Ready to Change: a scheduled telephone counselling programme for problem gambling

Participants' Experiences of a Workplace-Oriented Problem Gambling Prevention Program for Managers and HR Officers: A Qualitative Study

Workplace health promotion programs (WHPPs) refer to a set of health promotion and protection strategies implemented at a worksite and designed to meet the health and safety needs of employees. One important question for WHPPs is how middle management experience their participation in a WHPP. This study aims to explore this question further by applying a qualitative content analysis to interviews with thirteen managers and ten human resource officers participating in a WHPP focusing on problem gambling. The WHPP consisted of two components: policy implementation and skills-development training. The participants were interviewed about their experiences of these two components and the implementation process. The qualitative content analysis resulted in six themes: (1) Expectations of the skills-development training, (2) Experiences of and prior beliefs about problem gambling, (3) A good foundation, (4) The difficult conversation, (5) Appreciated aspects of the training sessions, and (6) Remaining obstacles. The results suggest that the presentation of cases, facts, and general knowledge was appreciated by most participants. However, participants also expressed that they would benefit from tailored interventions, more support in the policy implementation process, and following up on the results.

Longitudinal Study of Effectiveness of a Patient-Centered Self-Management Empowerment Intervention During Predischarge Planning on Stroke Survivors

PURPOSE

To examine the effectiveness of a patient-centered self-management empowerment intervention (PCSMEI) on self-efficacy, activities of daily living (ADL), and rehospitalization of first-time stroke survivors.

METHODS

One hundred forty-four first-time stroke survivors were recruited from a comprehensive hospital in China. The intervention group (IG; n = 72) received a PCSMEI, whereas the control group (CG; n = 72) received routine care. The data on self-efficacy and ADL were collected at baseline (T0), on discharge (T1), 1-month postdischarge (T2), and 3 months postdischarge (T3) while the rehospitalization was collected at T2 and T3. The general estimation equations model was used to examine the effects of the PCSMEI program on the outcome variables.

RESULTS

One hundred twenty-six participants finished the study (IG: n = 64; CG: n = 62). Compared with the CG, patients in the IG showed significant higher level in self-efficacy on discharge (p = .014), 1-month postdischarge (p = .008), and 3 months postdischarge (p = .023), and higher level in ADL at 3 months postdischarge (p = .044). The rehospitalization rate of the IG was lower than that in the CG at 1-month postdischarge and 3 months postdischarge, which had clinical significance.

LINKING EVIDENCE TO ACTION

PCSMEI is of great value to stroke patients. This paper forms the basis for more widespread implementation of PCSMEI.

The New England 4G framework for the treatment of a common health concerns: a gambling case analysis

Approaches using self-help have proved successful at treating a range of mental and physical conditions. Guidance by a trained worker enhances the effects of self-help materials, in particular those based on Cognitive-Behavior Therapy. In the United Kingdom, the Improving Access to Psychological Therapies (IAPT) program was introduced to provide better outcomes for people experiencing mild or moderate anxiety and depression. This stepped care approach included low intensity, guided self-help offered by a newly trained workforce of Psychological Wellbeing Workers. The IAPT program has been extensively evaluated and shown to be cost effective and leads to positive treatment outcomes. This paper describes how the IAPT model has been adapted for use in Australia with gamblers. Two case studies illustrate the application of this guided approach to systematically accessing existing self-help treatments for problem gamblers. Assessment information is gathered, before a plan of action, including a problem statement and achievable goals, is agreed upon by the worker and the person with the gambling problem. The worker then gives the person options based on self-help CBT interventions and, once an option has been chosen, the worker guides the person as they work through various activities. The benefits of this approach are discussed.