A motivation-focused weight loss maintenance program is an effective alternative to a skill-based approach.

PubMed

West, D S; Gorin, A A; Subak, L L; Foster, G; Bragg, C; Hecht, J; Schembri, M; Wing, R R

2011-02-01

Maintaining weight loss is a major challenge in obesity treatment. Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors. Therefore, a novel weight loss maintenance program that specifically targets motivational factors was evaluated. Overweight women (N=338; 19% African American) with urinary incontinence were randomized to lifestyle obesity treatment or control and followed for 18 months. All participants in lifestyle (N=226) received the same initial 6-month group behavioral obesity treatment and were then randomized to (1) a novel motivation-focused maintenance program (N=113) or (2) a standard skill-based maintenance approach (N=113). Weight assessed at baseline, 6 and 18 months. Both treatment groups (motivation-focused and skill-based) achieved comparable 18-month weight losses (-5.48% for motivation-focused vs -5.55% in skill-based, P=0.98), and both groups lost significantly more than controls (-1.51%; P=0.0012 in motivation-focused and P=0.0021 in skill-based). A motivation-focused maintenance program offers an alternative, effective approach to weight maintenance expanding available evidence-based interventions beyond traditional skill-based programs.

PROMOTING SUPPORTIVE PARENTING IN NEW MOTHERS WITH SUBSTANCE-USE PROBLEMS: A PILOT RANDOMIZED TRIAL OF RESIDENTIAL TREATMENT PLUS AN ATTACHMENT-BASED PARENTING PROGRAM

PubMed Central

BERLIN, LISA J.; SHANAHAN, MEGHAN; CARMODY, KAREN APPLEYARD

2015-01-01

This pilot randomized trial tested the feasibility and efficacy of supplementing residential substance-abuse treatment for new mothers with a brief, yet rigorous, attachment-based parenting program. Twenty-one predominantly (86%) White mothers and their infants living together in residential substance-abuse treatment were randomly assigned to the program (n = 11) or control (n = 10) group. Program mothers received 10 home-based sessions of Dozier’s Attachment and Biobehavioral Catch-up (ABC) intervention. Postintervention observations revealed more supportive parenting behaviors among the randomly assigned ABC mothers. PMID:25424409

A theory-based newsletter nutrition education program reduces nutritional risk and improves dietary intake for congregate meal participants.

PubMed

Francis, Sarah L; MacNab, Lindsay; Shelley, Mack

2014-01-01

At-risk older adults need community-based nutrition programs that improve nutritional status and practices. This 6-month study assessed the impact of the traditional Chef Charles (CC) program (Control) compared to a theory-based CC program (Treatment) on nutritional risk (NR), dietary intakes, self-efficacy (SE), food security (FS), and program satisfaction for congregate meal participants. Participants were mostly educated, single, "food secure" White females. NR change for the treatment group was significantly higher (P = 0.042) than the control group. No differences were noted for SE or FS change and program satisfaction between groups. The overall distribution classification levels of FS changed significantly (P < .001) from pre to post. Over half (n = 46, 76.7%) reported making dietary changes and the majority (n = 52, 86.7%) rated CC as good to excellent. Results suggest the theory-based CC program (treatment) is more effective in reducing NR and dietary practices than the traditional CC program (control).

Content and Methods used to Train Tobacco Cessation Treatment Providers: An International Survey.

PubMed

Kruse, Gina R; Rigotti, Nancy A; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy

2017-12-01

There are limited existing data describing the training methods used to educate tobacco cessation treatment providers around the world. To measure the prevalence of tobacco cessation treatment content, skills training and teaching methods reported by tobacco treatment training programs across the world. Web-based survey in May-September 2013 among tobacco cessation training experts across six geographic regions and four World Bank income levels. Response rate was 73% (84 of 115 countries contacted). Of 104 individual programs from 84 countries, most reported teaching brief advice (78%) and one-to-one counseling (74%); telephone counseling was uncommon (33%). Overall, teaching of knowledge topics was more commonly reported than skills training. Programs in lower income countries less often reported teaching about medications, behavioral treatments and biomarkers and less often reported skills-based training about interviewing clients, medication management, biomarker measurement, assessing client outcomes, and assisting clients with co-morbidities. Programs reported a median 15 hours of training. Face-to-face training was common (85%); online programs were rare (19%). Almost half (47%) included no learner assessment. Only 35% offered continuing education. Nearly all programs reported teaching evidence-based treatment modalities in a face-to-face format. Few programs delivered training online or offered continuing education. Skills-based training was less common among low- and middle-income countries (LMICs). There is a large unmet need for tobacco treatment training protocols which emphasize practical skills, and which are more rapidly scalable than face-to-face training in LMICs.

School-Based Mental Health Programming for Children with Inattentive and Disruptive Behavior Problems: First-Year Treatment Outcome

ERIC Educational Resources Information Center

Owens, Julie Sarno; Richerson, Lauren; Beilstein, Elizabeth A.; Crane, Anna; Murphy, Caroline E.; Vancouver, Jeffrey B.

2005-01-01

This article examines the effectiveness of an evidence-based behavioral treatment package for children with inattentive and disruptive behavior problems when delivered in the context of a school-based mental health program. Child symptomatology and functioning are assessed in a treatment group (n = 30) and a waitlist control group (n = 12) across…

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

PubMed

Culler, Corinna S; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M

2017-10-01

School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment. Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades. Outcomes were compared in bivariate analysis, stratified by grade and income levels. A greater percentage of Chelsea students had untreated decay and severe treatment need than students statewide. Yet, fewer Chelsea third graders had severe treatment need, and more had dental sealants. There was no significant difference in the percentage of Chelsea students having severe treatment need or dental sealants by income level. Students participating in our program do not have lower decay levels than students statewide. However, they do have lower levels of severe treatment need, likely due to treatment referrals. Our results confirm that school-based prevention programs can lead to increased prevalence of dental sealants among high-risk populations. Results provide support for the establishment of full-service school-based programs in similar communities. © 2017, American School Health Association.

School-Based Anxiety Treatments for Children and Adolescents

PubMed Central

Herzig-Anderson, Kathleen; Colognori, Daniela; Fox, Jeremy K.; Stewart, Catherine E.; Warner, Carrie Masia

2012-01-01

SUMMARY School-based empirically supported treatments for anxiety disorders are a promising avenue for providing necessary intervention to distressed youth who would otherwise never receive treatment. Sustaining such programs in school settings should be viewed as a multiple-stage process, from integration of the program into the institution and maintenance of the intervention to responding to institutional change and ownership of the program by the school.51 Given the scarce resources available to schools, additional research on embedding programs into the school culture and maximizing existing resources is essential to enhancing the sustainability of school-based interventions for anxiety disorders and reaching youth in need. PMID:22801000

Healing the community to heal the individual

PubMed Central

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-01-01

ABSTRACT OBJECTIVE To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. SOURCES OF INFORMATION MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). MAIN MESSAGE Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. CONCLUSION Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for long-term program sustainability. Programs require increased documentation of their inroads in this developing field. PMID:18625824

An Internet-based self-help treatment for fear of public speaking: a controlled trial.

PubMed

Botella, C; Gallego, M J; Garcia-Palacios, A; Guillen, V; Baños, R M; Quero, S; Alcañiz, M

2010-08-01

This study offers data about the efficacy of "Talk to Me," an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.

Comparing responses to horticultural-based and traditional activities in dementia care programs.

PubMed

Jarrott, Shannon E; Gigliotti, Christina M

2010-12-01

Engaging persons with dementia in meaningful activities supports well-being; however, care staff are challenged to implement age- and ability-appropriate activities in a group setting. We compared a randomly assigned treatment group, who received horticultural therapy-based (HT-based) programming to a comparison group, who engaged in traditional activities (TA) programming, on engagement and affect. Horticultural therapy-based programming was implemented twice weekly at 4 treatment sites for 6 weeks, while regular TA were observed at comparison sites. Results revealed no differences between groups on affective domains. Levels of adaptive behavior differed between the groups, with the treatment group demonstrating higher levels of active, passive, and other engagement and the comparison group demonstrating higher levels of self-engagement. Our results highlight the value of HT-based programs and the importance of simultaneously capturing participants' affective and behavioral responses. Theoretical and practical considerations about the facilitation of and context in which the programming occurs are discussed.

Outcomes of Parent Education Programs Based on Reevaluation Counseling

ERIC Educational Resources Information Center

Wolfe, Randi B.; Hirsch, Barton J.

2003-01-01

We report two studies in which a parent education program based on Reevaluation Counseling was field-tested on mothers randomly assigned to treatment groups or equivalent, no-treatment comparison groups. The goal was to evaluate the program's viability, whether there were measurable effects, whether those effects were sustained over time, and…

Feasibility Study of an Interactive Multimedia Electronic Problem Solving Treatment Program for Depression: A Preliminary Uncontrolled Trial

PubMed Central

Berman, Margit I.; Jr., Jay C. Buckey; Hull, Jay G.; Linardatos, Eftihia; Song, Sueyoung L.; McLellan, Robert K.; Hegel, Mark T.

2014-01-01

Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9 weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a mini mally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4 weeks), and study endpoint (10 weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated. PMID:24680231

The Efficacy of Coerced Treatment for Offenders: An Evaluation of Two Residential Forensic Drug and Alcohol Treatment Programs.

ERIC Educational Resources Information Center

Baird, Francis X.; Frankel, Arthur J.

2001-01-01

Reviews the history of community-based treatment for offenders with drug and alcohol addiction. Describes the treatment regimen in two residential programs for offenders with drug and alcohol problems, including a description of the components of the residential treatment model utilized in these two programs. Findings support the efficacy of…

Impact of early treatment programs on HIV epidemics: An immunity-based mathematical model.

PubMed

Rahman, S M Ashrafur; Vaidya, Naveen K; Zou, Xingfu

2016-10-01

While studies on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have demonstrated substantial advantages in controlling HIV transmission, the overall benefits of the programs with early initiation of antiretroviral therapy (ART) have not been fully understood and are still on debate. Here, we develop an immunity-based (CD4+ T cell count based) mathematical model to study the impacts of early treatment programs on HIV epidemics and the overall community-level immunity. The model is parametrized using the HIV prevalence data from South Africa and fully analyzed for stability of equilibria and infection persistence criteria. Using our model, we evaluate the effects of early treatment on the new infection transmission, disease death, basic reproduction number, HIV prevalence, and the community-level immunity. Our model predicts that the programs with early treatments significantly reduce the new infection transmission and increase the community-level immunity, but the treatments alone may not be enough to eliminate HIV epidemics. These findings, including the community-level immunity, might provide helpful information for proper implementation of HIV treatment programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Process Evaluation for a Prison-based Substance Abuse Program.

ERIC Educational Resources Information Center

Staton, Michele; Leukefeld, Carl; Logan, T. K.; Purvis, Rick

2000-01-01

Presents findings from a process evaluation conducted in a prison-based substance abuse program in Kentucky. Discusses key components in the program, including a detailed program description, modifications in planned treatment strategies, program documentation, and perspectives of staff and clients. Findings suggest that prison-based programs have…

Evidence-based decision-making as a practice-based learning skill: a pilot study.

PubMed

Falzer, Paul R; Garman, D Melissa

2012-03-01

As physicians are being trained to adapt their practices to the needs and experience of patients, initiatives to standardize care have been gaining momentum. The resulting conflict can be addressed through a practice-based learning and improvement (PBL) program that develops competency in using treatment guidelines as decision aids and incorporating patient-specific information into treatment recommendations. This article describes and tests a program that is consistent with the ACGME's multilevel competency-based approach, targets students at four levels of training, and features progressive learning objectives and assessments. The program was pilot-tested with 22 paid volunteer psychiatric residents and fellows. They were introduced to a schizophrenia treatment guideline and reviewed six case vignettes of varying complexity. PBL assessments were based on how treatment recommendations were influenced by clinical and patient-specific factors. The task permitted separate assessments of learning objectives all four training levels. Among the key findings at each level, most participants found the treatment guideline helpful in making treatment decisions. Recommendations were influenced by guideline-based assessment criteria and other clinical features. They were also influenced by patients' perceptions of their illness, patient-based progress assessments, and complications such as stressors and coping patterns. Recommendations were strongly influenced by incongruence between clinical facts and patient experience. Practical understanding of how patient experience joins with clinical knowledge can enhance the use of treatment guidelines as decision tools and enable clinicians to appreciate more fully how and why patients' perceptions of their illness should influence treatment recommendations. This PBL program can assist training facilities in preparing students to cope with contradictory demands to both standardize and adapt their practice. The program can be modified to accommodate various disorders and a range of clinical factors and patient-specific complications.

Native Nutrition--Northwest Indian Treatment Center Honors Culture to Heal the Mind

ERIC Educational Resources Information Center

Krohn, Elise

2011-01-01

The Northwest Indian Treatment Center runs a 45-day inpatient treatment program in Elma, Washington. The Squaxin Island Tribe created the program to address an unmet need for culturally based drug and alcohol treatment centers for Indian people who grew up on reservations. The program specializes in treating people with chronic relapse patterns…

Motivation for Treatment Among Women Offenders in Prison-Based Treatment and Longitudinal Outcomes Among Those Who Participate in Community Aftercare

PubMed Central

Grella, Christine E.; Rodriguez, Luz

2011-01-01

Participation in aftercare may reduce risk of recidivism among women offenders with substance use problems following their release to the community. This study examines motivation to participate in aftercare among women offenders and whether their participation in both in-custody and aftercare treatment reduces their risk of recidivism. Surveys were conducted with women (N = 1,158) in prison-based substance abuse treatment programs. Return-to-prison was examined among participants in community-based aftercare (N = 1,182) over 12 months following treatment discharge. Higher treatment motivation was associated with child welfare involvement, prior treatment, and use of “harder” drugs; ethnic minority women had lower treatment motivation compared with White women. Participants who completed the aftercare program, or who had longer treatment duration, and those who had participated in an in-prison program prior to parole had reduced risk of recidivism. Study findings suggest the value of community aftercare for women offenders, particularly when combined with prior in-prison treatment. PMID:22185040

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

ERIC Educational Resources Information Center

Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

2003-01-01

Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

Translating Addictions Research into Evidence-based Practice: the Polaris CD Outcomes Management System

PubMed Central

Toche-Manley, L.; Grissom, G.; Dietzen, L.; Sangsland, S.

2011-01-01

Converting the findings from addictions studies into information actionable by (non-research) treatment programs is important to improving program outcomes. This paper describes the translation of the findings of studies on Patient-Services matching, prediction of patient response to treatment (Expected Treatment Response) and prediction of dropout to provide evidence-based decision support in routine treatment. The findings of the studies and their application to the development of an outcomes management system are described. Implementation issues in a network of addictions treatment programs are discussed. The work illustrates how outcomes management systems can play an important role in translating research into practice. PMID:21324606

Enhancing access and retention in substance abuse treatment: the role of Medicaid payment acceptance and cultural competence.

PubMed

Guerrero, Erick G

2013-10-01

Health insurance coverage and quality of care are common factors believed to improve access for and retention of racial and ethnic minority groups in health care. However, there is little evidence that acceptance of public insurance and provision of culturally responsive care decrease wait time and retention of minority populations in community-based substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, CA. An analytical sample of 13,328 primarily African American and Latino clients nested within 104 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on count measures of days to initiate and days spent in treatment. Programs that accepted public insurance (p<.001) and in which staff reported personal involvement (p<.01) and linkages and resources with minority communities (p<.001) were negatively associated with client wait time. Similarly, programs with culturally responsive policies and assessment and treatment practices (p<.05) were positively associated with retention in treatment, after controlling for individual and program characteristics. These preliminary findings provide an evidentiary base for the role of community-based financial and cultural practices in improving accessibility and treatment adherence in a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to expand public insurance and enhance culturally competent care, are discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The selective treatment of clinical mastitis based on on-farm culture results: II. Effects on lactation performance, including clinical mastitis recurrence, somatic cell count, milk production, and cow survival.

PubMed

Lago, A; Godden, S M; Bey, R; Ruegg, P L; Leslie, K

2011-09-01

The objective of this multi-state, multi-herd clinical trial was to report on the efficacy of using an on-farm culture system to guide strategic treatment decisions in cows with clinical mastitis. The study was conducted in 8 commercial dairy farms ranging in size from 144 to 1,795 cows from Minnesota, Wisconsin, and Ontario, Canada. A total of 422 cows affected with mild or moderate clinical mastitis in 449 quarters were randomly assigned to either (1) a positive-control treatment program or (2) an on-farm culture-based treatment program. Quarter cases assigned to the positive-control group received immediate on-label intramammary treatment with cephapirin sodium. Quarters assigned to the culture-based treatment program were not treated until the results of on-farm culture were determined after 18 to 24h of incubation. Quarters in the culture-based treatment program that had gram-positive growth or a mixed infection were treated according to label instruction using intramammary cephapirin sodium. Quarters assigned to the culture-based treatment program that had gram-negative or no-growth did not receive intramammary therapy. It was already reported in a companion paper that the selective treatment of clinical mastitis based on on-farm culture results decreases antibiotic use by half and tends to decrease milk withholding time without affecting short-term clinical and bacteriological outcomes. The present article reports on long-term outcomes of the aforementioned study. No statistically significant differences existed between cases assigned to the positive-control program and cases assigned to the culture-based treatment program in risk and days for recurrence of clinical mastitis in the same quarter (35% and 78 d vs. 43% and 82 d), linear somatic cell count (4.2 vs. 4.4), daily milk production (30.0 vs. 30.7 kg), and risk and days for culling or death events (28% and 160 d vs. 32% and 137 d) for the rest of the lactation after enrollment of the clinical mastitis case. In summary, the selective treatment of clinical mastitis based on on-farm culture resulted in no differences in long-term outcomes, such as recurrence of clinical mastitis in the same quarter, somatic cell count, milk production, and cow survival for the rest of the lactation after clinical mastitis. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Predictors of treatment use among foster mothers in an attachment-based intervention program.

PubMed

Bick, Johanna; Dozier, Mary; Moore, Shannon

2012-01-01

The current study examined predictors of treatment use among 56 foster mothers who participated in an attachment-based intervention program for foster infants. Foster mothers' levels of treatment use were coded at early, middle, and late phases of the intervention program. Foster mothers' states of mind with regard to attachment predicted their understanding of the intervention session concepts. Specifically, autonomous foster mothers showed higher levels of understanding at the start of the intervention program, when compared with non-autonomous foster mothers. State of mind with regard to attachment also predicted foster mothers' levels of reflective functioning during the intervention sessions. Autonomous foster mothers showed higher levels of reflective functioning at early, middle, and late stages of the intervention program, when compared with non-autonomous foster mothers. The relevance of these findings for both treatment effectiveness and treatment delivery is discussed.

A National Evaluation of Community-Based Youth Cessation Programs: Design and Implementation

ERIC Educational Resources Information Center

Curry, Susan J.; Mermelstein, Robin J.; Sporer, Amy K.; Emery, Sherry L.; Berbaum, Michael L.; Campbell, Richard T.; Carusi, Charles; Flay, Brian; Taylor, Kristie; Warnecke, Richard B.

2010-01-01

Although widely available, little is known about the effectiveness of youth cessation treatments delivered in real-world settings. The authors recruited a nonprobability sample of 41 community-based group-format programs that treated at least 15 youth per year and included evidence-based treatment components. Data collection included longitudinal…

Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

PubMed Central

McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

2008-01-01

Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

Obesity coverage gap: Consumers perceive low coverage for obesity treatments even when workplace wellness programs target BMI.

PubMed

Wilson, Elizabeth Ruth; Kyle, Theodore K; Nadglowski, Joseph F; Stanford, Fatima Cody

2017-02-01

Evidence-based obesity treatments, such as bariatric surgery, are not considered essential health benefits under the Affordable Care Act. Employer-sponsored wellness programs with incentives based on biometric outcomes are allowed and often used despite mixed evidence regarding their effectiveness. This study examines consumers' perceptions of their coverage for obesity treatments and exposure to workplace wellness programs. A total of 7,378 participants completed an online survey during 2015-2016. Respondents answered questions regarding their health coverage for seven medical services and exposure to employer wellness programs that target weight or body mass index (BMI). Using χ 2 tests, associations between perceptions of exposure to employer wellness programs and coverage for medical services were examined. Differences between survey years were also assessed. Most respondents reported they did not have health coverage for obesity treatments, but more of the respondents with employer wellness programs reported having coverage. Neither the perception of coverage for obesity treatments nor exposure to wellness programs increased between 2015 and 2016. Even when consumers have exposure to employer wellness programs that target BMI, their health insurance often excludes obesity treatments. Given the clinical and cost-effectiveness of such treatments, reducing that coverage gap may mitigate obesity's individual- and population-level effects. © 2017 The Obesity Society.

Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB): study protocol for a randomized controlled trial.

PubMed

Beck, Emma; Bo, Sune; Gondan, Matthias; Poulsen, Stig; Pedersen, Liselotte; Pedersen, Jesper; Simonsen, Erik

2016-07-12

Evidence-based outpatient psychotherapeutic programs are first-line treatment of borderline personality disorder (BPD). Early and effective treatment of BPD is crucial to the prevention of its individual, psychosocial, and economic consequences. However, in spite of recent advantages in diagnosing adolescent BPD, there is a lack of cost-effective evidence-based treatment programs for adolescents. Mentalization-based treatment is an evidence-based program for BPD, originally developed for adults. We will investigate whether a specifically designed mentalization-based treatment in groups is an efficacious treatment for adolescents with BPD or subthreshold BPD compared to treatment as usual. The trial is a four-center, two-armed, parallel-group, assessor-blinded randomized clinical superiority trial. One hundred twelve patients aged 14 to 17 referred to Child and Adolescent Psychiatric Clinics in Region Zealand are randomized to 1 year of either mentalization-based treatment in groups or treatment as usual. Patients will be included if they meet at least four DSM-5 criteria for BPD. The primary outcome is self-reported borderline features at discharge. Secondary outcomes will include self-harm, depression, BPD criteria, externalizing and internalizing symptoms, and social functioning, together with parental reports on borderline features, externalizing and internalizing symptoms. Measures of attachment and mentalization will be included as mediational variables. Follow-up assessment will take place at 3 and 12 months after end of treatment. This is the first randomized controlled trial to test the efficacy of a group-based mentalization-based treatment for adolescents with BPD or subthreshold BPD. If the results confirm our hypothesis, this trial will add to the treatment options of cost-effective treatment of adolescent BPD. Clinicaltrials.gov NCT02068326 , February 19, 2014.

Translational research: are community-based child obesity treatment programs scalable?

PubMed

Hardy, Louise L; Mihrshahi, Seema; Gale, Joanne; Nguyen, Binh; Baur, Louise A; O'Hara, Blythe J

2015-07-14

Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions. Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables. Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001). Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program. This is one of the few studies to report outcomes of a government-funded, program at scale in a real-world setting, and shows that investment in a community-based child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.

The adoption of wraparound services among substance abuse treatment organizations serving criminal offenders: The role of a women-specific program.

PubMed

Oser, Carrie; Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

2009-08-01

Women's substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative's National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n=217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings.

Impact of Community-Based HIV/AIDS Treatment on Household Incomes in Uganda

PubMed Central

Feulefack, Joseph F.; Luckert, Martin K.; Mohapatra, Sandeep; Cash, Sean B.; Alibhai, Arif; Kipp, Walter

2013-01-01

Though health benefits to households in developing countries from antiretroviral treatment (ART) programs are widely reported in the literature, specific estimates regarding impacts of treatments on household incomes are rare. This type of information is important to governments and donors, as it is an indication of returns to their ART investments, and to better understand the role of HIV/AIDS in development. The objective of this study is to estimate the impact of a community-based ART program on household incomes in a previously underserved rural region of Uganda. A community-based ART program, based largely on labor contributions from community volunteers, was implemented and evaluated. All households with HIV/AIDS patients enrolled in the treatment programme (n = 134 households) were surveyed five times; once at the beginning of the treatment and every three months thereafter for a period of one year. Data were collected on household income from cash earnings and value of own production. The analysis, using ordinary least squares and quantile regressions, identifies the impact of the ART program on household incomes over the first year of the treatment, while controlling for heterogeneity in household characteristics and temporal changes. As a result of the treatment, health conditions of virtually all patients improved, and household incomes increased by approximately 30% to 40%, regardless of household income quantile. These increases in income, however, varied significantly depending on socio-demographic and socio-economic control variables. Overall, results show large and significant impacts of the ART program on household incomes, suggesting large returns to public investments in ART, and that treating HIV/AIDS is an important precondition for development. Moreover, development programs that invest in human capital and build wealth are important complements that can increase the returns to ART programs. PMID:23840347

Factors Related to Outcome in a School-Based Intensive Mental Health Program: An Examination of Nonresponders

ERIC Educational Resources Information Center

Jacobs, Anne K.; Roberts, Michael C.; Vernberg, Eric M.; Nyre, Joseph E.; Randall, Camille J.; Puddy, Richard W.

2008-01-01

We examined factors related to treatment responders (n = 35) and nonresponders (n = 16) in a group of 51 children admitted to the Intensive Mental Health Program (IMHP). Children's response to treatment was coded based on their functioning at intake and discharge using total CAFAS scores. Demographic variables, length of treatment, number of…

Organizational Readiness for Change and Opinions toward Treatment Innovations

PubMed Central

Fuller, Bret E.; Rieckmann, Traci; Nunes, Edward V.; Miller, Michael; Arfken, Cynthia; Edmundson, Eldon; McCarty, Dennis

2007-01-01

Program administrators and staff in treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) completed surveys to characterize participating programs and practitioners. A two-level random effects regression model assessed the influence of Organizational Readiness for Change (ORC) and organizational attributes on opinions toward the use of four evidence-based practices (manualized treatments, medication, integrated mental health services, and motivational incentives) and practices with less empirical support (confrontation and noncompliance discharge). The ORC Scales suggested greater support for evidence-based practices in programs where staff perceived more program need for improvement, better Internet access, higher levels of peer influence, more opportunities for professional growth, a stronger sense of organizational mission and more organizational stress. Support for confrontation and noncompliance discharge, in contrast, was strong when staff saw less opportunity for professional growth, weaker peer influence, less Internet access, and perceived less organizational stress. The analysis provides evidence of the ORC’s utility in assessing agency strengths and needs during the implementation of evidence-based practices. PMID:17434708

An Evidence-Based Assessment of Faith-Based Programs: Do Faith-Based Programs "Work" to Reduce Recidivism?

ERIC Educational Resources Information Center

Dodson, Kimberly D.; Cabage, Leann N.; Klenowski, Paul M.

2011-01-01

Faith-based organizations administer many of the prison-based programs aimed at reducing recidivism. Many of these organizations also manage treatment programs for substance abusers, at-risk juveniles, and ex-offenders. Much of the research on religiosity and delinquency indicates that the two are inversely related. Therefore, it seems plausible…

PERCEIVED FEASIBILITY OF ESTABLISHING DEDICATED ELDER ABUSE PROGRAMS OF CARE AT HOSPITAL-BASED SEXUAL ASSAULT/DOMESTIC VIOLENCE TREATMENT CENTETR.

PubMed

Du Mont, Janice; Mirzaei, Aftab; Macdonald, Sheila; White, Meghan; Kosa, Daisy; Reimer, Linda

2014-12-01

Elder abuse is an increasingly important issue that must be addressed in a systematic and coordinated way. Our objective was to evaluate the perceived feasibility of establishing an elder abuse care program at hospital-based sexual assault and domestic violence treatment centers in Ontario, Canada. In July 2012, a questionnaire focused on elder abuse care was distributed to all of Ontario's Sexual Assault/Domestic Violence Treatment Centre (SA/DVTC) Program Coordinators/Managers. We found that the majority of Program Coordinators/ Managers favored expansion of their program mandates to include an elder abuse care program. However, these respondents viewed collaboration with a large network of well trained professionals and available services in the community that address elder abuse as integral to responding in a coordinated manner. The expansion of health services to address the needs of abused older adults in a comprehensive and integrated manner should be considered as an important next step for hospital-based violence care programs worldwide.

Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

ERIC Educational Resources Information Center

Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

2005-01-01

TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

Continuing Day Treatment Programs Promote Recovery in Schizophrenia

PubMed Central

2009-01-01

Continuing day treatment programs focus on community stabilization through comprehensive individualized rehabilitation. They promote recovery through a variety of practical clinical therapeutic interventions. This empirically based report describes a continuing day treatment program’s rehabilitation of four clients with schizophrenia, chronic type in a western New York mental health clinic who were in each of the specialty services: a two-phase program, a program for seniors, and a program for co-occurring substance dependence. Some particularly difficult psychiatric symptoms of schizophrenia were successfully treated in this continuing day treatment program. Each of these clients showed improvements in their symptoms and overall community adjustment that may well have been unobtainable with less intensive outpatient treatment. PMID:19724730

Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs.

PubMed

Killeen, Therese K; Back, Sudie E; Brady, Kathleen T

2015-05-01

The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services.

PubMed

Guerrero, Erick G; Padwa, Howard; Fenwick, Karissa; Harris, Lesley M; Aarons, Gregory A

2016-05-14

Despite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices. We relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs. Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members during the uptake of new practices, knowledgeable to properly guide the implementation process, and perseverant to address ongoing barriers that are likely to stall implementation efforts. These findings emphasize how leadership approaches are leveraged to facilitate the implementation and delivery of EBPs in publicly funded addiction treatment programs. Findings have implications for the content and structure of leadership interventions needed in community-based addiction treatment programs and the development of leadership interventions in these and other service settings.

Treatment Readiness as a Determinant of Treatment Participation in a Prison-Based Rehabilitation Program: An Exploratory Study.

PubMed

Bosma, Anouk Q; Kunst, Maarten J J; Dirkzwager, Anja J E; Nieuwbeerta, Paul

2017-06-01

The current study had three aims. First, it measured treatment readiness among offenders who entered the Prevention of Recidivism program. This is a prison-based rehabilitation program in the Netherlands that aims to lower re-offending rates among offenders with a prison sentence of at least for months and that is carried out during the final months of incarceration. Second, the study evaluated whether treatment readiness was associated with treatment participation. Third, the study examined whether treatment readiness measured with a validated instrument predicted treatment participation above and beyond a clinical assessment of treatment readiness, currently used as a criterion to include offenders in rehabilitation programs. To address these aims, data were used from the fourth wave of a research project studying the effects of imprisonment on the life of detainees in the Netherlands. Results indicated that treatment readiness as measured with a validated instrument was a significant predictor of treatment participation. Also, the current study showed that treatment readiness measured with a validated instrument improved the prediction of treatment participation above and beyond a clinical assessment of treatment readiness. Outcomes were discussed in light of study limitations and implications.

A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

ERIC Educational Resources Information Center

Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

2011-01-01

This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

Long-term impact of integration of household water treatment and hygiene promotion with antenatal services on maternal water treatment and hygiene practices in Malawi.

PubMed

Loharikar, Anagha; Russo, Elizabeth; Sheth, Anandi; Menon, Manoj; Kudzala, Amose; Tauzie, Blessius; Masuku, Humphreys D; Ayers, Tracy; Hoekstra, Robert M; Quick, Robert

2013-02-01

A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants.

The Adoption of Wraparound Services among Substance Abuse Treatment Organizations Serving Criminal Offenders: The Role of a Women-Specific Program

PubMed Central

Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

2009-01-01

Women’s substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative’s National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n = 217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings. PMID:19181457

Coordinated Technology-Delivered Treatment to Prevent Rehospitalization in Schizophrenia: A Novel Model of Care.

PubMed

Brunette, Mary F; Rotondi, Armando J; Ben-Zeev, Dror; Gottlieb, Jennifer D; Mueser, Kim T; Robinson, Delbert G; Achtyes, Eric D; Gingerich, Susan; Marcy, Patricia; Schooler, Nina R; Meyer-Kalos, Piper; Kane, John M

2016-04-01

Despite advances in schizophrenia treatment, symptom relapses and rehospitalizations impede recovery for many people and are a principal driver of the high cost of care. Technology-delivered or technology-enhanced treatment may be a cost-effective way to provide flexible, personalized evidence-based treatments directly to people in their homes and communities. However, evidence for the safety, acceptability, and efficacy of such interventions is only now being established. The authors of this Open Forum describe a novel, technology-based approach to prevent relapse after a hospitalization for psychosis, the Health Technology Program (HTP), which they developed. HTP provides in-person relapse prevention planning that directs use of tailored, technology-based treatment based on cognitive-behavioral therapy for psychosis, family psychoeducation for schizophrenia, and prescriber decision support through a Web-based program that solicits information from clients at every visit. Technology-based treatments are delivered through smartphones and computers.

Posttreatment attrition and its predictors, attrition bias, and treatment efficacy of the anxiety online programs.

PubMed

Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

2014-10-14

Although relatively new, the field of e-mental health is becoming more popular with more attention given to researching its various aspects. However, there are many areas that still need further research, especially identifying attrition predictors at various phases of assessment and treatment delivery. The present study identified the predictors of posttreatment assessment completers based on 24 pre- and posttreatment demographic and personal variables and 1 treatment variable, their impact on attrition bias, and the efficacy of the 5 fully automated self-help anxiety treatment programs for generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). A complex algorithm was used to diagnose participants' mental disorders based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR). Those who received a primary or secondary diagnosis of 1 of 5 anxiety disorders were offered an online 12-week disorder-specific treatment program. A total of 3199 individuals did not formally drop out of the 12-week treatment cycle, whereas 142 individuals formally dropped out. However, only 347 participants who completed their treatment cycle also completed the posttreatment assessment measures. Based on these measures, predictors of attrition were identified and attrition bias was examined. The efficacy of the 5 treatment programs was assessed based on anxiety-specific severity scores and 5 additional treatment outcome measures. On average, completers of posttreatment assessment measures were more likely to be seeking self-help online programs; have heard about the program from traditional media or from family and friends; were receiving mental health assistance; were more likely to learn best by reading, hearing and doing; had a lower pretreatment Kessler-6 total score; and were older in age. Predicted probabilities resulting from these attrition variables displayed no significant attrition bias using Heckman's method and thus allowing for the use of completer analysis. Six treatment outcome measures (Kessler-6 total score, number of diagnosed disorders, self-confidence in managing mental health issues, quality of life, and the corresponding pre- and posttreatment severity for each program-specific anxiety disorder and for major depressive episode) were used to assess the efficacy of the 5 anxiety treatment programs. Repeated measures MANOVA revealed a significant multivariate time effect for all treatment outcome measures for each treatment program. Follow-up repeated measures ANOVAs revealed significant improvements on all 6 treatment outcome measures for GAD and PTSD, 5 treatment outcome measures were significant for SAD and PD/A, and 4 treatment outcome measures were significant for OCD. Results identified predictors of posttreatment assessment completers and provided further support for the efficacy of self-help online treatment programs for the 5 anxiety disorders. Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).

Community-Based Addiction Treatment Staff Attitudes about the Usefulness of Evidence-Based Addiction Treatment and CBO Organizational Linkages to Research Institutions

ERIC Educational Resources Information Center

Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

2011-01-01

This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n = 296) and clinical staff (n = 518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical…

Virtual reality-based prospective memory training program for people with acquired brain injury.

PubMed

Yip, Ben C B; Man, David W K

2013-01-01

Acquired brain injuries (ABI) may display cognitive impairments and lead to long-term disabilities including prospective memory (PM) failure. Prospective memory serves to remember to execute an intended action in the future. PM problems would be a challenge to an ABI patient's successful community reintegration. While retrospective memory (RM) has been extensively studied, treatment programs for prospective memory are rarely reported. The development of a treatment program for PM, which is considered timely, can be cost-effective and appropriate to the patient's environment. A 12-session virtual reality (VR)-based cognitive rehabilitation program was developed using everyday PM activities as training content. 37 subjects were recruited to participate in a pretest-posttest control experimental study to evaluate its treatment effectiveness. Results suggest that significantly better changes were seen in both VR-based and real-life PM outcome measures, related cognitive attributes such as frontal lobe functions and semantic fluency. VR-based training may be well accepted by ABI patients as encouraging improvement has been shown. Large-scale studies of a virtual reality-based prospective memory (VRPM) training program are indicated.

Cost-Utility and Cost-Effectiveness Analyses of Face-to-Face Versus Telephone-Based Nonpharmacologic Multidisciplinary Treatments for Patients With Generalized Osteoarthritis.

PubMed

Cuperus, Nienke; van den Hout, Wilbert B; Hoogeboom, Thomas J; van den Hoogen, Frank H J; Vliet Vlieland, Thea P M; van den Ende, Cornelia H M

2016-04-01

To evaluate, from a societal perspective, the cost utility and cost effectiveness of a nonpharmacologic face-to-face treatment program compared with a telephone-based treatment program for patients with generalized osteoarthritis (GOA). An economic evaluation was carried out alongside a randomized clinical trial involving 147 patients with GOA. Program costs were estimated from time registrations. One-year medical and nonmedical costs were estimated using cost questionnaires. Quality-adjusted life years (QALYs) were estimated using the EuroQol (EQ) classification system, EQ rating scale, and the Short Form 6D (SF-6D). Daily function was measured using the Health Assessment Questionnaire (HAQ) disability index (DI). Cost and QALY/effect differences were analyzed using multilevel regression analysis and cost-effectiveness acceptability curves. Medical costs of the face-to-face treatment and telephone-based treatment were estimated at €387 and €252, respectively. The difference in total societal costs was nonsignificantly in favor of the face-to-face program (difference €708; 95% confidence interval [95% CI] -€5,058, €3,642). QALYs were similar for both groups according to the EQ, but were significantly in favor of the face-to-face group, according to the SF-6D (difference 0.022 [95% CI 0.000, 0.045]). Daily function was similar according to the HAQ DI. Since both societal costs and QALYs/effects were in favor of the face-to-face program, the economic assessment favored this program, regardless of society's willingness to pay. There was a 65-90% chance that the face-to-face program had better cost utility and a 60-70% chance of being cost effective. This economic evaluation from a societal perspective showed that a nonpharmacologic, face-to-face treatment program for patients with GOA was likely to be cost effective, relative to a telephone-based program. © 2016, American College of Rheumatology.

Early family-based intervention in the path to alcohol problems: rationale and relationship between treatment process characteristics and child and parenting outcomes.

PubMed

Nye, C L; Zucker, R A; Fitzgerald, H E

1999-03-01

Risk for subsequent development of alcohol problems is not uniform across the population of alcoholic families, but varies with parental comorbidity and family history. Recent studies have also identified disruptive child behavior problems in the preschool years as predictive of alcoholism in adulthood. Given the quality of risk structure in highest risk families, prevention programming is more appropriately family based rather than individual. A family-based intervention program for the prevention of conduct problems among preschool-age sons of alcoholic fathers was implemented to change this potential mediating risk structure. A population-based recruitment strategy enrolled 52 alcoholic families in a 10-month intervention involving parent training and marital problem solving. The study examined the interplay between parent treatment investment and parent and therapist expectations and satisfaction in predicting change in child behavior and authoritative parenting style during the program, and for 6 months afterward among the 29 families whose sustained involvement allowed these effects to be evaluated. Parent expectations at pretreatment influenced their early investment in the program, which in turn predicted child and parenting outcomes. Parent and therapist satisfaction ratings during treatment were associated with one another and with expectations that the program would continue to promote changes in their child. Parent investment was a particularly salient influence on outcome, as higher investment throughout the program was associated with improvement in child behavior and authoritative parenting at termination. Findings indicate that treatment process characteristics mediate the influence of baseline parent functioning on treatment success and that treatment changes themselves predict later child outcomes.

Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation

PubMed Central

Renton, Tian; Tang, Herman; Ennis, Naomi; Cusimano, Michael D; Bhalerao, Shree; Schweizer, Tom A

2014-01-01

Background Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers. Objective The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program? Methods Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score. Results The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms. Conclusions There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool. PMID:25249003

Web-based intervention programs for depression: a scoping review and evaluation.

PubMed

Renton, Tian; Tang, Herman; Ennis, Naomi; Cusimano, Michael D; Bhalerao, Shree; Schweizer, Tom A; Topolovec-Vranic, Jane

2014-09-23

Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers. The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program? Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score. The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms. There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool.

Organizational Implementation of Evidence-Based Substance Abuse Treatment in Racial and Ethnic Minority Communities

PubMed Central

He, Amy; Kim, Ahraemi; Aarons, Gregory A.

2013-01-01

We evaluated organizational factors associated with the implementation of contingency management treatment (CMT) and medication-assisted treatment (MAT) in substance abuse treatment (SAT) programs serving racial and ethnic minority communities. Analysis of cross-sectional data collected in 2010–2011 from a random sample of 148 publicly funded SAT programs showed that accepting private insurance was positively associated with CMT and MAT implementation, whereas larger programs were associated with greater implementation of MAT. Supervisorial openness to and expectations about implementing evidence-based practices (EBPs) and attributes for change were strongly associated with CMT, whereas the interactions between openness to EBPs and programs that accept private insurance and that are governed by parent organizations were positively associated with MAT. These external expectations and managerial attitudes supported the implementation of psychosocial and pharmacotherapy treatments in SAT. Implications for improving standards of care in minority communities are discussed. PMID:24046236

Cognitive-Behavioral Treatment for Adolescents Who Sexually Offend and Their Families: Individual and Family Applications in a Collaborative Outpatient Program

ERIC Educational Resources Information Center

Kolko, David J.; Noel, Colleen; Thomas, Gretchen; Torres, Eunice

2004-01-01

This article describes an outpatient treatment program for adolescent sexual abusers that was established by a mental health agency in collaboration with a specialized probation program in the juvenile court. Individualized treatment is based on a comprehensive clinical assessment with the youth and guardian, for which examples are provided. Given…

Treatment Cost Analysis Tool (TCAT) for Estimating Costs of Outpatient Treatment Services

PubMed Central

Flynn, Patrick M.; Broome, Kirk M.; Beaston-Blaakman, Aaron; Knight, Danica K.; Horgan, Constance M.; Shepard, Donald S.

2009-01-01

A Microsoft® Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment types were $882, $1,310, and $1,381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment. PMID:19004576

Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

PubMed

Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

2009-02-01

A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

Drug Abuse Treatment in Prisons. Treatment Research Report.

ERIC Educational Resources Information Center

National Inst. for Advanced Studies, Washington, DC.

This report, based on a 1979 national survey of drug abuse treatment programs in the prisons of the 50 states and the District of Columbia, presents data on 160 operational programs. Descriptive information on the identification of drug-dependent inmates and the provision of drug abuse treatment by state adult correctional institutions is…

A Framework for Conducting a National Study of Substance Abuse Treatment Programs Serving American Indian and Alaska Native Communities

PubMed Central

Novins, Douglas K.; Moore, Laurie A.; Beals, Janette; Aarons, Gregory A.; Rieckmann, Traci; Kaufman, Carol E.

2013-01-01

Background Because of their broad geographic distribution, diverse ownership and operation, and funding instability, it is a challenge to develop a framework for studying substance abuse treatment programs serving American Indian and Alaska Native communities at a national level. This is further complicated by the historic reluctance of American Indian and Alaska Native communities to participate in research. Objectives and Methods We developed a framework for studying these substance abuse treatment programs (n = 293) at a national level as part of a study of attitudes toward, and use of, evidence-based treatments among substance abuse treatment programs serving AI/AN communities with the goal of assuring participation of a broad array of programs and the communities that they serve. Results Because of the complexities of identifying specific substance abuse treatment programs, the sampling framework divides these programs into strata based on the American Indian and Alaska Native communities that they serve: (1) the 20 largest tribes (by population); (2) urban AI/AN clinics; (3) Alaska Native Health Corporations; (4) other Tribes; and (5) other regional programs unaffiliated with a specific AI/AN community. In addition, the recruitment framework was designed to be sensitive to likely concerns about participating in research. Conclusion and Scientific Significance This systematic approach for studying substance abuse and other clinical programs serving AI/AN communities assures the participation of diverse AI/AN programs and communities and may be useful in designing similar national studies. PMID:22931088

Melding Infant Mental Health and Multisystemic Therapy Approaches to Community-Based Treatment

ERIC Educational Resources Information Center

Willoughby, Jay C.; Carubia, Beau A.; Murgolo, Marisa A.; Carter, Debbie R.; Frankel, Karen A.

2013-01-01

A recent partnership between the Irving Harris Program in Child Development and Infant Mental Health and the Community Based Psychiatry Program at University of Colorado Hospital joined two different approaches to child mental health treatment: infant mental health and multisystemic therapy (MST). This article illustrates the compatibility of…

Finding Web-Based Anxiety Interventions on the World Wide Web: A Scoping Review

PubMed Central

Olander, Ellinor K; Ayers, Susan

2016-01-01

Background One relatively new and increasingly popular approach of increasing access to treatment is Web-based intervention programs. The advantage of Web-based approaches is the accessibility, affordability, and anonymity of potentially evidence-based treatment. Despite much research evidence on the effectiveness of Web-based interventions for anxiety found in the literature, little is known about what is publically available for potential consumers on the Web. Objective Our aim was to explore what a consumer searching the Web for Web-based intervention options for anxiety-related issues might find. The objectives were to identify currently publically available Web-based intervention programs for anxiety and to synthesize and review these in terms of (1) website characteristics such as credibility and accessibility; (2) intervention program characteristics such as intervention focus, design, and presentation modes; (3) therapeutic elements employed; and (4) published evidence of efficacy. Methods Web keyword searches were carried out on three major search engines (Google, Bing, and Yahoo—UK platforms). For each search, the first 25 hyperlinks were screened for eligible programs. Included were programs that were designed for anxiety symptoms, currently publically accessible on the Web, had an online component, a structured treatment plan, and were available in English. Data were extracted for website characteristics, program characteristics, therapeutic characteristics, as well as empirical evidence. Programs were also evaluated using a 16-point rating tool. Results The search resulted in 34 programs that were eligible for review. A wide variety of programs for anxiety, including specific anxiety disorders, and anxiety in combination with stress, depression, or anger were identified and based predominantly on cognitive behavioral therapy techniques. The majority of websites were rated as credible, secure, and free of advertisement. The majority required users to register and/or to pay a program access fee. Half of the programs offered some form of paid therapist or professional support. Programs varied in treatment length and number of modules and employed a variety of presentation modes. Relatively few programs had published research evidence of the intervention’s efficacy. Conclusions This review represents a snapshot of available Web-based intervention programs for anxiety that could be found by consumers in March 2015. The consumer is confronted with a diversity of programs, which makes it difficult to identify an appropriate program. Limited reports and existence of empirical evidence for efficacy make it even more challenging to identify credible and reliable programs. This highlights the need for consistent guidelines and standards on developing, providing, and evaluating Web-based interventions and platforms with reliable up-to-date information for professionals and consumers about the characteristics, quality, and accessibility of Web-based interventions. PMID:27251763

Finding Web-Based Anxiety Interventions on the World Wide Web: A Scoping Review.

PubMed

Ashford, Miriam Thiel; Olander, Ellinor K; Ayers, Susan

2016-06-01

One relatively new and increasingly popular approach of increasing access to treatment is Web-based intervention programs. The advantage of Web-based approaches is the accessibility, affordability, and anonymity of potentially evidence-based treatment. Despite much research evidence on the effectiveness of Web-based interventions for anxiety found in the literature, little is known about what is publically available for potential consumers on the Web. Our aim was to explore what a consumer searching the Web for Web-based intervention options for anxiety-related issues might find. The objectives were to identify currently publically available Web-based intervention programs for anxiety and to synthesize and review these in terms of (1) website characteristics such as credibility and accessibility; (2) intervention program characteristics such as intervention focus, design, and presentation modes; (3) therapeutic elements employed; and (4) published evidence of efficacy. Web keyword searches were carried out on three major search engines (Google, Bing, and Yahoo-UK platforms). For each search, the first 25 hyperlinks were screened for eligible programs. Included were programs that were designed for anxiety symptoms, currently publically accessible on the Web, had an online component, a structured treatment plan, and were available in English. Data were extracted for website characteristics, program characteristics, therapeutic characteristics, as well as empirical evidence. Programs were also evaluated using a 16-point rating tool. The search resulted in 34 programs that were eligible for review. A wide variety of programs for anxiety, including specific anxiety disorders, and anxiety in combination with stress, depression, or anger were identified and based predominantly on cognitive behavioral therapy techniques. The majority of websites were rated as credible, secure, and free of advertisement. The majority required users to register and/or to pay a program access fee. Half of the programs offered some form of paid therapist or professional support. Programs varied in treatment length and number of modules and employed a variety of presentation modes. Relatively few programs had published research evidence of the intervention's efficacy. This review represents a snapshot of available Web-based intervention programs for anxiety that could be found by consumers in March 2015. The consumer is confronted with a diversity of programs, which makes it difficult to identify an appropriate program. Limited reports and existence of empirical evidence for efficacy make it even more challenging to identify credible and reliable programs. This highlights the need for consistent guidelines and standards on developing, providing, and evaluating Web-based interventions and platforms with reliable up-to-date information for professionals and consumers about the characteristics, quality, and accessibility of Web-based interventions.

Evaluation of Drug Abuse Treatment Effectiveness: Summary of the DARP Followup Research. Treatment Research Report.

ERIC Educational Resources Information Center

Simpson, D. Dwayne; Sells, S. B.

The Drug Abuse Reporting Program (DARP) was initiated in 1969 as a federally supported client reporting system for community-based drug abuse treatment programs. Posttreatment follow-up interviews were conducted with over 4,000 persons from 34 treatment agencies to describe major findings from the drug abuse treatment research of the DARP relating…

Systematic review of community-based, school-based, and combined delivery modes for reaching school-aged children in mass drug administration programs for schistosomiasis.

PubMed

Burnim, Michael; Ivy, Julianne A; King, Charles H

2017-10-01

The mainstay of current schistosomiasis control programs is mass preventive chemotherapy of school-aged children with praziquantel. This treatment is delivered through school-based, community-based, or combined school- and community-based systems. Attaining very high coverage rates for children is essential in mass schistosomiasis treatment programs, as is ensuring that there are no persistently untreated subpopulations, a potential challenge for school-based programs in areas with low school enrollment. This review sought to compare the different treatment delivery methods based both on their coverage of school-aged children overall and on their coverage specifically of non-enrolled children. In addition, qualitative community or programmatic factors associated with high or low coverage rates were identified, with suggestions for overall coverage improvement. This review was registered prospectively with PROSPERO (CRD 42015017656). Five hundred forty-nine publication of potential relevance were identified through database searches, reference lists, and personal communications. Eligible studies included those published before October 2015, written in English or French, containing quantitative or qualitative data about coverage rates for MDA of school-aged children with praziquantel. Among the 22 selected studies, combined community- and school-based programs achieved the highest median coverage rates (89%), followed by community-based programs (72%). School-based programs had both the lowest median coverage of children overall (49%) and the lowest coverage of the non-enrolled subpopulation of children. Qualitatively, major factors affecting program success included fear of side effects, inadequate education about schistosomiasis, lack of incentives for drug distributors, and inequitable distribution to minority groups. This review provides an evidence-based framework for the development of future schistosomiasis control programs. Based on our results, a combined community and school-based delivery system should maximize coverage for both in- and out-of-school children, especially when combined with interventions such as snacks for treated children, educational campaigns, incentives for drug distributors, and active inclusion of marginalized groups. ClinicalTrials.gov CRD42015017656.

Internet-based Cognitive Behavioral Therapy for Depression: Current Progress & Future Directions

PubMed Central

Webb, Christian A.; Rosso, Isabelle M.; Rauch, Scott L.

2016-01-01

The World Health Organization (WHO) estimates that during a given 12-month period approximately 34 million people suffering from major depressive disorder go untreated in Europe and the Americas alone.1 Barriers to treatment include geographic distance, lack of mental health insurance, prohibitive cost of treatment, long wait-lists, and perceived stigma. Over the past two decades internet-based cognitive behavioral therapy (iCBT) programs have proliferated. A growing body of research supports the efficacy of iCBT for depression and other psychiatric conditions, and these programs may help address barriers that hinder access to effective treatment. The present review describes common iCBT programs along with the evidence base supporting their efficacy in reducing symptoms of depression, reviews research on moderators of treatment response, and provides suggestions for future directions in research and care. PMID:28475503

Increased Mental Health Treatment Financing, Community-Based Organization's Treatment Programs, and Latino-White Children's Financing Disparities.

PubMed

Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve

2017-09-01

Latino child populations are large and growing, and they present considerable unmet need for mental health treatment. Poverty, lack of health insurance, limited English proficiency, stigma, undocumented status, and inhospitable programming are among many factors that contribute to Latino-White mental health treatment disparities. Lower treatment expenditures serve as an important marker of Latino children's low rates of mental health treatment and limited participation once enrolled in services. We investigated whether total Latino-White expenditure disparities declined when autonomous, county-level mental health plans receive funds free of customary cost-sharing charges, especially when they capitalized on cultural and language-sensitive mental health treatment programs as vehicles to receive and spend treatment funds. Using Whites as benchmark, we considered expenditure pattern disparities favoring Whites over Latinos and, in a smaller number of counties, Latinos over Whites. Using segmented regression for interrupted time series on county level treatment systems observed over 64 quarters, we analyzed Medi-Cal paid claims for per-user total expenditures for mental health services delivered to children and youth (under 18 years of age) during a study period covering July 1, 1991 through June 30, 2007. Settlement-mandated Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. Terms were introduced to assess immediate and long term inequality reduction as well as the role of culture and language-sensitive community-based programs. Settlement-mandated increased EPSDT treatment funding was associated with more spending on Whites relative to Latinos unless plans arranged for cultural and language-sensitive mental health treatment programs. However, having programs served more to prevent expenditure disparities from growing than to reduce disparities. EPSDT expanded funding increased proportional expenditures for Whites absent cultural and language-sensitive treatment programs. The programs moderate, but do not overcome, entrenched expenditure disparities. These findings use investment in mental health services for Latino populations to indicate treatment access and utilization, but do not explicitly reflect penetration rates or intensity of services for consumers. New funding, along with an expectation that Latino children's well documented mental health treatment disparities will be addressed, holds potential for improved mental health access and reducing utilization inequities for this population, especially when specialized, culturally and linguistically sensitive mental health treatment programs are present to serve as recipients of funding. To further expand knowledge of how federal or state funding for community based mental health services for low income populations can drive down the longstanding and considerable Latino-White mental health treatment disparities, we must develop and test questions targeting policy drivers which can channel funding to programs and organizations aimed at delivering linguistically and culturally sensitive services to Latino children and their families.

Addressing Trauma Among Women With Serious Addictive Disorders: Treatment Models, Program Factors, And Potential Mediators

PubMed Central

Nayak, Madhabika B.; Blacksher, Susan

2009-01-01

A large majority of women entering addiction treatment present significant symptoms of trauma related to physical or sexual abuse. Despite research indicating that trauma interventions are integral to women’s successful recovery from addiction, many programs do not adequately address violence-related trauma. This chapter provides a review of the literature on trauma among women with addictive disorders and several manual based interventions developed to address co-occurring addiction and trauma-related disorders. One intervention, “Beyond Trauma,” which has become increasingly popular among community based programs is described in detail. Beyond Trauma appears to have several advantages over other therapies for treating trauma and addiction in women, including 1) a theoretical foundation that draws on relational theory as a guide to the intervention, 2) a broad based approach that can be utilized by a variety of professional and paraprofessional staff members, 3) a focus that goes beyond treating women with a formal diagnosis of post traumatic stress disorder to include treatment for an array of symptoms and problems associated with trauma, and 4) gender-appropriate use of expressive arts in its curriculum. The chapter also discusses treatment program environment factors that may be critically important to treatment outcome for women: 1) whether the program is gender specific, 2) the degree of emphasis on peer involvement in recovery, 3) program recognition of the value of knowledge-based recovery experience, 4) program facilitation of cohesion, 5) the empowerment of clients in decisions affecting the program and 6) skills training relevant to managing moods, relationships and a variety of problems that women face during recovery. Possible mechanisms of change for Beyond Trauma are explored with particular emphasis on the variety of ways the intervention attempts to impact problem areas experienced by women (e.g., mental health functioning self esteem and social support). Recommendations for future research in the treatment of trauma and addiction-related disorders in women are outlined. PMID:24348202

Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review.

PubMed

Laufer, Yocheved; Dar, Gali; Kodesh, Einat

2014-01-01

Exercise programs that challenge an individual's balance have been shown to reduce the risk of falls among older adults. Virtual reality computer-based technology that provides the user with opportunities to interact with virtual objects is used extensively for entertainment. There is a growing interest in the potential of virtual reality-based interventions for balance training in older adults. This work comprises a systematic review of the literature to determine the effects of intervention programs utilizing the Nintendo Wii console on balance control and functional performance in independently functioning older adults. STUDIES WERE OBTAINED BY SEARCHING THE FOLLOWING DATABASES: PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus, and Google Scholar, followed by a hand search of bibliographic references of the included studies. Included were randomized controlled trials written in English in which Nintendo Wii Fit was used to enhance standing balance performance in older adults and compared with an alternative exercise treatment, placebo, or no treatment. Seven relevant studies were retrieved. The four studies examining the effect of Wii-based exercise compared with no exercise reported positive effects on at least one outcome measure related to balance performance in older adults. Studies comparing Wii-based training with alternative exercise programs generally indicated that the balance improvements achieved by Wii-based training are comparable with those achieved by other exercise programs. The review indicates that Wii-based exercise programs may serve as an alternative to more conventional forms of exercise aimed at improving balance control. However, due to the great variability between studies in terms of the intervention protocols and outcome measures, as well as methodological limitations, definitive recommendations as to optimal treatment protocols and the potential of such an intervention as a safe and effective home-based treatment cannot be made at this point.

A randomized controlled trial of an audio-based treatment program for child anxiety disorders.

PubMed

Infantino, Alyssa; Donovan, Caroline L; March, Sonja

2016-04-01

The aim of this study was to investigate the efficacy of an audio-based cognitive-behavioural therapy (CBT) program for child anxiety disorders. Twenty-four children aged 5-11 years were randomly allocated into either the audio-based CBT program condition (Audio, n = 12) or a waitlist control (WL; n = 12) group. Outcome measures included a clinical diagnostic interview, clinician-rated global assessment of functioning, and parent and child self-report ratings of anxiety and internalisation. Assessments were conducted prior to treatment, 12 weeks following treatment, and at 3-month follow-up. Results indicated that at post-assessment, 58.3% of children receiving treatment compared to 16.7% of waitlist children were free of their primary diagnosis, with this figure rising to 66.67% at the 3-month follow-up time point. Additionally, at post-assessment, 25.0% of children in the treatment condition compared to .0% of the waitlist condition were free of all anxiety diagnoses, with this figure rising to 41.67% for the treatment group at 3-month follow-up. Overall, the findings suggest that the audio program tested in this study has the potential to be an efficacious treatment alternative for anxious children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Summer Sports: A Recreationally Based Program for Building Peer Relations.

ERIC Educational Resources Information Center

Pelham, Jr., William E.; Gnagy, Elizabeth M.

1998-01-01

Describes the Summer Treatment Program (STP), a comprehensive sports training and treatment program for students with Attention Deficit/Hyperactivity Disorder. STP incorporates social-skills training, academic instruction, parent training, and medication evaluation. STP has been shown to be highly successful and its principles can be transferred…

Successful testing and treating of HIV/AIDS in Indonesia depends on the addiction treatment modality

PubMed Central

Iskandar, Shelly; de Jong, Cor AJ; Hidayat, Teddy; Siregar, Ike MP; Achmad, Tri H; van Crevel, Reinout; van der Ven, Andre

2012-01-01

Background In many settings, people who inject drugs (PWID) have limited access to human immunodeficiency virus (HIV) care which is provided in several hospitals and primary health centers in big cities. Substance abuse treatment (SAT) can be used as the entry-point to HIV programs. The aim of this study is to describe the characteristics of the PWID who had accessed SAT and determine which SAT modality associates significantly with HIV programs. Methods PWID were recruited by respondent-driven sampling in an urban setting in Java, Indonesia and interviewed with the Addiction Severity Index (ASI), Blood-Borne Virus Transmission Risk Assessment Questionnaires, and Knowledge Questionnaire on HIV/AIDS. The information regarding the use of substance abuse treatment and HIV program were based on questions in ASI. Results Seventy-seven percent of 210 PWID had accessed SAT at least once. PWID who had accessed a SAT modality reported more severe drug problems. The most widely used SAT were opioid substitution (57%) and traditional/faith-based treatment (56%). Accessing substitution treatment (adjusted odds ratio [OR] = 5.8; 95% confidence interval [CI]: 2.5–13.9) or residential drug-free treatment (adjusted OR = 3.7; 95% CI: 1.4–9.7) was significantly associated with HIV testing, whereas accessing substitution treatment (adjusted OR = 3.8; 95% CI: 1.9–7.5) or other medical services (adjusted OR = 3.1; 95% CI: 1.1–8.7) was significantly associated with HIV treatment. There was no significant association between accessing traditional/faith-based treatment and HIV testing and treatment. Conclusion Efforts should be made to link HIV services with traditional/faith-based treatment to increase the coverage of HIV programs. PMID:23293529

Successful testing and treating of HIV/AIDS in Indonesia depends on the addiction treatment modality.

PubMed

Iskandar, Shelly; de Jong, Cor Aj; Hidayat, Teddy; Siregar, Ike Mp; Achmad, Tri H; van Crevel, Reinout; van der Ven, Andre

2012-01-01

In many settings, people who inject drugs (PWID) have limited access to human immunodeficiency virus (HIV) care which is provided in several hospitals and primary health centers in big cities. Substance abuse treatment (SAT) can be used as the entry-point to HIV programs. The aim of this study is to describe the characteristics of the PWID who had accessed SAT and determine which SAT modality associates significantly with HIV programs. PWID were recruited by respondent-driven sampling in an urban setting in Java, Indonesia and interviewed with the Addiction Severity Index (ASI), Blood-Borne Virus Transmission Risk Assessment Questionnaires, and Knowledge Questionnaire on HIV/AIDS. The information regarding the use of substance abuse treatment and HIV program were based on questions in ASI. Seventy-seven percent of 210 PWID had accessed SAT at least once. PWID who had accessed a SAT modality reported more severe drug problems. The most widely used SAT were opioid substitution (57%) and traditional/faith-based treatment (56%). Accessing substitution treatment (adjusted odds ratio [OR] = 5.8; 95% confidence interval [CI]: 2.5-13.9) or residential drug-free treatment (adjusted OR = 3.7; 95% CI: 1.4-9.7) was significantly associated with HIV testing, whereas accessing substitution treatment (adjusted OR = 3.8; 95% CI: 1.9-7.5) or other medical services (adjusted OR = 3.1; 95% CI: 1.1-8.7) was significantly associated with HIV treatment. There was no significant association between accessing traditional/faith-based treatment and HIV testing and treatment. Efforts should be made to link HIV services with traditional/faith-based treatment to increase the coverage of HIV programs.

An Assessment of Prison-Based Drug Treatment; Texas' In-Prison Therapeutic Community Program.

ERIC Educational Resources Information Center

Knight, Kevin; Simpson, D. Dwayne; Chatham, Lois R.; Camacho, L. Mabel

1997-01-01

Provides an overview of a comprehensive, prison-based treatment assessment, including a six-month follow-up study. Results show that 80% of the inmates referred to the program graduated. Graduates demonstrated marked reductions in criminal and drug-use activity and had lower relapse and recidivism rates when compared to other parolees. (RJM)

Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

ERIC Educational Resources Information Center

Trotman, Adria J.; Taxman, Faye S.

2011-01-01

A cognitive-behaviorally based substance abuse treatment program was implemented within a community supervision setting. This program included a goals group that used a contingency management component and included the probation agent as a part of the treatment. In this article, the authors describe the contingency management component of the…

Efficacy of a School-Based Treatment Program for Middle School Youth With ADHD: Pilot Data

ERIC Educational Resources Information Center

Evans, Steven W.; Axelrod, Jennifer; Langberg, Joshua M.

2004-01-01

The effects of a set of behavioral and educational interventions provided in a middle-school-based mental health program on the behavior and academic performance of 7 students diagnosed with attention-deficit/hyperactivity disorder (ADHD) were studied. The treatments included educational, social skills and family interventions designed to target…

Evaluating a School-Based Day Treatment Program for Students with Challenging Behaviors

ERIC Educational Resources Information Center

Hickman, Antoine Lewis

2014-01-01

Jade County Public Schools has provided school-based therapeutic day treatment in its public schools for more than 10 years. This program was adopted by the school system to provide an intervention in the school and classroom to address the challenging behaviors of students with emotional and behavioral disorders. Currently, three human services…

School-Based Prevention and Intervention Programs for Children with Emotional Disturbance: A Review of Treatment Components and Methodology

ERIC Educational Resources Information Center

Reddy, Linda A.; De Thomas, Courtney Anne; Newman, Erik; Chun, Victoria

2009-01-01

School practitioners and educators are frequently challenged by the diverse and pervasive academic, social, and behavioral needs of children at risk for and with emotional disturbance. The present article examines the outcome literature on school-based prevention and intervention programs by systematically reviewing the key treatment interventions…

Evaluation of 6 remote First Nations community-based buprenorphine programs in northwestern Ontario: Retrospective study.

PubMed

Mamakwa, Solomon; Kahan, Meldon; Kanate, Dinah; Kirlew, Mike; Folk, David; Cirone, Sharon; Rea, Sara; Parsons, Pierre; Edwards, Craig; Gordon, Janet; Main, Fiona; Kelly, Len

2017-02-01

To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. Retrospective cohort study. Six First Nations communities in northwestern Ontario. A total of 526 First Nations participants in opioid-dependence treatment programs. Buprenorphine-naloxone substitution therapy and First Nations healing programming. Retention rates and urine drug screening (UDS) results. Treatment retention rates at 6, 12, and 18 months were 84%, 78%, and 72%, respectively. We estimate that the rate at 24 months will also be more than 70%. The UDS programming varied and was implemented in only 1 community. Initially urine testing was voluntary and it then became mandatory. Screening with either method found the proportion of urine samples with negative results for illicit opioids ranged between 84% and 95%. The program's treatment retention rates and negative UDS results were higher than those reported for most methadone and buprenorphine-naloxone programs, despite a patient population where severe posttraumatic stress disorder is endemic, and despite the programs' lack of resources and addiction expertise. Community-based programs like these overcome the initial challenge of cultural competence. First Nations communities in other provinces should establish their own buprenorphinenaloxone programs, using local primary care physicians as prescribers. Sustainable core funding is needed for programming, long-term aftercare, and trauma recovery for such initiatives. Copyright© the College of Family Physicians of Canada.

Results of an asthma disease management program in an urban pediatric community clinic.

PubMed

Newcomb, Patricia

2006-07-01

Asthma is increasing in incidence, but adherence to national diagnosis and treatment guidelines is poor. The Children's Asthma Management Program (CHAMP) was designed and implemented by nurse practitioners to address the problem of inconsistent asthma management. This is an outcome-based evaluation of a novel asthma management program in which practitioners created a structured mechanism for implementing national evidence-based asthma treatment guidelines. Children who completed the program experienced an 85% decrease in hospitalizations for asthma, 87% decrease in emergency room visits for asthma, and 71% decrease in acute office visits for asthma exacerbations. Patients may benefit from microsystem structures intentionally designed to facilitate implementation of evidence-based guidelines.

The impact of an empowering Internet-based Breast Cancer Patient Pathway program on breast cancer patients' clinical outcomes: a randomised controlled trial.

PubMed

Ryhänen, Anne M; Rankinen, Sirkku; Siekkinen, Mervi; Saarinen, Maiju; Korvenranta, Heikki; Leino-Kilpi, Helena

2013-04-01

To evaluate the effect of the Breast Cancer Patient Pathway program on breast cancer patient's empowerment process. The results of earlier studies indicate that the use of tailored Internet-based patient education programs increased patient's knowledge level; however, other outcome measures differed. This randomised control trial studied the effect of the Internet-based patient educational program on breast cancer patients' empowerment. In this study, we measured the quality of life, anxiety and managing with treatment-related side effects as the outcomes of breast cancer patients' empowering process. Breast cancer patients who were Internet users in one Finnish university hospital during 2008-2010 were randomised to the control group (n=43) and the intervention group (n=47). Baseline data were collected first in the hospital and the following data seven times during the treatment process, the last time one year after breast cancer diagnosis. There were no statistically significant differences in the quality of life, anxiety or side effects of treatment between the groups. The amount of treatment-related side effects was connected to both physical and psychological well-being. In this study, the Breast Cancer Patient Pathway program did not decrease anxiety level or treatment-related side effects among breast cancer patients or improve subscales of quality of life when compared with controls. There is a need to relieve the side effects caused by patients' care with the help of patient education. Internet-based patient education programs need more focus when developing new patient education methods. © 2013 Blackwell Publishing Ltd.

School-based mental health programming for children with inattentive and disruptive behavior problems: first-year treatment outcome.

PubMed

Owens, Julie Sarno; Richerson, Lauren; Beilstein, Elizabeth A; Crane, Anna; Murphy, Caroline E; Vancouver, Jeffrey B

2005-08-01

This article examines the effectiveness of an evidence-based behavioral treatment package for children with inattentive and disruptive behavior problems when delivered in the context of a school-based mental health program. Child symptomatology and functioning are assessed in a treatment group (n = 30) and a waitlist control group (n = 12) across multiple time points (fall, winter, and spring). Treatment includes a daily report card procedure, year-long teacher consultation, and parenting sessions. According to the parent report, treated children show marked reductions in hyperactive and impulsive, oppositional or defiant and aggressive behavior, and marked improvement in peer relationships. Teachers observe treatment-related group differences in inattention, academic functioning, and the student-teacher relationship. Feasibility and acceptability data have implications for transporting evidence-based treatments to community settings and for integrating mental health services into the culture of the school community.

Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts.

PubMed

Formica, Scott W; Apsler, Robert; Wilkins, Lindsay; Ruiz, Sarah; Reilly, Brittni; Walley, Alexander Y

2018-04-01

Opioid overdose is a significant public health problem. Collaborative programs between local public health and public safety agencies have emerged to connect overdose survivors and their personal networks with harm reduction and addiction treatment services following a non-fatal overdose event. This study explored the prevalence of these programs in Massachusetts and the different ways they have been structured and function. We sent an online screening questionnaire to police and fire departments in all 351 communities in Massachusetts to find instances in which they collaborated with a community-based public health agency to implement a post-overdose outreach and support program. We conducted telephone interviews with communities that implemented this type of program and categorized programs based on their structure, outreach approach, and other key characteristics. Police and fire personnel from 110 of the 351 communities in Massachusetts (31% response rate) completed the screening survey. Among respondents, 21% (23/110) had implemented a collaborative, community-based, post-overdose program with a well-defined process to connect overdose survivors and their personal networks with support services or addiction treatment services. Using data from the interviews, we identified four types of programs: (1) Multi-Disciplinary Team Visit, (2) Police Visit with Referrals, (3) Clinician Outreach, and (4) Location-Based Outreach. This study represents the first attempt to systematically document an emerging approach intended to connect opioid overdose survivors and their personal networks with harm reduction and addiction treatment services soon after a non-fatal overdose event. These programs have the potential to increase engagement with the social service and addiction treatment systems by those who are at elevated risk for experiencing a fatal opioid overdose. Copyright © 2018 Elsevier B.V. All rights reserved.

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

Treatment Algorithms Based on Tumor Molecular Profiling: The Essence of Precision Medicine Trials.

PubMed

Le Tourneau, Christophe; Kamal, Maud; Tsimberidou, Apostolia-Maria; Bedard, Philippe; Pierron, Gaëlle; Callens, Céline; Rouleau, Etienne; Vincent-Salomon, Anne; Servant, Nicolas; Alt, Marie; Rouzier, Roman; Paoletti, Xavier; Delattre, Olivier; Bièche, Ivan

2016-04-01

With the advent of high-throughput molecular technologies, several precision medicine (PM) studies are currently ongoing that include molecular screening programs and PM clinical trials. Molecular profiling programs establish the molecular profile of patients' tumors with the aim to guide therapy based on identified molecular alterations. The aim of prospective PM clinical trials is to assess the clinical utility of tumor molecular profiling and to determine whether treatment selection based on molecular alterations produces superior outcomes compared with unselected treatment. These trials use treatment algorithms to assign patients to specific targeted therapies based on tumor molecular alterations. These algorithms should be governed by fixed rules to ensure standardization and reproducibility. Here, we summarize key molecular, biological, and technical criteria that, in our view, should be addressed when establishing treatment algorithms based on tumor molecular profiling for PM trials. © The Author 2015. Published by Oxford University Press.

Cost Evaluation of Evidence-Based Treatments

PubMed Central

Sindelar, Jody L.; Ball, Samuel A.

2010-01-01

Many treatment programs have adopted or are considering adopting evidence-based treatments (EBTs). When a program evaluates whether to adopt a new intervention, it must consider program objectives, operational goals, and costs. This article examines cost concepts, cost estimation, and use of cost information to make the final decision on whether to adopt an EBT. Cost categories, including variable and fixed, accounting and opportunity, and costs borne by patients and others, are defined and illustrated using the example of expenditures for contingency management. Ultimately, cost is one consideration in the overall determination of whether implementing an EBT is the best use of a program’s resources. PMID:22002453

A Formative Evaluation of Two Evidence-Based Psychotherapies for PTSD In VA Residential Treatment Programs

PubMed Central

Cook, Joan M.; O’Donnell, Casey; Dinnen, Stephanie; Bernardy, Nancy; Rosenheck, Robert; Desai, Rani

2013-01-01

Thirty-eight U.S. Department of Veterans Affairs (VA) residential treatment programs for posttraumatic stress disorder (PTSD) participated in a formative evaluation of their programmatic services, including evidenced-based treatments (EBTs), between July 2008 and March 2011. Face-to-face qualitative interviews were conducted with over 250 staff by an independent psychologist along with on-site participant observations. This evaluation coincided with a national VA dissemination initiative to train providers in two EBTs for PTSD, Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). A substantial proportion of eligible (based on professional background) residential treatment providers received training in PE (37.4%) or CPT (64.2%), with 9.5% completing case consultation or becoming national trainers in each therapy respectively. In semi-structured interviews, providers reported that their clinical programs had adopted these EBTs at varying levels ranging from no adoption to every patient receiving the full protocol. Suggestions for improving the adoption of PE and CPT are noted, including distilling manualized treatments to essential common elements. PMID:23417875

Communication and quality of life outcomes from an interprofessional intensive, comprehensive, aphasia program (ICAP).

PubMed

Hoover, Elizabeth L; Caplan, David N; Waters, Gloria S; Carney, Anne

2017-03-01

Intensive Comprehensive Aphasia Programs (ICAPs) have developed in response to a growing need for treatments which produce changes in language function in people with aphasia, especially in the chronic phase of recovery. ICAPs are growing in number and several papers have presented preliminary results of their use, but little data exist about their efficacy or effectiveness. This paper explores the communication effects of an ICAP program that incorporated evidenced-based individual and group treatment in an interprofessional program. Twenty-seven individuals with chronic aphasia were provided with 30 h of interprofessional treatment a week for a four-week period in both individual and group formats. A delayed treatment, within-participant research protocol was used. Language measures were taken at two intervals pre- and two intervals post treatment. Functional, narrative, and quality of life measures were taken once pre and once post treatment. Significant change was observed on targeted language functions post treatment. Significant treatment effects were also observed on functional and quality of life measures as well as on all impairment-based language measures for the group. The results provide evidence of linguistic and quality of life change in individuals with chronic aphasia who were treated in an interprofessional ICAP.

What do Internet-based alcohol treatment websites offer?

PubMed

Toll, Benjamin A; Sobell, Linda C; D'Arienzo, Justin; Sobell, Mark B; Eickleberry-Goldsmith, Lori; Toll, Heather J

2003-12-01

The Internet was searched for websites that advertised or provided treatment or help for alcohol problems. Websites were evaluated for the types of treatment offered and whether the treatment had an empirical basis. While a wide range of treatments were advertised, very few websites offered online services. In addition, very few sites provided or advertised alcohol treatment programs that were empirically based. Recommendations for future Internet-based health care and treatment are offered.

Treating Internet Addiction with Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists

ERIC Educational Resources Information Center

van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike

2012-01-01

In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing…

The Treatment of Eating Disorder Clients in a Community-Based Partial Hospitalization Program.

ERIC Educational Resources Information Center

Levitt, John L.; Sansone, Randy A.

2003-01-01

Outlines a multi-faceted treatment approach to eating disorders within a partial hospital program that is affiliated with a community mental health hospital. Although empirical confirmation is not currently available, initial clinical impressions indicate that the program is facilitating the recovery of these difficult-to-treat individuals.…

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

PubMed

Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

2017-07-01

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

PubMed

Deardorff, Katrina V; Rubin Means, Arianna; Ásbjörnsdóttir, Kristjana H; Walson, Judd

2018-02-01

Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns. We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%), distributor incentives (n = 2, +25.3%), distribution along kinship networks (n = 1, +24.5%), intensified information, education, and communication activities (n = 8, +21.6%), fixed-point delivery (n = 1, +21.4%), door-to-door delivery (n = 1, +14.0%), integrated service distribution (n = 9, +12.7%), conversion from school- to community-based delivery (n = 3, +11.9%), and management by a non-governmental organization (n = 1, +5.8%). Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature

PubMed Central

2018-01-01

Background Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns. Methodology/ principal findings We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%), distributor incentives (n = 2, +25.3%), distribution along kinship networks (n = 1, +24.5%), intensified information, education, and communication activities (n = 8, +21.6%), fixed-point delivery (n = 1, +21.4%), door-to-door delivery (n = 1, +14.0%), integrated service distribution (n = 9, +12.7%), conversion from school- to community-based delivery (n = 3, +11.9%), and management by a non-governmental organization (n = 1, +5.8%). Conclusions/significance Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs. PMID:29420534

Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs

PubMed Central

Terry-McElrath, Yvonne M; Chriqui, Jamie F; McBride, Duane C

2011-01-01

Objective To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. Data Sources Secondary analysis of 2003–2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly available data. Study Design We used cross-sectional analyses, including state fixed effects, to assess relationships between SA treatment program Medicaid acceptance and (1) program-level factors, (2) county-level sociodemographics and treatment program density, and (3) state-level population characteristics, SA treatment-related factors, and Medicaid policy and usage. Data Extraction Methods State Medicaid policy data were compiled based on reviews of state Medicaid-related statutes/regulations and Medicaid plans. Other data were publicly available. Principal Findings Medicaid acceptance was significantly higher for programs: (a) that were publicly funded and in states with Medicaid policy allowing SA treatment coverage; (b) with accreditation/licensure and nonprofit/government ownership, as well as mental- and general-health focused programs; and (c) in counties with lower household income. Conclusions SA treatment program Medicaid acceptance related to program-, county, and state-level factors. The data suggest the importance of state policy and licensure/accreditation requirements in increasing SA program Medicaid access. PMID:21105870

Exercise programming and counseling preferences of breast cancer survivors during or after radiation therapy.

PubMed

Karvinen, Kristina H; Raedeke, Thomas D; Arastu, Hyder; Allison, Ron R

2011-09-01

To explore exercise programming and counseling preferences and exercise-related beliefs in breast cancer survivors during and after radiation therapy, and to compare differences based on treatment and insurance status. Cross-sectional survey. Ambulatory cancer center in a rural community in eastern North Carolina. 91 breast cancer survivors during or after radiation therapy. The researchers administered the questionnaire to participants. Exercise programming and counseling preferences and exercise beliefs moderated by treatment status (on-treatment, early, and late survivors) and insurance status (Medicaid, non-Medicaid). Chi-square analyses indicated that fewer Medicaid users were physically active and reported health benefits as an advantage of exercise compared to non-Medicaid users (p < 0.05). In addition, more Medicaid users preferred exercise programming at their cancer center compared to non-Medicaid users (p < 0.05). More on-treatment and early survivors listed health benefits as advantages to exercise, but fewer indicated weight control as an advantage compared to late survivors (p < 0.05). Early survivors were more likely than on-treatment survivors to indicate that accessible facilities would make exercising easier for them (p < 0.05). Medicaid users are less active, less likely to identify health benefits as an advantage for exercising, and more likely to prefer cancer center-based exercise programming compared to non-Medicaid users. In addition, on-treatment and early survivors are more likely to list health benefits and less likely to indicate weight control as advantages of exercising compared to late survivors. The low activity levels of Medicaid users may be best targeted by providing cancer center-based exercise programming. Exercise interventions may be most effective if tailored to the unique needs of treatment status.

The cost-effectiveness of rapid HIV testing in substance abuse treatment: results of a randomized trial.

PubMed

Schackman, Bruce R; Metsch, Lisa R; Colfax, Grant N; Leff, Jared A; Wong, Angela; Scott, Callie A; Feaster, Daniel J; Gooden, Lauren; Matheson, Tim; Haynes, Louise F; Paltiel, A David; Walensky, Rochelle P

2013-02-01

The President's National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk-reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost-Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Cost-effectiveness of Rapid HIV Testing in Substance Abuse Treatment: Results of a Randomized Trial*

PubMed Central

Schackman, Bruce R.; Metsch, Lisa R.; Colfax, Grant N.; Leff, Jared A.; Wong, Angela; Scott, Callie A.; Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Haynes, Louise F.; Paltiel, A. David; Walensky, Rochelle P.

2012-01-01

BACKGROUND The President’s National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. METHODS We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. RESULTS Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. CONCLUSIONS A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. PMID:22971593

Determinants of hospital-based substance abuse treatment programs.

PubMed

Bell, R

1994-01-01

Experts agree that treatment is the best solution to substance abuse problems. As the societywide problem of drug and alcohol dependence increases, so does the need for treatment programs. Research has shown that many hospitals have entered into the substance abuse treatment program business because a need for quality programs exists and because an alcohol and a substance abuse treatment product line has the potential for increasing sagging revenues. This article addresses the question of what types of hospitals are likely to engage in providing inpatient and/or outpatient treatment programs. The results indicate that organizational size (measured by the number of beds) is the best predictor of treatment service provision for both inpatient and outpatient settings, with larger hospitals being more likely to provide substance abuse programs. A need for additional chemical dependency treatment programs does not appear to be the primary motivating factor for hospitals developing this service. Rather, it seems hospitals provide these programs for other reasons--as part of providing a full array of services, as an average toward achieving organizational goals, as a means of sustaining a competitive advantage, or as a strategy for maintaining the same level of service as the competition.

"Where's My Choice?" An Examination of Veteran and Provider Experiences With Hepatitis C Treatment Through the Veteran Affairs Choice Program.

PubMed

Tsai, Jack; Yakovchenko, Vera; Jones, Natalie; Skolnik, Avy; Noska, Amanda; Gifford, Allen L; McInnes, D Keith

2017-07-01

The Department of Veterans Affairs (VA) is the country's largest provider for chronic hepatitis C virus (HCV) infection. The VA created the Choice Program, which allows eligible veterans to seek care from community providers, who are reimbursed by the VA. This study aimed to examine perspectives and experiences with the VA Choice Program among veteran patients and their HCV providers. Qualitative study based on semistructured interviews with veteran patients and VA providers. Interview transcripts were analyzed using rapid assessment procedures based in grounded theory. A total of 38 veterans and 10 VA providers involved in HCV treatment across 3 VA medical centers were interviewed. Veterans and providers were asked open-ended questions about their experiences with HCV treatment in the VA and through the Choice Program, including barriers and facilitators to treatment access and completion. Four themes were identified: (1) there were difficulties in enrollment, ongoing support, and billing with third-party administrators; (2) veterans experienced a lack of choice in location of treatment; (3) fragmented care led to coordination challenges between VA and community providers; and (4) VA providers expressed reservations about sending veterans to community providers. The Choice Program has the potential to increase veteran access to HCV treatment, but veterans and VA providers have described substantial problems in the initial years of the program. Enhancing care coordination, incorporating shared decision-making, and establishing a wide network of community providers may be important areas for further development in designing community-based specialist services for needy veterans.

The Coping Cat Program for Anxious Youth: The FEAR Plan Comes to Life

ERIC Educational Resources Information Center

Podell, Jennifer L.; Mychailyszyn, Matthew; Edmunds, Julie; Puleo, Connor M.; Kendall, Philip C.

2010-01-01

Manual-based treatments (therapist manuals, child workbooks) exist for the treatment of anxiety disorders in youth. The current article describes a cognitive-behavioral treatment program, "Coping Cat", for childhood anxiety, with an emphasis on its flexible application and implementation as well as video components to demonstrate aspects of the…

Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity

ERIC Educational Resources Information Center

Kitzmann, Katherine M.; Dalton, William T., III; Buscemi, Joanna

2008-01-01

Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for…

Multidisciplinary Treatment of Eating Disorders - Part 2: Primary Goals and Content of Treatment

ERIC Educational Resources Information Center

Stewart, Tiffany M.; Williamson, Donald A.

2004-01-01

This article describes the program content of a multidisciplinary, hospital-based program for severe eating disorders. Common goals for treatment of patients with eating disorders are discussed. Details about the specific therapeutic strategies used in individual and group therapy are provided. Also, information about dietary counseling and…

In Support of a National Treatment Evaluation Study.

PubMed

Brown, Barry S; Flynn, Patrick M

2015-01-01

Argument is made for the importance of conducting a national treatment evaluation to permit understanding of the nature and effectiveness of typical treatment programming. Only through such study can we hope to learn areas of success and failure of normative programming relative to population characteristics and treatment strategies, and the extent to which research-based initiatives have been adopted by the field. That information is central to efforts to draw up a research agenda appropriate to the needs of clients and the staffs responsible for their treatment, and to clarify and respond to gaps in the application of potentially useful treatment components. In spite of such need, our understanding of typical treatment programming and of its effectiveness is based on data collected from a treatment cohort of 20 years ago, although patterns of drug use, characteristics of clients, and the treatment components available have all undergone substantial change. The responsibility taken to provide such information to the field, once seen as a central task of research, needs to be reasserted to strengthen and support our treatment efforts.

Examining Treatment Climate Across Prison-Based Substance Abuse Treatment Groups.

PubMed

Kelly, Christopher E; Welsh, Wayne N

2016-06-06

With notable exceptions, few studies have looked critically at the role and effects of factors other than individual or programmatic differences that contribute to the climate within substance abuse treatment programs. De Leon's work on the therapeutic community, however, indicates that factors beyond the individual and program can contribute to the overall functioning of similarly situated communities. In this study, we introduce and examine the concept of the "treatment group," the level of aggregation between the individual who participates in treatment and the organization that provides it. The treatment group refers to the social context and dynamics that operate among treatment participants, and we sought to study differences in treatment climate across 12 prison-based treatment groups within a single prison. Using data from 604 participants who were assigned at random to one of the 12 groups, we analyzed differences on seven treatment climate indicators from one month and six months into the program across the treatment groups. No differences were found among the treatment groups at after one month; however, after 6 months, significant differences emerged across the groups on three treatment climate variables: program structure, counselor rapport, and counselor competence. This study is among the first of its kind to conceptualize and examine treatment climate across otherwise similar groups and find that differences emerge on several indicators of climate. As such, we argue that the treatment group may be important to consider in both the delivery and evaluation of substance abuse treatment.

The selective treatment of clinical mastitis based on on-farm culture results: I. Effects on antibiotic use, milk withholding time, and short-term clinical and bacteriological outcomes.

PubMed

Lago, A; Godden, S M; Bey, R; Ruegg, P L; Leslie, K

2011-09-01

The objective of this multi-state, multi-herd clinical trial was to evaluate the efficacy of using an on-farm culture system to guide strategic treatment decisions in cows with clinical mastitis. The study was conducted in 8 commercial dairy farms ranging in size from 144 to 1,795 cows from Minnesota, Wisconsin, and Ontario, Canada. A total of 422 cows affected with mild or moderate clinical mastitis in 449 quarters were randomly assigned to either (1) a positive-control treatment program or (2) an on-farm, culture-based treatment program. Quarter cases assigned to the positive-control group received immediate on-label intramammary treatment with cephapirin sodium. Quarters assigned to the culture-based treatment program were cultured on-farm and treated with cephapirin sodium after 18 to 24h of incubation if they had gram-positive growth or a mixed infection. Quarters with gram-negative or no growth did not receive intramammary therapy. The proportion of quarter cases assigned to positive-control and culture-based treatments that received intramammary antibiotic therapy because of study assignment was 100 and 44%, respectively; the proportion of cases that received secondary antibiotic therapy was 36 and 19%, respectively; and the proportion of cases that received intramammary antibiotic therapy because of study assignment or secondary therapy was 100 and 51%, respectively. A tendency existed for a decrease in the number of days in which milk was discarded from cows assigned to the culture-based treatment program versus cows assigned to the positive-control group (5.9 vs. 5.2 d). No statistically significant differences existed between cases assigned to the positive-control and cases assigned to the culture-based treatment program in days to clinical cure (2.7 vs. 3.2 d), bacteriological cure risk within 21 d of enrollment (71 vs. 60%), new intramammary infection risk within 21 d of enrollment (50 vs. 50%), and treatment failure risk (presence of infection, secondary treatment, clinical mastitis recurrence, or removal from herd within 21 d after enrollment; 81 vs. 78%). In summary, the use of an on-farm culture system to guide the strategic treatment of clinical mastitis reduced intramammary antibiotic use by half and tended to decrease milk withholding time by 1 d, without significant differences in days to clinical cure, bacteriological cure risk, new intramammary infection risk, and treatment failure risk within 21 d after the clinical mastitis event. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Patient engagement and attrition in pediatric obesity clinics and programs: results and recommendations.

PubMed

Hampl, Sarah; Paves, Heather; Laubscher, Katie; Eneli, Ihuoma

2011-09-01

Pediatric tertiary care institutions are well positioned to provide multidisciplinary, intensive interventions for pediatric obesity known as stage 3 treatment. One contributor to the difficulty in administering this treatment is the high rate of patient attrition. Little is known about the practices used by pediatric weight-management clinics and group-based programs to minimize attrition. Hospital members and nonmembers of FOCUS on a Fitter Future were surveyed on the methods used to engage and retain obese children in their clinics and programs. Shortly thereafter, a benchmarking activity that centered on rates of patient nonattendance at initial and follow-up clinic visits was initiated among FOCUS-group-participating hospitals. Clinic- and group-based program results were contrasted. Staff from group-based programs reported that the majority of patients did not complete even 50% of program follow-up visits. Multiple patient/family- and clinic/program-level barriers to retention were identified. Attention to successful techniques should be paid during planning for new programs and improvement of established ones.

Evaluation of 6 remote First Nations community-based buprenorphine programs in northwestern Ontario

PubMed Central

Mamakwa, Solomon; Kahan, Meldon; Kanate, Dinah; Kirlew, Mike; Folk, David; Cirone, Sharon; Rea, Sara; Parsons, Pierre; Edwards, Craig; Gordon, Janet; Main, Fiona; Kelly, Len

2017-01-01

Abstract Objective To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. Design Retrospective cohort study. Setting Six First Nations communities in northwestern Ontario. Participants A total of 526 First Nations participants in opioid-dependence treatment programs. Intervention Buprenorphine-naloxone substitution therapy and First Nations healing programming. Main outcome measures Retention rates and urine drug screening (UDS) results. Results Treatment retention rates at 6, 12, and 18 months were 84%, 78%, and 72%, respectively. We estimate that the rate at 24 months will also be more than 70%. The UDS programming varied and was implemented in only 1 community. Initially urine testing was voluntary and it then became mandatory. Screening with either method found the proportion of urine samples with negative results for illicit opioids ranged between 84% and 95%. Conclusion The program’s treatment retention rates and negative UDS results were higher than those reported for most methadone and buprenorphine-naloxone programs, despite a patient population where severe posttraumatic stress disorder is endemic, and despite the programs’ lack of resources and addiction expertise. Community-based programs like these overcome the initial challenge of cultural competence. First Nations communities in other provinces should establish their own buprenorphinenaloxone programs, using local primary care physicians as prescribers. Sustainable core funding is needed for programming, long-term aftercare, and trauma recovery for such initiatives. PMID:28209683

Professional confidence and job satisfaction: an examination of counselors' perceptions in faith-based and non-faith-based drug treatment programs.

PubMed

Chu, Doris C; Sung, Hung-En

2014-08-01

Understanding substance abuse counselors' professional confidence and job satisfaction is important since such confidence and satisfaction can affect the way counselors go about their jobs. Analyzing data derived from a random sample of 110 counselors from faith-based and non-faith-based treatment programs, this study examines counselors' professional confidence and job satisfaction in both faith-based and non-faith-based programs. The multivariate analyses indicate years of experience and being a certified counselor were the only significant predictors of professional confidence. There was no significant difference in perceived job satisfaction and confidence between counselors in faith-based and non-faith-based programs. A majority of counselors in both groups expressed a high level of satisfaction with their job. Job experience in drug counseling and prior experience as an abuser were perceived by counselors as important components to facilitate counseling skills. Policy implications are discussed. © The Author(s) 2013.

Insurer and employer views on pediatric obesity treatment: a qualitative study.

PubMed

Hampl, S E; Davis, A M; Sampilo, M L; Stephens, K L; Dean, K

2013-04-01

The effectiveness of group-based comprehensive, multidisciplinary (stage 3) pediatric weight management programs is backed by a growing body of literature, yet insurance coverage of these programs is scarce to nonexistent, limiting their reach and long-term survival. The objective of this study was to better understand the perspectives of insurers and large employers on the issue of group-based treatment coverage. The authors performed a qualitative study utilizing structured interviews with these stakeholders, following accepted techniques. Six major themes emerged: cost, program effectiveness, corporate social responsibility, secondary parental (employee) benefits, coverage options and new benefit determination. Future efforts to secure payment for group-based pediatric weight management programs should address these key themes. Copyright © 2012 The Obesity Society.

Systematic review of community-based, school-based, and combined delivery modes for reaching school-aged children in mass drug administration programs for schistosomiasis

PubMed Central

Burnim, Michael; Ivy, Julianne A.

2017-01-01

Background The mainstay of current schistosomiasis control programs is mass preventive chemotherapy of school-aged children with praziquantel. This treatment is delivered through school-based, community-based, or combined school- and community-based systems. Attaining very high coverage rates for children is essential in mass schistosomiasis treatment programs, as is ensuring that there are no persistently untreated subpopulations, a potential challenge for school-based programs in areas with low school enrollment. This review sought to compare the different treatment delivery methods based both on their coverage of school-aged children overall and on their coverage specifically of non-enrolled children. In addition, qualitative community or programmatic factors associated with high or low coverage rates were identified, with suggestions for overall coverage improvement. Methodology/Principal findings This review was registered prospectively with PROSPERO (CRD 42015017656). Five hundred forty-nine publication of potential relevance were identified through database searches, reference lists, and personal communications. Eligible studies included those published before October 2015, written in English or French, containing quantitative or qualitative data about coverage rates for MDA of school-aged children with praziquantel. Among the 22 selected studies, combined community- and school-based programs achieved the highest median coverage rates (89%), followed by community-based programs (72%). School-based programs had both the lowest median coverage of children overall (49%) and the lowest coverage of the non-enrolled subpopulation of children. Qualitatively, major factors affecting program success included fear of side effects, inadequate education about schistosomiasis, lack of incentives for drug distributors, and inequitable distribution to minority groups. Conclusions/Significance This review provides an evidence-based framework for the development of future schistosomiasis control programs. Based on our results, a combined community and school-based delivery system should maximize coverage for both in- and out-of-school children, especially when combined with interventions such as snacks for treated children, educational campaigns, incentives for drug distributors, and active inclusion of marginalized groups. Trial registration ClinicalTrials.gov CRD42015017656 PMID:29077723

Acceptance and relationship context: a model of substance use disorder treatment outcome.

PubMed

Gifford, Elizabeth V; Ritsher, Jennifer B; McKellar, John D; Moos, Rudolf H

2006-08-01

This study presented and tested a model of behavior change in long-term substance use disorder recovery, the acceptance and relationship context (ARC) model. The model specifies that acceptance-based behavior and constructive social relationships lead to recovery, and that treatment programs with supportive, involved relationships facilitate the development of these factors. This study used a prospective longitudinal naturalistic design and controlled for baseline levels of study variables. The model was tested on a sample of 2549 patients in 15 residential substance use disorder treatment programs. Acceptance-based responding (ABR), social relationship quality (SRQ), treatment program alliance (TPA) and substance use-related impairment were assessed using interviews and self-report questionnaires. TPA predicted ABR and SRQ and, in turn, ABR predicted better 2-year and 5-year treatment outcomes. The baseline-controlled model accounted for 41% of the variance in outcome at 2-year follow-up and 28% of the variance in outcome at 5-year follow-up. CONCLUSIONS Patients from treatment programs with an affiliative relationship network are more likely to respond adaptively to internal states associated previously with substance use, develop constructive social relationships and achieve long-term treatment benefits.

Improving Body Satisfaction in Preadolescent Girls and Boys: Short-Term Effects of a School-Based Program

ERIC Educational Resources Information Center

Hinz, Arnold

2017-01-01

Introduction: The aim of this study was to evaluate the school-based "My Body and I" program which was designed to help girls and boys to cope better with inevitable pubertal body changes. Method: Using a pre-post treatment-control design with 25 treatment and 17 control classes from schools in Germany and France (484 boys, 485 girls;…

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Three-Month Follow-Up Investigation

ERIC Educational Resources Information Center

Springer, Craig; Misurell, Justin R.; Hiller, Atara

2012-01-01

This study examined the efficacy of a game-based cognitive-behavioral group therapy program for addressing problems typically found among elementary school-aged victims of child sexual abuse immediately after treatment and at three months following treatment. It was hypothesized that positive gains would be observed among the following domains:…

Design of a randomized controlled trial of Internet-based cognitive behavioral therapy for treatment-induced menopausal symptoms in breast cancer survivors.

PubMed

Atema, Vera; van Leeuwen, Marieke; Oldenburg, Hester S A; Retèl, Valesca; van Beurden, Marc; Hunter, Myra S; Aaronson, Neil K

2016-11-25

Menopausal symptoms are common and may be particularly severe in younger women who undergo treatment-induced menopause. Medications to reduce menopausal symptoms are either contra-indicated or have bothersome side effects. Previous studies have demonstrated that face-to-face cognitive behavioral therapy (CBT) is effective in alleviating menopausal symptoms in women with breast cancer. However, compliance with face-to-face CBT programs can be problematic. A promising approach is to use the Internet to make this form of CBT more accessible and feasible for patients. This study is evaluating the efficacy and cost-effectiveness of an Internet-based CBT program, with or without therapist guidance, in alleviating or reducing the severity of menopausal symptoms. In a multicenter, randomized controlled trial we are evaluating the efficacy of two Internet-based CBT programs in alleviating or reducing the impact of menopausal symptoms, and particularly hot flushes and night sweats, in breast cancer survivors who have experienced a treatment-induced menopause. Secondary outcomes include sexual functioning, sleep quality, hot flush frequency, psychological distress, health-related quality of life and cost-effectiveness. We will recruit 248 women who will be randomized to either a therapist guided or a self-management version of the 6-week Internet-based CBT program, or to a usual care, waiting list control group. Self-administered questionnaires are completed at baseline (T0), and at 10 weeks (T1) and 24 weeks (T2) post-randomization. Internet-based CBT is a potentially useful treatment for reducing menopausal symptoms in breast cancer survivors. This study will provide evidence on the efficacy and cost-effectiveness of such an Internet-based CBT program, with or without therapist support. If demonstrated to be efficacious and cost-effective, the availability of such structured supportive intervention programs will be a welcome addition to standard medical treatment offered to cancer patients with treatment-induced menopause. The study is retrospectively registered at ClinicalTrials.gov on January 26th 2016 ( NCT02672189 ).

Public School and Community Mental Health Interagency Cooperation for Treatment of the Child with Special Educational Needs.

ERIC Educational Resources Information Center

Barr, William; DelFava, Christine

The paper describes combined public education and community mental health in a preschool educational day treatment program for seriously emotionally disturbed children. The Developmental Therapy model on which the Tacoma, Washington, program is based is described as using five normal developmental stages to facilitate treatment which stresses the…

The Addiction Treatment Unit: a dual diagnosis program at the California Medical Facility--a descriptive report.

PubMed

Katz, R I

1999-01-01

The Addiction Treatment Unit is a dual diagnosis program which exists in the California Department of Corrections. It is housed in the California Medical Facility in Vacaville, California. Program residents must meet the diagnostic criteria of having a major mental disorder substantiated by a DSM-IV Axis I diagnosis and also meet the criteria for a substance abuse/dependence disorder. All patients are housed in one wing of the facility, which is based on the format of a modified therapeutic community and focuses on the concept of recovery. A multidisciplinary treatment team comprised of a psychiatrist, a psychologist, a social worker and a psychiatric technician delivers clinical interventions, including individual and group therapy as well as medication management. The focus of the drug treatment aspect is an Alcoholics Anonymous/Narcotics Anonymous approach based on 12-Step philosophy. Research involving other therapeutic communities running in prisons is discussed as is the aspect of dual diagnosis programs. Logistical and environmental constraints which pose challenges to running the Addiction Treatment Unit are considered. A summary section reflects on aspects which have been successful, what has not worked or has been changed and upcoming program revisions.

Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.

PubMed

Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci

2016-04-01

Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review

PubMed Central

Laufer, Yocheved; Dar, Gali; Kodesh, Einat

2014-01-01

Background Exercise programs that challenge an individual’s balance have been shown to reduce the risk of falls among older adults. Virtual reality computer-based technology that provides the user with opportunities to interact with virtual objects is used extensively for entertainment. There is a growing interest in the potential of virtual reality-based interventions for balance training in older adults. This work comprises a systematic review of the literature to determine the effects of intervention programs utilizing the Nintendo Wii console on balance control and functional performance in independently functioning older adults. Methods Studies were obtained by searching the following databases: PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus, and Google Scholar, followed by a hand search of bibliographic references of the included studies. Included were randomized controlled trials written in English in which Nintendo Wii Fit was used to enhance standing balance performance in older adults and compared with an alternative exercise treatment, placebo, or no treatment. Results Seven relevant studies were retrieved. The four studies examining the effect of Wii-based exercise compared with no exercise reported positive effects on at least one outcome measure related to balance performance in older adults. Studies comparing Wii-based training with alternative exercise programs generally indicated that the balance improvements achieved by Wii-based training are comparable with those achieved by other exercise programs. Conclusion The review indicates that Wii-based exercise programs may serve as an alternative to more conventional forms of exercise aimed at improving balance control. However, due to the great variability between studies in terms of the intervention protocols and outcome measures, as well as methodological limitations, definitive recommendations as to optimal treatment protocols and the potential of such an intervention as a safe and effective home-based treatment cannot be made at this point. PMID:25364238

Evidence-Based Practices, Attitudes, and Beliefs in Substance Abuse Treatment Programs Serving American Indians and Alaska Natives: A Qualitative Study

PubMed Central

Larios, Sandra E.; Wright, Serena; Jernstrom, Amanda; Lebron, Dorothy; Sorensen, James L.

2012-01-01

Substance abuse disproportionately impacts American Indian/Alaska Native (AI/AN) communities in the United States. For the increasing numbers of AI/AN individuals who enter and receive treatment for their alcohol or other drug problem it is imperative that the service they receive be effective. This study used qualitative methodology to examine attitudes toward evidence-based practices, also known as evidence-based treatments (EBTs) in minority-serving substance abuse treatment programs in the San Francisco Bay area. Twenty-two interviews were conducted in the study, of which seven were with program directors and substance abuse counselors at two urban AI/AN focused sites. These clinics were more likely than other minority-focused programs to have experience with research and knowledge about adapting EBTs. Only in the AI/AN specific sites did an issue arise concerning visibility, that is, undercounting AI/AN people in national and state databases. Similar to other minority-focused programs, these clinics described mistrust, fear of exploitation from the research community, and negative attitudes towards EBTs. The underutilization of EBTs in substance abuse programs is prevalent and detrimental to the health of patients who would benefit from their use. Future research should explore how to use this research involvement and experience with adaptation to increase the adoption of EBTs in AI/AN serving clinics. PMID:22400469

Installation Restoration Program. Phase I. Records Search. Seymour Johnson Air Force Base, North Carolina.

DTIC Science & Technology

1982-07-01

and waste treatment pilot plants . Developed odor control program which suc- cessfully reduced odor emissions and represented Union Carbide at a public...the runway where oil and grease has been detected as well as the discharge from the City of Goldsboro waste- water treatment plant which occurs within...There are no known threatened or en- dangered plant species on base. The only endangered animal species which may potentially inhabit the base is the Red

Culturally Adapted Cognitive Behavioral Guided Self-Help for Binge Eating: A Feasibility Study with Mexican Americans

PubMed Central

Cachelin, Fary M.; Shea, Munyi; Phimphasone, Phoutdavone; Wilson, G. Terence; Thompson, Douglas R.; Striegel, Ruth H.

2014-01-01

Objective was to test feasibility and preliminary efficacy of a culturally adapted cognitive-behavioral self-help program to treat binge eating and related problems in Mexican Americans. Participants were 31 women recruited from the Los Angeles area and diagnosed with binge eating disorder, recurrent binge eating or bulimia nervosa. Participants completed a culturally adapted version of a CBT-based self-help program with 8 guidance sessions over a 3-month period. Treatment efficacy was evaluated in terms of binge eating, psychological functioning, and weight loss. Intent-to-treat analyses revealed 35.5% abstinence from binge eating at post-treatment and 38.7% diagnostic remission. Results indicated significant pre-treatment to post-treatment improvement on distress level, BMI, eating disorder psychopathology, and self-esteem. Satisfaction with the program was high. Findings demonstrate that the program is acceptable, feasible, and efficacious in reducing binge eating and associated symptoms for Mexican American women. Study provides “proof of concept” for implementation of culturally adapted forms of evidence-based programs. PMID:25045955

Day treatment versus enhanced standard methadone services for opioid-dependent patients: a comparison of clinical efficacy and cost.

PubMed

Avants, S K; Margolin, A; Sindelar, J L; Rounsaville, B J; Schottenfeld, R; Stine, S; Cooney, N L; Rosenheck, R A; Li, S H; Kosten, T R

1999-01-01

This study examined the differential efficacy and relative costs of two intensities of adjunctive psychosocial services--a day treatment program and enhanced standard care--for the treatment of opioid-dependent patients maintained on methadone hydrochloride. A 12-week randomized clinical trial with 6-month follow-up was conducted in a community-based methadone maintenance program. Of the 308 patients who met inclusion criteria, 291 began treatment (day treatment program: N=145; enhanced standard care: N=146), and 237 completed treatment (82% of those assigned to the day treatment program and 81% of those receiving enhanced standard care). Two hundred twenty of the patients participated in the 6-month follow-up (75% of those in the day treatment program and 73% of those in enhanced standard care provided a follow-up urine sample for screening). Both interventions were 12 weeks in duration, manual-guided, and provided by master's-level clinicians. The day treatment was an intensive, 25-hour-per-week program. The enhanced standard care was standard methadone maintenance plus a weekly skills training group and referral to on- and off-site services. Outcome measures included twice weekly urine toxicology screens, severity of addiction-related problems, prevalence of HIV risk behaviors, and program costs. Although the cost of the day treatment program was significantly higher, there was no significant difference in the two groups' use of either opiates or cocaine. Over the course of treatment, drug use, drug-related problems, and HIV risk behaviors decreased significantly for patients assigned to both treatment intensities. Improvements were maintained at follow-up. Providing an intensive day treatment program to unemployed, inner-city methadone patients was not cost-effective relative to a program of enhanced methadone maintenance services, which produced comparable outcomes at less than half the cost.

Perceptions of a Prison-Based Substance Abuse Treatment Program among Some Staff and Participants

ERIC Educational Resources Information Center

Goodrum, Sarah; Staton, Michele; Leukefeld, Carl; Webster, J. Matthew; Purvis, Richard T.

2003-01-01

Almost 90% of all State and Federal prisons in the U.S. offer some form of substance abuse counseling, and one in eight prisoners have participated in a substance abuse treatment program while incarcerated. Evidence indicates that these programs can be successful in stopping prisoners' substance abuse. While some data are available about the…

An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

PubMed

Fitch, Dale

2014-01-01

This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

FACTORS AFFECTING INFECTION OR REINFECTION WITH SCHISTOSOMA HAEMATOBIUM IN COASTAL KENYA: SURVIVAL ANALYSIS DURING A NINE-YEAR, SCHOOL-BASED TREATMENT PROGRAM

PubMed Central

SATAYATHUM, SUDTIDA A.; MUCHIRI, ERIC M.; OUMA, JOHN H.; WHALEN, CHRISTOPHER C.; KING, CHARLES H.

2010-01-01

Urinary schistosomiasis remains a significant burden for Africa and the Middle East. Success of regional control strategies will depend, in part, on what influence local environmental and behavioral factors have on individual risk for primary infection and/or reinfection. Based on experience in a multi-year (1984–1992), school-based Schistosoma haematobium control program in Coast Province, Kenya, we examined risk for infection outcomes as a function of age, sex, pretreatment morbidity, treatment regimen, water contact, and residence location, with the use of life tables and Cox proportional-hazards analysis. After adjustment, location of residence, age less than 12 years, pretreatment hematuria, and incomplete treatment were the significant independent predictors of infection, whereas sex and frequency of water contact were not. We conclude that local physical features and age-related factors play a predominant role in S. haematobium transmission in this setting. In large population-based control programs, treatment allocation strategies may need to be tailored to local conditions on a village-by-village basis. PMID:16837713

A decade of experience promoting the clinical treatment of tobacco dependence in Wisconsin.

PubMed

Redmond, Lezli A; Adsit, Robert; Kobinsky, Kathleen H; Theobald, Wendy; Fiore, Michael C

2010-04-01

The University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) is the designated lead agency at the University of Wisconsin-Madison charged with the responsibility of reducing the harms from tobacco use in Wisconsin and beyond. In 2000, the UW-CTRI, with funding from the state of Wisconsin, launched a population-wide effort--the Wisconsin Cessation Outreach Program (Program)--to increase the availability and use of evidence-based clinical treatments for tobacco dependence. This paper describes the Program's strategies, outcomes, and impact on the clinical treatment of tobacco dependence in Wisconsin. The Program was designed to change the standard of health care in Wisconsin, so that primary care professionals, and the health systems in which they work, universally identified and intervened with tobacco users. Five primary strategies were used to accomplish its goal: (1) deliver clinic-based and Web-based training and technical assistance for clinicians, including free continuing medical education (CME); (2) provide technical assistance to accomplish health systems' change to support the routine provision of tobacco-dependence treatment; (3) include evidence-based cessation treatment as a covered insurance benefit and reduce other barriers to cessation treatment such as co-pays; (4) provide telephonic tobacco cessation quit line services to all state residents and integrate it with routine medical services; and (5) reduce tobacco-related disparities by increasing access to and use of evidence-based treatment by priority populations. In the 10 years since the Program was initiated, progress has been achieved in a number of tobacco use parameters in Wisconsin, including higher rates of Wisconsin smokers making a quit attempt; increased insurance coverage for cessation counseling and medications; higher rates of discussion of cessation treatment options by clinicians; and integration of the Wisconsin Tobacco Quit Line (WTQL) into routine primary care, with almost 100,000 Wisconsin smokers using the WTQL. Nearly half of all WTQL callers were uninsured or Medicaid enrollees. Additionally, smoking rates in Wisconsin have fallen by almost 20% during this period, from about 24% of all adults in 2000 to <20% today.

HIV/AIDS Services in Private Substance Abuse Treatment Programs

PubMed Central

Abraham, Amanda J.; O’Brien, Lauren A.; Bride, Brian E.; Roman, Paul M.

2010-01-01

Background HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. Methods This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and clinical directors of treatment programs in 2007–2008. Results Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. Conclusions Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes. PMID:21145179

Childhood Obesity: Concept, Feasibility, and Interim Results of a Local Group-Based, Long-Term Treatment Program

ERIC Educational Resources Information Center

Weigel, Corina; Kokocinski, Kathrin; Lederer, Peter; Dotsch, Jorg; Rascher, Wolfgang; Knerr, Ina

2008-01-01

Objective: The authors performed a group-based program for obese children and adolescents in Bavaria, Germany to enable them to establish a health-oriented lifestyle and to reduce overweight. The authors compared this program with a control approach based on the patients' own initiative. Design: This is a controlled clinical trial. Setting: A…

COMPUTER PROGRAM FOR CALCULATING THE COST OF DRINKING WATER TREATMENT SYSTEMS

EPA Science Inventory

This FORTRAN computer program calculates the construction and operation/maintenance costs for 45 centralized unit treatment processes for water supply. The calculated costs are based on various design parameters and raw water quality. These cost data are applicable to small size ...

Language-Specific Attention Treatment for Aphasia: Description and Preliminary Findings.

PubMed

Peach, Richard K; Nathan, Meghana R; Beck, Katherine M

2017-02-01

The need for a specific, language-based treatment approach to aphasic impairments associated with attentional deficits is well documented. We describe language-specific attention treatment, a specific skill-based approach for aphasia that exploits increasingly complex linguistic tasks that focus attention. The program consists of eight tasks, some with multiple phases, to assess and treat lexical and sentence processing. Validation results demonstrate that these tasks load on six attentional domains: (1) executive attention; (2) attentional switching; (3) visual selective attention/processing speed; (4) sustained attention; (5) auditory-verbal working memory; and (6) auditory processing speed. The program demonstrates excellent inter- and intrarater reliability and adequate test-retest reliability. Two of four people with aphasia exposed to this program demonstrated good language recovery whereas three of the four participants showed improvements in auditory-verbal working memory. The results provide support for this treatment program in patients with aphasia having no greater than a moderate degree of attentional impairment. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

An economic evaluation: Simulation of the cost-effectiveness and cost-utility of universal prevention strategies against osteoporosis-related fractures

PubMed Central

Nshimyumukiza, Léon; Durand, Audrey; Gagnon, Mathieu; Douville, Xavier; Morin, Suzanne; Lindsay, Carmen; Duplantie, Julie; Gagné, Christian; Jean, Sonia; Giguère, Yves; Dodin, Sylvie; Rousseau, François; Reinharz, Daniel

2013-01-01

A patient-level Markov decision model was used to simulate a virtual cohort of 500,000 women 40 years old and over, in relation to osteoporosis-related hip, clinical vertebral, and wrist bone fractures events. Sixteen different screening options of three main scenario groups were compared: (1) the status quo (no specific national prevention program); (2) a universal primary prevention program; and (3) a universal screening and treatment program based on the 10-year absolute risk of fracture. The outcomes measured were total directs costs from the perspective of the public health care system, number of fractures, and quality-adjusted life-years (QALYs). Results show that an option consisting of a program promoting physical activity and treatment if a fracture occurs is the most cost-effective (CE) (cost/fracture averted) alternative and also the only cost saving one, especially for women 40 to 64 years old. In women who are 65 years and over, bone mineral density (BMD)-based screening and treatment based on the 10-year absolute fracture risk calculated using a Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is the best next alternative. In terms of cost-utility (CU), results were similar. For women less than 65 years old, a program promoting physical activity emerged as cost-saving but BMD-based screening with pharmacological treatment also emerged as an interesting alternative. In conclusion, a program promoting physical activity is the most CE and CU option for women 40 to 64 years old. BMD screening and pharmacological treatment might be considered a reasonable alternative for women 65 years old and over because at a healthcare capacity of $50,000 Canadian dollars ($CAD) for each additional fracture averted or for one QALY gained its probabilities of cost-effectiveness compared to the program promoting physical activity are 63% and 75%, respectively, which could be considered socially acceptable. Consideration of the indirect costs could change these findings. PMID:22991210

Manual for Drug Abuse Treatment Program Self-Evaluation. Supplement II: CODAP Tables.

ERIC Educational Resources Information Center

Guess, L. Lynn; Tuchfeld, Barry S.

This is the second of two supplements to a manual on the self-evaluation of drug abuse treatment programs. Data based on treatment outcome information that agencies and clinics routinely collect or have available in the files of individual clients are presented. While it is possible to use this volume without referring to the discussion of…

The Relative Effectiveness of Women-Only and Mixed-Gender Treatment for Substance-Abusing Women

PubMed Central

Prendergast, Michael L.; Messina, Nena P.; Hall, Elizabeth A.; Warda, Umme S.

2011-01-01

Following research indicating that the treatment needs of women are different from those of men, researchers and clinicians have argued that drug treatment programs for women should be designed to take their needs into account. Such programs tend to admit only women and incorporate philosophies and activities that are based on a social, peer-based model that is responsive to their needs. To assess the relative effectiveness of women-only (WO) outpatient programs compared to mixed-gender (MG) outpatient programs, 291 study volunteers were recruited (152 WO, 139 MG), and a 1-year follow-up was completed with 259 women (135 WO, 124 MG). Using bivariate, logistic regression, and generalized estimating equation analysis, the following four outcomes were examined: drug and alcohol use, criminal activity, arrests, and employment. In both groups, women showed improvement in the four outcome measures. Comparison of the groups on outcomes yielded mixed results; women who participated in WO treatment reported significantly less substance use and criminal activity than women in MG treatment, but there were no differences in arrest or employment status at follow up compared with those in MG treatment. PMID:21315540

Nurse turnover in substance abuse treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network.

PubMed

Knudsen, Hannah K; Abraham, Amanda J; Roman, Paul M; Studts, Jamie L

2011-04-01

Voluntary nurse turnover, which is costly and disrupts patient care, has not been studied as an organizational phenomenon within substance abuse treatment organizations. In this exploratory study, we examined the frequency and correlates of nurse turnover within treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network. During face-to-face interviews conducted in 2005-2006, 215 program administrators reported the number of nurses currently employed. Leaders of programs with nursing staff then described the number of nurses who had voluntarily quit in the past year, the degree to which filling vacant nursing positions was difficult, and the average number of days to fill a vacant position. About two thirds of these programs had at least one nurse on staff. In programs with nurses, the average rate of voluntary turnover was 15.0%. Turnover was significantly lower in hospital-based programs and programs offering adolescent treatment but higher in facilities offering residential treatment. Most of the administrators indicated that filling vacant nurse positions was difficult and took more than 2 months to complete. These findings suggest that nurse turnover is a significant issue facing many substance abuse treatment facilities. Efforts to improve retention of the addiction treatment workforce should be expanded to include nursing professionals. Copyright © 2011 Elsevier Inc. All rights reserved.

Effectiveness of Community-Based Early Intervention Based on Pivotal Response Treatment

ERIC Educational Resources Information Center

Smith, Isabel M.; Flanagan, Helen E.; Garon, Nancy; Bryson, Susan E.

2015-01-01

Preschoolers (n = 118) with autism spectrum disorder (ASD) participated in this prospective effectiveness study of an early intervention program. Treatment entailed parent training and therapist-implemented components, incorporating Pivotal Response Treatment and Positive Behaviour Support. Standardized ability and behavioural measures were…

Acceptability Study of "Ascenso": An Online Program for Monitoring and Supporting Patients with Depression in Chile.

PubMed

Espinosa, H Daniel; Carrasco, Álvaro; Moessner, Markus; Cáceres, Cristian; Gloger, Sergio; Rojas, Graciela; Perez, J Carola; Vanegas, Jorge; Bauer, Stephanie; Krause, Mariane

2016-07-01

Major depression is a highly prevalent and severe mental disease. Despite the effective treatment options available, the risk of relapse is high. Interventions based on information and communication technologies generate innovative opportunities to provide support to patients after they completed treatment for depression. This acceptability study evaluated the Internet-based program Apoyo, Seguimiento y Cuidado de Enfermedades a partir de Sistemas Operativos (ASCENSO) in terms of its feasibility and acceptability in a sample of 35 patients in Chile. The study reveals high rates of acceptance and satisfaction among patients who actively used the program. As obstacles, patients mentioned technical problems, a lack of contact with other participants, and an insufficient connection between the program and the health service professionals. ASCENSO appears to be a promising complement to regular care for depression. Following improvements of the program based on participants' feedback, future research should evaluate its efficacy and cost-effectiveness.

The Integration of a Family Systems Approach for Understanding Youth Obesity, Physical Activity, and Dietary Programs

PubMed Central

Wilson, Dawn K.; St. George, Sara M.; Lawman, Hannah; Segal, Michelle; Fairchild, Amanda

2012-01-01

Rates of overweight in youth have reached epidemic proportions and are associated with adverse health outcomes. Family-based programs have been widely used to treat overweight in youth. However, few programs incorporate a theoretical framework for studying a family systems approach in relation to youth health behavior change. Therefore, this review provides a family systems theory framework for evaluating family-level variables in weight loss, physical activity, and dietary approaches in youth. Studies were reviewed and effect sizes were calculated for interventions that manipulated the family system, including components that targeted parenting styles, parenting skills, or family functioning, or which had novel approaches for including the family. Twenty-one weight loss interventions were identified, and 25 interventions related to physical activity and/or diet were identified. Overall, family-based treatment programs that incorporated training for authoritative parenting styles, parenting skills, or child management, and family functioning had positive effects on youth weight loss. Programs to improve physical activity and dietary behaviors that targeted the family system also demonstrated improvements in youth health behaviors; however, direct effects of parent-targeted programming is not clear. Both treatment and prevention programs would benefit from evaluating family functioning and parenting styles as possible mediators of intervention outcomes. Recommendations are provided to guide the development of future family-based obesity prevention and treatment programs for youth. PMID:20689989

Services Received and Parental Perception of Quality of Life for Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Cholewicki, Judith Marie

2015-01-01

With the rapid increase in the rate of children diagnosed with Autism Spectrum Disorder (ASD), there has been a surge in treatment interventions and outcome measures. Treatment interventions consist of evidence-based practices and programs that lack scientific validation. Parents' selection of a treatment or multiple treatments is often based on…

An investigation of language and phonological development and the responsiveness of preschool age children to the Lidcombe Program.

PubMed

Rousseau, Isabelle; Packman, Ann; Onslow, Mark; Harrison, Elisabeth; Jones, Mark

2007-01-01

Knowledge of variables that predict treatment time is of benefit in deciding when to start treatment for early stuttering. To date, the only variable clearly related to treatment time with the Lidcombe Program is pre-treatment stuttering frequency. Previous studies have shown that children whose stuttering is more severe take longer to complete Stage 1 of the program. However, studies to date have not investigated phonology and language as predictors of treatment time. In the context of a Phase II clinical trial, the present prospective study showed that phonological development does not predict treatment time but that, together, stuttering severity, MLU and CELF Receptive Score predict 35-45% of the variance for time taken to complete Stage 1. The reader should be able to (1) understand guidelines developed for the timing of intervention with the Lidcombe Program based on previous retrospective studies, (2) determine whether pre-treatment language and phonological development play a role in treatment-led recovery with the Lidcombe Program and (3) understand recent empirical evidence on time taken by preschool children to complete Stage 1 of the Lidcombe Program.

A Clinical Model in Action in Intensive Residential Treatment: Meeting the Needs of Adolescent Boys Who Have Experienced Domestic Violence

ERIC Educational Resources Information Center

Stewart, Janet; Todd, Nick; Kopeck, Cameron

2010-01-01

The Habitat Program at Wood's Homes, Calgary, Alberta, is an eight bed residential treatment program for conduct-disordered youth who have been exposed or subjected to high levels of violence in their family home. The program was based on the assumption that working effectively with such youth requires consideration of the background experiences…

Home-based asthma education of young low-income children and their families.

PubMed

Brown, Josephine V; Bakeman, Roger; Celano, Marianne P; Demi, Alice S; Kobrynski, Lisa; Wilson, Sandra R

2002-12-01

To conduct a controlled trial of a home-based education program for low-income caregivers of young children with asthma. Participants were randomized to treatment-eight weekly asthma education sessions adapted from the Wee Wheezers program (n = 49)-or usual care (n = 46). Baseline and 3- and 12-month follow-up data were gathered from caregivers and from children's medical records. Treatment was associated with less bother from asthma symptoms, more symptom-free days, and better caregiver quality of life at follow-up for children 1-3, but not those 4-6, years of age. Treatment and control groups did not differ in caregiver asthma management behavior or children's acute care utilization. This home-based asthma education program was most effective with younger children; perhaps their caregivers were more motivated to learn about asthma management. Targeting psychosocial factors associated with asthma morbidity might also enhance the efficacy of asthma education for these families.

Evidence-Based Practices in Outpatient Treatment for Eating Disorders

ERIC Educational Resources Information Center

Schaffner, Angela D.; Buchanan, Linda Paulk

2010-01-01

This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

[Effectiveness of smoking cessation in group-based behavioral treatment in association to health status and motivation of participants--own research findings].

PubMed

Broszkiewicz, Marzenna; Drygas, Wojciech

2009-01-01

The efficacy and cost-effectiveness of behavioral treatments compare favorably with the pharmacotherapies and community-based interventions. Group-based behavioral programs have been scientifically proven as the effective smoking cessation intervention. Aim of the study was identifying predictors of the efficacy of smoking cessation in health factors: health status and motivation and doctor's advice. Program is a multicomponent group-based behavioral intervention with the elements recommended by the US Public Health Service as the most effective. 517 smokers were included into the program in the outpatient clinic setting in years 2001-2007. A point prevalence abstinence (PPA) was estimated by self-reported smoking cessation. Three homogeneous groups of patients according to their status health were established: participants with tobacco-related diseases n = 182, with psychiatric disorders n = 101 and healthy ones n = 150. 59.6% of participants stopped smoking during four-week program. Program was effective in smoking cessation both for sick and healthy participants. Motivational factors, among others health motivation did not distinguish for whole population as well as for participants with tobacco-related diseases. Lack of doctor's advice increased efficacy of smoking cessation both for the whole population and for group with tobacco-related diseases. Nor health status and motivation neither doctor's advice were predictors of behavioral group-based treatment for tobacco smokers.

Optimal blood glucose control in diabetes mellitus treatment using dynamic programming based on Ackerman’s linear model

NASA Astrophysics Data System (ADS)

Pradanti, Paskalia; Hartono

2018-03-01

Determination of insulin injection dose in diabetes mellitus treatment can be considered as an optimal control problem. This article is aimed to simulate optimal blood glucose control for patient with diabetes mellitus. The blood glucose regulation of diabetic patient is represented by Ackerman’s Linear Model. This problem is then solved using dynamic programming method. The desired blood glucose level is obtained by minimizing the performance index in Lagrange form. The results show that dynamic programming based on Ackerman’s Linear Model is quite good to solve the problem.

Effects of contact-based mental illness stigma reduction programs: age, gender, and Asian, Latino, and White American differences.

PubMed

Wong, Eunice C; Collins, Rebecca L; Cerully, Jennifer L; Yu, Jennifer W; Seelam, Rachana

2018-03-01

Mental illness stigma disproportionately affects help seeking among youth, men, and ethnic minorities. As part of a comprehensive statewide initiative to reduce mental illness stigma and discrimination in California, a broad set of contact-based educational programs were widely disseminated. This study examined whether the effects of contact-based educational programs varied depending on the age, gender, and race-ethnicity of participants. Participants (N = 4122) attended a contact-based educational program that was delivered as part of the statewide initiative to reduce mental illness stigma and discrimination. Self-administered surveys assessing beliefs, attitudes, and intentions toward mental illnesses and treatment were conducted immediately before and after participation in contact-based educational programs. Participant age, gender, and race-ethnicity significantly moderated pre-post changes in mental illness stigma. Although all groups exhibited significant pre-post changes across most of the stigma domains assessed, young adults, females, and Asian and Latino American participants reported larger improvements compared to older adults, males, and Whites, respectively. Findings suggest that contact-based educational programs can achieve immediate reductions in mental illness stigma across a variety of sociodemographic groups and may particularly benefit young adults and racial-ethnic minorities. Further research is needed to assess whether contact-based educational programs can sustain longer-term changes and aid in the reduction of disparities in mental illness stigma and treatment.

Generating AN Optimum Treatment Plan for External Beam Radiation Therapy.

NASA Astrophysics Data System (ADS)

Kabus, Irwin

1990-01-01

The application of linear programming to the generation of an optimum external beam radiation treatment plan is investigated. MPSX, an IBM linear programming software package was used. All data originated from the CAT scan of an actual patient who was treated for a pancreatic malignant tumor before this study began. An examination of several alternatives for representing the cross section of the patient showed that it was sufficient to use a set of strategically placed points in the vital organs and tumor and a grid of points spaced about one half inch apart for the healthy tissue. Optimum treatment plans were generated from objective functions representing various treatment philosophies. The optimum plans were based on allowing for 216 external radiation beams which accounted for wedges of any size. A beam reduction scheme then reduced the number of beams in the optimum plan to a number of beams small enough for implementation. Regardless of the objective function, the linear programming treatment plan preserved about 95% of the patient's right kidney vs. 59% for the plan the hospital actually administered to the patient. The clinician, on the case, found most of the linear programming treatment plans to be superior to the hospital plan. An investigation was made, using parametric linear programming, concerning any possible benefits derived from generating treatment plans based on objective functions made up of convex combinations of two objective functions, however, this proved to have only limited value. This study also found, through dual variable analysis, that there was no benefit gained from relaxing some of the constraints on the healthy regions of the anatomy. This conclusion was supported by the clinician. Finally several schemes were found that, under certain conditions, can further reduce the number of beams in the final linear programming treatment plan.

Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program

ERIC Educational Resources Information Center

Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen

2006-01-01

Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…

Promoting Self-Esteem, Defining Culture.

ERIC Educational Resources Information Center

Witt, Norbert

1998-01-01

Treatment programs for the growing problem of solvent abuse, in the form of sniffing gasoline, among Canadian-Native youth have had no success. Increased self-esteem, which is central to successful treatment, can only be achieved through programs designed by Native people and based on the their culture. Contains 32 references. (TD)

Innovative Adolescent Chemical Dependency Treatment and Its Outcome: A Model Based on Outward Bound Programming.

ERIC Educational Resources Information Center

McPeake, John D.; And Others

1991-01-01

Describes adolescent chemical dependency treatment model developed at Beech Hill Hospital (New Hampshire) which integrated Twelve Step-oriented alcohol and drug rehabilitation program with experiential education school, Hurricane Island Outward Bound School. Describes Beech Hill Hurricane Island Outward Bound School Adolescent Chemical Dependency…

Physician Peer Assessments for Compliance with Methadone Maintenance Treatment Guidelines

ERIC Educational Resources Information Center

Strike, Carol; Wenghofer, Elizabeth; Gnam, William; Hillier, Wade; Veldhuizen, Scott; Millson, Margaret

2007-01-01

Introduction: Medical associations and licensing bodies face pressure to implement quality assurance programs, but evidence-based models are lacking. To improve the quality of methadone maintenance treatment (MMT), the College of Physicians and Surgeons of Ontario, Canada, conducts an innovative quality assurance program on the basis of peer…

The use of art and music therapy in substance abuse treatment programs.

PubMed

Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

2014-01-01

Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

Substance Use Recovery Outcomes among a Cohort of Youth Participating in a Mobile-Based Texting Aftercare Pilot Program

PubMed Central

Gonzales, Rachel; Ang, Alfonso; Murphy, Debra A.; Glik, Deborah C.; Anglin, M. Douglas

2014-01-01

Project ESQYIR (Educating & Supporting inquisitive Youth in Recovery) is a pilot study examining the feasibility of a 12-week mobile-based aftercare intervention for youth (ages 12 to 24) transitioning out of community-based substance abuse treatment programs. From January 2012 through July 2013, a total of 80 youth were recruited from outpatient and residential treatment programs, geographically dispersed throughout Los Angeles County, California. Results revealed that youth who participated in the texting mobile pilot intervention were significantly less likely to relapse to their primary compared to the aftercare as usual control condition (OR = 0.52, p = 0.002) over time (from baseline throughout the 12-week aftercare pilot program to a 90-day follow-up). Participants in the texting aftercare pilot program also reported significantly less substance use problem severity (β = −0.46, p = .03) and were more likely to participate in extracurricular recovery behaviors (β = 1.63, p = .03) compared to participants in the standard aftercare group. Collectively, findings from this pilot aftercare study suggest that mobile texting could provide a feasible way to engage youth in recovery after substance abuse treatment to aid with reducing relapse and promoting lifestyle behavior change. PMID:24629885

A Conceptual Framework for the Expansion of Behavioral Interventions for Youth Obesity: A Family-Based Mindful Eating Approach

PubMed Central

Brody, Janet L.; Staples, Julie K.; Sedillo, Donna

2015-01-01

Abstract Background: Currently, over 30% of US youth are overweight and 1 in 6 have metabolic syndrome, making youth obesity one of the major global health challenges of the 21st century. Few enduring treatment strategies have been identified in youth populations, and the majority of standard weight loss programs fail to adequately address the impact of psychological factors on eating behavior and the beneficial contribution of parental involvement in youth behavior change. Methods: A critical need exists to expand treatment development efforts beyond traditional education and cognitive-behavioral programs and explore alternative treatment models for youth obesity. Meditation-based mindful eating programs represent a unique and novel scientific approach to the current youth obesity epidemic given that they address key psychological variables affecting weight. Results: The recent expansion of mindfulness programs to include family relationships shows the immense potential for broadening the customarily individual focus of this intervention to include contextual factors thought to influence youth health outcomes. Conclusions: This article provides an overview of how both mindful eating and family systems theory fits within a conceptual framework in order to guide development of a comprehensive family-based mindful eating program for overweight youth. PMID:26325143

A model of nonparticipation in alcohol treatment programs.

PubMed

Burton, T L; Williamson, D L

1997-01-01

Why do the vast majority of those who suffer harm from drinking fail to obtain treatment? Based on a review of research literature and educational and treatment program materials, a model of nonparticipation in treatment is proposed whereby particular population groups are separated out according to whether or not they exhibit specified characteristics related to both harm from drinking and attitudes towards treatment. Eleven groups have been identified in the model, each of which has different reasons for failing to seek and/or obtain treatment. It is suggested that differing educational program messages should be sent to each group. While the model does not purport to be wholly inclusive of all nonparticipation, it offers a basis for addressing the variety of disparate groups that suffer harm from drinking but do not obtain treatment.

Evaluation of a community-based sex offender treatment program using a good lives model approach.

PubMed

Harkins, Leigh; Flak, Vanja E; Beech, Anthony R; Woodhams, Jessica

2012-12-01

In this study the authors assessed a Good Lives model (GLM) approach to sex offender treatment and compare it to a standard Relapse Prevention program. The comparisons examined (a) attrition rates, (b) treatment change in areas targeted in treatment and achievement of a posttreatment treated profile, and (c) views of offenders and facilitators. There were no differences in the attrition rates or the rates of treatment change between the two programs, indicating that they were equally effective at retaining participants and achieving change on areas targeted within treatment. Both facilitators and program participants reported the Good Lives approach module's impact in a positive, future-focused manner. In contrast, those who attended the Relapse Prevention module did not report their perceptions and motivations in a manner that was focused on the positives in their future as frequently as those who attended the module with the Good Lives model approach.

Impact of computer-based treatment planning software on clinical judgment of dental students for planning prosthodontic rehabilitation

PubMed Central

Deshpande, Saee; Chahande, Jayashree

2014-01-01

Purpose Successful prosthodontic rehabilitation involves making many interrelated clinical decisions which have an impact on each other. Self-directed computer-based training has been shown to be a very useful tool to develop synthetic and analytical problem-solving skills among students. Thus, a computer-based case study and treatment planning (CSTP) software program was developed which would allow students to work through the process of comprehensive, multidisciplinary treatment planning for patients in a structured and logical manner. The present study was aimed at assessing the effect of this CSTP software on the clinical judgment of dental students while planning prosthodontic rehabilitation and to assess the students’ perceptions about using the program for its intended use. Methods A CSTP software program was developed and validated. The impact of this program on the clinical decision making skills of dental graduates was evaluated by real life patient encounters, using a modified and validated mini-CEX. Students’ perceptions about the program were obtained by a pre-validated feedback questionnaire. Results The faculty assessment scores of clinical judgment improved significantly after the use of this program. The majority of students felt it was an informative, useful, and innovative way of learning and they strongly felt that they had learnt the logical progression of planning, the insight into decision making, and the need for flexibility in treatment planning after using this program. Conclusion CSTP software was well received by the students. There was significant improvement in students’ clinical judgment after using this program. It should thus be envisaged fundamentally as an adjunct to conventional teaching techniques to improve students’ decision making skills and confidence. PMID:25170288

Evidence, Goals, and Outcomes in Stuttering Treatment: Applications With an Adolescent Who Stutters.

PubMed

Marcotte, Anne K

2018-01-09

The purpose of this clinical focus article is to summarize 1 possible process that a clinician might follow in designing and conducting a treatment program with John, a 14-year-old male individual who stutters. The available research evidence, practitioner experience, and consideration of individual preferences are combined to address goals, treatment procedures, and outcomes for John. The stuttering treatment research literature includes multiple well-designed reviews and individual studies that have shown the effectiveness of prolonged speech (and smooth speech and related variations) for improving stuttered speech and for improving social, emotional, cognitive, and related variables in adolescents who stutter. Based on that evidence, and incorporating the additional elements of practitioner experience and client preferences, this clinical focus article suggests that John would be likely to benefit from a treatment program based on prolonged speech. The basic structure of 1 possible such program is also described, with an emphasis on the goals and outcomes that John could be expected to achieve.

Transporting Clinical Research to Community Settings: Designing and Conducting a Multisite Trial of Brief Strategic Family Therapy

PubMed Central

Robbins, Michael S.; Alonso, Elizabeth; Horigian, Viviana E.; Bachrach, Ken; Burlew, Kathy; Carrión, Ibis S.; Hodgkins, Candace C.; Miller, Michael; Schindler, Eric; VanDeMark, Nancy; Henderson, Craig; Szapocznik, José

2010-01-01

This paper describes the development and implementation of a trial of Brief Strategic Family Therapy (BSFT), an evidence-based drug intervention for adolescents, in eight community substance abuse treatment programs. Researchers and treatment programs collaborated closely to identify and overcome challenges, many of them related to achieving results that were both scientifically rigorous and applicable to the widest possible variety of adolescent substance abuse treatment programs. To meet these challenges, the collaborative team drew on lessons and practices from efficacy, effectiveness, and implementation research. PMID:22002455

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial.

PubMed

ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; DeJong, Cor A J

2013-11-16

Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants' motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. The protocol for this study is registered with the Netherlands Trial Registry NTR2415.

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial

PubMed Central

2013-01-01

Background Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Methods/design This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants’ motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. Discussion This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Trial registration The protocol for this study is registered with the Netherlands Trial Registry NTR2415. PMID:24238630

Counting the cost: estimating the economic benefit of pedophile treatment programs.

PubMed

Shanahan, M; Donato, R

2001-04-01

The principal objective of this paper is to identify the economic costs and benefits of pedophile treatment programs incorporating both the tangible and intangible cost of sexual abuse to victims. Cost estimates of cognitive behavioral therapy programs in Australian prisons are compared against the tangible and intangible costs to victims of being sexually abused. Estimates are prepared that take into account a number of problematic issues. These include the range of possible recidivism rates for treatment programs; the uncertainty surrounding the number of child sexual molestation offences committed by recidivists; and the methodological problems associated with estimating the intangible costs of sexual abuse on victims. Despite the variation in parameter estimates that impact on the cost-benefit analysis of pedophile treatment programs, it is found that potential range of economic costs from child sexual abuse are substantial and the economic benefits to be derived from appropriate and effective treatment programs are high. Based on a reasonable set of parameter estimates, in-prison, cognitive therapy treatment programs for pedophiles are likely to be of net benefit to society. Despite this, a critical area of future research must include further methodological developments in estimating the quantitative impact of child sexual abuse in the community.

Evaluation of skill-based training program on rational drug treatment for medical interns

PubMed Central

Venkatesan, Murugan; Dongre, Amol R; Ganapathy, Kalaiselvan

2017-01-01

Context: A module-based training program for medical interns using World Health Organization guide for good prescription along with the individual feedback on their prescription was developed and implemented. Objective: The objective of the study was to obtain the medical interns’ reactions to newly developed skill-based training program on rational treatment. Study Setting: This study was conducted at the Department of Community Medicine. Participants: A total of 96 medical interns were included in the study. Study Design: A cross-sectional study consisting of retro-prefeedback and open-ended questions about self-assessment of perceived skill on rational treatment. Analysis: Collected data were entered in Epi Info (3.5.4) and analyzed. Results: After training, there was a significant increase in self-perceived posttest scores of setting up the therapeutic objective for the treatment (2.9–4.9), ability to select the correct drug (2.8–5.1), ability to select right dose, schedule, and duration of drugs (2.5–4.9). and overall prescription skill (2.9–4.9). There is a significant decrease in self-perceived scores in the skill of practicing polypharmacy (4.1–2.5). Conclusions: Overall, the training program was taken well and interns perceived their skill on rational treatment was improved as shown by the feedback. PMID:29564272

A Randomized Trial of a Multimodal Community-Based Prisoner Reentry Program Emphasizing Substance Abuse Treatment

ERIC Educational Resources Information Center

Grommon, Eric; Davidson, William S., II; Bynum, Timothy S.

2013-01-01

Prisoner reentry programs continue to be developed and implemented to ease the process of transition into the community and to curtail fiscal pressures. This study describes and provides relapse and recidivism outcome findings related to a randomized trial evaluating a multimodal, community-based reentry program that prioritized substance abuse…

Learning to pass: sex offenders' strategies for establishing a viable identity in the prison general population.

PubMed

Schwaebe, Charles

2005-12-01

This article endeavors to illustrate the realities of prison life for sex offenders and the means by which they attempt to establish viable identities and acquire a survivable niche in the prison general population, particularly when established identities and protective niches are put at risk by entry into a sex offender treatment program. Qualitative data was collected by repeatedly interviewing a cohort of sex offenders for 6 months as they completed a basic sex offender treatment program. The findings indicate a need to include consideration of treatment context in understanding the limits of treatment gain in prison-based programs.

Didactic Migraine Education in US Doctor of Pharmacy Programs

PubMed Central

Padiyara, Rosalyn S.; Schommer, Jon C.

2010-01-01

Objective To compare didactic migraine education in doctor of pharmacy (PharmD) programs in the United States with the Headache Consortium's evidence-based migraine treatment recommendations. Methods A self-administered survey instrument was mailed to all 90 Accreditation Council for Pharmacy Education (ACPE) approved PharmD programs in the United States. Results Seventy-seven programs responded (86%) and 69 useable survey instruments were analyzed. Fifty-five percent of programs discussed the Consortium's guidelines, 49% discussed the selection of nonprescription versus prescription agents, 45% recommended a butalbital-containing product as migraine treatment, and 20% educated students about tools for assessing migraine-related debilitation. At least 50% of programs taught information consistent with the remaining Consortium recommendations. Conclusion Approximately half of the PharmD programs teach concepts about migraine headache treatment consistent with the US Headache Consortium's recommendations. PMID:20221355

Unique Practice, Unique Place: Exploring Two Assertive Community Treatment Teams in Maine.

PubMed

Schroeder, Rebecca A

2018-06-01

Assertive Community Treatment (ACT) is a model of care that provides comprehensive community-based psychiatric care for persons with serious mental illness. This model has been widely documented and has shown to be an evidence-based model of care for reducing hospitalizations for this targeted population. Critical ingredients of the ACT model are the holistic nature of their services, a team based approach to treatment and nurses who assist with illness management, medication monitoring, and provider collaboration. Although the model remains strong there are clear differences between urban and rural teams. This article describes present day practice in two disparate ACT programs in urban and rural Maine. It offers a new perspective on the evolving and innovative program of services that treat those with serious mental illness along with a review of literature pertinent to the ACT model and future recommendations for nursing practice. The success and longevity of these two ACT programs are testament to the quality of care and commitment of staff that work with seriously mentally ill consumers. Integrative care models such as these community-based treatment teams and nursing driven interventions are prime elements of this successful model.

Morita-Based Therapy and Its Use across Cultures in the Treatment of Bulimia Nervosa.

ERIC Educational Resources Information Center

LeVine, Peg

1993-01-01

Provides an overview of classical inpatient Morita therapy (a four-stage treatment for anxiety-based neurotic disorders), contrasts it with features of rational emotive therapy (RET), and illustrates an intervention program for women suffering from bulimia nervosa. A session-to-session short-term treatment methodology is provided. (Author/SR)

Development and evaluation of addiction treatment programs in Latin America.

PubMed

Marín-Navarrete, Rodrigo; Medina-Mora, María Elena; Pérez-López, Alejandro; Horigian, Viviana E

2018-07-01

The aim of this article is to present a state-of-the-art review of the scientific studies that have evaluated healthcare systems, services and programs for addiction treatment in Latin America. As a secondary aim, this article presents a brief description and analysis of the addiction prevention and treatment resources and programs available in Latin America, based on information from the ATLAS on Substance Use (ATLAS-SU) project led by the WHO. Substance use disorders (SUDs) are among the main causes associated with global burden of disease. Around the world, many initiatives have been proposed to promote policies to reduce substance use and reduce the impact of SUD, including integrating treatments into healthcare systems, increasing access to treatment programs and impacting outcome measures. In Latin America, multiple efforts have been implemented to improve addiction services and programs, although little is known about the impact they have generated. International studies report the availability of strategies and public inicitatives on prevention and treatment of addiction in Latin America. These studies also report established networks of public and private services that include prevention and detoxification programs, outpatient and residential treatment, and also social reintegration initiatives. However, despite these advances, information on the evaluation of the progress, results and impact of these programs is limited.

Integrative Health Services in School Health Clinics

PubMed Central

Milosavljevic, Nada

2015-01-01

Objective: Mental health treatment today incorporates neurobiology, genetics, neuro-imaging, and pharmacologic mechanisms, offering more options to patients. For some, these modern approaches are not viable choices due to reasons such as limited access to care, cost, intolerable side effects, and, in the pediatric population, fears of potential long-term effects. With the growing prevalence of chronic health conditions, concerns for age of onset, (McGorry, Purcell, Goldstone, & Amminger, 2011) and a growing population of mental health patients, cost-effective and evidence-based treatment options should be evaluated. Integrative treatments, also known as complementary and alternative medicine (CAM), may offer interventions that meet today’s clinical needs. Method: To evaluate evidence-based treatment options, we initiated the school-based integrative health program (IHP) in January 2011 at three high schools located in Massachusetts. Our goal was two-fold: first, to design a holistic treatment program and evaluate several integrative modalities, and; second, to determine the feasibility of providing a CAM health program through school clinics. Our protocol utilized three integrative treatments that addressed stress and anxiety conditions. Anxiety disorders are the most common mental illness affecting over 40 million adults in the US (Anxiety and Depression Association of America). Results: The program has been successfully implemented. Preliminary results indicate that this intervention decreased anxiety in these youth. Conclusion: Providing integrative techniques to students in the school setting has the potential to decrease barriers to accessing care, lowering treatment costs and decreasing school absenteeism by instituting care on-site. Offering a holistic approach to treatment in schools is feasible. Because utilizing these approaches involves their active participation, adolescents can acquire life-long skills that improve their ability to cope and confront inevitable life stressors. PMID:28580235

The Blackfeet Indian culture camp: Auditioning an alternative indigenous treatment for substance use disorders.

PubMed

Gone, Joseph P; Calf Looking, Patrick E

2015-05-01

American Indian and Alaska Native (AIAN) communities experience alarming health disparities, including high rates of substance use disorders (SUDs). Psychological services for AIANs, including SUDs treatment, are primarily funded by the federal Indian Health Service and typically administered by tribal governments. Tribal administration of SUDs treatment programs has routinely involved either inclusion of traditional cultural practices into program activities or adaptation of conventional treatment approaches to distinctive community sensibilities. In this article, we investigate a third possibility: the collaborative, community-based development of an alternative indigenous intervention that was implemented as a form of SUDs treatment in its own right and on its own terms. Specifically, in July of 2012, we undertook a trial implementation of a seasonal cultural immersion camp based on traditional Pikuni Blackfeet Indian cultural practices for 4 male clients from the reservation's federally funded SUDs treatment program. Given a variety of logistical and methodological constraints, the pilot offering of the culture camp primarily served as a demonstration of "proof of concept" for this alternative indigenous intervention. In presenting and reflecting on this effort, we consider many challenges associated with alternative indigenous treatment models, especially those associated with formal outcome evaluation. Indeed, we suggest that the motivation for developing local indigenous alternatives for AIAN SUDs treatment may work at cross-purposes to the rigorous assessment of therapeutic efficacy for such interventions. Nevertheless, we conclude that these efforts afford ample opportunities for expanding the existing knowledge base concerning the delivery of community-based psychological services for AIANs. (c) 2015 APA, all rights reserved).

Developing an Integrative Treatment Program for Cancer-Related Fatigue Using Stakeholder Engagement - A Qualitative Study.

PubMed

Canella, Claudia; Mikolasek, Michael; Rostock, Matthias; Beyer, Jörg; Guckenberger, Matthias; Jenewein, Josef; Linka, Esther; Six, Claudia; Stoll, Sarah; Stupp, Roger; Witt, Claudia M

2017-11-01

Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.

Outcome Data for MICA Clients after Participation in an Institutional Therapeutic Community

ERIC Educational Resources Information Center

Van Stelle, Kit R.; Moberg, D. Paul

2004-01-01

The current study assessed the effectiveness of a prison-based substance abuse treatment therapeutic community (TC) providing treatment to male inmates dually diagnosed with both substance abuse and mental health disorders. The findings show a short-term impact of the program on arrest after release, with program participants significantly less…

Organizational Readiness for Change in Correctional and Community Substance Abuse Programs

ERIC Educational Resources Information Center

Lehman, Wayne E. K.; Greener, Jack M.; Rowan-Szal, Grace A.; Flynn, Patrick M.

2012-01-01

Significant needs exist for increased and better substance abuse treatment services in our nation's prisons. The TCU Organizational Readiness for Change (ORC) survey has been widely used in community-based treatment programs and evidence is accumulating for relationships between readiness for change and implementation of new clinical practices.…

Manualized-Group Treatment of Eating Disorders: Attunement in Mind, Body, and Relationship (AMBR)

ERIC Educational Resources Information Center

Cook-Cottone, Catherine; Beck, Meredith; Kane, Linda

2008-01-01

This article describes a manualized-group treatment of eating disorders, the attunement in mind, body, and relationship (AMBR) program. The cognitive behavioral and dialectic behavioral research as well as the innovative prevention interventions upon which the program is based (e.g., interactive discourse, yoga, and mediation) are introduced. The…

Description of Exemplar Cases in the Intensive Mental Health Program: Illustrations of Application of the Therapeutic Model

ERIC Educational Resources Information Center

Nelson, Timothy D.; Mashunkashey, Joanna O.; Mitchell, Montserrat C.; Benson, Eric R.; Vernberg, Eric M.; Roberts, Michael C.

2008-01-01

We describe cases from the clinical records in the Intensive Mental Health Program to illustrate the diverse presenting problems, intervention strategies, therapeutic process, and outcomes for children receiving services in this school-based, community-oriented treatment model. Cases reflect varying degrees of treatment response and potential…

Development of a Competency-Based Curriculum for Upgrading Water Treatment Technicians. Final Report.

ERIC Educational Resources Information Center

Ross-Harrington, Melinda

The major purpose of a project has been to develop an instructional program for training water treatment technicians through the cooperative efforts of industry, the regulatory agency (West Virginia State Department of Health), and vocational education. After the appropriate job competencies were identified, a program was developed combining a…

Providing Tobacco Treatment in a Community Mental Health Setting: A Pilot Study.

PubMed

Okoli, Chizimuzo T C; Mason, Dia A; Brumley-Shelton, Angela; Robertson, Heather

Individuals with mental illnesses (MIs) are disproportionately affected by tobacco-related disease burden because of higher tobacco use prevalence and poor tobacco treatment outcomes. This pilot study examines the outcomes of delivering an evidence-based tobacco treatment program (the Cooper-Clayton program) in a community mental health setting. A prospective nonequivalent group design was used to assess outcomes. This study included 47 participants, of which 19 were in a community mental health setting and 28 were from two non-mental-health settings. Information on sociodemographic (gender, age, educational level, and current life stressors) and medical, MI, substance use, and tobacco use and cessation histories were obtained. Program completion and smoking cessation at the end of treatment (verified with expired carbon monoxide monitoring) were assessed. The program consists of combining behavioral counseling with nicotine replacement therapy for 12 weeks. Participants from the mental health setting were significantly less educated, had greater medical comorbidities, had greater psychiatric and mental health histories, and had greater perceived secondhand tobacco smoke exposure as compared with those from the non-mental-health settings. Thirty-two percent of the participants (6/19) completed the program in the mental health site as compared with 68% (19/28) from the non-mental-health site. None of those from the mental health site achieved cessation as compared with 68% of those from non-mental-health sites. The differential outcomes of evidence-based tobacco treatment programs in non-mental-health versus mental health settings may suggest the need to modify existing tobacco treatment approaches for those with MIs in community settings.

Patient’s self-evaluation of two education programs for age-related skin changes in the face: a prospective, randomized, controlled study

PubMed Central

Williams, Linda M; Alderman, Jane E; Cussell, Garry; Goldston, John; Hamilton, Neal; Lim, Adrian C; Goodman, Greg J; Halstead, Michael B; Rogers, John D

2011-01-01

Background: An interactive software program (HOYS) has been developed utilizing a database of digital images depicting various aspects and degrees of aging of exposed skin across seven geographic regions, representing a total of 35 facial and extrafacial subregions. A five-point photonumeric rating scale, which portrays age-related skin changes across five decades for each of these subregions, underpins this patient-based interactive self-assessment program. Based on the resulting outputs from this program, an individualized treatment prioritization list is generated for each region where significant differences between the patient’s chronological and esthetic ages exist. This provides guidance for the patient and the treating physician on treatment options. Methods: To evaluate the utility of HOYS in the clinic, relative to education programs currently used in Australian private esthetic clinics, a total of 95 esthetically-orientated patients were enrolled in a prospective, randomized, controlled, multicenter study. Results: Compared with a prospective cohort of patients completing a standard education program commonly utilized in Australian esthetic clinics, patients receiving the HOYS education program reported greater empowerment through improved knowledge of specific age-related skin changes. This was associated with a clearer understanding of treatment options available to them, and a perceived ability to participate in the selection of the treatments potentially administered to improve their appearance. These differences between the two education groups were highly significant. Conclusion: Patients completing the HOYS patient education program have an improved understanding of age-related changes to exposed skin of their face, neck, décolletage, and hands. Due to the patient-specific nature of the program, these patients perceive a greater role in the deciding which esthetic treatments should be subsequently administered to enhance their appearance, through an improved understanding of the rationale for these treatments and indeed how they should be prioritized to achieve the best outcome for them. PMID:22087069

Gender differences among prisoners in drug treatment.

PubMed

Langan, N P; Pelissier, B M

2001-01-01

Nearly all prison-based substance abuse treatment programs have been designed with male prisoners in mind. Administering these male-oriented programs to women prisoners has been the standard correctional practice. Recently, this practice has received considerable criticism. Critics argue that female prisoners have special needs that are not met by programs originally designed for male prisoners. However, most of the empirical support for the existence of such special needs rely on two inappropriate samples: prisoners who are not in treatment and treatment participants who are not incarcerated. Findings from these two different groups may not be generalizable to the population of prisoners in treatment. This paper directly addresses this generalizability problem with an examination of gender differences among 1,326 male and 318 female federal prisoners who were enrolled in a substance abuse treatment program. Women used drugs more frequently, used harder drugs, and used them for different reasons than men. Women also confronted more difficulties than men in areas linked to substance abuse such as educational background, childhood family environment, adult social environment, mental health, and physical health. We find support for the argument that substance abuse treatment programs which were originally designed for men may be inappropriate for the treatment of women.

Implementation of Motivational Interviewing in Substance Use Disorder Treatment: Research Network Participation and Organizational Compatibility.

PubMed

Rieckmann, Traci R; Abraham, Amanda J; Bride, Brian E

Despite considerable empirical evidence that psychosocial interventions improve addiction treatment outcomes across populations, implementation remains problematic. A small body of research points to the importance of research network participation as a facilitator of implementation; however, studies examined limited numbers of evidence-based practices. To address this gap, the present study examined factors impacting implementation of motivational interviewing (MI). This study used data from a national sample of privately funded treatment programs (n = 345) and programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) (n = 156). Data were collected via face-to-face interviews with program administrators and clinical directors (2007-2009). Analysis included bivariate t tests and chi-square tests to compare private and CTN programs, and multivariable logistic regression of MI implementation. A majority (68.0%) of treatment programs reported use of MI. Treatment programs participating in the CTN (88.9%) were significantly more likely to report use of MI compared with non-CTN programs (58.5%; P < 0.01). CTN programs (82.1%) also were more likely to use trainers from the Motivational Interviewing Network of Trainers as compared with private programs (56.1%; P < 0.05). Multivariable logistic regression models reveal that CTN-affiliated programs and programs with a psychiatrist on staff were more likely to use MI. Programs that used the Stages of Change Readiness and Treatment Eagerness Scale assessment tool were more likely to use MI, whereas programs placing greater emphasis on confrontational group therapy were less likely to use MI. Findings suggest the critical role of research network participation, access to psychiatrists, and organizational compatibility in adoption and sustained use of MI.

Telephone-based disease management: why it does not save money.

PubMed

Motheral, Brenda R

2011-01-01

To understand why the current telephone-based model of disease management (DM) does not provide cost savings and how DM can be retooled based on the best available evidence to deliver better value. Literature review. The published peer-reviewed evaluations of DM and transitional care models from 1990 to 2010 were reviewed. Also examined was the cost-effectiveness literature on the treatment of chronic conditions that are commonly included in DM programs, including heart failure, diabetes mellitus, coronary artery disease, and asthma. First, transitional care models, which have historically been confused with commercial DM programs, can provide credible savings over a short period, rendering them low-hanging fruit for plan sponsors who desire real savings. Second, cost-effectiveness research has shown that the individual activities that constitute contemporary DM programs are not cost saving except for heart failure. Targeting of specific patients and activity combinations based on risk, actionability, treatment and program effectiveness, and costs will be necessary to deliver a cost-saving DM program, combined with an outreach model that brings vendors closer to the patient and physician. Barriers to this evidence-driven approach include resources required, marketability, and business model disruption. After a decade of market experimentation with limited success, new thinking is called for in the design of DM programs. A program design that is based on a cost-effectiveness approach, combined with greater program efficacy, will allow for the development of DM programs that are cost saving.

Knowledge, Stigma, and Behavioral Outcomes among Antiretroviral Therapy Patients Exposed to Nalamdana's Radio and Theater Program in Tamil Nadu, India

ERIC Educational Resources Information Center

Nambiar, Devaki; Ramakrishnan, Vimala; Kumar, Paresh; Varma, Rajeev; Balaji, Nithya; Rajendran, Jeeva; Jhona, Loretta; Chandrasekar, Chokkalingam; Gere, David

2011-01-01

Arts-based programs have improved HIV-related knowledge, attitudes, and behavior in general and at-risk populations. With HIV transformed into a chronic condition, this study compares patients at consecutive stages of receiving antiretroviral treatment, coinciding with exposure to a radio-and-theater-based educational program (unexposed [N = 120],…

The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

PubMed

Morgan, Vanessa

2014-03-01

The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

Biological Treatment of Solvent-Based Paint

DTIC Science & Technology

2011-01-01

ESTCP Environmental Security Technology Certification Program FK-WTP Fort Kamehameha Wastewater Treatment Plant FTIR Fourier Transform Infrared...established by the Fort Kamehameha Wastewater Treatment Plant (FK-WTP) for the water; toxicity characteristic leaching procedure (TCLP) requirements for

A Comprehensive Review of the Effectiveness of Different Exercise Programs for Patients with Osteoarthritis

PubMed Central

Golightly, Yvonne M.; Allen, Kelli D.; Caine, Dennis J.

2014-01-01

Exercise is recommended as a first-line conservative intervention approach for osteoarthritis (OA). A wide range of exercise programs are available, and scientific evidence is necessary for advising patients with OA on the optimal treatment strategy. The purpose of this review is to discuss the effectiveness of different types of exercise programs for OA based on trials, systematic reviews, and meta-analyses in the literature. Publications from January 1997 to July 2012 were searched in 4 electronic databases using the terms osteoarthritis, exercise, exercise program, effectiveness, and treatment outcome. Strong evidence supports that aerobic and strengthening exercise programs, both land- and water-based, are beneficial for improving pain and physical function in adults with mild to moderate knee and hip OA. Areas that require further research include examination of the long-term effects of exercise programs for OA, balance training for OA, exercise programs for severe OA, the effect of exercise programs on progression of OA, the effectiveness of exercise for joint sites other than the knee or hip, and the effectiveness of exercise for OA by such factors as age, gender and obesity. Efforts to improve adherence to evidence-based exercise programs for OA and to promote the dissemination and implementation of these programs are crucial. PMID:23306415

An economic evaluation: Simulation of the cost-effectiveness and cost-utility of universal prevention strategies against osteoporosis-related fractures.

PubMed

Nshimyumukiza, Léon; Durand, Audrey; Gagnon, Mathieu; Douville, Xavier; Morin, Suzanne; Lindsay, Carmen; Duplantie, Julie; Gagné, Christian; Jean, Sonia; Giguère, Yves; Dodin, Sylvie; Rousseau, François; Reinharz, Daniel

2013-02-01

A patient-level Markov decision model was used to simulate a virtual cohort of 500,000 women 40 years old and over, in relation to osteoporosis-related hip, clinical vertebral, and wrist bone fractures events. Sixteen different screening options of three main scenario groups were compared: (1) the status quo (no specific national prevention program); (2) a universal primary prevention program; and (3) a universal screening and treatment program based on the 10-year absolute risk of fracture. The outcomes measured were total directs costs from the perspective of the public health care system, number of fractures, and quality-adjusted life-years (QALYs). Results show that an option consisting of a program promoting physical activity and treatment if a fracture occurs is the most cost-effective (CE) (cost/fracture averted) alternative and also the only cost saving one, especially for women 40 to 64 years old. In women who are 65 years and over, bone mineral density (BMD)-based screening and treatment based on the 10-year absolute fracture risk calculated using a Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is the best next alternative. In terms of cost-utility (CU), results were similar. For women less than 65 years old, a program promoting physical activity emerged as cost-saving but BMD-based screening with pharmacological treatment also emerged as an interesting alternative. In conclusion, a program promoting physical activity is the most CE and CU option for women 40 to 64 years old. BMD screening and pharmacological treatment might be considered a reasonable alternative for women 65 years old and over because at a healthcare capacity of $50,000 Canadian dollars ($CAD) for each additional fracture averted or for one QALY gained its probabilities of cost-effectiveness compared to the program promoting physical activity are 63% and 75%, respectively, which could be considered socially acceptable. Consideration of the indirect costs could change these findings. Copyright © 2013 American Society for Bone and Mineral Research.

Use of the evidence base in substance abuse treatment programs for American Indians and Alaska Natives: pursuing quality in the crucible of practice and policy.

PubMed

Novins, Douglas K; Aarons, Gregory A; Conti, Sarah G; Dahlke, Dennis; Daw, Raymond; Fickenscher, Alexandra; Fleming, Candace; Love, Craig; Masis, Kathleen; Spicer, Paul

2011-06-16

A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Broadening this conversation beyond its primary focus on the use of evidence-based treatments to other salient issues such as building the necessary research evidence (including incorporating American Indian and Alaska Native cultural values into clinical practice) and developing the human and infrastructural resources to support the use of this evidence may be far more effective for advancing efforts to improve substance abuse services for American Indian and Alaska Native communities.

Promoting weight control at the worksite: a pilot program of self-motivation using payroll-based incentives.

PubMed

Jeffery, R W; Forster, J L; Snell, M K

1985-03-01

Thirty-six individuals participated in a worksite weight-loss program in which the central component was a self-motivation program of biweekly payroll deductions refunded contingent on meeting self-selected weight-loss goals. Half were assigned to early treatment and the remainder to a delayed treatment control group. Nine additional individuals also enrolled at the time of delayed treatment and were included in descriptive analyses of factors associated with weight loss. Results showed low program attrition over 6 months (6%) and mean weight losses (12.3 lb) that are competitive with those obtained in clinical settings. Although not different at baseline, participants in the delayed treatment group lost more than twice as much weight as those in the early treatment condition. This difference was interpreted as either a strong seasonal effect or a critical mass effect related to the proportion of employees at the worksite participating in the program. We conclude that self-motivation programs for health behavior change using the payroll system as an organization framework offer a promising new methodology for promoting healthful behaviors in work settings.

Brief Strategic Family Therapy versus Treatment as Usual: Results of a Multisite Randomized Trial for Substance Using Adolescents

ERIC Educational Resources Information Center

Robbins, Michael S.; Feaster, Daniel J.; Horigian, Viviana E.; Rohrbaugh, Michael; Shoham, Varda; Bachrach, Ken; Miller, Michael; Burlew, Kathleen A.; Hodgkins, Candy; Carrion, Ibis; Vandermark, Nancy; Schindler, Eric; Werstlein, Robert; Szapocznik, Jose

2011-01-01

Objective: To determine the effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. Method: A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to…

Effects of Motivation and Problem Severity on Court-Based Drug Treatment

ERIC Educational Resources Information Center

Cosden, Merith; Basch, Janice E.; Campos, Emily; Greenwell, Ashley; Barazani, Sivan; Walker, Sara

2006-01-01

This study addresses the effects of motivation and problem severity on outcomes in two court-based drug treatment programs. Data were examined for 578 offenders served by a drug court and 223 served by a drug treatment court mandated through California's Substance Abuse Crime Prevention Act (SACPA). It was hypothesized that client-reported…

Three Treatments for Bilingual Children with Primary Language Impairment: Examining Cross-Linguistic and Cross-Domain Effects

ERIC Educational Resources Information Center

Ebert, Kerry Danahy; Kohnert, Kathryn; Pham, Giang; Disher, Jill Rentmeester; Payesteh, Bita

2014-01-01

Purpose: This study examines the absolute and relative effects of 3 different treatment programs for school-age bilingual children with primary or specific language impairment (PLI). It serves to expand the evidence base on which service providers can base treatment decisions. It also explores hypothesized relations between languages and cognition…

Developing and Implementing a New Prison-Based Buprenorphine Treatment Program

ERIC Educational Resources Information Center

Kinlock, Timothy W.; Gordon, Michael S.; Schwartz, Robert P.; Fitzgerald, Terrence T.

2010-01-01

Research suggests that buprenorphine treatment may be a promising intervention for incarcerated individuals with heroin addiction histories. However, its implementation varies from corrections-based methadone because of unique challenges regarding dosing, administration, and regulation. Describing the first randomized clinical trial of…

Effectiveness of a Hospital-Based Multidisciplinary Pediatric Weight Management Program: Two-Year Outcomes of PHIT Kids.

PubMed

Hampl, Sarah; Odar Stough, Cathleen; Poppert Cordts, Katrina; Best, Cora; Blackburn, Katherine; Dreyer Gillette, Meredith L

2016-02-01

For children with obesity, long-term sustainability of weight loss after treatment is difficult to achieve. This study examined 2-year anthropometric outcomes of a moderately intensive group behaviorally based weight management program. One hundred seventy-three children with obesity ages 8-18 years participated with their parent or adult caregiver in a 24-week multicomponent intervention, which was followed by monthly sessions for a total of 2 years. Children were considered treatment completers if they attended ≥50% of the 24 weekly sessions. A multilevel model (multiple assessment time points nested within participants) was used to test person-level change in BMI z-score (BMIz) for program completers between (1) pre- and post-treatment, (2) pretreatment and 24-month follow-up, (3) post-treatment and 12-month follow-up, and (4) post-treatment and 24-month follow-up. One hundred twenty-four (72%) of the participants completed the 24-week intervention. Significant reductions in BMIz were observed over the course of treatment (β = -0.03; standard error [SE] = 0.004; t = -6.85; p < 0.001). Completers showed a significant reduction in BMIz between initiation of treatment and 2-year follow-up (n = 110 at 24 weeks; n = 38 at 24 months; β = -0.02; SE = 0.005; t = -4.12; p < 0.001). Children did not show any significant changes in BMIz between post-treatment and 24-month follow-up (β = -0.006; SE = 0.011; t = -0.61; p = 0.54), suggesting that treatment effects were maintained. Children maintained treatment gains achieved during a 24-week family-based behavioral weight management program at 2-year follow-up. Although these findings suggest that gains are sustainable, further research is needed to understand how these long-term changes impact child health.

PARTIAL ARTICULAR SUPRASPINATUS TENDON AVULSION (PASTA) LESION. CURRENT CONCEPTS IN REHABILITATION

PubMed Central

2016-01-01

ABSTRACT Rotator cuff pathology can contribute to shoulder pain and may affect the performance of sport activities, work, and activities of daily living. The partial articular supraspinatus tendon avulsion (PASTA) lesion represents a very common type of rotator cuff pathology seen in rehabilitation. When conservative treatment fails, surgery is generally required. Success of recovery depends on several factors, including: repair techniques, healing process related to timing, rehabilitation programs, and patient compliance with home exercises. To date, most treatment modalities and rehabilitation programs are based on clinical experience rather than scientific evidence. Therefore, the purpose of this clinical commentary is to provide an overview on the PASTA lesion, discuss the common treatment approaches adopted to date and to propose a rehabilitation program based on the available scientific evidence. Level of Evidence 5 PMID:27274431

Adults with Pedophilic Interests in the United States: Current Practices and Suggestions for Future Policy and Research.

PubMed

Lasher, Michael P; Stinson, Jill D

2017-04-01

Adults with pedophilic interests are often viewed by the public as a homogenous subgroup based on what we know from those who sexually offend against children. The stigma associated with child sexual abuse may serve to deter such behaviors but may also interfere with the person's stability and willingness to seek assistance in managing pedophilic interests. This article contrasts the sex offender response and prevention efforts typically employed in the U.S. (i.e., containment, registration, and notification policies and public education programs) with treatment programs aimed at preventing child sexual abuse in Germany, Belgium, and Canada. Five major areas are identified that should be further examined with regard to implementing preventative outreach and treatment programs in the U.S.: barriers to outreach and treatment programs, how to expand or reframe current preventative educational programs, implementation of such programs in light of current mandating reporting policies, promising treatment approaches for pedophilic interests among non-offenders, and ethical concerns relevant to preventative psychological interventions.

New treatment policy of malaria as a part of malaria control program in Indonesia.

PubMed

Kusriastuti, Rita; Surya, Asik

2012-07-01

Malaria control program is one of the oldest program in the Ministry of Health (MoH) Republic of Indonesia. Started with effort to eradicate malaria in 1959 through Malaria Eradication Command well known as KOPEM (Komando Pembasmian Malaria) then it evolves to Malaria Control Program, Roll Back Malaria Program, and the current Malaria Elimination Program. In terms of diagnostic and treatment, the policy has formulated by strictly follow evidence-based principles as well as technical guided from World Health Organization (WHO). In 2004, based on numerous researches conducted in Indonesia the use of chloroquine was stopped and artemisinin-based combination therapy (ACT) was then initiated. For severe cases the use of intravenous (iv) Artesunate for cases treated in hospitals and intramuscular (im) Arthemeter for cases treated in the primary care setting were also introduced. ACT, Artesunate iv, and Artemether im, all are provided nationwide through the procurement system. For radical treatment, the recommendation in Indonesia is to add primaquine (PQ) to ACT for Plasmodium vivax and Plasmodium ovale infections to prevent relapses and for Plasmodium Falciparum infection to kill the gametocytes. These recommendations put hope to reduce malaria mortality to zero and eventually with other interventions will eliminate malaria from the country by 2030. The dissemination of this information is important for the policy to apply in practice across the country.

The effect of adding Coping Power Program-Sweden to Parent Management Training-effects and moderators in a randomized controlled trial.

PubMed

Helander, Maria; Lochman, John; Högström, Jens; Ljótsson, Brjánn; Hellner, Clara; Enebrink, Pia

2018-04-01

For children with oppositional defiant disorder (ODD), Parent Management Training (PMT) is a recommended treatment in addition to child Cognitive Behavioral Therapy (child-CBT). There is however a lack of studies investigating the additive effect of group-based child-CBT to PMT for children between 8 and 12 years. The current study investigated the incremental effect of group-based child-CBT, based on the Coping Power Program, when added to the Swedish group-based PMT program KOMET. Outcomes were child behavior problems, child prosocial behavior, parenting skills and the moderating effect of child characteristics. One hundred and twenty children 8-12 years with ODD or Disruptive Behavioral Disorder NOS and their parents were randomized either to combined child-CBT and PMT (n = 63) or to PMT only (n = 57) in Swedish Child- and Adolescent Psychiatric settings. Participants were assessed pre- and post-treatment using semi-structured interviews and child- and parent ratings. After treatment, behavior problems were reduced in both groups. Prosocial behavior were significantly more improved in the combined treatment. Parenting skills were improved in both groups. In moderator analyses, behavior problems and prosocial behavior improved significantly more in the combined treatment compared to PMT only in the group of children with high levels of ODD symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

Using MMPI-A Profiles to Predict Success in a Military-Style Residential Treatment Program for Adolescents with Academic and Conduct Problems

ERIC Educational Resources Information Center

Weis, Robert; Crockett, Thomas E.; Vieth, Sasha

2004-01-01

Military-style residential treatment for adolescents with academic and conduct problems is an increasingly popular alternative to traditional school-based services. However, dropout from "boot camp" programs is a primary reason for their high cost. Social-emotional functioning before referral may differentiate adolescents who…

Group Lidcombe Program Treatment for Early Stuttering: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Arnott, Simone; Onslow, Mark; O'Brian, Sue; Packman, Ann; Jones, Mark; Block, Susan

2014-01-01

Purpose: This study adds to the Lidcombe Program evidence base by comparing individual and group treatment of preschoolers who stutter. Method: A randomized controlled trial of 54 preschoolers was designed to establish whether group delivery outcomes were not inferior to the individual model. The group arm used a rolling group model, in which a…

Batterer and Facilitator Talk in the Context of a Batterer Intervention Program for Men

ERIC Educational Resources Information Center

Shahane, Amit

2009-01-01

The most common approach to treating male perpetrators of domestic violence has been batterer intervention programs (BIPs) (Aldarondo & Mederos, 2002). In particular, the use of group treatment modalities is due to theoretically-based assumptions that the group treatment context is best for male resocialization, and the most cost effective (Dutton…

Improving Adherence to Smoking Cessation Treatment: Intervention Effects in a Web-Based Randomized Trial.

PubMed

Graham, Amanda L; Papandonatos, George D; Cha, Sarah; Erar, Bahar; Amato, Michael S; Cobb, Nathan K; Niaura, Raymond S; Abrams, David B

2017-03-01

Web-based smoking cessation interventions can deliver evidence-based treatments to a wide swath of the population, but effectiveness is often limited by insufficient adherence to proven treatment components. This study evaluated the impact of a social network (SN) intervention and free nicotine replacement therapy (NRT) on adherence to evidence-based components of smoking cessation treatment in the context of a Web-based intervention. A sample of adult U.S. smokers (N = 5290) was recruited via BecomeAnEX.org, a free smoking cessation Web site. Smokers were randomized to one of four arms: (1) an interactive, evidence-based smoking cessation Web site (WEB) alone; (2) WEB in conjunction with an SN intervention designed to integrate participants into the online community (WEB+SN); (3) WEB plus free NRT (WEB+NRT); and (4) the combination of all treatments (WEB+SN+NRT). Adherence outcomes assessed at 3-month follow-up were as follows: Web site utilization metrics, use of skills training components, intratreatment social support, and pharmacotherapy use. WEB+SN+NRT outperformed all others on Web site utilization metrics, use of practical counseling tools, intratreatment social support, and NRT use. It was the only intervention to promote the sending of private messages and the viewing of community pages over WEB alone. Both social network arms outperformed WEB on most metrics of online community engagement. Both NRT arms showed higher medication use compared to WEB alone. This study demonstrated the effectiveness of two approaches for improving adherence to evidence-based components of smoking cessation treatment. Integrated approaches to medication provision and social network engagement can enhance adherence to components known to improve cessation. This study demonstrated that an integrated approach to medication provision and social network integration, when delivered through an online program, can enhance adherence across all three recommended components of an evidence-based smoking cessation program (skills training, social support, and pharmacotherapy use). Nicotine replacement therapy-when provided as part of an integrated program-increases adherence to other program elements, which in turn augment its own therapeutic effects. An explicit focus on approaches to improve treatment adherence is an important first step to identifying leverage points for optimizing intervention effectiveness. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Substance use recovery outcomes among a cohort of youth participating in a mobile-based texting aftercare pilot program.

PubMed

Gonzales, Rachel; Ang, Alfonso; Murphy, Debra A; Glik, Deborah C; Anglin, M Douglas

2014-07-01

Project ESQYIR (Educating & Supporting Inquisitive Youth in Recovery) is a pilot study examining the feasibility of a 12-week mobile-based aftercare intervention for youth (ages 12 to 24) transitioning out of community-based substance abuse treatment programs. From January 2012 through July 2013, a total of 80 youth were recruited from outpatient and residential treatment programs, geographically dispersed throughout Los Angeles County, California. Results revealed that youth who participated in the texting mobile pilot intervention were significantly less likely to relapse to their primary compared to the aftercare as usual control condition (OR=0.52, p=0.002) over time (from baseline throughout the 12-week aftercare pilot program to a 90-day follow-up). Participants in the texting aftercare pilot program also reported significantly less substance use problem severity (β=-0.46, p=0.03) and were more likely to participate in extracurricular recovery behaviors (β=1.63, p=0.03) compared to participants in the standard aftercare group. Collectively, findings from this pilot aftercare study suggest that mobile texting could provide a feasible way to engage youth in recovery after substance abuse treatment to aid with reducing relapse and promoting lifestyle behavior change. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors Associated with HIV Testing Among Participants from Substance Use Disorder Treatment Programs in the US: A Machine Learning Approach.

PubMed

Pan, Yue; Liu, Hongmei; Metsch, Lisa R; Feaster, Daniel J

2017-02-01

HIV testing is the foundation for consolidated HIV treatment and prevention. In this study, we aim to discover the most relevant variables for predicting HIV testing uptake among substance users in substance use disorder treatment programs by applying random forest (RF), a robust multivariate statistical learning method. We also provide a descriptive introduction to this method for those who are unfamiliar with it. We used data from the National Institute on Drug Abuse Clinical Trials Network HIV testing and counseling study (CTN-0032). A total of 1281 HIV-negative or status unknown participants from 12 US community-based substance use disorder treatment programs were included and were randomized into three HIV testing and counseling treatment groups. The a priori primary outcome was self-reported receipt of HIV test results. Classification accuracy of RF was compared to logistic regression, a standard statistical approach for binary outcomes. Variable importance measures for the RF model were used to select the most relevant variables. RF based models produced much higher classification accuracy than those based on logistic regression. Treatment group is the most important predictor among all covariates, with a variable importance index of 12.9%. RF variable importance revealed that several types of condomless sex behaviors, condom use self-efficacy and attitudes towards condom use, and level of depression are the most important predictors of receipt of HIV testing results. There is a non-linear negative relationship between count of condomless sex acts and the receipt of HIV testing. In conclusion, RF seems promising in discovering important factors related to HIV testing uptake among large numbers of predictors and should be encouraged in future HIV prevention and treatment research and intervention program evaluations.

Addressing Prediabetes in Childhood Obesity Treatment Programs: Support from Research and Current Practice

PubMed Central

Grow, H. Mollie; Fernandez, Cristina; Lukasiewicz, Gloria J.; Rhodes, Erinn T.; Shaffer, Laura A.; Sweeney, Brooke; Woolford, Susan J.; Estrada, Elizabeth

2014-01-01

Abstract Background: Type 2 diabetes mellitus (T2DM) and prediabetes have increased in prevalence among overweight and obese children, with significant implications for long-term health. There is little published evidence on the best approaches to care of prediabetes among overweight youth or the current practices used across pediatric weight management programs. Methods: This article reviews the literature and summarizes current practices for screening, diagnosis, and treatment of prediabetes at childhood obesity treatment centers. Findings regarding current practice were based on responses to an online survey from 28 pediatric weight management programs at 25 children's hospitals in 2012. Based on the literature reviewed, and empiric data, consensus support statements on prediabetes care and T2DM prevention were developed among representatives of these 25 children's hospitals' obesity clinics. Results: The evidence reviewed demonstrates that current T2DM and prediabetes diagnostic parameters are derived from adult-based studies with little understanding of clinical outcomes among youth. Very limited evidence exists on preventing progression of prediabetes. Some evidence suggests that a significant proportion of obese youth with prediabetes will revert to normoglycemia without pharmacological management. Evidence supports lifestyle modification for children with prediabetes, but further study of specific lifestyle changes and pharmacological treatments is needed. Conclusion: Evidence to guide management of prediabetes in children is limited. Current practice patterns of pediatric weight management programs show areas of variability in practice, reflecting the limited evidence base. More research is needed to guide clinical care for overweight youth with prediabetes. PMID:25055134

Do Pilates-based exercises following total knee arthroplasty improve postural control and quality of life?

PubMed

Karaman, Aysenur; Yuksel, Inci; Kinikli, Gizem Irem; Caglar, Omur

2017-04-01

The aim of this prospective, randomized, controlled study was to investigate the effects of the addition of Pilates-based exercises to standard exercise programs performed after total knee arthroplasty on quality of life and balance. Forty-six volunteers were divided into two groups. The control group (n = 17) was assigned a standard exercise program after discharge; the study group (n = 17) was assigned Pilates-based exercises along with the standard exercise program. We carried out clinical evaluations of all patients on the day of discharge and after the completion of the 6-week exercise program. We also recorded sociodemographic data, Berg Balance test scores, and Short Form-36 (SF-36) health-related quality of life measurements. When we compared the differences between pre- and post-treatment balance scores of the groups, we found a significant change in favor of the Pilates-based exercise group (13.64 ± 1.45; p < 0.01). The changes in the pre- and post-treatment SF-36 scores of the Pilates-based exercises group were found to be significant in terms of physical function (p = 0.001), physical role restriction (p = 0.01), and physical component score (p = 0.001). Pilates-based exercises performed along with standard exercise programs were more effective for improving balance and quality of life than standard exercise programs alone.

Predictors of treatment attrition as indicators for program improvement not offender shortcomings: a study of sex offender treatment attrition.

PubMed

Beyko, Michelle J; Wong, Stephen C P

2005-10-01

This study classified potential attrition predictors under the domains of risk, need and responsivity (D. Andrews & J. Bonta, 2003). Non-sexual criminogenic needs (e.g. aggression, rule violating behaviors) and responsivity factors (e.g. lack of motivation and denial) were the two main clusters of predictors that correctly classified 95.3% of program completers and non-completers using discriminant function analysis in a sample of high-risk male sexual offenders treated in an accredited inpatient sex offender treatment program. Rapists were more aggressive than other types of sex offenders and were more likely to drop out of treatment. Some studies of predictors of treatment attrition have used offender problem behaviors or psychopathologies to predict attrition and then use the information to exclude offenders from treatment. Others have argued, and we concur, that results of attrition research should not be used to develop an "attrition profile" to exclude offenders from treatment. Predictors of attrition should be seen as markers for program improvement, rather than shortcomings of the offender. Suggestions for program improvements to reduce the rate of attrition, based on results of research, are presented.

A Randomized Experimental Study of Gender-Responsive Substance Abuse Treatment for Women in Prison

PubMed Central

Messina, Nena; Grella, Christine E.; Cartier, Jerry; Torres, Stephanie

2009-01-01

This experimental pilot study compared post-release outcomes for 115 women who participated in prison-based substance abuse treatment. Women were randomized to a gender-responsive treatment (GRT) program using manualized curricula (Helping Women Recover and Beyond Trauma) or a standard prison-based therapeutic community (TC). Data were collected from the participants at prison program entry and 6 and 12 months after release. Bivariate and multivariate analyses were conducted. Results indicate that both groups improved in psychological well-being; however, GRT participants had greater reductions in drug use, were more likely to remain in residential aftercare longer (2.6 months vs. 1.8 months, p < .05), and were less likely to have been reincarcerated within 12 months after parole (31% vs. 45%, respectively; a 67% reduction in odds for the experimental group, p < .05). Findings show the beneficial effects of treatment components oriented toward women's needs and support the integration of GRT in prison programs for women. PMID:20015605

Treatment Retention Among Patients Participating in Coordinated Specialty Care for First-Episode Psychosis: a Mixed-Methods Analysis.

PubMed

Hamilton, Jane E; Srivastava, Devika; Womack, Danica; Brown, Ashlie; Schulz, Brian; Macakanja, April; Walker, April; Wu, Mon-Ju; Williamson, Mark; Cho, Raymond Y

2018-06-05

Young adults experiencing first-episode psychosis have historically been difficult to retain in mental health treatment. Communities across the United States are implementing Coordinated Specialty Care to improve outcomes for individuals experiencing first-episode psychosis. This mixed-methods research study examined the relationship between program services and treatment retention, operationalized as the likelihood of remaining in the program for 9 months or more. In the adjusted analysis, male gender and participation in home-based cognitive behavioral therapy were associated with an increased likelihood of remaining in treatment. The key informant interview findings suggest the shared decision-making process and the breadth, flexibility, and focus on functional recovery of the home-based cognitive behavioral therapy intervention may have positively influenced treatment retention. These findings suggest the use of shared decision-making and improved access to home-based cognitive behavioral therapy for first-episode psychosis patients may improve outcomes for this vulnerable population.

Spanish language proficiency among providers and Latino clients' engagement in substance abuse treatment.

PubMed

Guerrero, Erick G; Khachikian, Tenie; Kim, Tina; Kong, Yinfei; Vega, William A

2013-12-01

Quality of care, such as provision of services in Spanish, is a common factor believed to improve treatment engagement among Spanish-speaking Latinos in health care. However, there is little evidence that Spanish language proficiency among providers increases treatment access and retention in publicly funded substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, California. An analytic sample of 1903 Latino clients nested within 40 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on days to initiate and spent in treatment. As hypothesized, Spanish language proficiency was negatively associated with client wait time and positively associated with retention in treatment, after controlling for individual and program characteristics. The path analysis models showed that Spanish language proficiency played a mediating role between professional accreditation and client wait time and retention. These preliminary findings provide an evidentiary base for the role of providers' Spanish language proficiency and Latino engagement in treatment for a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to enhance linguistically competent care, are discussed. © 2013.

[Guideline-adherent inpatient psychiatric psychotherapeutic treatment of borderline personality disorder : Normative definition of personnel requirements].

PubMed

Bohus, M; Schmahl, C; Herpertz, S C; Lieb, K; Berger, M; Roepke, S; Heinz, A; Gallinat, J; Lyssenko, L

2016-07-01

Borderline personality disorders (BPD) are severe mental diseases which place high pressure on the psychiatric healthcare system. Nowadays, well-tested, disorder-specific treatment concepts are available also for inpatient treatment in Germany. These show very good and long-term improvements in the psychopathology as well as posttreatment social participation; however, prerequisites for the implementation of these evidence-based inpatient psychotherapy programs are well-trained treatment teams and appropriate financing of resource expenditure. The aim was to formulate a definition of normative needs for treatment duration and intensity for a guideline-conform, empirically proven and effective inpatient treatment of borderline personality disorder as well as the derived personnel requirements in comparison to the currently available resources within the framework of the Psychiatry Personnel Act (Psych-PV). The resource requirements were established based on evaluated hospital ward models, the recommendations of the S2 guidelines and the criteria of specialist societies and compared with the personnel stipulations according to the Psych-PV. The results for a normatively established treatment program showed a pronounced deficit in the financing of the evaluated resource requirements, even when the stipulations laid down in the Psych-PV were implemented to 100 %. Disorder-specific inpatient treatment programs for borderline personality disorder have been scientifically proven to be highly effective; however, resource analyses show that the personnel requirements necessary for effective implementation of these programs are much higher than those allocated by the funding according to the Pysch-PV. The current underfunding leads to inadequate treatment outcomes with high readmission rates and as a result high direct and indirect costs of illness.

Issues and Potential Program on Denatured Fuel Utilization.

DTIC Science & Technology

1978-12-01

HTGR fuel develop - ment program ; 4. coated particles of (U,Th)02 have been extensively tested as potential HTGR fuels . A detailed summary of the...current scrap and waste treatment requirements. dBase case for all HTGR (Prismatic Fuel Element) cases based on data in "Summary Program Plan...Alternate Program for HTGR Fuel Recycle," April 11, 1975, Draft. 19 a --- AC8NCi09 The principal factors that result in a nominally-higher cost for

Physiological work performance in chronic low back disability: effects of a progressive activity program.

PubMed

Thomas, L K; Hislop, H J; Waters, R L

1980-04-01

Fifteen patients were tested before and after treatment in a multifaceted inpatient program for chronic low back pain to determine if a gradually progressive activity program affected gait performance and physiological capacity. Before treatment, all patients demonstrated decreased physiological conditioning by higher-than-expected values for oxygen consumption and heart rate and by lower-than-normal gait velocity, stride length, and cadence. After treatment, an increase in mean walking velocity of 19 meters/minute reflected parallel gains in cadence and stride length. Improved mechanical performance resulted in improved "energetics." Energy spent per unit of distance walked decreased by 18 percent after treatment, providing a useful measure of increased physiological efficiency. Results indicated that patients with chronic low back disability can derive significant conditioning effects from an exercise program based on general function.

A prospective pilot study to evaluate an animated home-based physical exercise program as a treatment option for patients with rheumatoid arthritis.

PubMed

Zernicke, Jan; Kedor, Claudia; Müller, Angela; Burmester, Gerd-Rüdiger; Reißhauer, Anett; Feist, Eugen

2016-08-18

Physical exercises and physiotherapy are of great importance for maintenance of joint function in patients with rheumatoid arthritis (RA). However, many RA patients complain about problems to receive prescriptions or have a lack of access to physiotherapy. Recent reports have shown positive effects of the Wii game console on physical and psychosocial conditions of patients with other underlying diseases. The primary objectives of this prospective controlled pilot study were to investigate feasibility and patients' assessment using an animated home-based exercise program. This pilot study was conducted as a single-center, cross-over trial with two treatment arms over 24 weeks. Eligibility criteria included patients with RA reaching low disease activity under therapy with a biological disease modifying anti-rheumatic drug (bDMARD). After detailed instruction, 15 patients started with a conventional home-based physical exercise program and 15 patients began with a predefined animated exercise program by using the Wii game console for 12 weeks. Afterwards, patients were crossed-over to the other treatment arm for another period of 12 weeks. Multi-methodical assessments were performed by qualitative analysis of the interview-data as well as statistical analysis of functional tests and patient reported outcomes (PRO's). Evaluation of the interviews indicated feasibility and usefulness of the chosen animated home-based exercise program. Forefoot disabilities were identified as a main limiting factor for performing some of the animated exercises. After 12 weeks, both treatment arms showed improvement of functional tests without significant differences between groups: Overall muscle strength improved for a mean value of 10 Newton (+12 %) and the mean 6-min walk test (6-MWT) distance increased for 28 meters (+5 %). This study showed that an animated home-based exercise program by using a Wii game console was feasible and beneficial for RA patients. Compared to standard physical home exercises, similar effects were observed indicating that such an animated program might be an alternative supportive option for RA patients. ClinicalTrials.gov ID: NCT02658370 (19-Jan-2016).

Effectiveness of an Activity Tracker- and Internet-Based Adaptive Walking Program for Adults: A Randomized Controlled Trial.

PubMed

Poirier, Josée; Bennett, Wendy L; Jerome, Gerald J; Shah, Nina G; Lazo, Mariana; Yeh, Hsin-Chieh; Clark, Jeanne M; Cobb, Nathan K

2016-02-09

The benefits of physical activity are well documented, but scalable programs to promote activity are needed. Interventions that assign tailored and dynamically adjusting goals could effect significant increases in physical activity but have not yet been implemented at scale. Our aim was to examine the effectiveness of an open access, Internet-based walking program that assigns daily step goals tailored to each participant. A two-arm, pragmatic randomized controlled trial compared the intervention to no treatment. Participants were recruited from a workplace setting and randomized to a no-treatment control (n=133) or to treatment (n=132). Treatment participants received a free wireless activity tracker and enrolled in the walking program, Walkadoo. Assessments were fully automated: activity tracker recorded primary outcomes (steps) without intervention by the participant or investigators. The two arms were compared on change in steps per day from baseline to follow-up (after 6 weeks of treatment) using a two-tailed independent samples t test. Participants (N=265) were 66.0% (175/265) female with an average age of 39.9 years. Over half of the participants (142/265, 53.6%) were sedentary (<5000 steps/day) and 44.9% (119/265) were low to somewhat active (5000-9999 steps/day). The intervention group significantly increased their steps by 970 steps/day over control (P<.001), with treatment effects observed in sedentary (P=.04) and low-to-somewhat active (P=.004) participants alike. The program is effective in increasing daily steps. Participants benefited from the program regardless of their initial activity level. A tailored, adaptive approach using wireless activity trackers is realistically implementable and scalable. Clinicaltrials.gov NCT02229409, https://clinicaltrials.gov/ct2/show/NCT02229409 (Archived by WebCite at http://www.webcitation.org/6eiWCvBYe).

Academic Facility Utilization and Survival Outcomes in Adult Head and Neck Sarcomas: An NCDB Analysis.

PubMed

Cannon, Richard B; Carpenter, Patrick S; Boothe, Dustin; Buchmann, Luke O; Hunt, Jason P; Lloyd, Shane; Hitchcock, Ying J; Houlton, Jeffrey J; Weis, John R; Shepherd, Hailey M; Monroe, Marcus M

2018-04-01

Objectives To investigate clinicopathologic and treatment factors associated with survival in adult head and neck sarcomas in the National Cancer Database (NCDB). To analyze whether treatment settings and therapies received influence survival outcomes and to compare trends in utilization via an aggregated national data set. Study Design Prospectively gathered data. Setting NCDB. Subjects and Methods The study comprised a total of 6944 adult patients treated for a head and neck sarcoma from January 2004 to December 2013. Overall survival (OS) was the primary outcome. Results Increased age and tumor size, nodal involvement, and poorly differentiated histology had significantly reduced OS ( P < .001). Angiosarcoma, malignant nerve sheath tumor, malignant fibrous histiocytoma, osteosarcoma, and rhabdomyosarcoma histologic subtypes had significantly reduced OS, while liposarcoma, chondrosarcoma, and chordoma had improved OS ( P < .001). Utilization of surgical therapy was associated with improved OS, while positive surgical margins were associated with treatment at a community-based cancer program and had reduced OS ( P < .001). On multivariate analysis, treatment with radiation and/or chemotherapy was not significantly associated with OS; however, primary treatment with definitive chemoradiotherapy had significantly reduced OS. Patients treated at academic/research cancer programs (n = 3874) had significantly improved 5- and 10-year OS (65% and 54%, respectively) when compared with patients treated at community-based cancer programs (n = 3027; 49% and 29%; P < .001). The percentage utilization of these programs (56% vs 44%) did not change over the study period. Conclusion For adult head and neck sarcomas, treatment at an academic/research cancer program was associated with improved survival; however, despite increasing medical specialization, the percentage utilization of these programs for this rare tumor remains constant.

The adoption and implementation of an evidence based practice in child and family mental health services organizations: a pilot study of functional family therapy in New York State.

PubMed

Zazzali, James L; Sherbourne, Cathy; Hoagwood, Kimberly Eaton; Greene, Deborah; Bigley, Michael F; Sexton, Thomas L

2008-03-01

Numerous challenges persist in providing evidence-based treatments to children and families in community-based settings. Functional Family Therapy (FFT), one such evidence-based treatment, is a family prevention and intervention program for adolescents with conduct disorder or oppositional defiant disorder. This paper presents pilot data in support of a conceptual framework explaining the adoption and implementation of FFT in a small sample of family and child mental health services organizations in New York State. The conceptual framework is grounded in the diffusion of innovations and the organizational behavior literatures, as well as previously published accounts of the adoption and implementation of evidence-based treatments in mental health. Pilot study data demonstrated that factors associated with the adoption of FFT included: The program fitting with the mission of the organization, as well as the organization having a strong interest in evidence-based treatments. Once a decision to adopt FFT was made, the degree to which it fit with organizational characteristics (e.g., available resource sets, organizational structure, and culture) influenced the ease with which it was implemented. Implications for the adoption and implementation of other evidence-based treatments are discussed.

The Use of Art and Music Therapy in Substance Abuse Treatment Programs

PubMed Central

Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.

2014-01-01

While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689

Psychological correlates of obese patients seeking surgical or residential behavioral weight loss treatment.

PubMed

Stout, Anna L; Applegate, Katherine L; Friedman, Kelli E; Grant, John P; Musante, Gerard J

2007-01-01

The purpose of this study was to gain a better understanding of the psychological factors related to obese individuals self-selecting for either a residential cognitive-behavioral-based program or surgical treatment program for weight loss. Two patient samples with a body mass index of > or =35 kg/m(2) were administered a battery of psychological questionnaires, including the Beck Depression Inventory, Binge Eating Scale, and Impact of Weight on Quality of Life-Lite, at the evaluation for entry into either a surgical weight loss treatment program (n = 76) or cognitive-behavioral-based weight loss treatment program (n = 101). No significant difference was found in the mean body mass index of the 2 samples. No significant difference was found in the self-reported level of depressive symptoms of the 2 samples, with both samples obtaining a mean depressive symptom score in the mild range. Surgical treatment seekers, however, reported significantly greater emotional eating and attributed greater impairment in their quality of life to their weight. Individuals seeking a surgical approach to weight loss might perceive their weight as having a greater negative impact on their life than those selecting a residential behavioral lifestyle change approach, even when their weight and depressive symptoms are equivalent. Therefore, an individual's own cognitive appraisal of the negative consequences of their weight might correlate with their treatment choice.

Effectiveness of a Brief Home-Based Social Work Motivational Intervention for Male Methamphetamine Users in Tehran: A Randomized Clinical Trial.

PubMed

Danaee-Far, Morteza; Maarefvand, Masoomeh; Rafiey, Hassan

2016-12-05

Methamphetamine, a highly addictive psychostimulant drug, is widely used by substance users who are not motivated to undergo treatment throughout the world, including Iran. This research was conducted to evaluate the effectiveness of a brief home-based social work motivational intervention (HSWMI) to encourage male methamphetamine users to participate in a treatment program. Fifty-six unmotivated male methamphetamine users participated in a randomized controlled trial. The case group received the HSWMI in addition to the usual consulting services in the clinic; the control group just received the usual consulting services. Data were collected 7 and 90 days after the intervention to evaluate participation and retention in a treatment program. Data were analyzed using the chi-square test. Drug users with a mean age of 32.55 years and mean duration of drug use of 7.73 years, participated in the case (n = 28) and control (n = 28) groups. The case group participated in treatment programs significantly more than the control group and the retention rate for the case group was significantly higher than for the control group. This brief HSWMI was effective to increase the motivation of methamphetamine users to participate and remain in treatment programs. This intervention can be implemented by social workers in substance use treatment centers.

High School-Based Treatment for Adolescents with Attention-Deficit/Hyperactivity Disorder: Results from a Pilot Study Examining Outcomes and Dosage

ERIC Educational Resources Information Center

Evans, Steven W.; Schultz, Brandon K.; DeMars, Christine E.

2014-01-01

The purpose of this study was to examine the efficacy and dose-response relationship of a school-based treatment program for high school students with attention-deficit/hyperactivity disorder (ADHD). Two paraprofessionals provided interventions to 24 students with ADHD randomly assigned to the treatment condition at two public high schools. They…

Preventing Parolees from Returning to Prison through Community-Based Reintegration

ERIC Educational Resources Information Center

Zhang, Sheldon X.; Roberts, Robert E. L.; Callanan, Valerie J.

2006-01-01

In the late 1990s, California legislators funded a statewide, community-based correctional program intended to reduce parolee recidivism. Overseen by the California Department of Corrections, the Preventing Parolee Crime Program (PPCP) provided literacy training, employment services, housing assistance, and substance abuse treatment to tens of…

A School-Based Program for Overweight and Obese Adolescents: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Pbert, Lori; Druker, Susan; Barton, Bruce; Schneider, Kristin L.; Olendzki, Barbara; Gapinski, Mary A.; Kurtz, Stephen; Osganian, Stavroula

2016-01-01

Background: Given the dramatic increase in adolescent overweight and obesity, models are needed for implementing weight management treatment through readily accessible venues. We evaluated the acceptability and efficacy of a school-based intervention consisting of school nurse-delivered counseling and an afterschool exercise program in improving…

Two Student Self-Management Techniques Applied to Data-Based Program Modification.

ERIC Educational Resources Information Center

Wesson, Caren

Two student self-management techniques, student charting and student selection of instructional activities, were applied to ongoing data-based program modification. Forty-two elementary school resource room students were assigned randomly (within teacher) to one of three treatment conditions: Teacher Chart-Teacher Select Instructional Activities…

Building Strengths in the Neighborhood

ERIC Educational Resources Information Center

Quigley, Richard

2005-01-01

This article features Woodland Hills's Neighborhood Youth Services. The Neighborhood Youth Services (NYS) program is a community-based program created by Woodland Hills, a residential program for troubled adolescents in Duluth, Minnesota. Principles for building respectful adult and peer relationships developed in the treatment environment were…

Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial

PubMed Central

Wang, Philip S.; Simon, Gregory E.; Avorn, Jerry; Azocar, Francisca; Ludman, Evette J.; McCulloch, Joyce; Petukhova, Maria Z.; Kessler, Ronald C.

2010-01-01

Context Although guideline-concordant depression treatment is clearly effective, treatment often falls short of evidence-based recommendations. Organized depression care programs significantly improve treatment quality, but employer-purchasers have been slow to demand these programs based on lack of evidence for cost-effectiveness from their perspective. Objective To evaluate the effects of a depression outreach-treatment program on workplace outcomes of concern to employers. Design Randomized controlled trial with allocation concealment and blinded assessment of depression severity and work performance at 6 and 12 months. Setting and Participants Two-stage screening of employees covered by a managed behavioral health plan identified 604 with clinically significant depression (excluding those with lifetime bipolar disorder, substance disorder, recent mental health specialty care, or suicidality). Intervention A telephonic outreach and care management program encouraged workers to enter outpatient treatment (psychotherapy and/or antidepressant medication), monitored treatment quality-continuity, and attempted to improve treatment by giving recommendations to providers. Participants reluctant to enter treatment were offered a structured telephone cognitive-behavioral psychotherapy. Main Outcome Measures Depression severity (Quick Inventory of Depressive Symptomatology, QIDS-SR) and work performance (WHO Health and Productivity Questionnaire, HPQ, a validated self-report instrument assessing job retention, time missed from work, work performance, and critical workplace incidents). Results Combining data across 6-month and 12-month assessments, the intervention group had significantly lower QIDS-SR scores (1.4 relative-odds of recovery), significantly higher job retention (1.7 relative-odds), and significantly more hours worked among the employed (equivalent to an annualized effect of approximately 2.5 weeks of work) than usual care subjects. Conclusions A systematic program to identify depression and promote effective treatment significantly improves not only clinical outcomes but also workplace outcomes. The financial value of the latter to employers in terms of recovered hiring-training and salary costs suggests that many employers would experience a positive return on investment from outreach and enhanced treatment of depressed workers. PMID:17895456

[The total-quality-management-analysis of the continuation and discontinuation of alcohol family treatment: a grassroots approach].

PubMed

Nishikawa, K; Tatsuki, S

2001-06-01

A family support/treatment program was provided to thirty-three cases where a drinking family member (identified patient) had shown alcohol related problems but not yet admitted the problem. After a period of between thirteen and twenty-one months of family treatment, fourteen (42.4%) identified patients started their own treatment. The only statistically significant factor that was related to the patients' treatment program participation was the continuation of family members' involvement in a family treatment program. Among the thirty-three cases, a little less than one half (48.5%) continued the family program. In order to increase the patients' participation, it is crucial to encourage family members to continue their family support/treatment program. In order to identify factors that contribute treatment continuation as well as dropouts, workshops were held with those who dropped out and those who continued the family treatment program. The Total-Quality-Management (TQM) affinity and arrow diagram techniques were employed to classify the participants' statements and to find cause-effect relationships among the identified factors, respectively. Five family treatment discontinuation factors were identified: 1) a lack of information about family support program, 2) resistance against a "family change" orientation in family treatment program, 3) family member burnout, 4) a misfit between family needs for immediate problem solutions and what family program offers, and 5) a temporal improvement of patients' drinking problems. While widely varied factors were found to contribute discontinuation, only a very few factors were identified to facilitate the treatment continuation. It was concluded that treatment discontinuation, rather than continuation, was the norm among the families of problem drinkers. Based on the above findings, three kaizen plans were proposed. First, in order to make sure that family members obtain necessary information about the family support/treatment program, a pamphlet would be created and handed out to those who come to family treatment. Second, family support efforts would be emphasized more. Treatment staff is expected to become more cautious with regard to the family behavior change facilitation, especially at the early stage. Third, treatment staff is expected to become more aggressive about contacting family group members when they do not show up to a meeting.

The comparative effectiveness of clinic, work-site, phone, and Web-based tobacco treatment programs.

PubMed

An, Lawrence C; Betzner, Anne; Schillo, Barbara; Luxenberg, Michael G; Christenson, Matthew; Wendling, Ann; Saul, Jessie E; Kavanaugh, Annette

2010-10-01

Tobacco treatment programs may be offered in clinical settings, at work-sites, via telephone helplines, or over the Internet. Little comparative data exist regarding the real-world effectiveness of these programs. This paper compares the reach, effectiveness, and costs of these different modes of cessation assistance. This is an observational study of cohorts of participants in Minnesota's QUITPLAN programs in 2004. Cessation assistance was provided in person at 9 treatment centers, using group counseling at 68 work-sites, via a telephone helpline, or via the Internet. The main outcomes of the study are enrollment by current smokers, self-reported 30-day abstinence, and cost per quit. Reach was calculated statewide for the helpline and Web site, regionally for the treatment centers, and for the employee population for work-site programs. Enrollment was greatest for the Web site (n = 4,698), followed by the helpline (n = 2,351), treatment centers (n = 616), and work-sites (n = 479). The Web site attracted younger smokers. Smokers at treatment centers had higher levels of nicotine dependence. The helpline reached more socially disadvantaged smokers. Responder 30-day abstinence rates were higher for the helpline (29.3%), treatment centers (25.8%), and work-sites (19.6%) compared with the online program (12.5%). These differences persisted after controlling for baseline differences in participant characteristics and use of pharmacological therapy. The cost per quit was lowest for the Web site program ($291 per quit, 95% CI = $229-$372). Treatment center, work-site, helpline, and Web site programs differ in their reach, effectiveness, and estimated cost per quit. Each program plays a part in assisting populations of tobacco users in quitting.

The Relative Effectiveness of 10 Adolescent Substance Abuse Treatment Programs in the United States. Technical Report

ERIC Educational Resources Information Center

Morral, Andrew R.; McCaffrey, Daniel F.; Ridgeway, Greg; Mukherji, Arnab; Beighley, Christopher

2006-01-01

Each year, substance abuse treatment programs in the United States record approximately 150,000 admissions of youths under the age of 18. Nevertheless, little is known about the effectiveness of the types of community-based services typically available to youths and their families. Recognizing the need for better information on the effectiveness…

Alternative Funding Resources Manual for Drug Abuse and Alcohol Treatment and Rehabilitation Programs.

ERIC Educational Resources Information Center

Bertagnoli, Cliff

The purpose of this manual is to guide and assist alcohol and other drug abuse treatment programs to maximize cost recovery from third party reimbursements. It is intended to be a guide for planning and decision making rather than a resource manual. The text is based on the experiences of agencies in six states participating in a demonstration…

What sex abusers say about their treatment: results from a qualitative study on pedophiles in treatment at a Canadian penitentiary clinic.

PubMed

Drapeau, Martin; Korner, Annett C; Granger, Luc; Brunet, Louis

2005-01-01

This exploratory study used qualitative methodology to examine what pedophiles think about treatment, as well as their daily experience of a treatment program. To this end, twenty-three offenders receiving treatment from the La Macaza federal penitentiary clinic were interviewed using non-directive semi-structured interviews. Comparative analysis was used to analyze the resulting material. The following themes are discussed based on the results of this analysis: (a) the participants' past experience of therapy; (b) motivations for choosing the La Macaza clinic for treatment; (c) the structure of the program; (d) the group dynamics; (e) the therapists; and (f) the hardships and difficulties of treatment. Results suggest that the therapists and the program may have a function of containment or holding. Although part of the therapeutic process involves a focus on identifying and reducing cognitive distortions, results also warn therapists against misusing this concept by applying it to legitimately different opinions. Findings are discussed in terms of possible program improvements. The authors conclude that greater attention must be given to process research.

Protocols for treating patients with end-stage renal disease: a survey of undergraduate dental programs.

PubMed

Sturgill, Jeremiah; Howell, Scott; Perry, Maureen Munnelly; Kothari, Hemali

2016-11-01

Approximately 14% of Americans are living with chronic kidney disease (CKD). The prevalence of end-stage renal disease (ESRD), the result of progressing CKD continues to rise by 21,000 per year. There are no updated, evidence-based antibiotic prophylaxis guidelines for patients with renal disease undergoing dental treatment. The most recent was a scientific statement from the American Heart Association (AHA) in 2003. Presented in three parts, the goal of the first part of this study is to determine the current protocol being used to treat renal patients at U.S. dental schools. A 21 multiple-choice question survey was e-mailed to 58 clinic deans of accredited dental schools in the United States regarding renal treatment protocol details including antibiotic prophylaxis. Fifty-two percent of programs report having no established renal patient treatment protocol. For programs with a protocol, when using prophylactic antibiotics, 54% followed AHA protocol, whereas 62% used a modified protocol. There is a lack of consistent, established protocols among undergraduate dental programs. It is suggested that evidence-based guidelines for the safe treatment of patients be developed. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

Competing values among criminal justice administrators: The importance of substance abuse treatment.

PubMed

Henderson, Craig E; Taxman, Faye S

2009-08-01

This study applied latent class analysis (LCA) to examine heterogeneity in criminal justice administrators' attitudes toward the importance of substance abuse treatment relative to other programs and services commonly offered in criminal justice settings. The study used data collected from wardens, probation and/or parole administrators, and other justice administrators as part of the National Criminal Justice Treatment Practices survey (NCJTP), and includes both adult criminal and juvenile justice samples. Results of the LCA suggested that administrators fell into four different latent classes: (1) those who place a high importance on substance abuse treatment relative to other programs and services, (2) those who place equal importance on substance abuse treatment and other programs and services, (3) those who value other programs and services moderately more than substance abuse treatment, and (4) those who value other programs and services much more than substance abuse treatment. Latent class membership was in turn associated with the extent to which evidence-based substance abuse treatment practices were being used in the facilities, the region of the country in which the administrator worked, and attitudes toward rehabilitating drug-using offenders. The findings have implications for future research focused on the impact that administrators' attitudes have on service provision as well as the effectiveness of knowledge dissemination and diffusion models.

Competing Values Among Criminal Justice Administrators: The Importance of Substance Abuse Treatment*

PubMed Central

Henderson, Craig E.; Taxman, Faye S.

2009-01-01

This study applied latent class analysis (LCA) to examine heterogeneity in criminal justice administrators’ attitudes toward the importance of substance abuse treatment relative to other programs and services commonly offered in criminal justice settings. The study used data collected from wardens, probation and/or parole administrators, and other justice administrators as part of the National Criminal Justice Treatment Practices survey (NCJTP), and includes both adult criminal and juvenile justice samples. Results of the LCA suggested that administrators fell into four different latent classes: (1) those who place a high importance on substance abuse treatment relative to other programs and services, (2) those who place equal importance on substance abuse treatment and other programs and services, (3) those who value other programs and services moderately more than substance abuse treatment, and (4) those who value other programs and services much more than substance abuse treatment. Latent class membership was in turn associated with the extent to which evidence-based substance abuse treatment practices were being used in the facilities, the region of the country in which the administrator worked, and attitudes toward rehabilitating drug-using offenders. The findings have implications for future research focused on the impact that administrators’ attitudes have on service provision as well as the effectiveness of knowledge dissemination and diffusion models. PMID:19054632

Implementing a mental health ministry committee in faith-based organizations: the promoting emotional wellness and spirituality program.

PubMed

Williams, Laverne; Gorman, Robyn; Hankerson, Sidney

2014-01-01

Social workers have successfully collaborated with African-American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African-American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a preexisting relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation.

Testing the Efficacy of Theoretically Derived Improvements in the Treatment of Social Phobia

ERIC Educational Resources Information Center

Rapee, Ronald M.; Gaston, Jonathan E.; Abbott, Maree J.

2009-01-01

Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in…

A meta-analysis of experimental studies of diversion programs for juvenile offenders.

PubMed

Schwalbe, Craig S; Gearing, Robin E; MacKenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan

2012-02-01

Research to establish an evidence-base for the treatment of conduct problems and delinquency in adolescence is well established; however, an evidence-base for interventions with offenders who are diverted from the juvenile justice system has yet to be synthesized. The purpose of this study was to conduct a meta-analysis of experimental studies testing juvenile diversion programs and to examine the moderating effect of program type and implementation quality. A literature search using PsycINFO, Web of Science, and the National Criminal Justice Reference Service data-bases and research institute websites yielded 28 eligible studies involving 57 experimental comparisons and 19,301 youths. Recidivism was the most common outcome reported across all studies. Overall, the effect of diversion programs on recidivism was non-significant (k=45, OR=0.83, 95%CI=0.43-1.58). Of the five program types identified, including case management (k=18, OR=0.78), individual treatment (k=11, OR=0.83), family treatment (k=4, OR=0.57), youth court (k=6, OR=0.93), and restorative justice (k=6, OR=0.87), only family treatment led to a statistically significant reduction in recidivism. Restorative justice studies that were implemented with active involvement of researchers led to statistically significant reductions in recidivism (k=3, OR=0.69). Other outcomes, including frequency of offending, truancy, and psycho-social problems were reported infrequently and were not subjected to meta-analysis. High levels of heterogeneity characterize diversion research. Results of this study recommend against implementation of programs limited to case management and highlight the promise of family interventions and restorative justice. Copyright © 2011 Elsevier Ltd. All rights reserved.

Comparison of cigarette smoking knowledge, attitudes, and practices among staff in perinatal and other substance abuse treatment settings.

PubMed

Miller-Thomas, Tonya; Leoutsakos, Jeannie-Marie S; Terplan, Mishka; Brigham, Emily P; Chisolm, Margaret S

2014-01-01

Despite the high prevalence and known morbidity and mortality caused by cigarette smoking, 60% to 70% of substance abuse treatment programs lack smoking cessation counseling or fail to offer pharmacotherapy for smoking cessation, including those programs designed to meet the needs of drug-dependent pregnant patients. Previous studies of staff knowledge, attitudes, and practices (S-KAP) at general substance abuse/HIV treatment programs have suggested that staff may contribute to the deficiency in smoking cessation treatment in these settings. It is not known whether similar deficiencies exist at perinatal substance abuse treatment programs. This study compared cigarette S-KAP in perinatal substance abuse (n = 41) and general substance abuse/HIV treatment (Veterans Affairs [VA] medical center, hospital-, and community-based) workforce samples (n = 335). Significant differences were seen between the 2 groups on all measures, but perinatal staff compared favorably to general staff only on measures of barriers to smoking cessation services. Perinatal staff compared unfavorably on all other measures: knowledge, beliefs/attitudes, self-efficacy, and smoking cessation practices. Pair-wise comparisons of knowledge and beliefs/attitudes revealed a significant difference between perinatal and VA staff; of self-efficacy, between perinatal and staff at all other settings; and of smoking cessation practices, between perinatal and VA and community-based staff. These results-showing deficiencies of perinatal staff on most S-KAP measures-are concerning and suggest that identifying gaps in and improving S-KAP in perinatal substance abuse programs is urgently needed, for which the VA may provide an efficacious model.

Perceived coercion in inpatients with Anorexia nervosa: Associations with illness severity and hospital course.

PubMed

Schreyer, Colleen C; Coughlin, Janelle W; Makhzoumi, Saniha H; Redgrave, Graham W; Hansen, Jennifer L; Guarda, Angela S

2016-04-01

The use of coercion in the treatment for anorexia nervosa (AN) is controversial and the limited studies to date have focused on involuntary treatment. However, coercive pressure for treatment that does not include legal measures is common in voluntarily admitted patients with AN. Empirical data examining the effect of non-legal forms of coerced care on hospital outcomes are needed. Participants (N = 202) with AN, Avoidant/Restrictive Food Intake Disorder (ARFID), or subthreshold AN admitted to a hospital-based behavioral specialty program completed questionnaires assessing illness severity and perceived coercion around the admissions process. Hospital course variables included inpatient length of stay, successful transition to a step-down partial hospitalization program, and achievement of target weight prior to program discharge. Higher perceived coercion at admission was associated with increased drive for thinness and body dissatisfaction, but not with admission BMI. Perceived coercion was not related to inpatient length of stay, rate of weight gain, or achievement of target weight although it was predictive of premature drop-out prior to transition to an integrated partial hospitalization program. These results, from an adequately powered sample, demonstrate that perceived coercion at admission to a hospital-based behavioral treatment program was not associated with rate of inpatient weight gain or achieving weight restoration, suggesting that coercive pressure to enter treatment does not necessarily undermine formation of a therapeutic alliance or clinical progress. Future studies should examine perceived coercion and long-term outcomes, patient views on coercive pressures, and the effect of different forms of leveraged treatment. © 2015 Wiley Periodicals, Inc.

Infrequent Illicit Methadone Use Among Stimulant-Using Patients in Methadone Maintenance Treatment Programs: A National Drug Abuse Treatment Clinical Trials Network Study

PubMed Central

Wu, Li-Tzy; Blazer, Dan G.; Stitzer, Maxine L.; Patkar, Ashwin A.; Blaine, Jack D.

2009-01-01

We sought to determine the prevalence, patterns, and correlates of past-month illicit methadone use and history of regular illicit use among stimulant-using methadone maintenance treatment patients. We obtained self-reported information on illicit methadone use from 383 participants recruited from six community-based methadone maintenance programs. Overall, 1.6% of participants reported illicit use in the past month, and 4.7% reported a history of regular use. Younger age and history of outpatient psychological treatment were associated with increased odds of past-month illicit use. Illicit methadone use among patients in maintenance programs is infrequent; however, a number of factors may increase risk of illicit use. PMID:18612886

Knowledge-based computer systems for radiotherapy planning.

PubMed

Kalet, I J; Paluszynski, W

1990-08-01

Radiation therapy is one of the first areas of clinical medicine to utilize computers in support of routine clinical decision making. The role of the computer has evolved from simple dose calculations to elaborate interactive graphic three-dimensional simulations. These simulations can combine external irradiation from megavoltage photons, electrons, and particle beams with interstitial and intracavitary sources. With the flexibility and power of modern radiotherapy equipment and the ability of computer programs that simulate anything the machinery can do, we now face a challenge to utilize this capability to design more effective radiation treatments. How can we manage the increased complexity of sophisticated treatment planning? A promising approach will be to use artificial intelligence techniques to systematize our present knowledge about design of treatment plans, and to provide a framework for developing new treatment strategies. Far from replacing the physician, physicist, or dosimetrist, artificial intelligence-based software tools can assist the treatment planning team in producing more powerful and effective treatment plans. Research in progress using knowledge-based (AI) programming in treatment planning already has indicated the usefulness of such concepts as rule-based reasoning, hierarchical organization of knowledge, and reasoning from prototypes. Problems to be solved include how to handle continuously varying parameters and how to evaluate plans in order to direct improvements.

The promise of prison-based treatment for dually diagnosed inmates.

PubMed

Wexler, Harry K

2003-10-01

The Stay'n Out therapeutic community was created 25 years ago, the first rigorously evaluated prison program that demonstrated recidivism reduction. Since then, there has been a growing appreciation for the recidivism-reducing benefit of substance abuse treatment and the general understanding has been reached that prison treatment for substance abuse is good for the public interest. A number of replicated outcome studies have led to increases in treatment capacity in most state correctional systems, primarily utilizing the therapeutic community model. In contrast, efforts to introduce treatment for offenders with co-occurring mental illness and substance abuse disorders (COD) are only beginning. This article describes developments in prison substance abuse treatment and reentry programs and offers some guiding observations from prison substance abuse treatment history that could facilitate the development of COD treatment. Lessons learned include that: public safety (i.e., recidivism reduction) is a primary goal; personal accountability as a basic treatment value facilitates cooperation between treatment and correctional staff; self-help approaches foster more ambitious treatment goals than just symptom reduction; and well-run treatment programs often ease the burden of correctional administration.

Breast cancer survivors' barriers and motives for participating in a group-based physical activity program offered in the community.

PubMed

Wurz, Amanda; St-Aubin, Anik; Brunet, Jennifer

2015-08-01

The purpose of this qualitative study was to explore the barriers and motives experienced by women attending an 8-week group-based physical activity program offered in the community following treatment for breast cancer. Seven women were interviewed during the first and last week of the program. Data were analyzed using thematic analysis. Factors that hindered women's continued participation could be subdivided into situational barriers, which encompassed community (i.e., distance of center and traffic) and institutional factors (i.e., competing roles and responsibilities), and internal barriers, which consisted of cancer-specific limitations. Motives for initial and continued participation were situational (i.e., gaining social support, networking, and being around similar others) and internal (i.e., feeling a sense of personal fulfillment, acquiring health benefits, and recovering from cancer). The findings contribute to a deeper understanding of women's motives to engage in a group-based physical activity program after treatment for breast cancer. Further, they underscore the necessity of considering situational and internal barriers when developing group-based physical activity programs to increase regular participation, optimize adherence, and reduce drop-out.

Reaching out to high school youth: the effectiveness of a video-based antistigma program.

PubMed

Stuart, Heather

2006-09-01

To evaluate the impact on high school students of a video-based antistigma program portraying real life experiences of individuals with schizophrenia and lesson plans to guide classroom discussions and active learning. We used a pre- and posttest design to measure the short-term impact of the program on student's knowledge of schizophrenia and its treatment as well as students' self-reported socially distancing behaviours. Participants (571 students) were from 8 high schools across Canada. Following the Reaching Out antistigma program, high school students were significantly more knowledgeable and less socially distancing. Impact also varied by age group and sex. Video-based antistigma programs are comparable to programs that deliver educational messages through direct contact with individuals with mental illnesses. Video-based programs are more easily disseminated on a broad scale.

Feasibility, Acceptability and Preliminary Treatment Outcomes in a School-Based CBT Intervention Program for Adolescents with ASD and Anxiety in Singapore.

PubMed

Drmic, Irene E; Aljunied, Mariam; Reaven, Judy

2017-12-01

Adolescents with autism spectrum disorder (ASD) are at high risk for anxiety difficulties and disorders. Clinic-based cognitive behavioral therapy (CBT) is effective; however, few published school-based CBT programs for youth with ASD exist. In this study, the Facing Your Fears CBT protocol was adapted for delivery and piloted within a school setting by non-clinicians, with culturally appropriate adaptations. 44 13-15 aged youth with ASD from 22 mainstream schools in Singapore participated. Feasibility, acceptability and preliminary treatment outcomes were examined. Decreases in youth and parent reported anxiety symptoms were reported. Staff and parents found the program useful. Stakeholder support was important for implementation. Initial findings reflect the importance of carefully bridging research-to-practice for youth with ASD and anxiety.

Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study.

PubMed

Humphreys , K; Moos, R

2001-05-01

Twelve-step-oriented inpatient treatment programs emphasize 12-step treatment approaches and the importance of ongoing attendance at 12-step self-help groups more than do cognitive-behavioral (CB) inpatient treatment programs. This study evaluated whether this difference in therapeutic approach leads patients who are treated in 12-step programs to rely less on professionally provided services and more on self-help groups after discharge, thereby reducing long-term health care costs. A prospective, quasi-experimental comparison of 12-step-based (N = 5) and cognitive-behavioral (n = 5) inpatient treatment programs was conducted. These treatments were compared on the degree to which their patients participated in self-help groups, used outpatient and inpatient mental health services, and experienced positive outcomes (e.g., abstinence) in the year following discharge. Using a larger sample from an ongoing research project, 887 male substance-dependent patients from each type of treatment program were matched on pre-intake health care costs (N = 1774). At baseline and 1-year follow-up, patients' involvement in self-help groups (e.g., Alcoholics Anonymous), utilization and costs of mental health services, and clinical outcomes were assessed. Compared with patients treated in CB programs, patients treated in 12-step programs had significantly greater involvement in self-help groups at follow-up. In contrast, patients treated in CB programs averaged almost twice as many outpatient continuing care visits after discharge (22.5 visits) as patients treated in 12-step treatment programs (13.1 visits), and also received significantly more days of inpatient care (17.0 days in CB versus 10.5 in 12-step), resulting in 64% higher annual costs in CB programs ($4729/patient, p < 0.001). Psychiatric and substance abuse outcomes were comparable across treatments, except that 12-step patients had higher rates of abstinence at follow-up (45.7% versus 36.2% for patients from CB programs, p < 0.001). Professional treatment programs that emphasize self-help approaches increase their patients' reliance on cost-free self-help groups and thereby lower subsequent health care costs. Such programs therefore represent a cost-effective approach to promoting recovery from substance abuse.

Costs and Cost-Effectiveness of Hypertension Screening and Treatment in Adults with Hypertension in Rural Nigeria in the Context of a Health Insurance Program

PubMed Central

Verhagen, Mark D.; Bolarinwa, Oladimeji A.; Sanya, Emmanuel O.; Kolo, Philip M.; Adenusi, Peju; Agbede, Kayode; van Eck, Diederik; Tan, Siok Swan; Akande, Tanimola M.; Redekop, William; Schultsz, Constance; Gomez, Gabriela B.

2016-01-01

Background High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA). We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI) program in rural Nigeria. Methods A Markov model was developed to assess the costs and cost-effectiveness of population-level hypertension screening and subsequent antihypertensive treatment for the population at-risk of cardiovascular disease (CVD) within the KSHI program. The primary outcome was the incremental cost per disability-adjusted life year (DALY) averted in the KSHI scenario compared to no access to hypertension care. We used setting-specific and empirically-collected data to inform the model. We defined two strategies to assess eligibility for antihypertensive treatment based on 1) presence of hypertension grade 1 and 10-year CVD risk of >20%, or grade 2 hypertension irrespective of 10-year CVD risk (hypertension and risk based strategy) and 2) presence of hypertension in combination with a CVD risk of >20% (risk based strategy). We generated 95% confidence intervals around the primary outcome through probabilistic sensitivity analysis. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the reference scenario. Results Screening and treatment for hypertension was potentially cost-effective but the results were sensitive to changes in underlying assumptions with a wide range of uncertainty. The incremental cost-effectiveness ratio for the first and second strategy respectively ranged from US$ 1,406 to US$ 7,815 and US$ 732 to US$ 2,959 per DALY averted, depending on the assumptions on risk reduction after treatment and compared to no access to antihypertensive treatment. Conclusions Hypertension care within a subsidized private health insurance program may be cost-effective in rural Nigeria and public-private partnerships such as the KSHI program may provide opportunities to finance CVD prevention care in SSA. PMID:27348310

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.

Adding smartphone-based cognitive-behavior therapy to pharmacotherapy for major depression (FLATT project): study protocol for a randomized controlled trial.

PubMed

Watanabe, Norio; Horikoshi, Masaru; Yamada, Mitsuhiko; Shimodera, Shinji; Akechi, Tatsuo; Miki, Kazuhira; Inagaki, Masatoshi; Yonemoto, Naohiro; Imai, Hissei; Tajika, Aran; Ogawa, Yusuke; Takeshima, Nozomi; Hayasaka, Yu; Furukawa, Toshi A

2015-07-07

Major depression is one of the most debilitating diseases in terms of quality of life. Less than half of patients suffering from depression can achieve remission after adequate antidepressant treatment. Another promising treatment option is cognitive-behavior therapy (CBT). However, the need for experienced therapists and substantive dedicated time prevent CBT from being widely disseminated. In the present study, we aim to examine the effectiveness of switching antidepressants and starting a smartphone-based CBT program at the same time, in comparison to switching antidepressants only, among patients still suffering from depression after adequate antidepressant treatment. A multi-center randomized trial is currently being conducted since September 2014. The smartphone-based CBT program, named the "Kokoro-App," for major depression has been developed and its feasibility has been confirmed in a previous open study. The program consists of an introduction, 6 sessions and an epilogue, and is expected to be completed within 9 weeks by patients. In the present trial, 164 patients with DSM-5 major depressive disorder and still suffering from depressive symptoms after adequate antidepressant treatment for more than 4 weeks will be allocated to the Kokoro-App plus switching antidepressant group or the switching antidepressant alone group. The participants allocated to the latter group will receive full components of the Kokoro-App after 9 weeks. The primary outcome is the change in the total score on the Patient Health Questionnaire through the 9 weeks of the program, as assessed at week 0, 1, 5 and 9 via telephone by blinded raters. The secondary outcomes include the change in the total score of the Beck Depression Inventory-II, change in side effects as assessed by the Frequency, Intensity and Burden of Side Effects Rating, and treatment satisfaction. An effective and reachable intervention may not only lead to healthier mental status among depressed patients, but also to reduced social burden from this illness. This paper outlines the background and methods of a trial that evaluates the possible additive value of a smartphone-based CBT program for treatment-resistant depression. UMIN-CTR: UMIN000013693 (registered on 1 June 2014).

Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

PubMed Central

Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2009-01-01

Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

Happy Despite Pain

PubMed Central

Smeets, Elke; Feijge, Marion; van Breukelen, Gerard; Andersson, Gerhard; Buhrman, Monica; Linton, Steven J.

2017-01-01

Objectives: There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program. Materials and Methods: A randomized controlled trial was carried out with 3 conditions: an internet-delivered positive psychology program, an internet-delivered cognitive-behavioral program and waitlist control. A total of 276 patients were randomized to 1 of the 3 conditions and posttreatment data were obtained from 206 patients. Primary outcomes were happiness, depression, and physical impairments at posttreatment and at 6-month follow-up. Intention-to-treat analyses were carried out using mixed regression analyses. Results: Both treatments led to significant increases in happiness and decreases in depression. Physical impairments did not significantly decrease compared with waitlist. Improvements in happiness and depression were maintained until 6-month follow-up. There were no overall differences in the efficacy of the 2 active interventions but effects seemed to be moderated by education. Patients with a higher level of education profited slightly more from the positive psychology intervention than from the cognitive-behavioral program. Discussion: The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs. PMID:28379873

Assessing the effects of Families for Safe Dates, a family-based teen dating abuse prevention program.

PubMed

Foshee, Vangie A; McNaughton Reyes, Heath Luz; Ennett, Susan T; Cance, Jessica D; Bauman, Karl E; Bowling, J Michael

2012-10-01

To examine the effects of a family-based teen dating abuse prevention program, Families for Safe Dates, primarily on outcomes related to testing the conceptual underpinnings of the program including (1) factors motivating and facilitating caregiver engagement in teen dating abuse prevention activities, and 2) risk factors for teen dating abuse, and secondarily on dating abuse behaviors. Families were recruited nationwide using listed telephone numbers. Caregivers and teens completed baseline and 3-month follow-up telephone interviews (n = 324). Families randomly allocated to treatment condition received the Families for Safe Dates program including six mailed activity booklets followed-up by health educator telephone calls. There were significant (<.05) treatment effects in hypothesized directions on most of the factors motivating and facilitating caregiver engagement in teen dating abuse prevention activities including caregiver perceived severity of dating abuse, response efficacy for preventing dating abuse, self-efficacy for talking about dating abuse, knowledge of dating abuse, acceptance of dating abuse, communication skills with the teen, and belief in the importance of involvement in their male (but not female) teen's dating. The latter effect was the only one moderated by sex of the teen. The targeted risk factor affected by the program was teen acceptance of dating abuse. Treatment was also significantly associated with less physical dating abuse victimization. Modifications to the program are warranted, but overall, the findings are very favorable for the first family-based teen dating abuse prevention program to be evaluated. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Examining the Efficacy of a Brief Mindfulness-Based Stress Reduction (Brief MBSR) Program on Psychological Health

ERIC Educational Resources Information Center

Bergen-Cico, Dessa; Possemato, Kyle; Cheon, Sanghyeon

2013-01-01

Objective: The purpose of the study was to examine potential psychological health benefits of participating in a brief (5-week) mindfulness-based stress reduction (brief MBSR) program integrated into an academic course. Participants: Participants were 119 undergraduate students (treatment: "n" = 72; control: "n" = 47) enrolled…

Assessing the Costs of School-based Mental Health Services.

ERIC Educational Resources Information Center

Nabors, Laura A.; Leff, Stephen S.; Mettrick, Jennifer E.

2001-01-01

Evaluated the costs of a school-based mental health program in Baltimore, Maryland, calculating the costs for care of adolescents who had participated in treatment. Results indicated that costs were relatively low compared to costs from the private sector and other community programs. Children with depressive disorders and children with more…

Web-Based SBIRT Skills Training for Health Professional Students and Primary Care Providers

ERIC Educational Resources Information Center

Tanner, T. Bradley; Wilhelm, Susan E.; Rossie, Karen M.; Metcalf, Mary P.

2012-01-01

The authors have developed and assessed 2 innovative, case-based, interactive training programs on substance abuse, one for health professional students on alcohol and one for primary care providers on screening, brief intervention, and referral to treatment (SBIRT). Both programs build skills in substance abuse SBIRT. Real-world effectiveness…

Demonstrating Support for the Formative and Summative Assessment Paradigm in a School-Based Intensive Mental Health Program

ERIC Educational Resources Information Center

Puddy, Richard W.; Boles, Richard E.; Dreyer, Meredith L.; Maikranz, Julie; Roberts, Michael C.; Vernberg, Eric M.

2008-01-01

We illustrate the use of formative and summative assessment in evaluating a therapeutic classroom program for children with serious emotional disturbances. Information was analyzed based on data gathered for clinical decision-making during treatment (formative assessment) and measurement of outcomes at discharge (summative assessment) from a…

Initial Open Trial of a Computerized Behavioral Activation Treatment for Depression

ERIC Educational Resources Information Center

Spates, C. Richard; Kalata, Alyssa H.; Ozeki, Satoshi; Stanton, Cory E.; Peters, Sofia

2013-01-01

This article presents preliminary findings from use of a novel computer program that implements an evidence-based psychological intervention to treat depression based on behavioral activation (BA) therapy. The program is titled “Building a Meaningful Life Through Behavioral Activation”. The findings derive from an open trial with moderate to…

Preliminary Examination of Adolescent Spending in a Contingency Management-Based Smoking-Cessation Program

ERIC Educational Resources Information Center

Cavallo, Dana A.; Nich, Charla; Schepis, Ty S.; Smith, Anne E.; Liss, Thomas B.; McFetridge, Amanda K.; Krishnan-Sarin, Suchitra

2010-01-01

Contingency management (CM) utilizing monetary incentives is efficacious in enhancing abstinence in an adolescent smoking-cessation program, but how adolescents spend their money has not been examined. We assessed spending habits of 38 adolescent smokers in a CM-based smoking-cessation project prior to quitting and during treatment using a…

Water treatment and handwashing behaviors among non-pregnant friends and relatives of participants in an antenatal hygiene promotion program in Malawi.

PubMed

Russo, Elizabeth T; Sheth, Anandi; Menon, Manoj; Wannemuehler, Kathleen; Weinger, Merri; Kudzala, Amose C; Tauzie, Blessius; Masuku, Humphreys D; Msowoya, Tapona E; Quick, Robert

2012-05-01

Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases. To integrate hygiene improvement with antenatal care, free hygiene kits (water storage containers, water treatment solution, soap) and educational messages were distributed to pregnant women at antenatal clinics in Malawi. We assessed water treatment and hygiene practices of 275 non-pregnant friends and relatives of the hygiene kit recipients at baseline and follow-up nine months later to measure program impact on non-participants in the same communities. At follow-up, friends and relatives who did not receive kits or education were more likely than at baseline to purchase and use water treatment solution (25% versus 1%; P < 0.0001) and demonstrate correct handwashing practices (60% versus 18%; P < 0.0001). This antenatal clinic-based program resulted in improved water treatment and hygiene behaviors among non-pregnant friends and relatives living in the same communities as hygiene kit recipients, suggesting that program benefits extended beyond direct beneficiaries.

Program factors related to women's substance abuse treatment retention and other outcomes: a review and critique.

PubMed

Sun, An-Pyng

2006-01-01

This study examined program factors related to women's substance abuse treatment outcomes. Although substance abuse research is traditionally focused on men, some more recent studies target women. A systematic review of 35 empirical studies that included solely women subjects or that analyzed female subjects separately from male subjects revealed five elements related to women's substance abuse treatment effectiveness; these are (1) single- versus mixed-sex programs, (2) treatment intensity, (3) provision for child care, (4) case management and the "one-stop shopping" model, and (5) supportive staff plus the offering of individual counseling. Although all 35 studies contribute to the knowledge base, critiques of six areas of design weakness in the studies were included to provide directions for future studies; these are (1) lack of a randomized controlled design, (2) nondisentanglement of multiple conditions, (3) lack of a consistent definition for treatment factors and outcomes, (4) small sample size, (5) lack of thorough program description, and (6) lack of thorough statistical analyses.

The Impulsive Lifestyle Counseling Program for Antisocial Behavior in Outpatient Substance Abuse Treatment.

PubMed

Thylstrup, Birgitte; Hesse, Morten

2016-06-01

Antisocial behavior is associated with low quality of life for the patient and with adverse effects on society and those close to the antisocial patient. However, most patients with antisocial behavior are not seen in treatment settings that focus on their personality but rather in criminal justice settings, substance-abuse treatment, and social welfare settings. This article describes the adaptation and implementation of a highly structured manualized treatment, Impulsive Lifestyle Counseling (ILC), based on the Lifestyle Issues program, a 10-week psychoeducation program studied in prison settings. ILC consists of four sessions over 4 weeks and a booster session 8 weeks later. The goal of treatment is described to patients as "to help people identify their impulsive thoughts and lifestyle leading to problems with drug use, other people, and the police." Two clinical examples and reflections on our experiences with the training and implementation of the ILC program are presented. © The Author(s) 2011.

The effectiveness of web-based patient education and action and coping plans as an adjunct to patient treatment in physiotherapy: A randomized controlled trial.

PubMed

Clark, Heather; Bassett, Sandra; Siegert, Richard

2018-05-03

The study investigated: (1) the effect of combining web-based patient education (WBPE) with action and coping plans on patients' adherence to physiotherapy and their subsequent functional outcomes; and (2) the participants' satisfaction with the WBPE program. One hundred and eight participants enrolled in this 8-week two group randomized controlled trial. They were allocated to either the WBPE planning group or the attention-control group. The WBPE group made action and coping plans and were familiarized with their web-based program. The attention control group was given access to a web-based neutral information program about shoulder injuries and physiotherapy rehabilitation. Throughout the 8-week study physiotherapists measured the participants' clinic-based adherence and participants recorded their home-based adherence using a self-report diary. Functional outcomes for all participants were measured at the beginning and end of the study. Participants provided feedback about their respective websites. The intervention group had a significantly higher clinic based adherence than the control group (p < 0.04). Both groups had a significant improvement in shoulder function but there was no significant difference between them. Participants in the intervention group were highly satisfied with the WBPE program. The preferred delivery of physiotherapy by 87% of the intervention group was a combination of face-to-face appointments and WBPE. Control participants indicated that they would have appreciated information about shoulder exercises and the shoulder complex in their program. The WBPE program was an effective adjunct to physiotherapy in terms of patient satisfaction and clinic-based treatment adherence.

Organizational Predictors and Use of Evidence-Based Practices in Adolescent Substance Abuse Treatment.

PubMed

Paino, Maria; Aletraris, Lydia; Roman, Paul M

2015-01-01

Adolescent substance abuse remains a significant problem in the United States, yet treatment centers do not always admit adolescent clients. In this paper, we first determine the extent to which treatment is available for adolescents in general and whether or not adolescent-specific (segregated) tracks are offered. Second, we examine the organizational characteristics associated with adolescent treatment. Third, we illuminate how the adolescent caseload in a treatment center is related to offering evidence-based practices (EBPs). Drawing upon a nationally representative sample of US treatment programs, we use logistic regression to assess how organizational characteristics are associated with the provision of adolescent treatment. Using ordinal logistic regression, we analyze how the treatment center's adolescent caseload and organizational characteristics affect the extent to which a treatment center offers medication-assisted treatment (MAT) and psychosocial treatment. Half (49.5%) of treatment programs admitted adolescents, and 41.8% offered an adolescent-specific track. Findings from the logistic regression suggested several organizational characteristics that were significantly associated with treating adolescents and/or having an adolescent-only track. Our findings from the ordinal models indicated a negative relationship between the percent of adolescents in a treatment center and the extent of MAT, and a positive relationship between the percent of adolescent clients and the extent of psychosocial treatment offered. This paper highlights organizational barriers to treatment entry for adolescents, who remain a small proportion of clients in treatment centers. When treatment centers serve adolescents, however, those adolescents are likely to receive care in adolescent-only tracks and/or services and in programs that offer several psychosocial EBPs. Finally, adolescents are less likely to receive treatment in centers that offer a variety of MAT.

Organizational Predictors and Use of Evidence-Based Practices in Adolescent Substance Abuse Treatment

PubMed Central

Paino, Maria; Aletraris, Lydia; Roman, Paul M.

2014-01-01

Background Adolescent substance abuse remains a significant problem in the United States, yet treatment centers do not always admit adolescent clients. In this article, we first determine the extent to which treatment is available for adolescents in general and whether or not adolescent-specific (segregated) tracks are offered. Second, we examine the organizational characteristics associated with adolescent treatment. Third, we illuminate how the adolescent caseload in a treatment center is related to offering evidence-based practices (EBPs). Methods Drawing upon a nationally representative sample of U.S. treatment programs, we use logistic regression to assess how organizational characteristics are associated with the provision of adolescent treatment. Using ordinal logistic regression, we analyze how the treatment center’s adolescent caseload and organizational characteristics affect the extent to which a treatment center offers medication-assisted treatment (MAT) and psychosocial treatment. Results Half (49.5%) of treatment programs admitted adolescents and 41.8% offered an adolescent-specific track. Findings from the logistic regression suggested several organizational characteristics that were significantly associated with treating adolescents and/or having an adolescent-only track. Our findings from the ordinal models indicated a negative relationship between the percent of adolescents in a treatment center and the extent of MAT, and a positive relationship between the percent of adolescent clients and the extent of psychosocial treatment offered. Conclusions This paper highlights organizational barriers to treatment entry for adolescents, who remain a small proportion of clients in treatment centers. When treatment centers serve adolescents, however, those adolescents are likely to receive care in adolescent-only tracks and/or services and in programs that offer several psychosocial EBPs. Finally, adolescents are less likely to receive treatment in centers that offer a variety of MAT. PMID:25257691

Initial Feasibility and Validity of a Prospective Memory Training Program in a Substance Use Treatment Population

PubMed Central

Sweeney, Mary M.; Rass, Olga; Johnson, Patrick S.; Strain, Eric C.; Berry, Meredith S.; Vo, Hoa T.; Fishman, Marc J.; Munro, Cynthia A.; Rebok, George W.; Mintzer, Miriam Z.; Johnson, Matthew W.

2016-01-01

Individuals with substance use disorders have shown deficits in the ability to implement future intentions, called prospective memory. Deficits in prospective memory and working memory, a critical underlying component of prospective memory, likely contribute to substance use treatment failures. Thus, improvement of prospective memory and working memory in substance use patients is an innovative target for intervention. We sought to develop a feasible and valid prospective memory training program that incorporates working memory training and may serve as a useful adjunct to substance use disorder treatment. We administered a single session of the novel prospective memory and working memory training program to participants (n = 22; 13 male; 9 female) enrolled in outpatient substance use disorder treatment and correlated performance to existing measures of prospective memory and working memory. Generally accurate prospective memory performance in a single session suggests feasibility in a substance use treatment population. However, training difficulty should be increased to avoid ceiling effects across repeated sessions. Consistent with existing literature, we observed superior performance on event-based relative to time-based prospective memory tasks. Performance on the prospective memory and working memory training components correlated with validated assessments of prospective memory and working memory, respectively. Correlations between novel memory training program performance and established measures suggest that our training engages appropriate cognitive processes. Further, differential event- and time-based prospective memory task performance suggests internal validity of our training. These data support development of this intervention as an adjunctive therapy for substance use disorders. PMID:27690506

Initial feasibility and validity of a prospective memory training program in a substance use treatment population.

PubMed

Sweeney, Mary M; Rass, Olga; Johnson, Patrick S; Strain, Eric C; Berry, Meredith S; Vo, Hoa T; Fishman, Marc J; Munro, Cynthia A; Rebok, George W; Mintzer, Miriam Z; Johnson, Matthew W

2016-10-01

Individuals with substance use disorders have shown deficits in the ability to implement future intentions, called prospective memory. Deficits in prospective memory and working memory, a critical underlying component of prospective memory, likely contribute to substance use treatment failures. Thus, improvement of prospective memory and working memory in substance use patients is an innovative target for intervention. We sought to develop a feasible and valid prospective memory training program that incorporates working memory training and may serve as a useful adjunct to substance use disorder treatment. We administered a single session of the novel prospective memory and working memory training program to participants (n = 22; 13 men, 9 women) enrolled in outpatient substance use disorder treatment and correlated performance to existing measures of prospective memory and working memory. Generally accurate prospective memory performance in a single session suggests feasibility in a substance use treatment population. However, training difficulty should be increased to avoid ceiling effects across repeated sessions. Consistent with existing literature, we observed superior performance on event-based relative to time-based prospective memory tasks. Performance on the prospective memory and working memory training components correlated with validated assessments of prospective memory and working memory, respectively. Correlations between novel memory training program performance and established measures suggest that our training engages appropriate cognitive processes. Further, differential event- and time-based prospective memory task performance suggests internal validity of our training. These data support the development of this intervention as an adjunctive therapy for substance use disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Hispanic Parenting Women in Women-Only versus Mixed-Gender Drug Treatment: A 10-Year Prospective Study

PubMed Central

Hser, Yih-Ing; Hunt, Samantha A.; Evans, Elizabeth; Chang, Yen-Jung; Messina, Nena P.

2012-01-01

The present study examined Hispanic substance-using parenting women treated in women-only (WO; n=126) versus mixed-gender (MG; n=853) programs and associated outcomes assessed 10 years after admission. Relative to other races/ethnicities of women admitted to the set of 40 California treatment programs in 2000–2002, Hispanic women were underrepresented in WO programs. Compared to those in MG programs, Hispanic women in WO programs demonstrated more severe treatment needs, indicated by their greater severity in drug and alcohol use, health and mental health problems, and criminal justice involvement at admission. They also had fewer economic resources (15% WO vs. 23% MG were employed, p<.05; 48% vs. 37% on public assistance, p<.05). Data based on administrative records covering 3 years pre-admission and 8 years post-admission showed that Hispanic women treated in WO programs had higher mental health service utilization over 8 years post-treatment admission, though no differences were found in trajectories of arrests and incarceration. In sum, long-term outcomes (in terms of criminal justice involvement) among Hispanic women in WO treatment were comparable to those in the MG treatment, despite greater service needs at admission. WO programs were able to engage more Hispanic women in use of mental health services. Future research should focus on factors limiting Hispanic women’s participation in WO programs, which could suggest ways for improvement so as to benefit all Hispanic women in need of these special services. PMID:22398357

Dementia: treating patients and caregivers with complementary and alternative medicine--results of a clinical expert conference using the World Café method.

PubMed

Teut, Michael; Bloedt, Susanne; Baur, Roland; Betsch, Frederik; Elies, Michael; Fruehwald, Maria; Fuesgen, Ingo; Kerckhoff, Annette; Krüger, Eckard; Schimpf, Dorothee; Schnabel, Katharina; Walach, Harald; Warme, Britta; Warning, Albercht; Wilkens, Johannes; Witt, Claudia M

2013-01-01

In Germany the number of inhabitants with dementia is expected to increase from 1.2 million at present to 2.3 million in 2050. Our aim was to investigate which treatments complementary and alternative medicine (CAM) experts consider to be of therapeutic use in developing treatment strategies and hypotheses for further clinical studies. In a participatory group workshop the 'World Café' method was used. As questions we asked: 1) 'Based on your clinical experience, which CAM therapies are effective in the treatment of patients with dementia? 2) Based on your clinical experience, which CAM therapies are effective in the treatment of lay and professional caregivers of patients with dementia?, and 3) How should a CAM treatment program look like?' Further Delphi rounds were used to reach consensus and summarize the results. The 2-day workshop took place in January 2012 in Berlin. A total of 17 experts participated. The most important subject in the treatment was the need to understand patients' biographies in order to individualize the therapy. Therapy itself consists of the therapeutic relationship, nonmedical therapies such as sports, massage, music and arts therapy as well as medical treatment such as herbal or homeopathic medicines. With regard to caregivers the most important aim is to prevent or reduce psychological distress, e.g., by mind-body programs. Instead of single treatments, more general elements such as understanding the patients' biographies, therapeutic relationships, individualizing, networking, and self-care emerged as main results. An integrative treatment program should connect outpatient and inpatient care as well as all experts. CAM training courses should be offered to doctors, nurses, and caregivers. Future clinical studies should focus on complex intervention programs integrating these key elements. © 2013 S. Karger GmbH, Freiburg.

Caregiver Expectations of Family-based Pediatric Obesity Treatment.

PubMed

Giannini, Courtney; Irby, Megan B; Skelton, Joseph A

2015-07-01

To explore caregivers' expectations of pediatric weight management prior to starting treatment. Interviews conducted with 25 purposefully selected caregivers of children, ages 8-12 years, waiting to begin 4 different weight management programs. Interviews were conducted and recorded via telephone and coded using a multistage inductive approach. Caregivers listed specific motivators for seeking treatment that did not often align with clinical measures of success: caregivers perceived child's socio-emotional health improvement to be an important success measure. Caregivers understood the program's approach, but were unsure of the commitment required. Caregivers were confident they would complete treatment but not in being successful. Caregivers' expectations of treatment success and their role in treatment may be a hindrance to adherence.

Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

PubMed Central

Matthews, Alicia K.; Li, Chien-Ching; Kuhns, Lisa M.; Tasker, Timothy B.; Cesario, John A.

2013-01-01

Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT) people's response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N = 198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association's “Freedom from Smoking Program” (ALA-FFS) and were tailored to LGBT smokers' needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5) were mostly White (70.4%) and male (60.5%) and had at least a college degree (58.4%). Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions). Higher educational attainment and use of nicotine replacement therapy (NRT) were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45), use of NRT (OR = 4.24), and lower nicotine dependency (OR = 0.73) were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake. PMID:23840237

The Canadian effort to prevent and control hypertension: can other countries adopt Canadian strategies?

PubMed

Campbell, Norm R C; Sheldon, Tobe

2010-07-01

To indicate the key elements of current Canadian programs to treat and control hypertension. In the early 1990s Canada had a hypertension treatment and control rate of 13%. A Canadian strategy to prevent and control hypertension was developed and a coalition of national organizations and volunteers formed to develop increasingly extensive programs. The Canadian effort was largely based on annually updated hypertension management recommendations, an integrated and extensive hypertension knowledge translation program and an increasingly comprehensive outcomes assessment program. After the start of the annual process in 1999, there were very large increases in diagnosis and hypertension treatment coupled with dropping rates of cardiovascular disease. More recent initiatives include an extensive education program for the public and people with hypertension, a program to reduce dietary salt and a funded leadership position. The treatment and control rate increased to 66% when last assessed (2007-2009). The study describes important aspects of the Canadian hypertension management programs to aid those wishing to develop similar programs. Many of the programs could be fully or partially implemented by other countries.

Use of the evidence base in substance abuse treatment programs for American Indians and Alaska natives: pursuing quality in the crucible of practice and policy

PubMed Central

2011-01-01

Background A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. Discussion We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Summary Broadening this conversation beyond its primary focus on the use of evidence-based treatments to other salient issues such as building the necessary research evidence (including incorporating American Indian and Alaska Native cultural values into clinical practice) and developing the human and infrastructural resources to support the use of this evidence may be far more effective for advancing efforts to improve substance abuse services for American Indian and Alaska Native communities. PMID:21679438

Feasibility, Acceptability and Preliminary Treatment Outcomes in a School-Based CBT Intervention Program for Adolescents with ASD and Anxiety in Singapore

ERIC Educational Resources Information Center

Drmic, Irene E.; Aljunied, Mariam; Reaven, Judy

2017-01-01

Adolescents with autism spectrum disorder (ASD) are at high risk for anxiety difficulties and disorders. Clinic-based cognitive behavioral therapy (CBT) is effective; however, few published school-based CBT programs for youth with ASD exist. In this study, the Facing Your Fears CBT protocol was adapted for delivery and piloted within a school…

The Role of Expectations in Game-Based Training.

PubMed

Kreutzer, Christine; Bowers, Clint

2015-01-01

The present work seeks to examine the importance of expectancies in computer-mediated treatment and training programs. Two studies examining the role of patient and trainee expectations are presented. Study 1 investigated how expectations of a training game for military surgical teams influence training performance outcomes. The findings have implications for the administration of game-based treatment and training systems. Study 2 explored how pre-treatment expectancies influence post-treatment reactions to a game-based intervention for post-traumatic stress disorder (PTSD). Results indicate that self-efficacy plays a mediating role in the relationship between expectancies and reactions. Together, these studies offer implications regarding the critical role of attitudes towards game-based training and treatment mechanisms.

The BRIGHTEN program: implementation and evaluation of a program to bridge resources of an interdisciplinary geriatric health team via electronic networking.

PubMed

Emery, Erin E; Lapidos, Stan; Eisenstein, Amy R; Ivan, Iulia I; Golden, Robyn L

2012-12-01

To demonstrate the feasibility of the BRIGHTEN Program (Bridging Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking), an interdisciplinary team intervention for assessing and treating older adults for depression in outpatient primary and specialty medical clinics. The BRIGHTEN team collaborates "virtually" to review patient assessment results, develop a treatment plan, and refer to appropriate team members for follow-up care. Older adults in 9 academic medical center clinics and 2 community-based clinics completed screening forms for symptoms of depression and anxiety. Those with positive screens engaged in comprehensive assessment with the BRIGHTEN Program Coordinator; the BRIGHTEN virtual team provided treatment recommendations based on the results of assessment. A collaborative treatment plan was developed with each participant, who was then connected to appropriate services. Two thousand four hundred twenty-two older adults were screened in participating clinics over a 40-month period. Eight hundred fifty-nine older adults screened positive, and 150 elected to enroll in BRIGHTEN. From baseline to 6 months, significant improvements were found in depression symptoms (Geriatric Depression Scale, p < .01) and general mental health (SF-12 Mental Component, p < .01). The BRIGHTEN Program demonstrated that an interdisciplinary virtual team linked with outpatient medical clinics can be an effective, nonthreatening, and seamless approach to enable older adults to access treatment for depression.

Practical application of computer programs for supersonic combustion

NASA Technical Reports Server (NTRS)

Groves, F. R., Jr.

1972-01-01

Experimental data were interpreted using two supersonic combustion computer programs. The P1 program is based on a conventional boundary layer treatment of the mixing of concentric gas streams and complete combustion chemistry. The H1 program is based on a modified boundary layer approach which accounts for radial pressure gradients in the flow and also incorporates a finite rate chemistry calculation. The objective of the investigation was to compare the experimental data with theoretical predictions of the two programs with special emphasis on the prediction of radial pressure gradients by the H1 program. A test of the H1 program was also desired through comparison with the experimental data and with the P1 program.

A mental health program for ground zero rescue and recovery workers: cases and observations.

PubMed

Katz, Craig L; Smith, Rebecca; Silverton, Marsha; Holmes, Anastasia; Bravo, Carlos; Jones, Kristina; Kiliman, Marta; Lopez, Norma; Malkoff, Laurie; Marrone, Kathryn; Neuman, Alla; Stephens, Tricia; Tavarez, Wendy; Yarowsky, Anne; Levin, Stephen; Herbert, Robin

2006-09-01

Clinical vignettes from the World Trade Center Worker and Volunteer Mental Health Monitoring and Treatment Program at the Mount Sinai Medical Center in New York City are presented. The hospital-based program pairs mental health screenings with federally funded occupational medical screenings to identify persons with mental health problems related to their rescue and recovery roles. The program also provides on-site mental health treatment. The cases illustrate the diverse mental health needs of the rescue and recovery workers, some of whom initially sought treatment years after September 11, 2001. The cases show that in addition to symptoms of posttraumatic stress disorder, workers experienced survivor guilt, distressing memories of childhood trauma, shame associated with intense feelings, substance abuse relapse, psychosis, and problems with family relationships.

[PSYCHOEDUCATIONAL PROGRAM AS A WAY OF CORRECTING MOTIVATIONAL COMPONENTS IN PATIENTS WITH PARANOID SCHIZOPHRENIA WITH ABDOMINAL OBESITY].

PubMed

Sinayko, V; Korovina, L

2016-01-01

The aim of the study was to investigate the influence of motivational and targeted psychoeducational programs designed for patients with paranoid schizophrenia with abdominal obesity. We observed 34 women aged 18-42 with continuous-flow type paranoid schizophrenia. All patients had a concomitant abdominal obesity, which developed secondarily after long-term administration of second generation antipsychotic medications (at least 1 year). Based on clinical-psychopathological and psychometric methods of assessment and on the analysis of Treatment Satisfaction Questionnaire we have developed modules for psychoeducational programs. Based on the results of the treatment we conclude that the application of psychoeducational programs is an effective component of complex treatment of patients with paranoid schizophrenia. Abdominal obesity should be regarded as an important and the main side effect of long-term therapy with atypical antipsychotic medications. It has a marked negative effect on subjective assessment of patients and decreases the level of their mental and social adaptation. This factor should be the basis for the formation of re-socialization and compliance-oriented actions.

Treatment-Based Classification versus Usual Care for Management of Low Back Pain

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-11-1-0657 TITLE: Treatment-Based Classification versus Usual Care for Management of Low Back Pain PRINCIPAL INVESTIGATOR...Treatment-Based Classification versus Usual Care for Management of Low Back Pain 5b. GRANT NUMBER W81XWH-11-1-0657 5c. PROGRAM ELEMENT NUMBER 6...AUTHOR(S) MAJ Daniel Rhon – daniel_rhon@baylor.edu 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S

Esthetic considerations for the treatment of the edentulous maxilla based on current informatic alternatives: a case report.

PubMed

Rodríguez-Tizcareño, Mario H; Barajas, Lizbeth; Pérez-Gásque, Marisol; Gómez, Salvador

2012-06-01

This report presents a protocol used to transfer the virtual treatment plan data to the surgical and prosthetic reality and its clinical application, bone site augmentation with computer-custom milled bovine bone graft blocks to their ideal architecture form, implant insertion based on image-guided stent fabrication, and the restorative manufacturing process through computed tomography-based software programs and navigation systems and the computer-aided design and manufacturing techniques for the treatment of the edentulous maxilla.

An Adaptation of Family-Based Behavioral Pediatric Obesity Treatment for a Primary Care Setting: Group Health Family Wellness Program Pilot

PubMed Central

Riggs, Karin R; Lozano, Paula; Mohelnitzky, Amy; Rudnick, Sarah; Richards, Julie

2014-01-01

Objective: To assess the feasibility and acceptability of family-based group pediatric obesity treatment in a primary care setting, to obtain an estimate of its effectiveness, and to describe participating parents’ experiences of social support for healthy lifestyle changes. Methods: We adapted an evidence-based intervention to a group format and completed six 12- to 16-week groups over 3 years. We assessed program attendance and completion, changes in child and parent body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and changes in child quality of life in a single-arm before-and-after trial. Qualitative interviews explored social support for implementing healthy lifestyle changes. Results: Thirty-eight parent-child pairs enrolled (28% of the 134 pairs invited). Of those, 24 (63%) completed the program and another 6 (16%) attended at least 4 sessions but did not complete the program. Children who completed the program achieved a mean change in BMI Z-scores (Z-BMI) of −0.1 (0.1) (p < 0.001) and significant improvement in parent-reported child quality of life (mean change = 8.5; p = 0.002). Mean BMI of parents changed by −0.9 (p = 0.003). Parents reported receiving a wide range of social support for healthy lifestyle changes and placed importance on the absence or presence of support. Conclusions: A pilot group program for family-based treatment of pediatric obesity is feasible and acceptable in a primary care setting. Change in child and parent BMI outcomes and child quality of life among completers were promising despite the pilot’s low intensity. Parent experiences with lack of social support suggest possible ways to improve retention and adherence. PMID:24937148

Evaluating component effects of a prison-based treatment continuum.

PubMed

Butzin, Clifford A; Martin, Steven S; Inciardi, James A

2002-03-01

A continuum of correctional-based therapeutic community (TC) treatment programs for drug-involved offenders has been functioning for several years in Delaware. Previous evaluations have shown the efficacy of the full continuum for up to three years posttreatment, though there has been some question of the benefits of treatment within prison. The particular focus here is on the relative impact of the within-prison, transitional, and aftercare treatment components upon criminal recidivism and relapse to illicit drug use. The relative benefit of participation in each component is supported, over and above the effects of differences in demographics and histories of criminal behavior and illicit substance use. However, the residential transitional program effects are generally larger and more long lasting. Additionally, the two outcomes appear differentially sensitive to the degree of completion of the continuum. Copyright 2002 Elsevier Science Inc.

Implementing a Mental Health Ministry Committee in Faith-Based Organizations: The Promoting Emotional Wellness and Spirituality Program

PubMed Central

Williams, Laverne; Gorman, Robyn; Hankerson, Sidney

2014-01-01

Social workers have successfully collaborated with African American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a pre-existing relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation. PMID:24717187

32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...

32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...

32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...

32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...

32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...

Evaluating an Action Threshold-Based Insecticide Program on Onion Cultivars Varying in Resistance to Onion Thrips (Thysanoptera: Thripidae).

PubMed

Nault, Brian A; Huseth, Anders S

2016-08-01

Onion thrips, Thrips tabaci Lindeman (Thysanoptera: Thripidae), is a highly destructive pest of onion, Allium cepa L., and its management relies on multiple applications of foliar insecticides. Development of insecticide resistance is common in T. tabaci populations, and new strategies are needed to relax existing levels of insecticide use, but still provide protection against T. tabaci without compromising marketable onion yield. An action threshold-based insecticide program combined with or without a thrips-resistant onion cultivar was investigated as an improved approach for managing T. tabaci infestations in commercial onion fields. Regardless of cultivar type, the average number of insecticide applications needed to manage T. tabaci infestations in the action-threshold based program was 4.3, while the average number of sprays in the standard weekly program was 7.2 (a 40% reduction). The mean percent reduction in numbers of applications following the action threshold treatment in the thrips-resistant onion cultivar, 'Advantage', was 46.7% (range 40-50%) compared with the standard program, whereas the percentage reduction in applications in action threshold treatments in the thrips-susceptible onion cultivar, 'Santana', was 34.3% (range 13-50%) compared with the standard program, suggesting a benefit of the thrips-resistant cultivar. Marketable bulb yields for both 'Advantage' and 'Santana' in the action threshold-based program were nearly identical to those in the standard program, indicating that commercially acceptable bulb yields will be generated with fewer insecticide sprays following an action threshold-based program, saving money, time and benefiting the environment. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Dissemination and Implementation of Evidence-Based Psychological Treatments: A Review of Current Efforts

ERIC Educational Resources Information Center

McHugh, R. Kathryn; Barlow, David H.

2010-01-01

Recognizing an urgent need for increased access to evidenced-based psychological treatments, public health authorities have recently allocated over $2 billion to better disseminate these interventions. In response, implementation of these programs has begun, some of it on a very large scale, with substantial implications for the science and…

Phone and Web-Based Tobacco Cessation Treatment: Real-World Utilization Patterns and Outcomes for 11,000 Tobacco Users

PubMed Central

Hapgood, Jenny; Smucker Barnwell, Sara; McAfee, Tim

2008-01-01

Background Phone-based tobacco cessation programs have been proven effective and widely adopted. Web-based solutions exist; however, the evidence base is not yet well established. Many cessation treatments are commercially available, but few integrate the phone and Web for delivery and no published studies exist for integrated programs. Objective This paper describes a comprehensive integrated phone/Web tobacco cessation program and the characteristics, experience, and outcomes of smokers enrolled in this program from a real-world evaluation. Methods We tracked program utilization (calls completed, Web log-ins), quit status, satisfaction, and demographics of 11,143 participants who enrolled in the Free & Clear Quit For Life Program between May 2006 and October 2007. All participants received up to five proactive phone counseling sessions with Quit Coaches, unlimited access to an interactive website, up to 20 tailored emails, printed Quit Guides, and cessation medication information. The program was designed to encourage use of all program components rather than asking participants to choose which components they wanted to use while quitting. Results We found that participants tended to use phone services more than Web services. On average, participants completed 2-2.5 counseling calls and logged in to the online program 1-2 times. Women were more adherent to the overall program; women utilized Web and phone services significantly (P = .003) more than men. Older smokers (> 26 years) and moderate smokers (15-20 cigarettes/day) utilized services more (P < .001) than younger (< 26 years) and light or heavy smokers. Satisfaction with services was high (92% to 95%) and varied somewhat with Web utilization. Thirty-day quit rates at the 6-month follow-up were 41% using responder analysis and 21% using intent-to-treat analysis. Web utilization was significantly associated with increased call completion and tobacco abstinence rates at the 6-month follow-up evaluation. Conclusions This paper expands our understanding of a real-world treatment program combining two mediums, phone and Web. Greater adherence to the program, as defined by using both the phone and Web components, is associated with higher quit rates. This study has implications for reaching and treating tobacco users with an integrated phone/Web program and offers evidence regarding the effectiveness of integrated cessation programs. PMID:19017583

[Prediction of the efficacy of the non-medicamental treatment with the use of the ensemble of classifiers].

PubMed

Zaĭtsev, A A; Khodashinskiĭ, I A; Plotnikov, O O

2011-01-01

The importance to have the most efficacious tools and methods for the prevention and treatment of various diseases and rehabilitation of the patients dictates the necessity of search for new means of optimal correction of individual reserves of the organism. One of the approaches to addressing this problem is simulation of prognostication of curative effects of non-medicamental therapy. It is proposed to choose the therapeutic program using an ensemble of classifiers. Two types of them are considered, one based on the solution trees, the other based on the fuzzy rule basis. The software was developed that ensures high accuracy of th e prognosis of the efficiency of the two programs of the spa and resort treatment.

Humanistic psychotherapy research 1990-2015: from methodological innovation to evidence-supported treatment outcomes and beyond.

PubMed

Angus, Lynne; Watson, Jeanne Cherry; Elliott, Robert; Schneider, Kirk; Timulak, Ladislav

2015-01-01

Over the past 25 years, humanistic psychotherapy (HP) researchers have actively contributed to the development and implementation of innovative practice-informed research measures and coding systems. Qualitative and quantitative research findings, including meta-analyses, support the identification of HP approaches as evidence-based treatments for a variety of psychological conditions. Implications for future psychotherapy research, training, and practice are discussed in terms of addressing the persistent disjunction between significant HP research productivity and relatively low support for HP approaches in university-based clinical training programs, funding agencies, and government-supported clinical guidelines. Finally, specific recommendations are provided to further enhance and expand the impact of HP research for clinical training programs and the development of treatment guidelines.

Development of a unified web-based national HIV/AIDS information system in China

PubMed Central

Mao, Yurong; Wu, Zunyou; Poundstone, Katharine; Wang, Changhe; Qin, Qianqian; Ma, Ye; Ma, Wei

2010-01-01

Background In the past, many data collection systems were in operation for different HIV/AIDS projects in China. We describe the creation of a unified, web-based national HIV/AIDS information system designed to streamline data collection and facilitate data use. Methods Integration of separate HIV/AIDS data systems was carried out in three phases. Phase 1, from January 2006 to December 2007, involved creating a set of unified data collection forms that took into account existing program needs and the reporting requirements of various international organizations. Phase 2, from January to October 2007, involved creating a web-based platform to host the integrated HIV/AIDS data collection system. Phase 3, from November to December 2007, involved pilot testing the new, integrated system prior to nationwide application. Results Eight web-based data collection subsystems based on one platform began operation on 1 January 2008. These eight subsystems cover: (i) HIV/AIDS case reporting; (ii) HIV testing and counselling; (iii) antiretroviral treatment (ART) for adults; (iv) ART for children; (v) behavioural interventions for high-risk groups; (vi) methadone maintenance treatment; (vii) sentinel and behavioural surveillance; and (viii) local county background information. The system provides real-time data to monitor HIV testing, prevention and treatment programs across the country. Conclusion China’s new unified, web-based HIV/AIDS information system has improved the efficiency of data collection, reporting, analysis and use, as well as data quality and security. It is a powerful tool to support policy making, program evaluation and implementation of the national HIV/AIDS program and, thus, may serve a model for other countries. PMID:21113041

Efficacy of cognitive behavioral internet-based therapy in parents after the loss of a child during pregnancy: pilot data from a randomized controlled trial.

PubMed

Kersting, Anette; Kroker, Kristin; Schlicht, Sarah; Baust, Katja; Wagner, Birgit

2011-12-01

The loss of a child during pregnancy can be a traumatic event associated with long-lasting grief and psychological distress. This study examined the efficacy of an internet-based cognitive behavioral therapy program for mothers after pregnancy loss. In a randomized controlled trial with a waiting list control group, 83 participants who had lost a child during pregnancy were randomly allocated either to 5 weeks of internet therapy or to a 5-week waiting condition. Within a manualized cognitive behavioral treatment program, participants wrote ten essays on loss-specific topics. Posttraumatic stress, grief, and general psychopathology, especially depression, were assessed pretreatment, posttreatment, and at 3-month follow-up. Intention-to-treat analyses and completer analyses were performed. Relative to controls, participants in the treatment group showed significant improvements in posttraumatic stress, grief, depression, and overall mental health, but not in anxiety or somatization. Medium to large effect sizes were observed, and the improvement was maintained at 3-month follow-up. This internet-based cognitive behavioral therapy program represents an effective treatment approach with stable effects for women after pregnancy loss. Implementation of the program can thus help to improve the health care provision for mothers in this traumatic loss situation.

Animation, audio, and spatial ability: Optimizing multimedia for scientific explanations

NASA Astrophysics Data System (ADS)

Koroghlanian, Carol May

This study investigated the effects of audio, animation and spatial ability in a computer based instructional program for biology. The program presented instructional material via text or audio with lean text and included eight instructional sequences presented either via static illustrations or animations. High school students enrolled in a biology course were blocked by spatial ability and randomly assigned to one of four treatments (Text-Static Illustration Audio-Static Illustration, Text-Animation, Audio-Animation). The study examined the effects of instructional mode (Text vs. Audio), illustration mode (Static Illustration vs. Animation) and spatial ability (Low vs. High) on practice and posttest achievement, attitude and time. Results for practice achievement indicated that high spatial ability participants achieved more than low spatial ability participants. Similar results for posttest achievement and spatial ability were not found. Participants in the Static Illustration treatments achieved the same as participants in the Animation treatments on both the practice and posttest. Likewise, participants in the Text treatments achieved the same as participants in the Audio treatments on both the practice and posttest. In terms of attitude, participants responded favorably to the computer based instructional program. They found the program interesting, felt the static illustrations or animations made the explanations easier to understand and concentrated on learning the material. Furthermore, participants in the Animation treatments felt the information was easier to understand than participants in the Static Illustration treatments. However, no difference for any attitude item was found for participants in the Text as compared to those in the Audio treatments. Significant differences were found by Spatial Ability for three attitude items concerning concentration and interest. In all three items, the low spatial ability participants responded more positively than high spatial ability participants. In addition, low spatial ability participants reported greater mental effort than high spatial ability participants. Findings for time-in-program and time-in-instruction indicated that participants in the Animation treatments took significantly more time than participants in the Static Illustration treatments. No time differences of any type were found for participants in the Text versus Audio treatments. Implications for the design of multimedia instruction and topics for future research are included in the discussion.

Mass Screening: An Aid to Competency Based Program Development.

ERIC Educational Resources Information Center

Siehl, Peterann M.; Studer, Jeannine

Adolescent suicide is the second leading cause of death in the adolescent population and is on the rise. This study used a mass screening concept as a pre-test identifier of at risk clients for suicide ideation and depressions; development of a competency-based prevention group treatment program, and the post-testing of the identified at-risk…

Pennsylvania SBIRT Medical and Residency Training: Developing, Implementing, and Evaluating an Evidenced-Based Program

ERIC Educational Resources Information Center

Pringle, Janice L.; Melczak, Michael; Johnjulio, William; Campopiano, Melinda; Gordon, Adam J.; Costlow, Monica

2012-01-01

Medical residents do not receive adequate training in screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use disorders. The federally funded Pennsylvania SBIRT Medical and Residency Training program (SMaRT) is an evidence-based curriculum with goals of training residents in SBIRT knowledge and skills and…

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Preliminary Investigation

ERIC Educational Resources Information Center

Misurell, Justin R.; Springer, Craig; Tryon, Warren W.

2011-01-01

This preliminary investigation examined the efficacy of a game-based cognitive-behavioral therapy group program for elementary school-aged children who have experienced sexual abuse. Treatment aimed to improve: (a) internalizing symptoms, (b) externalizing behaviors, (c) sexually inappropriate behaviors, (d) social skills deficits, (e) self-esteem…

Identification and Development of Competency-Based Curriculum for Water and Wastewater Program.

ERIC Educational Resources Information Center

Kirkwood Community Coll., Cedar Rapids, IA.

A project was undertaken at Kirkwood Community College to develop a full-time and part-time competency based program to educate water and wastewater treatment plant operators. First, a survey was conducted to identify the job tasks performed by the operators, their frequency, importance, and necessity. A questionnaire listing 651 tasks divided…

Exploring how prison-based drug rehabilitation programming shapes racial disparities in substance use disorder recovery.

PubMed

Kerrison, Erin M

2018-02-01

Prison-based therapeutic community (TC) programming is derived from the perspective that drug addiction is primarily symptomatic of cognitive dysfunction, poor emotional management, and underdeveloped self-reliance skills, and can be addressed in a collaborative space where a strong ideological commitment to moral reform and personal responsibility is required of its members. In this space, evidence of rehabilitation is largely centered on the client's relationship to language and the public adoption of a "broken self" narrative. Failure to master these linguistic performances can result in the denial of material and symbolic resources, thus participants learn how to use TC language to present themselves in ways that support existing institutionalized hierarchies, even if that surrender spells their self-denigration. This research examines the interview narratives of 300 former prisoners who participated in a minimum of 12 months of prison-based TC programming, and described how programming rhetoric impacted their substance abuse treatment experiences. While many of the respondents described distressing experiences as TC participants, White respondents were more likely to eventually embrace the "addict" label and speak of privileges and reintegrative support subsequently received. Black respondents were more likely to defy the treatment rhetoric, and either fail to complete the program or simulate a deficit-based self-narrative without investing in the content of those stories. The following explores the significance of language and identity construction in these carceral spaces, and how treatment providers as well as agency agendas are implicated in the reproduction of racial disparities in substance abuse recovery. Published by Elsevier Ltd.

Retention predictors related to intensive outpatient programs for substance use disorders.

PubMed

Veach, L J; Remley, T P; Kippers, S M; Sorg, J D

2000-08-01

The purpose of this research was to expand knowledge in the current literature regarding treatment retention in intensive outpatient substance abuse treatment programs. The sample in this study participated in a hospital-based program accredited by the Joint Commission on Accreditation for Health Organizations (JCAHO) that utilized the Minnesota model. Specifically, this inquiry investigated whether treatment retention would be predicted by gender, age, employment status, number of problems on the treatment plan, whether the referral was related to driving while intoxicated (DWI), marital status, race, and whether each of the following substance problems was listed as the client's primary DSM-IV diagnosis: alcohol dependence, cocaine dependence, polysubstance dependence, opioid dependence, sedative/hypnotic dependence, cannabis dependence, other (or unknown) dependence, alcohol abuse, cannabis abuse, amphetamine abuse, and caffeine intoxication. Findings indicated that those retained in treatment, when compared to those who dropped out, had significantly more problems on their treatment plans, were more likely to be alcoholics, were less often cocaine addicts, and were more likely to be employed. The results of this study suggest that clients with this profile have increased likelihood of being retained in intensive outpatient substance abuse treatment programs.

Healthy Learning Mind - a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial.

PubMed

Volanen, Salla-Maarit; Lassander, Maarit; Hankonen, Nelli; Santalahti, Päivi; Hintsanen, Mirka; Simonsen, Nina; Raevuori, Anu; Mullola, Sari; Vahlberg, Tero; But, Anna; Suominen, Sakari

2016-07-11

Mindfulness has shown positive effects on mental health, mental capacity and well-being among adult population. Among children and adolescents, previous research on the effectiveness of mindfulness interventions on health and well-being has shown promising results, but studies with methodologically sound designs have been called for. Few intervention studies in this population have compared the effectiveness of mindfulness programs to alternative intervention programs with adequate sample sizes. Our primary aim is to explore the effectiveness of a school-based mindfulness intervention program compared to a standard relaxation program among a non-clinical children and adolescent sample, and a non-treatment control group in school context. In this study, we systematically examine the effects of mindfulness intervention on mental well-being (primary outcomes being resilience; existence/absence of depressive symptoms; experienced psychological strengths and difficulties), cognitive functions, psychophysiological responses, academic achievements, and motivational determinants of practicing mindfulness. The design is a cluster randomized controlled trial with three arms (mindfulness intervention group, active control group, non-treatment group) and the sample includes 59 Finnish schools and approx. 3 000 students aged 12-15 years. Intervention consists of nine mindfulness based lessons, 45 mins per week, for 9 weeks, the dose being identical in active control group receiving standard relaxation program called Relax. The programs are delivered by 14 educated facilitators. Students, their teachers and parents will fill-in the research questionnaires before and after the intervention, and they will all be followed up 6 months after baseline. Additionally, students will be followed 12 months after baseline. For longer follow-up, consent to linking the data to the main health registers has been asked from students and their parents. The present study examines systematically the effectiveness of a school-based mindfulness program compared to a standard relaxation program, and a non-treatment control group. A strength of the current study lies in its methodologically rigorous, randomized controlled study design, which allows novel evidence on the effectiveness of mindfulness over and above a standard relaxation program. ISRCTN18642659 . Retrospectively registered 13 October 2015.

SU-F-J-94: Development of a Plug-in Based Image Analysis Tool for Integration Into Treatment Planning

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

Owen, D; Anderson, C; Mayo, C

Purpose: To extend the functionality of a commercial treatment planning system (TPS) to support (i) direct use of quantitative image-based metrics within treatment plan optimization and (ii) evaluation of dose-functional volume relationships to assist in functional image adaptive radiotherapy. Methods: A script was written that interfaces with a commercial TPS via an Application Programming Interface (API). The script executes a program that performs dose-functional volume analyses. Written in C#, the script reads the dose grid and correlates it with image data on a voxel-by-voxel basis through API extensions that can access registration transforms. A user interface was designed through WinFormsmore » to input parameters and display results. To test the performance of this program, image- and dose-based metrics computed from perfusion SPECT images aligned to the treatment planning CT were generated, validated, and compared. Results: The integration of image analysis information was successfully implemented as a plug-in to a commercial TPS. Perfusion SPECT images were used to validate the calculation and display of image-based metrics as well as dose-intensity metrics and histograms for defined structures on the treatment planning CT. Various biological dose correction models, custom image-based metrics, dose-intensity computations, and dose-intensity histograms were applied to analyze the image-dose profile. Conclusion: It is possible to add image analysis features to commercial TPSs through custom scripting applications. A tool was developed to enable the evaluation of image-intensity-based metrics in the context of functional targeting and avoidance. In addition to providing dose-intensity metrics and histograms that can be easily extracted from a plan database and correlated with outcomes, the system can also be extended to a plug-in optimization system, which can directly use the computed metrics for optimization of post-treatment tumor or normal tissue response models. Supported by NIH - P01 - CA059827.« less

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting.

PubMed

Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

2017-01-01

Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3-18), and the median BMI SDS was 2.85 (range: 1.26-8.96) in boys and 2.48 (range: 1.08-4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30-0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12-0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7-4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0-6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility.

The Treatment Advocacy Program: A Randomized Controlled Trial of a Peer-Led Safer Sex Intervention for HIV-Infected Men Who Have Sex with Men

ERIC Educational Resources Information Center

McKirnan, David J.; Tolou-Shams, Marina; Courtenay-Quirk, Cari

2010-01-01

Objective: Primary care may be an effective venue for delivering behavioral interventions for sexual safety among HIV-positive men who have sex with men (MSM); however, few studies show efficacy for such an approach. We tested the efficacy of the Treatment Advocacy Program (TAP), a 4-session, primary-care-based, individual counseling intervention…

National Institute on Drug Abuse International Program: improving opioid use disorder treatment through international research training.

PubMed

Gust, Steven W; McCormally, Judy

2018-07-01

For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD). Studies in several countries have demonstrated the effectiveness of physician office-based opioid substitution therapies. Other research has demonstrated the effectiveness of different formulations and doses of the opioid antagonist naltrexone, as well as different approaches to providing naloxone to treat opioid overdose. Continuing research into implementation of evidence-based treatment in international settings with limited resources is applicable to US regions that face similar structural, legal, and fiscal constraints. The current review describes international research on OUD treatment and opioid overdose, most coauthored by former NIDA fellows. The findings from outside the United States have important implications for best practices domestically and in other countries that are experiencing increases in OUD prevalence and related overdose deaths.

Predictors of Sex Offender Treatment Completion.

ERIC Educational Resources Information Center

Moore, Donna L.; Bergman, Barbara A.; Knox, Pamela L.

1999-01-01

Reviews records of 126 incarcerated offenders who participated in a prison-based sex offender treatment program. Discriminate function analysis reveals that offenders who completed treatment were more often diagnosed with a substance disorder, had a history of nonviolence offenses, and were less often diagnosed as having an antisocial personality…

Web-Based Aftercare for Women With Bulimia Nervosa Following Inpatient Treatment: Randomized Controlled Efficacy Trial.

PubMed

Jacobi, Corinna; Beintner, Ina; Fittig, Eike; Trockel, Mickey; Braks, Karsten; Schade-Brittinger, Carmen; Dempfle, Astrid

2017-09-22

Relapse rates in bulimia nervosa (BN) are high even after successful treatment, but patients often hesitate to take up further treatment. An easily accessible program might help maintain treatment gains. Encouraged by the effects of Web-based eating disorder prevention programs, we developed a manualized, Web-based aftercare program (IN@) for women with BN following inpatient treatment. The objective of this study was to determine the efficacy of the web-based guided, 9-month, cognitive-behavioral aftercare program IN@ for women with BN following inpatient treatment. We conducted a randomized controlled efficacy trial in 253 women with DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) BN and compared the results of IN@ with treatment as usual (TAU). Assessments were carried out at hospital admission (T0), hospital discharge/baseline (T1), postintervention (T2; 9 months after baseline), 9-month follow-up (T3; 18 months after baseline). The primary outcome, abstinence from binge eating and compensatory behaviors during the 2 months preceding T2, was analyzed by intention to treat, using logistic regression analyses. Frequencies of binge eating and vomiting episodes, and episodes of all compensatory behaviors were analyzed using mixed effects models. At T2, data from 167 women were available. There were no significant differences in abstinence rates between the TAU group (n=24, 18.9%) and the IN@ group (n=27, 21.4%; odds ratio, OR=1.29; P=.44). The frequency of vomiting episodes in the IN@ group was significantly (46%) lower than in the TAU group (P=.003). Moderator analyses revealed that both at T2 and T3, women of the intervention group who still reported binge eating and compensatory behaviors after inpatient treatment benefited from IN@, whereas women who were already abstinent after the inpatient treatment did not (P=.004; P=.002). Additional treatment utilization was high in both groups between baseline and follow-up. Overall, data from this study suggest moderate effects of IN@. High rates of outpatient treatment utilization after inpatient treatment may have obscured potential intervention effects on abstinence. An aftercare intervention might be more beneficial as part of a stepped-care approach. International Standard Randomized Controlled Trial Number (ISRCTN): 08870215; http://www.isrctn.com/ISRCTN08870215 (Archived by WebCite at http://www.webcitation.org/6soA5bIit). ©Corinna Jacobi, Ina Beintner, Eike Fittig, Mickey Trockel, Karsten Braks, Carmen Schade-Brittinger, Astrid Dempfle. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.09.2017.

Web-Based Aftercare for Women With Bulimia Nervosa Following Inpatient Treatment: Randomized Controlled Efficacy Trial

PubMed Central

Fittig, Eike; Trockel, Mickey; Braks, Karsten; Schade-Brittinger, Carmen; Dempfle, Astrid

2017-01-01

Background Relapse rates in bulimia nervosa (BN) are high even after successful treatment, but patients often hesitate to take up further treatment. An easily accessible program might help maintain treatment gains. Encouraged by the effects of Web-based eating disorder prevention programs, we developed a manualized, Web-based aftercare program (IN@) for women with BN following inpatient treatment. Objective The objective of this study was to determine the efficacy of the web-based guided, 9-month, cognitive-behavioral aftercare program IN@ for women with BN following inpatient treatment. Methods We conducted a randomized controlled efficacy trial in 253 women with DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) BN and compared the results of IN@ with treatment as usual (TAU). Assessments were carried out at hospital admission (T0), hospital discharge/baseline (T1), postintervention (T2; 9 months after baseline), 9-month follow-up (T3; 18 months after baseline). The primary outcome, abstinence from binge eating and compensatory behaviors during the 2 months preceding T2, was analyzed by intention to treat, using logistic regression analyses. Frequencies of binge eating and vomiting episodes, and episodes of all compensatory behaviors were analyzed using mixed effects models. Results At T2, data from 167 women were available. There were no significant differences in abstinence rates between the TAU group (n=24, 18.9%) and the IN@ group (n=27, 21.4%; odds ratio, OR=1.29; P=.44). The frequency of vomiting episodes in the IN@ group was significantly (46%) lower than in the TAU group (P=.003). Moderator analyses revealed that both at T2 and T3, women of the intervention group who still reported binge eating and compensatory behaviors after inpatient treatment benefited from IN@, whereas women who were already abstinent after the inpatient treatment did not (P=.004; P=.002). Additional treatment utilization was high in both groups between baseline and follow-up. Conclusions Overall, data from this study suggest moderate effects of IN@. High rates of outpatient treatment utilization after inpatient treatment may have obscured potential intervention effects on abstinence. An aftercare intervention might be more beneficial as part of a stepped-care approach. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 08870215; http://www.isrctn.com/ISRCTN08870215 (Archived by WebCite at http://www.webcitation.org/6soA5bIit) PMID:28939544

The Effectiveness of a Bicycle Safety Program for Improving Safety-Related Knowledge and Behavior in Young Elementary Students

PubMed Central

Glang, Ann

2010-01-01

Objective The purpose of this study was to evaluate the “Bike Smart” program, an eHealth software program that teaches bicycle safety behaviors to young children. Methods Participants were 206 elementary students in grades kindergarten to 3. A random control design was employed to evaluate the program, with students assigned to either the treatment condition (Bike Smart) or the control condition (a video on childhood safety). Outcome measures included computer-based knowledge items (safety rules, helmet placement, hazard discrimination) and a behavioral measure of helmet placement. Results Results demonstrated that regardless of gender, cohort, and grade the participants in the treatment group showed greater gains than control participants in both the computer-presented knowledge items (p > .01) and the observational helmet measure (p > .05). Conclusions Findings suggest that the Bike Smart program can be a low cost, effective component of safety training packages that include both skills-based and experiential training. PMID:19755497

Effectiveness of Placebo Therapy for Maintaining Masking in a Clinical Trial of Vergence/Accommodative Therapy

PubMed Central

Kulp, Marjean; Mitchell, G. Lynn; Borsting, Eric; Scheiman, Mitchell; Cotter, Susan; Rouse, Michael; Tamkins, Susanna; Mohney, Brian G.; Toole, Andrew; Reuter, Kathleen

2009-01-01

Purpose To evaluate the effectiveness of the Convergence Insufficiency Treatment Trial (CITT) placebo therapy program in maintaining masking of patients randomized to the office-based treatment arms, determine whether demographic variables affect masking, and determine whether perception of assigned treatment group was associated with treatment outcome or adherence to treatment. Methods Patients (n = 221, ages, 9–17 years) were randomized to one of four treatment groups, two of which were office-based and masked to treatment (n = 114). The placebo therapy program was designed to appear to be real vergence/accommodative therapy, without stimulating vergence, accommodation, or fine saccades (beyond levels of daily visual activities). After treatment, patients in the office-based groups were asked whether they thought they had received real or placebo therapy and how confident they were in their answers. Results Ninety-three percent of patients assigned to real therapy and 85% assigned to placebo therapy thought they were in the real therapy group (P = 0.17). No significant differences were found between the two groups in adherence to the therapy (P ≥ 0.22 for all comparisons). The percentage of patients who thought they were assigned to real therapy did not differ by age, sex, race, or ethnicity (P > 0.30 for all comparisons). No association was found between patients' perception of group assignment and symptoms or signs at outcome (P ≥ 0.38 for all comparisons). Conclusions The CITT placebo therapy program was effective in maintaining patient masking in this study and therefore may have potential for use in future clinical trials using vergence/accommodative therapy. Masking was not affected by demographic variables. Perception of group assignment was not related to symptoms or signs at outcome (ClinicalTrials.gov number, NCT00338611). PMID:19151384

Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial.

PubMed

Meyer, Björn; Berger, Thomas; Caspar, Franz; Beevers, Christopher G; Andersson, Gerhard; Weiss, Mario

2009-05-11

Depression is associated with immense suffering and costs, and many patients receive inadequate care, often because of the limited availability of treatment. Web-based treatments may play an increasingly important role in closing this gap between demand and supply. We developed the integrative, Web-based program Deprexis, which covers therapeutic approaches such as behavioral activation, cognitive restructuring, mindfulness/acceptance exercises, and social skills training. To evaluate the effectiveness of the Web-based intervention in a randomized controlled trial. There were 396 adults recruited via Internet depression forums in Germany, and they were randomly assigned in an 80:20 weighted randomization sequence to either 9 weeks of immediate-program-access as an add-on to treatment-as-usual (N = 320), or to a 9-week delayed-access plus treatment-as-usual condition (N = 76). At pre- and post-treatment and 6-month follow-up, we measured depression (Beck Depression Inventory) as the primary outcome measure and social functioning (Work and Social Adjustment Scale) as the secondary outcome measure. Complete analyses and intention-to-treat analyses were performed. Of 396 participants, 216 (55%) completed the post-measurement 9 weeks later. Available case analyses revealed a significant reduction in depression severity (BDI), Cohen's d = .64 (CI 95% = 0.33 - 0.94), and significant improvement in social functioning (WSA), Cohen's d = .64, 95% (CI 95% = 0.33 - 0.95). These improvements were maintained at 6-month follow-up. Intention-to-treat analyses confirmed significant effects on depression and social functioning improvements (BDI: Cohen's d = .30, CI 95% = 0.05 - 0.55; WSA: Cohen's d = .36, CI 95% = 0.10 - 0.61). Moreover, a much higher percentage of patients in the intervention group experienced a significant reduction of depression symptoms (BDI: odds ratio [OR] = 6.8, CI 95% = 2.90 - 18.19) and recovered more often (OR = 17.3, 95% CI 2.3 - 130). More than 80% of the users felt subjectively that the program had been helpful. This integrative, Web-based intervention was effective in reducing symptoms of depression and in improving social functioning. Findings suggest that the program could serve as an adjunctive or stand-alone treatment tool for patients suffering from symptoms of depression.

The VUKA Family Program: Piloting a family-based psychosocial intervention to promote health and mental health among HIV infected early adolescents in South Africa

PubMed Central

Bhana, Arvin; Mellins, Claude Ann; Petersen, Inge; Alicea, Stacey; Myeza, Nonhlahla; Holst, Helga; Abrams, Elaine; John, Sally; Chhagan, Meera; Nestadt, Danielle F; Leu, Cheng-Shiun; McKay, Mary

2013-01-01

An increasing number of adolescents born with HIV in South Africa are on antiretroviral treatment and have to confront complex issues related to coping with a chronic, stigmatizing and transmittable illness. Very few evidence-based mental health and health promotion programs for this population exist in South Africa. This study builds on a previous collaboratively designed and developmentally-timed family-based intervention for early adolescents (CHAMP). The study uses community-based participatory approach as part of formative research to evaluate a pilot randomized control trial at two hospitals. The paper reports on the development, feasibility and acceptability of the VUKA family-based program and its short-term impact on a range of psychosocial variables for HIV+ pre-adolescents and their caregivers. A ten session intervention of approximately 3 months duration was delivered to 65 pre-adolescents aged 10-13 years and their families. VUKA participants were noted to improve on all dimensions, including mental health, youth behaviour, HIV treatment knowledge, stigma, communication and adherence to medication. VUKA shows promise as a family-based mental and HIV prevention program for HIV+ pre-adolescents and which could be delivered by trained lay staff. PMID:23767772

Needs assessment and treatment compliance at state opioid substitution treatment programes in Georgia.

PubMed

Piralishvili, G; Gamkrelidze, I; Nikolaishvili, N; Chavchanidze, M

2013-01-01

conduct needs assessments and treatment compliance evaluations in MMT and Suboxone Substitution State Programs in Georgia (Republic of). 506 patients (2 females) were surveyed (92% on Methadone, 8% on Suboxone) from 6 Tbilisi and 4 regional State Programs in 2011 November. Mean age - 40±8,56 (22-65) year; 254 (51.4%) were in treatment for 1-3 year. Evaluation was carried out on the base of structured self-questionnaire that covers demographics, drug use history, general drug use trends, psychotherapeutic sessions' acceptance and open label question regarding treatment challenges and satisfaction. 305 (60.3%) attended individual and 57 (11.3%) group psychotherapy sessions with 50.79% attending once/month or rare. The main reason given for therapy non-attendance - no needs for it (29.48%); the main drugs before admission - heroin (80.04%), buprenorphine (53.49%); Main drugs used in Georgia nowadays - desomorphine ("crocodile"), alcohol and marihuana. Commonly used drugs by program patients (136 positive answers) - alcohol-13.62%, marihuana-10.39%, pregabalin - 8.17%, opioids- 6.62% (mostly-"crocodile"), home-made stimulants-6.23%, sedatives -5.45%. 55.4% are extremely satisfied with treatment, 82.4% - with program staff. Patients' main wishes- free of charge programs (46.4%) and provide take-home doses (22.07%). Methadone and Suboxone ST are being well accepted in Georgia and appear to be reducing illegal opioid use. However, the psychotherapeutic sessions' attendance is very low.

Substance abuse treatment for women who are under correctional supervision in the community: a systematic review of qualitative findings.

PubMed

Finfgeld-Connett, Deborah; Johnson, E Diane

2011-01-01

This systematic review was conducted to more fully analyze qualitative research findings relating to community-based court-supervised substance abuse treatment for women and to make recommendations regarding treatment enhancement. Five reports of qualitative research met the inclusion criteria. Findings from these reports were extracted and analyzed using constant comparative methods. Women who are referred to court-sanctioned substance abuse treatment programs may initially be reluctant to participate. Once engaged, however, they advocate for a full complement of well-financed comprehensive services. To optimize treatment effectiveness, women recommend gender-specific programs in which ambivalence is diminished, hope is instilled, and care is individualized.

Perceptions of the state policy environment and adoption of medications in the treatment of substance use disorders.

PubMed

Knudsen, Hannah K; Abraham, Amanda J

2012-01-01

Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state's Medicaid formulary and that state-contract funding permitted the purchase of medications. States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment.

Perceptions of the State Policy Environment and Adoption of Medications in the Treatment of Substance Use Disorders

PubMed Central

Knudsen, Hannah K.; Abraham, Amanda J.

2012-01-01

Objective Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Methods Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. Results A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state’s Medicaid formulary and that state-contract funding permitted the purchase of medications. Conclusions States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment. PMID:22227755

DESALINATION AND WATER TREATMENT RESEARCH AT SANDIA NATIONAL LABORATORIES.

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

Rigali, Mark J.; Miller, James E.; Altman, Susan J.

Water is the backbone of our economy - safe and adequate supplies of water are vital for agriculture, industry, recreation, and human consumption. While our supply of water today is largely safe and adequate, we as a nation face increasing water supply challenges in the form of extended droughts, demand growth due to population increase, more stringent health-based regulation, and competing demands from a variety of users. To meet these challenges in the coming decades, water treatment technologies, including desalination, will contribute substantially to ensuring a safe, sustainable, affordable, and adequate water supply for the United States. This overview documentsmore » Sandia National Laboratories' (SNL, or Sandia) Water Treatment Program which focused on the development and demonstration of advanced water purification technologies as part of the larger Sandia Water Initiative. Projects under the Water Treatment Program include: (1) the development of desalination research roadmaps (2) our efforts to accelerate the commercialization of new desalination and water treatment technologies (known as the 'Jump-Start Program),' (3) long range (high risk, early stage) desalination research (known as the 'Long Range Research Program'), (4) treatment research projects under the Joint Water Reuse & Desalination Task Force, (5) the Arsenic Water Technology Partnership Program, (6) water treatment projects funded under the New Mexico Small Business Administration, (7) water treatment projects for the National Energy Technology Laboratory (NETL) and the National Renewable Energy Laboratory (NREL), (8) Sandia- developed contaminant-selective treatment technologies, and finally (9) current Laboratory Directed Research and Development (LDRD) funded desalination projects.« less

The development of an RDoC-based treatment program for adolescent depression: “Training for Awareness, Resilience, and Action” (TARA)

PubMed Central

Henje Blom, Eva; Duncan, Larissa G.; Ho, Tiffany C.; Connolly, Colm G.; LeWinn, Kaja Z.; Chesney, Margaret; Hecht, Frederick M.; Yang, Tony T.

2014-01-01

Major depressive disorder (MDD) is one of the current leading causes of disability worldwide. Adolescence is a vulnerable period for the onset of depression, with MDD affecting 8–20% of all youth. Traditional treatment methods have not been sufficiently effective to slow the increasing prevalence of adolescent depression. We therefore propose a new model for the treatment of adolescent depression – Training for Awareness, Resilience, and Action (TARA) – that is based on current understanding of developmental and depression neurobiology. The TARA model is aligned with the Research Domain Criteria (RDoC) of the National Institute of Mental Health. In this article, we first address the relevance of RDoC to adolescent depression. Second, we identify the major RDoC domains of function involved in adolescent depression and organize them in a way that gives priority to domains thought to be driving the psychopathology. Third, we select therapeutic training strategies for TARA based on current scientific evidence of efficacy for the prioritized domains of function in a manner that maximizes time, resources, and feasibility. The TARA model takes into consideration the developmental limitation in top-down cognitive control in adolescence and promotes bottom-up strategies such as vagal afference to decrease limbic hyperactivation and its secondary effects. The program has been informed by mindfulness-based therapy and yoga, as well as modern psychotherapeutic techniques. The treatment program is semi-manualized, progressive, and applied in a module-based approach designed for a group setting that is to be conducted one session per week for 12 weeks. We hope that this work may form the basis for a novel and more effective treatment strategy for adolescent depression, as well as broaden the discussion on how to address this challenge. PMID:25191250

Happy Despite Pain: A Randomized Controlled Trial of an 8-Week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients With Chronic Pain.

PubMed

Peters, Madelon L; Smeets, Elke; Feijge, Marion; van Breukelen, Gerard; Andersson, Gerhard; Buhrman, Monica; Linton, Steven J

2017-11-01

There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program. A randomized controlled trial was carried out with 3 conditions: an internet-delivered positive psychology program, an internet-delivered cognitive-behavioral program and waitlist control. A total of 276 patients were randomized to 1 of the 3 conditions and posttreatment data were obtained from 206 patients. Primary outcomes were happiness, depression, and physical impairments at posttreatment and at 6-month follow-up. Intention-to-treat analyses were carried out using mixed regression analyses. Both treatments led to significant increases in happiness and decreases in depression. Physical impairments did not significantly decrease compared with waitlist. Improvements in happiness and depression were maintained until 6-month follow-up. There were no overall differences in the efficacy of the 2 active interventions but effects seemed to be moderated by education. Patients with a higher level of education profited slightly more from the positive psychology intervention than from the cognitive-behavioral program. The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs.

Development and Pilot Randomized Control Trial of a Drama Program to Enhance Well-being Among Older Adults

PubMed Central

Moore, Raeanne C.; Straus, Elizabeth; Dev, Sheena I.; Parish, Steven M.; Sueko, Seema; Eyler, Lisa T.

2016-01-01

Objective Develop a novel theatre-based program and test its feasibility, tolerability, and preliminary efficacy for improving empathy/compassion and well-being among older adults. Method Thirteen older adults were randomized to a 6-week Drama Workshop (DW) program or time-equivalent Backstage Pass (BP) control condition. Pre- and post-treatment measures included empathy, compassion, and mood scales. Additional post-treatment measures included self-rated change in empathy/compassion, confidence, and affect. Participants also rated their mood/affect after each session. Results The program was successfully completed and well-liked. No pre-to-post-treatment changes in empathy/compassion or mood symptoms were found in either group. Compared to BP, DW weekly ratings indicated higher levels of anxiety and lower happiness; however, the DW program had higher self-ratings of positive change in self-esteem, confidence, and happiness post-treatment. Discussion While the DW may not promote empathy/compassion and was personally challenging during the program, engagement in dramatic exercises and rehearsing and performing a dramatic piece was seen by participants as a positive growth experience, as indicated by the post-treatment ratings of enhanced self-esteem, confidence and happiness. Thus, such a program might be useful for counteracting some of the potential negative aspects of aging, including reduced self-efficacy due to physical limitations and negative affect due to losses. PMID:28503015

Effects of Brief Psychoeducational Program on Stigma in Malaysian Pre-clinical Medical Students: A Randomized Controlled Trial.

PubMed

Fernandez, Aaron; Tan, Kit-Aun; Knaak, Stephanie; Chew, Boon How; Ghazali, Sazlina Shariff

2016-12-01

If presented with serious mental illness (SMI), individuals' low help-seeking behaviors and poor adherence to treatment are associated with negative stereotypes and attitudes of healthcare providers. In this study, we examined the effects of a brief psychoeducational program on reducing stigma in pre-clinical medical students. One hundred and two pre-clinical medical students (20-23 years old) were randomly assigned to face-to-face contact + educational lecture (n = 51) condition or video-based contact + educational lecture (n = 51) condition. Measures of pre-clinical medical students' mental illness-related stigma using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) were administered at pre-, post-treatment, and 1-month follow-up. A 2 (condition: face-to-face contact + educational lecture, video-based contact + educational lecture) by 3 (time: pre-treatment, post-treatment, and 1-month follow-up) mixed model MANOVA was conducted on the Attitudes, Disclosure and Help-Seeking, and Social Distance OMS-HC subscales. Participants' scores on all subscales changed significantly across time, regardless of conditions. To determine how participants' scores changed significantly over time on each subscale, Bonferroni follow-up comparisons were performed to access pairwise differences for the main effect of time. Specifically, pairwise comparisons produced a significant reduction in Social Distance subscale between pre-treatment and post-treatment and between pre-treatment and 1-month follow-up, and a significant increase between post-treatment and 1-month follow-up, regardless of conditions. With respect to the Attitudes and Disclosure and Help-Seeking subscales, pairwise comparisons produced a significant reduction in scores between pre-treatment and post-treatment and a significant increase between post-treatment and 1-month follow-up. Our findings provide additional evidence that educational lecture on mental illness, coupled with either face-to-face contact or video-based contact, is predictive of positive outcomes in anti-stigma programs targeting future healthcare providers.

Setting up chronic disease programs: perspectives from Aboriginal Australia.

PubMed

Hoy, Wendy E; Kondalsamy-Chennakesavan, S; Smith, J; Sharma, S; Davey, R; Gokel, G

2006-01-01

To share some perspectives on setting up programs to improve management of hypertension, renal disease, and diabetes in high-risk populations, derived from experience in remote Australian Aboriginal settings. Regular integrated checks for chronic disease and their risk factors and appropriate treatment are essential elements of regular adult health care. Programs should be run by local health workers, following algorithms for testing and treatment, with back up from nurses. Constant evaluation is essential. COMPONENTS: Theses include testing, treatment, education for individuals and communities, skills and career development for staff, ongoing evaluation, program modification, and advocacy. Target groups, elements, and frequency of testing, as well as the reagents and treatment modalities must be designed for local circumstances, which include disease burden and impact, competing priorities, and available resources. Pilot surveys or record reviews can define target groups and conditions. Opportunistic testing will suffice if people are seen with some regularity for other conditions; otherwise, systematic screening is needed, preferably embedded in primary care streams. The chief goal of treatment is to lower blood pressure, and if the patient is diabetic, to control hyperglycemia. Many people will need multiple drugs for many years. Challenges include lack of resources, competing demands of acute care, the burden of treatment when disease rates are high, problems with information systems, and in our setting, health worker absenteeism. Businesses, altruistic organizations, and pharmaceutical and biotechnology companies might fund feasibility studies. Where governments or insurance companies already support health services, they must ultimately commit to chronic disease services over the long- term. Effective advocacy requires the presentation of an integrated view of chronic disease and a single cross-disciplinary program for its containment. Arguments based on preserving the economic base of societies by preventing or delaying premature death will carry most weight, as will the costs of dialysis avoided in countries that already support open-access programs.

Perception of Helpfulness among Participants in a Prison-Based Residential Substance Abuse Treatment Program

ERIC Educational Resources Information Center

Raney, Valerie K.; Magaletta, Philip; Hubbert, Timothy A.

2005-01-01

The purpose of the current study was to determine the extent to which an early prison release incentive impacted inmates' perceptions of substance abuse treatment helpfulness, overall satisfaction and focus on treatment issues. Three groups of inmates participating in their first, third or sixth month of residential drug abuse treatment were…

Maintenance and Generalization Effects of Semantic and Phonological Treatments of Anomia: A Case Study

ERIC Educational Resources Information Center

Macoir, Joel; Routhier, Sonia; Simard, Anne; Picard, Josee

2012-01-01

Anomia is one of the most frequent manifestations in aphasia. Model-based treatments for anomia usually focus on semantic and/or phonological levels of processing. This study reports treatment of anomia in an individual with chronic aphasia. After baseline testing, she received a training program in which semantic and phonological treatments were…

40 CFR 122.62 - Modification or revocation and reissuance of permits (applicable to State programs, see § 123.25).

Code of Federal Regulations, 2010 CFR

2010-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EPA ADMINISTERED PERMIT PROGRAMS: THE... limitation guideline, EPA approved or promulgated water quality standards, or the Secondary Treatment... regard to a water quality standard on which the permit condition was based; and (C) A permittee requests...

Intensive Time Out Program Evaluation.

ERIC Educational Resources Information Center

Burton, Mary; Parks, Stephen

The New Brunswick (Canada) Youth Treatment Program is a community-based intervention strategy for conduct disordered youth in New Brunswick. The Program's Intensive Time Out (ITO) is a strategy to eliminate unacceptable behaviors. It is recommended within the school setting for children from 6 to 11 years of age, and is designed to reverse the…

Baylor SBIRT Medical Residency Training Program: Model Description and Initial Evaluation

ERIC Educational Resources Information Center

Bray, James H.; Kowalchuk, Alicia; Waters, Vicki; Laufman, Larry; Shilling, Elizabeth H.

2012-01-01

The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment (SBIRT) methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the…

Neuropsychological Treatment of Dyslexia: Does Type of Treatment Matter?

ERIC Educational Resources Information Center

Lorusso, Maria Lulsa; Facoetti, Andrea; Bakker, Dirk J.

2011-01-01

In this study, 123 children with a diagnosis of developmental dyslexia were assigned to different treatment groups, either variations of Bakker's intervention program based on the balance model or a control, a specific reading training group. Thorough cognitive and neuropsychological assessment allowed determination of the subtype of dyslexia…

Skills for social and academic success: a school-based intervention for social anxiety disorder in adolescents.

PubMed

Fisher, Paige H; Masia-Warner, Carrie; Klein, Rachel G

2004-12-01

This paper describes Skills for Academic and Social Success (SASS), a cognitive-behavioral, school-based intervention for adolescents with social anxiety disorder. Clinic-based treatment studies for socially anxious youth are reviewed, and a strong rationale for transporting empirically-based interventions into schools, such as SASS, is provided. The SASS program consists of 12, 40-min group sessions that emphasize social skills and in-vivo exposure. In addition to group sessions, students are seen individually at least twice and participate in 4 weekend social events with prosocial peers from their high schools. Meetings with teachers provide information about social anxiety and facilitate classroom exposures for socially anxious participants. Parents attend 2 psychoeducational meetings about social anxiety, its treatment, and approaches for managing their child's anxiety. Initial findings regarding the program's effectiveness are presented. We conclude by discussing the challenges involved in implementing treatment protocols in schools and provide suggestions to address these issues.

[Modern concepts of medical care--what has been achieved by the implementation of disease management programs?].

PubMed

Kirchner, H

2005-01-01

Since 2003, structured treatment programs for chronically ill patients (disease management programs; DMPs) have been under development in Germany. Virtually nationwide, programs in which physicians and patients can register are being offered for diabetes mellitus types 1 and 2, breast cancer, coronary heart disease and asthma/COPD. The medical content of the programs is determined on the basis of evidence-based medicine. Even though the effectiveness of structured treatment programs is documented for diabetes, adequate studies confirming the overall transferability of results to the German health care system are as yet lacking. Physicians above all strongly criticise the coupling of DMPs with the risk adjustment scheme of the statutory health insurance funds, as well as the large amount of paperwork involved.

Implementing residential treatment for prison inmates with mental illness.

PubMed

O'Connor, Frederica W; Lovell, David; Brown, Linda

2002-10-01

There is evidence that mentally ill offenders (MIOs) in prisons commit more infractions, serve longer sentences, and are more likely to be victimized than inmates who are not mentally ill. Humanistic and prison management interests are served if intervention programs minimize symptoms and promote coping and other functional skills. A collaborative agreement was established between Washington State Department of Corrections and a consortium of University of Washington faculty to mutually develop a prison-based program of clinical management and psychoeducation for MIOs. The resulting program is described, along with rationale, planning processes, implementation, and initial evaluation. Most aspects of the planned program are in place. Clinical and behavioral progress by inmates following program participation has been documented. Issues concerning treatment program implementation in prisons are discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.

Analysis of an algae-based CELSS. I - Model development

NASA Technical Reports Server (NTRS)

Holtzapple, Mark T.; Little, Frank E.; Makela, Merry E.; Patterson, C. O.

1989-01-01

A steady state chemical model and computer program have been developed for a life support system and applied to trade-off studies. The model is based on human demand for food and oxygen determined from crew metabolic needs. The model includes modules for water recycle, waste treatment, CO2 removal and treatment, and food production. The computer program calculates rates of use and material balance for food, O2, the recycle of human waste and trash, H2O, N2, and food production/supply. A simple noniterative solution for the model has been developed using the steady state rate equations for the chemical reactions. The model and program have been used in system sizing and subsystem trade-off studies of a partially closed life support system.

Analysis of an algae-based CELSS. Part 1: model development

NASA Technical Reports Server (NTRS)

Holtzapple, M. T.; Little, F. E.; Makela, M. E.; Patterson, C. O.

1989-01-01

A steady state chemical model and computer program have been developed for a life support system and applied to trade-off studies. The model is based on human demand for food and oxygen determined from crew metabolic needs. The model includes modules for water recycle, waste treatment, CO2 removal and treatment, and food production. The computer program calculates rates of use and material balance for food. O2, the recycle of human waste and trash, H2O, N2, and food production supply. A simple non-iterative solution for the model has been developed using the steady state rate equations for the chemical reactions. The model and program have been used in system sizing and subsystem trade-off studies of a partially closed life support system.

Initial Field Trial of a Coach-Supported Web-Based Depression Treatment.

PubMed

Schueller, Stephen M; Mohr, David C

2015-08-01

Early web-based depression treatments were often self-guided and included few interactive elements, instead focusing mostly on delivering informational content online. Newer programs include many more types of features. As such, trials should analyze the ways in which people use these sites in order to inform the design of subsequent sites and models of support. The current study describes of a field trial consisting of 9 patients with major depressive disorder who completed a 12-week program including weekly coach calls. Patients usage varied widely, however, patients who formed regular patterns tended to persist with the program for the longest. Future sites might be able to facilitate user engagement by designing features to support regular use and to use coaches to help establish patterns to increase long-term use and benefit.

Health Insurance Enrollment and Availability of Medications for Substance Use Disorders.

PubMed

Abraham, Amanda J; Rieckmann, Traci; Andrews, Christina M; Jayawardhana, Jayani

2017-01-01

Medications for treatment of substance use disorders are underutilized in treatment programs in the United States. Little is known about how insurance enrollment within states affects treatment program decisions about whether to offer medications. The primary objective of the study was to examine the impact of health insurance enrollment on availability of substance use disorder medications among treatment programs. Data from the 2012 National Survey of Substance Abuse Treatment Services, National Survey on Drug Use and Health, American Community Survey, Area Health Resource File, and the Substance Abuse and Mental Health Services Administration were combined to examine the impact of state insurance enrollment on availability of substance use disorder medications in treatment programs (N=9,888). A two-level, random-intercept logistic regression model was estimated to account for potential unobserved heterogeneity among treatment programs nested in states. The percentage of state residents with employer-based insurance and Medicaid was associated with greater odds of offering at least one medication among treatment programs. A 5% increase in the rate of private insurance enrollment was associated with a 7.7% increase in the probability of offering at least one medication, and a 5% increase in the rate of state Medicaid enrollment was associated with a 9.3% increase in the probability of offering at least one medication. Results point to the potential significance of health insurance enrollment in shaping the availability of substance use disorder medications. Significant expansions in health insurance enrollment spurred by the Affordable Care Act have the potential to increase access to medications for many Americans.

Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program.

PubMed

Deyle, Gail D; Allison, Stephen C; Matekel, Robert L; Ryder, Michael G; Stang, John M; Gohdes, David D; Hutton, Jeremy P; Henderson, Nancy E; Garber, Matthew B

2005-12-01

Manual therapy and exercise have not previously been compared with a home exercise program for patients with osteoarthritis (OA) of the knee. The purpose of this study was to compare outcomes between a home-based physical therapy program and a clinically based physical therapy program. One hundred thirty-four subjects with OA of the knee were randomly assigned to a clinic treatment group (n=66; 61% female, 39% male; mean age [+/-SD]=64+/-10 years) or a home exercise group (n=68, 71% female, 29% male; mean age [+/-SD]=62+/-9 years). Subjects in the clinic treatment group received supervised exercise, individualized manual therapy, and a home exercise program over a 4-week period. Subjects in the home exercise group received the same home exercise program initially, reinforced at a clinic visit 2 weeks later. Measured outcomes were the distance walked in 6 minutes and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Both groups showed clinically and statistically significant improvements in 6-minute walk distances and WOMAC scores at 4 weeks; improvements were still evident in both groups at 8 weeks. By 4 weeks, WOMAC scores had improved by 52% in the clinic treatment group and by 26% in the home exercise group. Average 6-minute walk distances had improved about 10% in both groups. At 1 year, both groups were substantially and about equally improved over baseline measurements. Subjects in the clinic treatment group were less likely to be taking medications for their arthritis and were more satisfied with the overall outcome of their rehabilitative treatment compared with subjects in the home exercise group. Although both groups improved by 1 month, subjects in the clinic treatment group achieved about twice as much improvement in WOMAC scores than subjects who performed similar unsupervised exercises at home. Equivalent maintenance of improvements at 1 year was presumably due to both groups continuing the identical home exercise program. The results indicate that a home exercise program for patients with OA of the knee provides important benefit. Adding a small number of additional clinical visits for the application of manual therapy and supervised exercise adds greater symptomatic relief.

The effects of the evidence-based Safe Dates dating abuse prevention program on other youth violence outcomes.

PubMed

Foshee, Vangie A; Reyes, Luz McNaughton; Agnew-Brune, Christine B; Simon, Thomas R; Vagi, Kevin J; Lee, Rosalyn D; Suchindran, Chiravath

2014-12-01

In response to recent calls for programs that can prevent multiple types of youth violence, the current study examined whether Safe Dates, an evidence-based dating violence prevention program, was effective in preventing other forms of youth violence. Using data from the original Safe Dates randomized controlled trial, this study examined (1) the effectiveness of Safe Dates in preventing peer violence victimization and perpetration and school weapon carrying 1 year after the intervention phase was completed and (2) moderation of program effects by the sex or race/ethnicity of the adolescent. Ninety percent (n = 1,690) of the eighth and ninth graders who completed baseline questionnaires completed the 1-year follow-up assessment. The sample was 51 % female and 26 % minority (of whom 69 % was black and 31 % was of another minority race/ethnicity). There were no baseline treatment group differences in violence outcomes. Treatment condition was significantly associated with peer violence victimization and school weapon carrying at follow-up; there was 12 % less victimization and 31 % less weapon carrying among those exposed to Safe Dates than those among controls. Treatment condition was significantly associated with perpetration among the minority but not among white adolescents; there was 23 % less violence perpetration among minority adolescents exposed to Safe Dates than that among controls. The observed effect sizes were comparable with those of other universal school-based youth violence prevention programs. Implementing Safe Dates may be an efficient way of preventing multiple types of youth violence.

Web-Based Intervention for Postpartum Depression: Formative Research and Design of the MomMoodBooster Program.

PubMed

Danaher, Brian G; Milgrom, Jeannette; Seeley, John R; Stuart, Scott; Schembri, Charlene; Tyler, Milagra S; Ericksen, Jennifer; Lester, Whitney; Gemmill, Alan W; Lewinsohn, Peter

2012-11-22

Postpartum depression is a significant public health problem affecting approximately 13% of women. There is strong evidence supporting Cognitive Behavioral Therapy (CBT) for successful psychosocial treatment. This treatment model combines cognitive and behavioral strategies to address pessimism, attributions for failure, low self-esteem, low engagement in pleasant activities, social withdrawal, anxiety, and low social support. Encouraging results have been reported for using Web-based CBT interventions for mental health domains, including the treatment of panic disorder, post-traumatic stress disorder, and complicated grief and depression. To date, however, Web-based interventions have not been used and evaluated specifically for the treatment of postpartum depression. We describe the formative work that contributed to the development of our Web-based intervention for helping to ameliorate symptoms of postpartum depression, and the design and key components of the program. A total of 17 focus group participants and 22 usability testers, who shared key characteristics with the participants of our planned feasibility study, took part. The proposed structure and ingredients of the program and mock-ups of selected webpages were presented to focus group participants. At various points, participants were asked a series of thought questions designed to elicit opinions and set the occasion for group discussion. At the end of the session, participants were asked to describe their overall reaction to the proposed features of the program emphasizing candid opinions about what they did not like and features they thought were missing and should be added. Usability testers were asked to interact with a series of seven different Web-based interactions planned for the program while receiving minimal direction. Each tester was asked to describe her thoughts using a think-aloud technique. They were then asked to consider all that they had learned about the program and complete the System Usability Scale that we adapted slightly to be appropriate for evaluating the proposed website. Transcripts from the focus groups and usability tests were reviewed by research team members for overarching themes with particular emphasis on suggested changes. A list emerged, and iterative and incremental adjustments were made as a result. The qualitative and quantitative data gathered in the focus groups and usability sessions reported here suggest that the new mothers involved had largely positive reactions to the major features of the program and that those program features performed well in terms of usability. An overview of the eventual design, architecture, and key program ingredients of the MomMoodBooster program is provided including innovative features supplementing 6 core CBT sessions, which include a partner's website, a library, and individual feedback by a personal coach.

An exploratory qualitative assessment of self-reported treatment outcomes and satisfaction among patients accessing an innovative voluntary drug treatment centre in Malaysia.

PubMed

Ghani, Mansur A; Brown, Shan-Estelle; Khan, Farrah; Wickersham, Jeffrey A; Lim, Sin How; Dhaliwal, Sangeeth K; Kamarulzaman, Adeeba; Altice, Frederick L

2015-02-01

In Malaysia, compulsory drug detention centres (CDDCs) hold suspected drug users for two years without adjudication. Acute detoxification without healthcare access has been documented. CDDCs are criticized globally due to ineffectiveness in treating addiction and human rights violations. In response, the Malaysian government began transitioning these facilities into voluntary drug treatment centres known as "Cure and Care" (C&C) centres that embrace a holistic treatment-based approach to drug addiction rehabilitation. An explorative qualitative study was undertaken to explore patient perspectives and satisfaction regarding treatment and services at the new Cure and Care centre in Kota Bharu, Malaysia. A convenience sample of 20 patients was recruited to participate in semi-structured in-depth interviews. Content analysis was used to identify the salient themes. Patients identified methadone treatment, psychosocial programs, religious instruction, and recreational activities as important factors contributing to treatment success for addressing both health and addiction needs. Though many had previously been in a CDDC, adherence to treatment in the C&C centre was perceived to be facilitated by the degree of social support, the voluntary nature and the array of new programs available for selection. C&Cs represents a dramatic shift in the Malaysian government's approach to drug addiction. Our findings demonstrate positive patient experiences associated with the holistic treatment-based approach of these centres. This exploratory study provides additional evidence to document this ongoing policy transition and may guide continued expansion of new holistic drug treatment programs across the country. Copyright © 2014 Elsevier B.V. All rights reserved.

An Exploratory Qualitative Assessment of Self-Reported Treatment Outcomes and Satisfaction Among Patients Accessing an Innovative Voluntary Drug Treatment Centre in Malaysia

PubMed Central

Ghani, Mansur A.; Brown, Shan-Estelle; Khan, Farrah; Wickersham, Jeffrey A.; Lim, Sin How; Dhaliwal, Sangeeth K.; Kamarulzaman, Adeeba; Altice, Frederick L.

2014-01-01

Background In Malaysia, compulsory drug detention centres (CDDCs) hold suspected drug users for two years without adjudication. Acute detoxification without healthcare access has been documented. CDDCs are criticized globally due to ineffectiveness in treating addiction and human rights violations. In response, the Malaysian government began transitioning these facilities into voluntary drug treatment centres known as “Cure and Care” (C&C) centres that embrace a holistic treatment-based approach to drug addiction rehabilitation. Methods An explorative qualitative study was undertaken to explore patient perspectives and satisfaction regarding treatment and services at the new Cure and Care centre in Kota Bharu, Malaysia. A convenience sample of 20 patients was recruited to participate in semi-structured in-depth interviews. Content analysis approach was used to identify the salient themes. Results Patients identified methadone treatment, psychosocial programs, religious instruction, and recreational activities as important factors contributing to treatment success for addressing both health and addiction needs. Though many had previously been in a CDDC, adherence to treatment in the C&C centre was perceived to be facilitated by the degree of social support, the voluntary nature and the array of new programs available for selection. Conclusion C&Cs represents a dramatic shift in the Malaysian government’s approach to drug addiction. Our findings demonstrate positive patient experiences associated with the holistic treatment-based approach of these centres. This exploratory study provides additional evidence to document this ongoing policy transition and may guide continued expansion of new holistic drug treatment programs across the country. PMID:25577322

Behavioral predictors of attrition in adolescents participating in a multidisciplinary obesity treatment program: EVASYON study.

PubMed

De Miguel-Etayo, P; Muro, C; Santabárbara, J; López-Antón, R; Morandé, G; Martín-Matillas, M; Azcona-San Julián, M C; Martí, A; Campoy, C; Marcos, A; Moreno, L A; Garagorri, J M

2016-01-01

The aims of this study were to identify the cognitive and behavioral predictors of dropping out and to estimate the attrition rate during different phases of an intervention program to treat overweight and obesity in adolescents. Overweight/obese adolescents (n=156, aged: 13-16 years; 71 male and 85 female subjects) were included in a multicomponent (diet, physical activity and psychological support) family-based group treatment program. At baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up, we measured adolescents' cognitive and behavioral dimensions, together with the parents' perception of their child's behavior. Of the 156 adolescents selected, 112 completed the full program (drop-out rate of 28.2%). The risk of dropping out during the extensive phase increased by 20% for each unit increase in the adolescent's social insecurity score (odds ratio=1.20, 95% confidence interval=1.07-1.34, P=0.002). The adolescents who had a high interoceptive awareness showed a significant decrease of 13.0% in the probability of dropping out (odds ratio=0.87, 95% confidence interval=0.77-0.99, P=0.040). Adolescents' social insecurity was the main predictor of drop-out in a multicomponent family-group-based obesity treatment program. To reduce attrition rates in these programs, the individual's social insecurity level needs to be reduced, whereas the family's awareness of eating-related behavior needs adjustment.

Water Treatment and Handwashing Behaviors among Non-Pregnant Friends and Relatives of Participants in an Antenatal Hygiene Promotion Program in Malawi

PubMed Central

Russo, Elizabeth T.; Sheth, Anandi; Menon, Manoj; Wannemuehler, Kathleen; Weinger, Merri; Kudzala, Amose C.; Tauzie, Blessius; Masuku, Humphreys D.; Msowoya, Tapona E.; Quick, Robert

2012-01-01

Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases. To integrate hygiene improvement with antenatal care, free hygiene kits (water storage containers, water treatment solution, soap) and educational messages were distributed to pregnant women at antenatal clinics in Malawi. We assessed water treatment and hygiene practices of 275 non-pregnant friends and relatives of the hygiene kit recipients at baseline and follow-up nine months later to measure program impact on non-participants in the same communities. At follow-up, friends and relatives who did not receive kits or education were more likely than at baseline to purchase and use water treatment solution (25% versus 1%; P < 0.0001) and demonstrate correct handwashing practices (60% versus 18%; P < 0.0001). This antenatal clinic–based program resulted in improved water treatment and hygiene behaviors among non-pregnant friends and relatives living in the same communities as hygiene kit recipients, suggesting that program benefits extended beyond direct beneficiaries. PMID:22556088

Grade Level and Gender Differences in a School-Based Reading Tutoring Program

ERIC Educational Resources Information Center

Chang, Sau Hou

2011-01-01

The purpose of the present study is to investigate the grade level and gender differences in a school-based reading tutoring program. The treatment group included 10 first-grade and 12 second-grade struggling readers, and the control group included 41 first-grade and 63 second-grade nonstruggling readers. The tutors were teacher candidates in an…

Impacts of a Discussion-Based Academic Language Program on Classroom Interactions in 4th through 7th Grades

ERIC Educational Resources Information Center

LaRusso, Maria; Jones, Stephanie M.; Kim, Ha Yeon; Kim, James; Donovan, Suzanne; Snow, Catherine

2016-01-01

This paper presents an exploratory analysis of treatment-control differences in the quality of classroom interactions in 4th through 7th grade urban classrooms. Word Generation (WG) is a research-based academic language program for middle school students designed to teach novel vocabulary and literacy through language arts, math, science, and…

The Development of an Interactive Computer-Based Training Program for Timely and Humane On-Farm Pig Euthanasia.

PubMed

Mullins, Caitlyn R; Pairis-Garcia, Monique D; Campler, Magnus R; Anthony, Raymond; Johnson, Anna K; Coleman, Grahame J; Rault, Jean-Loup

2018-02-05

With extensive knowledge and training in the prevention, management, and treatment of disease conditions in animals, veterinarians play a critical role in ensuring good welfare on swine farms by training caretakers on the importance of timely euthanasia. To assist veterinarians and other industry professionals in training new and seasoned caretakers, an interactive computer-based training program was created. It consists of three modules, each containing five case studies, which cover three distinct production stages (breeding stock, piglets, and wean to grower-finisher pigs). Case study development was derived from five specific euthanasia criteria defined in the 2015 Common Swine Industry Audit, a nationally recognized auditing program used in the US. Case studies provide information regarding treatment history, clinical signs, and condition severity of the pig and prompt learners to make management decisions regarding pig treatment and care. Once a decision is made, feedback is provided so learners understand the appropriateness of their decision compared to current industry guidelines. In addition to training farm personnel, this program may also be a valuable resource if incorporated into veterinary, graduate, and continuing education curricula. This innovative tool represents the first interactive euthanasia-specific training program in the US swine industry and offers the potential to improve timely and humane on-farm pig euthanasia.

Integrated, Home-based Treatment for MDR-TB and HIV in Rural South Africa: An Alternate Model of Care

PubMed Central

Brust, James C.M.; Shah, N. Sarita; Scott, Michelle; Chaiyachati, Krisda; Lygizos, Melissa; van der Merwe, Theo L.; Bamber, Sheila; Radebe, Zanele; Loveday, Marian; Moll, Anthony P.; Margot, Bruce; Lalloo, Umesh G.; Friedland, Gerald H.; Gandhi, Neel R.

2012-01-01

SUMMARY Treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) in South Africa have suffered as centralized, inpatient treatment programs struggle to cope with rising prevalence and HIV co-infection rates. A new treatment model is needed to expand treatment capacity and improve MDR-TB and HIV outcomes. We describe the design and preliminary results of an integrated, home-based MDR-TB/HIV treatment program created in rural KwaZulu-Natal. In 2008, a decentralized center was established to provide outpatient MDR-TB and HIV treatment. Nurses, community health workers, and family supporters have been trained to administer injections, provide adherence support, and monitor adverse reactions in patients’ homes. Physicians assess clinical response, adherence, and adverse reaction severity to MDR-TB and HIV therapy at monthly follow-up visits. Treatment outcomes are assessed by monthly cultures and CD4 and viral load every 6 months. Eighty patients initiated MDR-TB therapy from 2/2008–4/2010; 66 were HIV co-infected. Retention has been high (only 5% defaults, 93% of visits attended) and preliminary outcomes have been favorable (77% cured/still on treatment, 82% undetectable viral load). Few patients have required escalation of care (9%), had severe adverse events (8%), or died (6%). Integrated, home-based treatment for MDR-TB and HIV is a promising treatment model to expand capacity and achieve improved outcomes in rural, resource-poor, and high-HIV prevalent settings. PMID:22668560

Empirically Supported Treatment's Impact on Organizational Culture and Climate.

PubMed

Patterson-Silver Wolf, David A; Dulmus, Catherine N; Maguin, Eugene

2012-11-01

OBJECTIVES: With the continued push to implement empirically supported treatments (ESTs) into community-based organizations, it is important to investigate whether working condition disruptions occur during this process. While there are many studies investigating best practices and how to adopt them, the literature lacks studies investigating the working conditions in programs that currently use ESTs. METHOD: This study compared the culture and climate scores of a large organization's programs that use ESTs and those programs indicating no EST usage. RESULTS: Of the total 55 different programs (1,273 frontline workers), 27 programs used ESTs. Results indicate that the programs offering an EST had significantly more rigid and resistant cultures, compared to those without any ESTs. In regard to climate, programs offering an EST were significantly less engaged, less functional, and more stressed. CONCLUSION: Outcomes indicate a significant disruption in organizational culture and climate for programs offering ESTs.

Youth at High Risk for Substance Abuse. Proceedings of a Technical Review on "Special Youth Populations--What Etiology Suggests about Prevention and Treatment Programming" (Rockville, Maryland, July 16-17, 1986).

ERIC Educational Resources Information Center

Brown, Barry S.; Mills, Arnold R.

This publication is based on papers and discussion from a technical review on etiology and prevention and treatment programming for special populations. Full transcripts were edited in preparing the reports of panel discussions and, in a few instances, phrases have been added to increase clarity. Four youthful populations (children of substance…

Effectiveness of short-term specialized inpatient treatment for war-related posttraumatic stress disorder: a role for adventure-based counseling and psychodrama.

PubMed

Ragsdale, K G; Cox, R D; Finn, P; Eisler, R M

1996-04-01

Psychological tests were administered to 24 participants of an inpatient posttraumatic stress disorder (PTSD) treatment program both immediately before and following completion of treatment. Responses were compared to a treatment/wait list comparison group composed of 24 subjects awaiting entry into the program. All treatment/wait list comparison group subjects received weekly PTSD outpatient group therapy. Significant improvements were found in the inpatient treatment group in areas of hopelessness, feelings of guilt and shame, loneliness, and emotional expressiveness. Other indices of psychological functional, including interpersonal skills, gender role stress, anxiety, anger, and PTSD symptomatology did not change significantly in response to treatment. No positive changes in any area of psychological function occurred in the treatment/wait list comparison group. Implications for PTSD and areas of future research are discussed.

Perceptions of Attrition and Family Participation: A Qualitative Study of Pediatric Obesity Clinicians

PubMed Central

Skelton, Joseph A.; Irby, Megan B.; Beech, Bettina M.; Rhodes, Scott D.

2012-01-01

Objective The majority of participants drop out of pediatric obesity treatment programs; however, clinicians have little knowledge of how to address this problem. The objective of this study was to explore obesity treatment clinicians’ perceptions of contributors to attrition, as well as methods to maintain family participation. Methods Semi-structured interviews were conducted with 29 pediatric obesity clinicians representing primary care (PC), community-based (CB), and tertiary-care (TC) treatment programs in North Carolina. Interviews were recorded, transcribed verbatim, and coded using a multistage inductive approach. Grounded theory was used to analyze responses. Results Eleven themes emerged from analysis, including: the influence of program elements, family characteristics, and the variety of approaches employed to address retention. Only TC programs reported attempts to address attrition. Patients’ past experiences with obesity treatment, desire for immediate outcomes, and relationships with clinicians were perceived as important factors related to attrition. Other important themes were: families’ understanding of obesity treatment; importance of realistic expectations; and families’ value of treatment. Important differences and similarities among programs were identified. All clinicians reported families came to treatment through physician-, not self-referral. Conclusions Clinicians perceive attrition to be a significant problem in pediatric obesity treatment. As a result of clinical interviews, several potential avenues to address attrition were identified, including: the need for clinicians to develop relationships with families, assist in building appropriate expectations, and address families’ value of treatment. Findings of this study can inform larger investigations of attrition, and guide exploration of family impressions of and experiences in treatment. PMID:22795203

SU-E-P-05: Electronic Brachytherapy: A Physics Perspective On Field Implementation

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

Pai, S; Ayyalasomayajula, S; Lee, S

2015-06-15

Purpose: We want to summarize our experience implementing a successful program of electronic brachytherapy at several dermatology clinics with the help of a cloud based software to help us define the key program parameters and capture physics QA aspects. Optimally developed software helps the physicist in peer review and qualify the physical parameters. Methods: Using the XOFT™ Axxent™ electronic brachytherapy system in conjunction with a cloud-based software, a process was setup to capture and record treatments. It was implemented initially at about 10 sites in California. For dosimetric purposes, the software facilitated storage of the physics parameters of surface applicatorsmore » used in treatment and other source calibration parameters. In addition, the patient prescription, pathology and other setup considerations were input by radiation oncologist and the therapist. This facilitated physics planning of the treatment parameters and also independent check of the dwell time. From 2013–2014, nearly1500 such calculation were completed by a group of physicists. A total of 800 patients with multiple lesions have been treated successfully during this period. The treatment log files have been uploaded and documented in the software which facilitated physics peer review of treatments per the standards in place by AAPM and ACR. Results: The program model was implemented successfully at multiple sites. The cloud based software allowed for proper peer review and compliance of the program at 10 clinical sites. Dosimtery was done on 800 patients and executed in a timely fashion to suit the clinical needs. Accumulated physics data in the software from the clinics allows for robust analysis and future development. Conclusion: Electronic brachytherapy implementation experience from a quality assurance perspective was greatly enhanced by using a cloud based software. The comprehensive database will pave the way for future developments to yield superior physics outcomes.« less

A Values-Based Motivational Interviewing (MI) Intervention for Pediatric Obesity: Study Design and Methods for MI Values

PubMed Central

Bean, Melanie K.; Mazzeo, Suzanne E.; Stern, Marilyn; Bowen, Deborah; Ingersoll, Karen

2011-01-01

To reduce pediatric obesity in clinical settings, multidisciplinary behaviorally-based treatment programs are recommended. High attrition and poor compliance are two difficulties frequently encountered in such programs. A brief, empathic and directive clinical intervention, Motivational Interviewing (MI), might help address these motivational and behavioral issues, ultimately resulting in more positive health outcomes. The efficacy of MI as an adjunct in the treatment of pediatric obesity remains relatively understudied. MI Values was developed to implement within an existing multidisciplinary treatment program for obese, ethnically diverse adolescents, the T.E.E.N.S. Program (Teaching, Encouragement, Exercise, Nutrition, Support). T.E.E.N.S. participants who consent to MI Values are randomized to either MI or an education control condition. At weeks 1 and 10 of T.E.E.N.S. participation, the subset of participants assigned to the MI condition engage in individual MI sessions and control participants view health education videos. All MI sessions are audiotaped and coded to monitor treatment fidelity, which has been satisfactory thus far. Participants complete comprehensive assessments at baseline, 3-and 6-month follow-up. We hypothesize that MI participants will demonstrate greater reductions in Body Mass Index (BMI) percentile, improved diet and physical activity behaviors, better compliance with T.E.E.N.S., and lower attrition than participants in the control group. We present study design and methods for MI Values as well as data on feasibility of recruitment methods and treatment integrity. At study completion, findings will contribute to the emerging literature examining the efficacy of MI in the treatment of pediatric obesity. PMID:21554994

Using cost and health impacts to prioritize the targeted testing of tuberculosis in the United States.

PubMed

Miller, Thaddeus L; Hilsenrath, Peter; Lykens, Kristine; McNabb, Scott J N; Moonan, Patrick K; Weis, Stephen E

2006-04-01

Evaluation improves efficiency and effectiveness. Current U.S. tuberculosis (TB) control policies emphasize the treatment of latent TB infection (LTBI). However, this policy, if not targeted, may be inefficient. We determined the efficiency of a state-law mandated TB screening program and a non state-law mandated one in terms of cost, morbidity, treatment, and disease averted. We evaluated two publicly funded metropolitan TB prevention and control programs through retrospective analyses and modeling. Main outcomes measured were TB incidence and prevalence, TB cases averted, and cost. A non state-law mandated TB program for homeless persons in Tarrant County screened 4.5 persons to identify one with LTBI and 82 persons to identify one with TB. A state-law mandated TB program for jail inmates screened 109 persons to identify one with LTBI and 3274 persons to identify one with TB. The number of patients with LTBI treated to prevent one TB case was 12.1 and 15.3 for the homeless and jail inmate TB programs, respectively. Treatment of LTBI by the homeless and jail inmate TB screening programs will avert 11.9 and 7.9 TB cases at a cost of 14,350 US dollars and 34,761 US dollars per TB case, respectively. Mandated TB screening programs should be risk-based, not population-based. Non mandated targeted testing for TB in congregate settings for the homeless was more efficient than state-law mandated targeted testing for TB among jailed inmates.

Confirmational study: a positive-based thumb and finger sucking elimination program.

PubMed

Green, Shari E

2010-11-01

This article emphasizes the critical need for information specifically regarding the topic of retained sucking behaviors. The study aimed to confirm results provided by Van Norman of 723 subjects in 1997. Parent surveys were collected on 441 subjects who received an orofacial myofunctional treatment program provided by one certified orofacial myologist. Results of this study do confirm that retained digit sucking behavior may be addressed successfully and expediently by a program based on positive behavior modification techniques.

Control of odor and VOC emissions at wastewater treatment plants: Boston Harbor case study

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

Getter, R.; Breen, C.; Laquidara, M.

1994-12-31

Siting of the new wastewater treatment plant (WWTP) for the Massachusetts Water Resources Authority (MWRA) in Boston was based on an assumption of mitigation of total reduced sulfur (TRS) and volatile organic compound (VOC) emissions. Collection and treatment of exhaust streams from potential emission sources was recommended. Best Available Control Technology (BACT) for VOC control was conservatively suggested to consist of wet by carbon adsorption based on initial sampling performed in 1988 during facilities planning, which estimated uncontrolled VOC emissions in excess of 1,000 tons per year. This concept was carried forward to the design phase in 1990, concurrent withmore » an extensive air emissions testing and pilot treatment program at the NMRA`s existing primary treatment plant. Results of the pilot program, however, indicated source VOC concentrations well below what was expected as a result of the initial sampling study. Use of the 1990 pilot data in a top-down BACT analysis led to a recommendation to reconsider VOC control with carbon adsorption on the basis of prohibitive cost. This paper summarizes the background and permitting approach for five new odor control facilities on Deer Island for the Boston Harbor Project, with emphasis on the new primary treatment facilities. The paper also presents results from the 1990 emissions characterization and pilot program, providing generally applicable ideas for solving the difficulties of characterizing and estimating emissions for WWTPS. Results from operation of the pilot facilities illustrate the effectiveness of met scrubbing and carbon adsorption in removing TRS and VOCs from wastewater treatment exhaust air streams. In addition, pilot program results indicate the importance of flexibility in design of odor control systems to accommodate variations in concentrations of TRS and VOCS.« less

Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway II--a 24-month follow-up pilot study.

PubMed

Rasmussen, Lars Bjørn; Mikkelsen, Knut; Haugen, Margaretha; Pripp, Are H; Fields, Jeremy Z; Førre, Øystein T

2012-05-01

Treatments offered at the Maharishi Ayurveda Health Centre in Norway are based on Maharishi Vedic Medicine (MVM). MVM is a consciousness-based revival by Maharishi Mahesh Yogi, the founder of the Transcendental Meditation (TM) program of the ancient Ayurvedic medicine tradition in India. To extend from 6 to 24 months, a pilot study of the effects of the treatment program at the Health Centre on fibromyalgia. Retesting 2 years after a clinical trial. In this intention to treat study, 31 women with a diagnosis of fibromyalgia received an individually tailored program of (1) physiological purification therapy (Maharishi Panchakarma) and (2) Ayurvedic recommendations regarding daily routine and diet including a novel approach to food intolerance. Five subjects chose to learn TM for stress reduction, pain management and personal development. All were recommended Ayurvedic herbal products for follow-up treatment. A modified Fibromyalgia Impact Questionnaire (FIQ) that included seven dimensions. Scores at 24 months follow-up were compared with pre-treatment scores. At 24-months follow-up, there were significant reductions (26% to 44%) in six of the seven fibromyalgia dimensions: impairment of working ability, pain, tiredness, morning tiredness, stiffness and anxiety. The 7th, depression, decreased 32% (borderline significant). At 24 months, the four subjects who continued practising TM, had almost no symptoms and significantly lower FIQ change scores (-92% to 97%) than the non-meditators on all outcomes. This pilot study suggests that the treatments and health promotion programs offered at the Maharishi Ayurveda Health Centre in Norway lead to long-term reductions in symptoms of fibromyalgia, which is considered a treatment-resistant condition, and further studies are warranted.

Patients' impression of change following treatment for chronic pain: global, specific, a single dimension, or many?

PubMed

Scott, Whitney; McCracken, Lance M

2015-06-01

The Patient Global Impression of Change (PGIC) measure has frequently been used as an indicator of meaningful change in treatments for chronic pain. However, limited research has examined the validity of PGIC items despite their wide adoption in clinical trials for pain. Additionally, research has not yet examined predictors of PGIC ratings following psychologically based treatment for pain. The purpose of the present study was to examine the validity, factor structure, and predictors of PGIC ratings following an interdisciplinary psychologically based treatment for chronic pain. Patients with chronic pain (N = 476) completed standard assessments of pain, daily functioning, and depression before and after a 4-week treatment program based on the principles of acceptance and commitment therapy. Following the program, patients rated 1 item assessing their impression of change overall and several items assessing their impression of more specific changes: physical and social functioning, work-related activities, mood, and pain. Results indicated that the global and specific impression of change items represent a single component. In the context of the acceptance and commitment therapy-based treatment studied here, overall PGIC ratings appeared to be influenced to a greater degree by patients' experienced improvements in physical activities and mood than by improvements in pain. The findings suggest that in addition to a single overall PGIC rating, domain-specific items may be relevant for some treatment trials. This article reports on the validity and predictors of patients' impression of change ratings following interdisciplinary psychologically based treatment for pain. In addition to a single overall PGIC rating, domain-specific items may be important for clinicians and researchers to consider depending on the focus of treatment. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

Employee assistance programs: history and program description.

PubMed

Gilbert, B

1994-10-01

1. The history and development of Employee Assistance Programs (EAPs) can be traced back to the 1800s. There are currently over 10,000 EAPs in the United States. 2. Standards for program accreditation and counselor certification have been established for EAPs. The "core technology of Employee Assistance Programs" includes identification of behavioural problems based on job performance issues, expert consultation with supervisors, appropriate use of constructive confrontation, microlinkages with treatment providers and resources, macrolinkages between providers, resources, and work organizations, focus on substance abuse, and evaluation of employee success based on job performance. 3. Some EAPs take a broad brush approach, and incorporate health promotion and managed care functions.

The tinnitus intensive therapy habituation program: a 2-year follow-up pilot study on subjective tinnitus.

PubMed

Bessman, Peter; Heider, Tom; Watten, Veslemøy P; Watten, Reidulf G

2009-05-01

To explore the effects of a new tinnitus treatment program (tinnitus intensive therapy [TIT]) based on auditory perception principles and neural habituation. A follow-up study with measurement of treatment effects every third month over a 2-year period in which the cases were their own controls. There were 25 participants with a mean age 50.1 years (SD = 16.1); 10 women (52.7 years; SD = 16.8) and 15 men (48.3 years; SD = 15.9). The participants were recruited from clinical population admitted to a polyclinic tinnitus treatment program in western Germany. There was a significant reduction of tinnitus in the follow-up period. Mean baseline tinnitus scores (Tinnitus Fragebogen; Goebel & Hiller, 1998) at the start of the treatment were 50.9 (SD = 14.5) and the final scores were 14.2 (SD = 5.9). In total, the clinical improvement over the follow-up period was 72.1%. The TIT program showed a significant clinical treatment effect and should be tested further in a multicenter treatment project. The findings support the Jastreboff habituation model of tinnitus, but social cognitive factors should also be taken into account. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke.

PubMed

Ng, Shamay S M; Hui-Chan, Christina W Y

2007-11-01

Previous studies have shown that repeated sensory inputs could enhance brain plasticity and cortical motor output. The purpose of this study was to investigate whether combining electrically induced sensory inputs through transcutaneous electrical nerve stimulation (TENS) with task-related training (TRT) in a home-based program would augment voluntary motor output in chronic stroke survivors better than either treatment alone or no treatment. Eighty-eight patients with stroke were assigned randomly to receive a home-based program of (1) TENS, (2) TENS+TRT, (3) placebo TENS+TRT, or (4) no treatment (control) 5 days a week for 4 weeks. Outcome measurements included Composite Spasticity Scale, peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors, and gait velocity recorded at baseline, after 2 and 4 weeks of treatment, and 4 weeks after treatment ended. When compared with TENS, the combined TENS+TRT group showed significantly greater improvement in ankle dorsiflexion torque at follow-up and in ankle plantarflexion torque at week 2 and follow-up (P<0.01). When compared with placebo+TRT, the TENS+TRT group produced earlier and greater reduction of plantarflexor spasticity and improvement in ankle dorsiflexion torque at week 2 (P<0.01). When compared with all 3 groups, the TENS+TRT group showed significantly greater improvement in gait velocity (P<0.01). In patients with chronic stroke, 20 sessions of a combined TENS+TRT home-based program decreased plantarflexor spasticity, improved dorsiflexor and plantarflexor strength, and increased gait velocity significantly more than TENS alone, placebo+TRT, or no treatment. Such improvements can even be maintained 4 weeks after treatment ended.

Operational Lessons Leaned During bioreactor Demonstrations for Acid Rock Drainage Treatment

EPA Science Inventory

The U.S. Environmental Protection Agency's Mine Waste Technology Program (MWTP) has emphasized the development of biologically-based treatment technologies for acid rock drainage (ARD). Progressively evolving technology demonstrations have resulted in significant advances in sulf...

Economic costs of Oxford House inpatient treatment and incarceration: a preliminary report.

PubMed

Olson, Bradley D; Viola, Judah; Jason, Leonard A; Davis, Margaret I; Ferrari, Joseph R; Rabin-Belyaev, Olga

2006-01-01

The Oxford House model for substance abuse recovery has potential economic advantages associated with the low cost of opening up and maintaining the settings. In the present study, annual program costs per person were estimated for Oxford House based on federal loan information and data collected from Oxford House Inc. In addition, annual treatment and incarceration costs were approximated based on participant data prior to Oxford House residence in conjunction with normative costs for these settings. Societal costs associated with the Oxford House program were relatively low, whereas estimated costs associated with inpatient and incarceration history were high. The implications of these findings are discussed.

Electronic laboratory quality assurance program: A method of enhancing the prosthodontic curriculum and addressing accreditation standards.

PubMed

Moghadam, Marjan; Jahangiri, Leila

2015-08-01

An electronic quality assurance (eQA) program was developed to replace a paper-based system and to address standards introduced by the Commission on Dental Accreditation (CODA) and to improve educational outcomes. This eQA program provides feedback to predoctoral dental students on prosthodontic laboratory steps at New York University College of Dentistry. The purpose of this study was to compare the eQA program of performing laboratory quality assurance with the former paper-based format. Fourth-year predoctoral dental students (n=334) who experienced both the paper-based and the electronic version of the quality assurance program were surveyed about their experiences. Additionally, data extracted from the eQA program were analyzed to identify areas of weakness in the curriculum. The study findings revealed that 73.8% of the students preferred the eQA program to the paper-based version. The average number of treatments that did not pass quality assurance standards was 119.5 per month. This indicated a 6.34% laboratory failure rate. Further analysis of these data revealed that 62.1% of the errors were related to fixed prosthodontic treatment, 27.9% to partial removable dental prostheses, and 10% to complete removable dental prostheses in the first 18 months of program implementation. The eQA program was favored by dental students who have experienced both electronic and paper-based versions of the system. Error type analysis can yield the ability to create customized faculty standardization sessions and refine the didactic and clinical teaching of the predoctoral students. This program was also able to link patient care activity with the student's laboratory activities, thus addressing the latest requirements of the CODA regarding the competence of graduates in evaluating laboratory work related to their patient care. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Malaria burden and treatment targets in Kachin Special Region II, Myanmar from 2008 to 2016: A retrospective analysis

PubMed Central

Bi, Yaw

2018-01-01

Although drug-based treatment is the primary intervention for malaria control and elimination, optimal use of targeted treatments remains unclear. From 2008 to 2016, three targeted programs on treatment were undertaken in Kachin Special Region II (KR2), Myanmar. Program I (2008–2011) treated all confirmed, clinical and suspected cases; program II (2012–2013) treated confirmed and clinical cases; and program III (2014–2016) targeted confirmed cases only. This study aims to evaluate the impacts of the three programs on malaria burden individually based on the annual parasite incidence (API), slide positivity rate (SPR) and their relative values. The API is calculated from original collected data and the incidence rate ratio (IRR) for each year is calculated by using the first-year API as a reference in each program phase across the KR2. Same method is applied to calculate SPR and risk ratio (RR) at the sentinel hospital too. During program I (2008–2011), malaria burden was reduced by 61% (95%CI: 58%-74%) and the actual API decreased from 9.8 (95%CI: 9.6–10.1) per 100 person-years in 2008 to 3.8 (3.6–4.1) per 100 person-years in 2011. Amid program II (2012–2013), the malaria burden increased by 33% (95%CI: 22%-46%) and the actual API increased from 2.1(95%CI: 2.0–2.3) per 100 person-years in 2012 to 2.8 (95%CI: 2.7–2.9) per 100 person-years in 2013. During program III (2014–2016) the malaria burden increased furtherly by 60% (95%CI: 51% - 69%) and the actual API increased from 3.2(95%CI: 3.0–3.3) per 100 person-years in 2014 to 5.1 (95%CI: 4.9–5.2) per 100 person-years in 2016. Results of the slide positivity of the sentinel hospital also confirm these results. Resurgence of malaria was mainly due to Plasmodium vivax during program II and III. This study indicates that strategy adopted in program I (2008–2011) should be more appropriate for the KR2. Quality-assured treatment of all confirmed, clinical and suspected malaria cases may be helpful for the reduction of malaria burden. PMID:29614088

Talalgia: plantar fasciitis☆

PubMed Central

Cardenuto Ferreira, Ricardo

2014-01-01

Plantar fasciitis is a very common painful syndrome, but its exact etiology still remains obscure. The diagnosis is essentially clinical, based on history-taking and physical examination. Complementary laboratory tests and imaging examinations may be useful for differential diagnoses. The treatment is essentially conservative, with a high success rate (around 90%). The essence of the conservative treatment is the home-based program of exercises to stretch the plantar fascia. Indications for surgical treatment are only made when the symptoms persist without significant improvement, after at least six months of conservative treatment supervised directly by the doctor. PMID:26229803

The Implementation of Inmate Mentor Programs in the Correctional Treatment System as an Innovative Approach

ERIC Educational Resources Information Center

Cook, Jana; McClure, Scott; Koutsenok, Igor; Lord, Scot

2008-01-01

In October 2006, the California Men's Colony (CMC) in San Luis Obispo, faced with staff recruitment and retention difficulties, took an innovative step to utilize long-term sentenced inmates as peer mentors and primary counselors to lead their prison-based therapeutic community (TC) program. The program was designed, developed, and implemented…

Treating university students with social phobia and public speaking fears: Internet delivered self-help with or without live group exposure sessions.

PubMed

Tillfors, Maria; Carlbring, Per; Furmark, Tomas; Lewenhaupt, Susanne; Spak, Maria; Eriksson, Anna; Westling, Bengt E; Andersson, Gerhard

2008-01-01

This study investigated the efficacy of an Internet-based self-help program with minimal therapist contact via e-mail for Swedish university students with social phobia and public speaking fears. The main objective was to test if the Internet-based self-help program would be more effective if five live group exposure sessions were added. Thirty-eight students meeting the diagnostic and statistical manual of mental disorders, 4th edition criteria for social phobia were randomized into two different treatment groups: Internet delivered cognitive behavior therapy combined with five group exposure sessions (ICBT+ exp) or the Internet program alone (ICBT). Results were analyzed on an intention-to-treat basis. Both treatment groups showed significant improvement from pre- to post-test, and from pre-test to 1-year follow-up, on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). For both the groups, the average within-group effect sizes for the primary social anxiety scales, expressed as Cohen's d, were comparable to those seen in traditionally administered cognitive behavioral therapy both at post-test and at 1- year follow-up. The results suggest that the Internet-based self-help program on its own is efficient in the treatment of university students with social phobia. Adding group exposure sessions did not improve the outcome significantly. Copyright 2008 Wiley-Liss, Inc.

Effects of eliminating psychiatric rehabilitation from the secure levels of a mental-health service system.

PubMed

Tarasenko, Melissa; Sullivan, Mary; Ritchie, A Jocelyn; Spaulding, William D

2013-11-01

Psychiatric rehabilitation (PR) is widely recognized as a treatment approach and an array of evidence-based practices effective for promoting the recovery of people with serious mental illness (SMI). However, its use in institutional settings is not widespread for unclear reasons. Policymakers may sometimes believe the superiority of PR in controlled research does not apply in the real world, for various reasons. This study exploits an unusual set of real-world circumstances surrounding the closure of a well-developed PR program in a state hospital. The program was closed after a period of mental-health services reform that significantly augmented the surrounding community-service system. The PR program was converted to conventional medical-institutional model-treatment units with no reduction in beds or funding within the state hospital. A database composed of public documents was used to analyze the consequences of the closing. Within the institution, the consequences included a persistent presence of long-term difficult-to-discharge patients, a slowed discharge rate, a net increase in the hospital's per capita treatment costs, and higher use of restraint/seclusion. Effects were also detectable in the surrounding mental-health service system, including degraded outcome of community-based step-down services and increased pressure on emergency/crisis services. The consequences of closing the program are consistent with expectations based on research, and demonstrate danger in assuming that real world exigencies obviate research findings.

Development and Evaluation of a Web-Based Training Program for Oral Health Care Providers on Secondary Prevention of Eating Disorders

PubMed Central

DeBate, Rita D.; Severson, Herbert; Zwald, Marissa L.; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott; Brown, Kelli McCormack; Tedesco, Lisa A.

2009-01-01

Although oral health care providers (OHP) are key in the secondary prevention of eating disorders (ED), the majority are not engaged in assessment, referral, and case management. This innovative pilot project developed and evaluated a web-based training program for dental and dental hygiene students and providers on the secondary prevention of ED. The intervention combined didactic and skill-based objectives to train OHP on ED and its oral health effects, OHP roles, skills in identifying the oral signs of ED, communication, treatment, and referral. Using a convenience sample of OHP (n=66), a pre-/post-test evaluated short-term outcomes and user satisfaction. Results revealed statistically significant improvements in self-efficacy (p<.001); knowledge of oral manifestations from restrictive behaviors (p<.001) and purging behaviors (p<.001); knowledge of oral treatment options (p<.001); and attitudes towards the secondary prevention of ED (p<.001). Most participants strongly agreed or agreed that the program provided more information (89 percent) and resources (89 percent) about the secondary prevention of ED than were currently available; 91 percent strongly agreed or agreed that they would access this program for information regarding the secondary prevention of ED. This pilot project provides unique training in the clinical evaluation, patient approach, referral, and oral treatment that takes a multidisciplinary approach to address ED. PMID:19491349

Buprenorphine from detox and beyond: preliminary evaluation of a pilot program to increase heroin dependent individuals' engagement in a full continuum of care.

PubMed

Donovan, Dennis M; Knox, Patricia C; Skytta, Jenny A F; Blayney, Jessica A; DiCenzo, Jessica

2013-04-01

Absence of successful transition to post-detoxification treatment leads to high rates of relapse among detoxified heroin users. The present study evaluated a pilot buprenorphine treatment program (BTP). Heroin dependent individuals were inducted onto buprenorphine/naloxone in detox, maintained while transitioning through an intensive inpatient program (IIP), and gradually tapered off medication over 5 months of outpatient (OP) treatment. Compared to programmatic indicators of treatment engagement in the year prior to BTP implementation, referrals from detox to IIP, entry into and completion of IIP and subsequent OP, and days in OP treatment increased substantially. BTP completers, compared to non-completers, viewed abstinence as more difficult and as requiring more assistance to achieve, were less likely to be current cocaine and alcohol users or to have relapsed during the course of treatment. Although preliminary and in need of replication, initial adjunctive use of buprenorphine in an abstinence-based continuum of care may improve post-detoxification treatment entry, engagement, and completion. Copyright © 2013 Elsevier Inc. All rights reserved.

A Step Forward in Teaching Addiction Counselors How to Supervise Motivational Interviewing Using a Clinical Trials Training Approach

ERIC Educational Resources Information Center

Martino, Steve; Gallon, Steve; Ball, Samuel A.; Carroll, Kathleen M.

2007-01-01

A clinical trials training approach to supervision is a promising and empirically supported method for preparing addiction counselors to implement evidence-based behavioral treatments in community treatment programs. This supervision approach has three main components: (1) direct observation of treatment sessions; (2) structured performance…

Improving Feeding Skills and Mealtime Behaviors in Children and Youth with Disabilities

ERIC Educational Resources Information Center

Bailey, Rita L.; Angell, Maureen E.

2005-01-01

A single-subject multiple treatment design counterbalanced across nine participants with moderate to severe and multiple disabilities was used to determine the efficacy of a school-based multi-treatment package (a combined dysphagia treatment and positive reinforcement behavior management program) for children and youth (ages 4-17) with feeding…

During-Treatment Outcomes among Female Methamphetamine-Using Offenders in Prison-Based Treatments

ERIC Educational Resources Information Center

Rowan-Szal, Grace A.; Joe, George W.; Simpson, D. Dwayne; Greener, Jack M.; Vance, Jerry

2009-01-01

An increasingly important treatment group is the expanding population of methamphetamine-using female offenders. This study focused on women methamphetamine-using offenders (n = 359) who were treated either in a modified therapeutic community (TC) program ("Clean Lifestyle is Freedom Forever" [CLIFF]-TC: n = 234) designed for non-violent offenders…

[Multiprofessional inpatient psychotherapy of depression in old age].

PubMed

Cabanel, N; Kundermann, B; Franz, M; Müller, M J

2017-11-01

Depression is common in old age but is often underdiagnosed and inadequately treated. Although psychotherapy is considered effective for treating elderly patients with depression, it is rarely applied in inpatient settings. Furthermore, treatment on inpatient units specialized for elderly patients and implementation of a psychotherapeutic treatment approach are currently more the exception. From this background, a multiprofessional inpatient behavioral treatment program (MVT) for elderly depressed patients was developed at a specialized unit of a university-affiliated regional psychiatric hospital. The MVT is based on specific and modularized group therapies accompanied by individual therapeutic interventions. While the provision of group therapies (such as psychotherapy, social skills training, relaxation training, euthymic and mindfulness-based methods, exercise and occupational therapy as well as psychoeducational sessions for relatives) is assigned to specific professional groups, a joint multiprofessional treatment planning is of central relevance. First evaluations of different treatment components support the high acceptability of the MVT and highlight that psychotherapeutic inpatient treatment programs for the elderly are feasible. Further research is required to investigate the clinical efficacy of psychotherapy in elderly depressive inpatients.

Feasibility of Providing Sexually Transmitted Infection Testing and Treatment in Off-Campus, Nonclinic Settings for Adolescents Enrolled in a School-Based Research Project

ERIC Educational Resources Information Center

Chacko, Mariam R.; Markham, Christine; Thiel, Melanie; Crandall, Stacy M.; Peskin, Melissa F.; Shegog, Ross; Tortolero, Susan

2014-01-01

Background: This study examined the acceptability and feasibility of using a biological outcome measure to evaluate a school-based sexuality education program. Confidential field-delivered sexually transmitted infection (STI) testing by nonmedical field staff and STI treatment by medically trained field staff was assessed in off-campus and…

Evaluation of Access to Care and Medical and Behavioral Outcomes in a School-Based Intervention Program for Attention-Deficit Hyperactivity Disorder.

ERIC Educational Resources Information Center

Williams, Richard A.; And Others

1993-01-01

The San Diego (California) school-based Project for Attention-Related Disorders helped improve access to care and increase treatment for children with attentional problems. Of 110 intervention children followed for 3 years, 60-70% showed improvement after enrollment, evaluation, and treatment. Medical and nonmedical interventions were helpful in…

Self-Administered Cued Naming Therapy: A Single-Participant Investigation of a Computer-Based Therapy Program Replicated in Four Cases

ERIC Educational Resources Information Center

Ramsberger, Gail; Marie, Basem

2007-01-01

Purpose: This study examined the benefits of a self-administered, clinician-guided, computer-based, cued naming therapy. Results of intense and nonintense treatment schedules were compared. Method: A single-participant design with multiple baselines across behaviors and varied treatment intensity for 2 trained lists was replicated over 4…

Outpatient treatment of deep venous thrombosis in diverse inner-city patients.

PubMed

Dunn, A S; Schechter, C; Gotlin, A; Vomvolakis, D; Jacobs, E; Sacks, H S; Coller, B

2001-04-15

We sought to describe the development and outcomes of a hospital-based program designed to provide safe and effective outpatient treatment to a diverse group of patients with acute deep venous thrombosis. Patients enrolled in the program were usually discharged on the day of or the day after presentation. Low- molecular-weight heparin was administered for a minimum of 5 days and warfarin was given for a minimum of 3 months. The hospital provided low-molecular-weight heparin free of charge to patients. Patients received daily home nursing visits to monitor the prothrombin time, assess compliance, and detect complications. The inpatient and outpatient records of the first 89 consecutive patients enrolled in the program were reviewed. Patients were observed for a 3-month period after enrollment. The median length of stay was 1 day. Low-molecular-weight heparin was administered for a mean (+/- standard deviation [SD]) of 4.7 +/- 2.4 days at home. Recurrent thromboembolism was noted in 1 patient (1%), major bleeding in 2 patients (2%), and minor bleeding in 2 patients (2%). No patients died or developed thrombocytopenia. Assuming that patients would have been hospitalized for the duration of treatment with low-molecular-weight heparin, the program eliminated a mean of 4.7 days of hospitalization, with an estimated reduction of $1,645 in total health care costs per patient. This hospital-based program to provide outpatient treatment of deep venous thrombosis to a diverse group of inner-city patients achieved a low incidence of adverse events and substantial health care cost savings. Specific strategies, including providing low-molecular-weight heparin free of charge and daily home nursing visits, can be utilized to facilitate access to outpatient treatment and ensure high-quality care.

Clinical Pedodontics: An Approach Based on Comprehensive Care.

ERIC Educational Resources Information Center

And Others; Bennett, Carroll G.

1981-01-01

The University of Florida uses a comprehensive care system to teach clinical pedodontics. Several block clinics permit further experience with children. Details of the program are described, and quantitative results of patient treatment are compared with those of other clinical pedodontics programs. (MSE)

Promoting new practices to increase access to and retention in addiction treatment: an analysis of five communication channels.

PubMed

Johnson, Kimberly A; Ford, James H; McCluskey, Matthew

2012-11-01

Addiction treatment programs adopt evidence-based practices slowly, in part because adopting a new practice is a process, not an event. Using different communication channels may have a different effect at different points in the process. This paper reports the effectiveness of five communication channels in getting substance abuse treatment programs to adopt new business practices. In this study, national trade media coverage produced the greatest interest among programs and the greatest number of decisions to adopt. Conference presentations produced fewer decisions to adopt than national media, but were the most effective channel when compared to the number of programs they reached. Peers were the greatest influence in moving clinic staff from the decision to adopt to implementation. These findings give preliminary evidence for using different communication channels at different times during an effort to promote the adoption of best practices. Copyright © 2012 Elsevier Ltd. All rights reserved.

Interdisciplinary treatment of diabetes mellitus in a military treatment facility.

PubMed

Earles, J E; Hartung, G H; Dickert, J M; Moriyama, H H; Coll, K J; Aiello, L M; Jackson, R; Polonsky, W

2001-10-01

The American Diabetes Association emphasizes interdisciplinary management as the standard of care for patients with diabetes. Many times, however, interdisciplinary means various health care professionals treating a patient but not necessarily interacting with each other regarding the patient's care. Recently, Tripler Army Medical Center replicated the Joslin Diabetes Center's diabetes outpatient intensive treatment program as part of a Joslin Diabetes Center/Department of Defense/Veteran's Administration research collaboration. Tripler Army Medical Center named this interdisciplinary program Holopono, which is Hawaiian for success. Holopono is a team of health care professionals providing integrated care and education to a group of diabetes patients over 3.5 days. Individual care management, aided by an Internet-based telemedicine system, then continues for 1 year after entry into the program. This article describes the Holopono program, the role of each team member, and how the team functions together to provide comprehensive diabetes care.

Feasibility of a computer-assisted alcohol screening, brief intervention and referral to treatment program for DWI offenders.

PubMed

Mullen, Jillian; Ryan, Stacy R; Mathias, Charles W; Dougherty, Donald M

2015-11-09

Alcohol use patterns that are hazardous for one's health is prevalent among DWI (driving while intoxicated) offenders and is a key predictor of recidivism. The aim of this program evaluation was to determine the feasibility and usability of implementing a computer-assisted screening, brief intervention and referral to treatment (SBIRT) program for DWI offenders to enable the identification of those in need of treatment services soon after arrest. Our treatment program consisted of a web-based, self-guided screening tool for assessing alcohol use patterns and generating a personalized feedback report that is then used to deliver a brief motivational intervention and if needed, a referral to treatment. Between August and November 2014, all DWI offenders attending orientation for pre-trial supervision were assessed for eligibility. Of the 129 eligible offenders, 53.5 percent enrolled and the first 50 were asked to complete a usability and satisfaction questionnaire. The results demonstrated that the majority of those screened reported at-risk alcohol use patterns requiring referral to treatment. Clients reported high ratings of usability and satisfaction with the screening tool and personalized feedback report, which did not significantly differ depending on alcohol use patterns. There were relatively few technical difficulties, and the majority of clients reported high levels of satisfaction with the overall SBIRT program. Results of this program evaluation suggest that computer-assisted SBIRT may be successfully implemented within the criminal justice system to DWI offenders soon after arrest; however, further research is required to examine its effects on treatment utilization and recidivism.

Development of a membrane-based process for the treatment of oily waste waters. Final report, March 4, 1992--March 5, 1994

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

McCray, S.B.

1994-05-25

This is a final report from Bend Research, Inc., (BRI) to the U.S. Department of Energy (DOE) for work performed under Contract No. DE-AC22-92MT92005, titled {open_quotes}Development of a Membrane-Based Process for the Treatment of Oily Waste Waters.{close_quotes} This report covers the period from March 4, 1992, to March 5, 1994. The overall goal of this program was to develop an economical oily-water treatment system based on reverse osmosis (RO). The RO system would be used to (1) reduce oil production costs by reducing the volume of waste water that must be disposed of, (2) form the basis of a genericmore » waste-water treatment system that can easily be integrated into oil-field operations, especially at production facilities that are small or in remote locations; and (3) produce water clean enough to meet existing and anticipated environmental regulations. The specific focus of this program was the development of a hollow-fiber membrane module capable of treating oily waste waters.« less

Operational Lessons Learned During Bioreactor Demonstrations for Acid Rock Drainage Treatment

EPA Science Inventory

The U.S. Environmental Protection Agency’s Mine Waste Technology Program (MWTP) has emphasized the development of biologically-based treatment technologies for acid rock drainage (ARD). Progressively evolving technology demonstrations have resulted in significant advances in sul...

Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

PubMed

Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

2011-11-01

This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

Case-based reimbursement for psychiatric hospital care.

PubMed

Sederer, L I; Eisen, S V; Dill, D; Grob, M C; Gougeon, M L; Mirin, S M

1992-11-01

A fixed-prepayment system (case-based reimbursement) for patients initially requiring hospital-level care was evaluated for one year through an arrangement between a private nonprofit psychiatric hospital and a self-insured company desiring to provide psychiatric services to its employees. This clinical and financial experiment offered a means of containing costs while monitoring quality of care. A two-group, case-control study was undertaken of treatment outcomes at discharge, patient satisfaction with hospital care, and service use and costs during the program's first year. Compared with costs for patients in the control group, costs for those in the program were lower per patient and per admission; cumulative costs for patients requiring rehospitalization were also lower. However, costs for outpatient services for patients in the program were not calculated. Treatment outcomes and patients' satisfaction with hospital care were comparable for the two groups.

Church-based health programs for mental disorders among African Americans: a review.

PubMed

Hankerson, Sidney H; Weissman, Myrna M

2012-03-01

African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans.

Long-term efficacy of Internet-based cognitive behavior therapy for obsessive-compulsive disorder with or without booster: a randomized controlled trial.

PubMed

Andersson, E; Steneby, S; Karlsson, K; Ljótsson, B; Hedman, E; Enander, J; Kaldo, V; Andersson, G; Lindefors, N; Rück, C

2014-10-01

As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program. A total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT. The entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58-2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan-Meier analysis also indicated a significantly slower relapse rate in the booster group. The results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.

Periodontal Management by Risk Assessment: A Pragmatic Approach.

PubMed

Mullins, Joanna M; Even, Joshua B; White, Joel M

2016-06-01

An evidence-based periodontal disease risk assessment and diagnosis system has been developed and combined with a clinical decision support and management program to improve treatment and measure patient outcomes. There is little agreement on a universally accepted periodontal risk assessment, periodontal diagnosis, and treatment management tool and their incorporation into dental practice to improve patient care. This article highlights the development and use of a practical periodontal management and risk assessment program that can be implemented in dental settings. The approach taken by Willamette Dental Group to develop a periodontal disease risk assessment, periodontal diagnosis, and treatment management tool is described using evidence-based best practices. With goals of standardized treatment interventions while maintaining personalized care and improved communication, this process is described to facilitate its incorporation into other dental settings. Current electronic health records can be leveraged to enhance patient-centered care through the use of risk assessments and standardized guidelines to more effectively assess, diagnose, and treat patients to improve outcomes. Dental hygienists, and other committed providers, with their emphasis on prevention of periodontal disease can be principal drivers in creation and implementation of periodontal risk assessments and personalized treatment planning. Willamette Dental Group believes that such evidence-based tools can advance dentistry to new diagnostic and treatment standards. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children.

PubMed

Tekin, Fatih; Kavlak, Erdogan; Cavlak, Ugur; Altug, Filiz

2018-01-01

The aim of this study was to show the effects of an 8-week Neurodevelopmental Treatment based posture and balance training on postural control and balance in diparetic and hemiparetic Cerebral Palsied children (CPC). Fifteen CPC (aged 5-15 yrs) were recruited from Denizli Yağmur Çocukları Rehabilitation Centre. Gross Motor Function Classification System, Gross Motor Function Measure, 1-Min Walking Test, Modified Timed Up and Go Test, Paediatric Balance Scale, Functional Independence Measure for Children and Seated Postural Control Measure were used for assessment before and after treatment. An 8-week NDT based posture and balance training was applied to the CPC in one session (60-min) 2 days in a week. After the treatment program, all participants showed statistically significant improvements in terms of gross motor function (p< 0.05). They also showed statistically significant improvements about balance abilities and independence in terms of daily living activities (p< 0.05). Seated Postural Control Measure scores increased after the treatment program (p< 0.05). The results of this study indicate that an 8-week Neurodevelopmental Treatment based posture and balance training is an effective approach in order to improve functional motor level and functional independency by improving postural control and balance in diparetic and hemiparetic CPC.

An Amazing Medical Discovery! A Comprehensive Neighborhood Quality of Life Enrichment Program. An Intensive Prevention Program To Address the Social Causes of Individual and Community Pathology in an Inner-City Neighborhood. Revised.

ERIC Educational Resources Information Center

Miami-Dade Community Coll., FL. Medical Center Campus.

In 1991, Miami-Dade Community College (MDCC) developed a proposal for the Comprehensive Neighborhood Quality of Life Enrichment Program, a program to be based on the principles of holism, prevention, and community synergy, focusing on the treatment of individuals with many, complex, and "all-at-once" needs. The program will operate in a poor…

Lessons learned from the deadly sisters: drug and alcohol treatment disruption, and consequences from Hurricanes Katrina and Rita.

PubMed

Maxwell, Jane Carlisle; Podus, Deborah; Walsh, David

2009-01-01

This paper reports on the effects of Hurricanes Katrina and Rita on drug and alcohol treatment in Texas in 2005-2006. Findings are based on a secondary analysis of administrative data on 567 hurricane-related admissions and on interview data from a sample of 20 staff in 11 treatment programs. Katrina evacuees differed from Rita clients in terms of demographics and primary problem substances and treatment needs, while the experiences of program staff and needed changes to improve disaster readiness were more similar. Additional systematic research is needed to document the intermediate and long-term impacts of the storms in these and other affected areas.

Web-based support as an adjunct to group-based smoking cessation for adolescents

PubMed Central

Mermelstein, Robin; Turner, Lindsey

2008-01-01

Although group-based programs remain the most common treatment approach for adolescent smoking cessation, success rates for these programs have been relatively modest, and their reach may be limited. Web-based adjuncts may be one way to boost the efficacy and reach of group-based approaches. The purpose of this study was to evaluate the effectiveness of enhancing the American Lung Association’s Not on Tobacco program (NOT) with a Web-based adjunct (NOT Plus). Twenty-nine high schools were randomly assigned to either the NOT program alone or to the NOT Plus condition, which included access to a specially designed Web site for teens, along with proactive phone calls from the group facilitator to the participant. Self-reported smoking behavior was obtained at end-of-program and at a 3-month follow-up. Using hierarchical linear modeling, accounting for the clustering of students in schools, and controlling for student gender, grade, race, and baseline smoking rate, there was a marginally significant (p = .06) condition effect at end-of-treatment and a significant effect at 3-month follow-up (p < .05) favoring the NOT Plus condition. Approximately 57% of adolescents reported visiting the Web site, and among the NOT Plus condition, use of the Web site was associated with cessation significantly at end-of-program (p < .05), but not at 3 months. Adolescents in urban schools were more likely to access the Web site than those in rural schools. Participants who visited the Web site rated it positively on several dimensions. Reasons for not using the Web site will be discussed, as well as its value as an adjunct. PMID:17491173

Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance.

PubMed

Robinson, Emma; Titov, Nickolai; Andrews, Gavin; McIntyre, Karen; Schwencke, Genevieve; Solley, Karen

2010-06-03

Internet-based cognitive behavioural therapy (iCBT) for generalized anxiety disorder (GAD) has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Penn State Worry Questionnaire (PSWQ) and the Generalized Anxiety Disorder-7 Item (GAD-7). Completion rates were high, and both treatment groups reduced scores on the PSWQ (p<0.001) and GAD-7 (p<0.001) compared to the delayed treatment group, but did not differ from each other. Within group effect sizes on the PSWQ were 1.16 and 1.07 for the clinician- and technician-assisted groups, respectively, and on the GAD-7 were 1.55 and 1.73, respectively. At 3 month follow-up participants in both treatment groups had sustained the gains made at post-treatment. Participants in the clinician-assisted group had made further gains on the PSWQ. Approximately 81 minutes of clinician time and 75 minutes of technician time were required per participant during the 10 week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment/control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for GAD. This form of treatment has potential to increase the capacity of existing mental health services. Australian New Zealand Clinical Trials Registry ACTRN12609000563268.

Internet Treatment for Generalized Anxiety Disorder: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance

PubMed Central

Robinson, Emma; Titov, Nickolai; Andrews, Gavin; McIntyre, Karen; Schwencke, Genevieve; Solley, Karen

2010-01-01

Background Internet-based cognitive behavioural therapy (iCBT) for generalized anxiety disorder (GAD) has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. Method Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Penn State Worry Questionnaire (PSWQ) and the Generalized Anxiety Disorder-7 Item (GAD-7). Completion rates were high, and both treatment groups reduced scores on the PSWQ (p<0.001) and GAD-7 (p<0.001) compared to the delayed treatment group, but did not differ from each other. Within group effect sizes on the PSWQ were 1.16 and 1.07 for the clinician- and technician-assisted groups, respectively, and on the GAD-7 were 1.55 and 1.73, respectively. At 3 month follow-up participants in both treatment groups had sustained the gains made at post-treatment. Participants in the clinician-assisted group had made further gains on the PSWQ. Approximately 81 minutes of clinician time and 75 minutes of technician time were required per participant during the 10 week treatment program. Conclusions Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment/control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for GAD. This form of treatment has potential to increase the capacity of existing mental health services. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000563268 PMID:20532167

Tobacco Dependence Treatment Training Programs: An International Survey

PubMed Central

Rigotti, Nancy A.; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy

2016-01-01

Abstract Introduction: In line with Article 14 guidelines for the WHO Framework Convention on Tobacco Control, we aimed to assess the progress in training individuals to deliver tobacco cessation treatment. Methods: Cross-sectional web-based survey in May–September 2013 among 122 experts in tobacco control and training from 84 countries (73% response rate among 115 countries surveyed). We measured training program prevalence, participants, and challenges faced. Results: Overall, 21% ( n = 18/84) of countries, mostly low and middle-income countries (LMICs; P = .002), reported no training program. Among 66 countries reporting at least one training program, most (84%) trained healthcare professionals but 54% also trained other individuals including community health workers, teachers, and religious leaders. Most programs (54%) cited funding challenges, although stability of funding varied by income level. Government funding was more commonly reported in higher income countries (high 56%, upper middle 50%, lower middle 27%, low 25%; P = .03) while programs in LMICs relied more on nongovernmental organizations (high 11%, upper middle 37%, lower middle 27%, low 38%; P = .02). Conclusions: One in five countries reported having no tobacco treatment training program representing little progress in terms of training individuals to deliver tobacco treatment in LMICs. Without more trained tobacco treatment providers, one of the tenets of Article 14 is not yet being met and health inequalities are likely to widen. More effort and resources are needed to ensure that healthcare worker educational programs include training to assess tobacco use and deliver brief advice and that training is available for individuals outside the healthcare system in areas with limited healthcare access. PMID:26117835

Integrated Care in College Health: A Case Study

ERIC Educational Resources Information Center

Tucker, Cary; Sloan, Sarah K.; Vance, Mary; Brownson, Chris

2008-01-01

This case study describes 1 international student's treatment experience with an integrated health program on a college campus. This program uses a multidisciplinary, mind-body approach, which incorporates individual counseling, primary care, psychiatric consultation, a mindfulness-based cognitive therapy class, and a meditation group.

Impact Evaluation of an Addiction Intervention Program in a Quebec Prison

PubMed Central

Arseneault, Catherine; Alain, Marc; Plourde, Chantal; Ferland, Francine; Blanchette-Martin, Nadine; Rousseau, Michel

2015-01-01

OBJECTIVES This study evaluates the effects of a prison-based addiction intervention program. The evaluation is based on a multidimensional data collection that draws a portrait of the respondents’ substance use, and of their psychological/emotional, social, and judicial spheres. It measures the changes, or lack thereof, in substance use; the psychological/emotional, social, and judicial spheres; as well as the post-treatment services used. METHOD A quasi-experimental repeated measures design (0, 6 weeks, and 6 months) was used. Effects of the program were identified by comparing the results obtained by a group of inmates who had participated in the program (n = 80; experimental group) with those of another group who had received no intervention (n = 70; control group). RESULTS The preliminary results suggested a certain treatment effect related to impulsivity and psychological distress. CONCLUSION Although the preliminary results were promising, the experimental and control groups did not differ significantly when more robust analyses were used. PMID:26056466

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

PubMed Central

Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

2017-01-01

Background Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. Methods In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children’s Obesity Clinics’ Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. Results From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12−0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. Conclusion BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility. PMID:28264043

The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act.

PubMed

Buck, Jeffrey A

2011-08-01

Public substance abuse treatment services have largely operated as an independent part of the overall health care system, with unique methods of administration, funding, and service delivery. The Affordable Care Act of 2010 and other recent health care reforms, coupled with declines in state general revenue spending, will change this. Overall funding for these substance abuse services should increase, and they should be better integrated into the mainstream of general health care. Reform provisions are also likely to expand the variety of substance abuse treatment providers and shift services away from residential and stand-alone programs toward outpatient programs and more integrated programs or care systems. As a result, patients should have better access to care that is more medically based and person-centered.

The Adolescent Behavioral Activation Program: Adapting Behavioral Activation as a Treatment for Depression in Adolescence.

PubMed

McCauley, Elizabeth; Gudmundsen, Gretchen; Schloredt, Kelly; Martell, Christopher; Rhew, Isaac; Hubley, Samuel; Dimidjian, Sona

2016-01-01

This study aimed to examine implementation feasibility and initial treatment outcomes of a behavioral activation (BA) based treatment for adolescent depression, the Adolescent Behavioral Activation Program (A-BAP). A randomized, controlled trial was conducted with 60 clinically referred adolescents with a depressive disorder who were randomized to receive either 14 sessions of A-BAP or uncontrolled evidenced-based practice for depression. The urban sample was 64% female, predominantly Non-Hispanic White (67%), and had an average age of 14.9 years. Measures of depression, global functioning, activation, and avoidance were obtained through clinical interviews and/or through parent and adolescent self-report at preintervention and end of intervention. Intent-to-treat linear mixed effects modeling and logistic regression analysis revealed that both conditions produced statistically significant improvement from pretreatment to end of treatment in depression, global functioning, and activation and avoidance. There were no significant differences across treatment conditions. These findings provide the first step in establishing the efficacy of BA as a treatment for adolescent depression and support the need for ongoing research on BA as a way to enhance the strategies available for treatment of depression in this population.

Chemokine programming dendritic cell antigen response: part II - programming antigen presentation to T lymphocytes by partially maintaining immature dendritic cell phenotype.

PubMed

Park, Jaehyung; Bryers, James D

2013-05-01

In a companion article to this study,(1) the successful programming of a JAWSII dendritic cell (DC) line's antigen uptake and processing was demonstrated based on pre-treatment of DCs with a specific 'cocktail' of select chemokines. Chemokine pre-treatment modulated cytokine production before and after DC maturation [by lipopolysaccharide (LPS)]. After DC maturation, it induced an antigen uptake and processing capacity at levels 36% and 82% higher than in immature DCs, respectively. Such programming proffers a potential new approach to enhance vaccine efficiency. Unfortunately, simply enhancing antigen uptake does not guarantee the desired activation and proliferation of lymphocytes, e.g. CD4(+) T cells. In this study, phenotype changes and antigen presentation capacity of chemokine pre-treated murine bone marrow-derived DCs were examined in long-term co-culture with antigen-specific CD4(+) T cells to quantify how chemokine pre-treatment may impact the adaptive immune response. When a model antigen, ovalbumin (OVA), was added after intentional LPS maturation of chemokine-treated DCs, OVA-biased CD4(+) T-cell proliferation was initiated from ~ 100% more undivided naive T cells as compared to DCs treated only with LPS. Secretion of the cytokines interferon-γ, interleukin-1β, interleukin-2 and interleukin-10 in the CD4(+) T cell : DC co-culture (with or without chemokine pre-treatment) were essentially the same. Chemokine programming of DCs with a 7 : 3 ratio of CCL3 : CCL19 followed by LPS treatment maintained partial immature phenotypes of DCs, as indicated by surface marker (CD80 and CD86) expression over time. Results here and in our companion paper suggest that chemokine programming of DCs may provide a novel immunotherapy strategy to obviate the natural endocytosis limit of DC antigen uptake, thus potentially increasing DC-based vaccine efficiency. © 2012 Blackwell Publishing Ltd.

A home-based exercise program for children with congenital heart disease following interventional cardiac catheterization: study protocol for a randomized controlled trial.

PubMed

Du, Qing; Salem, Yasser; Liu, Hao Howe; Zhou, Xuan; Chen, Sun; Chen, Nan; Yang, Xiaoyan; Liang, Juping; Sun, Kun

2017-01-23

Cardiac catheterization has opened an innovative treatment field for cardiac disease; this treatment is becoming the most popular approach for pediatric congenital heart disease (CHD) and has led to a significant growth in the number of children with cardiac catheterization. Unfortunately, based on evidence, it has been demonstrated that the majority of children with CHD are at an increased risk of "non-cardiac" problems. Effective exercise therapy could improve their functional status significantly. As studies identifying the efficacy of exercise therapy are rare in this field, the aims of this study are to (1) identify the efficacy of a home-based exercise program to improve the motor function of children with CHD with cardiac catheterization, (2) reduce parental anxiety and parenting burden, and (3) improve the quality of life for parents whose children are diagnosed with CHD with cardiac catheterization through the program. A total of 300 children who will perform a cardiac catheterization will be randomly assigned to two groups: a home-based intervention group and a control group. The home-based intervention group will carry out a home-based exercise program, and the control group will receive only home-based exercise education. Assessments will be undertaken before catheterization and at 1, 3, and 6 months after catheterization. Motor ability quotients will be assessed as the primary outcomes. The modified Ross score, cardiac function, speed of sound at the tibia, functional independence of the children, anxiety, quality of life, and caregiver burden of their parents or the main caregivers will be the secondary outcome measurements. The proposed prospective randomized controlled trial will evaluate the efficiency of a home-based exercise program for children with CHD with cardiac catheterization. We anticipate that the home-based exercise program may represent a valuable and efficient intervention for children with CHD and their families. http://www.chictr.org.cn/ on: ChiCTR-IOR-16007762 . Registered on 13 January 2016.

A Rasch Model Analysis of Evidence-Based Treatment Practices Used in the Criminal Justice System

PubMed Central

Henderson, Craig E.; Taxman, Faye S.; Young, Douglas W.

2008-01-01

This study used item response theory (IRT) to examine the extent to which criminal justice facilities and community-based agencies are using evidence-based substance abuse treatment practices (EBPs), which EBPs are most commonly used, and how EBPs cluster together. The study used data collected from wardens, justice administrators, and treatment directors as part of the National Criminal Justice Treatment Practices survey (NCJTP; Taxman et al., 2007a), and includes both adult criminal and juvenile justice samples. Results of Rasch modeling demonstrated that a reliable measure can be formed to gauge the extent to which juvenile and adult correctional facilities, and community treatment agencies serving offenders, have adopted various treatment practices supported by research. We also demonstrated the concurrent validity of the measure by showing that features of the facilities’ organizational contexts were associated with the extent to which facilities were using EBPs, and which EBPs they were using. Researchers, clinicians, and program administrators may find these results interesting not only because they show the program factors most strongly related to EBP use, but the results also suggest that certain treatment practices are generally clustered together, which may help stakeholders plan and prioritize the adoption of new EBPs in their facilities. The study has implications for future research focused on understanding the adoption and implementation of EBPs in correctional environments. PMID:18029116

Using Interactive Web-Based Screening, Brief Intervention and Referral to Treatment in an Urban, Safety-Net HIV Clinic

PubMed Central

Rose, Carol Dawson; Cuca, Yvette P.; Kamitani, Emiko; Eng, Shannon; Zepf, Roland; Draughon, Jessica; Lum, Paula

2015-01-01

Substance use among PLHIV is high, and screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach to addressing the issue. We examined the acceptability of a technology-based SBIRT program in an urban HIV clinic. An SBIRT intervention was programmed into the clinic’s electronic personal health record. We examined: demographic, health, HIV, and substance use characteristics of participants who completed the web-based intervention compared to those who did not. Fewer than half of the 96 participants assigned to the web-based SBIRT completed it (n=39; 41%). Severity of tobacco and amphetamine use differed significantly between participants who did and did not complete the intervention (p=.03, .04 respectively). Participants with higher severity of tobacco and amphetamines were significantly more likely to utilize the web-based SBIRT. It is important for technology-based approaches to behavioral interventions in clinic take into consideration feasibility, client knowledge, and comfort using technology. PMID:25963770

[Development and short-term effects of a standardized patient education program for in-patient cardiologic rehabilitation].

PubMed

Seekatz, B; Haug, G; Mosler, G; Schwaab, B; Altstidl, R; Worringen, U; Faller, H; Meng, K

2013-10-01

Patient education is an essential part in the treatment of coronary heart disease in medical rehabilitation. In the German-speaking area, no standardized and evaluated patient education program for coronary heart disease is available so far. In this paper, we demonstrate the development of a quality assured patient education program based on a health-education program of the German statutory pension insurance scheme. In a multi-level approach, an existing program was modified concerning treatment evidence, practical guidelines, theories of health and illness behavior and quality criteria for patient education as well as clinical experience and thereafter manualized. In a formative evaluation, feasibility and patient acceptance of this modified program were assessed using evaluation questionnaires of patients and trainers. Afterwards, effects of the patient education program as compared to a traditional education program were assessed on a short-term (at discharge), medium-term (6-month follow-up) and long-term (12-month follow-up) basis in a multicenter quasi-experimental control group study of patients with coronary heart disease (n=434). Results of the formative evaluation demonstrate an overall good acceptance and a good feasibility of the manualized program. Short-term results show a significant small treatment effect in the primary outcome variable patients' knowledge (p=0.001, η2 =0.028). Furthermore, small effects were also observed among some secondary outcomes, such as attitude towards medication, planning of physical activity, psychological quality of life and satisfaction with the education program. A standardized education program for patients with coronary heart disease has been developed in a systematic process based on established quality standards. Depending on the outstanding medium and long-term effects, the program may be recommended for general use in medical rehabilitation. The manual provides the prerequisites allowing for a successful transfer into clinical practice. © Georg Thieme Verlag KG Stuttgart · New York.

Programmatic assessment of a university-based implant training program using patient-reported outcomes.

PubMed

Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

2014-11-01

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

e-CBT (myCompass), Antidepressant Medication, and Face-to-Face Psychological Treatment for Depression in Australia: A Cost-Effectiveness Comparison

PubMed Central

2015-01-01

Background The economic cost of depression is becoming an ever more important determinant for health policy and decision makers. Internet-based interventions with and without therapist support have been found to be effective options for the treatment of mild to moderate depression. With increasing demands on health resources and shortages of mental health care professionals, the integration of cost-effective treatment options such as Internet-based programs into primary health care could increase efficiency in terms of resource use and costs. Objective Our aim was to evaluate the cost-effectiveness of an Internet-based intervention (myCompass) for the treatment of mild-to-moderate depression compared to treatment as usual and cognitive behavior therapy in a stepped care model. Methods A decision model was constructed using a cost utility framework to show both costs and health outcomes. In accordance with current treatment guidelines, a stepped care model included myCompass as the first low-intervention step in care for a proportion of the model cohort, with participants beginning from a low-intensity intervention to increasing levels of treatment. Model parameters were based on data from the recent randomized controlled trial of myCompass, which showed that the intervention reduced symptoms of depression, anxiety, and stress and improved work and social functioning for people with symptoms in the mild-to-moderate range. Results The average net monetary benefit (NMB) was calculated, identifying myCompass as the strategy with the highest net benefit. The mean incremental NMB per individual for the myCompass group was AUD 1165.88 compared to treatment as usual and AUD 522.58 for the cognitive behavioral therapy model. Conclusions Internet-based interventions can provide cost-effective access to treatment when provided as part of a stepped care model. Widespread dissemination of Internet-based programs can potentially reduce demands on primary and tertiary services and reduce unmet need. PMID:26561555

e-CBT (myCompass), Antidepressant Medication, and Face-to-Face Psychological Treatment for Depression in Australia: A Cost-Effectiveness Comparison.

PubMed

Solomon, Daniela; Proudfoot, Judith; Clarke, Janine; Christensen, Helen

2015-11-11

The economic cost of depression is becoming an ever more important determinant for health policy and decision makers. Internet-based interventions with and without therapist support have been found to be effective options for the treatment of mild to moderate depression. With increasing demands on health resources and shortages of mental health care professionals, the integration of cost-effective treatment options such as Internet-based programs into primary health care could increase efficiency in terms of resource use and costs. Our aim was to evaluate the cost-effectiveness of an Internet-based intervention (myCompass) for the treatment of mild-to-moderate depression compared to treatment as usual and cognitive behavior therapy in a stepped care model. A decision model was constructed using a cost utility framework to show both costs and health outcomes. In accordance with current treatment guidelines, a stepped care model included myCompass as the first low-intervention step in care for a proportion of the model cohort, with participants beginning from a low-intensity intervention to increasing levels of treatment. Model parameters were based on data from the recent randomized controlled trial of myCompass, which showed that the intervention reduced symptoms of depression, anxiety, and stress and improved work and social functioning for people with symptoms in the mild-to-moderate range. The average net monetary benefit (NMB) was calculated, identifying myCompass as the strategy with the highest net benefit. The mean incremental NMB per individual for the myCompass group was AUD 1165.88 compared to treatment as usual and AUD 522.58 for the cognitive behavioral therapy model. Internet-based interventions can provide cost-effective access to treatment when provided as part of a stepped care model. Widespread dissemination of Internet-based programs can potentially reduce demands on primary and tertiary services and reduce unmet need.

Combining medically assisted treatment and Twelve-Step programming: a perspective and review.

PubMed

Galanter, Marc

2018-01-01

People with severe substance use disorders require long-term rehabilitative care after the initial treatment. There is, however, a deficit in the availability of such care. This may be due both to inadequate medical coverage and insufficient use of community-based Twelve-Step programs in many treatment facilities. In order to address this deficit, rehabilitative care for severe substance use disorders could be promoted through collaboration between practitioners of medically assisted treatment, employing medications, and Twelve-Step-oriented practitioners. To describe the limitations and benefits in applying biomedical approaches and Twelve-Step resources in the rehabilitation of persons with severe substance use disorders; and to assess how the two approaches can be employed together to improve clinical outcome. Empirical literature focusing on clinical and manpower issues is reviewed with regard (a) to limitations in available treatment options in ambulatory and residential addiction treatment facilities for persons with severe substance use disorders, (b) problems of long-term rehabilitation particular to opioid-dependent persons, associated with the limitations of pharmacologic approaches, (c) the relative effectiveness of biomedical and Twelve-Step approaches in the clinical context, and (d) the potential for enhanced use of these approaches, singly and in combination, to address perceived deficits. The biomedical and Twelve-Step-oriented approaches are based on differing theoretical and empirically grounded models. Research-based opportunities are reviewed for improving addiction rehabilitation resources with enhanced collaboration between practitioners of these two potentially complementary practice models. This can involve medications for both acute and chronic treatment for substances for which such medications are available, and Twelve-Step-based support for abstinence and long-term rehabilitation. Clinical and Scientific Significance: Criteria for developing evidence-based approaches for combined treatment should be developed, and research for evidence-based treatment on this basis can be undertaken in order to develop improved clinical outcome.

A values-based Motivational Interviewing (MI) intervention for pediatric obesity: study design and methods for MI Values.

PubMed

Bean, Melanie K; Mazzeo, Suzanne E; Stern, Marilyn; Bowen, Deborah; Ingersoll, Karen

2011-09-01

To reduce pediatric obesity in clinical settings, multidisciplinary behaviorally-based treatment programs are recommended. High attrition and poor compliance are two difficulties frequently encountered in such programs. A brief, empathic and directive clinical intervention, Motivational Interviewing (MI), might help address these motivational and behavioral issues, ultimately resulting in more positive health outcomes. The efficacy of MI as an adjunct in the treatment of pediatric obesity remains relatively understudied. MI Values was developed to implement within an existing multidisciplinary treatment program for obese, ethnically diverse adolescents, the T.E.E.N.S. Program (Teaching, Encouragement, Exercise, Nutrition, Support). T.E.E.N.S. participants who consent to MI Values are randomized to either MI or an education control condition. At weeks 1 and 10 of T.E.E.N.S. participation, the subset of participants assigned to the MI condition engages in individual MI sessions and control participants view health education videos. All MI sessions are audiotaped and coded to monitor treatment fidelity, which has been satisfactory thus far. Participants complete comprehensive assessments at baseline, 3- and 6-month follow-ups. We hypothesize that MI participants will demonstrate greater reductions in Body Mass Index (BMI) percentile, improved diet and physical activity behaviors, better compliance with T.E.E.N.S., and lower attrition than participants in the control group. We present study design and methods for MI Values as well as data on feasibility of recruitment methods and treatment integrity. At study completion, findings will contribute to the emerging literature examining the efficacy of MI in the treatment of pediatric obesity. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis): A Randomized Clinical Trial

PubMed Central

Viswas, Rajadurai; Ramachandran, Rejeeshkumar; Korde Anantkumar, Payal

2012-01-01

Objective. To compare the effectiveness of supervised exercise program and Cyriax physiotherapy in the treatment of tennis elbow (lateral epicondylitis). Design. Randomized clinical trial. Setting. Physiotherapy and rehabilitation centre. Subjects. This study was carried out with 20 patients, who had tennis elbow (lateral epicondylitis). Intervention. Group A (n = 10) had received supervised exercise program. Group B (n = 10) was treated with Cyriax physiotherapy. All patients received three treatment sessions per week for four weeks (12 treatment sessions). Outcome measures. Pain was evaluated using a visual analogue scale (VAS), and functional status was evaluated by completion of the Tennis Elbow Function Scale (TEFS) which were recorded at base line and at the end of fourth week. Results. Both the supervised exercise program and Cyriax physiotherapy were found to be significantly effective in reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in greater improvement in comparison to those who received Cyriax physiotherapy. Conclusion. The results of this clinical trial demonstrate that the supervised exercise program may be the first treatment choice for therapist in managing tennis elbow. PMID:22629225

A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions.

PubMed

Dunne, Tom; Bishop, Lisa; Avery, Susan; Darcy, Stephen

2017-05-01

The majority of adult mental health and substance use (MH&SU) conditions emerge in adolescence. Prevention, diagnosis, and treatment programs targeting this age group have a unique opportunity to significantly impact the well-being of the future generation of adults. At the same time, youth are reluctant to seek treatment and have high rates of dropout from interventions. An emphasis on youth engagement in prevention and treatment interventions for MH&SU results in better health outcomes for those youth. This literature review was undertaken to evaluate opportunities to improve youth engagement in MH&SU programs. The intent was to determine best practices in the field that combined community-level improvement in clinical outcomes with proven strategies in engagement enhancement to inform program development at a local level. The results discuss 40 studies, reviews, and program reports demonstrating effective youth engagement. These have been grouped into six themes based on the underlying engagement mechanism: youth participation in program development, parental relationships, technology, the health clinic, school, and social marketing. A broad range of tools are discussed that intervention developers can leverage to improve youth engagement in prevention or treatment programs. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Installation Restoration Program, Phase II (Stage 2-1). Volume 2.

DTIC Science & Technology

1985-05-01

Worthington OH PAGES: 89 SOURCE: Radian Library COMMENTS: General manual for well drilling, sample collection . Includes good elementary background. FIRST... Collected from the Base Industrial and Domestic Waste Water Treatment Plants and Field * Sampling Data PAGES: 75 p. SOURCE: Capt. Mario Ierarti * COMMENTS...Analytical results for samples collected from the * base industrial and domestic wastewater treatment plants have been included. RADIAN FIRST AUTHOR

Faculty Development in Small-Group Teaching Skills Associated with a Training Course on Office-Based Treatment of Opioid Dependence

ERIC Educational Resources Information Center

Wong, Jeffrey G.; Holmboe, Eric S.; Becker, William C.; Fiellin, David A.; Jara, Gail B.; Martin, Judith

2005-01-01

The Drug Addiction Treatment Act of 2000 (DATA-2000) allows qualified physicians to treat opioid-dependent patients with schedule III-V medications, such as buprenorphine, in practices separate from licensed, accredited opioid treatment programs. Physicians may attain this qualification by completing 8-hours of training in treating opioid…

The Protected Addiction: Exploring Staff Beliefs toward Integrating Tobacco Dependence into Substance Abuse Treatment Services

ERIC Educational Resources Information Center

Teater, Barbra; Hammond, Gretchen Clark

2009-01-01

Survey research was used to explore the beliefs of 963 staff members regarding the myths to treating tobacco dependence and the integration of tobacco dependence into substance abuse treatment programs. The staff represented a mixture of residential, outpatient, and prevention-based gender-specific (women only) treatment centers throughout Ohio.…

Association between the Availability of Hospital-Based Palliative Care and Treatment Intensity for Critically Ill Patients.

PubMed

Hua, May; Ma, Xiaoyue; Morrison, R Sean; Li, Guohua; Wunsch, Hannah

2018-05-29

In the intensive care unit (ICU), studies involving specialized palliative care services have shown decreases in the use of non-beneficial life-sustaining therapies and ICU length of stay for patients. However, whether widespread availability of hospital-based palliative care is associated with less frequent use of high intensity care is unknown. To determine whether availability of hospital-based palliative care is associated with decreased markers of treatment intensity for ICU patients. Retrospective cohort study of adult ICU patients in New York State hospitals, 2008-2014. Multilevel regression was used to assess the relationship between availability of hospital-based palliative care during the year of admission and hospital length of stay, use of mechanical ventilation, dialysis and artificial nutrition, placement of a tracheostomy or gastrostomy tube, days in ICU and discharge to hospice. Of 1,025,503 ICU patients in 151 hospitals, 814,794 (79.5%) received care in a hospital with a palliative care program. Hospital length of stay was similar for patients in hospitals with and without palliative care programs (6 days, interquartile range (IQR) 3-12 vs. 6 days, IQR 3-11, adjusted rate ratio 1.04 [1.03 to 1.05], p < 0.001), as were other healthcare utilization outcomes. However, patients in hospitals with palliative care programs were 46% more likely to be discharged to hospice than those in hospitals without palliative care programs (1.7% vs. 1.4%, adjusted odds ratio 1.46 [1.30 to 1.64], p<0.001). Availability of hospital-based palliative care was not associated with differences in in-hospital treatment intensity but was associated with significantly increased hospice utilization for ICU patients. At this time, the measurable benefit of palliative care programs for critically ill patients may be the increased use of hospice facilities, as opposed to decreased healthcare utilization during an ICU-associated hospitalization.

Translating evidence into practice: pursuing perfection in pneumococcal vaccination in a rural community.

PubMed

Doyle, D M; Dauterive, R; Chuang, K H; Ellrodt, A G

2001-11-01

There are many challenges to effectively and efficiently translating evidence into practice. Potential strategies include (1) training more evidence-based practitioners in the art and science of evidence-based medicine, (2) enhancing the quality and availability of systematic reviews, and (3) more effectively linking evidence-based practitioners and evidence users through comprehensive behavioral change initiatives. Herein we explore the third strategy and highlight the key elements of success for a program using behavioral change strategies. We present a clinical model based on clear understanding of the "problem," a systematic approach to diagnosis, selection of scientifically sound treatment options, and effective evaluation with appropriate modification of the treatment plan. A successful program begins with effective team leadership, the expression of a clinically compelling case for change, and commitment to the pursuit of perfection in the delivery of key evidence-based interventions. The team must then diagnose behavioral barriers to change, using a systematic approach based on a published rigorous differential diagnosis framework. This diagnostic step provides the foundation for selection of effective dissemination and implementation strategies (treatments) proven to improve processes of care and clinical outcomes. Finally the team must evaluate progress toward perfection, reviewing interim data and adjusting the treatment regimen to newly diagnosed barriers. We then present a specific project (improving pneumococcal immunization rates in our rural community) and interim results to demonstrate the use of the framework in the real world.

Short-term effect of American summer treatment program for Japanese children with attention deficit hyperactivity disorder.

PubMed

Yamashita, Yushiro; Mukasa, Akiko; Honda, Yuko; Anai, Chizuru; Kunisaki, Chie; Koutaki, Jun-ichi; Motoyama, Satoko; Miura, Naoki; Sugimoto, Ami; Ohya, Takashi; Nakashima, Masayuki; Nagamitsu, Shin-ichiro; Gnagy, Elizabeth M; Greiner, Andrew R; Pelham, William E; Matsuishi, Toyojiro

2010-02-01

We reported the results of the 3-week summer treatment program (STP) for children with attention deficit hyperactivity disorder (ADHD) in 2006. The STP was based on methods established by Professor Pelham in Buffalo, NY and has been used in a number of studies and at a number of sites in the U.S. This is the first STP outside North America. Thirty-six children age 6-12 years with ADHD participated. The collection of evidence-based behavioral modification techniques that comprises the STP's behavioral program (e.g., point system, daily report card, positive reinforcement, time out) was used. Most children showed positive behavioral changes in multiple domains of functioning, demonstrated by significant improvement in points earned daily, which reflect behavior frequencies. Only one child with ADHD co-morbid with pervasive developmental disorder required an individualized program for excessive time outs. The ADHD rating scale, symptoms of oppositional defiant disorder, and hyperactivity/inattention in Strength and Difficulties Questionnaires evaluated by parents significantly improved after STP. Although the 3-week STP was much shorter than most STPs run in the U.S., the program is more intensive than typical outpatient treatment, providing 105h of intervenion in 3 weeks. The short-term effect of the STP was demonstrated for Japanese children with ADHD. 2008 Elsevier B.V. All rights reserved.

Family-based training program improves brain function, cognition, and behavior in lower socioeconomic status preschoolers

PubMed Central

Neville, Helen J.; Stevens, Courtney; Pakulak, Eric; Bell, Theodore A.; Fanning, Jessica; Klein, Scott; Isbell, Elif

2013-01-01

Using information from research on the neuroplasticity of selective attention and on the central role of successful parenting in child development, we developed and rigorously assessed a family-based training program designed to improve brain systems for selective attention in preschool children. One hundred forty-one lower socioeconomic status preschoolers enrolled in a Head Start program were randomly assigned to the training program, Head Start alone, or an active control group. Electrophysiological measures of children’s brain functions supporting selective attention, standardized measures of cognition, and parent-reported child behaviors all favored children in the treatment program relative to both control groups. Positive changes were also observed in the parents themselves. Effect sizes ranged from one-quarter to half of a standard deviation. These results lend impetus to the further development and broader implementation of evidence-based education programs that target at-risk families. PMID:23818591

Standalone Internet speech restructuring treatment for adults who stutter: A phase I study.

PubMed

Erickson, Shane; Block, Susan; Menzies, Ross; O'Brian, Sue; Packman, Ann; Onslow, Mark

2016-08-01

This Phase I trial reports the results of a clinician-free Internet speech restructuring treatment for adults who stutter. The program consists of nine phases with concepts loosely based on the Camperdown Program. Twenty adults who stutter were recruited. They were given unlimited access to the program for 6 months. Primary outcome measures were the percentage of syllables stuttered and self-reported severity ratings. Five participants accessed all phases of the program, while another five accessed more than half the phases. The remaining 10 accessed between one and four phases. Four of five participants who accessed all phases reduced their stuttering frequency by more than 50% and an additional two participants who accessed more than half the phases also achieved similar reductions. These results were confirmed by self-reports of stuttering severity. Stuttering reductions were largely commensurate with the amount of the program accessed. As with other clinician-free programs in related health areas, maintaining adherence to the program's procedures was a significant issue. Nonetheless, this novel approach to treating stuttering has the potential to be a viable alternative for some clients and may help to address the significant access and relapse issues that affect treatment provision for adults who stutter.

VA Residential Provider Perceptions of Dissuading Factors to the Use of Two Evidence-Based PTSD Treatments

PubMed Central

Cook, Joan M.; Dinnen, Stephanie; Simiola, Vanessa; Thompson, Richard; Schnurr, Paula P.

2014-01-01

Providers (N = 198) from 38 Department of Veterans Affairs residential posttraumatic stress disorder treatment programs across the United States completed qualitative interviews regarding implementation of 2 evidence-based treatments: prolonged exposure and cognitive processing therapy. As part of this investigation, providers were asked how they decide which patients are appropriate for these treatments. Many indicated that they did not perceive any patient factors that dissuade their use of either evidence-based treatment. However, 3 broad categories emerged surrounding reasons that patients were perceived to be less suitable candidates for the treatments: the presence of psychiatric comorbidities, cognitive limitations, and low levels of patient motivation. Interestingly, providers’ perceived reasons for limited or nonuse of a treatment did not correspond entirely to those espoused by treatment developers. Possible solutions to address provider concerns, including educational and motivational interventions, are noted. PMID:25309031

Determinants of mortality and nondeath losses from an antiretroviral treatment service in South Africa: implications for program evaluation.

PubMed

Lawn, Stephen D; Myer, Landon; Harling, Guy; Orrell, Catherine; Bekker, Linda-Gail; Wood, Robin

2006-09-15

The scale-up of antiretroviral treatment (ART) services in resource-limited settings requires a programmatic model to deliver care to large numbers of people. Understanding the determinants of key outcome measures--including death and nondeath losses--would assist in program evaluation and development. Between September 2002 and August 2005, all in-program (pretreatment and on-treatment) deaths and nondeath losses were prospectively ascertained among treatment-naive adults (n=1235) who were enrolled in a community-based ART program in South Africa. At study censorship, 927 patients had initiated ART after a median of 34 days after enrollment in the program. One hundred twenty-one (9.8%) patients died. Mortality rates were 33.3 (95% CI, 25.5-43.0), 19.1 (95% CI, 14.4-25.2), and 2.9 (95% CI, 1.8-4.8) deaths/100 person-years in the pretreatment interval, during the first 4 months of ART (early deaths), and after 4 months of ART (late deaths), respectively. Pretreatment and early treatment deaths together accounted for 87% of deaths, and were independently associated with advanced immunodeficiency at enrollment. Late deaths were comparatively few and were only associated with the response to ART at 4 months. Nondeath program losses (loss to follow-up, 2.3%; transfer-out, 1.9%; relocation, 0.7%) were not associated with immune status and were evenly distributed during the study period. Loss to follow-up and late mortality rates were low, reflecting good cohort retention and treatment response. However, the extremely high pretreatment and early mortality rates indicate that patients are enrolling in ART programs with far too advanced immunodeficiency. Causes of late access to the ART program, such as delays in health care access, health system delays, or inappropriate treatment criteria, need to be addressed.

Comparative effect of integrated pest management and farmers' standard pest control practice for managing insect pests on cabbage (Brassica spp.).

PubMed

Reddy, Gadi V P

2011-08-01

Studies were conducted on experimental cabbage plantings in 2009 and on experimental and commercial plantings in 2010, comparing farmers' current chemical standard pesticide practices with an integrated pest management (IPM) program based on the use of neem (Aza-Direct) and DiPel (Bacillus thuringiensis). In experimental plantings, the IPM program used six or eight applications of neem and DiPel on a rotational basis. The standard-practice treatments consisted of six or eight applications of carbaryl and malathion or control treatment. The IPM treatments reduced pest populations and damage, resulting in a better yield than with the standard chemical or control treatment. When IPM treatment included three applications of neem plus three applications of DiPel (on a rotational basis in experimental fields), it again reduced the pest population and damage and produced a better yield than the standard practice. The lower input costs of the IPM program resulted in better economic returns in both trials. The IPM components neem and DiPel are suitable for use in an IPM program for managing insect pests on cabbage (Brassica spp.). Copyright © 2011 Society of Chemical Industry.

Meeting the substance abuse treatment needs of lesbian, bisexual and transgender women: implications from research to practice

PubMed Central

Stevens, Sally

2012-01-01

Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT) women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1) examine issues relevant to LBT women and substance use, and (2) make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations. PMID:24474874

Shifting from presumptive to test-based management of malaria - technical basis and implications for malaria control in Ghana.

PubMed

Baiden, F; Malm, K; Bart-Plange, C; Hodgson, A; Chandramohan, D; Webster, J; Owusu-Agyei, S

2014-06-01

The presumptive approach was the World Health Organisation (WHO) recommended to the management of malaria for many years and this was incorporated into syndromic guidelines such as the Integrated Management of Childhood Illnesses (IMCI). In early 2010 however, WHO issued revised treatment guidelines that call for a shift from the presumptive to the test-based approach. Practically, this implies that in all suspected cases, the diagnosis of uncomplicated malaria should be confirmed using rapid test before treatment is initiated. This revision effectively brings to an end an era of clinical practice that span several years. Its implementation has important implications for the health systems in malaria-endemic countries. On the basis of research in Ghana and other countries, and evidence from program work, the Ghana National Malaria Control Program has issued revised national treatment guidelines that call for implementation of test-based management of malaria in all cases, and across all age groups. This article reviews the evidence and the technical basis for the shift to test-based management and examines the implications for malaria control in Ghana.

Cognitive-behavioral based physical therapy for patients with chronic pain undergoing lumbar spine surgery: a randomized controlled trial

PubMed Central

Archer, Kristin R.; Devin, Clinton J.; Vanston, Susan W.; Koyama, Tatsuki; Phillips, Sharon; George, Steven Z.; McGirt, Matthew J.; Spengler, Dan M.; Aaronson, Oran S.; Cheng, Joseph S.; Wegener, Stephen T.

2015-01-01

The purpose of this study was to determine the efficacy of a cognitive-behavioral based physical therapy (CBPT) program for improving outcomes in patients following lumbar spine surgery. A randomized controlled trial was conducted in 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an Education program occurred at 6 weeks after surgery. Assessments were completed pre-treatment, post-treatment and at 3 month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10 Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared to the Education group at 3 month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at-risk for poor recovery following spine surgery. PMID:26476267

Risk factors for poor attendance in a family-based pediatric obesity intervention program for young children.

PubMed

Williams, Natalie A; Coday, Mace; Somes, Grant; Tylavsky, Frances A; Richey, Phyllis A; Hare, Marion

2010-01-01

This study examined the role of demographic characteristics, psychological factors, and family functioning on attendance in a randomized controlled trial of a family-based pediatric obesity program. Participants included 155 children between the ages of 4 and 7 years (M age = 5.77, 57.4% female, 73.6% black, M body mass index = 25.5) and their primary caregivers who were randomized to the treatment group. Three groups of participants were created based on their patterns of attendance during the program: (1) noncompleters, (2) partial completers, and (3) completers. Results indicated no differences among the attendance groups in child gender, child body mass index, or child psychological functioning. Significant group differences were found with respect to race/ethnicity, parent marital status, and family income, such that noncompleters were more likely to be racial/ethnic minorities, to living in single parent households, and to have lower incomes than partial completers and completers. After controlling for the effects of these sociodemographic risk factors, noncompleters, and partial completers reported more family dysfunction characterized by high levels of disengagement than completers. Adapting existing weight management programs to include a focus on family engagement in the early stages of treatment may help to improve participation in family-based obesity interventions targeting high risk, socioeconomically disadvantaged youth.

Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance.

PubMed

Titov, Nickolai; Andrews, Gavin; Davies, Matthew; McIntyre, Karen; Robinson, Emma; Solley, Karen

2010-06-08

Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided. Would guidance from a technician be as effective as guidance from a clinician? Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health QUESTIONnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (p<0.001) and PHQ-9 (p<0.001) compared to the delayed treatment group but did not differ from each other. Within group effect sizes on the BDI-II were 1.27 and 1.20 for the clinician- and technician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services. Australian New Zealand Clinical Trials Registry ACTRN12609000559213.

Internet Treatment for Depression: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance

PubMed Central

Titov, Nickolai; Andrews, Gavin; Davies, Matthew; McIntyre, Karen; Robinson, Emma; Solley, Karen

2010-01-01

Background Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided. Question: Would guidance from a technician be as effective as guidance from a clinician? Method Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health Questionnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (p<0.001) and PHQ-9 (p<0.001) compared to the delayed treatment group but did not differ from each other. Within group effect sizes on the BDI-II were 1.27 and 1.20 for the clinician- and technician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. Conclusions Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000559213 PMID:20544030

Psychosocial Interventions in Reducing Cannabis Use in Early Phase Psychosis: A Canadian Survey of Treatments Offered.

PubMed

Aydin, Cristina; Tibbo, Philip G; Ursuliak, Zenovia

2016-06-01

Cannabis use in people with early phase psychosis (EPP) can have a significant impact on long-term outcomes. The purpose of this investigation was to describe current cannabis use treatment practices in English-speaking early intervention services (EISs) in Canada and determine if their services are informed by available evidence. Thirty-five Canadian English-speaking EISs for psychosis were approached to complete a survey through email, facsimile, or online in order to collect information regarding their current cannabis use treatment practices. Data were acquired from 27 of the 35 (78%) programs approached. Only 12% of EISs offered formal services that targeted cannabis use, whereas the majority (63%) of EISs offered informal services for all substance use, not specifically cannabis. In programs with informal services, individual patient psychoeducation (86%) was slightly more common than individual motivational interviewing (MI) (76%) followed by group patient psychoeducation (52%) and information handouts (52%). Thirty-seven percent of EISs offered formal services for substance use, and compared to programs with informal services, more MI, cognitive-behavioural therapy, and family services were offered, with individual treatment modalities more common than groups. No EISs used contingency management, even though it has some preliminary evidence in chronic populations. Evidence-based service implementation barriers included appropriate training and administrative support. While most English-speaking Canadian EIS programs offer individual MI and psychoeducation, which is in line with the available literature, there is room for improvement in cannabis treatment services based on current evidence for both people with EPP and their families. © The Author(s) 2016.

iPractice: piloting the effectiveness of a tablet-based home practice program in aphasia treatment.

PubMed

Kurland, Jacquie; Wilkins, Abigail R; Stokes, Polly

2014-02-01

The current study investigated the effectiveness of a home practice program based on the iPad (Apple Inc., Cupertino, CA), implemented after 2 weeks of intensive language therapy, for maintaining and augmenting treatment gains in people with chronic poststroke aphasia. Five of eight original participants completed the 6-month home practice program in which they autonomously practiced retrieving words for objects and actions. Half of these words had been trained and half were untrained during therapy. Practice included tasks such as naming to confrontation, repeating from a video model, and picture/word matching presented on an iPad. All participants maintained advances made on words trained during the intensive treatment and additionally were able to learn new words by practicing daily over a 6-month period. The iPad and other tablet devices have great potential for personalized home practice to maintain and augment traditional aphasia rehabilitation. It appears that motivation to use the technology and adequate training are more important factors than age, aphasia type or severity, or prior experience with computers. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adolescent substance use and abuse: recognition and management.

PubMed

Griswold, Kim S; Aronoff, Helen; Kernan, Joan B; Kahn, Linda S

2008-02-01

Substance abuse in adolescents is undertreated in the United States. Family physicians are well positioned to recognize substance use in their patients and to take steps to address the issue before use escalates. Comorbid mental disorders among adolescents with substance abuse include depression, anxiety, conduct disorder, and attention-deficit/ hyperactivity disorder. Office-, home-, and school-based drug testing is not routinely recommended. Screening tools for adolescent substance abuse include the CRAFFT questionnaire. Family therapy is crucial in the management of adolescent substance use disorders. Although family physicians may be able to treat adolescents with substance use disorders in the office setting, it is often necessary and prudent to refer patients to one or more appropriate consultants who specialize specifically in substance use disorders, psychology, or psychiatry. Treatment options include anticipatory guidance, brief therapeutic counseling, school-based drug-counseling programs, outpatient substance abuse clinics, day treatment programs, and inpatient and residential programs. Working within community and family contexts, family physicians can activate and oversee the system of professionals and treatment components necessary for optimal management of substance misuse in adolescents.

Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial.

PubMed

Kaale, Anett; Fagerland, Morten W; Martinsen, Egil W; Smith, Lars

2014-02-01

This study reports 12-month follow-up data from a randomized controlled trial of preschool-based social communication treatment for young children with autism. A total of 61 children (48 males) with autism, 29 to 60 months of age, had earlier been randomized either to 8 weeks of preschool-based social communication treatment in addition to standard preschool program (n = 34) or to standard preschool program only (n = 27). Significant short-term effects on targeted social communication skills have previously been published. Long-term gains in social communication, language and global social functioning and communication were assessed from video-taped preschool teacher-child and mother-child interactions, Early Social Communication Scales, Reynell Developmental Language Scale, and Social Communication Questionnaire. Compared with those in the control group, the treated children achieved significantly larger improvements in joint attention and joint engagement from baseline to 12-month follow-up. However, no effects were detected on language and global ratings of social functioning and communication. The treatment effect on child initiation of joint attention increased with increasing level of sociability at baseline, whereas nonverbal IQ and expressive language had no moderating effect. This study is the first to show that, similar to specialist-delivered treatment, preschool-based treatment may produce small but possibly clinically important long-term changes in social communication in young children with autism. The treatment did not affect language and global ratings of social functioning and communication. More studies are needed to better understand whether treatment effects may be improved by increasing the intensity and duration of the treatment. Clinical trial registration information--Joint Attention Intervention and Young Children With Autism; http://clinicaltrials.gov/; NCT00378157. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Neural responses to negative outcomes predict success in community-based substance use treatment

PubMed Central

Forster, Sarah E.; Finn, Peter R.; Brown, Joshua W.

2017-01-01

Background and aims Activation in some specific brain regions has demonstrated promise as prognostic indicators in substance dependent individuals (SDIs) but this issue has not yet been explored in SDIs attending typical of community-based treatment. We used a data-driven, exploratory approach to identify brain-based predictors of treatment outcome in a representative community sample of SDIs. The predictive utility of brain-based measures was evaluated against clinical indicators, cognitive-behavioral performance, and self-report assessments. Design Prospective clinical outcome design, evaluating baseline functional magnetic resonance imaging data from the Balloon Analogue Risk Task (BART) as a predictor of 3-month substance use treatment outcomes. Setting Community-based substance use programs in Bloomington, Indiana, USA. Participants Twenty-three SDIs (17 male, ages 18–43) in an intensive outpatient or residential treatment program; abstinent 1–4 weeks at baseline. Measurements Event-related brain response, BART performance, and self-report scores at treatment onset, substance use outcome measure (based on days of use) Findings Using voxel-level predictive modeling and leave-one-out cross-validation, an elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) at baseline successfully predicted greater substance use over the 3-month study interval (p ≤ 0.006, cluster-corrected). This effect was robust to inclusion of significant non-brain-based covariates. A larger response to negative feedback in bilateral Amyg/aHipp was also associated with faster reward-seeking responses after negative feedback (r(23) = −0.544, p = 0.007; r(23) = −0.588, p = 0.003). A model including Amyg/aHipp activation, faster reward-seeking after negative feedback, and significant self-report scores accounted for 45% of the variance in substance use outcomes in our sample. Conclusions An elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) appears to predict relapse to substance use in people attending community-based treatment. PMID:28029198

State medicaid coverage for tobacco cessation treatments and barriers to coverage - United States, 2008-2014.

PubMed

Singleterry, Jennifer; Jump, Zach; Lancet, Elizabeth; Babb, Stephen; MacNeil, Allison; Zhang, Lei

2014-03-28

Medicaid enrollees have a higher smoking prevalence than the general population (30.1% of adult Medicaid enrollees aged <65 years smoke, compared with 18.1% of U.S. adults of all ages), and smoking-related disease is a major contributor to increasing Medicaid costs. Evidence-based cessation treatments exist, including individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications. A Healthy People 2020 objective (TU-8) calls for all state Medicaid programs to adopt comprehensive coverage of these treatments. However, most states do not provide such coverage. To monitor trends in state Medicaid cessation coverage, the American Lung Association collected data on coverage of all evidence-based cessation treatments except telephone counseling by state Medicaid programs (for a total of nine treatments), as well as data on barriers to accessing these treatments (such as charging copayments or limiting the number of covered quit attempts) from December 31, 2008, to January 31, 2014. As of 2014, all 50 states and the District of Columbia cover some cessation treatments for at least some Medicaid enrollees, but only seven states cover all nine treatments for all enrollees. Common barriers in 2014 include duration limits (40 states for at least some populations or plans), annual limits (37 states), prior authorization requirements (36 states), and copayments (35 states). Comparing 2008 with 2014, 33 states added treatments to coverage, and 22 states removed treatments from coverage; 26 states removed barriers to accessing treatments, and 29 states added new barriers. The evidence from previous analyses suggests that states could reduce smoking-related morbidity and health-care costs among Medicaid enrollees by providing Medicaid coverage for all evidence-based cessation treatments, removing all barriers to accessing these treatments, promoting the coverage, and monitoring its use.

Health information system model for monitoring treatment and surveillance for leprosy patients in indonesia (case study in Pekalongan District, Central Java, Indonesia).

PubMed

Rachmani, Enny; Kurniadi, Arif; Hsu, Chien Yeh

2013-01-01

After India and Brazil, Indonesia has the third highest incidence/prevalence of leprosy in the world. Every year thousands of new cases and case with grade-2 disability are reported and, while the recovery rate lingers only 80-90 %. Therefore, more than 10 % of leprosy patients drop out of treatment and can be a source of new infections in the community. Our research was aimed at determining apparent difficulties in the leprosy control program as well as how a health information system (HIS) could assist the Indonesian leprosy control program. We used qualitative method with deep interview and observation of document. One of the difficulties which the Indonesian leprosy control program faces is discontinuity of patient's data due to rotating staff as well as the treatment monitoring and queries patients which should be monitored after treatment has ceased. Technology implementation is feasible through short message service (sms) reminders and web base applications. The leprosy control program urgently needs to implement continuous monitoring and recording of patients because of the particular characteristics of this contagious disease.

Developing a program for enhancing youth HIV treatment adherence and risk reduction.

PubMed

Fongkaew, Warunee; Udomkhamsuk, Warawan; Viseskul, Nongkran; Guptaruk, Marisa

2017-12-01

Youth living with HIV face difficult and challenging situations that decrease their adherence to antiretroviral medications. In this study, we developed a pilot program to enhance HIV treatment adherence and risk reduction among youth living with HIV based on collaboration with a community hospital involving a multi-disciplinary healthcare team. Participants were 25 youth living with HIV/AIDS, 18 caregivers, and 12 healthcare providers. The action research process comprised a preliminary stage and four phases of assessment, planning, implementation, and evaluation. This program used "edutainment", participatory learning, and multi-disciplinary collaboration to improve HIV treatment adherence and HIV risk behavior knowledge, motivation, and behavior. Education aimed to improve knowledge of antiretroviral drugs and HIV risk-taking behaviors. Motivation was directed at reframing beliefs and increasing positive attitudes of youth toward treatment adherence and raising awareness about safer sex behaviors. The behavioral skills focused on medication management in daily life activities, problem-solving, refusal and negotiation, and condom use. Findings provided preliminary evidence that the program was practical in a clinical context in a community hospital. © 2017 John Wiley & Sons Australia, Ltd.

Cognitive-behavioral treatments for criminogenic thinking: Barriers and facilitators to implementation within the Veterans Health Administration.

PubMed

Blonigen, Daniel M; Rodriguez, Allison L; Manfredi, Luisa; Nevedal, Andrea; Rosenthal, Joel; McGuire, James F; Smelson, David; Timko, Christine

2018-02-01

Cognitive-behavioral treatments for criminogenic thinking (i.e., antisocial cognitions, attitudes, and traits) are regarded as best practices for reducing criminal recidivism among justice-involved adults. However, the barriers and facilitators to implementation of these treatments within large health care systems such as the Veterans Health Administration (VHA) are largely unknown. To address this gap, we conducted qualitative interviews with 22 Specialists from the VHA's Veterans Justice Programs who had been trained in a cognitive-behavioral treatment for criminogenic thinking (i.e., Moral Reconation Therapy [MRT], Thinking for a Change [T4C]). The time-intensiveness of these treatments emerged as a barrier to implementation. Potential solutions identified were patient incentives for treatment engagement, streamlining the curriculum, and implementing the treatments within long-term/residential programs. At the program level, providers' stigma/bias toward patients with antisocial tendencies was seen as a barrier to implementation, as were time/resource constraints on providers. To address the latter, use of peer providers to deliver the treatments and partnerships between justice programs and behavioral health services were suggested. At the system level, lack of recognition of criminogenic treatments as evidence based, and uncertainty of sustained funds to support ongoing costs of these treatments emerged as implementation barriers. To address the latter, a train-the-trainers model was suggested. Our findings serve as a guide for implementation of criminogenic treatments for providers and policymakers in VHA and other large health care systems, which are increasingly called upon to provide care to justice-involved adults in the community. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Addiction Treatment in America: After Money or Aftercare?

PubMed

Miller, David; Miller, Merlene; Blum, Kenneth; Badgaiyan, Rajendra D; Febo, Marcelo

2015-10-21

There are approximately 14,500 clinics and programs in America that provide treatment for all types of addictive behaviors we call "Reward Deficiency Syndrome (RDS)". While most of these have good intentions to provide needed help to the victims of RDS, we propose herein that most of their efforts, especially during periods of aftercare, are not based on the existing scientific evidence. We use "aftercare" to refer to any form of program or therapy following primary treatment including 12-Step programs. Very few programs actually provide any evidenced-based treatment approaches during this most vulnerable period in recovery. In this trieste we are suggesting that a hypodopaminergic trait (genetic) and/or state (epigenetic) is critical in terms of continued motivation to use/abuse of alcohol or other drugs and can lead to relapse. While there is evidence for the approved FDA drugs to treat drug addiction (e.g. alcohol, opiates, nicotine) these drugs favor a short-term benefit by blocking dopamine. We argue instead for the utilization of long-term benefits that induce "dopamine homeostasis", or in simpler terms "normalcy". We suggest that this could be accomplished through a number of holistic modalities including, but not limited to, dopamine-boosting diets, hyper-oxygenation, heavy metal detoxification, exercise, meditation, yoga, and most importantly, brain neurotransmitter balancing with nutraceuticals such as KB220 variants. We embrace 12-step programs and fellowships but not as a stand-alone modality, especially during aftercare. We also provide some scientific basis for why resting state functional connectivity (rsfMRI) is so important and may be the cornerstone in terms of how to treat RDS. We postulate that since drugs, food, smoking, gambling, and even compulsive sexual behavior could reduce rsfMRI then modalities (following required research), that can restore this impaired cross talk between various brain regions (e.g. Nucleus accumbens, cingulate gyrus, hippocampus etc.) should be incorporated into the aftercare plan in all treatment programs in America. Anything less will ultimately lead to the so called "revolving door" for as many as 90% of treatment participants.

Cost analysis of the treatment of severe acute malnutrition in West Africa.

PubMed

Isanaka, Sheila; Menzies, Nicolas A; Sayyad, Jessica; Ayoola, Mudasiru; Grais, Rebecca F; Doyon, Stéphane

2017-10-01

We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support). For each category, total costs were calculated by multiplying input quantities expended in the Médecins Sans Frontières nutrition program in Niger during a 12-month study period by 2015 input prices. All children received outpatient treatment, with 43% also receiving inpatient treatment. In this large, well-established program, the average cost per child treated was €148.86, with outpatient and inpatient treatment costs of €75.50 and €134.57 per child, respectively. Therapeutic food (44%, €32.98 per child) and personnel (35%, €26.70 per child) dominated outpatient costs, while personnel (56%, €75.47 per child) dominated in the cost of inpatient care. Sensitivity analyses suggested lowering prices of medical treatments, and therapeutic food had limited effect on total costs per child, while increasing program size and decreasing use of expatriate staff support reduced total costs per child substantially. Updated estimates of severe acute malnutrition treatment cost are substantially lower than previously published values, and important cost savings may be possible with increases in coverage/program size and integration into national health programs. These updated estimates can be used to suggest approaches to improve efficiency and inform national-level resource allocation. © 2016 John Wiley & Sons Ltd.

Using concept mapping to design an indicator framework for addiction treatment centres.

PubMed

Nabitz, Udo; van Den Brink, Wim; Jansen, Paul

2005-06-01

The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. The setting is the Jellinek Centre based in Amsterdam, the Netherlands, which serves as a prototype for an addiction treatment centre. Concept mapping was used in the construction of the indicator framework. During the 1-day workshop, 16 stakeholders generated, prioritized and sorted 73 items concerning quality and performance. Multidimensional scaling and cluster analysis was applied in constructing a framework consisting of two dimensions and eight clusters. The horizontal axis of the indicator framework is named 'Organization' and has two poles, namely, 'Processes' and 'Results'. The vertical axis is named ' Task' and the poles are named 'Efficient treatment' and 'Prevention programs'. The eight clusters in the two-dimensional framework are arranged in the following, prioritized sequence: 'Efficient treatment network', 'Effective service', ' Target group', 'Quality of life', 'Efficient service', 'Knowledge transfer', 'Reducing addiction related problems', and 'Prevention programs'. The most important items in the framework are: 'patients are satisfied with their treatment', 'early interventions', and 'efficient treatment chain'. The indicator framework aligns with three clusters of the results criteria of the EFQM Excellence Model. It is based on the stakeholders' perspectives and is believed to be specific for addiction treatment centres. The study demonstrates that concept mapping is a suitable strategy for generating indicator frameworks.

A randomized controlled trial of the Cool Teens CD-ROM computerized program for adolescent anxiety.

PubMed

Wuthrich, Viviana M; Rapee, Ronald M; Cunningham, Michael J; Lyneham, Heidi J; Hudson, Jennifer L; Schniering, Carolyn A

2012-03-01

Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This paper describes the results of a small randomized controlled trial of the Cool Teens program for adolescent anxiety, and examines potential barriers to treatment and user preferences of computerized technology in this population. Forty-three adolescents with a primary diagnosis of anxiety were randomly allocated to the Cool Teens program, a 12-week computerized cognitive-behavioral therapy program for anxiety management, or a 12-week wait list. Effects on symptoms, negative thoughts, and life interference were assessed at post-treatment and 3-month follow-up, based on diagnosis as well as self and maternal report. Using mixed-model analyses, at post-treatment and follow-up assessments, adolescents in the Cool Teens condition, compared with those on the wait list, were found to have significant reductions in the total number of anxiety disorders, the severity of the primary anxiety disorder, and the average severity for all disorders. These results were matched by significant reductions in mother and child questionnaire reports of anxiety, internalizing symptoms, automatic thoughts, and life interference. Further few barriers to treatment were found, and user preferences indicated that the computerized treatment was well suited to adolescents with anxiety. The Cool Teens program is efficacious for treatment of adolescent anxiety. Clinical trial registration information-A randomized controlled trial of the Cool Teens computerized program for anxious adolescents compared with waist list; http://www.anzctr.org.au; ACTRN12611000508976. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Reinforcing Abstinence and Treatment Participation among Offenders in a Drug Diversion Program: Are Vouchers Effective?

PubMed Central

Hall, Elizabeth A.; Prendergast, Michael L.; Roll, John M.; Warda, Umme

2010-01-01

This study assessed a 26-week voucher-based intervention to reinforce abstinence and participation in treatment-related activities among substance-abusing offenders court referred to outpatient treatment under drug diversion legislation (California's Substance Abuse and Crime Prevention Act). Standard treatment consisted of criminal justice supervision and an evidence-based model for treating stimulant abuse. Participants were randomly assigned to four groups, standard treatment (ST) only, ST plus vouchers for testing negative, ST plus vouchers for performing treatment plan activities, and ST plus vouchers for testing negative and/or performing treatment plan activities. Results indicate that voucher-based reinforcement of negative urines and of treatment plan tasks (using a flat reinforcement schedule) showed no statistically significant effects on measures of retention or drug use relative to the standard treatment protocol. It is likely that criminal justice contingencies had a stronger impact on participants' treatment retention and drug use than the relatively low-value vouchers awarded as part of the treatment protocol. PMID:20463918

Realising the Mass Public Benefit of Evidence-Based Psychological Therapies: The IAPT Program

PubMed Central

Clark, David M

2018-01-01

Empirically supported psychological therapies have been developed for many mental health conditions. However, in most countries only a small proportion of the public benefit from these advances. The English Improving Access to Psychological Therapies (IAPT) program aims to bridge the gap between research and practice by training over 10,500 new psychological therapists in empirically supported treatments and deploying them in new services for the treatment of depression and anxiety disorders. Currently IAPT treats over 560,000 patients per year, obtains clinical outcome data on 98.5% of these individuals and places this information in the public domain. Around 50% of patients treated in IAPT services recover and two-thirds show worthwhile benefits. The clinical and economic arguments on which IAPT is based are presented, along with details of the service model, how the program was implemented, and recent findings about service organization. Limitations and future directions are outlined. PMID:29350997

Statements on the interdependence between the oncologist and the geriatrician in geriatric oncology.

PubMed

Terret, Catherine; Zulian, Gilbert; Droz, Jean-Pierre

2004-11-01

Geriatric oncology is defined by the multidimensional and multidisciplinary approach of the elderly cancer patients. Autonomy, beneficence, non-maleficence and justice are the four fundamental principles on which are based the treatment objectives and practical management of these patients. The comprehensive geriatric assessment is the tool the most likely to detect the functional problems in these elderly patients. The standard oncologic managements of cancer are applicable to these patients. However treatment plan and geriatric interventions must be tailored to each individual patient characteristics. Thus a strong interdependence between oncologic and geriatric teams is warranted. This implies specific teaching programs during initial medical studies and in the setting of continuous medical education. Furthermore, such worldwide teaching programs may help to the implementation of geriatric oncology programs which is only based, to date, on personal experiences as described in this report.

Randomized Controlled Trial Comparing Orthosis Augmented by Either Stretching or Stretching and Strengthening for Stage II Tibialis Posterior Tendon Dysfunction.

PubMed

Houck, Jeff; Neville, Christopher; Tome, Josh; Flemister, Adolph

2015-09-01

The value of strengthening and stretching exercises combined with orthosis treatment in a home-based program has not been evaluated. The purpose of this study was to compare the effects of augmenting orthosis treatment with either stretching or a combination of stretching and strengthening in participants with stage II tibialis posterior tendon dysfunction (TPTD). Participants included 39 patients with stage II TPTD who were recruited from a medical center and then randomly assigned to a strengthening or stretching treatment group. Excluding 3 dropouts, there were 19 participants in the strengthening group and 17 in the stretching group. The stretching treatment consisted of a prefabricated orthosis used in conjunction with stretching exercises. The strengthening treatment consisted of a prefabricated orthosis used in conjunction with the stretching and strengthening exercises. The main outcome measures were self-report (ie, Foot Function Index and Short Musculoskeletal Function Assessment) and isometric deep posterior compartment strength. Two-way analysis of variance was used to test for differences between groups at 6 and 12 weeks after starting the exercise programs. Both groups significantly improved in pain and function over the 12-week trial period. The self-report measures showed minimal differences between the treatment groups. There were no differences in isometric deep posterior compartment strength. A moderate-intensity, home-based exercise program was minimally effective in augmenting orthosis wear alone in participants with stage II TPTD. Level I, prospective randomized study. © The Author(s) 2015.

Developing a treatment planning process and software for improved translation of photodynamic therapy

NASA Astrophysics Data System (ADS)

Cassidy, J.; Zheng, Z.; Xu, Y.; Betz, V.; Lilge, L.

2017-04-01

Background: The majority of de novo cancers are diagnosed in low and middle-income countries, which often lack the resources to provide adequate therapeutic options. None or minimally invasive therapies such as Photodynamic Therapy (PDT) or photothermal therapies could become part of the overall treatment options in these countries. However, widespread acceptance is hindered by the current empirical training of surgeons in these optical techniques and a lack of easily usable treatment optimizing tools. Methods: Based on image processing programs, ITK-SNAP, and the publicly available FullMonte light propagation software, a work plan is proposed that allows for personalized PDT treatment planning. Starting with, contoured clinical CT or MRI images, the generation of 3D tetrahedral models in silico, execution of the Monte Carlo simulation and presentation of the 3D fluence rate, Φ, [mWcm-2] distribution a treatment plan optimizing photon source placement is developed. Results: Permitting 1-2 days for the installation of the required programs, novices can generate their first fluence, H [Jcm-2] or Φ distribution in a matter of hours. This is reduced to 10th of minutes with some training. Executing the photon simulation calculations is rapid and not the performance limiting process. Largest sources of errors are uncertainties in the contouring and unknown tissue optical properties. Conclusions: The presented FullMonte simulation is the fastest tetrahedral based photon propagation program and provides the basis for PDT treatment planning processes, enabling a faster proliferation of low cost, minimal invasive personalized cancer therapies.

Employment-based abstinence reinforcement as a maintenance intervention for the treatment of cocaine dependence: a randomized controlled trial.

PubMed

DeFulio, Anthony; Donlin, Wendy D; Wong, Conrad J; Silverman, Kenneth

2009-09-01

Due to the chronic nature of cocaine dependence, long-term maintenance treatments may be required to sustain abstinence. Abstinence reinforcement is among the most effective means of initiating cocaine abstinence. Practical and effective means of maintaining abstinence reinforcement programs over time are needed. To determine whether employment-based abstinence reinforcement can be an effective long-term maintenance intervention for cocaine dependence. Participants (n = 128) were enrolled in a 6-month job skills training and abstinence initiation program. Participants who initiated abstinence, attended regularly and developed needed job skills during the first 6 months were hired as operators in a data entry business and assigned randomly to an employment-only (control, n = 24) or abstinence-contingent employment (n = 27) group. A non-profit data entry business. Participants Unemployed welfare recipients who used cocaine persistently while enrolled in methadone treatment in Baltimore. Abstinence-contingent employment participants received 1 year of employment-based contingency management, in which access to employment was contingent upon provision of drug-free urine samples under routine and then random drug testing. If a participant provided drug-positive urine or failed to provide a mandatory sample, then that participant received a temporary reduction in pay and could not work until urinalysis confirmed recent abstinence. Cocaine-negative urine samples at monthly assessments across 1 year of employment. During the 1 year of employment, abstinence-contingent employment participants provided significantly more cocaine-negative urine samples than employment-only participants [79.3% and 50.7%, respectively; P = 0.004, odds ratio (OR) = 3.73, 95% confidence interval (CI) = 1.60-8.69]. Conclusions Employment-based abstinence reinforcement that includes random drug testing is effective as a long-term maintenance intervention, and is among the most promising treatments for drug dependence. Work-places could serve as therapeutic agents in the treatment of drug dependence by arranging long-term employment-based contingency management programs.

Exercise program for children and adolescents with leukemia and lymphoma during treatment: A comprehensive review.

PubMed

Zucchetti, Giulia; Rossi, Francesca; Chamorro Vina, Carolina; Bertorello, Nicoletta; Fagioli, Franca

2018-05-01

An exercise program (EP) during cancer treatment seems to be a valid strategy against physiological and quality-of-life impairments, but scientific evidence of benefits among pediatric patients is still limited. This review summarizes the literature focused on randomized controlled trials of EP offered to patients during leukemia and lymphoma treatment. Studies published up to June 2017 were selected from multiple databases and assessed by three independent reviewers for methodological validity. The review identified eight studies, but several types of bias have to be avoided to provide evidence-based recommendations accessible to patients, families, and professionals. © 2018 Wiley Periodicals, Inc.

Diet, exercise, behavior: the promise and limits of lifestyle change.

PubMed

Bennett, Brian; Sothern, Melinda S

2009-08-01

The prevalent surge in childhood and adolescent obesity within the past 3 decades poses a significant challenge for many pediatric clinicians who are charged with treating this condition. Comprehensive, research-based pediatric obesity treatment programs are essential to addressing this problem and preventing the transition of obesity and its many comorbidities into adulthood. This paper will identify dietary, physical activity, and behavioral approaches to lifestyle change and describe how they are incorporated as part of multidisciplinary treatment interventions in youth. Specific tailoring of treatment programs to address age and varying degrees of overweight and obesity will also be presented along with recommendations for future research.

Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes?

PubMed Central

Redler, Lauren H; Degen, Ryan M; McDonald, Lucas S; Altchek, David W; Dines, Joshua S

2016-01-01

Injury to the ulnar collateral ligament (UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes. PMID:27114930

Addiction Science: A Rationale and Tools for a Public Health Response to Drug Abuse

PubMed Central

Rawson, Richard A.; Rieckmann, Traci; Gust, Steven W.

2014-01-01

New scientific knowledge and effective, evidence-based interventions have provided health leaders and policymakers a remarkable paradigm to guide the development of addiction treatment services around the world. The definition of addiction as a brain disease, validated screening and assessment tools, medication-assisted treatment, and effective behavioral treatments have served as vehicles for both the United States and other countries to guide the transformation of their substance abuse treatment systems. Seeking to expand international research and infrastructure, the National Institute on Drug Abuse (NIDA)'s International Program has engaged international investigators and institutions in addiction research to promote dissemination of addiction science globally. This paper presents three mixed-methods case studies to exemplify the use of advancements in evidence-based practice in addiction treatment as guides and tools for the creation or further development of treatment systems in three countries, Vietnam, Lebanon, and Abu Dhabi. Results indicate that a framework of evidence-based medicine and empirical science creates a necessary platform from which objective conversations about addictions may begin. Other facilitative factors that help create treatment programs internationally include: a receptive and supportive government, support from international donors and technical experts, networking and interest from other international organizations, and often a synergistic and concerted effort by multiple entities and partners. Despite substantial differences in the circumstances that generated these initiatives and the varying scope of the services, common themes across these efforts have been the implementation of science-based approaches to systems transformation and support for a public health approach to addressing drug abuse and addiction. PMID:26752803

A social marketing model for disseminating research-based treatments to addictions treatment providers.

PubMed

Martin, G W; Herie, M A; Turner, B J; Cunningham, J A

1998-11-01

Researchers must develop effective strategies for disseminating research-based treatments. This study evaluates the application of a dissemination model based on principles of social marketing and diffusion theory. A case study describes how the model was implemented. A qualitative design was employed to examine rates of adoption and adaptation of an early intervention program by a targeted system of addictions agencies. The interventions were developed at the Addiction Research Foundation in Toronto and disseminated to Assessment and Referral (A/R) Centres in Ontario, Canada. Study participants included the managers and a designated therapist for 33 participating A/R centres. Managers were asked mainly open-ended questions concerning whether their agency had made a formal decision to adopt the intervention and whether therapists in their agency were using the early intervention program. "Adoption" was operationalized as offering the complete four-session intervention to at least one client. At 12 months after the completion of training workshops, 68% of 34 agencies in the target system had adopted the program while 85% of the agencies were using some components of the intervention with clients. The dissemination model appeared to be effective although its application proved to be time-consuming and labour-intensive. The "market analysis", systems focus and field-test components of the model appeared to contribute to its success.

76 FR 45259 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... OMB Review; Comment Request Title: Child Abuse Prevention Program. OMB No.: 0970-0155. Description... Prevention of Child Abuse and Neglect (administratively known as the Community Based Child Abuse Prevention Program, (CBCAP), as set forth in Title II of Public Law 111-320, Child Abuse Prevention and Treatment Act...

Teacher-Implemented Behavior Modification in a Case of Organically Based Epilepsy

ERIC Educational Resources Information Center

Balaschak, Barbara A.

1976-01-01

Significant reduction of seizures in an 11-year-old girl was achieved through a contingency management program implemented by her classroom teacher. The program was designed to shift the focus from her actual seizures to her seizure-free time periods. Seizures diminished over the total treatment period. (Author)

Effective Prototype Costing Policies in Research Universities: Are They Possible?

ERIC Educational Resources Information Center

McClure, Maureen W.; Abu-Duhou, Ibtisam

Policy problems of prototype costing at research universities are discussed, based on a case study of a clinical treatment prototype program at a research university hospital. Prototypes programs generate reproducible knowledge with useful applications and are primarily developed in professional schools. The potential of using costing prototypes…

Predicting Treatment Success in Social Skills Training for Adolescents with Autism Spectrum Disorders: The UCLA Program for the Education and Enrichment of Relational Skills

ERIC Educational Resources Information Center

Chang, Ya-Chih; Laugeson, Elizabeth A.; Gantman, Alexander; Ellingsen, Ruth; Frankel, Fred; Dillon, Ashley R.

2014-01-01

This study seeks to examine the predictors of positive social skills outcomes from the University of California, Los Angeles Program for the Education and Enrichment of Relational Skills, an evidence-based parent-assisted social skills program for high-functioning middle school and high school adolescents with autism spectrum disorders. The…

The Effect of the Threat of Legal Sanction on Program Retention and Completion: Is that Why They Stay in Drug Court?

ERIC Educational Resources Information Center

Hepburn, John R.; Harvey, Angela N.

2007-01-01

Drug courts routinely rely on the threat of legal sanction to motivate drug-using criminal offenders to enter and complete community-based treatment programs. In light of the high failure rates among drug court participants, what is the effect of the threat of legal sanction on program retention and completion? A quasiexperimental research design…

State policy influence on the early diffusion of buprenorphine in community treatment programs.

PubMed

Ducharme, Lori J; Abraham, Amanda J

2008-06-20

Buprenorphine was approved for use in the treatment of opioid dependence in 2002, but its diffusion into everyday clinical practice in community-based treatment programs has been slow. This study examines the net impact of efforts by state agencies, including provision of Medicaid coverage, on program-level adoption of buprenorphine as of 2006. Interviews were conducted with key informants in 49 of the 50 state agencies with oversight responsibility for addiction treatment services. Information from these interviews was integrated with organizational data from the 2006 National Survey of Substance Abuse Treatment Services. A multivariate logistic regression model was estimated to identify the effects of state efforts to promote the use of this medication, net of a host of organizational characteristics. The availability of Medicaid coverage for buprenorphine was a significant predictor of its adoption by treatment organizations. Inclusion of buprenorphine on state Medicaid formularies appears to be a key element in ensuring that patients have access to this state-of-the-art treatment option. Other potential barriers to the diffusion of buprenorphine require identification, and the value of additional state-level policies to promote its use should be evaluated.

The first decade of the National Drug Abuse Treatment Clinical Trials Network: bridging the gap between research and practice to improve drug abuse treatment.

PubMed

Tai, Betty; Straus, Michele M; Liu, David; Sparenborg, Steven; Jackson, Ron; McCarty, Dennis

2010-06-01

The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999 to improve the quality of addiction treatment using science as the vehicle. The network brings providers from community-based drug abuse treatment programs and scientists from university-based research centers together in an alliance that fosters bidirectional communication and collaboration. Collaboration enhanced the relevance of research to practice and facilitated the development and implementation of evidence-based treatments in community practice settings. The CTN's 20 completed trials tested pharmacological, behavioral, and integrated treatment interventions for adolescents and adults; more than 11,000 individuals participated in the trials. This article reviews the rationale for the CTN, describes the translation of its guiding principles into research endeavors, and anticipates the future evolution of clinical research within the Network.

The First Decade of the National Drug Abuse Treatment Clinical Trials Network: Bridging the Gap Between Research and Practice to Improve Drug Abuse Treatment

PubMed Central

Tai, Betty; Straus, Michele M.; Liu, David; Sparenborg, Steven; Jackson, Ron; McCarty, Dennis

2010-01-01

The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999 to improve the quality of addiction treatment using science as the vehicle. The network brings providers from community-based drug abuse treatment programs and scientists from university-based research centers together in an alliance that fosters bi-directional communication and collaboration. Collaboration enhanced the relevance of research to practice and facilitated the development and implementation of evidence-based treatments in community practice settings. The CTN’s 20 completed trials tested pharmacological, behavioral, and integrated treatment interventions for adolescents and adults; more than 11,000 individuals participated in the trials. This paper reviews the rationale for the CTN, describes the translation of its guiding principles into research endeavors, and anticipates the future evolution of clinical research within the Network. PMID:20307794

Cognitive Restructuring and a Collaborative Set in Couples' Work.

ERIC Educational Resources Information Center

Huber, Charles H.; Milstein, Barbara

1985-01-01

Investigated effects of cognitive restructuring efforts to modify unrealistic beliefs of marital partners in 17 couples. Treatment program sought to impact proactively upon positive therapeutic expectations and relationship goals and enhanced base level of marital satisfaction. On all outcome measures, treatment group (N=9 couples) showed…

Altruism, Empathy, and Sex Offender Treatment

ERIC Educational Resources Information Center

Ward, Tony; Durrant, Russil

2013-01-01

Treatment programs for serious offenders such as sex offenders typically include an empathy training component as part of a comprehensive intervention package. The reasons for doing so are partly based on research evidence indicating that social disconnection and relationship ruptures related to empathy failures often trigger offending, and also…

Social Support among Offenders with Substance Abuse Problems: Overlooked and Underused?

ERIC Educational Resources Information Center

Lemieux, Catherine M.

2002-01-01

The author examined correlates of social support among 101 offenders in corrections-based treatment programs. Respondents perceived high levels of support despite numerous interpersonal problems. Social support was significantly associated with visits, letters, arrests, and days in treatment. The author describes strategies for implementing…

[Diagnosis and treatment of child and adolescent depression].

PubMed

Bunge, Eduardo L; Carrea, Gabriela; Tosas de Molina, Mar; Soto, Natalie

2011-01-01

The present paper reviews the available literature on the current state of knowledge regarding depression in children and adolescents. Empirically supported psychotherapeutic treatment adjustments for children are described, such as the Self-Control Therapy (CBT), Penn Prevention Program; and other treatments that are experimental phase. Similarly empirically supported psychotherapeutic treatment adjustments for adolescents are described, such as Adolescent Coping with Depression, Interpersonal Psychotherapy; and other treatments that are experimental phase as Biblotherapy and Attachment-Based Family Therapy.

Income Levels and Response to Contingency Management for Smoking Cessation.

PubMed

López-Núñez, Carla; Secades-Villa, Roberto; Peña-Suárez, Elsa; Fernández-Artamendi, Sergio; Weidberg, Sara

2017-06-07

Contingency management (CM) has demonstrated its efficacy in treating many drug addictions, including nicotine. However, one of the most commonly perceived limitations with regard to its dissemination into community settings is whether this protocol could be equally effective for treating patients across different income levels. This study aimed to examine whether individuals' income levels affect treatment success in a cognitive behavioral treatment (CBT) that included a voucher-based CM protocol for smoking cessation. A total of 92 treatment-seeking smokers in a community setting were randomly assigned to a CBT group (N = 49) or to a CBT plus CM group (N = 43). The CM procedure included a voucher program through which smoking abstinence was reinforced on a schedule of escalating magnitude of reinforcement with a reset contingency. We analyzed the impact of self-reported monthly income, alone and in combination with treatment condition, on short-term (treatment retention) and long-term (self-reported number of days of continuous smoking abstinence at 6-month follow-up) results. Income had no effect on treatment retention and continuous abstinence outcomes at 6-month follow-up in either treatment condition. Treatment modality emerged as the only significant predictor of treatment success. Our findings suggest that treatment-seeking smokers from the general population respond equally well to CM regardless of their income levels. The results of this randomized controlled trial support the generalizability of this evidenced-based program into community settings.

Ultrasound visual feedback treatment and practice variability for residual speech sound errors

PubMed Central

Preston, Jonathan L.; McCabe, Patricia; Rivera-Campos, Ahmed; Whittle, Jessica L.; Landry, Erik; Maas, Edwin

2014-01-01

Purpose The goals were to (1) test the efficacy of a motor-learning based treatment that includes ultrasound visual feedback for individuals with residual speech sound errors, and (2) explore whether the addition of prosodic cueing facilitates speech sound learning. Method A multiple baseline single subject design was used, replicated across 8 participants. For each participant, one sound context was treated with ultrasound plus prosodic cueing for 7 sessions, and another sound context was treated with ultrasound but without prosodic cueing for 7 sessions. Sessions included ultrasound visual feedback as well as non-ultrasound treatment. Word-level probes assessing untreated words were used to evaluate retention and generalization. Results For most participants, increases in accuracy of target sound contexts at the word level were observed with the treatment program regardless of whether prosodic cueing was included. Generalization between onset singletons and clusters was observed, as well as generalization to sentence-level accuracy. There was evidence of retention during post-treatment probes, including at a two-month follow-up. Conclusions A motor-based treatment program that includes ultrasound visual feedback can facilitate learning of speech sounds in individuals with residual speech sound errors. PMID:25087938

Treatment Effects for Older Struggling Readers: An Application of Moderated Mediation.

PubMed

Roberts, Greg; Fletcher, Jack M; Stuebing, Karla K; Barth, Amy E; Vaughn, Sharon

2013-02-01

This study used multigroup structural equations to evaluate the possibility that a theory-driven, evidence-based, yearlong reading program for sixth-grade struggling readers moderates the interrelationships among elements of the simple model of reading (i.e., listening comprehension, word reading, and reading comprehension; Hoover & Gough, 1990). Our specific interest was in the relation of theory, program, and evaluation. Our motivating assumptions were that 1) a well-designed, theory-based program affects performance in predictable ways and that 2) treatment effects may be present even when group differences in posttest means are not robust. The analysis sample comprised 327 students, 113 in the business-as-usual condition and 214 in treatment. We pretested students in the fall of sixth grade and collected posttest data in the fall of seventh grade. There were 217 cases in the posttest sample, 47 comparison students and 170 treatment students at posttest. The findings support the possibility that treated sixth-grade students improved in response to an intensive, yearlong intervention, when conceptualizing change in terms of predictable interrelationships of important underlying skills, rather than in terms of group mean differences at posttest. Specifically, the results suggest that verbal knowledge is less proximal to the reading comprehension of students who have become proficient in the use of text processing and reading comprehension strategies.

Treatment Effects for Older Struggling Readers: An Application of Moderated Mediation

PubMed Central

Roberts, Greg; Fletcher, Jack M.; Stuebing, Karla K.; Barth, Amy E.; Vaughn, Sharon

2012-01-01

This study used multigroup structural equations to evaluate the possibility that a theory-driven, evidence-based, yearlong reading program for sixth-grade struggling readers moderates the interrelationships among elements of the simple model of reading (i.e., listening comprehension, word reading, and reading comprehension; Hoover & Gough, 1990). Our specific interest was in the relation of theory, program, and evaluation. Our motivating assumptions were that 1) a well-designed, theory-based program affects performance in predictable ways and that 2) treatment effects may be present even when group differences in posttest means are not robust. The analysis sample comprised 327 students, 113 in the business-as-usual condition and 214 in treatment. We pretested students in the fall of sixth grade and collected posttest data in the fall of seventh grade. There were 217 cases in the posttest sample, 47 comparison students and 170 treatment students at posttest. The findings support the possibility that treated sixth-grade students improved in response to an intensive, yearlong intervention, when conceptualizing change in terms of predictable interrelationships of important underlying skills, rather than in terms of group mean differences at posttest. Specifically, the results suggest that verbal knowledge is less proximal to the reading comprehension of students who have become proficient in the use of text processing and reading comprehension strategies. PMID:23472048

Orthopaedic Surgeon Burnout: Diagnosis, Treatment, and Prevention.

PubMed

Daniels, Alan H; DePasse, J Mason; Kamal, Robin N

2016-04-01

Burnout is a syndrome marked by emotional exhaustion, depersonalization, and low job satisfaction. Rates of burnout in orthopaedic surgeons are higher than those in the general population and many other medical subspecialties. Half of all orthopaedic surgeons show symptoms of burnout, with the highest rates reported in residents and orthopaedic department chairpersons. This syndrome is associated with poor outcomes for surgeons, institutions, and patients. Validated instruments exist to objectively diagnose burnout, although family members and colleagues should be aware of early warning signs and risk factors, such as irritability, withdrawal, and failing relationships at work and home. Emerging evidence indicates that mindfulness-based interventions or educational programs combined with meditation may be effective treatment options. Orthopaedic residency programs, departments, and practices should focus on identifying the signs of burnout and implementing prevention and treatment programs that have been shown to mitigate symptoms.

EFFECT OF JOB SKILLS TRAINING ON EMPLOYMENT AND JOB SEEKING BEHAVIORS IN AN AMERICAN INDIAN SUBSTANCE ABUSE TREATMENT SAMPLE

PubMed Central

Foley, K.; Pallas, D.; Forcehimes, A. A.; Houck, J. M.; Bogenschutz, M. P.; Keyser-Marcus, L.; Svikis, D.

2011-01-01

Employment difficulties are common among American Indian individuals in substance abuse treatment. To address this problem, the Southwest Node of NIDA’s Clinical Trials Network conducted a single-site adaptation of its national Job Seekers Workshop study in an American Indian treatment program, Na’Nizhoozhi Center (NCI). 102 (80% men, 100% American Indian) participants who were in residential treatment and currently unemployed were randomized to (1) a three session, manualized program (Job seekers workshop: JSW) or (2) a 40-minute Job Interviewing Video: JIV). Outcomes were assessed at 3-month follow up: 1) number of days to a new taxed job or enrollment in a job-training program, and 2) total hours working or enrolled in a job-training program. No significant differences were found between the two groups for time to a new taxed job or enrollment in a job-training program. There were no significant differences between groups in substance use frequency at 3-month follow-up. These results do not support the use of the costly and time-consuming JSW intervention in this population and setting. Despite of the lack of a demonstrable treatment effect, this study established the feasibility of including a rural American Indian site in a rigorous CTN trial through a community-based participatory research approach. PMID:21818173

28 CFR 33.53 - Participation by faith-based organizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Participation by faith-based... GRANT PROGRAMS Criminal Justice Block Grants Additional Requirements § 33.53 Participation by faith... standards set forth in part 38 (Equal Treatment for Faith-based Organizations) of this chapter. [Order No...

28 CFR 33.53 - Participation by faith-based organizations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Participation by faith-based... GRANT PROGRAMS Criminal Justice Block Grants Additional Requirements § 33.53 Participation by faith... standards set forth in part 38 (Equal Treatment for Faith-based Organizations) of this chapter. [Order No...

28 CFR 33.53 - Participation by faith-based organizations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Participation by faith-based... GRANT PROGRAMS Criminal Justice Block Grants Additional Requirements § 33.53 Participation by faith... standards set forth in part 38 (Equal Treatment for Faith-based Organizations) of this chapter. [Order No...

28 CFR 33.53 - Participation by faith-based organizations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Participation by faith-based... GRANT PROGRAMS Criminal Justice Block Grants Additional Requirements § 33.53 Participation by faith... standards set forth in part 38 (Equal Treatment for Faith-based Organizations) of this chapter. [Order No...

28 CFR 33.53 - Participation by faith-based organizations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Participation by faith-based... GRANT PROGRAMS Criminal Justice Block Grants Additional Requirements § 33.53 Participation by faith... standards set forth in part 38 (Equal Treatment for Faith-based Organizations) of this chapter. [Order No...

Nurse-Led School-Based Child Obesity Prevention

ERIC Educational Resources Information Center

Tucker, Sharon; Lanningham-Foster, Lorraine M.

2015-01-01

School-based childhood obesity prevention programs have grown in response to reductions in child physical activity (PA), increased sedentariness, poor diet, and soaring child obesity rates. Multiple systematic reviews indicate school-based obesity prevention/treatment interventions are effective, yet few studies have examined the school nurse role…

Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program.

PubMed

Marques, Andrea Horvath; Oliveira, Paula Approbato; Scomparini, Luciana Burim; Silva, Uiara Maria Rêgo E; Silva, Angelica Cristine; Doretto, Victoria; de Medeiros Filho, Mauro Victor; Scivoletto, Sandra

2015-01-01

The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries ("LMICs"). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program ("TEP"), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP's implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP's social impact, challenges, and limitations. The program's goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program's cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.

Impact of a Non-small Cell Lung Cancer Educational Program for Interdisciplinary Teams.

PubMed

Murgu, Septimiu; Rabito, Robb; Lasko, Greg; Jackson, Chad; Mino-Kenudson, Mari; Ettinger, David S; Ramalingam, Suresh S; Edell, Eric S

2018-04-01

Successful implementation of non-small cell lung cancer (NSCLC) evidence-based guideline recommendations requires effective educational programs that target all clinicians from interdisciplinary teams. This study describes and evaluates the Engaging an Interdisciplinary Team for NSCLC (GAIN 3.0) experiential learning-based educational curriculum. GAIN 3.0 was designed to enhance interdisciplinary collaboration for effective NSCLC diagnosis, assessment, and treatment. The program used a flipped classroom model that included an e-learning component prior to a live 6-hour interactive program. The interactive program included hands-on simulations, small group workshops, gamification, and case discussions. Participants included academic and community members of multidisciplinary lung cancer teams. Assessments included an online baseline survey, a pretest and posttest, a program evaluation, a long-term survey (LTS), and on-site faculty evaluation of participants. Of 416 attendees to 13 live GAIN 3.0 programs (nine in the United States and four in Europe), 304 (73%) completed the pretest and 187 (45%) completed the posttest. Out of a perfect score of 12 points, program participants had a mean test score of 6.3 ± 2.1 on the pretest (52%) and 7.8 ± 2.1 on the posttest (65%) (P = .03). There was an overall knowledge increase of 13% from pretest to posttest. Most LTS respondents (65%) rated the GAIN 3.0 live programs as "high impact." On the LTS, the areas with the greatest gains in participants who had very high confidence were communication across disciplines, use of a team-based approach, and personalized treatment. GAIN 3.0 was a highly successful interdisciplinary activity that improved participants' knowledge, competence, and likely the clinical care provided to patients with NSCLC. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia.

PubMed

Letebo, Mekitew; Shiferaw, Fassil

2016-06-02

Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organized and comprehensive response to NCDs. Lack of NCD national policy, strategies, treatment guidelines and surveillance and monitoring systems are features of health systems in many developing countries. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardization of patient and program monitoring tools. In this cross-sectional qualitative study we assessed existing monitoring and evaluation (M&E) tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, we explored the M&E tools being used in the program and analyzed how these tools might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data. Our findings indicate the apparent lack of information systems for NCD services, including the absence of standardized patient and program monitoring tools to support the services. We identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented. Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardized tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardizing patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.