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“It’s About Going From Good to Great”: Expert Approaches to Conducting a First Sport Psychology Session. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2022. [DOI: 10.1123/jcsp.2021-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to investigate expert practitioners’ approaches to conducting a first sport psychology session with individual clients as there is sparse empirical literature on this topic. Nine expert Certified Mental Performance Consultants completed a semistructured interview where they discussed experiences conducting a first meeting with an athlete. Primary objectives included establishing the relationship, setting guidelines and expectations, understanding the client’s background, identifying presenting concerns, and formulating the treatment plan and building skills. Building rapport was an aspect used to establish the relationship while discussing confidentiality was utilized to set guidelines. Important strategies employed to increase the perceived benefits to services included conveying the consulting approach and philosophy. Lessons learned centered around doing too much and not appreciating individual differences of clients. Findings show expert consultants aim to achieve similar broad objectives in the first session and provide a basis for best practices in this area.
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Petranker R, Anderson T, Maier LJ, Barratt MJ, Ferris JA, Winstock AR. Microdosing psychedelics: Subjective benefits and challenges, substance testing behavior, and the relevance of intention. J Psychopharmacol 2022; 36:85-96. [PMID: 33591231 DOI: 10.1177/0269881120953994] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Microdosing psychedelics is the practice of taking small, sub-hallucinogenic doses of lysergic acid diethylamide or psilocybin-containing mushrooms. Despite its surging popularity, little is known about the specific intentions to start microdosing and the effects of this practice. AIMS First, we aimed to replicate previous findings regarding the subjective benefits and challenges reported for microdosing. Second, we assessed whether people who microdose test their substances before consumption. Third, we examined whether having an approach-intention to microdosing was predictive of more reported benefits. METHODS The Global Drug Survey runs the world's largest online drug survey. Participants who reported last year use of lysergic acid diethylamide or psilocybin in the Global Drug Survey 2019 were offered the opportunity to answer a sub-section on microdosing. RESULTS Data from 6753 people who reported microdosing at least once in the last 12 months were used for analyses. Our results suggest a partial replication of previously reported benefits and challenges among the present sample often reporting enhanced mood, creativity, focus and sociability. Counter to our prediction, the most common challenge participants associated with microdosing was 'None'. As predicted, most participants reported not testing their substances. Counter to our hypothesis, approach-intention - microdosing to approach a desired goal - predicted less rather than more benefits. We discuss alternate frameworks that may better capture the reasons people microdose. CONCLUSION Our results suggest the perceived benefits associated with microdosing greatly outweigh the challenges. Microdosing may have utility for a variety of uses while having minimal side effects. Double-blind, placebo-controlled experiments are required to substantiate these reports.
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Affiliation(s)
- Rotem Petranker
- Clinical Psychology, York University, Toronto, Canada.,Psychedelic Studies Research Program, University of Toronto Mississauga, Mississauga, Canada
| | - Thomas Anderson
- Psychedelic Studies Research Program, University of Toronto Mississauga, Mississauga, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Larissa J Maier
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, United States of America.,Early Postdoc Mobility Grantee (P2ZHP1_17812), Swiss National Science Foundation, Bern, Switzerland
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jason A Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Adam R Winstock
- University College London, Gower Street, London, United Kingdom.,Global Drug Survey Ltd, London, United Kingdom
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Forsström D, Rozental A, Wiklund E, Carlbring P, Lindner P. Gamblers' Perception of the Playscan Risk Assessment: A Mixed-Methods Study. J Gambl Stud 2022; 38:591-606. [PMID: 34091781 PMCID: PMC9119887 DOI: 10.1007/s10899-021-10043-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 11/30/2022]
Abstract
Responsible gambling (RG) tools are globally widespread; they aim to prevent or decrease the harm caused by gambling. However, existing research suggests that several included features do not decrease gambling or significantly reduce the subsequent harm. Most of the previous studies have used gambling data to understand the changes in gambling behavior. However, the literature lacks research regarding gamblers' experience and perception of RG tools, which may provide insight into increasing the usage and effectiveness of RG tools. This mixed-methods study aimed to explore gamblers' perception of their risk assessment in the RG tool Playscan regarding developing harmful gambling problems. Overall, 757 participants rated the perceived accuracy of their risk assessment and their perception of the overall RG tool that conducted the assessment. Participants were also allowed to leave a comment providing feedback, which was analyzed using thematic analysis. Quantitative data was analyzed using logistic regression and structural equation modeling. Qualitative analyses revealed that most of the participants were pleased with the risk assessment and found it helpful. Moderated mediation analysis showed that participants' assessment agreement partially mediated the association between expressing a negative view and their general view of Playscan. These results highlight the need to decrease the level of disagreement for promoting a better general view of RG tools to potentially increase their usage and effectiveness.
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Affiliation(s)
- David Forsström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden. .,Department of Psychology, Stockholm University, Stockholm, Sweden. .,The Centre for Psychotherapy, Education and Research, Liljeholmstorget 7, SE-117 63, Stockholm, Sweden.
| | - Alexander Rozental
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,UCL Great Ormond Street Institute of Child Health, London, UK
| | - Emma Wiklund
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Parwati NM, Bakta IM, Januraga PP, Wirawan IMA. A Health Belief Model-Based Motivational Interviewing for Medication Adherence and Treatment Success in Pulmonary Tuberculosis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413238. [PMID: 34948846 PMCID: PMC8701142 DOI: 10.3390/ijerph182413238] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 11/16/2022]
Abstract
Medication adherence behavior plays a central role in the success of tuberculosis (TB) treatment. Conventional motivation is not optimal in strengthening long-term medication adherence. A motivational interviewing (MI) communication motivation model based on the Health Belief Model (HBM) was designed with the main objective of improving medication adherence and treatment success. This study used an experimental design with a randomized posttest-only control group design. The intervention and control groups consisted of 107 TB patients each, who were selected by random cluster sampling. The study was conducted from November 2020 to June 2021 at 38 public health centers in Bali Province. The HBM-based MI model intervention was given in seven counseling sessions, pill count percentages were used to measure medication adherence, and treatment success was based on sputum examination results. Logistic regression was used to assess the effect of the intervention on medication adherence and treatment success. Logistic regression analysis showed that MI-based HBM and knowledge were the most influential variables for increasing medication adherence and treatment success. Medication adherence was 4.5 times greater (ARR = 4.51, p = 0.018) and treatment success was 3.8 times greater (ARR = 3.81, p < 0.038) in the intervention group compared to the control group, while the secondary outcome of knowledge of other factors together influenced medication adherence and treatment success. The conclusion is that the HBM-based MI communication motivation model creates a patient-centered relationship by overcoming the triggers of treatment barriers originating from the HBM construct, effectively increasing medication adherence and treatment success for TB patients, and it needs further development by involving families in counseling for consistent self-efficacy of patients in long-term treatment.
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Affiliation(s)
- Ni Made Parwati
- Doctoral Study Program, Medical Faculty, Udayana University, Denpasar 80361, Indonesia
- Correspondence:
| | - I Made Bakta
- Department of Internal Medicine, Medical Faculty, Udayana University, Denpasar 80234, Indonesia;
| | - Pande Putu Januraga
- School of Public Health, Udayana University, Denpasar 80234, Indonesia; (P.P.J.); (I.M.A.W.)
| | - I Made Ady Wirawan
- School of Public Health, Udayana University, Denpasar 80234, Indonesia; (P.P.J.); (I.M.A.W.)
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56
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Why Do We Harm the Environment or Our Personal Health despite Better Knowledge? The Knowledge Action Gap in Healthy and Climate-Friendly Behavior. SUSTAINABILITY 2021. [DOI: 10.3390/su132313361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Non-communicable diseases, such as hypertension, diabetes, or depression, result from an interplay of physiological, genetic, behavioral, and environmental aspects. Together with climate change, they are arguably among the most significant challenges mankind faces in the 21st century. Additionally, the bidirectional influences of climate change and health on each other are undisputed. Behavioral changes could curb both climate change and the spread of non-communicable diseases. Much effort has been put into information campaigns in both fields, but success has been limited. In the following, the knowledge action gap is compared and analyzed in healthy and climate-friendly behavior from a practical point of view and the supporting theoretical models are highlighted. The analysis shows that self-efficacy plays an essential role in both areas of research for effecting behavioral changes. The models of ‘Planned Behavior’ and ‘Stages of Change’ seems helpful and can be applied and adapted to explain behavioral changes in health and climate changes settings. We compared two previously unrelated research fields to uncover new avenues for further study and stimulate fruitful transdisciplinary discussion. Future directions on how behavioral medicine and climate change research can learn from each other are discussed.
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57
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Kletter M, Melendez-Torres GJ, Lilford R, Taylor C. A Library of Logic Models to Explain How Interventions to Reduce Diagnostic Errors Work. J Patient Saf 2021; 17:e1223-e1233. [PMID: 29369895 DOI: 10.1097/pts.0000000000000459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES We aimed to create a library of logic models for interventions to reduce diagnostic error. This library can be used by those developing, implementing, or evaluating an intervention to improve patient care, to understand what needs to happen, and in what order, if the intervention is to be effective. METHODS To create the library, we modified an existing method for generating logic models. The following five ordered activities to include in each model were defined: preintervention; implementation of the intervention; postimplementation, but before the immediate outcome can occur; the immediate outcome (usually behavior change); and postimmediate outcome, but before a reduction in diagnostic errors can occur. We also included reasons for lack of progress through the model. Relevant information was extracted about existing evaluations of interventions to reduce diagnostic error, identified by updating a previous systematic review. RESULTS Data were synthesized to create logic models for four types of intervention, addressing five causes of diagnostic error in seven stages in the diagnostic pathway. In total, 46 interventions from 43 studies were included and 24 different logic models were generated. CONCLUSIONS We used a novel approach to create a freely available library of logic models. The models highlight the importance of attending to what needs to occur before and after intervention delivery if the intervention is to be effective. Our work provides a useful starting point for intervention developers, helps evaluators identify intermediate outcomes, and provides a method to enable others to generate libraries for interventions targeting other errors.
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Affiliation(s)
- Maartje Kletter
- From the Division of Health Sciences, University of Warwick, Coventry
| | | | - Richard Lilford
- From the Division of Health Sciences, University of Warwick, Coventry
| | - Celia Taylor
- From the Division of Health Sciences, University of Warwick, Coventry
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Tramonti F. Time to rethink the whole thing: The cul-de-sac of psychotherapy outcome research. J Eval Clin Pract 2021; 27:1184-1186. [PMID: 32567111 DOI: 10.1111/jep.13434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Francesco Tramonti
- Azienda USL Toscana Nordovest, Department of Mental Health, Pisa, Italy.,Istituto di Psicoterapia Relazionale, Pisa, Italy
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59
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Sookman D, Phillips KA, Anholt GE, Bhar S, Bream V, Challacombe FL, Coughtrey A, Craske MG, Foa E, Gagné JP, Huppert JD, Jacobi D, Lovell K, McLean CP, Neziroglu F, Pedley R, Perrin S, Pinto A, Pollard CA, Radomsky AS, Riemann BC, Shafran R, Simos G, Söchting I, Summerfeldt LJ, Szymanski J, Treanor M, Van Noppen B, van Oppen P, Whittal M, Williams MT, Williams T, Yadin E, Veale D. Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder. Psychiatry Res 2021; 303:113752. [PMID: 34273818 DOI: 10.1016/j.psychres.2021.113752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/21/2021] [Indexed: 12/19/2022]
Abstract
Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards.
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Affiliation(s)
- Debbie Sookman
- Department of Psychology, McGill University Health Center, 1025 Pine Ave W, Montreal, Quebec, H3A 1A1, Canada; Department of Psychiatry, McGill University, 845 Sherbrooke St W, Montreal, Quebec, H3A 0G4, Canada.
| | - Katharine A Phillips
- Department of Psychiatry, Weill Cornell Medicine, 1300 York Ave, New York, NY 10065, United States.
| | - Gideon E Anholt
- Department of Psychology, Marcus Family Campus, Ben-Gurion University of the Negev, Beer Sheva, P.O.B. 653 Beer-Sheva, 8410501, Israel.
| | - Sunil Bhar
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, 1 John St, Hawthorn, Victoria, 3122, Australia.
| | - Victoria Bream
- Oxford Health Specialist Psychological Interventions Clinic and Oxford Cognitive Therapy Centre, Warneford Hospital, Oxford, OX3 7JX, United Kingdom.
| | - Fiona L Challacombe
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF, United Kingdom.
| | - Anna Coughtrey
- Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom; UCL Great Ormond Street Institute of Child Health, 30 Guilford St, Holborn, London, WC1N 1EH, United Kingdom.
| | - Michelle G Craske
- Anxiety and Depression Research Center, Depression Grant Challenge, Innovative Treatment Network, Staglin Family Music Center for Behavioral and Brain Health, UCLA Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, Box 951563, 1285 Franz Hall, Los Angeles, CA, United States.
| | - Edna Foa
- Center for the Treatment and Study of Anxiety, University of Pennsylvania Perelman SOM, 3535 Market Street, Philadelphia, PA 19104, United States.
| | - Jean-Philippe Gagné
- Department of Psychology, Concordia University, 7141 Sherbrooke St, West, Montreal, Quebec H4B 1R6, Canada.
| | - Jonathan D Huppert
- Department of Psychology, The Hebrew University of Jerusalem, Mt. Scopus, Jerusalem, 91905, Israel.
| | - David Jacobi
- Rogers Behavioral Health, 34700 Valley Road, Oconomowoc, WI, 53066, United States.
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Rd, Manchester, M13 9PL, United Kingdom; Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M13 9PL, United Kingdom.
| | - Carmen P McLean
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 795 Willow Road, Menlo Park, CA, 94025, United States; Department of Psychiatry and Behavioral Sciences, Stanford University, 450 Serra Mall, Stanford, CA, 94305, United States.
| | - Fugen Neziroglu
- Bio-Behavioral Institute, 935 Northern Boulevard, Suite 102, Great Neck, NY, 11021, United States.
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, United Kingdom.
| | - Sean Perrin
- Department of Psychology, Lund University, Box 213, 22100, Lund, Sweden.
| | - Anthony Pinto
- Zucker School of Medicine at Hofstra/Northwell, Zucker Hillside Hospital - Northwell Health, 265-16 74th Avenue, Glen Oaks, NY, 11004, United States.
| | - C Alec Pollard
- Center for OCD and Anxiety-Related Disorders, Saint Louis Behavioral Medicine Institute, 1129 Macklind Ave, St. Louis, MO, 63110, United States; Department of Family and Community Medicine, Saint Louis University School of Medicine, Saint Louis, MO, 63110, United States.
| | - Adam S Radomsky
- Department of Psychology, Concordia University, 7141 Sherbrooke St, West, Montreal, Quebec H4B 1R6, Canada.
| | - Bradley C Riemann
- 34700 Valley Road, Rogers Behavioral Health, Oconomowoc, WI, 53066, United States.
| | - Roz Shafran
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Hospital Institute of Child Health, Holborn, London, WC1N 1EH, United Kingdom.
| | - Gregoris Simos
- Department of Educational and Social Policy, University of Macedonia, 156 Egnatia Street, 54636 Thessaloniki, Greece.
| | - Ingrid Söchting
- Departments of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada.
| | - Laura J Summerfeldt
- Department of Psychology, Trent University, 1600 West Bank Drive, Peterborough, K9L 0G2 Ontario, Canada.
| | - Jeff Szymanski
- International OCD Foundation, 18 Tremont Street, #308, Boston MA, 02108, United States.
| | - Michael Treanor
- Anxiety and Depression Research Center, University of California, Los Angeles, Box 951563, 1285 Franz Hall, Los Angeles, CA, United States.
| | - Barbara Van Noppen
- Clinical Psychiatry and Behavioral Sciences, OCD Southern California, 2514 Jamacha Road Ste, 502-35 El Cajon, CA, 92019, United States; Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, United States.
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam UMC, location VUmc, Netherlands; Amsterdam Public Health Research Institute - Mental Health, Netherlands; GGZ inGeest Specialized Mental Health Care, Netherlands.
| | - Maureen Whittal
- Vancouver CBT Centre, 302-1765 W8th Avenue, Vancouver, British Columbia, V6J5C6, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Monnica T Williams
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Pvt, Ottawa, K1N 6N5, Ontario, Canada.
| | - Timothy Williams
- Department of Psychology, University of Reading, PO Box 217, Reading, Berkshire, RG6 6AH, United Kingdom.
| | - Elna Yadin
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 2nd Floor, Philadelphia, PA 19104, United States.
| | - David Veale
- South London and the Maudsley NHS Foundation Trust & King's College London, Denmark Hill, London, SE5 8 AZ, United Kingdom.
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Abstract
Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD) worldwide. Smoking cessation is thus integral to the treatment of COPD. Nicotine addiction is a disease dependent on the complex interactions of neurotransmitter pathways, conditioned behaviors, environmental cues, genetic predisposition, and personal life circumstances, which render some more susceptible to tobacco abuse than others. The most successful smoking cessation programs are individualized, comprehensive, and utilize combinations of clinician counseling, behavioral reinforcement, community resources, advanced technology support (eg, smartphone apps, and Internet Web sites), and pharmacotherapy (both nicotine-based and nonnicotine medications). E-cigarettes were introduced to the US market in 2006 and touted as a safer alternative to tobacco cigarette smoking. Unfortunately, over the last 5 to 10 years, recreational e-cigarette use, or "vaping," has increased in popularity, especially among adolescents. This has introduced nicotine addiction to an entire generation of nonsmokers and resulted in numerous cases of acute lung disease, now known as e-cigarette or vape product use-associated lung injury (EVALI). In light of these adverse events, e-cigarettes and vape products are not currently recommended as a smoking cessation aid.
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Affiliation(s)
- Briana DiSilvio
- Division of Pulmonary Critical Care Medicine, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania
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Waldron-Perrine B, Rai JK, Chao D. Therapeutic assessment and the art of feedback: A model for integrating evidence-based assessment and therapy techniques in neurological rehabilitation. NeuroRehabilitation 2021; 49:293-306. [PMID: 34420989 DOI: 10.3233/nre-218027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Therapeutic assessment involves the integration of evidence-based approaches and humanistic principles, and there is empirical support for the use of this approach in the context of neuropsychological assessment broadly. OBJECTIVE We propose that therapeutic assessment (TA) and collaborative therapeutic neuropsychological assessment (CTNA) principles are appropriate and effective for application within a neurological rehabilitation population specifically. METHODS We review TA and CTNA principles and propose a model for their application to a neurological rehabilitation population, with an emphasis on describing the strengths of the collaborative approach, guidelines and principles for maximizing the efficacy of feedback, and transitioning the patient into psychotherapy services to further address their personal goals. A case example of a neurologically injured individual engaged in CTNA and subsequent intervention is shared to highlight the principles discussed. RESULTS AND CONCLUSION The proposed model and case study demonstrate the clinical utility of TA and CTNA principles with a neurological rehabilitation population.
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Affiliation(s)
- Brigid Waldron-Perrine
- Department of Physical Medicine andRehabilitation, Rehabilitation Psychology and Neuropsychology, University of Michigan, Ann Arbor, MI, USA
| | - Jaspreet K Rai
- Precision Neuropsychological Assessments, Edmonton, AB, Canada
| | - Dominique Chao
- Department of Physical Medicine andRehabilitation, Rehabilitation Psychology and Neuropsychology, University of Michigan, Ann Arbor, MI, USA
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Jakubowski KP, Jhamb M, Yabes J, Gujral S, Oberlin LE, Bender FH, Steel JL. Technology-assisted cognitive-behavioral therapy intervention for end-stage renal disease. Transl Behav Med 2021; 10:657-663. [PMID: 31131853 DOI: 10.1093/tbm/ibz077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Technology-assisted cognitive-behavioral therapy (CBT) interventions have been conducted for symptoms including depression, pain, and fatigue in patients with chronic illnesses but not in end-stage renal disease (ESRD). The purpose of this study was to pilot the feasibility and acceptability of a technology-assisted CBT intervention in ESRD patients on hemodialysis (HD), share design and implementation lessons learned, and provide preliminary results on changes in select patient-reported symptoms. This was a single-center pilot feasibility study of adult ESRD patients on HD. Study eligibility required clinically elevated levels of at least one symptom (depression, pain, or fatigue). Patients met weekly with a CBT therapist for eight sessions, each 45-60 min, during HD sessions via a video-conferencing platform. Symptom questionnaires were completed at baseline and 3 months follow-up. Of 10 patients screened, 100% screened positive for at least one symptom, 100% of eligible patients consented, and eight (of 10) completed the intervention (mean age 59 years, 50% male, 50% African American). Patient adherence and satisfaction was high, and seven of the eight patients completed all eight prescribed sessions. Minimal interference with HD was reported. Preliminary results indicate no statistically significant changes in depression, fatigue, or pain at follow-up. However, there was small improvement in SF-36 Physical Component score [t(7) = -2.60, p = .035], and four of the six patients (67%) with clinically elevated pain at baseline reported improvement at follow-up. A technology-assisted CBT intervention for ESRD patients was feasible, well-accepted, and required minimal additional resources in the HD setting. Larger, adequately powered clinical trials are needed to evaluate the effect on ESRD patient-reported outcomes.
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Affiliation(s)
| | - Manisha Jhamb
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jonathan Yabes
- Center for Research on Heath Care, Division of General Internal Medicine, Department of Medicine and Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Swathi Gujral
- Pittsburgh VA Healthcare System, Pittsburgh, PA, USA
| | - Lauren E Oberlin
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Filitsa H Bender
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer L Steel
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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63
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Gericke F, Ebert DD, Breet E, Auerbach RP, Bantjes J. A qualitative study of university students' experience of Internet‐based CBT for depression. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Franco Gericke
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
| | - David D. Ebert
- Psychology & Digital Mental Health Care, Department of Sport and Health Sciences Technical University Munich Munich Germany
| | - Elsie Breet
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
| | | | - Jason Bantjes
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
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64
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Munroe D, Moore MA, Bonnet JP, Rastorguieva K, Mascaro JS, Craighead LW, Haack CI, Quave CL, Bergquist SH. Development of Culinary and Self-Care Programs in Diverse Settings: Theoretical Considerations and Available Evidence. Am J Lifestyle Med 2021; 16:672-683. [DOI: 10.1177/15598276211031493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/20/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022] Open
Abstract
Culinary-based self-care programs are innovative and increasingly utilized models for catalyzing behavior change and improving health and well-being. The content, duration, and delivery of existing programs vary considerably. Between January and August 2019, we developed a teaching kitchen and self-care curriculum, which was administered as part of a year-long worksite well-being program to employees at an academic healthcare system. The curriculum domains included culinary skills, nutrition, physical activity, yoga, stress management, mindful eating, and ethnobotany. An informal systematic literature search was performed to assemble and evaluate key principles and practices related to self-care domains, learning methodologies, and programmatic design considerations. Here, we provide a qualitative summary of the evidence-informed development of the curriculum intervention.
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Affiliation(s)
- Dominique Munroe
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Miranda A. Moore
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Jonathan P. Bonnet
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Krystyna Rastorguieva
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Jennifer S. Mascaro
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Linda W. Craighead
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Carla I. Haack
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Cassandra L. Quave
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
| | - Sharon H. Bergquist
- American University of Integrated Sciences, St. Michael, Barbado (DM); Department of Family and Preventive Medicine; Emory University, Atlanta, GA, USA (MAM, JPB, JSM); Emory Healthcare, Atlanta, GA, USA (KR); Department of Psychology (LWC); Department of Surgery, Emory University, Atlanta, GA, USA (CIH); Department of Dermatology, Emory University (CLQ); and Department of Medicine, Emory University, Atlanta, GA, USA (SHB)
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Lopes ACS, Lopes MS, Duarte CK, de Freitas PP. Longitudinal effect of nutritional intervention on body weight: A randomized controlled trial. Nutrition 2021; 93:111436. [PMID: 34479045 DOI: 10.1016/j.nut.2021.111436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study evaluates, in the medium and long term (12, 36, and 48 mo), the effect of an intervention to promote consumption of fruit and vegetables on the body weight of Brazilian primary health care users. METHODS A follow-up with participants (n = 3414) in a controlled randomized trial was performed in a primary health care service. Those in the control group performed the service's usual intervention (guided physical exercise 3 times/wk), and those in the intervention group additionally participated for 7 mo in collective activities to promote consumption of fruit and vegetables. Sociodemographic, health, and body weight data were collected by face-to-face interview at baseline and after 12 mo. At 36 and 48 mo, weight was obtained by telephone interview and was validated. Adherence to the intervention was assessed by the presence of the actions. Weight change (Δ) was measured by subtracting the weight at each follow-up time from the baseline measurement. RESULTS Participants in both groups had a minor weight loss of about 0.1 kg over 12, 36, and 48 mo. The addition of an intervention for consumption of fruit and vegetables did not enhance this effect. Higher weight loss was observed in individuals with obesity classes II and III with low adherence in the intervention and after 36 mo (Δ = -27.1 kg; P = 0.024). CONCLUSIONS Participating in the primary health care service contributed to a small reduction in weight, and the intervention for consumption of fruit and vegetables did not enhance this effect. However, greater weight loss was observed in participants with obesity and those who adhered to the intervention.
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Affiliation(s)
- Aline Cristine Souza Lopes
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil.
| | - Mariana Souza Lopes
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil
| | - Camila Kummel Duarte
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil
| | - Patrícia Pinheiro de Freitas
- Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil
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66
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Green EP, Pradheep S, Heinzelman J, Nyanchoka A, Achieng D, Goyal S, Cusson L, Kurz AS, Bellows B. Predicting healthcare-seeking behavior based on stated readiness to act: development and validation of a prediction model. Transl Behav Med 2021; 12:6324644. [PMID: 34283889 DOI: 10.1093/tbm/ibab096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A starting point of many digital health interventions informed by the Stages of Change Model of behavior change is assessing a person's readiness to change. In this paper, we use the concept of readiness to develop and validate a prediction model of health-seeking behavior in the context of family planning. We conducted a secondary analysis of routinely collected, anonymized health data submitted by 4,088 female users of a free health chatbot in Kenya. We developed a prediction model of (future) self-reported action by randomly splitting the data into training and test data sets (80/20, stratified by the outcome). We further split the training data into 10 folds for cross-validating the hyperparameter tuning step in model selection. We fit nine different classification models and selected the model that maximized the area under the receiver operator curve. We then fit the selected model to the full training dataset and evaluated the performance of this model on the holdout test data. The model predicted who will visit a family planning provider in the future with high precision (0.93) and moderate recall (0.75). Using the Stages of Change framework, we concluded that 29% of women were in the "Preparation" stage, 21% were in the "Contemplation" stage, and 50% were in the "Pre-Contemplation" stage. We demonstrated that it is possible to accurately predict future healthcare-seeking behavior based on information learned during the initial encounter. Models like this may help intervention developers to tailor strategies and content in real-time.
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Affiliation(s)
- Eric P Green
- Duke Global Health Institute, Durham, NC 27708, USA.,Nivi, Inc., Boston, MA 02115, USA
| | | | | | | | | | | | | | - A Solomon Kurz
- VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System , Waco, TX 76711, USA
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67
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Michalowski M, Wilk S, Michalowski W, O’Sullivan D, Bonaccio S, Parimbelli E, Carrier M, Le Gal G, Kingwell S, Peleg M. A Health eLearning Ontology and Procedural Reasoning Approach for Developing Personalized Courses to Teach Patients about Their Medical Condition and Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7355. [PMID: 34299806 PMCID: PMC8307382 DOI: 10.3390/ijerph18147355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 11/16/2022]
Abstract
We propose a methodological framework to support the development of personalized courses that improve patients' understanding of their condition and prescribed treatment. Inspired by Intelligent Tutoring Systems (ITSs), the framework uses an eLearning ontology to express domain and learner models and to create a course. We combine the ontology with a procedural reasoning approach and precompiled plans to operationalize a design across disease conditions. The resulting courses generated by the framework are personalized across four patient axes-condition and treatment, comprehension level, learning style based on the VARK (Visual, Aural, Read/write, Kinesthetic) presentation model, and the level of understanding of specific course content according to Bloom's taxonomy. Customizing educational materials along these learning axes stimulates and sustains patients' attention when learning about their conditions or treatment options. Our proposed framework creates a personalized course that prepares patients for their meetings with specialists and educates them about their prescribed treatment. We posit that the improvement in patients' understanding of prescribed care will result in better outcomes and we validate that the constructs of our framework are appropriate for representing content and deriving personalized courses for two use cases: anticoagulation treatment of an atrial fibrillation patient and lower back pain management to treat a lumbar degenerative disc condition. We conduct a mostly qualitative study supported by a quantitative questionnaire to investigate the acceptability of the framework among the target patient population and medical practitioners.
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Affiliation(s)
- Martin Michalowski
- Nursing Informatics, School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA
| | - Szymon Wilk
- Institute of Computing Science, Poznan University of Technology, 60-965 Poznań, Poland;
| | - Wojtek Michalowski
- Telfer School of Management, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (W.M.); (S.B.)
| | - Dympna O’Sullivan
- School of Computer Science, Technological University Dublin, D02 HW71 Dublin, Ireland;
| | - Silvia Bonaccio
- Telfer School of Management, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (W.M.); (S.B.)
| | - Enea Parimbelli
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy;
| | - Marc Carrier
- Division of Hematology, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada;
| | - Grégoire Le Gal
- Department of Medicine, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada;
| | - Stephen Kingwell
- Department of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada;
| | - Mor Peleg
- Department of Information Systems, University of Haifa, Haifa 3498838, Israel;
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68
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Ratzan S, Schneider EC, Hatch H, Cacchione J. Missing the Point - How Primary Care Can Overcome Covid-19 Vaccine "Hesitancy". N Engl J Med 2021; 384:e100. [PMID: 33951377 DOI: 10.1056/nejmp2106137] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Scott Ratzan
- From the City University of New York Graduate School of Public Health (S.R.); the Commonwealth Fund (E.C.S.); and Phreesia Inc. (H.H.) - all in New York; and Ascension Health, St. Louis (J.C.)
| | - Eric C Schneider
- From the City University of New York Graduate School of Public Health (S.R.); the Commonwealth Fund (E.C.S.); and Phreesia Inc. (H.H.) - all in New York; and Ascension Health, St. Louis (J.C.)
| | - Hilary Hatch
- From the City University of New York Graduate School of Public Health (S.R.); the Commonwealth Fund (E.C.S.); and Phreesia Inc. (H.H.) - all in New York; and Ascension Health, St. Louis (J.C.)
| | - Joseph Cacchione
- From the City University of New York Graduate School of Public Health (S.R.); the Commonwealth Fund (E.C.S.); and Phreesia Inc. (H.H.) - all in New York; and Ascension Health, St. Louis (J.C.)
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Coorey G, Peiris D, Scaria A, Mulley J, Neubeck L, Hafiz N, Redfern J. An Internet-Based Intervention for Cardiovascular Disease Management Integrated With Primary Care Electronic Health Records: Mixed Methods Evaluation of Implementation Fidelity and User Engagement. J Med Internet Res 2021; 23:e25333. [PMID: 33900204 PMCID: PMC8111511 DOI: 10.2196/25333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/21/2020] [Accepted: 03/16/2021] [Indexed: 12/02/2022] Open
Abstract
Background Growing evidence supports the benefits of eHealth interventions to increase patient engagement and improve outcomes for a range of conditions. However, ineffective program delivery and usage attrition limit exposure to these interventions and may reduce their effectiveness. Objective This study aims to evaluate the delivery fidelity of an eHealth intervention, describe use patterns, compare outcomes between low and high users, and identify mediating factors on intervention delivery and receipt. Methods This is a mixed methods study of an internet-based intervention being evaluated for effectiveness in a randomized controlled trial (RCT). The intervention comprised medication and cardiovascular disease (CVD) risk data uploaded from the primary care electronic health record (EHR); interactive, personalized CVD risk score estimation; goal setting and self-monitoring; an interactive social forum; and optional receipt of heart health messages. Fidelity was assessed over 12 months. Trial outcomes were compared between low and high users. Data sources included program delivery records, web log data, trial data, and thematic analysis of communication records. Results Most participants in the intervention group (451/486, 93%) had an initial training session conducted by telephone (413/447, 92.4% of participants trained), with a mean duration of 44 minutes (range 10-90 minutes). Staff conducted 98.45% (1776/1804) of the expected follow-ups, mostly by telephone or email. Of the 451 participants who commenced log-ins, 46.8% (211) were categorized as low users (defined as at least one log-in in 3 or fewer months of follow-up), 40.4% (182) were categorized as high users (at least one log-in in more than 3 months of follow-up), and 12.8% (58) were nonadopters (no log-ins after their training session). The mean log-in frequency was 3-4 per month in ongoing users. There was no significant difference between the groups in the primary trial outcome of adherence to guideline-recommended medications (P=.44). In unadjusted analyses, high users had significantly greater eHealth literacy scores (P=.003) and were more likely to meet recommended weekly targets for fruit (P=.03) and fish (P=.004) servings; however, the adjusted findings were not significant. Interactive screen use was highest for goal tracking and lowest for the chat forum. Screens with EHR-derived data held only an early interest for most users. Fidelity measures (reach, content, dose delivered, and dose received) were influenced by the facilitation strategies used by staff, invisible qualities of staff-participant communication, and participants’ responsiveness to intervention attributes. Conclusions A multifeature internet-based intervention was delivered with high fidelity to the RCT protocol and was regularly used by 40.4% (182/451) of users over 12 months. Higher log-in frequency as an indicator of greater intervention exposure was not associated with statistically significant improvements in eHealth literacy scores, lifestyle changes, or clinical outcomes. Attributes of the intervention and individualized support influenced initial and ongoing use.
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Affiliation(s)
- Genevieve Coorey
- The George Institute for Global Health, Sydney, Australia, Sydney, Australia.,School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Peiris
- The George Institute for Global Health, Sydney, Australia, Sydney, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Anish Scaria
- The George Institute for Global Health, Sydney, Australia, Sydney, Australia
| | - John Mulley
- The George Institute for Global Health, Sydney, Australia, Sydney, Australia
| | - Lis Neubeck
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.,Susan Wakil School for Nursing and Midwifery, The University of Sydney, Sydney, Australia
| | - Nashid Hafiz
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Evaluation of the B.strong Queensland Indigenous Health Worker Brief Intervention Training Program for Multiple Health Risk Behaviours. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084220. [PMID: 33923462 PMCID: PMC8073127 DOI: 10.3390/ijerph18084220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
Queensland’s B.strong brief intervention training program was a complex intervention developed for Aboriginal and Torres Strait Islander health workers to assist clients address multiple health risks of smoking, poor nutrition and physical inactivity. This study evaluates program effectiveness by applying the Kirkpatrick four-level evaluation model: (1) Reaction, participants’ satisfaction; (2) Learning, changes in participants’ knowledge, confidence, attitudes, skills and usual practice; (3) Behaviour, application of learning to practice; and (4) Results, outcomes resulting from training. A retrospective analysis was conducted on data for respondents completing pre-training, post-workshop and follow-up surveys. Changes in domains such as training participant knowledge, confidence, attitudes, and practices between survey times were assessed using paired-samples t-tests. From 2017–2019, B.strong trained 1150 health professionals, reaching targets for workshop and online training. Findings showed statistically significant improvements from baseline to follow-up in: participants’ knowledge, confidence, and some attitudes to conducting brief interventions in each domain of smoking cessation, nutrition and physical activity; and in the frequency of participants providing client brief interventions in each of the three domains. There was a statistically significant improvement in frequency of participants providing brief interventions for multiple health behaviours at the same time from pre-workshop to follow-up. Indigenous Queenslander telephone counselling referrals for smoking cessation increased during the program period. B.strong improved practitioners’ capacity to deliver brief interventions addressing multiple health risks with Indigenous clients.
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Johnson AK, Buenrostro R, Soberanis G, McCarn B, Magner B, Maiorana A. Salud y Orgullo Mexicano: Development of a Culturally Specific Transnational Linkage and Retention in Care Intervention for Mexican Men Who Have Sex with Men Living with HIV in Chicago. J Immigr Minor Health 2021:10.1007/s10903-021-01185-9. [PMID: 33860874 DOI: 10.1007/s10903-021-01185-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/27/2022]
Abstract
This manuscript documents the development of an innovative individual-level peer navigation intervention "Salud y Orgullo Mexicano" (SOM) designed to increase linkage and retention to HIV care for Mexican men who have sex with men (MSM) in Chicago, Illinois. The intervention was developed via a modified intervention mapping process. Elements of two existing interventions were combined and refined with input from the Mexican MSM community, including informant interviews, an expert advisory board, and a design team. A manualized transnational intervention was developed via intervention mapping. A peer health navigation intervention "SOM" was created using intervention mapping and input from the focus community. Next steps include implementing and evaluating the intervention to determine acceptability and efficacy.
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Affiliation(s)
- Amy K Johnson
- Department of Pediatrics, Division of Adolescent Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611-2991, USA.
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- AIDS Foundation of Chicago, Chicago, IL, USA.
| | | | | | | | | | - Andres Maiorana
- Center for AIDS Prevention Studies, University of California San Francisco Prevention Research Center, San Francisco, USA
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Van der Gucht E, Dams L, Haenen V, Godderis L, Morlion B, Bernar K, Evenepoel M, De Vrieze T, Vandendriessche T, Asnong A, Geraerts I, Devoogdt N, De Groef A, Meeus M. Effectiveness of perioperative pain science education on pain, psychological factors and physical functioning: A systematic review. Clin Rehabil 2021; 35:1364-1382. [PMID: 33813914 DOI: 10.1177/02692155211006865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To synthesize the evidence on the effectiveness of pain science education on pain, psychological factors and physical functioning in adults who underwent surgery. DATA SOURCES A systematic literature search of English articles using PubMed/Medline, Embase, Web of Science Core Collection, and Cochrane Library. REVIEW METHODS The search strategy was constructed as follows: (((pain) AND (education)) OR (pain education)) AND (surgery). Only controlled quantitative studies in adults reporting outcome(s) on pain, psychological factors and/or physical functioning were included. Risk of bias was assessed using the Cochrane risk of bias tools. P-values and corresponding effect sizes for interaction-effect (time × group) portrayed the difference in change over time between groups were of interest. The last search was conducted on February 28, 2021. RESULTS Nine papers (n = 1078) were deemed eligible for this review. Two randomized controlled trials showed significant interaction effects. Breast cancer patients who had received one preoperative pain science education session showed a significant increase in postoperative pain compared to controls (P-value = 0.0394). Furthermore, psychological factors (pain catastrophizing and kinesiophobia) decreased in participants who had received pain science education before total knee arthroplasty, while this was not the case in the control group (P-value < 0.001, ƞ2p:0.11). CONCLUSIONS Overall, pain science education did not result in any significant postoperative effects on pain, psychological factors and/or physical functioning compared to controls. There is currently no strong evidence for the implementation of pain science education in the perioperative period.Registration number: PROSPERO: ID 161267, registration number CRD42020161267.
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Affiliation(s)
- Elien Van der Gucht
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Lore Dams
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Vincent Haenen
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Lode Godderis
- Centre for Environment and Health, University of Leuven, Leuven, Belgium.,IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Bart Morlion
- Department of Cardiovascular Sciences, Section Anaesthesiology & Algology, University of Leuven, Leuven, Belgium.,The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium
| | - Koen Bernar
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium
| | - Margaux Evenepoel
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | - Tessa De Vrieze
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | | | - Anne Asnong
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
| | - Inge Geraerts
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Center for Lymphoedema, UZ Leuven, University Hospitals Leuven, Leuven, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.,Pain in Motion International Research Group, Brussels, Belgium.,Ghent University, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent, Belgium
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Johnston J, Xia J, Yau MTK, Wang JCC, Okoli CTC, Khara M. The Impact of Psychiatric Disorder Diagnosis on Motivation to Quit and Stage of Change Among Patients at a Hospital-Based Outpatient Smoking Cessation Clinic. J Dual Diagn 2021; 17:113-123. [PMID: 33600740 DOI: 10.1080/15504263.2021.1881684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Smoking is among the greatest international public health concerns, causing excessive levels of preventable premature death, disability, and economic costs. The prevalence of tobacco use among people with psychiatric disorders (PDs) remains persistently high relative to the general population, highlighting the need to improve smoking cessation (SC) strategies in this group. We aimed to assess the associations between having a PD and baseline motivation to quit (MtQ) smoking and Prochaska's stage of change (SoC), two clinically important metrics linked to SC outcomes. Methods: This retrospective chart review included patients who completed a baseline visit at a hospital-based outpatient SC clinic (N = 896). Multivariate hierarchical logistic and linear regression models were developed to assess variables associated with MtQ (importance and confidence in quitting) and SoC, primarily PD category (externalizing, internalizing, externalizing/internalizing, psychotic or no PD) and secondarily, demographics, physical health history, and tobacco use/dependence metrics. Results: The variables negatively associated with MtQ were female sex (p = .011), older age (p = .038), deriving income from social assistance (p < .001), and age at smoking initiation (p = .005), whereas ≥ 1 quit attempt in the past year predicted higher MtQ (p < .0001). Being in the preparative/action SoC (versus the pre-contemplative/contemplative) was associated with income from social assistance (OR 0.39, p = .001), more daily cigarettes smoked (OR 0.98, p = .005) and ≥ 1 past-year quit attempt (OR 1.69, p = .013). Conclusions: Having a PD was not associated with either MtQ or SoC. Deriving income from social assistance predicted lower MtQ and SoC. Having made ≥ 1 quit attempt in the past year was associated with higher MtQ and SoC. Our study suggests that people with PDs are as motivated to quit smoking and ready for change as people without PDs, and smoking cessation efforts should be amplified in this group to address the disproportionately high level of tobacco use, especially because having at least one quit attempt may enhance MtQ and SoC.
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Affiliation(s)
- Jake Johnston
- Smoking Cessation Clinic, Centre for Cardiovascular Health, Vancouver General Hospital, Vancouver, Canada
| | - Joanna Xia
- Smoking Cessation Clinic, Centre for Cardiovascular Health, Vancouver General Hospital, Vancouver, Canada
| | - Man Ting Kristina Yau
- Smoking Cessation Clinic, Centre for Cardiovascular Health, Vancouver General Hospital, Vancouver, Canada
| | | | | | - Milan Khara
- Smoking Cessation Clinic, Centre for Cardiovascular Health, Vancouver General Hospital, Vancouver, Canada
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Ziser K, Decker S, Stuber F, Herschbach A, Giel KE, Zipfel S, Ehehalt S, Junne F. Barriers to Behavior Change in Parents With Overweight or Obese Children: A Qualitative Interview Study. Front Psychol 2021; 12:631678. [PMID: 33841261 PMCID: PMC8034266 DOI: 10.3389/fpsyg.2021.631678] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/24/2021] [Indexed: 12/20/2022] Open
Abstract
Overweight and obesity among children and adolescents are global problems of our time. Due to their authority and role modeling, parents play an essential part in the efficacy of prevention and intervention programs. This study assessed the barriers that parents of overweight/obese children face in preventive and interventional health care utilization. Sixteen parents were qualitatively interviewed. A content analysis was performed, and barriers to change were allocated to their stage of change according to the transtheoretical model. Among the main barriers is the underestimation of health risks caused by overweight/obesity in association with diminished problem awareness. Parents seem not necessarily in need of theoretical knowledge for prevention and interventions. They do however need support in evaluating the weight status of their child and the knowledge of whom to turn to for help as well as specific and hands-on possibilities for change. The results extend past studies by adding specific barriers to change that parents commonly experience. Possibilities to address these barriers, e.g., through trainings at the pediatric practice or adoption of conversation techniques, are discussed. Future studies might identify subgroups experiencing specific barriers and thus be able to address these in an individualized way.
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Affiliation(s)
- Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Decker
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Anne Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefan Ehehalt
- Public Health Department of Stuttgart, Stuttgart, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
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75
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Kazan AS, Perry LM, Atiya WF, Voss HM, Kim S, Easwar S, Mercorella HN, Lewson A, Rogers JL, Arnold D, Raines AM, Brown L, Moore T, Hoerger M. Development and acceptability of an educational video about a smoking cessation quitline for use in adult outpatient mental healthcare. Transl Behav Med 2021; 11:1579-1584. [PMID: 33647990 DOI: 10.1093/tbm/ibaa145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tobacco use is a leading preventable cause of early mortality and is prevalent among adults with mental health diagnoses, especially in the southern USA. Increasing cessation resources in outpatient mental health care and targeting individuals most receptive to changing their behavior may improve cessation. Drawing on the transtheoretical model, our goals were to develop an educational video about the Louisiana Tobacco Quitline and evaluate its acceptability. We designed the video with knowledge derived from Louisiana-specific data (2016 Louisiana Adult Tobacco Survey, N = 6,469) and stakeholder feedback. Bivariate associations between demographic/tobacco-use characteristics and participants' stage of quitting (preparation phase vs. nonpreparation phase) were conducted, which informed design elements of the video. Four stakeholder advisory board meetings involving current smokers, mental health clinicians, and public health advocates convened to provide iterative feedback on the intervention. Our stakeholder advisory board (n = 10) and external stakeholders (n = 20) evaluated intervention acceptability. We found that 17.9% of Louisiana adults were current smokers, with 46.9% of them in the preparation phase of quitting. Using insights from data and stakeholders, we succeeded in producing a 2-min video about the Louisiana Tobacco Quitline which incorporated three themes identified as important by stakeholders: positivity, relatability, and approachability. Supporting acceptability, 96.7% of stakeholders rated the video as helpful and engaging. This study demonstrates the acceptability of combining theory, existing data, and iterative stakeholder feedback to develop a quitline educational video. Future research should examine whether the video can be used to reduce tobacco use.
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Affiliation(s)
- Adina S Kazan
- Department of Psychology, Tulane University, New Orleans, LA, USA
| | - Laura M Perry
- Department of Psychology, Tulane University, New Orleans, LA, USA
| | - Wasef F Atiya
- Department of Psychology, Tulane University, New Orleans, LA, USA
| | - Hallie M Voss
- Department of Psychology, Tulane University, New Orleans, LA, USA
| | - Seowoo Kim
- Department of Psychology, Tulane University, New Orleans, LA, USA
| | - Sanjana Easwar
- Department of Psychology, Tulane University, New Orleans, LA, USA
| | - Hannah N Mercorella
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Ashley Lewson
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - James L Rogers
- Department of Psychology, Tulane University, New Orleans, LA, USA
| | - Dodie Arnold
- Louisiana Public Health Institute, New Orleans, LA, USA
| | - Amanda M Raines
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA.,School of Medicine, Louisiana State University, New Orleans, LA, USA
| | - Lisanne Brown
- Louisiana Public Health Institute, New Orleans, LA, USA
| | - Tonia Moore
- Louisiana Public Health Institute, New Orleans, LA, USA
| | - Michael Hoerger
- Department of Psychology, Tulane University, New Orleans, LA, USA.,Tulane Cancer Center, Tulane University, New Orleans, LA, USA
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76
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Onyeneke GB, Abe T. The effect of change leadership on employee attitudinal support for planned organizational change. JOURNAL OF ORGANIZATIONAL CHANGE MANAGEMENT 2021. [DOI: 10.1108/jocm-08-2020-0244] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to examine how change leadership activities help bring about employee support for planned organizational change.Design/methodology/approachUsing a non-experimental quantitative research design, and a self-administered Likert-type questionnaire survey, the study sourced data from employees in an organization undergoing significant change. Data analysis was by structural equation modeling (SEM).FindingsChange leadership behaviors bearing on; visioning, communication, participation, support and concern for change participants' interests were found to be of significant importance in ensuring employee buy-in and support for planned change efforts. Although change leadership had no direct effect on employees' behavioral intentions to support change, it was strongly related to employee cognitive appraisal of change. The relationship between change leadership and employee behavioral intentions to support planned change was serially mediated by employee cognitive appraisal and emotional response toward the planned change event.Practical implicationsIn appraising planned organizational change efforts, managers tend to focus on employee behaviors toward the change instead of conditions that drive such behaviors. This study underscores the need to focus on employee attitudes as precursors to desired behavior toward change.Originality/valuePrior research suggests that change leadership behaviors affect employee attitudinal reactions to change but yet lacked empirical validation. By applying a multidimensional approach to attitude and investigating its hierarchy of effects, this study enhanced our accuracy in explaining the influence change leadership has on employee attitudinal support for change.
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77
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Xu M, Petty RE. Two-Sided Messages Promote Openness for Morally Based Attitudes. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2021; 48:1151-1166. [PMID: 33588648 DOI: 10.1177/0146167220988371] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This research demonstrates that two- versus one-sided counterattitudinal messages can encourage people with a strong moral basis for their attitudes to be more open to contrary positions. Studies 1A/B demonstrated that the interaction between moral basis and message sidedness was present not just for a controversial issue with balanced views in society but also for a topic with a majority opinion. In Study 2, the relative effectiveness of two- over one-sided messages for people with a moral attitude basis was shown to occur only when the two-sided message respectfully acknowledged the recipient's side. In Study 3, the effect was replicated in a preregistered experiment. Furthermore, moral bases provided unique predictive power beyond alternative attitude strength indicators. Across all studies, perceived appreciation of the speaker acknowledging the recipient's view mediated the impact of the independent variables on openness.
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Affiliation(s)
- Mengran Xu
- The Ohio State University, Columbus, USA
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78
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Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia. Infect Dis Rep 2021; 13:136-147. [PMID: 33562888 PMCID: PMC7930988 DOI: 10.3390/idr13010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022] Open
Abstract
This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and 2017. The study participants were 170 newly diagnosed PLHIV and 17 outreach-counselor workers (OWs). We interviewed PLHIV for their experiences in receiving counseling, and acceptance of and adherence to ART. We surveyed four counseling domains (privacy, contents, frequency, and duration) and explored the key findings through in-depth interviews. In addition, 24 exit interviews and record reviews were performed. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Out of 170 PLHIV who received the counseling program, 139 (81.76%) accepted ART, and 52 (37.4%) discontinued ART in six months of follow up. Although counselors covered most of the content (16/17 components), the median time and frequency of counseling were insufficient. Despite a high score of HIV counseling provided to PLHIV in our study location, the overall acceptance of and adherence to ART remains fair or moderate. Our study suggests that counseling before ART initiation is inadequate for improving acceptance and adherence to ART in Bali Province. This reduced effectiveness is influenced by internal issues (interpersonal skills, limited technical capacity) and external factors both from PLHIV and society (stigma, disclosure, discrimination).
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79
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Corella C, Abarca-Sos A, Gallardo LO, Martín-Albo J, Zaragoza J. Longitudinal study of physical activity in college students: Testing self-determination theory based on stages of change. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01269-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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80
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Weintraub JA, Jamison AR, Rozier RG, Atchison KA. Assessing oral health content in nondental professional association websites. J Public Health Dent 2021; 81:240-244. [PMID: 33386613 DOI: 10.1111/jphd.12441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 11/16/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Determine the prevalence and type of oral health (OH) content among nondental health professional associations' websites. METHODS Fifty-nine organizations were selected from three lists of health professional associations and categorized as physician-, nurse- and other healthcare-related professions. Eight dental search terms were used on searchable websites. Six types of OH information were collected. Websites were assessed for any OH content and comparisons made. Frequencies, chi-square, and Fisher extract test statistics were calculated. RESULTS Thirty-five (59 percent) of websites had any OH information content. Twenty (34 percent) had OH authored content, 10-19 percent had OH webpages, interest groups, or initiatives, CE courses or webinars, or curriculum information. The term "oral hygiene" gave the greatest yield and "dentistry" the least. No significant differences in existence of "Any OH content" was found between each organization type versus others. CONCLUSION Many nondental professional associations could increase OH website content and education with assistance from dental organizations.
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Affiliation(s)
- Jane A Weintraub
- Division of Pediatric and Public Health, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, NC, USA.,Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alice R Jamison
- General Practice Resident, Mountain Area Health Education Center (MAHEC), Asheville, NC, USA
| | - R Gary Rozier
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn A Atchison
- Division of Public Health and Community Dentistry, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA
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81
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Woo S, Park KH. Motivating Children and Adolescents in Obesity Treatment. J Obes Metab Syndr 2020; 29:260-269. [PMID: 32843587 PMCID: PMC7789025 DOI: 10.7570/jomes20026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/10/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022] Open
Abstract
Enhancing motivation is a crucial issue in pediatric obesity interventions, as behavioral changes related to food intake and physical exercise are difficult to carry out with an insufficient level of motivation. In the treatment setting, low motivation towards change may lead to early termination or inadequate treatment outcomes. This paper reviews widely-used models of motivation, including the transtheoretical model of change, self-determination theory, and motivational interviewing (MI). We introduce useful strategies based on each theoretical model to enhance motivation, such as an importance and confidence scale and a decisional balance technique. A review of recent MI interventions in children and adolescents is presented to discuss the efficacy of MI-based interventions and considerations for applying MI in pediatric obesity.
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Affiliation(s)
- Sarah Woo
- Major in Biomedical Science, Department of Medical Sciences, Hallym University College of Medicine, Chuncheon, Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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82
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Chua MWJ. Managing patients with obesity in the post COVID-19 world: Time to sharpen the saw. Obes Res Clin Pract 2020; 15:85-88. [PMID: 33388254 PMCID: PMC7713546 DOI: 10.1016/j.orcp.2020.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/18/2020] [Accepted: 11/29/2020] [Indexed: 02/06/2023]
Abstract
The clash of the dual pandemics - COVID-19 and obesity (Chua et al., 2020) [1], threatens to exponentially increase the rates of obesity, which is a risk factor for severe COVID-19 and death (Garg et al., 2020; Peng et al., 2020; Wu et al., 2020; Kass et al., 2020) [2-5]. We need to urgently find solutions to halt this vicious circle. Where do we begin? Our patients - who are often our best teachers. In my clinical practice, I have observed disparate responses among my patients in response to the pandemic. This highlighted the importance of understanding the factors underlying motivation and provided important clues on what clinicians can do to help our patients create a virtuous circle towards positive health outcomes.
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Affiliation(s)
- Marvin Wei Jie Chua
- Department of General Medicine, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore.
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83
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Audet S. L’étude du changement humain dans le cadre de la consultation d’un professionnel de la relation d’aide : un modèle systémique. PSYCHOLOGIE FRANCAISE 2020. [DOI: 10.1016/j.psfr.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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84
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Ghomi M, Wrightman M, Ghaemian A, Grey N, Pickup T, Richardson T. Development and validation of the Readiness for Therapy Questionnaire (RTQ). Behav Cogn Psychother 2020; 49:1-13. [PMID: 33198833 DOI: 10.1017/s1352465820000764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Motivational factors are generally regarded as an important ingredient for change in therapy. However, there is currently a lack of available instruments that can measure clients' readiness for change in therapy. AIM The objective of this paper was to create an instrument, the Readiness for Therapy Questionnaire (RTQ), which could measure clients' readiness for change. METHOD The RTQ was created by researchers following analysis of themes drawn from a review of the literature and interviews with patients at the end of therapy. This included both people who completed therapy and those who dropped out. As part of the standard assessment process, the RTQ was administered to 349 participants (69.6% female and 30.4% male; mean age 37.1 years; 90.5% Caucasian) who were patients at a psychological therapy service for common mental health difficulties. RESULT An initial 12-item scale was reduced to 6 items. This scale significantly correlated with post-therapy PHQ-9 and GAD-7 scores and changes in these scores across therapy. After controlling for baseline scores and demographic variables, a logistic regression showed that scores on this 6-item measure pre-therapy significantly predicted three outcome variables: completing therapy, being recovered on both PHQ-9 and GAD-7 post-therapy, and having a reliable change in both the PHQ-9 and GAD-7 post-therapy. However, receiver operating characteristic (ROC) curve analysis showed the measure had poor sensitivity and specificity. Symptom severity did not have a significant impact on motivation to change. CONCLUSION The RTQ is potentially a valid measure with useful clinical applications in treatment of common mental health difficulties.
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Affiliation(s)
- Mahdi Ghomi
- Talking Change, Solent NHS Trust, Portsmouth, UK
| | | | | | - Nick Grey
- Sussex Partnership NHS Foundation Trust Department of Psychology, University of Sussex, Brighton, UK
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85
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Schlegelmilch A, Roskowski M, Brinck EA, Anderson CA, Hartman E, Chan F, Tansey TN, Decker-Maurer H. Stages of Change Scale to Measure Work Readiness of Transition-Age Youth With Disabilities: A Promising Approach. REHABILITATION COUNSELING BULLETIN 2020. [DOI: 10.1177/0034355220970619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The experience of transitioning into adulthood is a critical phase in life. The navigation of government benefits adds further complexity that can affect employment outcomes for youth with disabilities. Some individuals hesitate to work out of fear to losing access to monetary, disability, and related health care benefits. However, using available work incentives while pursuing employment and career paths can provide opportunities to work and address poverty without forgoing needed services. The Wisconsin Promoting Readiness of Minors in Supplemental Security Income (PROMISE) research grant aimed to positively change youth readiness to work through the use of Motivational Interviewing, work incentive benefits counseling, financial capability building, shifting expectations, and help in navigating transition resources. To measure the impact on readiness to work, 126 transition-age youth receiving supplemental security income (SSI), 188 of their family members, and 411 Division of Vocational Rehabilitation (DVR) counselors working with the youth and families completed a modified Stages of Change Scale survey. Results indicated that youths’ work readiness and positive feelings about work significantly increased from baseline to follow-up, along with an increase in employment rates. The implications of these findings highlight the utility of incorporating the stages of change theory into the design and implementation of services and supports to increase work readiness for youth with disabilities in transition.
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Affiliation(s)
- Amanda Schlegelmilch
- University of Wisconsin-Stout Vocational Rehabilitation Institute, Menomonie, USA
| | - Matthew Roskowski
- University of Wisconsin-Stout Vocational Rehabilitation Institute, Menomonie, USA
| | | | | | - Ellie Hartman
- Wisconsin Department of Workforce Development, Madison, USA
| | - Fong Chan
- Univeristy of Wisconsin-Madison, Madison, USA
| | | | - Heidi Decker-Maurer
- University of Wisconsin-Stout Vocational Rehabilitation Institute, Menomonie, USA
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86
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[Development and evaluation of the psychometric properties of the Stage to Change in the Reduction of Childhood Overweight Scale (SCROS)]. NUTR HOSP 2020; 37:951-957. [PMID: 32960619 DOI: 10.20960/nh.03120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Objectives: the purpose of this paper is to evaluate the psychometric properties of the "Stage of change in the reduction of childhood overweight" scale by means of an exploratory factor analysis, and its reliability. This questionnaire is a new measure to identify the stage of awareness of the problem, and the willingness to change, in parents of children with overweight and obesity, based on the transtheoretical model by Prochaska and DiClemente (1983). Method: the study involved 484 women with school-aged children, of which 65.9 % were classified with obesity, and 34.1 % with overweight. Results: the SCROS psychometric characteristics were assessed, obtaining an internal consistency of 0.789 using Cronbach's alpha with 16 elements (items). By means of the Exploratory Factor Analysis four factors were obtained with eigen values higher than one, which explained 62.89 % of the total variance. The items were grouped in the following dimensions: Preparation (4 items), Precontemplation (4 items), Contemplation (4 items), and Action (4 items). Conclusions: the SCROS is a valid and reliable questionnaire to evaluate the stage in which parents of children with overweight and obesity problems are located, which will allow us to design more suitable interventions for these children and their families.
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87
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Occupational Physicians' Perspectives on Determinants of Employee Participation in a Randomized Controlled Musculoskeletal Health Promotion Measure: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207445. [PMID: 33066098 PMCID: PMC7650758 DOI: 10.3390/ijerph17207445] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022]
Abstract
Occupational physicians (OPs) are key figures for advising employees and employers about prevention and health at the workplace. However, knowledge of their views on participation in health promotion measures is sparse. This qualitative study aims to explore occupational physicians' experiences with employee participation in a randomized controlled workplace measure for musculoskeletal disorders (MSDs) in Germany. We conducted eight semi-structured telephone interviews with occupational physicians. Interviews were transcribed verbatim and analyzed using a combination of conventional and directed content analysis. Findings were mapped based on Andersen's behavioral model of health services use, resulting in four categories and 10 subcategories. (a) Contextual factors of the measure comprised impacts of the healthcare system and company environment, (b) individual factors of measure participation comprised demographic, social, belief, and MSD need characteristics, (c) health behavior during the measure included OPs' communication, employees' personal practices and measure participation, and (d) outcomes of participation included health status, satisfaction, and dissatisfaction with the measure. Findings imply occupational physicians' and employees' views should be investigated on a broader scale. Researchers should use present statements for the development of intervention studies, while political and managerial authorities can improve organizational conditions of prevention based on these findings.
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88
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Thompson HM, Faig W, VanKim NA, Sharma B, Afshar M, Karnik NS. Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service. PLoS One 2020; 15:e0239761. [PMID: 33035229 PMCID: PMC7546454 DOI: 10.1371/journal.pone.0239761] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/13/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Addiction medicine consultation services (ACS) may improve outcomes of hospitalized patients with substance use disorders (SUD). Our aim was to examine the difference in length of stay and the hazard ratio for a routine hospital discharge between SUD patients receiving and not receiving ACS. METHODS Structured EHR data from 2018 of 1,900 adult patients with a SUD-related diagnostic code at an urban academic health center were examined among 35,541 total encounters. Cox proportional hazards regression models were fit using a cause-specific approach to examine differences in hospital outcome (i.e., routine discharge, leaving against medical advice, in-hospital death, or transfer to another level of care). Models were adjusted for age, sex, race, ethnicity, insurance status, and comorbidities. RESULTS Length of stay was shorter among encounters with a SUD that received a SUIT consultation versus those admissions that did not receive one (5.77 v. 6.54 days, p<0.01). In adjusted analyses, admissions that received a SUIT consultation had a higher hazard of a routine discharge [hazard ratio (95% confidence interval): 1.16 (1.03-1.30)] compared to those not receiving a SUIT consultation. CONCLUSIONS The SUIT consultation service was associated with a reduced length of stay and an increased hazard of a routine discharge. The SUIT model may serve as a benchmark and inform other health systems attempting to improve outcomes in SUD patient cohorts.
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Affiliation(s)
- Hale M. Thompson
- Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America
| | - Walter Faig
- Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America
| | - Nicole A. VanKim
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Brihat Sharma
- Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America
| | - Majid Afshar
- Division of Pulmonary and Critical Care, Department of Public Health Sciences, Center for Health Outcomes & Informatics Research, Loyola University, Maywood, IL, United States of America
| | - Niranjan S. Karnik
- Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America
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Deruelle P, Lelorain S, Deghilage S, Couturier E, Guilbert E, Berveiller P, Sénat MV, Vayssière C, Sentilhes L, Perrotin F, Gallot D, Chauleur C, Sananes N, Roth E, Luton D, Caputo M, Lorio E, Chatelet C, Couster J, Timbely O, Doret-Dion M, Duhamel A, Pigeyre M. Rationale and design of ePPOP-ID: a multicenter randomized controlled trial using an electronic-personalized program for obesity in pregnancy to improve delivery. BMC Pregnancy Childbirth 2020; 20:602. [PMID: 33028261 PMCID: PMC7542973 DOI: 10.1186/s12884-020-03288-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/27/2020] [Indexed: 11/29/2022] Open
Abstract
Background Pre-pregnancy obesity and excessive gestational weight gain (GWG) are established risk factors for adverse pregnancy, delivery and birth outcomes. Pregnancy is an ideal moment for nutritional interventions in order to establish healthier lifestyle behaviors in women at high risk of obstetric and neonatal complications. Methods Electronic-Personalized Program for Obesity during Pregnancy to Improve Delivery (ePPOP-ID) is an open multicenter randomized controlled trial which will assess the efficacy of an e-health web-based platform offering a personalized lifestyle program to obese pregnant women in order to reduce the rate of labor procedures and delivery interventions in comparison to standard care. A total of 860 eligible pregnant women will be recruited in 18 centers in France between 12 and 22 weeks of gestation, randomized into the intervention or the control arm and followed until 10 weeks of postpartum. The intervention is based on nutrition, eating behavior, physical activity, motivation and well-being advices in which personalization is central, as well as the use of a mobile/tablet application. Inputs includes data from the medical record of participants (medical history, anthropometric data), from the web platform (questionnaires on dietary habits, eating behavior, physical activity and motivation in both groups), and adherence to the program (time of connection for the intervention group only). Data are collected at inclusion, 32 weeks, delivery and 10 weeks postpartum. As primary outcome, we will use a composite endpoint score of obstetrical interventions during labor and delivery, defined as caesarean section and instrumental delivery (forceps and vacuum extractor). Secondary outcomes will consist of data routinely collected as part of usual antenatal and perinatal care, such as GWG, hypertension, preeclampsia, as well as fetal and neonatal outcomes including premature birth, gestational age at birth, birth weight, macrosomia, Apgar score, arterial umbilical cord pH, neonatal traumatism, hyperbilirubinemia, respiratory distress syndrome, transfer in neonatal intensive care unit, and neonatal adiposity. Post-natal outcomes will be duration of breastfeeding, maternal weight retention and child weight at postnatal visit. Discussion The findings of the ePPOP-ID trial will help design e-health intervention program for obese women in pregnancy. Trial registration ClinicalTrials.gov Identifier: NCT02924636 / October 5th 2016.
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Affiliation(s)
- Philippe Deruelle
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France. .,Pôle Gynécologie, Obstétrique et Fertilité, Hôpitaux Universitaires de Strasbourg, 67200, Strasbourg cedex, France.
| | - Sophie Lelorain
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Cognitive and Affective Sciences, Lille, France
| | - Sylvie Deghilage
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France
| | - Emmanuelle Couturier
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France
| | - Elodie Guilbert
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy Saint Germain hospital, Poissy, France
| | - Marie Victoire Sénat
- Assistance Publique-Hôpitaux de Paris, Department of Gynecology-Obstetrics, Bicêtre Hospital, University of Paris-Sud, University of Medicine Paris- Saclay Le Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Christophe Vayssière
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Franck Perrotin
- Department of Gynecology and Obstetrics, Inserm U1253 « Imaging and Brain » (iBrain). CHU Bretonneau, Tours, France
| | - Denis Gallot
- Pôle Femme Et Enfant, CHU Estaing, Clermont-Ferrand cedex 1, France.,R2D2-EA7281, Université d'Auvergne, Faculté de Médecine, Place Henri Dunant, Clermont-Ferrand, France
| | - Céline Chauleur
- INSERM, SAINBIOSE, U1059, Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, CIC1408, F- 42055, Saint-Etienne, France
| | - Nicolas Sananes
- Pôle Gynécologie, Obstétrique et Fertilité, Hôpitaux Universitaires de Strasbourg, 67200, Strasbourg cedex, France.,Maternal Fetal Medicine Department, INSERM 1121 "Biomaterials and Bioengineering", Strasbourg University Hospital, Strasbourg, France
| | - Emmanuel Roth
- Pôle Gynécologie, Obstétrique et Fertilité, Hôpitaux Universitaires de Strasbourg, 67200, Strasbourg cedex, France
| | - Dominique Luton
- Department of Obstetrics and Gynecology, AP-HP, Bichat hospital, Paris, France
| | - Marie Caputo
- Department of Obstetrics and Gynecology, Lens general hospital, Lens, France
| | - Elodie Lorio
- Department of Obstetrics and Gynecology, Valenciennes general hospital, Valenciennes, France
| | - Carla Chatelet
- Department of Obstetrics and Gynecology, Béthune general hospital, Béthune, France
| | - Julien Couster
- Department of Obstetrics and Gynecology, Boulogne general hospital, Boulogne, France
| | - Oumar Timbely
- Department of Obstetrics and Gynecology, Meaux general hospital, Meaux, France
| | - Muriel Doret-Dion
- Department of obstetrics and gynecology surgery, Femme mere enfant university hospital, hospices civils de Lyon, Bron, France
| | - Alain Duhamel
- Univ. Lille, CHU Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, F-59000, Lille, France
| | - Marie Pigeyre
- Department of medicine, endocrinology division, Mc Master university, Hamilton, Canada
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Leal J, Cunha C, Santos A, Salgado J. Helping Clients Victimized by Intimate Partners Through Stages of Change: An Emotion-Focused Approach. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2020. [DOI: 10.1007/s10879-020-09474-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Field CA, Richards DK, Castro Y, Alonso Cabriales J, Wagler A, von Sternberg K. The Effects of a Brief Motivational Intervention for Alcohol Use through Stages of Change among Nontreatment Seeking Injured Patients. Alcohol Clin Exp Res 2020; 44:2361-2372. [PMID: 32981123 DOI: 10.1111/acer.14466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 09/12/2020] [Accepted: 09/14/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about the mechanisms of change underlying brief interventions and the patient characteristics that may affect them. The present study tested whether the stages of change mediate the effects of a BMI with and without a telephone booster relative to brief advice (i.e., multiple mediation). Further, the present study tested whether the effects of the BMI conditions on the stages of change were contingent on patients' alcohol use severity (i.e., moderated mediation). METHODS The present study is a secondary analysis using data from injured adult patients at 3 trauma centers who were screened for inclusion in the study and randomly assigned to brief advice (n = 200), BMI (n = 203), or BMI with a telephone booster (n = 193) (Field et al., 2014). Participants completed a baseline assessment and 3-, 6-, and 12-month follow-up assessments that included self-report measures of the stages of change, alcohol use, and alcohol-related problems, as well as other variables of interest. RESULTS The results demonstrated significant and consistent mediation at p < 0.05 wherein BMI with a telephone booster increased action at 3-month follow-up leading to reduced likelihood of at-risk drinking, less alcohol use, and fewer alcohol problems at both 6- and 12-month follow-up. However, moderated mediation analyses suggested that the effects of the BMI conditions on the stages of change were not contingent on patients' alcohol use severity. CONCLUSIONS This study contributes to the understanding of stages of change as potential mechanisms of change in BMI. Directions for future research are discussed.
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Affiliation(s)
- Craig A Field
- From the, Department of Psychology, (CAF), Latino Alcohol and Health Disparities Research and Training Center, University of Texas at El Paso, El Paso, Texas, USA
| | - Dylan K Richards
- Center on Alcohol, Substance use, And Addictions, (DKR), University of New Mexico, Albuquerque, New Mexico, USA
| | - Yessenia Castro
- Steve Hicks School of Social Work, (YC, KS), University of Texas at Austin, Texas, USA
| | - José Alonso Cabriales
- Arts and Sciences Division, (JAC), University of New Mexico-Gallup, Gallup, New Mexico, USA
| | - Amy Wagler
- Department of Mathematical Science, (AW), University of Texas at El Paso El Paso, Texas, USA
| | - Kirk von Sternberg
- Steve Hicks School of Social Work, (YC, KS), University of Texas at Austin, Texas, USA
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92
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Coorey G, Peiris D, Neubeck L, Redfern J. A realist evaluation approach to explaining the role of context in the impact of a complex eHealth intervention for improving prevention of cardiovascular disease. BMC Health Serv Res 2020; 20:764. [PMID: 32811480 PMCID: PMC7433103 DOI: 10.1186/s12913-020-05597-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 07/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background Reduction of cardiovascular disease (CVD) is a worldwide health priority and innovative uses of technology-based interventions may assist patients with improving prevention behaviours. Targeting these interventions to recipients most likely to benefit requires understanding how contexts of use influence responsiveness to the intervention, and how this interaction favours or discourages health behaviour. Using a realist evaluation approach, the aim of this study was to examine the contextual factors influencing behaviour change within a multi-feature eHealth intervention with personalised data integration from the primary care electronic health record (EHR). Methods Realist evaluation of qualitative data from the Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) randomised trial (N = 934). Thirty-six participants from the intervention group (N = 486) who had completed 12 months of study follow-up were interviewed. Coding of transcripts was structured around configurations of contexts, mechanisms, and outcomes of intervention use. Contextual narratives were derived from thematic analysis of the interviews. Results Mechanisms favouring positive health behaviour occurred when participants responded to four interactive features of the intervention. Facilitating mechanisms included greater cognitive engagement whereby participants perceived value and benefit, and felt motivated, confident and incentivised. Participants moved from being unconcerned (or unaware) to more task-oriented engagement with personal CVD risk profile and prevention. Increased personalisation occurred when modifiable CVD risk factors became relatable to lifestyle behaviour; and experiences of feeling greater agency/self-efficacy emerged. Use and non-use of the intervention were influenced by four overarching narratives within the individual’s micro-level and meso-level environments: illness experiences; receptiveness to risk and prevention information; history of the doctor-patient relationship; and relationship with technology. Conclusions Intervention-context interactions are central to understanding how change mechanisms activate within complex interventions to exert their impact on recipients. Intervention use and non-use were context-dependent, underscoring the need for further research to target eHealth innovations to those most likely to benefit.
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Affiliation(s)
- Genevieve Coorey
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. .,The George Institute for Global Health, Sydney, New South Wales, Australia.
| | - David Peiris
- The George Institute for Global Health, Sydney, New South Wales, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Lis Neubeck
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Julie Redfern
- The George Institute for Global Health, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, Sydney, New South Wales, Australia
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93
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Webb TL, du Plessis H, Christian H, Raffan E, Rohlf V, White GA. Understanding obesity among companion dogs: New measures of owner's beliefs and behaviour and associations with body condition scores. Prev Vet Med 2020; 180:105029. [PMID: 32474335 DOI: 10.1016/j.prevetmed.2020.105029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
This research aimed to improve our understanding of how owners' beliefs and behaviour are associated with obesity in companion dogs. To do this, we employed new theoretical frameworks and integrated previously reported measures to curate a collection of brief, user-friendly self-report measures to assess owner factors. The reliability and validity of these was examined in two phases of empirical research, each with a cross-sectional questionnaire design that also examined the validity of assessing body condition score (BCS) from photographs submitted by owners. Phase 1 (n = 47 dog owners from France) found that the brief owner-report measures correlated with the long-form measures (all correlations except one exceeded r = 0.70). BCS as coded from photographs were highly correlated with a vet's assessment of the same dogs (r = 0.67). Phase 2 (n = 3339 dog owners from France, Germany, the UK, Italy, and Russia) investigated which measures are associated with obesity among companion dogs. Perceptions of the dog's vulnerability to the threat of obesity, perceived weight status, perceived costs associated with ownership, normative beliefs about feeding, social support from friends, and being in the precontemplation stage of change predicted BCS alongside demographic factors (e.g., dog's age, neutered status). Taken together, the findings provide a method for assessing a wide range of factors that may be associated with obesity among companion dogs and point to potential targets for interventions designed to reduce obesity.
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Affiliation(s)
| | | | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, Australia
| | - Eleanor Raffan
- Wellcome Trust-MRC Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | | | - Gavin A White
- University of Nottingham, Sutton Bonington Campus, UK
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94
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Adair KC, Rodriguez-Homs LG, Masoud S, Mosca PJ, Sexton JB. Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers. J Med Internet Res 2020; 22:e15562. [PMID: 32406864 PMCID: PMC7256751 DOI: 10.2196/15562] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/31/2019] [Accepted: 12/16/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Emotional exhaustion (EE) in health care workers is common and consequentially linked to lower quality of care. Effective interventions to address EE are urgently needed. OBJECTIVE This randomized single-exposure trial examined the efficacy of a gratitude letter-writing intervention for improving health care workers' well-being. METHODS A total of 1575 health care workers were randomly assigned to one of two gratitude letter-writing prompts (self- vs other focused) to assess differential efficacy. Assessments of EE, subjective happiness, work-life balance, and tool engagement were collected at baseline and 1-week post intervention. Participants received their EE score at baseline and quartile benchmarking scores. Paired-samples t tests, independent t tests, and correlations explored the efficacy of the intervention. Linguistic Inquiry and Word Count software assessed the linguistic content of the gratitude letters and associations with well-being. RESULTS Participants in both conditions showed significant improvements in EE, happiness, and work-life balance between the intervention and 1-week follow-up (P<.001). The self-focused (vs other) instruction conditions did not differentially predict improvement in any of the measures (P=.91). Tool engagement was high, and participants reporting higher motivation to improve their EE had higher EE at baseline (P<.001) and were more likely to improve EE a week later (P=.03). Linguistic analyses revealed that participants high on EE at baseline used more negative emotion words in their letters (P=.005). Reduction in EE at the 1-week follow-up was predicted at the level of a trend by using fewer first-person (P=.06) and positive emotion words (P=.09). No baseline differences were found between those who completed the follow-up assessment and those who did not (Ps>.05). CONCLUSIONS This single-exposure gratitude letter-writing intervention appears to be a promising low-cost, brief, and meaningful tool to improve the well-being of health care workers.
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Affiliation(s)
- Kathryn C Adair
- Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC, United States
| | | | - Sabran Masoud
- Duke University School of Medicine, Durham, NC, United States
| | - Paul J Mosca
- Duke Network Services Duke University Health System, Duke University Health System, Durham, NC, United States
- Department of Surgery, Duke University School of Medicine, Duke University Health System, Durham, NC, United States
| | - J Bryan Sexton
- Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC, United States
- Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, NC, United States
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de Freitas PP, de Menezes MC, dos Santos LC, Pimenta AM, Ferreira AVM, Lopes ACS. The transtheoretical model is an effective weight management intervention: a randomized controlled trial. BMC Public Health 2020; 20:652. [PMID: 32393214 PMCID: PMC7216547 DOI: 10.1186/s12889-020-08796-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 04/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Given the current worldwide epidemic of obesity, there is a demand for interventions with higher impact, such as those carried out in the primary health care (PHC) setting. Here we evaluate the effect of intervention performed according to the stages of change of the transtheoretical model (TTM) for weight management. METHODS This randomized controlled trial in Brazilian PHC offered free physical exercise and nutrition education. The participants were women, aged 20 years or older who were obese or overweight, users in PHC service. The intervention group (IG, n = 51) received the same orientation as the comparison group (CG, n = 35) plus individual health counseling based on the TTM aimed at weight loss, which lasted 6 months. The outcome measures were anthropometric, food, and nutrient profiles. Inflammatory parameters were evaluated in a random subsample. The inter-group and intra-group differences were evaluated using interntion-to-treat analysis, and analysis of covariance (ANCOVA) used to assess intervention effectiveness. RESULTS There was a difference between groups of - 1.4 kg (CI95%: - 2.5; - 0.3) in body weight after the intervention. About 97% of women in the IG reported benefits of the intervention and presented positive changes in diet, biochemical markers, and anthropometry. The IG showed better body mass index, resistine, and blood glucose results compared to the CG during follow-up. CONCLUSION The individualized TTM-based intervention, combined with usual care, was an effective strategy in PHC. These results should encourage the use of interdisciplinary practices; nevertheless, research to identify additional strategies is needed to address barriers to weight maintenance among obese low-income women. TRIAL REGISTRATION The trial is registered with Brazilian clinical trials under the code: RBR-8t7ssv, Registration date: 12/12/2017 (retrospectively registered).
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Affiliation(s)
- Patrícia Pinheiro de Freitas
- Research Group in Nutrition Interventions, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Mariana Carvalho de Menezes
- Research Group in Nutrition Interventions, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Luana Caroline dos Santos
- Research Group in Nutrition Interventions, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Adriano Marçal Pimenta
- Research Group in Nutrition Interventions, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Adaliene Versiani Matos Ferreira
- Research Group in Nutrition Interventions, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Aline Cristine Souza Lopes
- Research Group in Nutrition Interventions, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
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Tanikawa Y, Kimachi M, Ishikawa M, Hisada T, Fukuhara S, Yamamoto Y. Association between work schedules and motivation for lifestyle change in workers with overweight or obesity: a cross-sectional study in Japan. BMJ Open 2020; 10:e033000. [PMID: 32354776 PMCID: PMC7213847 DOI: 10.1136/bmjopen-2019-033000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the association between work schedules and motivation for behavioural change of lifestyle, based on the transtheoretical model (TTM) in workers with overweight or obesity. DESIGN A cross-sectional observational study. SETTING A healthcare examination centre in Japan. PARTICIPANTS Between April 2014 and March 2016, we recruited 9243 participants who underwent healthcare examination and met the inclusion criteria, namely, age 20-65 years, body mass index (BMI) ≥25 kg/m2 and full-time workers. EXPOSURE Night and shift (night/shift) workers were compared with daytime workers in terms of motivation for behavioural change. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was action and maintenance stages of change (SOC) for lifestyle in TTM. In a subgroup analysis, we investigated interactions between characteristics, including age, sex, BMI, current smoking, alcohol habits, hours of sleep and working hours. RESULTS Overall, 1390 participants (15.0%) were night/shift workers; night/shift workers were younger (median age (IQR): 46 (40-54) vs 43 (37-52) years) and the proportion of men was lesser (75.4 vs 60.9%) compared with daytime workers. The numbers of daytime and night/shift workers in the action and maintenance SOC were 2113 (26.9%) and 309 (22.2%), respectively. Compared with daytime workers, night/shift workers were less likely to demonstrate action and maintenance SOC (adjusted OR (AOR): 0.85, 95% CI: 0.74 to 0.98). In a subgroup analysis that included only those with long working hours (≥10 hours/day), results revealed a strong inverse association between night/shift work and action and maintenance SOC (AOR: 0.65, 95% CI: 0.48 to 0.86). A significant interaction was observed between long working hours and night/shift work (P for interaction=0.04). CONCLUSIONS In workers with overweight or obesity, a night/shift work schedule was associated with a lower motivation for behavioural change in lifestyle, and the association was strengthened in those with long working hours.
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Affiliation(s)
- Yukihiro Tanikawa
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Miho Kimachi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Ishikawa
- Health Examination Centre, Urasoe General Hospital, Urasoe, Japan
| | | | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University, Kyoto, Japan
- Centre for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
- Shirakawa STAR for General Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Assessing the potential of a Virtual Patient Advocate to provide preconception care and health advice to women living in Australia. J Dev Orig Health Dis 2020; 12:300-308. [PMID: 32308183 DOI: 10.1017/s2040174420000264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A preconception Virtual Patient Advocate (VPA) called "Gabby" supported African-American women to decrease their preconception health risks and may be a scalable resource to increase women's access to preconception care. Aims were to assess the acceptability of a preconception VPA in women living in Australia and document the changes required to adapt Gabby to suit an Australian context. Taking a descriptive qualitative approach, nonpregnant female participants (n = 31), aged 18-45 years, living in metropolitan and regional Victoria, Australia interacted with Gabby. Focus groups (n = 7) that gathered participants' perspectives of their experience with Gabby ran in July-August 2019 before being transcribed verbatim and thematically analyzed. Six interrelated themes and 12 subthemes were identified. Participants found VPAs to be an acceptable provider of health information with potential to increase women's access preconception health advice. Gabby was considered to be trustworthy and was able to develop rapport with participants in a relatively short time. Context-specific, relevant, tailored and trustworthy information and advice were considered more important that Gabby's physical appearance. Participants had strong opinions about potential technological advancements (e.g., reminders and rewards) and addressing navigation issues to increase Gabby's acceptability. Participants envisaged that they would use Gabby for readily available and evidence-based information before seeking advice from a health professional if required. Overall, the concept VPAs to provide preconception advice and Gabby were acceptable to participants. Future development of VPAs, Gabby, and other online technology-based resources should consider women's high expectations of the online health information they choose to interact with.
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98
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To contemplate or not to contemplate evaluating a preliminary intervention proposal in an outpatient setting: the contemplation therapy group. Eat Weight Disord 2020; 25:389-398. [PMID: 30414075 DOI: 10.1007/s40519-018-0610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/26/2018] [Indexed: 10/27/2022] Open
Abstract
PURPOSE The concept for the contemplation group intervention was derived from motivational interviewing (MI) to support people suffering from an eating disorder who are reluctant to engage with treatment. This evaluation focuses on the contemplation group run by the eating disorder services in the Cardiff and Vale area between 2012 and 2016 to investigate the outcomes for participants and implications for working with people suffering from an eating disorder who are ambivalent about change. METHOD Quantitative measures were used to assess eating disorder symptomatology, motivation to change and location within the stages of change model. A brief qualitative evaluation of client experiences was also included. RESULTS While dropout was high, a number of patients displayed increased readiness for treatment at the end of the group or even started to engage in change-focussed therapy. Participants who completed the group described it as challenging but helpful. CONCLUSIONS This evaluation shows that explorative contemplation of their ambivalence towards their eating disorder and treatment was helpful for the participants of the group and supported them in achieving more clarity and decisiveness regarding whether to engage in treatment or not. Further research is needed to evaluate long-term outcomes for patients who feel ambivalent towards treatment, and to explore what interventions can be used to help them. EVIDENCE LEVEL Level IV: Evidence obtained from multiple time series with or without the intervention.
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99
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Restifo S, Tan LYH. On what basis should we select treatment in clinical psychiatry: a question too obvious to ask? Australas Psychiatry 2020; 28:202-205. [PMID: 31530168 DOI: 10.1177/1039856219875060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Given the differences between our profession and the broader set of medical disciplines, a review of the factors to be considered in treatment planning was conducted. CONCLUSION Treatment planning in psychiatry is inherently more complicated than in other medical disciplines for various reasons including: a broader range of conceptual models of mental illness and treatment; greater complexities around nosology and diagnosis; the greater limitations of the research evidence base and clinical practice guidelines; and the more substantial impacts of patients' subjectivity and contextual aspects. Diagnosis is generally neither a sufficient nor necessarily the most useful criterion for treatment planning in psychiatry, with a number of other considerations to help guide treatment being outlined.
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Affiliation(s)
- Sam Restifo
- Psychiatrist, Wheatbelt Mental Health Service, Northam, WA, Australia
| | - Lemuel Y H Tan
- Psychologist, Wheatbelt Mental Health Service, Northam, WA, Australia
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Probst T, Kleinstäuber M, Lambert MJ, Tritt K, Pieh C, Loew TH, Dahlbender RW, Delgadillo J. Why are some cases not on track? An item analysis of the Assessment for Signal Cases during inpatient psychotherapy. Clin Psychol Psychother 2020; 27:559-566. [PMID: 32131148 PMCID: PMC7496290 DOI: 10.1002/cpp.2441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 01/02/2020] [Accepted: 03/03/2020] [Indexed: 11/25/2022]
Abstract
Within the Routine Outcome Monitoring system “OQ‐Analyst,” the questionnaire “Assessment for Signal Cases” (ASC) supports therapists in detecting potential reasons for not‐on‐track trajectories. Factor analysis and a machine learning algorithm (LASSO with 10‐fold cross‐validation) were applied, and potential predictors of not‐on‐track classifications were tested using logistic multilevel modeling methods. The factor analysis revealed a shortened (30 items) version of the ASC with good internal consistency (α = 0.72–0.89) and excellent predictive value (area under the curve = 0.98; positive predictive value = 0.95; negative predictive value = 0.94). Item‐level analyses showed that interpersonal problems captured by specific ASC items (not feeling able to speak about problems with family members; feeling rejected or betrayed) are the most important predictors of not‐on‐track trajectories. It should be considered that our results are based on analyses of ASC items only. Our findings need to be replicated in future studies including other potential predictors of not‐on‐track trajectories (e.g., changes in medication, specific therapeutic techniques, or treatment adherence), which were not measured this study.
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Affiliation(s)
- Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria
| | - Maria Kleinstäuber
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Karin Tritt
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria
| | - Thomas H Loew
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Reiner W Dahlbender
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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