nutrition. PMID:25376017

Behavioral Family Intervention for Children with Developmental Disabilities and Behavioral Problems

ERIC Educational Resources Information Center

Roberts, Clare; Mazzucchelli, Trevor; Studman, Lisa; Sanders, Matthew R.

2006-01-01

The outcomes of a randomized clinical trial of a new behavioral family intervention, Stepping Stones Triple P, for preschoolers with developmental and behavior problems are presented. Forty-eight children with developmental disabilities participated, 27 randomly allocated to an intervention group and 20 to a wait-list control group. Parents…

Implementing Positive Behavior Support in Preschools: An Exploratory Study of CW-FIT Tier 1

ERIC Educational Resources Information Center

Jolstead, Krystine A.; Caldarella, Paul; Hansen, Blake; Korth, Byran B.; Williams, Leslie; Kamps, Debra

2017-01-01

Challenging behavior in preschool is a serious concern for teachers. Positive behavior interventions and supports (PBIS) have been shown to be effective in reducing such behaviors. Class-Wide Function-Related Intervention Teams (CW-FIT) is a specific multi-tiered intervention for implementing effective classroom management strategies using PBIS…

Implementing Positive Behavior Support in Preschools: An Exploratory Study of CW-FIT Tier 1

ERIC Educational Resources Information Center

Jolstead, Krystine A.; Caldarella, Paul; Hansen, Blake D.; Korth, Byran B.; Williams, Leslie; Kamps, Debra M.

2017-01-01

Challenging behavior in preschool is a serious concern for teachers. Positive behavior interventions and supports (PBIS) has been shown to be effective in reducing such behaviors. Class-Wide Function-Related Intervention Teams (CW-FIT) is a specific multi-tiered intervention for implementing effective classroom management strategies using PBIS…

Positive Behavior Interventions: The Issue of Sustainability of Positive Effects

ERIC Educational Resources Information Center

Yeung, Alexander Seeshing; Craven, Rhonda G.; Mooney, Mary; Tracey, Danielle; Barker, Katrina; Power, Anne; Dobia, Brenda; Chen, Zhu; Schofield, Jill; Whitefield, Phillip; Lewis, Timothy J.

2016-01-01

During the last decade, positive behavior interventions have resulted in improvement of school behavior and academic gains in a range of school settings worldwide. Recent studies identify sustainability of current positive behavior intervention programs as a major concern. The purpose of this article is to identify future direction for effective…

Behavioral Mediators of Weight Loss in Two Group-Based Behavioral Interventions in Older Adults

ERIC Educational Resources Information Center

Baruth, Meghan; Schlaff, Rebecca A.

2017-01-01

Background: Understanding the mechanisms by which behavioral interventions exert their effects is important. Purpose: To examine behavioral mediators of weight loss in a sample of older adults participating in an evidence-based physical activity (PA) or nutrition intervention. Methods: Participants (n = 46) were randomized to a 12-week,…

Behavioral Intervention Planning: Increasing Appropriate Behavior of a Socially Withdrawn Student

ERIC Educational Resources Information Center

Christensen, Lynnette; Young, K. Richard; Marchant, Michelle

2007-01-01

This study examined the effects of an assessment-based intervention plan on the appropriate classroom behavior of a socially withdrawn, Hispanic, learning disabled, third grade student. The study focused on (1) the effects of peer mediation as part of a behavioral intervention package of empirically validated components, (2) the effects of…

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

ERIC Educational Resources Information Center

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

2009-01-01

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

Treatment of Autism in Young Children: Behavioral Intervention and Applied Behavior Analysis.

ERIC Educational Resources Information Center

Jensen, Vanessa K.; Sinclair, Leslie V.

2002-01-01

This article discusses the etiology and scope of autism in young children, screening and diagnosis, intervention options, and the use of applied behavior analysis. Supporting evidence of the efficacy of intensive behavioral intervention is cited, and variations in treatments and techniques are reviewed. Barriers to effective services are also…

Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs.

PubMed

Cowell, Alexander J; Dowd, William N; Mills, Michael J; Hinde, Jesse M; Bray, Jeremy W

2017-02-01

To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists. Practitioners in seven SBIRT programs who received grants from the US Substance Abuse and Mental Health Services Administration (SAMHSA). Program costs and revenues were measured using data from grantees. Patient flows were measured from administrative data and adjusted with prevalence and screening estimates from the literature. SBIRT can be sustained through health insurance reimbursement in out-patient and emergency department settings in most staffing mixes. To sustain SBIRT in in-patient programs, a patient flow larger than the national average may be needed; if that flow is achieved, the range of screens required to maintain a surplus is narrow. Sensitivity analyses suggest that the results are very sensitive to changes in the proportion of insured patients. Screening, Brief Intervention and Referral to Treatment programs in the United States can be sustained by health insurance payments under a variety of staffing models. Screening, Brief Intervention and Referral to Treatment programs can be sustained only in an in-patient setting with above-average patient flow (more than 2500 screens). Screening, Brief Intervention and Referral to Treatment programs in out-patient and emergency department settings can be sustained with below-average patient flows (fewer than 125 000 out-patient visits and fewer than 27 000 emergency department visits). © 2017 Society for the Study of Addiction.

Cost effectiveness of an internet-delivered lifestyle intervention in primary care patients with high cardiovascular risk.

PubMed

Smith, Kenneth J; Kuo, Shihchen; Zgibor, Janice C; McTigue, Kathleen M; Hess, Rachel; Bhargava, Tina; Bryce, Cindy L

2016-06-01

To assess the cost-effectiveness of an online adaptation of the diabetes prevention program (ODPP) lifestyle intervention. ODPP was a before-after evaluation of a weight loss intervention comprising 16 weekly and 8 monthly lessons, incorporating behavioral tools and regular, brief, web-based individualized counseling in an overweight/obese cohort (mean age 52, 76% female, 92% white, 28% with diabetes). A Markov model was developed to estimate ODPP cost effectiveness compared with usual care (UC) to reduce metabolic risk over 10years. Intervention costs and weight change outcomes were obtained from the study; other model parameters were based on published reports. In the model, diabetes risk was a function of weight change with and without the intervention. Compared to UC, the ODPP in our cohort cost $14,351 and $29,331 per quality-adjusted life-year (QALY) gained from the health care system and societal perspectives, respectively. In a hypothetical cohort without diabetes, the ODPP cost $7777 and $18,263 per QALY gained, respectively. Results were robust in sensitivity analyses, but enrolling cohorts with lower annual risk of developing diabetes (≤1.8%), enrolling fewer participants (≤15), or increasing the hourly cost (≥$91.20) or annual per-participant time (≥1.45h) required for technical support could increase ODPP cost to >$20,000 per QALY gained. In probabilistic sensitivity analyses, ODPP was cost-effective in 20-58% of model iterations using an acceptability threshold of $20,000, 73-92% at $50,000, and 95-99% at $100,000 per QALY gained. The ODPP may offer an economical approach to combating overweight and obesity. Copyright © 2016 Elsevier Inc. 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

Interventions to maximize facial cleanliness and achieve environmental improvement for trachoma elimination: A review of the grey literature.

PubMed

Delea, Maryann G; Solomon, Hiwote; Solomon, Anthony W; Freeman, Matthew C

2018-01-01

Efforts are underway to scale-up the facial cleanliness and environmental improvement (F&E) components of the World Health Organization's SAFE strategy for elimination of trachoma as a public health problem. Improving understanding of the F&E intervention landscape could inform advancements prior to scale-up, and lead to more effective and sustained behavior change. We systematically searched for relevant grey literature published from January 1965 through August 2016. Publications were eligible for review if they described interventions addressing F&E in the context of trachoma elimination programs. Subsequent to screening, we mapped attributes of F&E interventions. We then employed three behavior change frameworks to synthesize mapped data and identify potential intervention gaps. We identified 27 documents meeting inclusion criteria. With the exception of some recent programming, F&E interventions have largely focused on intermediate and distal antecedents of behavior change. Evidence from our analyses suggests many interventions are not designed to address documented determinants of improved F&E practices. No reviewed documents endorsed inclusion of intervention components related to behavioral maintenance or resilience-factors critical for sustaining improved behaviors. If left unaddressed, identified gaps in intervention content may continue to challenge uptake and sustainability of improved F&E behaviors. Stakeholders designing and implementing trachoma elimination programs should review their F&E intervention content and delivery approaches with an eye toward improvement, including better alignment with established behavior change theories and empirical evidence. Implementation should move beyond information dissemination, and appropriately employ a variety of behavior change techniques to address more proximal influencers of change.

Pilot study of a program delivered within the regular service system in Germany: effect of a short-term attachment-based intervention on maternal sensitivity in mothers at risk for child abuse and neglect.

PubMed

Pillhofer, Melanie; Spangler, Gottfried; Bovenschen, Ina; Kuenster, Anne K; Gabler, Sandra; Fallon, Barbara; Fegert, Joerg M; Ziegenhain, Ute

2015-04-01

This pilot study examined the effectiveness of a short-term attachment-based intervention, the Ulm Model, in a German population at risk for child abuse and neglect. The intervention used home visits and video feedback to promote maternal sensitivity, and was implemented by trained staff within the health care and youth welfare systems. Mothers in the control group (n=33) received standard services only, while those in the intervention group (n=63) additionally the Ulm Model intervention. The outcomes measured were maternal sensitivity, as assessed by the CARE-Index at pre-intervention, after the last session, and at about 6 and 12 months of age; and infant socio-emotional development, as assessed by the ET6-6 development test at about 6 and 12 months of age. The moderating effects on treatment outcomes of two variables were examined: risk for child abuse (moderate vs. high) and type of maternal attachment representation (secure vs. insecure). Among participants at moderate risk for child abuse, no differences were found between the intervention group and control group in either maternal sensitivity or infant development. Among those considered high risk, mothers in the intervention group showed a significant increase in maternal sensitivity from pre- to post-intervention; however, no group differences were seen at follow-up. There were some indications that infants of mothers in the intervention group showed better emotional development. The variable of maternal attachment representation was not a significant moderator for the intervention effect, but post hoc analysis indicated that the mean sensitivity of secure mothers was significant higher at the 6-month follow-up. Copyright © 2014 Elsevier Ltd. All rights reserved.

Peer relationships of bereaved siblings and comparison classmates after a child's death from cancer.

PubMed

Gerhardt, Cynthia A; Fairclough, Diane L; Grossenbacher, Julie C; Barrera, Maru; Gilmer, Mary Jo; Foster, Terrah L; Compas, Bruce E; Davies, Betty; Hogan, Nancy S; Vannatta, Kathryn

2012-03-01

To compare peer relationships among bereaved siblings and matched classmates, and to examine gender, grade level, and time since death as moderators. Families were recruited from cancer registries at four hospitals 3-12 months after a child's death. Measures of social behavior and peer acceptance were completed by children in the classrooms of 105 bereaved siblings (ages 8-17 years). Teachers also reported on children's social behavior. Three classmates were matched for gender, race, and age to each bereaved sibling to form a comparison group (n = 311). Teachers reported bereaved siblings were more prosocial than comparison classmates. Peers perceived bereaved boys as more sensitive-isolated and victimized, while bereaved siblings in elementary grades were perceived by peers as less prosocial, more sensitive-isolated, less accepted, and as having fewer friends. Peers and teachers viewed bereaved siblings in middle/high school grades as higher on leadership-popularity. Bereaved siblings who were male and in elementary grades were more vulnerable to social difficulties, while those in middle/high school may exhibit some strengths. Ongoing research to inform the development of interventions for bereaved siblings is warranted.

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS

PubMed Central

Collins, Linda M.; Kugler, Kari C.; Gwadz, Marya Viorst

2015-01-01

To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally. PMID:26238037

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS.

PubMed

Collins, Linda M; Kugler, Kari C; Gwadz, Marya Viorst

2016-01-01

To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally.

Evidence-Based Behavioral Interventions for Repetitive Behaviors in Autism

PubMed Central

McDonough, Stephen G.; Bodfish, James W.

2013-01-01

Restricted and repetitive behaviors (RRBs) are a core symptom of autism spectrum disorders (ASD). There has been an increased research emphasis on repetitive behaviors; however, this research primarily has focused on phenomenology and mechanisms. Thus, the knowledge base on interventions is lagging behind other areas of research. The literature suggests there are evidence-based practices to treat “lower order” RRBs in ASD (e.g., stereotypies); yet, there is a lack of a focused program of intervention research for “higher order” behaviors (e.g., insistence on sameness). This paper will (a) discuss barriers to intervention development for RRBs; (b) review evidence-based interventions to treat RRBs in ASD, with a focus on higher order behaviors; and (c) conclude with recommendations for practice and research. PMID:21584849

Promising Behavior Change Techniques in a Multicomponent Intervention to Reduce Concerns about Falls in Old Age: A Delphi Study

ERIC Educational Resources Information Center

Vestjens, Lotte; Kempen, Gertrudis I. J. M.; Crutzen, Rik; Kok, Gerjo; Zijlstra, G. A. Rixt

2015-01-01

Complex behavior change interventions need evidence regarding the effectiveness of individual components to understand how these interventions work. The objective of this study was to identify the least and most promising behavior change techniques (BCTs) within the Dutch intervention "A Matter of Balance" (AMB-NL) aimed at concerns…

Clinical management of behavioral insomnia of childhood

PubMed Central

Vriend, Jennifer; Corkum, Penny

2011-01-01

Behavioral insomnia is highly prevalent, affecting approximately 25% of children. It involves difficulties initiating and maintaining sleep and frequently results in inadequate sleep, leading to an array of negative effects for both the child and the child’s family. In this paper, we describe a variety of empirically supported behavioral interventions for insomnia from infancy through adolescence. We explore how biological, cognitive, and psychosocial developmental changes contribute to behavioral insomnia and how these changes may affect sleep and behavioral interventions. We also discuss barriers that prevent families from accessing interventions, including why many empirically-supported behavioral interventions are overlooked by health care providers. PMID:22114537

Food-Related Impulsivity in Obesity and Binge Eating Disorder-A Systematic Update of the Evidence.

PubMed

Giel, Katrin E; Teufel, Martin; Junne, Florian; Zipfel, Stephan; Schag, Kathrin

2017-10-27

The specific eating pattern of Binge Eating Disorder (BED) patients has provoked the assumption that BED might represent a phenotype within the obesity spectrum that is characterized by increased impulsivity. Following the guidelines of the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses), we here provide a systematic update on the evidence on food-related impulsivity in obese individuals, with and without BED, as well as normal-weight individuals. We separately analyzed potential group differences in the impulsivity components of reward sensitivity and rash-spontaneous behavior. Our search resulted in twenty experimental studies with high methodological quality. The synthesis of the latest evidence consolidates conclusions drawn in our initial systematic review that BED represents a distinct phenotype within the obesity spectrum that is characterized by increased impulsivity. Rash-spontaneous behavior in general, and specifically towards food, is increased in BED, while food-specific reward sensitivity is also increased in obese individuals without BED, but potentially to a lesser degree. A major next step for research entails the investigation of sub-domains and temporal components of inhibitory control in BED and obesity. Based on the evidence of impaired inhibitory control in BED, affected patients might profit from interventions that address impulsive behavior.

Behavioral interventions for agitation in older adults with dementia: an evaluative review.

PubMed

Spira, Adam P; Edelstein, Barry A

2006-06-01

Older adults with dementia commonly exhibit agitated behavior that puts them at risk of injury and institutionalization and is associated with caregiver stress. A range of theoretical approaches has produced numerous interventions to manage these behavior problems. This paper critically reviews the empirical literature on behavioral interventions to reduce agitation in older adults with dementia. A literature search yielded 23 articles that met inclusion criteria. These articles described interventions that targeted wandering, disruptive vocalization, physical aggression, other agitated behaviors and a combination of these behaviors. Studies are summarized individually and then evaluated. Behavioral interventions targeting agitated behavior exhibited by older adults with dementia show considerable promise. A number of methodological issues must be addressed to advance this research area. Problem areas include inconsistent use of functional assessment techniques, failure to report quantitative findings and inadequate demonstrations of experimental control. The reviewed studies collectively provide evidence that warrants optimism regarding the application of behavioral principles to the management of agitation among older adults with dementia. Although the results of some studies were mixed and several studies revealed methodological shortcomings, many of them offered innovations that can be used in future, more rigorously designed, intervention studies.

Interest in Health Behavior Intervention Delivery Modalities Among Cancer Survivors: A Cross-Sectional Study.

PubMed

Martin, Emily C; Basen-Engquist, Karen; Cox, Matthew G; Lyons, Elizabeth J; Carmack, Cindy L; Blalock, Janice A; Demark-Wahnefried, Wendy

2016-02-11

Effective, broad-reaching channels are important for the delivery of health behavior interventions in order to meet the needs of the growing population of cancer survivors in the United States. New technology presents opportunities to increase the reach of health behavior change interventions and therefore their overall impact. However, evidence suggests that older adults may be slower in their adoption of these technologies than the general population. Survivors' interest for more traditional channels of delivery (eg, clinic) versus new technology-based channels (eg, smartphones) may depend on a variety of factors, including demographics, current health status, and the behavior requiring intervention. The aim of this study was to determine the factors that predict cancer survivors' interest in new technology-based health behavior intervention modalities versus traditional modalities. Surveys were mailed to 1871 survivors of breast, prostate, and colorectal cancer. Participants' demographics, diet and physical activity behaviors, interest in health behavior interventions, and interest in intervention delivery modalities were collected. Using path analysis, we explored the relationship between four intervention modality variables (ie, clinic, telephone, computer, and smartphone) and potential predictors of modality interest. In total, 1053 respondents to the survey (56.3% response rate); 847 provided complete data for this analysis. Delivery channel interest was highest for computer-based interventions (236/847, 27.9% very/extremely interested) and lowest for smartphone-based interventions (73/847, 8.6%), with interest in clinic-based (147/847, 17.3%) and telephone-delivered (143/847, 16.9%) falling in between. Use of other technology platforms, such as Web cameras and social networking sites, was positively predictive of interest in technology-based delivery channels. Older survivors were less likely to report interest in smartphone-based diet interventions. Physical activity, fruit and vegetable consumption, weight status, and age moderated relationships between interest in targeted intervention behavior and modality. This study identified several predictors of survivor interest in various health behavior intervention delivery modalities. Overall, computer-based interventions were found to be most acceptable, while smartphones were the least. Factors related to survivors' current technology use and health status play a role in their interest for technology-based intervention versus more traditional delivery channels. Future health behavior change research in this population should consider participants' demographic, clinical, and lifestyle characteristics when selecting a delivery channel. Furthermore, current health behavior interventions for older cancer survivors may be best delivered over the Internet. Smartphone interventions may be feasible in the future following further adoption and familiarization by this particular population. ©Emily C Martin, Karen Basen-Engquist, Matthew G Cox, Elizabeth J Lyons, Cindy L Carmack, Janice A Blalock, Wendy Demark-Wahnefried. Originally published in JMIR Cancer (http://cancer.jmir.org), 11.02.2016.

A Systematic Review and Meta-analysis of Interventions for Sexual Health Promotion Involving Serious Digital Games.

PubMed

DeSmet, Ann; Shegog, Ross; Van Ryckeghem, Dimitri; Crombez, Geert; De Bourdeaudhuij, Ilse

2015-04-01

Serious games may be effective in promoting sexual health behavior. Their confidential nature may encourage users to discuss sensitive sexuality topics. Furthermore, they can tailor messages to the individual's needs and may be intrinsically motivating. This meta-analysis investigates the effectiveness of interventions for sexual health promotion that use serious games. A database search was conducted in PubMed, Web of Science, CINAHL, and PsycINFO for publications before the end of July 2013. Serious digital games studies measuring effects on behavior or its determinants, using a control condition, allowing the calculation of an effect size (Hedges' g, random-effects model) were included. Seven game studies for sexual health promotion were included. These showed positive effects on determinants (g=0.242; 95 percent confidence interval, 0.129, 0.356), albeit of small effect size. The effects on behavior, measured in only two studies, were not significant (g=0.456; 95 percent confidence interval, -0.649, 1.561). Most games did not use many game features that are considered to be immersive or enhancing flow. Instead, there was a strong reliance on pure gamification features, such as rewards and feedback. The effectiveness of the next generation of games may be enhanced by building on the behavioral change and educational gaming literatures (e.g., using role-play and simulation game formats, individual tailoring, offering adaptation in the difficulty of the challenge, and amount and timing of the feedback). There is a need for studies with rigorous evaluations of game effectiveness, longer-term follow-up, and using measures of behavior rather than merely their determinants.

Failing to learn from negative prediction errors: Obesity is associated with alterations in a fundamental neural learning mechanism.

PubMed

Mathar, David; Neumann, Jane; Villringer, Arno; Horstmann, Annette

2017-10-01

Prediction errors (PEs) encode the difference between expected and actual action outcomes in the brain via dopaminergic modulation. Integration of these learning signals ensures efficient behavioral adaptation. Obesity has recently been linked to altered dopaminergic fronto-striatal circuits, thus implying impairments in cognitive domains that rely on its integrity. 28 obese and 30 lean human participants performed an implicit stimulus-response learning paradigm inside an fMRI scanner. Computational modeling and psycho-physiological interaction (PPI) analysis was utilized for assessing PE-related learning and associated functional connectivity. We show that human obesity is associated with insufficient incorporation of negative PEs into behavioral adaptation even in a non-food context, suggesting differences in a fundamental neural learning mechanism. Obese subjects were less efficient in using negative PEs to improve implicit learning performance, despite proper coding of PEs in striatum. We further observed lower functional coupling between ventral striatum and supplementary motor area in obese subjects subsequent to negative PEs. Importantly, strength of functional coupling predicted task performance and negative PE utilization. These findings show that obesity is linked to insufficient behavioral adaptation specifically in response to negative PEs, and to associated alterations in function and connectivity within the fronto-striatal system. Recognition of neural differences as a central characteristic of obesity hopefully paves the way to rethink established intervention strategies: Differential behavioral sensitivity to negative and positive PEs should be considered when designing intervention programs. Measures relying on penalization of unwanted behavior may prove less effective in obese subjects than alternative approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

A dietary behaviors measure for use with low-income, Spanish-speaking Caribbean Latinos with type 2 diabetes: The Latino Dietary Behaviors Questionnaire (LDBQ)

PubMed Central

Fernandez, Senaida; Olendzki, Barbara; Rosal, Milagros C.

2011-01-01

This study examines the validity of a Spanish-language dietary behaviors self-report questionnaire (LDBQ) for Latinos with diabetes. The sample (n = 252) was Spanish-speaking, female (77%), middle-aged (mean age = 55 years), low-education (56% < 8th grade education), and low-income (50% < $10,000 annual household income). Baseline and 12-month measures were collected as part of a randomized clinical trial. LDBQ reliability, validity, and sensitivity to change over time were evaluated using exploratory factor analysis; internal consistency analysis; and correlation analysis using baseline and change scores for: LDBQ, three day 24-hour dietary recall nutrient mean, and clinical measures. Cronbach’s alphas were moderate. Four factors were identified at both time points. Significant baseline correlations (r) were found for LDBQ total scores, factor scores and: caloric intake (r = −.29 to −.34); total dietary fiber (r = .19); sodium (r = −.24 to −.30); percent calories from total fat (r = −.16); fat subtypes (r = −.16 to .15); and percent calories from protein (r = .17). Twelvemonth data produced a similar pattern. T-tests of LDBQ change scores showed significantly greater change in dietary behaviors for the intervention group than for the control group, t(135) = −4.17, p < .01. LDBQ change scores correlated significantly with mean 24-hour nutrient intake and a subset of clinical measures, but were not associated with clinical change scores (except HDL). The LDBQ is a useful tool to assess and target behaviors for change and assess intervention effects. PMID:21443994

Prefrontal Cortex and Drug Abuse Vulnerability: Translation to Prevention and Treatment Interventions

PubMed Central

Perry, Jennifer L.; Joseph, Jane E.; Jiang, Yang; Zimmerman, Rick S.; Kelly, Thomas H.; Darna, Mahesh; Huettl, Peter; Dwoskin, Linda P.; Bardo, Michael T.

2010-01-01

Vulnerability to drug abuse is related to both reward seeking and impulsivity, two constructs thought to have a biological basis in the prefrontal cortex (PFC). This review addresses similarities and differences in neuroanatomy, neurochemistry and behavior associated with PFC function in rodents and primates. Emphasis is placed on monoamine and amino acid neurotransmitter systems located in anatomically distinct subregions: medial prefrontal cortex (mPFC); lateral prefrontal cortex (lPFC); anterior cingulate cortex (ACC); and orbitofrontal cortex (OFC). While there are complex interconnections and overlapping functions among these regions, each is thought to be involved in various functions related to health-related risk behaviors and drug abuse vulnerability. Among the various functions implicated, evidence suggests that mPFC is involved in reward processing, attention and drug reinstatement; lPFC is involved in decision-making, behavioral inhibition and attentional gating; ACC is involved in attention, emotional processing and self-monitoring; and OFC is involved in behavioral inhibition, signaling of expected outcomes and reward/punishment sensitivity. Individual differences factors (e.g., age and sex) influence functioning of these regions, which, in turn, impacts drug abuse vulnerability. Implications for the development of drug abuse prevention and treatment strategies aimed at engaging PFC inhibitory processes that may reduce risk-related behaviors are discussed, including the design of effective public service announcements, cognitive exercises, physical activity, direct current stimulation, feedback control training and pharmacotherapies. A major challenge in drug abuse prevention and treatment rests with improving intervention strategies aimed at strengthening PFC inhibitory systems among at-risk individuals. PMID:20837060

Intervention Effects on Safety Compliance and Citizenship Behaviors: Evidence from the Work, Family, and Health Study

PubMed Central

Hammer, Leslie B.; Johnson, Ryan C.; Crain, Tori L.; Bodner, Todd; Kossek, Ellen Ernst; Davis, Kelly; Kelly, Erin L.; Buxton, Orfeu M.; Karuntzos, Georgia; Chosewood, L. Casey; Berkman, Lisa

2015-01-01

We tested the effects of a work-family intervention on employee reports of safety compliance and organizational citizenship behaviors in 30 healthcare facilities using a group-randomized trial. Based on Conservation of Resources theory and the Work-Home Resources Model, we hypothesized that implementing a work-family intervention aimed at increasing contextual resources via supervisor support for work and family and employee control over work time would lead to improved personal resources and increased employee performance on the job in the form of self-reported safety compliance and organizational citizenship behaviors. Multilevel analyses used survey data from 1,524 employees at baseline, 6-month and 12-month post-intervention follow-ups. Significant intervention effects were observed for safety compliance at the 6-month and organizational citizenship behaviors at the 12-month follow-ups. More specifically, results demonstrate that the intervention protected against declines in employee self-reported safety compliance and organizational citizenship behaviors, compared to employees in the control facilities. The hypothesized mediators of perceptions of family supportive supervisor behaviors, control over work time, and work-family conflict (work-to-family conflict, family-to-work conflict) were not significantly improved by the intervention. However, baseline perceptions of family supportive supervisor behaviors, control over work time, and work-family climate were significant moderators of the intervention effect on the self-reported safety compliance and organizational citizenship behavior outcomes. PMID:26348479

A behavior change model for internet interventions.

PubMed

Ritterband, Lee M; Thorndike, Frances P; Cox, Daniel J; Kovatchev, Boris P; Gonder-Frederick, Linda A

2009-08-01

The Internet has become a major component to health care and has important implications for the future of the health care system. One of the most notable aspects of the Web is its ability to provide efficient, interactive, and tailored content to the user. Given the wide reach and extensive capabilities of the Internet, researchers in behavioral medicine have been using it to develop and deliver interactive and comprehensive treatment programs with the ultimate goal of impacting patient behavior and reducing unwanted symptoms. To date, however, many of these interventions have not been grounded in theory or developed from behavior change models, and no overarching model to explain behavior change in Internet interventions has yet been published. The purpose of this article is to propose a model to help guide future Internet intervention development and predict and explain behavior changes and symptom improvement produced by Internet interventions. The model purports that effective Internet interventions produce (and maintain) behavior change and symptom improvement via nine nonlinear steps: the user, influenced by environmental factors, affects website use and adherence, which is influenced by support and website characteristics. Website use leads to behavior change and symptom improvement through various mechanisms of change. The improvements are sustained via treatment maintenance. By grounding Internet intervention research within a scientific framework, developers can plan feasible, informed, and testable Internet interventions, and this form of treatment will become more firmly established.

Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder.

PubMed

Gabriels, Robin L; Pan, Zhaoxing; Dechant, Briar; Agnew, John A; Brim, Natalie; Mesibov, Gary

2015-07-01

This study expands previous equine-assisted intervention research by evaluating the effectiveness of therapeutic horseback riding (THR) on self-regulation, socialization, communication, adaptive, and motor behaviors in children with autism spectrum disorder (ASD). Participants with ASD (aged 6-16 years; N = 127) were stratified by nonverbal IQ standard scores (≤85 or >85) and randomized to 1 of 2 groups for 10 weeks: THR intervention or a barn activity (BA) control group without horses that used similar methods. The fidelity of the THR intervention was monitored. Participants were evaluated within 1 month pre- and postintervention by raters blinded to intervention conditions and unblinded caregiver questionnaires. During the intervention, caregivers rated participants' behaviors weekly. Intent-to-treat analysis conducted on the 116 participants who completed a baseline assessment (THR n = 58; BA control n = 58) revealed significant improvements in the THR group compared to the control on measures of irritability (primary outcome) (p = .02; effect size [ES] = 0.50) and hyperactivity (p = .01; ES = 0.53), beginning by week 5 of the intervention. Significant improvements in the THR group were also observed on a measure of social cognition (p = .05; ES = 0.41) and social communication (p = .003; ES = 0.63), along with the total number of words (p = .01; ES = 0.54) and new words (p = .01; ES = 0.54) spoken during a standardized language sample. Sensitivity analyses adjusting for age, IQ, and per protocol analyses produced consistent results. This is the first large-scale, randomized, controlled trial demonstrating efficacy of THR for the ASD population, and findings are consistent with previous equine-assisted intervention studies. Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder; http://clinicaltrials.gov; NCT02301195. Published by Elsevier Inc.

Economic analyses of the Be Fit Be Well program: a weight loss program for community health centers.

PubMed

Ritzwoller, Debra P; Glasgow, Russell E; Sukhanova, Anna Y; Bennett, Gary G; Warner, Erica T; Greaney, Mary L; Askew, Sandy; Goldman, Julie; Emmons, Karen M; Colditz, Graham A

2013-12-01

The U.S. Preventive Services Task Force has released new guidelines on obesity, urging primary care physicians to provide obese patients with intensive, multi-component behavioral interventions. However, there are few studies of weight loss in real world nonacademic primary care, and even fewer in largely racial/ethnic minority, low-income samples. To evaluate the recruitment, intervention and replications costs of a 2-year, moderate intensity weight loss and blood pressure control intervention. A comprehensive cost analysis was conducted, associated with a weight loss and hypertension management program delivered in three community health centers as part of a pragmatic randomized trial. Three hundred and sixty-five high risk, low-income, inner city, minority (71 % were Black/African American and 13 % were Hispanic) patients who were both hypertensive and obese. Measures included total recruitment costs and intervention costs, cost per participant, and incremental costs per unit reduction in weight and blood pressure. Recruitment and intervention costs were estimated $2,359 per participant for the 2-year program. Compared to the control intervention, the cost per additional kilogram lost was $2,204 /kg, and for blood pressure, $621 /mmHg. Sensitivity analyses suggest that if the program was offered to a larger sample and minor modifications were made, the cost per participant could be reduced to the levels of many commercially available products. The costs associated with the Be Fit Be Well program were found to be significantly more expensive than many commercially available products, and much higher than the amount that the Centers for Medicare and Medicaid reimburse physicians for obesity counseling. However, given the serious and costly health consequences associated with obesity in high risk, multimorbid and socioeconomically disadvantaged patients, the resources needed to provide interventions like those described here may still prove to be cost-effective with respect to producing long-term behavior change.

Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

PubMed Central

Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

2016-01-01

Background The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. Objective This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. Methods A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Results Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. Conclusions There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic and cross-disciplinary nature of the field. There is a need to develop and deliver methods of understanding users’ psychological experiences while using an intervention. PMID:27363519

Design and outcomes of a Mothers In Motion behavioral intervention pilot study.

PubMed

Chang, Mei-Wei; Nitzke, Susan; Brown, Roger

2010-01-01

This paper describes the design and findings of a pilot Mothers In Motion (P-MIM) program. A randomized controlled trial that collected data via telephone interviews and finger stick at 3 time points: baseline and 2 and 8 months post-intervention. Three Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites in southern Michigan. One hundred and twenty nine overweight and obese African-American and white mothers, 18-34 years old. The 10-week, theory-based, culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences. Dietary fat, fruit, and vegetable intake; physical activity; stress; feelings; body weight; and blood glucose. General linear mixed model was applied to assess treatment effects across 2 and 8 months post-intervention. No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention. However, changes in body weight and blood glucose showed apparent trends consistent with the study's hypotheses. The P-MIM showed promise for preventing weight gain in low-income overweight and obese women. However, a larger experimental trial is warranted to determine the effectiveness of this intervention. Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals.

PubMed

den Braver, N R; de Vet, E; Duijzer, G; Ter Beek, J; Jansen, S C; Hiddink, G J; Feskens, E J M; Haveman-Nies, A

2017-06-12

Although there are many effective lifestyle interventions for type 2 diabetes (T2DM) prevention, insight into effective intervention pathways, especially of long-term interventions, is often lacking. This study aims to provide insight into the effective intervention pathways of the SLIMMER diabetes prevention intervention using mediation analyses. In total, 240 participants at increased risk of T2DM were included in the analyses over 18 months. The intervention was a combined lifestyle intervention with a dietary and a physical activity (PA) component. The primary and secondary outcomes were change in fasting insulin (pmol/L) and change in body weight (kg) after 18 months, respectively. Firstly, in a multiple mediator model, we investigated whether significant changes in these outcomes were mediated by changes in dietary and PA behavior. Secondly, in multiple single mediator models, we investigated whether changes in dietary and PA behavior were mediated by changes in behavioral determinants and the participants' psychological profile. The mediation analyses used linear regression models, where significance of indirect effects was calculated with bootstrapping. The effect of the intervention on decreased fasting insulin was 40% mediated by change in dietary and PA behavior, where dietary behavior was an independent mediator of the association (34%). The effect of the intervention on decreased body weight was 20% mediated by change in dietary and PA behavior, where PA behavior was an independent mediator (17%). The intervention significantly changed intake of fruit, fat from bread spread, and fiber from bread. Change in fruit intake was mediated by change in action control (combination of consciousness, self-control, and effort), motivation, self-efficacy, intention, and skills. Change in fat intake was mediated by change in action control and psychological profile. No mediators could be identified for change in fiber intake. The change in PA behavior was mediated by change in action control, motivation, and psychological profile. The effect of the SLIMMER intervention on fasting insulin and body weight was mediated by changes in dietary and PA behavior, in distinct ways. These results indicate that changing dietary as well as PA behavior is important in T2DM prevention.

Improving Health and Reducing Comorbidity Associated with HIV: The Development of TAVIE en santé, a Web-Based Tailored Intervention to Support the Adoption of Health Promoting Behaviors among People Living with HIV.

PubMed

Côté, José; Cossette, Sylvie; Ramirez-Garcia, Pilar; Rouleau, Geneviève; Auger, Patricia; Boudreau, François; Gagnon, Marie-Pierre

2017-01-01

Background . In the domain of health behavior change, the deployment and utilization of information and communications technologies as a way to deliver interventions appear to be promising. This article describes the development of a web-based tailored intervention, TAVIE en santé , to support people living with HIV in the adoption of healthy behaviors. Methods . This intervention was developed through an Intervention Mapping (IM) framework and is based on the theory of planned behavior. Results . Crucial steps of IM are the selection of key determinants of behavior and the selection of useful theory-based intervention methods to change the targeted determinants (active ingredients). The content and the sequence of the intervention are then created based on these parameters. TAVIE en santé is composed of 7 interactive web sessions hosted by a virtual nurse. It aims to develop and strengthen skills required for behavior change. Based on an algorithm using individual cognitive data (attitude, perceived behavioral control, and intention), the number of sessions, theory-based intervention methods, and messages contents are tailored to each user. Conclusion . TAVIE en santé is currently being evaluated. The use of IM allows developing intervention with a systematic approach based on theory, empirical evidence, and clinical and experiential knowledge.

Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion.

PubMed

Swendeman, Dallas; Rotheram-Borus, Mary Jane

2010-03-01

Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Information and communication technology is rapidly diffusing globally. Over the next 5-10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions.

Improving Health and Reducing Comorbidity Associated with HIV: The Development of TAVIE en santé, a Web-Based Tailored Intervention to Support the Adoption of Health Promoting Behaviors among People Living with HIV

PubMed Central

Cossette, Sylvie; Ramirez-Garcia, Pilar; Rouleau, Geneviève; Auger, Patricia; Boudreau, François; Gagnon, Marie-Pierre

2017-01-01

Background. In the domain of health behavior change, the deployment and utilization of information and communications technologies as a way to deliver interventions appear to be promising. This article describes the development of a web-based tailored intervention, TAVIE en santé, to support people living with HIV in the adoption of healthy behaviors. Methods. This intervention was developed through an Intervention Mapping (IM) framework and is based on the theory of planned behavior. Results. Crucial steps of IM are the selection of key determinants of behavior and the selection of useful theory-based intervention methods to change the targeted determinants (active ingredients). The content and the sequence of the intervention are then created based on these parameters. TAVIE en santé is composed of 7 interactive web sessions hosted by a virtual nurse. It aims to develop and strengthen skills required for behavior change. Based on an algorithm using individual cognitive data (attitude, perceived behavioral control, and intention), the number of sessions, theory-based intervention methods, and messages contents are tailored to each user. Conclusion. TAVIE en santé is currently being evaluated. The use of IM allows developing intervention with a systematic approach based on theory, empirical evidence, and clinical and experiential knowledge. PMID:28393077

Work Site-Based Environmental Interventions to Reduce Sedentary Behavior: A Systematic Review.

PubMed

Hutcheson, Amanda K; Piazza, Andrew J; Knowlden, Adam P

2018-01-01

The purpose of this investigation was to systematically review work site-based, environmental interventions to reduce sedentary behavior following preferred reporting items for systematic reviews and meta-analyses guidelines. Data were extracted from Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials, and Web of Science between January 2005 and December 2015. Inclusion criteria were work site interventions, published in peer-reviewed journals, employing environmental modalities, targeting sedentary behavior, and using any quantitative design. Exclusion criteria were noninterventions and non-English publications. Data extracted included study design, population, intervention dosage, intervention activities, evaluation measures, and intervention effects. Data were tabulated quantitatively and synthesized qualitatively. A total of 15 articles were identified for review and 14 reported statistically significant decreases in sedentary behavior. The majority of studies employed a randomized controlled trial design (n = 7), used inclinometers to measure sedentary behavior (n = 9), recruited predominantly female samples (n = 15), and utilized sit-to-stand desks as the primary intervention modality (n = 10). The mean methodological quality score was 6.2 out of 10. Environmental work site interventions to reduce sedentary behavior show promise because work sites often have more control over environmental factors. Limitations of this intervention stream include inconsistent measurement of sedentary behavior, absence of theoretical frameworks to guide program development, and absence of long-term evaluation. Future studies should include clear reporting of intervention strategies and explicit operationalization of theoretical constructs.

Paternal alcoholism, negative parenting, and the mediating role of marital satisfaction

PubMed Central

Kachadourian, Lorig K.; Eiden, Rina D.; Leonard, Kenneth E.

2013-01-01

Given the documented association between paternal alcoholism and negative parenting behaviors, the purpose of this study was to examine longitudinally whether marital satisfaction mediates this relationship. Participants consisted of 197 families (102 without an alcoholic father, 95 with an alcoholic father) who were assessed at three time points: when children were 12, 24, and 36 months old. Results indicated that paternal alcoholism at 12 months was associated with decreased marital satisfaction at 24 months for both mothers and fathers. Marital satisfaction at 24 months in turn was associated with decreases in parental warmth and sensitivity at 36 months. Furthermore, marital satisfaction mediated the association between paternal alcoholism and parental warmth and sensitivity for both mothers and fathers. The implications of these findings for interventions for alcoholic families are discussed. PMID:19541430

Functional Analysis of Precursors for Serious Problem Behavior and Related Intervention

ERIC Educational Resources Information Center

Langdon, Nancy A.; Carr, Edward G.; Owen-DeSchryver, Jamie S.

2008-01-01

Precursor behaviors are innocuous behaviors that reliably precede the occurrence of problem behavior. Intervention efforts applied to precursors might prevent the occurrence of severe problem behavior. We examined the relationship between precursor behavior and problem behavior in three individuals with developmental disabilities. First, a…

Reported Theory Use by Digital Interventions for Hazardous and Harmful Alcohol Consumption, and Association With Effectiveness: Meta-Regression

PubMed Central

Crane, David; Brown, Jamie; Kaner, Eileen; Beyer, Fiona; Muirhead, Colin; Hickman, Matthew; Redmore, James; de Vocht, Frank; Beard, Emma; Michie, Susan

2018-01-01

Background Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this. Objective The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness. Methods Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models. Results Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I2=77.6%, P<.001). No significant associations were detected between reporting of theory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations. Conclusions Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories. PMID:29490895

Evolution of Research on Interventions for Individuals with Autism Spectrum Disorder: Implications for Behavior Analysts

ERIC Educational Resources Information Center

Smith, Tristram

2012-01-01

The extraordinary success of behavior-analytic interventions for individuals with autism spectrum disorder (ASD) has fueled the rapid growth of behavior analysis as a profession. One reason for this success is that for many years behavior analysts were virtually alone in conducting programmatic ASD intervention research. However, that era has…

Trends and Topics in Early Intensive Behavioral Interventions for Toddlers with Autism

ERIC Educational Resources Information Center

Matson, Johnny L.; Tureck, Kimberly; Turygin, Nicole; Beighley, Jennifer; Rieske, Robert

2012-01-01

The use of applied behavior analysis (ABA) to treat persons with autism goes back several decades. Many specific target behaviors and intervention strategies have been developed. In the last two decades the most heavily studied of these methods has been Early Intensive Behavioral Interventions (EIBI). This package of ABA methods is unique in two…

Using Concept Mapping to Improve Parent Implementation of Positive Behavioral Interventions for Children with Challenging Behaviors

ERIC Educational Resources Information Center

Alkahtani, Keetam D. F.

2013-01-01

Children's challenging behaviors can be addressed with effective interventions that can meet children's emotional needs and support their families. Positive Behavioral Interventions and Supports (PBIS) value the family involvement in the process of their child treatment. The intention of this study was to use concept mapping as an adjunct to PBIS…

PI3 kinase is involved in cocaine behavioral sensitization and its reversal with brain area specificity

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

Zhang Xiuwu; Mi Jing; Wetsel, William C.

Phosphatidylinositol 3-kinase (PI3K) is an important signaling molecule involved in cell differentiation, proliferation, survival, and phagocytosis, and may participate in various brain functions. To determine whether it is also involved in cocaine sensitization, we measured the p85{alpha}/p110 PI3K activity in the nuclear accumbens (NAc) shell, NAc core, and prefrontal cortex (PFC) following establishment of cocaine sensitization and its subsequent reversal. Naive rats were rank-ordered and split into either daily cocaine or saline pretreatment group based on their locomotor responses to an acute cocaine injection (7.5 mg/kg, i.p.). These two groups were then injected with cocaine (40 mg/kg, s.c.) or salinemore » for 4 consecutive days followed by 9-day withdrawal. Cocaine sensitization was subsequently reversed by 5 daily injections of the D{sub 1}/D{sub 2} agonist pergolide (0.1 mg/kg, s.c.) in combination with the 5-HT{sub 3} antagonist ondansetron (0.2 mg/kg, s.c., 3.5 h after pergolide injection). After another 9-day withdrawal, behavioral cocaine sensitization and its reversal were confirmed with an acute cocaine challenge (7.5 mg/kg, i.p.), and animals were sacrificed the next day for measurement of p85{alpha}/p110 PI3K activity. Cocaine-sensitized animals exhibited increased PI3K activity in the NAc shell, and this increase was reversed by combined pergolide/ondansetron treatment, which also reversed behavioral sensitization. In the NAc core and PFC, cocaine sensitization decreased and increased the PI3K activity, respectively. These changes, in contrast to that in the NAc shell, were not normalized following the reversal of cocaine-sensitization. Interestingly, daily injections of pergolide alone in saline-pretreated animals induced PI3K changes that were similar to the cocaine sensitization-associated changes in the NAc core and PFC but not the NAc shell; furthermore, these changes in saline-pretreated animals were prevented by ondansetron given 3.5 h after pergolide. The present study suggests that selective enhancement of the PI3K activity in the NAc shell may be one of key alterations underlying the long-term cocaine sensitization. To the extent cocaine sensitization is an important factor in human cocaine abuse, pharmacological interventions targeted toward the NAc shell PI3K alteration may be useful in cocaine abuse treatment.« less

Extending the Reach of Early Intervention Training for Practitioners: A Preliminary Investigation of an Online Curriculum for Teaching Behavioral Intervention Knowledge in Autism to Families and Service Providers

ERIC Educational Resources Information Center

Hamad, Charles D.; Serna, Richard W.; Morrison, Leslie; Fleming, Richard

2010-01-01

Early behavioral intervention (BI), based on the methods of applied behavior analysis, has the strongest and most consistent scientific support as a means of teaching skills to young children with autism spectrum disorder and reducing their restricted and maladaptive behavior. Although individual applied behavior analysis (ABA)-based treatment…

Sustained sexual behavior change following acute HIV diagnosis in Malawi.

PubMed

Rucinski, Katherine B; Rutstein, Sarah E; Powers, Kimberly A; Pasquale, Dana K; Dennis, Ann M; Phiri, Sam; Hosseinipour, Mina C; Kamanga, Gift; Nsona, Dominic; Massa, Cecilia; Hoffman, Irving F; Miller, William C; Pettifor, Audrey E

2018-06-05

Identification of acute HIV infection (AHI) allows important opportunities for HIV prevention through behavior change and biomedical intervention. Here, we evaluate changes in sexual risk behaviors among persons with AHI enrolled in a combined behavioral and biomedical intervention designed to reduce onward transmission of HIV. Participants were randomized to standard HIV counseling, a multi-session behavioral intervention, or a multi-session behavioral intervention plus antiretrovirals. Sexual behaviors were assessed periodically over one year. Four weeks after diagnosis, the predicted probability of reporting multiple sexual partners decreased from 24% to 9%, and the probability of reporting unprotected sex from 71% to 27%. These declines in sexual risk behaviors were sustained over follow-up irrespective of study arm. AHI diagnosis alone may be sufficient to achieve immediate and sustained behavior change during this highly infectious period.

A family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth.

PubMed

Milburn, Norweeta G; Iribarren, Francisco Javier; Rice, Eric; Lightfoot, Marguerita; Solorio, Rosa; Rotheram-Borus, Mary Jane; Desmond, Katherine; Lee, Alex; Alexander, Kwame; Maresca, Katherine; Eastmen, Karen; Arnold, Elizabeth Mayfield; Duan, Naihua

2012-04-01

We evaluate the efficacy of a short family intervention in reducing sexual risk behavior, drug use, and delinquent behaviors among homeless youth. A randomized controlled trial of 151 families with a homeless adolescent aged 12 to 17 years. Between March 2006 and June 2009, adolescents were recruited from diverse sites in Southern California and were assessed at recruitment (baseline), and at 3, 6, and 12 months later. Families were randomly assigned to an intervention condition with five weekly home-based intervention sessions or a control condition (standard care). Main outcome measures reflect self-reported sexual risk behavior, substance use, and delinquent behaviors over the past 90 days. Sexual risk behavior (e.g., mean number of partners; p < .001), alcohol use (p = .003), hard drug use (p < .001), and delinquent behaviors (p = .001) decreased significantly more during 12 months in the intervention condition compared with the control condition. Marijuana use, however, significantly increased in the intervention condition compared with the control condition (p < .001). An intervention to reengage families of homeless youth has significant benefits in reducing risk over 12 months. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Recruiting drug-using men who have sex with men into behavioral interventions: a two-stage approach.

PubMed

Kanouse, David E; Bluthenthal, Ricky N; Bogart, Laura; Iguchi, Martin Y; Perry, Suzanne; Sand, Kelly; Shoptaw, Steven

2005-03-01

Drug-using men who have sex with men (MSM) are at high risk of acquiring or transmitting HIV infection. Efforts to change behaviors in this population have been hampered by difficulties in recruiting drug-using MSM into behavioral interventions. This study sought to develop an effective strategy for recruiting drug-using MSM into behavioral interventions that consist of motivational interviewing alone or motivational interviewing plus contingency management. MSM were recruited through advertising and community outreach into groups to discuss party drugs, party burnout, and sexual behavior, with the intervention subsequently described and enrollment offered in the group setting. Many more eligible MSM responded to advertisements for the discussion groups than advertisements for the interventions, and 58% of those who participated in the discussion groups volunteered for counseling. Men who entered counseling reported high levels of drug use and sexual activity and were racially and ethnically diverse; only 35% were willing to accept drug treatment. Results demonstrate that a two-stage strategy in which drug-using MSM are first recruited into discussion groups before they are offered a behavioral intervention can be an effective way to induce voluntary acceptance of an intervention employing a behavioral risk-reduction approach.

The use and utility of specific nonpharmacological interventions for behavioral symptoms in dementia: an exploratory study.

PubMed

Cohen-Mansfield, Jiska; Marx, Marcia S; Dakheel-Ali, Maha; Thein, Khin

2015-02-01

This study compares different nonpharmacological interventions for persons with behavioral symptoms and dementia on frequency of use and perceived efficacy in terms of change in behavior and interest. Participants were 89 nursing home residents from six Maryland nursing homes with a mean age of 85.9 years (SD: 8.6 years). Research assistants presented interventions tailored to the participants' needs and preferences in a pre-intervention trial phase and in an intervention phase. The impact of each intervention on behavioral symptoms and on the person's interest was rated immediately after the intervention by a research assistant. The most utilized interventions in both trial and treatment phases were the social intervention of one-on-one interaction, simulated social interventions such as a lifelike doll and respite video, the theme intervention of magazine, and the sensory stimulation intervention of music. In contrast, the least utilized interventions in both phases were sewing, fabric book, and flower arrangement. Interventions with the highest impact on behavioral symptoms included one-on-one social interaction, hand massage, music, video, care, and folding towels. Other high impact interventions included walking, going outside, flower arranging, food or drink, sewing, group activity, book presentation, ball toss, coloring or painting, walking, and family video. The results provide initial directions for choosing specific interventions for persons with dementia and also demonstrate a methodology for increasing knowledge through ongoing monitoring of practice. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Cognitive-Behavioral Group Therapy for Latino youth with Type 1 Diabetes and depression: A case study.

PubMed

Cumba-Avilés, Eduardo

2017-02-01

This group case study describes the course of a 14-session Cognitive Behavioral Therapy (CBT) for Latino adolescents with Type 1 Diabetes Mellitus (T1DM) and depressive symptoms. The intervention, known as CBT-DM, is an adaptation of an efficacious group intervention for adolescent depression. The treatment rationale and cultural adaption model are described as well as procedures used to achieve sensitivity to the characteristics of the T1DM culture as experienced by Latino youth from Puerto Rico. Session-by-session protocol is reviewed and treatment gains on the group as a whole and on its individual members are presented, providing quantitative and qualitative data. Treatment feasibility, clients' acceptance and satisfaction with treatment, and follow-up data up to 6 months post-treatment are also examined, considering cognitive, behavioral, emotional, relational, medical, and functional outcomes. Complicating factors, barriers to care, and treatment implications are discussed in the context of treating clients with comorbid chronic physical illness and emotional problems also embedded in a Latino culture. Translation of evidence-based treatments for depression into primary care settings and adapting protocols to youth populations with other medical illnesses is proposed. Recommendations for clinicians are provided, emphasizing the establishment of collaborative relationships with clients, assessing their stage in the process of accepting their chronic illness, as well as understanding their overall context to avoid unnecessary attributions of pathology to their thoughts, behaviors, and feelings.

Cognitive-Behavioral Group Therapy for Latino youth with Type 1 Diabetes and depression: A case study

PubMed Central

Cumba-Avilés, Eduardo

2018-01-01

This group case study describes the course of a 14-session Cognitive Behavioral Therapy (CBT) for Latino adolescents with Type 1 Diabetes Mellitus (T1DM) and depressive symptoms. The intervention, known as CBT-DM, is an adaptation of an efficacious group intervention for adolescent depression. The treatment rationale and cultural adaption model are described as well as procedures used to achieve sensitivity to the characteristics of the T1DM culture as experienced by Latino youth from Puerto Rico. Session-by-session protocol is reviewed and treatment gains on the group as a whole and on its individual members are presented, providing quantitative and qualitative data. Treatment feasibility, clients’ acceptance and satisfaction with treatment, and follow-up data up to 6 months post-treatment are also examined, considering cognitive, behavioral, emotional, relational, medical, and functional outcomes. Complicating factors, barriers to care, and treatment implications are discussed in the context of treating clients with comorbid chronic physical illness and emotional problems also embedded in a Latino culture. Translation of evidence-based treatments for depression into primary care settings and adapting protocols to youth populations with other medical illnesses is proposed. Recommendations for clinicians are provided, emphasizing the establishment of collaborative relationships with clients, assessing their stage in the process of accepting their chronic illness, as well as understanding their overall context to avoid unnecessary attributions of pathology to their thoughts, behaviors, and feelings. PMID:29568241

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

Multimodal Secondary Prevention Behavioral Interventions for TIA and Stroke: A Systematic Review and Meta-Analysis

PubMed Central

Lawrence, Maggie; Pringle, Jan; Kerr, Susan; Booth, Joanne; Govan, Lindsay; Roberts, Nicola J.

2015-01-01

Background Guidelines recommend implementation of multimodal interventions to help prevent recurrent TIA/stroke. We undertook a systematic review to assess the effectiveness of behavioral secondary prevention interventions. Strategy Searches were conducted in 14 databases, including MEDLINE (1980-January 2014). We included randomized controlled trials (RCTs) testing multimodal interventions against usual care/modified usual care. All review processes were conducted in accordance with Cochrane guidelines. Results Twenty-three papers reporting 20 RCTs (6,373 participants) of a range of multimodal behavioral interventions were included. Methodological quality was generally low. Meta-analyses were possible for physiological, lifestyle, psychosocial and mortality/recurrence outcomes. Note: all reported confidence intervals are 95%. Systolic blood pressure was reduced by 4.21 mmHg (mean) (−6.24 to −2.18, P = 0.01 I2 = 58%, 1,407 participants); diastolic blood pressure by 2.03 mmHg (mean) (−3.19 to −0.87, P = 0.004, I2 = 52%, 1,407 participants). No significant changes were found for HDL, LDL, total cholesterol, fasting blood glucose, high sensitivity-CR, BMI, weight or waist:hip ratio, although there was a significant reduction in waist circumference (−6.69 cm, −11.44 to −1.93, P = 0.006, I2 = 0%, 96 participants). There was no significant difference in smoking continuance, or improved fruit and vegetable consumption. There was a significant difference in compliance with antithrombotic medication (OR 1.45, 1.21 to 1.75, P<0.0001, I2 = 0%, 2,792 participants) and with statins (OR 2.53, 2.15 to 2.97, P< 0.00001, I2 = 0%, 2,636 participants); however, there was no significant difference in compliance with antihypertensives. There was a significant reduction in anxiety (−1.20, −1.77 to −0.63, P<0.0001, I2 = 85%, 143 participants). Although there was no significant difference in odds of death or recurrent TIA/stroke, there was a significant reduction in the odds of cardiac events (OR 0.38, 0.16 to 0.88, P = 0.02, I2 = 0%, 4,053 participants). Conclusions There are benefits to be derived from multimodal secondary prevention interventions. However, the findings are complex and should be interpreted with caution. Further, high quality trials providing comprehensive detail of interventions and outcomes, are required. Review Registration PROSPERO CRD42012002538. PMID:25793643

Behavioral family intervention for children with developmental disabilities and behavioral problems.

PubMed

Roberts, Clare; Mazzucchelli, Trevor; Studman, Lisa; Sanders, Matthew R

2006-06-01

The outcomes of a randomized clinical trial of a new behavioral family intervention, Stepping Stones Triple P, for preschoolers with developmental and behavior problems are presented. Forty-eight children with developmental disabilities participated, 27 randomly allocated to an intervention group and 20 to a wait-list control group. Parents completed measures of parenting style and stress, and independent observers assessed parent-child interactions. The intervention was associated with fewer child behavior problems reported by mothers and independent observers, improved maternal and paternal parenting style, and decreased maternal stress. All effects were maintained at 6-month follow-up.

Increasing Treatment Seeking Among At-Risk Service Members Returning from Warzones

DTIC Science & Technology

2017-03-01

treatment among at-risk service members. Hypothesis 1a: Participants receiving the cognitive -behavioral (CB) intervention will have significant...Participants assigned to the treatment condition are presented an individualized cognitive -behavioral (CB) intervention. The CB intervention takes 45-60... cognitive -behavioral intervention 6 3. OVERALL PROJECT SUMMARY Recruitment for this trial began on March 2, 2013. We aimed to recruit

Is there life after DEBI? Examining health behavior maintenance in the diffusion of effective behavioral interventions initiative.

PubMed

Feldman, Matthew B; Silapaswan, Andrew; Schaefer, Nathan; Schermele, Daniel

2014-06-01

The evidence-based interventions that are identified, packaged, and disseminated by the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention as part of the Diffusion of Effective Behavioral Interventions (DEBI) initiative-commonly referred to the "DEBIs"-currently represent a primary source of HIV prevention interventions for community-based providers. To date, little attention has focused on whether the intended outcomes of the DEBIs, i.e., reductions in HIV-related risk behaviors, are maintained over time. This review summarized evidence for the sustainability of the effects of the DEBIs on HIV sexual risk behavior and intravenous drug use from studies of original and adapted DEBIs. Evidence of intervention decay or a lack of any intervention effect was identified in several original and adapted versions of the DEBIs included in this review. Recommendations include modifications to current criteria for inclusion in the DEBI portfolio, in addition to the development of remediation strategies to address intervention decay. Further, theoretical models that specify the processes that underlie the maintenance of health behaviors over time should be used in developing HIV prevention interventions.

Interactive Two-Way mHealth Interventions for Improving Medication Adherence: An Evaluation Using The Behaviour Change Wheel Framework

PubMed Central

Amico, K Rivet; Atkins, Lou; Lester, Richard T

2018-01-01

Background Medication adherence is an important but highly complex set of behaviors, which for life-threatening and infectious diseases such as HIV carry critical consequences for individual and public health. There is growing evidence that mobile phone text messaging interventions (mHealth) connecting providers with patients positively impact medication adherence, particularly two-way engagement platforms that require bidirectional communication versus one-way in which responses are not mandatory. However, mechanisms of action have not been well defined. The Behavior Change Wheel is a comprehensive framework for behavior change that includes an all-encompassing model of behavior known as Capability Opportunity Motivation-Behavior and is complemented by a taxonomy of behavior change techniques. Evaluating mHealth interventions for medication adherence using these tools could provide useful insights that may contribute to optimizing their integration into the healthcare system and successful scaling-up. Objective This study aimed to help address the current knowledge gap regarding how two-way mHealth interventions for medication adherence may work by applying the Behavior Change Wheel to characterize WelTel: an interactive digital health outreach platform with robust evidence for improving adherence to antiretroviral therapy. Methods To characterize how WelTel may promote medication adherence, we applied the Behavior Change Wheel to systematically (1) generate a behavioral diagnosis through mapping known antiretroviral therapy adherence barriers onto the Capability Opportunity Motivation-Behavior model of behavior, (2) specify the behavior change techniques that WelTel delivers, (3) link identified behavior change techniques to corresponding intervention functions of the Behavior Change Wheel, and (4) connect these behavior change techniques and intervention functions to respective Capability Opportunity Motivation-Behavior influences on behavior to determine potential mechanisms of action. Results Our evaluation of WelTel using the Behavior Change Wheel suggests that most of its impact is delivered primarily through its personalized communication component, in which 8 different behavior change techniques were identified and linked with 5 intervention functions (environmental restructuring, enablement, education, persuasion, and training). Its mechanisms of action in promoting antiretroviral therapy adherence may involve addressing all Capability Opportunity Motivation-Behavior influences on behavior (physical and psychological capability, physical and social opportunity, reflective and automatic motivation). Conclusions Systematically unpacking the potential active ingredients of effective interventions facilitates the creation and implementation of more parsimonious, tailored, and targeted approaches. Evaluating WelTel using the Behavior Change Wheel has provided valuable insights into how and why such interactive two-way mHealth interventions may produce greater impact than one-way in addressing both nonintentional and intentional forms of nonadherence. The application of the Behavior Change Wheel for evidence synthesis across mHealth interventions targeting various conditions would contribute to strengthening the knowledge base regarding how they may work to impact medication adherence behavior. PMID:29650504

Interactive Two-Way mHealth Interventions for Improving Medication Adherence: An Evaluation Using The Behaviour Change Wheel Framework.

PubMed

Chiang, Nicole; Guo, Michael; Amico, K Rivet; Atkins, Lou; Lester, Richard T

2018-04-12

Medication adherence is an important but highly complex set of behaviors, which for life-threatening and infectious diseases such as HIV carry critical consequences for individual and public health. There is growing evidence that mobile phone text messaging interventions (mHealth) connecting providers with patients positively impact medication adherence, particularly two-way engagement platforms that require bidirectional communication versus one-way in which responses are not mandatory. However, mechanisms of action have not been well defined. The Behavior Change Wheel is a comprehensive framework for behavior change that includes an all-encompassing model of behavior known as Capability Opportunity Motivation-Behavior and is complemented by a taxonomy of behavior change techniques. Evaluating mHealth interventions for medication adherence using these tools could provide useful insights that may contribute to optimizing their integration into the healthcare system and successful scaling-up. This study aimed to help address the current knowledge gap regarding how two-way mHealth interventions for medication adherence may work by applying the Behavior Change Wheel to characterize WelTel: an interactive digital health outreach platform with robust evidence for improving adherence to antiretroviral therapy. To characterize how WelTel may promote medication adherence, we applied the Behavior Change Wheel to systematically (1) generate a behavioral diagnosis through mapping known antiretroviral therapy adherence barriers onto the Capability Opportunity Motivation-Behavior model of behavior, (2) specify the behavior change techniques that WelTel delivers, (3) link identified behavior change techniques to corresponding intervention functions of the Behavior Change Wheel, and (4) connect these behavior change techniques and intervention functions to respective Capability Opportunity Motivation-Behavior influences on behavior to determine potential mechanisms of action. Our evaluation of WelTel using the Behavior Change Wheel suggests that most of its impact is delivered primarily through its personalized communication component, in which 8 different behavior change techniques were identified and linked with 5 intervention functions (environmental restructuring, enablement, education, persuasion, and training). Its mechanisms of action in promoting antiretroviral therapy adherence may involve addressing all Capability Opportunity Motivation-Behavior influences on behavior (physical and psychological capability, physical and social opportunity, reflective and automatic motivation). Systematically unpacking the potential active ingredients of effective interventions facilitates the creation and implementation of more parsimonious, tailored, and targeted approaches. Evaluating WelTel using the Behavior Change Wheel has provided valuable insights into how and why such interactive two-way mHealth interventions may produce greater impact than one-way in addressing both nonintentional and intentional forms of nonadherence. The application of the Behavior Change Wheel for evidence synthesis across mHealth interventions targeting various conditions would contribute to strengthening the knowledge base regarding how they may work to impact medication adherence behavior. ©Nicole Chiang, Michael Guo, K Rivet Amico, Lou Atkins, Richard T Lester. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 12.04.2018.

Bidirectional Effects between Parenting and Aggressive Child Behavior in the Context of a Preventive Intervention.

PubMed

Te Brinke, Lysanne W; Deković, Maja; Stoltz, Sabine E M J; Cillessen, Antonius H N

2017-07-01

Over time, developmental theories and empirical studies have gradually started to adopt a bidirectional viewpoint. The area of intervention research is, however, lagging behind in this respect. This longitudinal study examined whether bidirectional associations between (changes in) parenting and (changes in) aggressive child behavior over time differed in three conditions: a child intervention condition, a child + parent intervention condition and a control condition. Participants were 267 children (74 % boys, 26 % girls) with elevated levels of aggression, their mothers and their teachers. Reactive aggression, proactive aggression and perceived parenting were measured at four measurement times from pretest to one-year after intervention termination. Results showed that associations between aggressive child behavior and perceived parenting are different in an intervention context, compared to a general developmental context. Aggressive behavior and perceived parenting were unrelated over time for children who did not receive an intervention. In an intervention context, however, decreases in aggressive child behavior were related to increases in perceived positive parenting and decreases in perceived overreactivity. These findings underscore the importance of addressing child-driven processes in interventions aimed at children, but also in interventions aimed at both children and their parents.

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

PubMed

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

1991-01-01

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

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

PubMed Central

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

2010-01-01

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

Interventions to maximize facial cleanliness and achieve environmental improvement for trachoma elimination: A review of the grey literature

PubMed Central

Solomon, Hiwote; Solomon, Anthony W.; Freeman, Matthew C.

2018-01-01

Background Efforts are underway to scale-up the facial cleanliness and environmental improvement (F&E) components of the World Health Organization’s SAFE strategy for elimination of trachoma as a public health problem. Improving understanding of the F&E intervention landscape could inform advancements prior to scale-up, and lead to more effective and sustained behavior change. Methods/findings We systematically searched for relevant grey literature published from January 1965 through August 2016. Publications were eligible for review if they described interventions addressing F&E in the context of trachoma elimination programs. Subsequent to screening, we mapped attributes of F&E interventions. We then employed three behavior change frameworks to synthesize mapped data and identify potential intervention gaps. We identified 27 documents meeting inclusion criteria. With the exception of some recent programming, F&E interventions have largely focused on intermediate and distal antecedents of behavior change. Evidence from our analyses suggests many interventions are not designed to address documented determinants of improved F&E practices. No reviewed documents endorsed inclusion of intervention components related to behavioral maintenance or resilience–factors critical for sustaining improved behaviors. Conclusions If left unaddressed, identified gaps in intervention content may continue to challenge uptake and sustainability of improved F&E behaviors. Stakeholders designing and implementing trachoma elimination programs should review their F&E intervention content and delivery approaches with an eye toward improvement, including better alignment with established behavior change theories and empirical evidence. Implementation should move beyond information dissemination, and appropriately employ a variety of behavior change techniques to address more proximal influencers of change. PMID:29370169

One or many? Which and how many parenting variables should be targeted in interventions to reduce children's externalizing behavior?

PubMed

Loop, Laurie; Mouton, Bénédicte; Stievenart, Marie; Roskam, Isabelle

2017-05-01

This research compared the efficacy of two parenting interventions that vary according to the number and the nature of variables in reducing preschoolers' externalizing behavior (EB). The goal was to identify which parenting intervention format (one-variable versus two-variable) caused higher behavioral adjustment in children. The first was a one-variable intervention manipulating parental self-efficacy beliefs. The second was a two-variable intervention manipulating both parents' self-efficacy beliefs and emotion coaching practices. The two interventions shared exactly the same design, consisting of eight parent group sessions. Effect on children's EB and observed behaviors were evaluated through a multi-method assessment at three points (pre-test, post-test and follow-up). The results highlighted that compared to the waitlist condition, the two intervention formats tended to cause a significant reduction in children's EB reported by their parent. However, the one-variable intervention was found to lead to a greater decrease in children's EB at follow-up. The opposite was reported for children's observed behavior, which was improved to a greater extent in the two-variable intervention at post-test and follow-up. The results illustrated that interventions' format cannot be considered as purely interchangeable since their impact on children's behavior modification is different. The results are discussed for their research and clinical implications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparing School-Based Teen Pregnancy Prevention Programming: Mixed Outcomes in an At-Risk State.

PubMed

Oman, Roy F; Merritt, Breanca T; Fluhr, Janene; Williams, Jean M

2015-12-01

The purpose of this study is to compare the effectiveness of a national comprehensive teen pregnancy prevention (TPP) intervention to a national abstinence-only TPP intervention on middle school students' knowledge, attitudes, and behaviors related to teen sexual behaviors in a state with high teen birth rates. Pre- and post-intervention data were collected annually (2005-2010) from seventh-grade students to evaluate school-based TPP programs that implemented a comprehensive (N = 3244) or abstinence-only (N = 3172) intervention. Chi-square and t tests, logistic regressions, and hierarchical multiple regressions examined relationships between sexuality-related behavioral intentions, knowledge, and attitudes. Students in both interventions reported significant (p < .05) improvements post-intervention. Youth in the comprehensive TPP intervention were more likely (p < .05) to have significantly improved their attitudes (odds ratios [ORs] = 1.35, 1.83, 1.23) and behavior regarding abstinence decisions in the past 3 months (OR = 1.39). The interventions' improvements in attitudes were more explanatory for behavioral intentions for students in the abstinence-only intervention than for students in the comprehensive TPP intervention. The mixed results suggest the comprehensive TPP intervention was only slightly more effective than the abstinence intervention, but that changing student attitudes and perceptions may be a key component of more effective TPP interventions. © 2015, American School Health Association.

Identifying at-risk children at school entry: the usefulness of multibehavioral problem profiles.

PubMed

Flanagan, Kelly S; Bierman, Karen L; Kam, Chi-Ming

2003-09-01

Found that 1st-grade teacher ratings of aggressive, hyperactive-inattentive, and low levels of prosocial behaviors made unique contributions to the prediction of school outcomes (measured 2 years later) for 755 children. Person-oriented analyses compared the predictive utility of 5 screening strategies based on child problem profiles to identify children at risk for school problems. A broad screening strategy, in which children with elevations in any 1 of the 3 behavior problem dimensions were identified as "at-risk," showed lower specificity but superior sensitivity, odds ratios, and overall accuracy in the prediction of school outcomes than the other screening strategies that were more narrowly focused or were based on a total problem score. Results are discussed in terms of implications for the screening and design of preventive interventions.

Web-based intervention to change perceived norms of college student alcohol use and sexual behavior on spring break.

PubMed

Patrick, Megan E; Lee, Christine M; Neighbors, Clayton

2014-03-01

The purpose of the present study was to evaluate an adapted web-based multi-component personalized feedback intervention to reduce college student alcohol use and risky sexual behavior during Spring Break. This is one of the first interventions focused on Spring Break alcohol use and related sexual behavior. Personalized feedback intervention components addressed intentions, expected consequences, norms, motivations, protective behavioral strategies, and pacts with friends. Participants were college students (N=263; 55% women) between the ages of 18 and 21 who planned to go on a Spring Break trip with their friends. Effects were not significant in reducing alcohol use or sexual behavior during Spring Break or some of the proposed intervention mechanisms. However, consistent results showed that the intervention succeeded in reducing perceived social norms for Spring Break drinking and sexual behavior. Findings suggest that changing norms alone is not sufficient for changing risk behavior during this event and alternative strategies are needed to impact other putative mediators. Copyright © 2013 Elsevier Ltd. All rights reserved.

Online Prevention Aimed at Lifestyle Behaviors: A Systematic Review of Reviews

PubMed Central

Kohl, Leonie FM; de Vries, Nanne K

2013-01-01

Background Interventions aimed at behavior change are increasingly being delivered over the Internet. Although research on intervention effectiveness has been widely conducted, their true public health impact as indicated by reach, effectiveness, and use is unclear. Objective The aim of this paper is to (1) review the current literature on online prevention aimed at lifestyle behaviors, and (2) identify research gaps regarding reach, effectiveness, and use. Methods A systematic search in PubMed revealed relevant literature published between 2005 and 2012 on Internet-delivered behavior change interventions aimed at dietary behaviors, physical activity, alcohol use, smoking, and condom use. Our search yielded 41 eligible reviews, which were analyzed in terms of reach, effectiveness, and use according to the RE-AIM framework. Results According to health priorities, interventions are largely targeted at weight-related behaviors, such as physical activity and dietary behavior. Evaluations are predominantly effect-focused and overall effects are small, variable, and not sustainable. Determinants of effectiveness are unclear; effectiveness cannot yet be unambiguously attributed to isolated elements. Actual reach of interventions is undiversified, mostly reaching participants who are female, highly educated, white, and living in high-income countries. One of the most substantial problems in online prevention is the low use of the interventions, a phenomenon seen across all behavior domains. Conclusions More research is needed on effective elements instead of effective interventions, with special attention to long-term effectiveness. The reach and use of interventions need more scientific input to increase the public health impact of Internet-delivered interventions. PMID:23859884

Interventions for Challenging Behavior in Residential Settings.

ERIC Educational Resources Information Center

Stancliffe, Roger J.; Lakin, K. Charlie; Hayden, Mary F.

1999-01-01

A study investigated the use of different interventions for 151 individuals with mental retardation in residential care: Individualized Habilitation Plan objectives concerning challenging behavior, one-to-one crisis intervention in the preceding 30 days, and behavior management professional services in the preceding 6 months. Externalized…

Predicting Adult Criminal Behavior from Juvenile Delinquency: Ex-Ante vs. Ex-Post Benefits of Early Intervention

PubMed Central

White, Barry A. B.; Temple, Judy A.; Reynolds, Arthur J.

2016-01-01

Recent analyses of the long-term societal benefits from early intervention (prenatal care, home visitation, and high quality preschool) for at-risk children commonly include significant savings to society in the form of reduced juvenile delinquency and adult criminal behavior. However, a nontrivial proportion of the reported benefits of several early intervention programs are based on forecasts of criminal behavior throughout adulthood conditional on intervention effects on delinquency in adolescence. Data from the Chicago Longitudinal Study (CLS), an investigation of the life course of 1,539 children from low-income families born in 1979–1980, are used to investigate the bias resulting from predicting the effect of early intervention on adult criminal behavior from the effect on delinquency in adolescence. The investigation concludes that the general method used to predict adult criminal behavior results in a conservative estimate of the reduction in the cost of adult criminal behavior attributed to early intervention. PMID:27867324

Predicting Adult Criminal Behavior from Juvenile Delinquency: Ex-Ante vs. Ex-Post Benefits of Early Intervention.

PubMed

White, Barry A B; Temple, Judy A; Reynolds, Arthur J

2010-12-01

Recent analyses of the long-term societal benefits from early intervention (prenatal care, home visitation, and high quality preschool) for at-risk children commonly include significant savings to society in the form of reduced juvenile delinquency and adult criminal behavior. However, a nontrivial proportion of the reported benefits of several early intervention programs are based on forecasts of criminal behavior throughout adulthood conditional on intervention effects on delinquency in adolescence. Data from the Chicago Longitudinal Study (CLS), an investigation of the life course of 1,539 children from low-income families born in 1979-1980, are used to investigate the bias resulting from predicting the effect of early intervention on adult criminal behavior from the effect on delinquency in adolescence. The investigation concludes that the general method used to predict adult criminal behavior results in a conservative estimate of the reduction in the cost of adult criminal behavior attributed to early intervention.

Behavioral Nutrition Interventions Using e- and m-Health Communication Technologies: A Narrative Review.

PubMed

Olson, Christine M

2016-07-17

e- and m-Health communication technologies are now common approaches to improving population health. The efficacy of behavioral nutrition interventions using e-health technologies to decrease fat intake and increase fruit and vegetable intake was demonstrated in studies conducted from 2005 to 2009, with approximately 75% of trials showing positive effects. By 2010, an increasing number of behavioral nutrition interventions were focusing on body weight. The early emphasis on interventions that were highly computer tailored shifted to personalized electronic interventions that included weight and behavioral self-monitoring as key features. More diverse target audiences began to participate, and mobile components were added to interventions. Little progress has been made on using objective measures rather than self-reported measures of dietary behavior. A challenge for nutritionists is to link with the private sector in the design, use, and evaluation of the many electronic devices that are now available in the marketplace for nutrition monitoring and behavioral change.

Harms, benefits, and the nature of interventions in pragmatic clinical trials.

PubMed

Ali, Joseph; Andrews, Joseph E; Somkin, Carol P; Rabinovich, C Egla

2015-10-01

To produce evidence capable of informing healthcare decision making at all critical levels, pragmatic clinical trials are diverse both in terms of the type of intervention (medical, behavioral, and/or technological) and the target of intervention (patients, clinicians, and/or healthcare system processes). Patients and clinicians may be called on to participate as designers, investigators, intermediaries, or subjects of pragmatic clinical trials. Other members of the healthcare team, as well as the healthcare system itself, also may be affected directly or indirectly before, during, or after study implementation. This diversity in the types and targets of pragmatic clinical trial interventions has brought into focus the need to consider whether existing ethics and regulatory principles, policies, and procedures are appropriate for pragmatic clinical trials. Specifically, further examination is needed to identify how the types and targets of pragmatic clinical trial interventions may influence the assessment of net potential risk, understood as the balance of potential harms and benefits. In this article, we build on scholarship seeking to align ethics and regulatory requirements with potential research risks and propose an approach to the assessment of net risks that is sensitive to the diverse nature of pragmatic clinical trial interventions. We clarify the potential harms, burdens, benefits, and advantages of common types of pragmatic clinical trial interventions and discuss implications for patients, clinicians, and healthcare systems. © The Author(s) 2015.

Do Student Characteristics Influence the Effectiveness of the Tools for Getting along Curriculum? An Examination Using a Cognitive-Behavioral Intervention

ERIC Educational Resources Information Center

Barnes, Tia Navelene; Smith, Stephen W.; Daunic, Ann P.; Leite, Walter L.

2016-01-01

Cognitive-behavioral interventions (CBIs) are effective in decreasing externalizing behavior in school-aged children. To ensure that CBIs meet the needs of a diverse student population, it is important to examine whether intervention effectiveness is influenced by characteristics common to students identified with problem behaviors. In this study,…

The Effectiveness of a Cross-Setting Complementary Staff- and Parent-Mediated Early Intensive Behavioral Intervention for Young Children with ASD

ERIC Educational Resources Information Center

Fava, Leonardo; Strauss, Kristin; Valeri, Giovanni; D'Elia, Lidia; Arima, Serena; Vicari, Stefano

2011-01-01

We compared the effects of Early Intensive Behavioral Intervention (EIBI) and eclectic intervention in children with ASD on autism severity, developmental performance, adaptive behavior, language skills and challenging behaviors. Twelve children received cross-setting staff- and parent-mediated EIBI of centre-based one-to-one and play sessions as…

An Investigation of Multitiered Behavioral Interventions on Disruptive Behavior and Academic Engagement of Elementary Students

ERIC Educational Resources Information Center

Bunch-Crump, Kimberly R.; Lo, Ya-yu

2017-01-01

This study examined the effects of a multitiered system of support using Check-In Check-Out (CICO) as a secondary intervention and function-based self-monitoring (FBSM) as a tertiary intervention on the disruptive behavior and academic engagement of four elementary students identified as being in need of additional behavioral supports. A multiple…

Progress Monitoring Using Direct Behavior Rating Single Item Scales in a Multiple-Baseline Design Study of the Daily Report Card Intervention

ERIC Educational Resources Information Center

Fabiano, Gregory A.; Pyle, Kellina; Kelty, Mary Bridget; Parham, Brittany R.

2017-01-01

Direct behavior rating (DBR) may be a viable assessment for documenting current areas of impaired functioning and progress monitoring students' response to a behavioral intervention. Challenging behaviors are often addressed in general education settings using interventions such as the daily report card (DRC). To best implement and monitor such…

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.

Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials.

PubMed

James, Erica; Freund, Megan; Booth, Angela; Duncan, Mitch J; Johnson, Natalie; Short, Camille E; Wolfenden, Luke; Stacey, Fiona G; Kay-Lambkin, Frances; Vandelanotte, Corneel

2016-08-01

Growing evidence points to the benefits of addressing multiple health behaviors rather than single behaviors. This review evaluates the relative effectiveness of simultaneous and sequentially delivered multiple health behavior change (MHBC) interventions. Secondary aims were to identify: a) the most effective spacing of sequentially delivered components; b) differences in efficacy of MHBC interventions for adoption/cessation behaviors and lifestyle/addictive behaviors, and; c) differences in trial retention between simultaneously and sequentially delivered interventions. MHBC intervention trials published up to October 2015 were identified through a systematic search. Eligible trials were randomised controlled trials that directly compared simultaneous and sequential delivery of a MHBC intervention. A narrative synthesis was undertaken. Six trials met the inclusion criteria and across these trials the behaviors targeted were smoking, diet, physical activity, and alcohol consumption. Three trials reported a difference in intervention effect between a sequential and simultaneous approach in at least one behavioral outcome. Of these, two trials favoured a sequential approach on smoking. One trial favoured a simultaneous approach on fat intake. There was no difference in retention between sequential and simultaneous approaches. There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches. Given only three of the six trials observed a difference in intervention effectiveness for one health behavior outcome, and the relatively consistent finding that the sequential and simultaneous approaches were more effective than a usual/minimal care control condition, it appears that both approaches should be considered equally efficacious. PROSPERO registration number: CRD42015027876. Copyright © 2016 Elsevier Inc. All rights reserved.

Raising a Red Flag on Dating Violence: Evaluation of a Low-Resource, College-Based Bystander Behavior Intervention Program.

PubMed

Borsky, Amanda E; McDonnell, Karen; Turner, Monique Mitchell; Rimal, Rajiv

2016-03-09

Encouraging bystanders to intervene safely and effectively in situations that could escalate to violence-known as bystander behavior programs-is a growing yet largely untested strategy to prevent dating violence. Using a quasi-experimental design, we evaluate a low-resource, low-intensity intervention aimed at preventing dating violence among college students. The integrated behavioral model (IBM) was used to guide the evaluation. We also assess which IBM variables were most strongly associated with bystander behaviors. Participants were drawn from two Virginia colleges that predominantly train females in the health profession sciences. The intervention group (n = 329) participated in a university-wide bystander behavior intervention consisting of a 30-min presentation on dating violence at new-student orientation and a week-long "red flag" social marketing campaign on campus to raise awareness of dating violence. Controlling for changes at the comparison university, results showed an increase in bystander behaviors, such as encouraging a friend who may be in an abusive relationship to get help, after the intervention and adjusting for potential confounders (increase of 1.41 bystander behaviors, p = .04). However, no significant changes were found for bystander intentions, self-efficacy, social norms, or attitudes related to dating violence from pre- to post-intervention. Self-efficacy had a direct relationship with bystander behaviors. Results suggest that low-resource interventions have a modest effect on increasing bystander behaviors. However, higher resource interventions likely are needed for a larger impact, especially among students who already demonstrate strong baseline intentions to intervene and prevent dating violence. © The Author(s) 2016.

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

PubMed

Cropley, Lorelei

2004-12-01

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

A theory-based online health behavior intervention for new university students: study protocol

PubMed Central

2013-01-01

Background Too few young people engage in behaviors that reduce the risk of morbidity and premature mortality, such as eating healthily, being physically active, drinking sensibly and not smoking. The present research developed an online intervention to target these health behaviors during the significant life transition from school to university when health beliefs and behaviors may be more open to change. This paper describes the intervention and the proposed approach to its evaluation. Methods/design Potential participants (all undergraduates about to enter the University of Sheffield) will be emailed an online questionnaire two weeks before starting university. On completion of the questionnaire, respondents will be randomly assigned to receive either an online health behavior intervention (U@Uni) or a control condition. The intervention employs three behavior change techniques (self-affirmation, theory-based messages, and implementation intentions) to target four heath behaviors (alcohol consumption, physical activity, fruit and vegetable intake, and smoking). Subsequently, all participants will be emailed follow-up questionnaires approximately one and six months after starting university. The questionnaires will assess the four targeted behaviors and associated cognitions (e.g., intentions, self-efficacy) as well as socio-demographic variables, health status, Body Mass Index (BMI), health service use and recreational drug use. A sub-sample of participants will provide a sample of hair to assess changes in biochemical markers of health behavior. A health economic evaluation of the cost effectiveness of the intervention will also be conducted. Discussion The findings will provide evidence on the effectiveness of online interventions as well as the potential for intervening during significant life transitions, such as the move from school to university. If successful, the intervention could be employed at other universities to promote healthy behaviors among new undergraduates. Trial registration Current Controlled Trials, ISRCTN67684181. PMID:23384237

Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy?

PubMed

Slobodin, Ortal; de Jong, Joop T V M

2015-02-01

The prevalence of trauma-related problems among refugees and asylum seekers is extremely high due to adverse experiences associated with forced migration. Although the literature presents a considerable number of guidelines and theoretical frameworks for working with traumatized refugees and asylum seekers, the efficacy, feasibility and applicability of these interventions have little empirical evidence. The purpose of this article is to critically review the literature to provide a rationale for developing culturally sensitive, evidence-based interventions for refugees and asylum seekers. A literature review integrating research findings on interventions designed especially for traumatized asylum seekers and refugees was conducted. Retained studies had to use some quantitative measurements of post-traumatic stress and to have pre- and post-measurements to evaluate the efficacy of the intervention. Studies included in this review cover a wide variety of interventions, including trauma-focused interventions, group therapy, multidisciplinary interventions and pharmacological treatments. The majority of studies with traumatized refugees and asylum seekers reported positive outcomes of the intervention in reducing trauma-related symptoms. There is evidence to support the suitability of cognitive-behavioral therapy (CBT) and narrative exposure therapy (NET) in certain populations of refugees. Other intervention studies are limited by methodological considerations, such as lack of randomization, absence of control group and small samples. This review has again highlighted the shortage of guiding frameworks available to investigators and clinicians who are interested in tailoring interventions to work with refugees and asylum seekers. Theoretical, ethical and methodological considerations for future research are discussed. © The Author(s) 2014.

Use of intervention mapping to adapt a health behavior change intervention for endometrial cancer survivors: the shape-up following cancer treatment program.

PubMed

Koutoukidis, Dimitrios A; Lopes, Sonia; Atkins, Lou; Croker, Helen; Knobf, M Tish; Lanceley, Anne; Beeken, Rebecca J

2018-03-27

About 80% of endometrial cancer survivors (ECS) are overweight or obese and have sedentary behaviors. Lifestyle behavior interventions are promising for improving dietary and physical activity behaviors, but the constructs associated with their effectiveness are often inadequately reported. The aim of this study was to systematically adapt an evidence-based behavior change program to improve healthy lifestyle behaviors in ECS. Following a review of the literature, focus groups and interviews were conducted with ECS (n = 16). An intervention mapping protocol was used for the program adaptation, which consisted of six steps: a needs assessment, formulation of matrices of change objectives, selection of theoretical methods and practical applications, program production, adoption and implementation planning, and evaluation planning. Social Cognitive Theory and Control Theory guided the adaptation of the intervention. The process consisted of eight 90-min group sessions focusing on shaping outcome expectations, knowledge, self-efficacy, and goals about healthy eating and physical activity. The adapted performance objectives included establishment of regular eating, balanced diet, and portion sizes, reduction in sedentary behaviors, increase in lifestyle and organized activities, formulation of a discrepancy-reducing feedback loop for all above behaviors, and trigger management. Information on managing fatigue and bowel issues unique to ECS were added. Systematic intervention mapping provided a framework to design a cancer survivor-centered lifestyle intervention. ECS welcomed the intervention and provided essential feedback for its adaptation. The program has been evaluated through a randomized controlled trial.

The Effectiveness of Daily Behavior Report Cards for Children With ADHD: A Meta-Analysis.

PubMed

Iznardo, Michelle; Rogers, Maria A; Volpe, Robert J; Labelle, Patrick R; Robaey, Philippe

2017-11-01

This meta-analysis examined group-design studies investigating the effectiveness of Daily Behavior Report Cards (DBRC) as a school-based intervention to manage the classroom behavior of students with ADHD. A search of three article databases (PsycINFO, ERIC and Medline) identified seven group design evaluations of DBRC interventions. This meta-analysis included a total of 272 participants, with an average age of 7.9 years old. Three of the studies compared a control group to a treatment group with randomized group assignment, one study compared a control group to three treatment groups, two studies compared pre-and post-treatment scores in the same group, and one study compared pre-and post-treatment results of two intervention groups without random assignment. Dependent measures for these studies were teacher ratings (n = 5) and systematic direct observation of student academic and social behaviour (n = 2). Standardized mean differences ( Hedge's g) were calculated to obtain a pooled effect size using fixed effects. DBRCs were associated with reductions teacher-rated ADHD symptoms, with a Hedge's g of 0.36 (95% CI: 0.12-0.60, z=2.93, p ≤ .005) with low heterogeneity (Q-value: 2.40, I 2 = 0.00). This result excluded two studies that used observational coding instead of standardized tests to evaluate the effects of the intervention. A moderator analysis indicated that the effect size for systematic direct observation was large ( Hedge's G = 1.05[95% CI: 0.66-1.44, z=5.25, p ≤ .00]), with very high heterogeneity (Q-value: 46.34, I 2 : 93.53). A second moderator analysis found differences in the effects of DBRCs for comorbid externalizing symptoms with an overall effect size of 0.34 (95%CI: -0.04-0.72, z=1.76 p =0.08) with high heterogeneity (Q-value: 3.98, I 2 : 74.85). DBRCs effectively reduce the frequency and severity of ADHD symptoms in classroom settings. Additionally, they have a significant effect on co-occuring externalizing behaviors. It appears that systematic direct observation may be a more sensitive measure of treatment effects compared to teacher ratings of ADHD symptoms.

Obesity Prevention and Treatment in Primary Care.

PubMed

Brown, Callie L; Perrin, Eliana M

2018-05-28

Despite many public health and clinical interventions, obesity rates remain high and evidence-based preventive strategies are elusive. Many consensus guidelines suggest providers should screen all children after age 2 for obesity by measuring height and weight, calculating body mass index (BMI), and sensitively communicating weight status in the context of health to the family at each visit. However, preventive counseling should begin in infancy and focus on healthy feeding, activity, and family lifestyle behaviors. For children with overweight or obesity, the American Academy of Pediatrics outlined four stages of treatment. 1) Primary care providers should offer "Prevention Plus," the use of motivational interviewing to achieve healthy lifestyle modifications in family behaviors or environments. 2) Children requiring the next level of obesity treatment, "structured weight management," require additional support beyond the primary care provider (such as a dietitian, physical therapist, or mental health counselor) and more structured goal setting with the team including providers adept at weight management counseling. 3) Children with severe obesity and motivated families may benefit from a referral to a "comprehensive multidisciplinary intervention," such as an obesity treatment clinic. 4) "Tertiary care interventions" occur in a multidisciplinary pediatric obesity treatment clinic with standard clinical protocols for evaluation of interventions, including medications and surgery. While it is certainly a challenge for providers to fit all the desired prevention and treatment counseling during preventive health visits, by beginning to provide anticipatory guidance at birth, providers can respond to parental questions, add to parents' knowledge base, and partner with parents and children and adolescents to help them grow up healthy. This is especially important in an increasingly toxic food environment with many incentives and messages to eat unhealthfully, barriers to appropriate physical activity, and concomitant stigma about obesity. Focusing on key nutrition and physical activity habits, and establishing these healthy behaviors at an early age, will allow children to develop a healthy growth trajectory. Much more work is required, however, to determine the best evidence-based practices for providers to counsel families on improving target behaviors, environmental modifications, and parenting skills and to decrease abundant disparities in obesity prevalence and treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

An examination of Anglo and Latino parenting practices: relation to behavior problems in children with or without developmental delay.

PubMed

Marquis, Willa A; Baker, Bruce L

2014-02-01

The transactional model of development has received empirical support in research on at-risk children. However, little is known about the role of ethnicity or child delay status (i.e., developmental delay [DD] or typical cognitive development [TD]) in the process of parents adapting to their child's behavior problems and special needs. We examined whether Latina (N=44) and Anglo (N=147) mothers of 3-year-old children with or without DD differed in their use of two parenting practices, maternal scaffolding and sensitivity. We also examined how the status and ethnic groups differed in child behavior problems at ages 3 and 5 and whether parenting predicted change in behavior problems over time in the ethnic and status groups. Analyses generally supported previous research on status group differences in behavior problems (DD higher) and parenting practices (TD higher). Parenting practices predicted a decrease in externalizing problems from child age 3 to 5 years among Latino families only. Child developmental status was not associated with change in behavior problems. Cultural perspectives on the transactional model of development and implications for intervention are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

An application of the theory of planned behavior--a randomized controlled food safety pilot intervention for young adults.

PubMed

Milton, Alyssa C; Mullan, Barbara A

2012-03-01

Approximately 48 million Americans are affected by foodborne illness each year. Evidence suggests that the application of health psychology theory to food safety interventions can increase behaviors that reduce the incidence of illness such as adequately keeping hands, surfaces and equipment clean. This aim of this pilot study was to be the first to explore the effectiveness of a food safety intervention based on the Theory of Planned Behavior (TPB). Young adult participants (N = 45) were randomly allocated to intervention, general control or mere measurement control conditions. Food safety observations and TPB measures were taken at baseline and at 4-week follow-up. Within and between group differences on target variables were considered and regression analyses were conducted to determine the relationship between condition, behavior and the TPB intention constructs; attitude, subjective norm, perceived behavioral control (PBC). TPB variables at baseline predicted observed food safety behaviors. At follow-up, the intervention led to significant increases in PBC (p = .024) and observed behaviors (p = .001) compared to both control conditions. Furthermore, correlations were found between observed and self-reported behaviors (p = .008). The pilot intervention supports the utility of the TPB as a method of improving food safety behavior. Changes in TPB cognitions appear to be best translated to behavior via behavioral intentions and PBC. Further research should be conducted to increase effectiveness of translating TPB variables to food safety behaviors. The additional finding of a correlation between self-reported and observed behavior also has implications for future research as it provides evidence toward the construct validity of self-reported behavioral measures.

Comparing a Behavioral Check-In/Check-Out (CICO) Intervention to Standard Practice in an Urban Middle School Setting Using an Experimental Group Design

ERIC Educational Resources Information Center

Simonsen, Brandi; Myers, Diane; Briere, Donald E., III

2011-01-01

Students who continue to demonstrate at-risk behaviors after a school implements schoolwide primary (Tier 1) interventions require targeted-group secondary (Tier 2) interventions. This study was conducted to compare the effectiveness of a targeted-group behavioral check-in/check-out (CICO) intervention with the school's standard practice (SP) with…

Evaluation of Two Interventions to Reduce Aggressive and Antisocial Behavior in First and Second Graders in a Resource-Poor Setting

ERIC Educational Resources Information Center

Klevens, Joanne; Martinez, Jose William; Le, Brenda; Rojas, Carlos; Duque, Adriana; Tovar, Rafael

2009-01-01

We conducted a three-arm cluster randomized controlled trial (n = 2491) to evaluate a teacher delivered intervention to reduce aggressive and antisocial behavior and increase prosocial behavior in the classroom. A second aim of this trial was to establish whether combining this intervention with an intervention for parents was better than the…

Positive Behavior Support in Schools (PBSIS): An Administrative Perspective on the Implementation of a Comprehensive School-Wide Intervention in an Urban Charter School

ERIC Educational Resources Information Center

Christofferson, Remi Dabney; Callahan, Kathe

2015-01-01

This research explores the implementation of a school-wide intervention program that was designed to foster and instill intrinsic values based on an external reward system. The Positive Behavior Support in Schools (PBSIS) is an intervention intended to improve the climate of schools using system-wide positive behavioral interventions to discourage…

Early elementary school intervention to reduce conduct problems: a randomized trial with Hispanic and non-Hispanic children.

PubMed

Barrera, Manuel; Biglan, Anthony; Taylor, Ted K; Gunn, Barbara K; Smolkowski, Keith; Black, Carol; Ary, Dennis V; Fowler, Rollen C

2002-06-01

Children's aggressive behavior and reading difficulties during early elementary school years are risk factors for adolescent problem behaviors such as delinquency, academic failure, and substance use. This study determined if a comprehensive intervention that was designed to address both of these risk factors could affect teacher, parent, and observer measures of internalizing and externalizing problems. European American (n = 116) and Hispanic (n = 168) children from 3 communities who were selected for aggressiveness or reading difficulties were randomly assigned to an intervention or no-intervention control condition. Intervention families received parent training, and their children received social behavior interventions and supplementary reading instruction over a 2-year period. At the end of intervention, playground observations showed that treated children displayed less negative social behavior than controls. At the end of a 1-year follow-up, treated children showed less teacher-rated internalizing and less parent-rated coercive and antisocial behavior than controls. The study's limitations and implications for prevention are discussed.

Standards of Evidence for Behavioral Counseling Recommendations.

PubMed

McNellis, Robert J; Ory, Marcia G; Lin, Jennifer S; O'Connor, Elizabeth A

2015-09-01

Behavioral counseling interventions to promote healthy behaviors can significantly reduce leading causes of disease and death. Recommendations for delivery of these interventions in primary care have been and continue to be an important part of the U.S. Preventive Services Task Force's portfolio of clinical preventive services recommendations. However, primary and secondary research on the effectiveness of behavioral counseling interventions can be more complex than recommendations for screening or use of preventive medications. The nature of behavior change and interventions to promote it can lead to unique challenges. This paper summarizes and expands upon an extensive discussion held at the U.S. Preventive Services Task Force's Expert Forum on behavioral counseling interventions held in November 2013. The paper describes the foundational challenges for using behavioral outcomes as evidence to support a Task Force recommendation. The paper discusses research design and reporting characteristics needed by behavioral counseling intervention researchers in order for their research to contribute to the evidentiary basis of a Task Force recommendation. Finally, the paper identifies critical issues that need to be considered by the Task Force and other stakeholders to maintain confidence and credibility in the standards of evidence for behavioral counseling recommendations. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Using Confidence Interval-Based Estimation of Relevance to Select Social-Cognitive Determinants for Behavior Change Interventions.

PubMed

Crutzen, Rik; Peters, Gjalt-Jorn Ygram; Noijen, Judith

2017-01-01

When developing an intervention aimed at behavior change, one of the crucial steps in the development process is to select the most relevant social-cognitive determinants. These determinants can be seen as the buttons one needs to push to establish behavior change. Insight into these determinants is needed to select behavior change methods (i.e., general behavior change techniques that are applied in an intervention) in the development process. Therefore, a study on determinants is often conducted as formative research in the intervention development process. Ideally, all relevant determinants identified in such a study are addressed by an intervention. However, when developing a behavior change intervention, there are limits in terms of, for example, resources available for intervention development and the amount of content that participants of an intervention can be exposed to. Hence, it is important to select those determinants that are most relevant to the target behavior as these determinants should be addressed in an intervention. The aim of the current paper is to introduce a novel approach to select the most relevant social-cognitive determinants and use them in intervention development. This approach is based on visualization of confidence intervals for the means and correlation coefficients for all determinants simultaneously. This visualization facilitates comparison, which is necessary when making selections. By means of a case study on the determinants of using a high dose of 3,4-methylenedioxymethamphetamine (commonly known as ecstasy), we illustrate this approach. We provide a freely available tool to facilitate the analyses needed in this approach.

Multiple health behavior change in adults with or at risk for cancer: a systematic review.

PubMed

Green, Amanda C; Hayman, Laura L; Cooley, Mary E

2015-05-01

To identify components of efficacious interventions for multiple health behavior change (MHBC) in adult cancer survivors or adults at high risk for cancer. A systematic review of MHBC interventions was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Ten studies met inclusion criteria. Most studies changed at least 2 health behaviors. Diet, exercise, and smoking cessation were consistently changed with in-person interventions. Longer duration interventions using phone or mail contact had a positive association with changing diet and exercise. MHBC interventions positively influenced behavior change in adults with cancer and those at high risk for cancer. Future studies should focus on increasing dissemination and implementation of efficacious interventions.

Parenting behavior is associated with the early neurobehavioral development of very preterm children.

PubMed

Treyvaud, Karli; Anderson, Vicki A; Howard, Kelly; Bear, Merilyn; Hunt, Rod W; Doyle, Lex W; Inder, Terrie E; Woodward, Lianne; Anderson, Peter J

2009-02-01

There is an increasing focus on social and environmental factors that promote and support the early development of highly vulnerable children such as those born very preterm. The aim of this study was to assess the relationship between parenting behavior, parent-child synchrony, and neurobehavioral development in very preterm children at 24 months of age. Participants were 152 very preterm children (<30 weeks' gestation or <1250 g birth weight) and their parents/guardians. At 2 years' corrected age, parents/guardians and children completed a semistructured parent-child interaction task assessing dyad synchrony and parenting behavior (positive affect, negative affect, sensitivity, facilitation, and intrusiveness). Cognitive and motor development was assessed by using the Bayley Scales of Infant Development II, and the Infant Toddler Social and Emotional Assessment was used to assess socioemotional development (social-emotional competence and internalizing and externalizing behavior). fter controlling for social risk, most parenting domains were associated with cognitive development, with parent-child synchrony emerging as the most predictive. Greater parent-child synchrony was also associated with greater social-emotional competence, as was parenting that was positive, warm, and sensitive. Parents who displayed higher levels of negative affect were more likely to rate their children as withdrawn, anxious, and inhibited, but, unexpectedly, higher negative affect was also associated with more optimal psychomotor development. Parenting was not associated with externalizing behaviors at this age. Specific parenting behaviors, particularly parent-child synchrony, were associated with neurobehavioral development. These findings have implications for the development of targeted parent-based interventions to promote positive outcomes across different developmental domains during the first 2 years of life for very preterm children.

Behavioral therapy for Tourette syndrome and chronic tic disorders

PubMed Central

Woods, Douglas; Ganos, Christos

2017-01-01

Abstract Purpose of review: To summarize behavioral interventions for the treatment of primary tic disorders. Recent findings: Although tics were attributed to a disordered weak volition, the shift towards neurobiological models of tic disorders also transformed nonpharmacologic treatment practices. Current international guidelines recommend habit reversal training, comprehensive behavioral intervention, and exposure and response prevention as first-line therapies for tics. Appropriate patient selection, including age and presence of comorbidities, are salient clinical features that merit consideration. Evidence for further behavioral interventions is also presented. Summary: Currently recommended behavioral interventions view tics as habitual responses that may be further strengthened through negative reinforcement. Although availability and costs related to these interventions may limit their effect, Internet-based and telehealth approaches may facilitate wide accessibility. Novel nonpharmacologic treatments that take different approaches, such as autonomic modulation or attention-based interventions, may also hold therapeutic promise. PMID:29185535

Results of a Multi-level Intervention to Prevent and Control Childhood Obesity among Latino Children: The Aventuras Para Niños Study

PubMed Central

Crespo, Noe C.; Elder, John P.; Ayala, Guadalupe X.; Campbell, Nadia R.; Arredondo, Elva M.; Slymen, Donald J.; Baquero, Barbara; Sallis, James F.; McKenzie, Thomas L.

2014-01-01

Background Community-based behavioral interventions are needed to reduce the burden of childhood obesity. Purpose This study evaluated the impact of a multi-level promotora-based (Community Health Advisor) intervention to promote healthy eating and physical activity (PA) and prevent excess weight gain among Latino children. Methods Thirteen elementary schools were randomized to one of four intervention conditions: individual and family level (Fam-only), school and community level (Comm-only), combined Fam+Comm intervention, or a measurement-only condition. Participants were 808 Latino parents and their children enrolled in kindergarten through 2nd grade. Measures included parent and child BMI and a self-administered parent survey that assessed several parent and child behaviors. Results There were no intervention effects on children's BMI z-score. The Fam-only and Fam+Comm interventions changed several obesity-related child behaviors and these were mediated by changes in parenting variables. Discussion A promotora-based behavioral intervention was efficacious at changing parental factors and child obesity-related health behaviors. PMID:22215470

Progression along the Bipolar Spectrum: A Longitudinal Study of Predictors of Conversion from Bipolar Spectrum Conditions to Bipolar I and II Disorders

PubMed Central

Alloy, Lauren B.; Urošević, Snežana; Abramson, Lyn Y.; Jager-Hyman, Shari; Nusslock, Robin; Whitehouse, Wayne G.; Hogan, Michael

2011-01-01

Little longitudinal research has examined progression to more severe bipolar disorders in individuals with “soft” bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a non-patient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of “soft” bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts. PMID:21668080

Behavioral Signal Processing: Deriving Human Behavioral Informatics From Speech and Language

PubMed Central

Narayanan, Shrikanth; Georgiou, Panayiotis G.

2013-01-01

The expression and experience of human behavior are complex and multimodal and characterized by individual and contextual heterogeneity and variability. Speech and spoken language communication cues offer an important means for measuring and modeling human behavior. Observational research and practice across a variety of domains from commerce to healthcare rely on speech- and language-based informatics for crucial assessment and diagnostic information and for planning and tracking response to an intervention. In this paper, we describe some of the opportunities as well as emerging methodologies and applications of human behavioral signal processing (BSP) technology and algorithms for quantitatively understanding and modeling typical, atypical, and distressed human behavior with a specific focus on speech- and language-based communicative, affective, and social behavior. We describe the three important BSP components of acquiring behavioral data in an ecologically valid manner across laboratory to real-world settings, extracting and analyzing behavioral cues from measured data, and developing models offering predictive and decision-making support. We highlight both the foundational speech and language processing building blocks as well as the novel processing and modeling opportunities. Using examples drawn from specific real-world applications ranging from literacy assessment and autism diagnostics to psychotherapy for addiction and marital well being, we illustrate behavioral informatics applications of these signal processing techniques that contribute to quantifying higher level, often subjectively described, human behavior in a domain-sensitive fashion. PMID:24039277

Effect of obesity treatments on eating behavior: psychosocial interventions versus surgical interventions. A systematic review.

PubMed

Moldovan, Adela R; David, Daniel

2011-08-01

(1) To use available research data to estimate the amount of change in eating behavior following obesity treatment; (2) To examine how this change relates to the amount of change in weight loss after treatment and at follow up. A meta-analysis was conducted in September 2009. Studies were identified through a computer search of articles in the PubMed and PsychInfo databases. Key terms entered were obesity, treatment, and eating behavior. Effect sizes (Glass d) were calculated according to published procedures. Eighteen studies met the inclusion and exclusion criteria, grouped into two categories: psychosocial interventions and surgical interventions. For psychosocial interventions, we found a medium effect size on eating behavior (d=.73, CI=(.66, .90)), and a low effect size on weight (d=.32, CI=(.28, .36)) at posttreatment and a low effect size for both outcomes at follow-up (for eating behavior d=.47, CI=(.45, .49), for weight d=.37, (CI=.18, .56)). For surgical interventions we found large effect sizes on both outcomes (for eating behavior d=1.84, CI=(1.26, 2.42); for weight d=1.40, CI=(1.25, 1.65)). Surgical interventions have superior results to psychosocial interventions, on both weight loss and eating behavior. Implications for treatment of obesity are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Outcome for Children Receiving the Early Start Denver Model Before and After 48 Months.

PubMed

Vivanti, Giacomo; Dissanayake, Cheryl

2016-07-01

The Early Start Denver Model (ESDM) is an intervention program recommended for pre-schoolers with autism ages 12-48 months. The rationale for this recommendation is the potential for intervention to affect developmental trajectories during early sensitive periods. We investigated outcomes of 32 children aged 18-48 months and 28 children aged 48-62 months receiving the ESDM for one year (approximately 20 h per week). Younger children achieved superior verbal DQ gains compared to their older counterparts. There were no group differences with respect to non-verbal DQ and adaptive behavior (with both age-groups undergoing significant change), or ASD severity (with neither age-group showing improvements on the ADOS). The association between verbal DQ gains and age at intake was moderated by baseline verbal level.

Adaptive Interventions and SMART Designs: Application to Child Behavior Research in a Community Setting

ERIC Educational Resources Information Center

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…

Sensory-Based Intervention for Children with Behavioral Problems: A Systematic Review

ERIC Educational Resources Information Center

Wan Yunus, Farahiyah; Liu, Karen P.; Bissett, Michelle; Penkala, Stefania

2015-01-01

Sensory-based intervention is a common approach used to address behavioral problems in children. Types of sensory-based intervention for children and details of the intervention effectiveness have not been systematically examined. This review examined the effectiveness and ideal types of sensory-based interventions for children with behavioral…

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…

Telephone-delivered cognitive behavioral therapy for high anxiety sensitivity: a randomized controlled trial.

PubMed

Olthuis, Janine V; Watt, Margo C; Mackinnon, Sean P; Stewart, Sherry H

2014-12-01

High anxiety sensitivity (AS) is associated with the development and maintenance of anxiety and depressive symptoms and is theorized to be a mediator of treatment outcomes for anxiety and depression. The present study tested the efficacy of a telephone-delivered cognitive behavioral therapy (CBT) intervention in reducing high AS and its associated anxiety and depressive symptoms. Treatment-seeking participants with high AS were recruited from the community (N = 80; M age = 36 years; 79% women; 76% Caucasian) and were randomly assigned to an 8-week telephone-delivered CBT program or a waiting list control. Participants completed anxiety and depression symptom and diagnostic measures at pre- and posttreatment, after a subsequent 4 weeks of continued interoceptive exposure, and 8 weeks later. Multilevel modeling showed the treatment was successful in reducing AS, as well as panic, social phobia, posttraumatic stress symptoms, and number of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses per participant when compared to a waiting list control. These gains were maintained at follow-up. Generalized anxiety and depressive symptoms, however, did not improve as a result of treatment. Mediated moderation analyses suggested that treatment-related changes in AS may mediate anxiety symptom changes. RESULTS of the present study provide promising evidence for this transdiagnostic treatment approach. Reductions in anxiety symptoms across diagnostic categories stemming from this AS-targeted intervention may have implications for helping a broad array of clients with various anxiety disorders that share AS as a common risk or maintenance factor.

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

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

PubMed

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

2005-08-01

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

Supporting health care professionals to improve the processes of shared decision making and self-management in a web-based intervention: randomized controlled trial.

PubMed

Sassen, Barbara; Kok, Gerjo; Schepers, Jan; Vanhees, Luc

2014-10-21

Research to assess the effect of interventions to improve the processes of shared decision making and self-management directed at health care professionals is limited. Using the protocol of Intervention Mapping, a Web-based intervention directed at health care professionals was developed to complement and optimize health services in patient-centered care. The objective of the Web-based intervention was to increase health care professionals' intention and encouraging behavior toward patient self-management, following cardiovascular risk management guidelines. A randomized controlled trial was used to assess the effect of a theory-based intervention, using a pre-test and post-test design. The intervention website consisted of a module to help improve professionals' behavior, a module to increase patients' intention and risk-reduction behavior toward cardiovascular risk, and a parallel module with a support system for the health care professionals. Health care professionals (n=69) were recruited online and randomly allocated to the intervention group (n=26) or (waiting list) control group (n=43), and invited their patients to participate. The outcome was improved professional behavior toward health education, and was self-assessed through questionnaires based on the Theory of Planned Behavior. Social-cognitive determinants, intention and behavior were measured pre-intervention and at 1-year follow-up. The module to improve professionals' behavior was used by 45% (19/42) of the health care professionals in the intervention group. The module to support the health professional in encouraging behavior toward patients was used by 48% (20/42). The module to improve patients' risk-reduction behavior was provided to 44% (24/54) of patients. In 1 of every 5 patients, the guideline for cardiovascular risk management was used. The Web-based intervention was poorly used. In the intervention group, no differences in social-cognitive determinants, intention and behavior were found for health care professionals, compared with the control group. We narrowed the intervention group and no significant differences were found in intention and behavior, except for barriers. Results showed a significant overall difference in barriers between the intervention and the control group (F1=4.128, P=.02). The intervention was used by less than half of the participants and did not improve health care professionals' and patients' cardiovascular risk-reduction behavior. The website was not used intensively because of time and organizational constraints. Professionals in the intervention group experienced higher levels of barriers to encouraging patients, than professionals in the control group. No improvements were detected in the processes of shared decision making and patient self-management. Although participant education level was relatively high and the intervention was pre-tested, it is possible that the way the information was presented could be the reason for low participation and high dropout. Further research embedded in professionals' regular consultations with patients is required with specific emphasis on the processes of dissemination and implementation of innovations in patient-centered care. Netherlands Trial Register Number (NTR): NTR2584; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2584 (Archived by WebCite at http://www.webcitation.org/6STirC66r).

Moving beyond the treatment package approach to developing behavioral interventions: addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST).

PubMed

Wyrick, David L; Rulison, Kelly L; Fearnow-Kenney, Melodie; Milroy, Jeffrey J; Collins, Linda M

2014-09-01

Given current pressures to increase the public health contributions of behavioral interventions, intervention scientists may wish to consider moving beyond the classical treatment package approach that focuses primarily on achieving statistical significance. They may wish also to focus on goals directly related to optimizing public health impact. The Multiphase Optimization Strategy (MOST) is an innovative methodological framework that draws on engineering principles to achieve more potent behavioral interventions. MOST is increasingly being adopted by intervention scientists seeking a systematic framework to engineer an optimized intervention. As with any innovation, there are challenges that arise with early adoption. This article describes the solutions to several critical questions that we addressed during the first-ever iterative application of MOST. Specifically, we describe how we have applied MOST to optimize an online program (myPlaybook) for the prevention of substance use among college student-athletes. Our application of MOST can serve as a blueprint for other intervention scientists who wish to design optimized behavioral interventions. We believe using MOST is feasible and has the potential to dramatically improve program effectiveness thereby advancing the public health impact of behavioral interventions.

Meta-analysis of the effects of academic interventions and modifications on student behavior outcomes.

PubMed

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

2017-09-01

The current study examined the effect of academic interventions and modifications on behavioral outcomes in a meta-analysis of 32 single-case design studies. Academic interventions included modifying task difficulty, providing instruction in reading, mathematics, or writing, and contingent reinforcement for academic performance. There was an overall small to moderate effect (ϕ = .56) on behavioral outcomes, with a stronger effect on increasing time on task (ϕ = .64) than on decreasing disruptive behavior (ϕ = .42). There was a small effect for using a performance-based contingent reinforcer (ϕ = .48). Interventions completed in an individual setting resulted in a moderate to large effects on behavior outcomes. Results of the current meta-analysis suggest that academic interventions can offer both positive academic and behavioral outcomes. Practical implications and suggestions for future research are included. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

PubMed Central

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

2012-01-01

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

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

PubMed

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

2011-09-01

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

Empowering peer group leaders for HIV prevention in Malawi.

PubMed

McCreary, Linda L; Kaponda, Chrissie P N; Davis, Kristina; Kalengamaliro, Mary; Norr, Kathleen F

2013-09-01

Behavioral change interventions using peer group leaders are effective and widely used, but few studies have examined how being a peer group leader affects the leaders. This study describes how participants felt being a peer group leader affected their lives. This descriptive qualitative study interviewed 18 experienced peer group leaders who had conducted a multisession human immunodeficiency virus (HIV) prevention peer group intervention in rural Malawi. We used inductive content analysis and comparisons within and between cases. Three major themes were identified. All leaders said they experienced personal changes in their knowledge, attitudes, or HIV prevention behaviors. They described interacting with family, neighbors, and friends, and speaking at church or community meetings, to discuss HIV prevention issues. They increased their self-efficacy to engage others in sensitive HIV prevention issues, developed a self-identity as a change agent, and came to be recognized in their community as trustworthy advisors about HIV and acquired immunodeficiency syndrome. These three themes, taken together, form the meta-theme of psychological empowerment. Being a peer group leader empowered the leaders as change agents for HIV prevention and had impacts in the community after the intervention ended, potentially increasing the long-term effectiveness and cost effectiveness of peer group interventions. Healthcare workers and community volunteers who led HIV prevention sessions continued HIV prevention activities in the community and workplace after the program ended. Training health workers as volunteer HIV prevention leaders offers a strategy to bring HIV prevention to limited-resource settings, despite health worker shortages. © 2013 Sigma Theta Tau International.

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

Incorporating prototyping and iteration into intervention development: a case study of a dining hall-based intervention.

PubMed

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

2013-01-01

Previous research from the fields of computer science and engineering highlight the importance of an iterative design process (IDP) to create more creative and effective solutions. This study describes IDP as a new method for developing health behavior interventions and evaluates the effectiveness of a dining hall-based intervention developed using IDP on college students' eating behavior and values. participants were 458 students (52.6% female, age = 19.6 ± 1.5 years [M ± SD]). The intervention was developed via an IDP parallel process. A cluster-randomized controlled study compared differences in eating behavior among students in 4 university dining halls (2 intervention, 2 control). The final intervention was a multicomponent, point-of-selection marketing campaign. Students in the intervention dining halls consumed significantly less junk food and high-fat meat and increased their perceived importance of eating a healthful diet relative to the control group. IDP may be valuable for the development of behavior change interventions.

Effectiveness of School-Wide Positive Behavior Interventions and Supports in a Middle School as Measured by Office Discipline Referrals and Explored in Teacher Perceptions

ERIC Educational Resources Information Center

Nunn, William E.

2017-01-01

Student behavior stands out among issues that greatly affect students' success and even teacher job satisfaction. Researchers have created Positive Behavior Interventions and Supports (PBIS) as a system of interventions that can help students improve their behavior and become more successful. This study sought to add to the body of knowledge…