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Dunn Navarra AM, Gormley M, Liang E, Loughran C, Vorderstrasse A, Garcia DR, Rosenberg MG, Fletcher J, Goldsamt LA. Developing and testing a web-based platform for antiretroviral therapy (ART) adherence support among adolescents and young adults (AYA) living with HIV. PEC Innov 2024; 4:100263. [PMID: 38463238 PMCID: PMC10920727 DOI: 10.1016/j.pecinn.2024.100263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/12/2024]
Abstract
Objective Describe the development and testing of a web-based platform for antiretroviral treatment (ART) adherence support among HIV+ adolescents and young adults (AYA) in a randomized controlled trial (RCT). Methods A seven-member multi-disciplinary team operationalized the flat, password protected, web-based platform. Manualized protocols guided the objectives and content for each of the eight web-based sessions. Team members evaluated usability and content validity. Client satisfaction and perceived ease of use was evaluated with the first ten HIV+ AYA participants. Results The web-based platform was developed, evaluated, refined, implemented and pilot tested between September 2020 to April 2022. Usability was rated as high; the evaluation of content validity showed an excellent fit between session content and objectives. HIV+ AYA participants (mean age = 24.2 years) were satisfied with the quality, type, and amount of support/education received, and found the platform easy to use, operate, and navigate. Average time spent per session was 6.5 min. Conclusion Findings support the usability, validity, acceptability, and feasibility of this web-based platform for ART adherence support among HIV+ AYA. Innovation Our research and findings are responsive to research gaps and the need for transparency in the methodological development and testing of web-based control arms for ART adherence support among HIV+ AYA.
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Affiliation(s)
- Ann-Margaret Dunn Navarra
- StonyBrook University, School of Nursing, 101 Nicolls Road, Health Sciences Center, Level 2, StonyBrook, NY 11794, USA
| | - Maurade Gormley
- University of Connecticut, School of Nursing, 231 Glenbrook Road, Storrs, CT 06269, USA
| | - Eva Liang
- New York University, Rory Meyers College of Nursing, 380 Second Avenue, New York, NY 10010, USA
| | - Claire Loughran
- New York University, Rory Meyers College of Nursing, 380 Second Avenue, New York, NY 10010, USA
| | - Allison Vorderstrasse
- University of Massachusetts Amherst, Elaine Marieb College of Nursing, 651 N Pleasant St., Amherst, MA 01003, USA
| | - David R. Garcia
- New York University, Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, USA
| | - Michael G. Rosenberg
- Division of Infectious Diseases, Department of Pediatrics, Jacobi Medical Center, Bronx, NY, 10461, USA
| | - Jason Fletcher
- New York University, Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, USA
| | - Lloyd A. Goldsamt
- New York University, Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, USA
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2
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Kennedy MA, Stevens CJ, Pepin R, Lyons KD. Behavioral Activation: Values-Aligned Activity Engagement as a Transdiagnostic Intervention for Common Geriatric Conditions. Gerontologist 2024; 64:gnad046. [PMID: 37068017 PMCID: PMC10943502 DOI: 10.1093/geront/gnad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Indexed: 04/18/2023] Open
Abstract
Scalable, transdiagnostic interventions are needed to meet the needs of a growing population of older adults experiencing multimorbidity and functional decline. Behavioral activation (BA) is a pragmatic, empirically supported treatment for depression that focuses on increasing engagement in values-aligned activities. We propose BA is an ideal transdiagnostic intervention approach for older adults because it (a) specifically targets activity restriction, a shared characteristic of common conditions of aging; and (b) has strong potential for scalability through delivery by a broad range of clinician and nonclinician interventionists and via telehealth. We describe the history of BA and review recent literature demonstrating impacts beyond depression including on cognition, social isolation, and disability. We also describe the feasibility of delivering BA across interventionists, settings, and modalities. Our approach advances scholarship by proposing BA as a scalable, transdiagnostic behavioral intervention to address functional decline in older adults with common geriatric conditions.
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Affiliation(s)
- Meaghan A Kennedy
- New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Courtney J Stevens
- Department of Psychiatry, Dartmouth-Hitchcock Medicine Center, Lebanon, New Hampshire, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Renée Pepin
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Kathleen D Lyons
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, Massachusetts, USA
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Baiden KMP, Williams ZJ, Schuck RK, Dwyer P, Wang M. The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults. J Autism Dev Disord 2024:10.1007/s10803-024-06297-3. [PMID: 38470531 DOI: 10.1007/s10803-024-06297-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/14/2024]
Abstract
Many in the autistic community have expressed concerns regarding the use of behavioral interventions with autistic children, suggesting that these interventions may not be socially valid. Though behavioral interventions have evolved to be more naturalistic and child-centered, little structured research has been done to explicitly seek autistic perspectives on the acceptability of specific components of behavioral interventions. Autistic adults (N = 235) were recruited online to take the Autism Intervention Attitudes Scale (AIAS), a questionnaire designed to gather feedback on common intervention goals and practices. Results indicate that participants find goals and practices that highlight quality of life, safety, and autistic interactions acceptable, while those that focus on normalization based on neurotypical standards are not. An exploratory graph analysis revealed three communities of goals ("uncontroversial goals", "controversial goals", and "social goals"). Comparison between naturalistic and structured intervention components additionally showed that autistic participants favored naturalistic strategies. These findings are in line with known criticisms of behavioral intervention from autistic adults, but also provide more information on the specific ways in which behavioral interventions can be reformed. This information can guide professionals in the development of appropriate goals and decisions around intervention planning.
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Affiliation(s)
- Kaitlynn M P Baiden
- Gevirtz Graduate School of Education, University of California, Santa Barbara, USA.
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, USA
| | - Rachel K Schuck
- Gevirtz Graduate School of Education, University of California, Santa Barbara, USA
| | - Patrick Dwyer
- Department of Psychology, University of California, Davis, Davis, USA
- Center for Mind and Brain, University of California, Davis, Davis, USA
- Olga Tennison Autism Research Centre (OTARC), School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Mian Wang
- Gevirtz Graduate School of Education, University of California, Santa Barbara, USA
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Bashian HM, Boyle JT, Correa S, Driver J, Madrigal C, Desroches I, Farrell M, Eiten O, Flanagan K, Shahal T, O'Malley KA. Implementation of STAR-VA for behavioral symptoms of dementia in acute care: Lessons learned. Geriatr Nurs 2024; 57:17-22. [PMID: 38452494 DOI: 10.1016/j.gerinurse.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
As the population grows, the incidence of dementia will increase. A common occurrence in people with dementia is behavioral and psychological symptoms of dementia (BPSD). BPSD can include apathy, aggression, resistance to care, and agitation. BPSD can start or worsen during an acute hospitalization, but these units are not well-equipped to handle BPSD, often relying on pharmacological interventions to address distress behaviors. One known behavioral intervention for BPSD is STAR-VA, an interdisciplinary approach to managing these behaviors. However, this intervention has not been utilized in acute care. Our team implemented STAR-VA in acute care at a Veterans Affairs hospital in the northeastern United States. Using the VA's Quality Enhancement Research Initiative (QUERI) implementation roadmap to guide our work, we first outlined the problem, completed a needs assessment with staff, and began implementation. Results from this quality improvement project demonstrated the feasibility and efficacy of STAR-VA in an acute care setting.
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Affiliation(s)
- Hannah M Bashian
- VA Boston Healthcare System, United States; Harvard Medical School, United States.
| | - Julia T Boyle
- VA Boston Healthcare System, United States; New England Geriatric Research Education and Clinical Center, United States; Harvard Medical School, United States
| | | | - Jane Driver
- VA Boston Healthcare System, United States; Harvard Medical School, United States
| | | | | | | | | | | | - Talya Shahal
- VA Boston Healthcare System, United States; Boston University Chobanian & Avedisian School of Medicine, United States; Harvard Medical School, United States
| | - Kelly A O'Malley
- VA Boston Healthcare System, United States; New England Geriatric Research Education and Clinical Center, United States; Harvard Medical School, United States
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5
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Vincent LB, Stone-Heaberlin M, Kandarpa K, McIntire H, Turner K, Krebs K. Clinical Outcomes from an Interdisciplinary Outpatient Feeding Treatment Pilot Program. J Clin Psychol Med Settings 2024; 31:208-223. [PMID: 37178340 PMCID: PMC10182748 DOI: 10.1007/s10880-023-09963-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
Many children with developmental disabilities experience feeding challenges, including food refusal and food selectivity. Feeding concerns are often multifaceted and, therefore, an interdisciplinary approach to treatment is needed. A pilot of an interdisciplinary outpatient feeding program was conducted in a hospital medical center by psychologists and occupational therapists. The pilot program focused on caregiver training and improvements in targeted feeding goals in both the clinic and home settings. Treatment outcomes from this pilot program found increases in bite acceptance, decreases in inappropriate mealtime behaviors, increases in caregiver-reported number of foods consumed, and mastery of most individualized feeding goals for children who participated in the treatment program. Additionally, caregivers reported decreased concerns related to feeding and increased confidence in addressing their child's feeding concerns after participation in the treatment. Caregivers also reported high levels of satisfaction with this pilot program and reported the intervention to be feasible.
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Affiliation(s)
- Lori B Vincent
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- School of Human Services, School Psychology Programs, University of Cincinnati, 450B Teacher-Dyer Complex, Cincinnati, OH, 45221, USA.
| | - Meg Stone-Heaberlin
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Kavya Kandarpa
- School of Human Services, School Psychology Programs, University of Cincinnati, 450B Teacher-Dyer Complex, Cincinnati, OH, 45221, USA
| | - Hannah McIntire
- School of Human Services, School Psychology Programs, University of Cincinnati, 450B Teacher-Dyer Complex, Cincinnati, OH, 45221, USA
| | - Krystin Turner
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kathy Krebs
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Woodford EC, McLay LK, France KG, Blampied NM. The Lighter Touch: Less-Restriction in Sequentially Implemented Behavioral Sleep Interventions for Children with Rare Genetic Neurodevelopmental Conditions. J Autism Dev Disord 2024:10.1007/s10803-024-06234-4. [PMID: 38324170 DOI: 10.1007/s10803-024-06234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE The prevalence of sleep difficulties among children with rare genetic neurodevelopmental conditions (RGNC) is high. Behavioral interventions are commonly used in the treatment of sleep difficulties in children with neurodevelopmental conditions such as autism, however, research is scarce in children with RGNC. The range of co-occurring complexities within this population, means there is a need for research to not only determine the effectiveness of behavioral sleep interventions, but also which components might be the least restrictive (i.e., intensive/aversive) and minimally sufficient. METHODS This study used a single-case multiple baseline design to investigate the effectiveness and acceptability of behavioral sleep interventions, indicated within a Functional Behavior formulation in eight children with RGNC (M = 7.3 years). Intervention components were sequentially administered across up to three phases, based on the principle of less restriction (from least to relatively more intensive) to determine what might be minimally sufficient. RESULTS Results showed an improvement in sleep onset latency, night wakings, early morning waking and unwanted bed-sharing for 7/7, 6/7, 3/3 and 3/3 children respectively. Improvement was observed for most participants following the less restrictive phases of intervention (circadian modifications, antecedent modifications and positive reinforcement), however, more restrictive, albeit modified, extinction procedures were still implemented for five participants. Improvements were maintained at follow-up and interventions were deemed acceptable to parents. CONCLUSIONS Less restrictive function-based behavioral strategies are an effective, and in some cases sufficient, contribution to a sequence of interventions for a range of sleep difficulties. They should be implemented first, before more restrictive strategies.
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Affiliation(s)
- Emma C Woodford
- Faculty of Health, Te Kaupeka Oranga, University of Canterbury, Christchurch, New Zealand.
| | - Laurie K McLay
- Faculty of Health, Te Kaupeka Oranga, University of Canterbury, Christchurch, New Zealand
- Child Wellbeing Research Institute, University of Canterbury, Christchurch, New Zealand
| | - Karyn G France
- Faculty of Health, Te Kaupeka Oranga, University of Canterbury, Christchurch, New Zealand
| | - Neville M Blampied
- Psychology Speech & Hearing, Faculty of Science, Te Kaupeka Pūtaiao, University of Canterbury, Christchurch, New Zealand
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7
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Thompson D, Callender C, Dave JM, Jibaja-Weiss ML, Montealegre JR. Health equity in action: using community-engaged research to update an intervention promoting a healthy home food environment to Black/African American families. Cancer Causes Control 2024; 35:311-321. [PMID: 37736870 DOI: 10.1007/s10552-023-01753-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/05/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Describe the method for conducting community-engaged research to identify needed changes for an existing evidence-based intervention, and prepare it for implementation in a community setting within the Dan L Duncan Comprehensive Cancer Center catchment area in an effort to achieve more equitable outcomes in diet-related disease risk factors. METHODS The intervention, Family Eats, was developed over 10 years ago. It works directly with parents of Black/African American 9-12 year old children to create a healthy home food environment to support prevention of obesity and related cancers. Data collection with community stakeholders occurred through a series of Community Advisory Board (CAB) meetings guided by the Delphi Technique, an iterative approach for gaining group consensus on a topic. RESULTS Key information on needed changes and potential implementation strategies were identified. Perceived level of engagement among CAB members was high overall and in terms of both quantity and quality. CONCLUSION The Delphi Technique shows promise as a method for conducting community-engaged research that promotes engagement and identifies key information needed to adapt and implement an existing intervention in a community setting.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Maria L Jibaja-Weiss
- School of Health Professions, Baylor College of Medicine, Houston, TX, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Jane R Montealegre
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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8
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Cotter R, Burns J, Kaufman K, Kudla A, Ehrlich-Jones L, Wafford QE, Heinemann AW. Effectiveness of Behavioral and Pharmacologic Interventions for Depressive Symptoms After Spinal Cord Injury: Findings From a Systematic Review. Arch Phys Med Rehabil 2024:S0003-9993(24)00037-6. [PMID: 38266762 DOI: 10.1016/j.apmr.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/10/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To summarize and evaluate evidence regarding the efficacy of interventions for depressive symptoms in adults living with spinal cord injury (SCI) and comorbid major depressive disorder or significant depressive symptoms to inform the development of clinical practice guidelines. DATA SOURCES Articles published since 2013 and available in Medline, The Cochrane Library, Embase, Scopus, CINAHL, or PsycINFO. Databases were searched in June 2022 and updated November 2023. STUDY SELECTION Inclusion criteria: age 18 years or older, traumatic SCI, and clinically significant depression (Population), mental health interventions including behavioral, pharmacologic, and complementary and alternative medicine (Intervention), inclusion of a control group (Comparator), with a primary outcome of depression symptom reduction (Outcome). Criteria were applied by multiple reviewers and disagreements were reconciled via unanimous decision among the entire research team. Eight articles of 2780 screened met the selection criteria. DATA EXTRACTION Data were extracted independently by multiple reviewers. Two reviewers independently assigned a quality score using the guidelines described by Hawker and associates and independently evaluated the risk of bias of each article using version 2 of the Cochrane risk-of-bias tool. DATA SYNTHESIS All studies assessed depressive symptoms during participant recruitment, screening, and/or at a baseline assessment stage. Pharmacotherapy with venlafaxine XR and several behavioral interventions appear promising, including an online mindfulness course and eye movement desensitization and reprocessing therapy. Remote interventions may be effective in reaching individuals who are unable to travel to in-person therapy sessions. CONCLUSIONS This systematic review provides valuable information for clinicians who treat individuals with SCI and comorbid major depressive disorder or significant depressive symptoms. It highlights the importance of considering a variety of interventions and individualizing treatment to meet individuals' needs and preferences. Future research should aim to identify effective interventions for treating depressive symptoms in individuals with SCI and optimal delivery methods for these interventions.
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Affiliation(s)
- Robert Cotter
- Shirley Ryan AbilityLab, Chicago, IL; Yale University School of Medicine, New Haven, CT.
| | | | | | | | - Linda Ehrlich-Jones
- Shirley Ryan AbilityLab, Chicago, IL; Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Q Eileen Wafford
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Allen W Heinemann
- Shirley Ryan AbilityLab, Chicago, IL; Northwestern University Feinberg School of Medicine, Chicago, IL
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Graybeal AJ, Brandner CF, Henderson A, Aultman RA, Vallecillo-Bustos A, Newsome TA, Stanfield D, Stavres J. Associations between eating behaviors and metabolic syndrome severity in young adults. Eat Behav 2023; 51:101821. [PMID: 37866123 DOI: 10.1016/j.eatbeh.2023.101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Metabolic syndrome (MetS), a precursor to cardiovascular disease and type II diabetes, is rapidly increasing in young adults. Accordingly, earlier interventions aimed at combating the onset of MetS in young adults are required. However, current behavioral interventions have failed to consider the eating behaviors that precede disease development, likely contributing to the consistently high failure rates of these interventions. The purpose of this cross-sectional study was to evaluate the associations between eating behaviors and MetS severity (MetSindex) in a sample of young adults. A sample of 104 (non-Hispanic White: 45; non-Hispanic Black: 49; Hispanic White: 5; Asian: 5) young adult (age: 23.1 ± 4.4) males and females (F:61, M:43) completed anthropometric, blood pressure, blood glucose, and blood lipid assessments; each of which were used to calculate a continuous MetSindex score. Participants also completed the revised version of the 18-item Three-factor Eating Questionnaire to measure emotional eating (EmE), uncontrolled eating (UE), and cognitive restraint (CR). EmE was positively associated with MetSindex for young adult females (p = 0.033) and non-Hispanic Black participants (p = 0.050), but not male (p = 0.506) or non-Hispanic White participants (p = 0.558). Additionally, MetSindex was greater in the highest EmE tertile compared to the lowest EmE tertile for the total sample (p = 0.037) and young adult females (p = 0.015). UE and CR were not associated with MetSindex. These data suggest a potential link between EmE and MetS severity in young adults, and that behavioral interventions aimed at MetS prevention should focus on treating the underlying EmE behaviors common in young adults, particularly for young female and Black adults at the greatest risk.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Caleb F Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Ryan A Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Ta'Quoris A Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
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Safwi SR. Autism spectrum disorder in the US: Have we done enough? Psychiatry Res 2023; 330:115595. [PMID: 37984282 DOI: 10.1016/j.psychres.2023.115595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023]
Abstract
Autism spectrum disorders (ASD) are a collection of neurodevelopmental disabilities, defined by the presence of social, behavioral and communication deficits, that are typically recognized during the first three years of life. Autism has emerged as a significant public health concern, yet there are no answers to its increasing rates. Recent data from the Autism and Developmental Disability Monitoring (ADDM) Network reported that 1 in every 36 (2.8 %) 8-year-old children were found to have autism in 2020. The current research attempts to identify the major challenges around autism care across the US such as: Inconsistent diagnosis and referral leading to delayed start of service, unequal availability of trained licensed Applied Behavioral Analysis (ABA) therapist, Inconsistent implementation of ABA interventions at various settings, Lack of support, education services and vocational opportunities for children transitioning into adulthood. This article also proposes and discusses possible strategies for mitigating those challenges.
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Affiliation(s)
- Sadia Rehman Safwi
- Department of Chronic Disease Epidemiology, Yale School Of Public Health, 60 College St, New Haven, CT 06510, USA.
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Malik AA, Ahmed N, Shafiq M, Elharake JA, James E, Nyhan K, Paintsil E, Melchinger HC, Team YBI, Malik FA, Omer SB. Behavioral interventions for vaccination uptake: A systematic review and meta-analysis. Health Policy 2023; 137:104894. [PMID: 37714082 PMCID: PMC10885629 DOI: 10.1016/j.healthpol.2023.104894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/22/2023] [Accepted: 08/15/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries. METHODS We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately. FINDINGS Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5-4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3-3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes. INTERPRETATION Our findings indicate that "provider recommendation" and "on-site vaccination" along with other behavioral interventions can be employed to increase vaccination rates globally.
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Affiliation(s)
- Amyn A Malik
- Yale Institute for Global Health, New Haven, CT 06510, USA; Analysis Group, Inc, Boston, MA 02199, USA
| | - Noureen Ahmed
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA
| | - Mehr Shafiq
- Yale Institute for Global Health, New Haven, CT 06510, USA; Columbia University School of Public Health, New York, NY 10032, USA
| | - Jad A Elharake
- Yale Institute for Global Health, New Haven, CT 06510, USA; UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA; The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Erin James
- Yale Institute for Global Health, New Haven, CT 06510, USA
| | - Kate Nyhan
- Yale University, New Haven, CT 06510, USA
| | - Elliott Paintsil
- Yale Institute for Global Health, New Haven, CT 06510, USA; Columbia University Institute of Human Nutrition, New York, NY 10032, USA
| | | | | | - Fauzia A Malik
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA
| | - Saad B Omer
- UT Southwestern Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA.
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12
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Shah SB, Sinha R, Hussain SY, Kumar A, Gupta A. Allaying Pediatric Preoperative Anxiety, Where are we Now? - A Nationwide Survey. J Indian Assoc Pediatr Surg 2023; 28:479-485. [PMID: 38173638 PMCID: PMC10760609 DOI: 10.4103/jiaps.jiaps_114_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/08/2023] [Accepted: 07/23/2023] [Indexed: 01/05/2024] Open
Abstract
Background Preoperative anxiety (PA) in children is a common phenomenon associated with various negative patient outcomes. Allaying PA is accepted as a standard of care, but its use is not universal and often overlooked. This survey is designed to evaluate the nationwide current practice patterns and attitudes of anesthesiologists toward the practice of allaying PA in children. Materials and Methods A questionnaire of 25 questions, including information on methods of relieving PA in children, reasons for noncompliance, and associated complications, was framed. It was circulated among members of the Indian Society of Anaesthesiologists through an online survey of Google Forms and manually. Results Four hundred and fifty anesthesiologists were surveyed. Responses were predominantly from anesthesiologists practicing in medical colleges across the country. Although 97% of the surveyed respondents practiced anxiety-relieving strategies, only 37% used it consistently. Seventy-three percent of anesthesiologists practiced both pharmacological and nonpharmacological techniques. The most common reason for avoiding premedication was an anticipated difficult airway (88%). Inadequate sedation was a commonly reported problem. Ninety-five percent of participants felt that PA-relieving strategies should be integral to pediatric anesthesia practice. The most common reason for not following these practices was an inadequate hospital infrastructure (67%). Ninety-seven percent of the participants believed that more awareness is required on this crucial perioperative issue. Conclusion Only 37% of the surveyed anesthesiologists consistently used some form of PA-relieving strategy and the practice varied widely. Further improvement and team approach involving anesthesiologists, surgeons, and nurses is required to ensure the quality of pediatric PA-relieving services and establish it as a standard of care.
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Affiliation(s)
- Shreya Bharat Shah
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Sinha
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Sana Yasmin Hussain
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Kumar
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Anju Gupta
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
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Grinberg AS, Damush TM, Lindsey H, Burrone L, Baird S, Takagishi SC, Snyder I, Goldman RE, Sico JJ, Seng EK. The Headache Psychologists' Role in Pediatric and Adult Headache Care: A Qualitative Study of Expert Practitioners. J Clin Psychol Med Settings 2023:10.1007/s10880-023-09972-2. [PMID: 37839060 DOI: 10.1007/s10880-023-09972-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE We examined the perspectives of expert headache psychologists to inform best practices for integrating headache psychologists into the care of children and adults with headache disorders within medical settings. BACKGROUND Headache disorders are prevalent, chronic, and disabling neurological conditions. As clinical providers trained in evidence-based behavior change interventions with expertise in headache disorders, headache psychologists are uniquely positioned to provide behavioral headache treatment. METHODS In 2020, we conducted semi-structured interviews with a purposive sample of expert headache psychologists working across the United States. Open-ended questions focused on their roles, clinical flow, and treatment content. Interviews were audio-recorded, transcribed, de-identified, and analyzed using a rapid qualitative analysis method. RESULTS We interviewed seven expert headache psychologists who have worked for an average of 18 years in outpatient settings with pediatric (n = 4) and adult (n = 3) patients with headache. The themes that emerged across the clinical workflow related to key components of behavioral headache treatment, effective behavioral treatment referral practices, and barriers to patient engagement. The expert headache psychologists offered evidence-based behavioral headache interventions such as biofeedback, relaxation training, and cognitive behavioral therapy emphasizing lifestyle modification as standalone options or concurrently with pharmacological treatment and were of brief duration. Participants reported many of their patients appeared reluctant to seek behavioral treatment for headache. Participants believed referrals were most effective when the referring provider explained to the patient the rationale for behavioral treatment, treatment content, and positive impact on headache activity, functioning, and quality of life. Barriers cited by participants to integrating headache psychology into headache care included the paucity of psychologists with specialized headache training, lack of insurance reimbursement, limited patient time to seek behavioral treatment, and inadequate patient knowledge of what behavioral treatment entails. CONCLUSION Headache psychologists are often core members of multidisciplinary headache teams offering short-term, evidence-based behavioral interventions, both as a standalone treatment or in conjunction with pharmacotherapy. However, barriers to care persist. Enhancing referring providers' familiarity with psychologists' role in headache care may aid successful referrals for behavioral interventions for headache.
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Affiliation(s)
- Amy S Grinberg
- VA Connecticut Healthcare System, West Haven, USA.
- Headache Centers of Excellence Research and Evaluation Center, Veterans Health Administration, West Haven, USA.
- Pain, Research, Informatics, Medical Comorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, USA.
- VA Connecticut Healthcare System Headache Center of Excellence, National Programs Center-Mailing Code 689GF VA Annex, 200 Edison Road, Orange, CT, 06477, USA.
| | - Teresa M Damush
- Headache Centers of Excellence Research and Evaluation Center, Veterans Health Administration, West Haven, USA
- Richard L. Roudebush VA Medical Center, Indianapolis, USA
- Indiana University School of Medicine, Indianapolis, USA
- Regenstrief Institute, Inc, Indianapolis, USA
| | - Hayley Lindsey
- VA Connecticut Healthcare System, West Haven, USA
- Headache Centers of Excellence Research and Evaluation Center, Veterans Health Administration, West Haven, USA
- Pain, Research, Informatics, Medical Comorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, USA
| | - Laura Burrone
- VA Connecticut Healthcare System, West Haven, USA
- Headache Centers of Excellence Research and Evaluation Center, Veterans Health Administration, West Haven, USA
- Pain, Research, Informatics, Medical Comorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, USA
| | - Sean Baird
- Richard L. Roudebush VA Medical Center, Indianapolis, USA
| | | | - Ivy Snyder
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, USA
| | - Roberta E Goldman
- Headache Centers of Excellence Research and Evaluation Center, Veterans Health Administration, West Haven, USA
- Warren Alpert Medical School of Brown University, Providence, USA
- Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jason J Sico
- VA Connecticut Healthcare System, West Haven, USA
- Headache Centers of Excellence Research and Evaluation Center, Veterans Health Administration, West Haven, USA
- Pain, Research, Informatics, Medical Comorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, USA
- Yale School of Medicine, New Haven, USA
| | - Elizabeth K Seng
- Headache Centers of Excellence Research and Evaluation Center, Veterans Health Administration, West Haven, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, USA
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, USA
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14
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Martin M, Steele B, Spreckelsen TF, Lachman JM, Gardner F, Shenderovich Y. The Association Between Facilitator Competent Adherence and Outcomes in Parenting Programs: a Systematic Review and SWiM Analysis. Prev Sci 2023; 24:1314-1326. [PMID: 36884129 PMCID: PMC10575799 DOI: 10.1007/s11121-023-01515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/09/2023]
Abstract
There is increasing interest about the fidelity with which interventions are implemented because it is theorized that better implementation fidelity by facilitators is associated with better participant outcomes. However, in the parenting program literature, there is mixed evidence on the relationship between implementation fidelity and outcomes. This paper provides a synthesis of the evidence on the relationship between facilitator delivery and outcomes in the parenting program literature. Following PRISMA guidelines, this paper synthesizes the results of a systematic review of studies on parenting programs aiming to reduce violence against children and child behavior problems. Specifically, it examines associations between observational measures of facilitator competent adherence and parent and child outcomes. A meta-analysis was not feasible due to study heterogeneity. As a result, Synthesis Without Meta-Analysis guidelines were followed. Searches in electronic databases, reference searching, forward citation tracking, and expert input identified 9653 articles. After screening using pre-specified criteria, 18 articles were included. The review found that most studies (n = 13) reported a statistically significant positive relationship with at least one parent or child outcome. However, eight studies reported inconsistent findings across outcomes, and four studies found no association with outcomes. The results suggest that better facilitator competent adherence is generally associated with positive parent and child outcomes. However, this finding is weakened by the methodological heterogeneity of included studies and due to the wide variety of ways in which studies conceptualized competent adherence-outcome relationships.
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Affiliation(s)
- M Martin
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | - B Steele
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - T F Spreckelsen
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - J M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - F Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Y Shenderovich
- Wolfson Centre for Young People's Mental Health, Cardiff, UK
- Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Centre for the Development, Cardiff University, Cardiff, UK
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15
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Gitman V, Moss K, Hodgson D. A systematic review and meta-analysis of the effects of non-pharmacological interventions on quality of life in adults with multiple sclerosis. Eur J Med Res 2023; 28:294. [PMID: 37608400 PMCID: PMC10463700 DOI: 10.1186/s40001-023-01185-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/22/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic debilitating disease that targets the central nervous system. Globally it is estimated that 2.8 million people live with MS (2018) and as there is no known cure; therefore, identifying methods to increase a patient's quality of life (QoL) is of considerable importance. Non-pharmacological interventions are a viable and effective option to increase QoL in patients with MS, however, to date, the literature lacks a complete systematic review of these interventions. METHODS A literature search was conducted for studies published up until March 4th 2022 in Scopus, Web of Science, CINAHL Plus, The Cochrane Library, Medline, and Embase. Studies were included if they were randomized control trials (RCTs) assessing a non-pharmacological intervention in adults with MS and measured QoL using the MSQOL-54, SF-36 or MSQLI tools for at least two time points. Quality assessment of each study was completed as well as a review of publication bias. Where possible, meta-analysis was conducted using a random effects model and for other studies a qualitative synthesis was presented. RESULTS Thirty studies were included in the meta-analysis and eleven studies were summarized qualitatively. The pooled effects across all non-pharmacological interventions showed a modest improvement in both the physical and mental components of QoL, with a standardized mean difference (SMD) of 0.44 (95% CI 0.26-0.61) and 0.42 (95% CI 0.24-0.60), respectively. Non-pharmacological interventions based around a physical activity were found to be particularly effective in improving both the physical composite score (PCS) and mental composite score (MCS), with an SMD of 0.40 (95% CI 0.14-0.66) and 0.31 (95% CI 0.08-0.55), respectively. Interventions incorporating balance exercises presented a significant advantageous solution for improving QoL, with an SMD of 1.71 (95% CI 1.22, 2.20) and 1.63(95% CI 1.15-2.12) for PCS and MCS respectively. CONCLUSIONS This systematic review and meta-analysis identified that non-pharmacological interventions can be an effective method of improving QoL in patients with MS, especially modalities with a physical activity component and balance interventions.
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Affiliation(s)
- Victor Gitman
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Kasey Moss
- Department of Medicine, McMaster University, Hamilton, Canada
| | - David Hodgson
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
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16
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O'Donnell HK, Trojanowski PJ, Alonso GT, Majidi S, Snell-Bergeon J, Wadwa RP, Vigers T, Pyle L, Gurka MJ, Shaffer E, Driscoll KA. A randomized controlled clinical trial to improve health outcomes in youth with type 1 diabetes: Study design and baseline characteristics. Contemp Clin Trials 2023; 131:107270. [PMID: 37348599 DOI: 10.1016/j.cct.2023.107270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/31/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
Most adolescents with T1D do not meet glycemic recommendations or consistently perform the required self-management behaviors to prevent acute- and long-term deleterious health outcomes. In addition, most youth with T1D do not have access to behavioral health services to address T1D management barriers. Thus, delivering behavioral interventions during routine medical appointments may hold promise for improving T1D outcomes in adolescents. The overall objective of this study was to examine the effect of behavioral interventions, either a Personalized T1D Self-Management Behaviors Feedback Report or Problem-Solving Skills, delivered by a T1D behavioral health provider and a T1D medical provider during a joint, fully integrated appointment to improve health outcomes in youth with T1D. This paper describes the study rationale, design, and baseline characteristics for the 109 adolescent-caregiver dyads who participated. Primary and secondary outcomes include hemoglobin A1c (A1C), T1D self-management behaviors, and biological indicators of complications.
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Affiliation(s)
- Holly K O'Donnell
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America.
| | - Paige J Trojanowski
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America.
| | - G Todd Alonso
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America.
| | - Shideh Majidi
- Children's National, Pediatric Endocrinology, 111 Michigan Ave NW, Washington DC, United States of America.
| | - Janet Snell-Bergeon
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America.
| | - R Paul Wadwa
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America.
| | - Tim Vigers
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America.
| | - Laura Pyle
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America.
| | - Matthew J Gurka
- University of Florida, College of Medicine, Department of Pediatrics, PO Box 100177, Gainesville, FL, United States of America.
| | - Emily Shaffer
- University of Florida, Department of Clinical and Health Psychology, 1225 Center Dr., Gainesville, FL, United States of America.
| | - Kimberly A Driscoll
- University of Colorado School of Medicine, Department of Pediatrics, Barbara Davis Center for Diabetes, 1775 Aurora Ct., Aurora, CO, United States of America; University of Florida, Department of Clinical and Health Psychology, 1225 Center Dr., Gainesville, FL, United States of America; University of Florida Diabetes Institute, United States of America.
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17
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García-Fernández G, Krotter A, González-Roz A, García-Pérez Á, Secades-Villa R. Effectiveness of including weight management in smoking cessation treatments: A meta-analysis of behavioral interventions. Addict Behav 2023; 140:107606. [PMID: 36642013 DOI: 10.1016/j.addbeh.2023.107606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The potential of weight gain after smoking cessation reduces the incentive to quit. This meta-analysis examines the efficacy of behavioral interventions for smoking cessation that also address post-cessation weight gain. METHODS Medline, Web of Science, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials on behavioral treatments targeting both health outcomes. Six separate meta-analyses were undertaken to assess treatment efficacy on smoking abstinence and weight outcomes at end of treatment (EOT), short-term, and long-term follow-up. Individual and treatment moderators were examined as well as methodological quality and publication bias of studies. RESULTS A total of 28 studies were included in the meta-analysis. There was a statistically significant positive impact of treatments addressing both targets on smoking outcomes at EOT (RR = 1.279, 95% CI: 1.096, 1.492, p = .002), but not at follow-ups. Age impacted on EOT abstinence rates Q (1) = 4.960, p = .026) while increasing the number of sessions significantly improved EOT abstinence rates (p = .020). There was no statistically significant impact of these treatments on weight at EOT (Hedges' g = -0.015, 95% CI: -.164, 0.135, p = .849) or follow-ups (short term: Hedges' g = 0.055, 95% CI: -0.060, 0.170, p = .347; long term: Hedges' g = -0.320, 95% CI: -.965, 0.325, p = .331). There were minimal impacts of publication bias, mostly related to sample size, meaning studies including small sample sizes revealed larger effect sizes on abstinence at EOT. DISCUSSION Addressing post-cessation weight management in treatments for smoking cessation significantly enhances tobacco abstinence at EOT though it was not found to have a lasting impact after treatment.
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Affiliation(s)
- Gloria García-Fernández
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain.
| | - Andrea Krotter
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
| | - Alba González-Roz
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
| | - Ángel García-Pérez
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
| | - Roberto Secades-Villa
- Department of Psychology, Addictive Behaviors Research Group, University of Oviedo, Plaza Feijoo S-N, Oviedo 33003, Spain
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18
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Rethorst CD, Carmody TJ, Argenbright KE, Mayes TL, Hamann HA, Trivedi MH. Considering depression as a secondary outcome in the optimization of physical activity interventions for breast cancer survivors in the PACES trial: a factorial randomized controlled trial. Int J Behav Nutr Phys Act 2023; 20:47. [PMID: 37081460 PMCID: PMC10120257 DOI: 10.1186/s12966-023-01437-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/13/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Depressive symptoms result in considerable burden for breast cancer survivors. Increased physical activity may reduce these burdens but existing evidence from physical activity interventions in equivocal. Furthermore, physical activity intervention strategies may differentially impact depressive symptoms, which should be considered in designing and optimizing behavioral interventions for breast cancer survivors. METHODS The Physical Activity for Cancer Survivors (PACES) trial enrolled 336 participants breast cancer survivors, who were 3 months to 10 years post-treatment, and insufficiently active (< 150 min of moderate-to-vigorous physical activity per week). Participants were randomly assigned to a combination of 4 intervention strategies in a full-factorial design: 1) supervised exercise sessions, 2) facility access, 3) Active Living Every Day, and 4) Fitbit self-monitoring. Depressive symptoms were assessed at baseline, mid-intervention (3 months), and post-intervention (6 months) using the Quick Inventory for Depressive Symptoms. Change in depressive symptoms were analyzed using a linear mixed-effects model. RESULTS Results from the linear mixed-effects model indicated that depressive symptoms decreased significantly across the entire study sample over the 6-month intervention (F = 4.09, p = 0.044). A significant ALED x time interaction indicated participants who received the ALED intervention experienced greater reductions in depressive symptoms (F = 5.29, p = 0.022). No other intervention strategy significantly impacted depressive symptoms. CONCLUSIONS The ALED intervention consists of strategies (i.e., goal setting, social support) that may have a beneficial impact on depressive symptoms above and beyond the effect of increased physical activity. Our findings highlight the need to consider secondary outcomes when designing and optimizing physical activity interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT03060941. Posted February 23, 2017.
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Affiliation(s)
- Chad D Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M Agrilife Research, 17360 Coit Road, Dallas, TX, 75252, USA.
| | - Thomas J Carmody
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Keith E Argenbright
- Moncrief Cancer Institute, University of Texas Southwestern Medical Center, Dallas, TX Fort Worth, TX, USA
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Heidi A Hamann
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Ling M, Xu L, Chu X. Heterogeneous effects of other-regarding interventions on household recycling: A field experimental study. J Environ Manage 2023; 329:117102. [PMID: 36549057 DOI: 10.1016/j.jenvman.2022.117102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Behavioral interventions that address other-regarding motivations (i.e., other-regarding interventions) are gaining momentum as promising tools to stimulate household recycling. However, previous studies have shown considerable variability in the impact of such strategies, and the factors that moderate treatment effects remain poorly studied. Using a field experiment with 7195 households in Quzhou, China, this study investigated treatment effect heterogeneity systematically based on intervention types, treatment durations, personal motivations, and social networks. Three strategies were examined, including biospheric and altruistic appeals and personalized normative feedback. We found that normative feedback outperformed other strategies in inducing household participation in recycling, that the influences of all strategies attenuated over time, and that the feedback effect was greater among recipients with weaker biospheric or altruistic concerns and those embedded within stronger neighbor networks. However, no significant treatment effects were found on the amount of waste recycled. These findings improve the understanding of the heterogeneous impact of other-regarding interventions, with important implications for the design of recycling policies. Future studies need to explore additional moderators and the effects of treatment combinations.
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Affiliation(s)
- Maoliang Ling
- School of Public Administration, Zhejiang Gongshang University, 18 Xuezheng Road, Hangzhou, 310018, China.
| | - Lin Xu
- School of Public Affairs, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China; Institute for Public Policy of Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China.
| | - Xiaojing Chu
- School of Public Affairs, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China.
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Lau T, Cook J, Archid R, Stengel A, Zipfel S, Mack I. Effects of Lifestyle and Educational Bridging Programs before Bariatric Surgery on Postoperative Weight Loss: A Systematic Review and Meta-Analysis. Obes Facts 2023; 16:1-10. [PMID: 36209729 PMCID: PMC9889730 DOI: 10.1159/000526945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/15/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To fulfill the requirements for bariatric surgery, patients often need to participate in mandatory preoperative lifestyle interventions. Currently, the efficacy of multi-month preoperative lifestyle intervention programs on body mass index (BMI) reduction from the start of the program (T0) through the immediate preoperative time point (T1) to 1 year post-surgery (T2) and how the amount of preoperative BMI reduction affects postoperative outcome (T1 to T2) is unclear. The aim of this meta-analysis was to analyze the effects of preoperative lifestyle interventions on BMI 1 year post-surgery. METHOD A systematic literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Randomized controlled trials that implemented preoperative lifestyle interventions lasting 1-8 months before bariatric surgery were included. The BMI of the intervention group was compared with that of a control group before participation in the preoperative lifestyle interventions (T0), after completion of the program before surgery (T1), and 1 year post-surgery (T2). Finally, the impact of successful BMI reduction at T1 on BMI at T2 was analyzed. RESULTS N = 345 patients derived from 4 studies undergoing preoperative lifestyle interventions reduced their BMI at T1 by 1.5 units compared to the control group (95% CI: -2.73, -0.28). One year post-surgery, both groups had lost comparable BMI points. The influence of reduced BMI at T1 on weight status at T2 is unclear due to the lack of available studies. Other endpoints and subgroup analyses were rarely examined. CONCLUSIONS Preoperative lifestyle interventions reduce BMI before bariatric surgery more effectively than usual care. These differences are not detectable 1 year post-surgery. Although a short-term energy reduction period before surgery is clearly important to minimize surgery risks, it is currently unclear whether, and if so, under what circumstances, participation in a preoperative lifestyle intervention is beneficial.
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Affiliation(s)
- Teresa Lau
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany,
| | - Jessica Cook
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Rami Archid
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Department of Psychosomatic Medicine, Charité - University Medicin Berlin, Berlin, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Navarra AMD, Rosenberg MG, Gormley M, Bakken S, Fletcher J, Whittemore R, Gwadz M, Cleland C, Melkus GD. Feasibility and Acceptability of the Adherence Connection Counseling, Education, and Support (ACCESS) Proof of Concept: A Peer-Led, Mobile Health (mHealth) Cognitive Behavioral Antiretroviral Therapy (ART) Adherence Intervention for HIV-Infected (HIV+) Adolescents and Young Adults (AYA). AIDS Behav 2022; 27:1807-1823. [PMID: 36574184 PMCID: PMC9792943 DOI: 10.1007/s10461-022-03913-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 12/28/2022]
Abstract
Effective antiretroviral therapy (ART) adherence strategies for HIV+ adolescents and young adults (AYA) are needed to prevent HIV-related morbidity, mortality, and onward transmission. In the Adherence Connection for Counseling, Education, and Support (ACCESS) pilot, an exploratory sequential mixed-methods design was used to develop and test a peer-led, mobile health (mHealth) cognitive behavioral ART adherence intervention. HIV+ AYA (ages 16-29 years) with unsuppressed plasma HIV RNA (HIV viral load) were eligible for this five-session intervention directed to improving ART adherence and HIV viral load. A total of 78 peer-led remote videoconferencing sessions (via WebEx) were delivered to 16 participants. High completion rates (97.5%) and client satisfaction scores (mean = 29.13 of 32; SD = 2.45) were observed. Self-reported ART adherence improved (32% increase in doses taken; 95th CI 11.2-53.3) with an annualized average rate of 47.5% (0.28 log10) reduction in HIV viral load. We established proof of concept for the ACCESS peer-led, mHealth cognitive behavioral ART adherence intervention, with promising adherence and virologic outcome data.
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Affiliation(s)
| | - Michael G Rosenberg
- Division of Infectious Diseases, Department of Pediatrics, Jacobi Medical Center, Bronx, NY, USA
| | - Maurade Gormley
- University of Connecticut, School of Nursing, Storrs, CT, USA
| | - Suzanne Bakken
- Columbia University School of Nursing, Columbia University, New York, NY, USA
| | - Jason Fletcher
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, USA
| | | | - Marya Gwadz
- Silver School of Social Work, New York University, New York, NY, USA
| | - Charles Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Gail D'Eramo Melkus
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, USA
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22
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Mattaini MA, Roose KM, Fawcett SB. Behavioral Interventions Contributing to Reducing Poverty and Inequities. Behav Soc Issues 2022; 32:1-24. [PMID: 38625310 PMCID: PMC9718469 DOI: 10.1007/s42822-022-00114-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 12/04/2022]
Abstract
Behavioral science has a long history of engaging in efforts to understand and address socially important issues. Poverty and inequities in health and development are among the most important and complex social issues facing the world today. With its Sustainable Development Goals (SDGs), the United Nations (2015) has focused attention and guidance on addressing key global challenges, including to "end poverty" (SDG 1), "ensure good health and well-being for all" (SDG3), and "reduce inequality within and among countries" (SDG 10). In this paper, we provide a framework and illustrative examples of contributions of behavioral science to these issues. We feature illustrative behavioral interventions at the individual, relationship, community, and societal levels. We highlight the diversity of issues, intervention methods, and settings reflected in applications of behavioral science. By joining methods from behavioral science, public health, and other disciplines-and the experiential knowledge of those most affected by inequities-behavioral methods can make significant contributions to collaborative efforts to assure health and well-being for all.
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Affiliation(s)
- Mark A. Mattaini
- Jane Addams College of Social Work, University of Illinois Chicago, PO Box 1045, Paguate, NM 87040 USA
| | | | - Stephen B. Fawcett
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS USA
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23
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Fox O, Ziv G. The effects of viewing cute images on the performance of simple computerized tasks in dog owners and non-dog owners. PeerJ 2022; 10:e14439. [PMID: 36438586 PMCID: PMC9686409 DOI: 10.7717/peerj.14439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/01/2022] [Indexed: 11/22/2022] Open
Abstract
Background Viewing cute images of puppies or kittens can improve the performance of various motor tasks due to increased behavioral carefulness. It is possible, however, that this effect can be moderated by the affinity of individuals towards specific cute stimuli. The purpose of this pre-registered study was to examine whether dog ownership moderates the effect of viewing cute images of puppies on two computerized RT-based tasks. Methods One-hundred and sixty-four participants were covertly recruited and randomly assigned to four groups: (1) dog owners viewing puppies' images (n = 35), (2) dog owners viewing adult dogs' images (n = 36), (3) non-dog owners viewing puppies' images (n = 48), and (4) non-dog owners viewing adult dogs' images (n = 45). The participants performed a Simon task and an alternate task-switching task before and after viewing seven images of puppies/adult dogs based on group affiliation. After performing the tasks, the participants rated each image on five characteristics: cuteness, infantility, pleasantness, excitability, and wanting to get closer. Results The participants who viewed images of puppies rated those characteristics (e.g., cuter, more infantile, etc.) as higher than the participants who viewed images of adult dogs. There were no differences in the performance of the two tasks between participants who viewed images puppies and participants who viewed images of adult dogs. However, dog owners reacted faster than non-dog owners in the post-test of the alternate task-switching task. It is possible that showing images of dogs to dog owners increased their motivation and attention to the task.
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Affiliation(s)
- Orly Fox
- The Academic College at Wingate, Netanya, Israel
| | - Gal Ziv
- The Academic College at Wingate, Netanya, Israel
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24
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Böhm R, Betsch C, Litovsky Y, Sprengholz P, Brewer NT, Chapman G, Leask J, Loewenstein G, Scherzer M, Sunstein CR, Kirchler M. Crowdsourcing interventions to promote uptake of COVID-19 booster vaccines. EClinicalMedicine 2022; 53:101632. [PMID: 36090456 PMCID: PMC9444232 DOI: 10.1016/j.eclinm.2022.101632] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/31/2022] [Accepted: 08/09/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND COVID-19 booster vaccine uptake rates are behind the rate of primary vaccination in many countries. Governments and non-governmental institutions rely on a range of interventions aiming to increase booster uptake. Yet, little is known how experts and the general public evaluate these interventions. METHODS We applied a novel crowdsourcing approach to provide rapid insights on the most promising interventions to promote uptake of COVID-19 booster vaccines. In the first phase (December 2021), international experts (n = 78 from 17 countries) proposed 46 unique interventions. To reduce noise and potential bias, in the second phase (January 2022), experts (n = 307 from 34 countries) and representative general population samples from the UK (n = 299) and the US (n = 300) rated the proposed interventions on several evaluation criteria, including effectiveness and acceptability, on a 5-point Likert-type scale. FINDINGS Sanctions were evaluated as potentially most effective but least accepted. Evaluations by expert and general population samples were considerably aligned. Interventions that received the most positive evaluations regarding both effectiveness and acceptability across evaluation groups were: a day off work after getting vaccinated, financial incentives, tax benefits, promotional campaigns, and mobile vaccination teams. INTERPRETATION The results provide useful insights to help governmental and non-governmental institutions in their decisions about which interventions to implement. Additionally, the applied crowdsourcing method may be used in future studies to retrieve rapid insights on the comparative evaluation of (health) policies. FUNDING This study received funding from the Austrian Science Fund (SFB F63) and the University of Vienna.
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Affiliation(s)
- Robert Böhm
- Faculty of Psychology, University of Vienna, Austria
- Department of Psychology, University of Copenhagen; 1354 Copenhagen K, Denmark
- Copenhagen Center for Social Data Science (SODAS), University of Copenhagen, Denmark
- Corresponding author at: Faculty of Psychology, University of Vienna, Universitätsstrasse 7, 1010 Vienna, Austria.
| | - Cornelia Betsch
- Media and Communication Science, University of Erfurt, Germany
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Germany
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Yana Litovsky
- Department of Banking and Finance, University of Innsbruck, Austria
| | - Philipp Sprengholz
- Media and Communication Science, University of Erfurt, Germany
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Noel T. Brewer
- Department of Health Behavior, Gillings School of Global Public Health and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, USA
| | - Gretchen Chapman
- Department of Social and Decision Sciences, Carnegie Mellon University, USA
| | - Julie Leask
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - George Loewenstein
- Department of Social and Decision Sciences, Carnegie Mellon University, USA
| | - Martha Scherzer
- Consultant, Behavioral and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark
| | | | - Michael Kirchler
- Department of Banking and Finance, University of Innsbruck, Austria
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25
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Agarwal S, Birk JL, Abukhadra SL, Rojas DA, Cornelius TM, Bergman M, Chang BP, Edmondson DE, Kronish IM. Psychological Distress After Sudden Cardiac Arrest and Its Impact on Recovery. Curr Cardiol Rep 2022; 24:1351-1360. [PMID: 35921024 PMCID: PMC9561080 DOI: 10.1007/s11886-022-01747-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To summarize the prevalence, correlates, and health consequences of poor mental health in the increasingly sizable population of survivors of Sudden cardiac arrest (CA) and to describe current intervention research in this area. RECENT FINDINGS After CA many patients report high psychological distress, including depression, generalized anxiety, and posttraumatic stress. Emerging evidence suggests that distressed patients' attention may narrow such that anxious awareness of afferent cardiac signals e.g., changes in heart rate or blood pressure, becomes predominant and a cause for concerned, constant monitoring. This cardiac-specific anxiety followed by behavioral avoidance and physiological hyperreactivity may increase patients' already high risk of secondary cardiovascular disease and undermine their health-related quality of life (HRQoL). Unlike other cardiovascular diseases, no clinical practice guidelines exist for assessing or treating psychological sequelae of CA. Future research should identify modifiable psychological targets to reduce secondary cardiovascular disease risk and improve HRQoL.
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Affiliation(s)
- Sachin Agarwal
- Department of Neurology, Division of Critical Care & Hospitalist Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, Milstein Hospital, 177 Fort Washington Avenue, New York, NY, 8GS-300, USA.
| | - Jeffrey L Birk
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, USA
| | - Sabine L Abukhadra
- Department of Neurology, Division of Critical Care & Hospitalist Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, Milstein Hospital, 177 Fort Washington Avenue, New York, NY, 8GS-300, USA
| | - Danielle A Rojas
- Department of Neurology, Division of Critical Care & Hospitalist Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, Milstein Hospital, 177 Fort Washington Avenue, New York, NY, 8GS-300, USA
| | - Talea M Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, USA
| | - Maja Bergman
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, USA
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, USA
| | - Donald E Edmondson
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, USA
| | - Ian M Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, USA
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26
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Pezley L, Cares K, Duffecy J, Koenig MD, Maki P, Odoms-Young A, Clark Withington MH, Lima Oliveira M, Loiacono B, Prough J, Tussing-Humphreys L, Buscemi J. Efficacy of behavioral interventions to improve maternal mental health and breastfeeding outcomes: a systematic review. Int Breastfeed J 2022; 17:67. [PMID: 36064573 PMCID: PMC9446548 DOI: 10.1186/s13006-022-00501-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/08/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite extensive benefits and high intentions, few mothers breastfeed exclusively for the recommended duration. Maternal mental health is an important underlying factor associated with barriers and reduced rates of breastfeeding intent, initiation, and continuation. Given evidence of a bidirectional association between maternal mental health and breastfeeding, it is important to consider both factors when examining the efficacy of interventions to improve these outcomes. The purpose of this manuscript is to review the literature on the efficacy of behavioral interventions focused on both maternal mental health and breastfeeding outcomes, examining the intersection of the two. METHODS This systematic review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Studies were selected if they were available in English, used primary experimental design, and used a behavioral intervention type to examine maternal mental health and breastfeeding outcomes. Articles were identified from PubMed, CINAHL, Embase, and PsycINFO from database inception to 3 March 2022. Study quality was assessed using the Cochrane Risk of Bias tool. Results were synthesized by intervention success for 1. Mental health and breastfeeding, 2. Breastfeeding only, 3. Mental health only, and 4. No intervention effect. PROSPERO CRD42021224228. RESULTS Thirty interventions reported in 33 articles were identified, representing 15 countries. Twelve studies reported statistically significant positive effect of the intervention on both maternal mental health and breastfeeding; most showing a decrease in self-report depressive and/or anxiety symptoms in parallel to an increase in breastfeeding duration and/or exclusivity. Common characteristics of successful interventions were a) occurring across pregnancy and postpartum, b) delivered by hospital staff or multidisciplinary teams, c) offered individually, and d) designed to focus on breastfeeding and maternal mental health or on breastfeeding only. Our results are not representative of all countries, persons, experiences, circumstances, or physiological characteristics. CONCLUSIONS Interventions that extend the perinatal period and offer individualized support from both professionals and peers who collaborate through a continuum of settings (e.g., health system, home, and community) are most successful in improving both mental health and breastfeeding outcomes. The benefits of improving these outcomes warrant continued development and implementation of such interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021224228.
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Affiliation(s)
- Lacey Pezley
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA.
| | - Kate Cares
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Jennifer Duffecy
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Mary Dawn Koenig
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Pauline Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Manoela Lima Oliveira
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | | | - Jilian Prough
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
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27
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MacDonell KK, Naar S. Self-Management Frameworks for Youth Living with Human Immunodeficiency Virus. Pediatr Clin North Am 2022; 69:759-77. [PMID: 35934498 DOI: 10.1016/j.pcl.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
HIV is now a chronic condition that can be managed. Adolescents and emerging adults represent a large proportion of new diagnoses, but struggle with many aspects of HIV-related self-management. Self-management of HIV is critical to maintaining health and involves retention in HIV care, medication adherence to achieve viral suppression, managing substance use, and sexual and general health-related behaviors. This article describes theoretic frameworks for HIV self-management as adapted for youth and reviews self-management interventions developed to improve health outcomes in youth living with HIV identified from a recent systematic review.
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28
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Pedersen M, Harris KJ, Brown B, Anderson K, Lewis JP. A Systematic Review of Interventions to Increase Physical Activity Among American Indian and Alaska Native Older Adults. Gerontologist 2022; 62:e328-e339. [PMID: 33605417 PMCID: PMC9335984 DOI: 10.1093/geront/gnab020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Physical activity (PA) is a powerful protective factor known to reduce risk for chronic conditions across the life span. PA levels are lower among American Indians and Alaska Natives (AIANs) when compared with other racial/ethnic groups and decrease with age. This evidence justifies a synthesis of current intervention research to increase PA levels among AIANs. This systematic review examines completed interventions to increase PA among AIAN older adults and considers recommended practices for research with Indigenous communities. RESEARCH DESIGN AND METHODS The systematic review was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for systematic review protocols and reporting guidelines. Three electronic databases, PubMed, Web of Science, and PsycINFO, were searched for academic literature. Trials investigating interventions to increase PA among AIAN adults older than 50 years were eligible. The Quality Assessment Tool for Quantitative Studies was used to evaluate the quality of evidence. RESULTS Three published trials were identified, including one group-level, clinic-based and two individual-level, home-based interventions. All were 6 weeks in duration, took place in urban areas, and used self-report PA measures. Findings indicated an overall increase in PA levels, improved PA-related outcomes, and improved psychosocial health among participants. None described community-engaged or culture-centered research strategies. DISCUSSION AND IMPLICATIONS The narrow yet promising evidence represents a need for expanded research and a call to action for using culture-centered strategies. An advanced understanding of cultural and contextual aspects of PA may produce more impactful interventions, supporting health and mobility across the life span.
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Affiliation(s)
- Maja Pedersen
- School of Public and Community Health Sciences, University of
Montana, Missoula, Montana, USA
| | - Kari Jo Harris
- School of Public and Community Health Sciences, University of
Montana, Missoula, Montana, USA
| | - Blakely Brown
- School of Public and Community Health Sciences, University of
Montana, Missoula, Montana, USA
| | - Keith Anderson
- School of Social Work, University of Texas at Arlington,
Arlington, Texas, USA
| | - Jordan P Lewis
- Department of Medicine and Biobehavioral Health, University of
Minnesota, Minnesota, Duluth, USA
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Abstract
PURPOSE OF REVIEW This review provides a recent update of behavioral research pertinent to young children with T1D and addresses current priorities and future directions. RECENT FINDINGS Rates of type 1 diabetes (T1D) in young children (ages 1-7) are continuing to rise. Since 2014, changes to diabetes care and management have impacted young children and reinforced the need for increased attention and interventions to support diabetes management, especially in caregivers who are primarily responsible for their young child's diabetes management. T1D is associated with unique physiologic challenges in young children, with constant management demands elevating parental diabetes-related stress and fear of hypoglycemia. Diabetes technology use has significantly increased in young children, contributing to improvements in glycemic levels and parent and child psychosocial functioning. Yet despite the positive outcomes demonstrated in select clinical behavioral interventions, research with this young child age group remains limited in scope and quantity.
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Affiliation(s)
- Maureen Monaghan
- grid.239560.b0000 0004 0482 1586Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010 USA
- grid.253615.60000 0004 1936 9510George Washington University School of Medicine, Washington, DC USA
| | - Breana L. Bryant
- grid.239560.b0000 0004 0482 1586Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010 USA
| | - Hailey Inverso
- grid.239560.b0000 0004 0482 1586Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010 USA
| | - Hailey R. Moore
- grid.239560.b0000 0004 0482 1586Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010 USA
| | - Randi Streisand
- grid.239560.b0000 0004 0482 1586Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010 USA
- grid.253615.60000 0004 1936 9510George Washington University School of Medicine, Washington, DC USA
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30
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Kwok JYY, Smith R, Chan LML, Lam LCC, Fong DYT, Choi EPH, Lok KYW, Lee JJ, Auyeung M, Bloem BR. Managing freezing of gait in Parkinson's disease: a systematic review and network meta-analysis. J Neurol 2022; 269:3310-3324. [PMID: 35244766 DOI: 10.1007/s00415-022-11031-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Freezing of gait (FOG) is one of the most disabling gait disorders affecting 80% of patients with Parkinson's disease (PD). Clinical guidelines recommend a behavioral approach for gait rehabilitation, but there is a wide diversity of behavioral modalities. OBJECTIVE The objective of this network meta-analysis was to compare the effectiveness of different behavioral interventions for FOG management in PD patients. METHODS Six databases were searched for randomized controlled trials of behavioral interventions for FOG management among PD patients from 1990 to December 2021. Bayesian network meta-analysis was used to combine both direct and indirect trial evidence on treatment effectiveness, while the surface under the cumulative ranking (SUCRA) score was used to estimate the ranked probability of intervention effectiveness. RESULTS Forty-six studies were included in the qualitative synthesis. Among, 36 studies (1454 patients) of 72 interventions or control conditions (12 classes) were included in the network meta-analysis, with a mean intervention period of 10.3 weeks. After adjusting for the moderating effect of baseline FOG severity, obstacle training [SMD -2.1; 95% credible interval (Crl): -3.3, -0.86], gait training with treadmill (SMD -1.2; 95% Crl: -2.0, -0.34), action observation training (SMD -1.0; 95% Crl: -1.9, -0.14), conventional physiotherapy (SMD -0.70; 95% Crl: -1.3, -0.12) and general exercise (SMD -0.64; 95% Crl: -1.2, -0.11) demonstrated significant improvement on immediate FOG severity compared to usual care. The SUCRA rankings suggest that obstacle training, gait training on treadmill and general exercises are most likely to reduce FOG severity. CONCLUSION Obstacle training, gait training on treadmill, general exercises, action observation training and conventional physiotherapy demonstrated immediate real-life benefits on FOG symptoms among patients with mild-moderate PD. With the promising findings, the sustained effects of high complexity motor training combined with attentional/cognitive strategy should be further explored. Future trials with rigorous research designs using both subjective and objective outcome measures, long-term follow-up and cost-effective analysis are warranted to establish effective behavioral strategies for FOG management.
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China.
| | - Robert Smith
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Lily Man Lee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Leo Chun Chung Lam
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, People's Republic of China
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Sensoy Bahar O, Nabunya P, Nabayinda J, Witte SS, Kiyingi J, Mayo-Wilson LJ, Filippone P, Yang LS, Nakigudde J, Tozan Y, Ssewamala FM. "I expected little, although I learned a lot": perceived benefits of participating in HIV risk reduction sessions among women engaged in sex work in Uganda. BMC Womens Health 2022; 22:162. [PMID: 35562821 PMCID: PMC9100307 DOI: 10.1186/s12905-022-01759-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The global HIV burden remains a public health concern. Women engaged in sex work (WESW) are at higher risk of acquiring HIV compared to the general adult population. Uganda reports high rates of HIV prevalence among WESW. While WESW in Uganda have long been the subject of surveillance studies, they have not been targeted by theory-informed HIV prevention intervention approaches. In this study, we explored the perceived benefits of an evidence-based HIV risk reduction intervention that was implemented as part of a combination intervention tested in a clinical trial in Uganda. METHODS As part of a larger randomized clinical trial, we conducted semi-structured in-depth interviews with 20 WESW selected using a stratified purposive sampling. All interviews were conducted in Luganda, language spoken in the study area, and audio-recorded. They were transcribed verbatim and translated to English. Thematic analysis was used to analyze the data. RESULTS WESW's narratives focused on: (1) condom use; (2) alcohol/drug consumption; (3) PrEP use; (4) "handling" customers; and (5) "massaging" customers. WESW agreed that male condom was one of the important learning points for them and planned to continue using them while female condoms were received with mixed reactions. Many women appreciated receiving information about the risks of consuming alcohol and drugs, and discussed how they reduced/ eliminated their consumption. PrEP information was appreciated though identified by fewer WESW. Handling a client was discussed as a helpful strategy for safer sex through improved ability to convince customers to use condoms or avoiding sex. Massaging was also beneficial to avoid penetrative sex, but similar to female condom, massaging also yielded mixed perceptions. CONCLUSION WESW found the intervention beneficial and described ways in which it improved their ability to engage in safer sex and stay healthy. The fact that WESW identified other strategies beyond condom use as helpful underlines the importance of adopting a comprehensive approach to behavioral interventions targeting HIV prevention even when combined with other interventions. Additionally, WESW's narratives suggest that incorporating the tenets of social cognitive theory and harm reduction approaches in HIV prevention among this population can result in risk behavior change.
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Affiliation(s)
- Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA.
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Josephine Nabayinda
- International Center for Child Health and Development Field Office, Masaka, Uganda
| | - Susan S Witte
- Columbia University School of Social Work, New York City, NY, USA
| | - Joshua Kiyingi
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Prema Filippone
- Columbia University School of Social Work, New York City, NY, USA
| | | | - Janet Nakigudde
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Yesim Tozan
- School of Global Public Health, New York University, New York City, NY, USA
| | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, USA
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Fuchs TA, Jaworski MG, Youngs M, Abdel-Kerim O, Wojcik C, Weinstock-Guttman B, Benedict RH. Preliminary Support of a Behavioral Intervention for Trait Conscientiousness in Multiple Sclerosis. Int J MS Care 2022; 24:45-53. [PMID: 35462870 PMCID: PMC9017661 DOI: 10.7224/1537-2073.2021-005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Background Conscientiousness, or the proclivity for deliberation, achievement, and order, declines in many individuals with multiple sclerosis (MS). Decreased conscientiousness predicts future cognitive deterioration, brain atrophy, and employment loss in individuals with MS. As a psychological trait, it may be an actionable antecedent to these important outcomes. We pilot tested an application (app)-facilitated behavioral intervention to help adaptation to low conscientiousness and, in turn, improve employment. Methods Eleven individuals with MS (5 treatment, 6 control) with low conscientiousness were recruited for a 12-week randomized controlled trial. The treatment group received a newly developed behavioral treatment and smartphone app designed to help people behave more conscientiously, 2 teleconference booster sessions, and weekly telephone calls to monitor progress. Employment changes were recorded at baseline and follow-up. Patients provided detailed posttreatment interviews. Results Participant groups were matched on baseline age, sex, education, disease duration, hours worked, and conscientiousness. All participants in the treatment arm reported benefits, found the app easy to use, and would recommend it to others. The treatment group reported significantly more positive work outcomes relative to controls at follow-up (P = .028). Other positive life changes were described by treatment participants during post-treatment interviews. Conclusions These results support the hypothesis that behaviors typically associated with low conscientiousness may be addressed by behavioral therapy in the MS population. In addition to the positive employment changes in the treatment group, several other quality of life changes were described by study participants. Additional research is needed.
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Affiliation(s)
- Tom A. Fuchs
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
- The Buffalo Neuroimaging Analysis Center (TAF), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael G. Jaworski
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Margaret Youngs
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Omar Abdel-Kerim
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Curtis Wojcik
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ralph H.B. Benedict
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
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Ríos-Barnés M, Fontalvo MA, Liñán N, Plana M, Moreno M, Esteva C, Muñoz-Almagro C, Noguera-Julian A, Alarcón A. Letter to the Editor on the original article: Lower prevalence of congenital cytomegalovirus infection in Portugal: possible impact of COVID-19 lockdown? Eur J Pediatr 2022; 181:1293-1294. [PMID: 35091799 PMCID: PMC8799405 DOI: 10.1007/s00431-021-04354-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/11/2021] [Accepted: 12/16/2021] [Indexed: 11/03/2022]
Affiliation(s)
- María Ríos-Barnés
- grid.411160.30000 0001 0663 8628Infectious Diseases Unit, Department of Pediatrics, Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Melissa Andrea Fontalvo
- grid.411160.30000 0001 0663 8628Department of Neonatology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Nerea Liñán
- grid.411160.30000 0001 0663 8628Department of Molecular Microbiology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Montserrat Plana
- grid.411160.30000 0001 0663 8628Department of Neonatology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - María Moreno
- grid.411160.30000 0001 0663 8628Department of Neonatology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristina Esteva
- grid.411160.30000 0001 0663 8628Department of Molecular Microbiology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain ,grid.466571.70000 0004 1756 6246Center for Biomedical Network Research On Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Carmen Muñoz-Almagro
- grid.411160.30000 0001 0663 8628Department of Molecular Microbiology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain ,grid.466571.70000 0004 1756 6246Center for Biomedical Network Research On Epidemiology and Public Health (CIBERESP), Madrid, Spain ,grid.410675.10000 0001 2325 3084Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Antoni Noguera-Julian
- Infectious Diseases Unit, Department of Pediatrics, Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain. .,Center for Biomedical Network Research On Epidemiology and Public Health (CIBERESP), Madrid, Spain. .,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain. .,Department of Pediatrics, University of Barcelona, Barcelona, Spain.
| | - Ana Alarcón
- grid.411160.30000 0001 0663 8628Department of Neonatology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Pediatrics, University of Barcelona, Barcelona, Spain
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Levy SA, Smith G, De Wit L, DeFeis B, Ying G, Amofa P, Locke D, Shandera-Ochsner A, McAlister C, Phatak V, Chandler M. Behavioral Interventions in Mild Cognitive Impairment (MCI): Lessons from a Multicomponent Program. Neurotherapeutics 2022; 19:117-131. [PMID: 35415779 PMCID: PMC9130435 DOI: 10.1007/s13311-022-01225-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 01/03/2023] Open
Abstract
Comparative effectiveness of behavioral interventions to mitigate the impacts of degeneration-based cognitive decline is not well understood. To better address this gap, we summarize the studies from the Healthy Action to Benefit Independence & Thinking (HABIT®) program, developed for persons with mild cognitive impairment (pwMCI) and their partners. HABIT® includes memory compensation training, computerized cognitive training (CCT), yoga, patient and partner support groups, and wellness education. Studies cited include (i) a survey of clinical program completers to establish outcome priorities; (ii) a five-arm, multi-site cluster randomized, comparative effectiveness trial; (iii) and a three-arm ancillary study. PwMCI quality of life (QoL) was considered a high-priority outcome. Across datasets, findings suggest that quality of life was most affected in groups where wellness education was included and CCT withheld. Wellness education also had greater impact on mood than CCT. Yoga had a greater impact on memory-dependent functional status than support groups. Yoga was associated with better functional status and improved caregiver burden relative to wellness education. CCT had the greatest impact on cognition compared to yoga. Taken together, comparisons of groups of program components suggest that knowledge-based interventions like wellness education benefit patient well-being (e.g., QoL and mood). Skill-based interventions like yoga and memory compensation training aid the maintenance of functional status. Notably, better adherence produced better outcomes. Future personalized intervention approaches for pwMCI may include different combinations of behavioral strategies selected to optimize outcomes prioritized by patient values and preferences.
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Affiliation(s)
- Shellie-Anne Levy
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA.
| | - Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Brittany DeFeis
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Gelan Ying
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Priscilla Amofa
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Dona Locke
- Division of Neuropsychology, Mayo Clinic, Scottsdale, AZ, USA
| | - Anne Shandera-Ochsner
- Department of Psychiatry and Psychology, Mayo Clinic Health System, La Crosse, WI, USA
| | - Courtney McAlister
- Department of Psychiatry and Psychology, Mayo Clinic Health System, La Crosse, WI, USA
| | - Vaishali Phatak
- Department of Neurological Sciences, University of Nebraska Medical Center Omaha, Nebraska, USA
| | - Melanie Chandler
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
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35
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Roberts SB, Anton S, Dao MC. Weight Loss Strategies. Handb Exp Pharmacol 2022; 274:331-348. [PMID: 35624229 DOI: 10.1007/164_2022_580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Lifestyle interventions for weight loss combine support for changing diet and physical activity with weight management education and are considered the first line treatment for obesity. A variety of diet-focused interventions including time-restricted eating are also increasingly being promoted for weight management. This chapter reviews different types of interventions for weight management, their underlying health behavior change models, and effectiveness to date in randomized trials. The results justify increasing efforts to improve program effectiveness generally, and to personalize interventions to support long-term adherence. The high prevalence of obesity worldwide, combined with the known increase in risk of non-communicable diseases with duration of excess weight, provides a compelling justification for routine delivery of effective weight management interventions in the community and in clinical care.
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Affiliation(s)
- Susan B Roberts
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Stephen Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Maria C Dao
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, USA
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36
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Aklin WM, Walton KM, Antkowiak P. Digital therapeutics for Substance Use Disorders: Research priorities and clinical validation. Drug Alcohol Depend 2021; 229:109120. [PMID: 34740068 DOI: 10.1016/j.drugalcdep.2021.109120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/17/2021] [Accepted: 10/05/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Will M Aklin
- National Institute on Drug Abuse, Division of Therapeutics and Medical Consequences, United States.
| | - Kevin M Walton
- National Institute on Drug Abuse, Division of Therapeutics and Medical Consequences, United States
| | - Patrick Antkowiak
- Food and Drug Administration, Center for Devices and Radiological Health, Office of Neurological and Physical Medicine Devices, United States
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37
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Shenk CE, Keeshin B, Bensman HE, Olson AE, Allen B. Behavioral and pharmacological interventions for the prevention and treatment of psychiatric disorders with children exposed to maltreatment. Pharmacol Biochem Behav 2021; 211:173298. [PMID: 34774585 DOI: 10.1016/j.pbb.2021.173298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/20/2021] [Accepted: 11/08/2021] [Indexed: 01/21/2023]
Abstract
There is a well-established relation between exposure to child maltreatment and the onset and course of multiple, comorbid psychiatric disorders. Given the heterogeneous clinical presentations at the time services are initiated, interventions for children exposed to maltreatment need to be highly effective to curtail the lifelong burden and public health costs attributable to psychiatric disorders. The current review describes the most effective, well-researched, and widely-used behavioral and pharmacological interventions for preventing and treating a range of psychiatric disorders common in children exposed to maltreatment. Detailed descriptions of each intervention, including their target population, indicated age range, hypothesized mechanisms of action, and effectiveness demonstrated through randomized controlled trials research, are presented. Current limitations of these interventions are noted to guide specific directions for future research aiming to optimize both treatment effectiveness and efficiency with children and families exposed to maltreatment. Strategic and programmatic future research can continue the substantial progress that has been made in the prevention and treatment of psychiatric disorders for children exposed to maltreatment.
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38
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Mohan D, MacMartin MA, Chelen JSC, Maezes CB, Barnato AE. Development of a theory-based video-game intervention to increase advance care planning conversations by healthcare providers. Implement Sci Commun 2021; 2:117. [PMID: 34645515 PMCID: PMC8513300 DOI: 10.1186/s43058-021-00216-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background Hospitalization offers an opportunity for healthcare providers to initiate advance care planning (ACP) conversations, yet such conversations occur infrequently. Barriers to these conversations include attitudes, skill, and time. Our objective was to develop a theory-based, provider-level intervention to increase the frequency of ACP conversations in hospitals. Methods We followed a systematic process to develop a theory-based, provider-level intervention to increase ACP conversations between providers and their hospitalized patients. Using principles established in Intervention Mapping and the Behavior Change Wheel, we identified a behavioral target, a theory of behavior change, behavior change techniques, and a mode of delivery. We addressed a limitation of these two processes of intervention development by also establishing a framework of design principles to structure the selection of intervention components. We partnered with a game development company to translate the output into a video game. Results We identified willingness to engage in ACP conversations as the primary contributor to ACP behavior, and attitudes as a modifiable source of this willingness. We selected self-determination theory, and its emphasis on increasing autonomous motivation, as a relevant theory of behavior change and means of changing attitudes. Second, we mapped the components of autonomous motivation (i.e., autonomy, competence, and relatedness) to relevant behavior change techniques (e.g., identity). Third, we decided to deliver the intervention using a video game and to use the narrative engagement framework, which describes the use of stories to educate, model behavior, and immerse the user, to structure our selection of intervention components. Finally, in collaboration with a game development company, we used this framework to develop an adventure video game (Hopewell Hospitalist). Conclusions The systematic development of a theory-based intervention facilitates the mechanistic testing of the efficacy of the intervention, including the specification of hypotheses regarding mediators and moderators of outcomes. The intervention will be tested in a randomized clinical trial. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00216-8.
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Affiliation(s)
- Deepika Mohan
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Meredith A MacMartin
- Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Julia S C Chelen
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Carolyn B Maezes
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Amber E Barnato
- Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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Wilson DK. Why the book "More than Medicine: the Broken Promise of American Health" is important to the future of behavioral medicine, health psychology, and public health. Transl Behav Med 2021; 11:291-293. [PMID: 31747039 DOI: 10.1093/tbm/ibz161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In his book, "More than Medicine: The Broken Promise of American Health," Robert Kaplan brings together extensive data to make the case that healthcare priorities in the USA need to place greater emphasis on behavioral, social and environmental determinants of health. Kaplan argues that the effect sizes for health outcomes resulting from environmental exposures, stress, and socioeconomic status are all much larger than are many traditional biological risk factors. There are discrepancies between estimates of how much the National Institutes of Health spends on behavioral and social sciences research, but an independent evaluation suggests it is <5% of the entire budget. Addressing this neglect requires advocacy and bringing together of like-minded organizations to promote more funding for behavioral interventions, health promotion and public health policies to address important contextual factors such as poverty, lack of education, and poor environmental conditions. Importantly, Kaplan argues that several metrics to integrate life expectancy and quality of life have been proposed and allow healthcare providers to prioritize the value of health over the volume of healthcare delivered. Although standards exist, there are still a limited number of studies on the cost-effectiveness and cost-utility of behavioral and public health interventions.
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Affiliation(s)
- Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, USA
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40
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Gaysynsky A, Vinson CA, Oh A. Development and evaluation of the SPeeding Research-tested INTerventions (SPRINT) training program. Transl Behav Med 2021; 10:1406-1415. [PMID: 31328785 DOI: 10.1093/tbm/ibz099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The National Cancer Institute established a dissemination and implementation accelerator program called SPeeding Research-tested INTerventions (SPRINT) to improve the uptake of evidence-based interventions. The purpose of this study was to describe the origin, structure, and goals of the SPRINT program, and present evaluation results from the first two cohorts of the program. Qualitative (focus group) and quantitative (survey) data collected from participants were used to evaluate the course and inform program improvement efforts. The majority of the participants (over 90% in both cohorts) rated the course highly, and over 80% would recommend the course to other researchers. Most participants indicated knowing relatively little about business model concepts before SPRINT, but after SPRINT, nearly all respondents felt that they had at least "some" knowledge of each business model component. Participants also indicated that they learned about the product-market fit of their intervention and gained insights from customer discovery interviews that would enable them to make their intervention more "stakeholder focused". Participants also indicated that they plan to use the knowledge and skills they gained during the SPRINT program in their future work. Feedback from participants was used by the management team to implement various program improvements to better serve the next cohort of participants. While behavioral researchers face significant barriers to commercializing their interventions, they recognize the importance of translating their research into practice. Training researchers to consider scale-up, implementation, and commercialization from the outset can help reduce the number of proven interventions that are never used in practice.
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Affiliation(s)
- Anna Gaysynsky
- ICF, Engagement and Transformation, ICF Next, Rockville, MD, USA
| | - Cynthia A Vinson
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Stephenson R, Garofalo R, Sullivan PS, Hidalgo MA, Bazzi AR, Hoehnle S, Bratcher A, Finneran CA, Mimiaga MJ. Stronger Together: Results from a Randomized Controlled Efficacy Trial of a Dyadic Intervention to Improve Engagement in HIV Care Among Serodiscordant Male Couples in Three US Cities. AIDS Behav 2021; 25:2369-2381. [PMID: 33630199 PMCID: PMC8247634 DOI: 10.1007/s10461-021-03199-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/23/2022]
Abstract
Engagement in HIV care and a high level of antiretroviral therapy (ART) adherence for people living with HIV is crucial to treatment success and can minimize the population burden of the disease. Despite this, there is a critical gap in HIV prevention science around the development of interventions for serodiscordant male couples. This paper reports on the results of a randomized controlled trial to assess the efficacy of Stronger Together, a dyadic counseling intervention aimed at increasing engagement in and optimizing HIV care among serodiscordant male couples in Atlanta, GA, Boston, MA, and Chicago, IL. Between 2014 and 2017, 159 male serodiscordant couples (total N = 318) in Atlanta, GA, Boston, MA, and Chicago, IL were enrolled and equally randomized to either the Stronger Together intervention arm (a three-session dyadic intervention involving HIV testing and adherence counseling) or a standard of care (SOC) control arm. Couples completed individual study assessments via an audio computer assisted self-interviewing (ACASI) system at baseline, 6, 12 and 18 months. Primary outcomes included being prescribed and currently taking ART, and fewer missed doses of ART in the past 30 days; because the trial was not powered to examine viral suppression, we examined this as an exploratory outcome. Longitudinal data analysis was by an intention-to-treat approach. Participants ages ranged from 18 to 69 (mean = 35.9), and are predominantly white (77.5%), and college educated (68.4% earned a college degree or higher). Participants randomized to the Stronger Together arm had a significantly greater odds of being prescribed and currently taking ART over time than those in the SOC arm (at 12 months OR 2.75, 95%CI 1.35-4.67, p-value 0.020, and at 18 months OR 2.91, 95%CI 1.61-4.88, p-value 0.013). Similarly, those in the Stronger Together arm had a significantly lower odds of missing a dose of ART in the past 30 days over time compared to those in the SOC arm (at 12 months OR 0.28, 95%CI 0.09-0.81, p-value 0.019, and at 18 months OR 0.25, 95%CI 0.07-0.82, p-value 0.023). Among male couples in serodiscordant relationships, the Stronger Together intervention resulted in significantly improved HIV treatment outcomes at both 12 and 18 months of follow-up. This trial is the first to date to demonstrate evidence of efficacy for a dyadic counseling intervention and has the potential to fill a critical gap in secondary HIV prevention interventions for serodiscordant male couples.
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Affiliation(s)
- Rob Stephenson
- Department of Systems, Population and Leadership & The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI, 48109, USA.
| | - Robert Garofalo
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Marco A Hidalgo
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Angela R Bazzi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Samuel Hoehnle
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anna Bratcher
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | | | - Matthew J Mimiaga
- Center for LGBTQ Advocacy, Research, and Health, UCLA, Los Angeles, CA, USA
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
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Berg CJ, Krishnan N, Graham AL, Abroms LC. A synthesis of the literature to inform vaping cessation interventions for young adults. Addict Behav 2021; 119:106898. [PMID: 33894483 PMCID: PMC8113079 DOI: 10.1016/j.addbeh.2021.106898] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 12/01/2022]
Abstract
There is an urgent need to address young adult (YA) vaping. However, there is limited vaping cessation intervention research, particularly studies tested via experimental designs. This manuscript focuses on YA vaping and critical needs for research to advance vaping cessation interventions for YAs. The smoking cessation literature, especially regarding YA smoking, provides evidence and theory from which to draw. However, the extent to which this literature has utility for vaping cessation warrants investigation. Research to inform the development and optimization of effective vaping cessation interventions for YAs requires attention to both potential targets for behavioral intervention (e.g., conceptual framework) and how to best reach YAs (i.e., delivery modality). Regarding the former, such interventions must consider the complexity of YA vaping (e.g., complex social influences, limited negative outcome expectancies, quit intentions). One particularly challenging aspect of YA cessation is co-use of other tobacco products and marijuana and ensuring that those who quit vaping do not continue or increase other product use. With regard to intervention modality, technology-based interventions (e.g., text messaging, apps) may prove promising, and individualized intervention (e.g., one-on-one counseling) may be needed to carefully intervene on the complexity of substance use, particularly cigarette and marijuana use, within this population.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States.
| | - Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Amanda L Graham
- Innovations Center, Truth Initiative, Washington, DC, United States; Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States
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Abstract
Although behavioral interventions have been known to effectively reduce stereotypy in children with ASD, these types of interventions are not accessible to all families. In response to this issue, we evaluated the effects of the iSTIM, an iOS application designed to support parents in the reduction of stereotypy in their child with ASD. We used a series of AB designs to determine the effectiveness of the iSTIM on stereotypy using parents as behavior change agents. The use of iSTIM by the parents led to a reduction in stereotypy for six of seven participants. Our results suggest that the use of technology may be a cost effective and easily accessible method for parents to reduce stereotypy in their child with ASD.
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Affiliation(s)
- Lydia Trudel
- École de Psychoéducation, Université de Montréal, Succursale Centre-Ville, Montreal, QC, C.P. 6128, H3C 3J7, Canada
| | - Marc J Lanovaz
- École de Psychoéducation, Université de Montréal, Succursale Centre-Ville, Montreal, QC, C.P. 6128, H3C 3J7, Canada. .,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.
| | - Isabelle Préfontaine
- École de Psychoéducation, Université de Montréal, Succursale Centre-Ville, Montreal, QC, C.P. 6128, H3C 3J7, Canada
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Mistree D, Loyalka P, Fairlie R, Bhuradia A, Angrish M, Lin J, Karoshi A, Yen SJ, Mistri J, Bayat V. Instructional interventions for improving COVID-19 knowledge, attitudes, behaviors: Evidence from a large-scale RCT in India. Soc Sci Med 2021; 276:113846. [PMID: 33773476 PMCID: PMC7963523 DOI: 10.1016/j.socscimed.2021.113846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/18/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022]
Abstract
Seeking ways to encourage broad compliance with health guidelines during the pandemic, especially among youth, we test two hypotheses pertaining to the optimal design of instructional interventions for improving COVID-19-related knowledge, attitudes, and behaviors. We randomly assigned 8376 lower-middle income youth in urban India to three treatments: a concentrated and targeted fact-based, instructional intervention; a longer instructional intervention that provided the same facts along with underlying scientific concepts; and a control. Relative to existing efforts, we find that both instructional interventions increased COVID-19-related knowledge immediately after intervention. Relative to the shorter fact-based intervention, the longer intervention resulted in sustained improvements in knowledge, attitudes, and self-reported behavior. Instead of reducing attention and comprehension by youth, the longer scientific based treatment appears to have increased understanding and retention of the material. The findings are instrumental to understanding the design of instruction and communication in affecting compliance during this and future pandemics.
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Affiliation(s)
- Dinsha Mistree
- Stanford University, Law School, 559 Nathan Abbott Way, Stanford, CA, 94305, USA.
| | - Prashant Loyalka
- Stanford University, Graduate School of Education and Freeman Spogli Institute for International Studies, Encina Hall East Wing Room 413, 616 Serra St., Stanford, CA, 94305, USA.
| | - Robert Fairlie
- University of California, Department of Economics, Santa Cruz, CA, 95064, USA.
| | - Ashutosh Bhuradia
- Freedom Employability Academy, Valmiki Temple One, Vasant Gaon, New Delhi, 110057, India; Harvard University, Graduate School of Education, 13 Appian Way, Cambridge, MA, 02138, USA.
| | - Manyu Angrish
- Freedom Employability Academy, Valmiki Temple One, Vasant Gaon, New Delhi, 110057, India.
| | - Jason Lin
- Harker School, 500 Saratoga Ave., San Jose, CA, 95129, USA.
| | - Amar Karoshi
- Harker School, 500 Saratoga Ave., San Jose, CA, 95129, USA.
| | - Sara J Yen
- Harker School, 500 Saratoga Ave., San Jose, CA, 95129, USA.
| | - Jamsheed Mistri
- University of California, Department of Electrical Engineering and Computer Science, Berkeley, CA, 94720, USA.
| | - Vafa Bayat
- Bitscopic, Inc., 715 Colorado Avenue Suite B, Palo Alto, CA, 94303, USA.
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Bendtsen M, McCambridge J. Causal models accounted for research participation effects when estimating effects in a behavioral intervention trial. J Clin Epidemiol 2021; 136:77-83. [PMID: 33727133 DOI: 10.1016/j.jclinepi.2021.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Participants in intervention studies are asked to take part in activities linked to the conduct of research, including signing consent forms and being assessed. If participants are affected by such activities through mechanisms by which the intervention is intended to work, then there is confounding. We examine how to account for research participation effects analytically. STUDY DESIGN AND SETTING Data from a trial of a brief alcohol intervention among Swedish university students is used to show how a proposed causal model can account for assessment effects. RESULTS The proposed model can account for research participation effects as long as researchers are willing to use existing data to make assumptions about causal influences, for instance on the magnitude of assessment effects. The model can incorporate several research processes which may introduce bias. CONCLUSIONS As our knowledge grows about research participation effects, we may move away from asking if participants are affected by study design, toward rather asking by how much they are affected, by which activities and in which circumstances. The analytic perspective adopted here avoids assuming there are no research participation effects.
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Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.
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Papaioannou D, Cooper C, Mooney C, Glover R, Coates E. Adverse event recording failed to reflect potential harms: a review of trial protocols of behavioral, lifestyle and psychological therapy interventions. J Clin Epidemiol 2021; 136:64-76. [PMID: 33684508 DOI: 10.1016/j.jclinepi.2021.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/07/2021] [Accepted: 03/01/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To explore how potential harms are assessed in trials of behavioral, lifestyle and psychological therapy interventions. STUDY DESIGN AND SETTING This study was a review of protocols from the National Institute of Health Research Health Technology Assessment and Public Health Research programmes. Protocols were included if the study was a randomized controlled trial and the intervention intended to change lifestyle or behavior to improve health or improve psychological outcomes. RESULTS 95 of 151 protocols planned to record adverse events (AEs). Definitions of AEs were often not given and varied widely. Serious AEs were mostly defined using standards originally devised for pharmacological trials. Twenty-two protocols listed expected AEs. Few protocols described assessment of causation between AEs and intervention. Examples of useful AE recording practice were identified. CONCLUSION Monitoring and recording AEs in behavioral intervention trials was variable and frequently based on reporting guidelines for pharmacological trials. This may mean potential harms are being missed. Future trials should consider: 1) Potential harms posed by the intervention 2) How to define serious AEs 3) What are expected AEs. Further research to achieve consensus on AE recording is required, including identification of core adverse outcomes in clinical areas or caused by interventions.
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Affiliation(s)
- Diana Papaioannou
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
| | - Cindy Cooper
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Cara Mooney
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Rachel Glover
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Elizabeth Coates
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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D'Rozario AL, Galgut Y, Crawford MR, Bartlett DJ. Summary and Update on Behavioral Interventions for Improving Adherence with Positive Airway Pressure Treatment in Adults. Sleep Med Clin 2021; 16:101-124. [PMID: 33485523 DOI: 10.1016/j.jsmc.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Continuous positive airway pressure (PAP) is still the most efficacious treatment for obstructive sleep apnea when used effectively. Since the availability of PAP 39 years ago there have been considerable technological advances, such as quieter, lighter and smaller machines with better humidification. However, adherence to treatment is still a major problem. This article reviews studies published on behavioral interventions aimed at improving the uptake and maintenance of PAP treatment (January 2016-February 2020). It discusses underlying factors in the poor uptake and discontinuation of treatment and the role of qualitative research to better understand the perspective of the patients.
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Affiliation(s)
- Angela L D'Rozario
- School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, The University of Sydney, Level 2, Building D17, Johns Hopkins Drive, Camperdown, New South Wales 2050, Australia; Sleep and Circadian Research Group, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia; Sydney Medical School, The University of Sydney.
| | - Yael Galgut
- Sleep and Circadian Research Group, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia
| | - Megan R Crawford
- The University of Strathclyde, Graham Hills Building, 50 George Street, Glasgow G1 1QE, UK
| | - Delwyn J Bartlett
- Sleep and Circadian Research Group, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia; Sydney Medical School, The University of Sydney
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Tanabe Y, Nakata Y, Zempo-Miyaki A, Hieda MY, Choi Y, Fujii N, Maeda S. Different degree of intervention in 6-month weight-loss support and arterial stiffness: Secondary analysis of a randomized controlled trial. Obes Res Clin Pract 2020; 15:93-95. [PMID: 33358148 DOI: 10.1016/j.orcp.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/21/2020] [Accepted: 11/25/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Weight reduction by lifestyle modification (i.e., low-calorie diet and/or exercise) decreases arterial stiffness in overweight or obese individuals. We previously demonstrated that weight loss differs depending on the degree of intervention in weight-loss support in a randomized controlled trial (UMIN000001259). However, the effect of different degrees of intervention on arterial stiffness remains unclear. METHODS AND RESULTS A total of 188 middle-aged men and women with overweight or obesity (51 ± 7 years, BMI: 29.0 ± 3.2 kg/m2) participated in the 6-month trial wherein they were assigned to a low (LI, n = 63), moderate (MI, n = 62), or high intensive intervention (HI, n = 63) group. Initially, one motivational lecture on weight loss was provided to all three groups, whereas educational materials (textbooks, notebooks, and a pedometer) were provided to groups MI and HI. Additionally, the HI group participated in a series of group-based sessions. Body weight and arterial stiffness assessed by brachial-ankle pulse wave velocity (baPWV) were measured at 0, 3, and 6 months. Six-month weight loss was greater in the order of HI, MI, and LI groups. The interventions reduced baPWV in all groups, and the reduction was not significantly different among the groups (114.3 ± 16.3, 82.6 ± 15.2, and 98.8 ± 90.4 cm/s, respectively). CONCLUSION In overweight or obese individuals, different degrees of intervention in weight-loss support affect body weight; however, the extent to which arterial stiffness improves does not differ among support programs.
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Affiliation(s)
- Yoko Tanabe
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Yoshio Nakata
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Asako Zempo-Miyaki
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan; Faculty of Sport and Health Sciences, Ryutsu Keizai University, Ibaraki, Japan
| | - Mutsuko Y Hieda
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan; Institute of Liberal Arts and Science, Toyohashi University of Technology, Aichi, Japan
| | - Youngju Choi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan; Institute of Sports & Arts Convergence, Inha University, Incheon, Republic of Korea
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Seiji Maeda
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan.
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Abstract
PURPOSE OF REVIEW Overweight and obesity are now the most common high-risk conditions in pregnancy in the United States and increase risk of adverse outcomes during pregnancy, delivery, and the postpartum. Importantly, excess gestational weight gain is highly predictive of maternal postpartum weight retention and risk of overweight and obesity in mothers and their children later in life. This makes pregnancy a unique window of opportunity in the fight against obesity across the lifespan. This narrative review critically evaluates research on the efficacy of interventions targeting excess gestational weight gain, highlighting the potential of targeting psychological mechanisms to facilitate positive weight-related behavior change specifically in pregnancy. The PUBMED and PsycInfo databases were searched for relevant articles, including meta-analyses, systematic reviews, and randomized controlled trials with the primary or secondary aim of reducing gestational weight gain. RECENT FINDINGS There is currently no gold standard for preventing excess gestational weight gain, especially in women with pre-pregnancy overweight and obesity. Existing interventions primarily target diet and physical activity but lack broad empirical support and typically have only modest effects on weight gain in pregnancy, with few successfully preventing excess weight gain. Furthermore, interventions that successfully target gestational weight gain have minimal positive impact on weight- and diet-related maternal and fetal health outcomes. A growing evidence points to the utility of targeting psychological mechanisms in the prevention of excess gestational weight gain, including cognitive and affective factors, food cravings, and self-efficacy. Given the lack of broad evidence to support the efficacy of interventions targeting diet and physical activity, there is a notable need for research to develop and evaluate interventions targeting psychological factors that could positively impact diet- and weight-related behavioral change in pregnancy.
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Affiliation(s)
- Lauren E Blau
- Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY, 12222, USA.
| | - Julia M Hormes
- Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY, 12222, USA
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Buchanan A, Roddy M, Badr H. Patient-reported outcomes of non-pharmacological interventions for endometrial cancer survivors: a systematic review. J Cancer Surviv 2020; 15:526-535. [PMID: 33140266 DOI: 10.1007/s11764-020-00946-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/18/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE The objective of this review was to assess the efficacy of non-pharmacological interventions on endometrial cancer (EC) survivors' QOL, and their use of patient-reported outcome measures (PROMs). METHODS We conducted a systematic review of randomized controlled trials (RCTs) of non-pharmacological interventions that assessed the impact of intervention on EC survivors' general and domain-specific QOL (i.e., physical, psychological, and social well-being) using PROMs. RESULTS Of the 3178 studies identified, 28 full-text articles were reviewed, and 10 were included in the review. Nine RCTs assessed at least one PROM as a primary outcome and six assessed a PROM as a secondary outcome, but few studies used validated PROMs. Significant improvements in general QOL were found in two studies, domain-specific QOL in three studies, and both general and domain-specific QOL in three studies; however, effect sizes ranged from small to large and no significant effects were found for social well-being and few were found for psychological well-being. CONCLUSIONS Few non-pharmacological interventions for EC survivors targeted QOL, even though QOL was assessed as either a primary or secondary outcome of the RCT. Despite this, findings suggest that non-pharmacological interventions for EC survivors hold promise for improving general and domain-specific QOL. Use of validated PROMs would greatly enhance outcome reporting and facilitate comparisons across studies. More interventions are also needed that address social and psychological functioning in this population. IMPLICATIONS FOR CANCER SURVIVORS Our review highlights a need to (1) expand non-pharmacological RCTs for EC survivors, (2) increase the use of validated PROMs measuring QOL, and (3) address psychosocial domains of QOL when developing interventions for this population.
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Affiliation(s)
- Ashley Buchanan
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - McKenzie Roddy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Hoda Badr
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
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