CONSORT-SPI 2018 Explanation and Elaboration: guidance for reporting social and psychological intervention trials

Coping styles mediate the relation between mindset and academic resilience in adolescents during the COVID-19 pandemic: a randomized controlled trial

The COVID-19 pandemic negatively impacted adolescent mental health on a global scale. However, many students were resilient during this crisis, despite exposure to COVID-related stressors. We aimed to study the protective effects of growth mindset on school-related resilience during the COVID-19 pandemic, and the mediating effects of coping styles. The two-year follow-up of an ongoing Randomized Controlled Trial, involving a growth mindset and control intervention, took place during the pandemic. We measured growth mindset, school burnout symptoms, COVID-19-specific stressor exposure, coping styles, and calculated a resilience score (corrected for pre-pandemic school burnout symptoms). Mediation analyses were performed in the total sample (N = 261), and exploratory in the intervention subsamples, to test whether the associations between mindset and resilience were mediated by coping styles. Growth-mindset students were more resilient during the pandemic and used less maladaptive and more adaptive (acceptance) coping styles. Coping mediated the relation between mindset and resilience in the total sample (both coping styles), and growth mindset intervention subsample (maladaptive coping). We found unique evidence for the beneficial effects of growth mindset on school-related resilience during the pandemic, and the mediating effect of coping styles as explanatory mechanism. This work contributes to a growing literature that shows positive effects of growth mindset on mental health.

Examination of Web-Based Single-Session Growth Mindset Interventions for Reducing Adolescent Anxiety: Study Protocol of a 3-Arm Cluster Randomized Controlled Trial

BACKGROUND

Anxiety disorders are the most common mental disorders worldwide. In Hong Kong, 7% of adolescents are diagnosed with anxiety disorders, and 1 in every 4 secondary school students reports clinical-level anxiety symptoms. However, 65% of them do not access services. Long waitlists in public services, the high cost of private services, or the fear of being stigmatized can hinder service access. The high prevalence of anxiety and low intervention uptake indicate a pressing need to develop timely, scalable, and potent interventions suitable for adolescents. Single-session interventions (SSIs) have the potential to be scalable interventions for diagnosable or subclinical psychopathology in adolescents. Providing precise and context-adapted intervention is the key to achieving intervention efficacy.

OBJECTIVE

This study aims to compare the effectiveness of three SSIs: single-session intervention of growth mindset on negative emotions (SIGMA), SSI of growth mindset of personality (SSI-GP), and active control, in reducing adolescent anxiety.

METHODS

Adolescents (N=549, ages 12-16 years) from secondary schools will be randomized to 1 of 3 intervention conditions: the SIGMA, SSI-GP, or active control. The implementation of each intervention is approximately 45 minutes in length. Adolescent participants will report anxiety symptoms (primary outcome), perceived control, hopelessness, attitude toward help-seeking, and psychological well-being at preintervention, the 2-week follow-up, and the 8-week follow-up. A pilot test has confirmed the feasibility and acceptability of SIGMA among adolescents. We hypothesized that SIGMA and SSI-GP will result in a larger reduction in anxiety symptoms than the control intervention during the posttest and 8-week follow-up period. We also predict that SIGMA will have a more significant effect than SSI-GP. We will use the intention-to-treat principle and linear regression-based maximum likelihood multilevel models for data analysis.

RESULTS

This study will be conducted from December 2022 to December 2023, with results expected to be available in January 2024.

CONCLUSIONS

This protocol introduces the implementation content and strategies of growth mindset SSIs (consists of 2 forms: SIGMA and SSI-GP) among school students. The study will provide evidence on the efficacy of different growth mindset SSIs for adolescent anxiety. It will also establish implementation strategies for self-administrative SSIs among school students, which can serve as a pioneer implementation of a scalable and self-accessible brief intervention to improve the well-being of young people.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05027880; https://clinicaltrials.gov/ct2/show/NCT05027880.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/41758.

Clinical outcomes of a short-term family-focused intervention for patients with atrial fibrillation-A randomised clinical trial

AIMS

To evaluate a family-focused intervention for patients with atrial fibrillation (AF) in addition to conventional care and to establish its effect on health-related quality of life (HRQoL), anxiety, depression, AF symptoms, and family support.

BACKGROUND

AF is a widespread heart disease affecting the well-being of patients and their family members physically and psychologically. Supporting patients and their family members could potentially facilitate regaining family strength and improve HRQoL.

METHODS

Patients with newly diagnosed AF were randomised to standard care or additional family-focused intervention with change in global score of the Atrial Fibrillation Quality of Life Questionnaire (AFEQT) as primary outcome after six months' follow-up. Secondary outcomes included the Hospital Anxiety and Depression Score, the European Heart Rhythm Association score, the Ice Expressive Family Functioning Questionnaire, and the Ice Family-Perceived Support Questionnaire (ICE-FPSQ).

RESULTS

Sixty-eight patients received standard care (n = 35) or family focused intervention (n = 33). The median change at the six-month follow-up on the global AFEQT score was 4.17 (-1.46-9.17) in the control group and 5.83 (-2.5-30) in the intervention group, yielding a median difference of -1.67 (p = 0.500). Change in ICE-FPSQ showed significant positive scores in favour of intervention (p < 0.001); other secondary outcome changes were non-significant.

CONCLUSION

The family-focused intervention had a small positive but non-significant effect on HRQoL compared to standard care. To address the impact of AF on the patients and family members seems to improve anxiety and depression scores and perceived family support.

Social norms and goal-setting interventions to promote responsible gambling in low-to-moderate online gamblers: protocol for a four-arm randomised controlled feasibility study

INTRODUCTION

Gambling is increasingly recognised as an important public health issue. Problem gambling is associated with highly negative impacts on physical, psychological and social well-being, not only for those who gamble but also for those around them. There has been a rapid expansion of internet gambling and attributes such as continuous play and instant rewards, and enhanced privacy may lead to a greater likelihood of gambling-related harms. In this randomised controlled feasibility study, we are testing (1) the acceptability and feasibility of three online responsible gambling interventions targeting people with low-to-moderate risk of online problem gambling and (2) the feasibility of a future full-scale randomised controlled trial (RCT) to test their effectiveness and cost-effectiveness.

METHODS AND ANALYSIS

Four-arm randomised controlled feasibility study with qualitative substudy. One-hundred and forty UK residents with low-to-moderate risk of online gambling recruited via gambling operators and social media will be randomised (1:1:1:1) to either (1) goal setting, (2) descriptive norms messages (challenge perceptions of peer behaviours), (3) injunctive norms messages (challenge perceptions of peer attitudes) and (4) control (delayed intervention). Interventions will be delivered over 6 weeks and individually tailored. Outcomes, administered online, will be measured at baseline, 7 weeks, and 3 and 6 months post randomisation (including gambling risk behaviours and cognitions, anxiety and depression, quality of life, health use and productivity). Analyses will be descriptive, focusing on feasibility and acceptability of the interventions and study procedures. Telephone/online interviews, with a subsample of approximately 30 participants, will elicit experiences of participating in the study. Prespecified progression criteria will guide decisions around whether to progress to a definitive RCT.

ETHICS AND DISSEMINATION

Ethical approval obtained from Bournemouth University Research Ethics Committee (reference number 33247). Participants will be given a participant information sheet plus a 'Key Facts' summary and will provide informed online consent. Findings will be published in peer-reviewed journals and presented at conferences and public engagement events.

TRIAL REGISTRATION NUMBER

ISRCTN37874344.

Communication skills training for improving the communicative abilities of student social workers

Background

Good communication is central to effective social work practice, helping to develop constructive working relationships and improve the outcomes of people in receipt of social work services. There is strong consensus that the teaching and learning of communication skills for social work students is an essential component of social work qualifying courses. However, the variation in communication skills training and its components is significant. There is a sizeable body of evidence relating to communication skills training therefore a review of the findings helps to clarify what we know about this important topic in social work education. We conducted this systematic review to determine whether communication skills training for social work students works and which types of communication skills training, if any, were more effective and lead to the most positive outcomes.

Objectives

This systematic review aimed to critically evaluate all studies which have investigated the effectiveness of communication skills training programmes for social work students. The research question which the review posed is: 'What is the effectiveness of communication skills training for improving the communicative abilities of social work students?' It was intended that the review would provide a robust evaluation of communication skills training for social work students and help explain variations in practice to support educators and policy-makers to make evidence-based decisions in social work education, practice and policy.

Search Methods

We conducted a search for published and unpublished studies using a comprehensive search strategy that included multiple electronic databases, research registers, grey literature sources, and reference lists of prior reviews and relevant studies.

Selection Criteria

Study selection was based on the following characteristics: Participants were social work students on generic (as opposed to client specific) qualifying courses; Interventions included any form of communication skills training; eligible studies were required to have an appropriate comparator such as no intervention or an alternative intervention; and outcomes included changes in knowledge, attitudes, skills and behaviours. Study selection was not restricted by geography, language, publication date or publication type.

Data Collection and Analysis

The search strategy was developed using the terms featuring in existing knowledge and practice reviews and in consultation with social work researchers, academics and the review advisory panel, to ensure that a broad range of terminology was included. One reviewer conducted the database searches, removing duplicates and irrelevant records, after which each record was screened by title and abstract by both reviewers to ensure robustness. Any studies deemed to be potentially eligible were retrieved in full text and screened by both reviewers.

Main Results

Fifteen studies met the inclusion criteria. Overall, findings indicate that communication skills training including empathy can be learnt, and that the systematic training of social work students results in some identifiable improvements in their communication skills. However, the evidence is dated, methodological rigour is weak, risk of bias is moderate to high/serious or incomplete, and extreme heterogeneity exists between the primary studies and the interventions they evaluated. As a result, data from the included studies were incomplete, inconsistent, and lacked validity, limiting the findings of this review, whilst identifying that further research is required.

Authors’ Conclusions

This review aimed to examine effects of communication skills training on a range of outcomes in social work education. With the exception of skill acquisition, there was insufficient evidence available to offer firm conclusions on other outcomes. For social work educators, our understanding of how communication skills and empathy are taught and learnt remain limited, due to a lack of empirical research and comprehensive discussion. Despite the limitations and variations in educational culture, the findings are still useful, and suggest that communication skills training is likely to be beneficial. One important implication for practice appears to be that the teaching and learning of communication skills in social work education should provide opportunities for students to practice skills in a simulated (or real) environment. For researchers, it is clear that further rigorous research is required. This should include using validated research measures, using research designs which include appropriate counterfactuals, alongside more careful and consistent reporting. The development of the theoretical underpinnings of the interventions used for the teaching and learning of communication skills in social work education is another area that researchers should address.

Substance use prevention during adolescence: Study protocol for a large-scale cluster randomized trial of Botvin High School LifeSkills Training

BACKGROUND

Concerns about the rise in adolescent vaping and cannabis use suggest the need for effective substance use prevention programs. Botvin LifeSkills Training (LST) has a strong evidence base at the middle school level for preventing or reducing tobacco use and related problems. A high school (grades 9-10) version of the LST program was also developed and shows promising initial evidence for reducing tobacco use in a single pilot study. However, the high school version of LST has not been sufficiently tested in an experimental trial, despite being widely implemented in high schools across the U.S. This paper outlines the study protocol for a large-scale cluster randomized trial of Botvin High School LST, with objectives of documenting the design of prospective research and promoting transparency.

METHODS

A total of 60 high schools in Colorado and Ohio were randomized to the 10-session, teacher-led intervention group (n = 33 schools) or business-as-usual control group (n = 27 schools). Across two cohorts of schools, 9th-grade students complete self-report surveys at pretest, immediate posttest, 1-year follow-up, and 21-month follow-up. Primary outcomes are tobacco (nicotine) use and cannabis use. Secondary outcomes are alcohol use, illicit drug use, psychosocial behaviors (e.g., violence and mental health), and academic achievement. Intent-to-treat analyses will use multilevel modeling to estimate intervention effects across assessment points.

CONCLUSION

This independent evaluation will help to determine whether the intervention is appropriate for large-scale adoption. This trial is preregistered with the Open Science Framework (https://osf.io/dnz5q/).

Evaluating Implementation of the Transparency and Openness Promotion Guidelines: Reliability of Instruments to Assess Journal Policies, Procedures, and Practices

The Transparency and Openness Promotion (TOP) Guidelines describe modular standards that journals can adopt to promote open science. The TOP Factor quantifies the extent to which journals adopt TOP in their policies, but there is no validated instrument to assess TOP implementation. Moreover, raters might assess the same policies differently. Instruments with objective questions are needed to assess TOP implementation reliably. In this study, we examined the interrater reliability and agreement of three new instruments for assessing TOP implementation in journal policies (instructions to authors), procedures (manuscript-submission systems), and practices (journal articles). Independent raters used these instruments to assess 339 journals from the behavioral, social, and health sciences. We calculated interrater agreement (IRA) and interrater reliability (IRR) for each of 10 TOP standards and for each question in our instruments (13 policy questions, 26 procedure questions, 14 practice questions). IRA was high for each standard in TOP; however, IRA might have been high by chance because most standards were not implemented by most journals. No standard had “excellent” IRR. Three standards had “good,” one had “moderate,” and six had “poor” IRR. Likewise, IRA was high for most instrument questions, and IRR was moderate or worse for 62%, 54%, and 43% of policy, procedure, and practice questions, respectively. Although results might be explained by limitations in our process, instruments, and team, we are unaware of better methods for assessing TOP implementation. Clarifying distinctions among different levels of implementation for each TOP standard might improve its implementation and assessment (study protocol: https://doi.org/10.1186/s41073-021-00112-8 ).

The TELE-DD Randomised Controlled Trial on Treatment Adherence in Patients with Type 2 Diabetes and Comorbid Depression: Clinical Outcomes after 18-Month Follow-Up

Clinical depression is associated with poorer adherence to hypoglycaemic medication in patients with diabetes mellitus, leading to poorer glycaemic control, diabetes management, and increased complications. The main aim of the TELE-DD trial was to demonstrate the efficacy of a proactive and psychoeducational telephonic intervention based on motivational interviewing and collaborative care to reduce nonadherence and improve prognosis in individuals with diabetes mellitus and concurrent depression.

DESIGN

The TELE-DD project is a three-phased prospective study including a nested randomised controlled trial.

METHODS

The baseline cohort included the entire population of adult patients diagnosed with type 2 diabetes and concurrent depression. A randomised controlled trial was conducted in a selection of patients from the baseline cohort, distributed into a control group (n = 192) and an intervention group (n = 192). Monthly telephonic interventions delivered by specifically trained research nurses were centred on a psychoeducational individualised monitoring protocol including motivational interviewing and collaborative care strategies. Clinical and patient-centred data were systematically collected during an 18-month follow-up including HbA1c, Patient Health Questionnaire, and the Diabetes Distress Scale.

RESULTS

During the trial, 18-month follow-up HbA1C levels significantly (p < 0.001) decreased in the intervention group at every follow-up from an average of 8.72 (SD:1.49) to 7.03 (SD:1.09), but slightly increased in the control group from 8.65 (SD:1.40) to 8.84 (SD:1.38). Similar positive results were obtained in depression severity and diabetes distress, LDL-cholesterol, and systolic and diastolic blood pressure, but only at the 18-month follow-up in body mass index reduction.

CONCLUSIONS

This is the first trial to concurrently decrease biological and psychological outcomes with a monthly brief telephonic intervention, pointing out that a combined biopsychosocial intervention and collaborative care strategy is essential for current world health challenges.

CLINICALTRIALS

gov Identifier: NCT04097483. Patient or Public Contribution: Diabetic patients not belonging to the TELE-DD population or trial sample were consulted during the study design to review and guarantee the clarity and understanding of the trial psychoeducational materials.

Comparison of the efficacy of acupuncture at the TUNG’s extra points and the traditional Chinese medicine points for elderly patients with chronic low back pain in Thailand

Objective

To compare the efficacy of acupuncture at TUNG’s extra points and traditional Chinese medicine (TCM) points for elderly patients with chronic low back pain (CLBP) in Thailand.

Methods

A single-blinded, randomized controlled trial with 84 elderly volunteers with CLBP was designed. The patients were randomly assigned either to the group getting acupuncture at TUNG’s extra points or to the group getting acupuncture at TCM points. The treatment period was 30 min per session for seven consecutive days. Before and after treatment, the score of the numeric rating scale (NRS), the back range of motion (BROM), and the back strength were measured and compared.

Results

After treatment, both groups were found with decreased NRS scores and increased BROM (P<0.05), but with no statistical difference in their back strength in comparison with that before treatment in the same group (P>0.05). Regarding the between-group comparison, no significant differences were found in the NRS score or BROM in the direction of forward flexion and right lateral flexion or the back strength after treatment (P>0.05). However, statistical differences were found in the BROM in directions of back extension (P<0.01) and left lateral flexion (P<0.05).

Conclusion

Acupuncture at TUNG’s extra points can decrease the low back pain NRS score and increase the back strength and the BROM in directions of forward flexion and right lateral flexion, equivalent to acupuncture at TCM points. Acupuncture at TCM points has a better effect in increasing the BROM in directions of back extension and left lateral flexion; acupuncture at TUNG’s extra points is suitable for elderly CLBP patients, and it should be supported and promoted.

Evaluation of cultural competency in a South African cluster randomised controlled trial: lessons learned for trial reporting standards

BACKGROUND

Failure to consider relevant cultural, ethnic and diversity parameters (and the intersection between these parameters) during trial protocol development and trial conduct may negatively impact recruitment, intervention development and delivery, and participant adherence and retention, potentially reducing overall internal validity. This case study aimed to evaluate the utility and comparability between the 9-item Gibbs Framework to measure cultural competency and the GRIPP-2(Short Form (SF)) 5-point checklist to assess patient and public involvement in the context of a complex clinical trial conducted in an African setting.

METHODS

We identified and collated all relevant publications, source and procedural data related to the trial and integrated the documents into a dynamic trial timeline. Two independent investigators applied and scored the Gibbs Framework and the GRIPP-2(SF) checklist to the four publications arising from the trial, noting functionality and comparability between tools. Where cultural competency was not met, a third investigator screened all procedural and source data and identified if cultural competency had been achieved but not reported in the publications, or if the trial had not met appropriate cultural competency based on the documentation.

RESULTS

Application of the Gibbs Framework found that the trial scored '2' for seven of the nine Gibbs items, indicating full cultural competency for those questions. The Framework indicated that the trial research question was not driven by the articulated needs of patients, and neither were patients, caregivers and clinical providers involved in the development of the intervention. Comparability with the GRIPP-2(SF) checklist showed that the Gibbs performed better on evaluation of partnerships with the community, identification of culturally competent data sources and target populations, and appointment of trial staff in an inclusive manner.

CONCLUSIONS

Comprehensive evaluation of the trial's cultural competency required scrutiny of both published manuscripts and source and procedural data, suggesting that there is a gap in current trial reporting standards with respect to cultural competence.

TRIAL REGISTRATION

PACTR201610001825403. Registered on 17 October 2016.

[Extensions of guidelines for reporting types of study in medicine]

The use of different guides to report types of study in the medical field has been widely disseminated for decades, however, their adherence and use by an important part of researchers is still limited, this has negatively impacted the dissemination of new findings, which has generated criticism regarding how medical research is designed, conducted and reported. Parallel to this, there are extensions to these guidelines which are little known and used by the personnel involved in research work, they focus on more specific approaches to report different types of studies, among which are: meta-analysis, systematic reviews, clinical trials randomized, diagnostic accuracy studies, observational studies, among others; for this reason, its promotion, knowledge, and use is of vital importance. The objective of this review is to synthesize the main extensions of the guidelines used in medical research; for this purpose, its main characteristics were reviewed, as well as application scenarios according to the level of evidence; Its adequate adherence will allow health personnel involved in research work to increase the transparency and quality of their findings, contemplate potential sources of bias, as well as the development of good practices for the presentation of their results according to the type of study selected.

Study protocol of a mixed method pragmatic quasi-experimental trial to evaluate the day activity services targeted at older home care clients in Finland

Background

In Finland, the ‘day activity service’ is targeted at older home care clients who are unable to participate in other available activities due to poor health or functional disabilities. The aim of the day activity service is to support home care client’s ability to live at home and to enhance their wellbeing and social inclusion. This mixed method study examines the effectiveness, cost-effectiveness and process of the day activity service.

Methods

The target sample size is 200 participants. The intervention group (n = 100) is composed of home care clients who begin to participate in the day activity service. The comparison group (n = 100) are home care clients who do not participate in the day activity service, and whose functioning and care needs are similar to the participants of the intervention group. The primary outcome is social inclusion (ESIS-scale). Secondary outcomes are loneliness (single item and De Jong Gierveld Loneliness Scale) and social care related quality of life (ASCOT). Baseline, three-month and six-month follow-up surveys are gathered from intervention and comparison group participants in order to compare outcomes between groups pre- and post-intervention.

Costs of health and social services, based on administrative data, and the costs of the intervention are utilized in examining the cost-effectiveness of the intervention with the above-described measurements. Qualitative data are collected by interviewing the intervention participants (n = 10) and professionals working at the day activity centres and older people’s services (4 focus groups) to explore the perceived outcomes and process of the intervention to find out how and why the intervention is effective or ineffective.

Discussion

The study seeks to produce a comprehensive understanding of the effectiveness, cost-effectiveness and implementation process of the day activity service.

Trial registration

ISRCTN13146087, Registration date 03/04/2022.

Promoting positive emotions and instilling concern for the needs of others during the COVID-19 pandemic

The purpose of this research is to study the efficacy of the home-based Hero program in promoting positive emotions and prosocial behavior during the COVID-19 pandemic. The sample included 237 12- to 15-year-old adolescents from Argentina. The level of positive emotions and prosocial behavior toward strangers, friends and family in the adolescent intervention group increased through the three evaluation periods. The Hero program was focused on recognizing one's own emotions and provided an opportunity to reflect on different positive aspects of life, thus allowing a change in perspective related to immediate negative events. Moreover, the program provided an opportunity to change adolescents' perspective from personal worries to concerns about others, including friends, family members, and even strangers in need.

Exploring the application of behaviour change technique taxonomies in childhood obesity prevention interventions: A systematic scoping review

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Novel critique of BCT taxonomy applications in childhood obesity prevention trials.

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Large variation in BCT methods and reporting of BCT-related methods and results.

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Scarce detail reported in selection of BCTs in prospective taxonomy applications.

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Need for guidance to standardise processes and reporting of taxonomy applications.

Behaviour change technique (BCT) taxonomies provide one approach to unpack the complexity of childhood obesity prevention interventions. This scoping review sought to examine how BCT taxonomies have been applied to understand childhood obesity prevention interventions targeting children aged 12 years or under and/or their caregivers. A systematic search was conducted in Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL and PROSPERO, to capture all eligible research up to February 2021. No limits were placed on country, language, publication dates, or full text availability. Eligible studies included any study design that applied a BCT taxonomy and evaluated behavioural childhood obesity prevention interventions targeting children aged 12 years or under and/or their parents or caregivers. Sixty-three records, describing 54 discrete studies were included; 32 applied a BCT taxonomy prospectively (i.e., to design interventions) and 23 retrospectively (i.e., to assess interventions), 1 study did both. There was substantial variation in the methods used to apply BCT taxonomies and to report BCT-related methods and results. There was a paucity of detail reported in how BCTs were selected in studies applying BCT taxonomies prospectively. Our review provides important insight into the application of BCT taxonomies in childhood obesity prevention and several ongoing challenges, pointing to the need for best practice reporting guidance.

Impact of Pain Neuroscience Education Program in Community Physiotherapy Context on Pain Perception and Psychosocial Variables Associated with It in Elderly Persons: A Ranzomized Controlled Trial

This study investigated the long-term effect (six-months) of a Pain Neuroscience Education (PNE) program on pain perception, quality of life, kinesiophobia and catastrophism in older adults with multimorbidity and chronic pain. Fifty participants (n = 50) were randomly assigned to the pain education therapy group (PET; n = 24) and control group (CG; n = 26). The PET group received six sessions (i.e., once a week, 50 min) about neurophysiology of pain while the CG carried on with their usual life. Perception of pain through the visual analogue scale (VAS), quality of life (EQ-5D questionnaire), kinesiophobia (TSK-11) and catastrophism (PCS) were assessed after six months since the last PNE session. Statistically significant differences on VAS (t₍₄₈₎ = 44, p = 0.01, ES = 0.42 [0.13, 0.65]) was found in favor to PET group. No other statistically significant differences were found. This study found that the application of a PNE intervention in an isolated form was able to significantly reduce pain perception with low effect size in the long-term (six months after intervention) in elderly people with chronic pain.

The effect of yoga on sexual function and body image in primiparous pregnant Women: A randomized controlled single-blind study

OBJECTIVE

This study was conducted to examine the effect of yoga practice during pregnancy on sexual function and body image.

STUDY DESING

This study was planned as a randomized controlled single-blind trial. The study was performed with 140 pregnant women randomized in a pregnancy outpatient clinic of a hospital in Istanbul, Turkey, between March and September 2021. Two groups (A: yoga group and B: routine hospital care) were included in this study. The Personal Information Form, Female Sexual Function Index (FSFI), and Body Exposure During Sexual Activity Questionnaire (BESAQ) were used to collect the data.

CLINICAL TRIAL ID

"NCT04764838″ RESULTS: The groups were homogeneously distributed, except for age and income status. The mean score of the Female Sexual Function Index in the yoga group was significantly higher in the post-test (24.71 ± 3.48) compared to the pre-test (22.95 ± 4.14) (t:-3.142; p: 0.002). In the control group, there was no difference between the pre-test (24.82 ± 6.15) and post-test (25.79 ± 2.47) mean scores of the Female Sexual Function Index (t:-1.351; p: 0.181). There was no significant difference between the groups' pre-test and post-test mean BESAQ scores (Z = -0.670, p = 0.503; Z = -0.225, p = 0.822, respectively). No correlation was found between the pre-test and post-test scores of the FSFI and BESAQ (r = -0.105; p = 0.218; r = -0.099; p = 0.244).

CONCLUSION

Yoga can have a positive effect on sexual function during pregnancy. However, the effect of yoga on body image during sexual function has not been observed. Midwives can direct pregnant women toward yoga practice to increase the positive effects on sexual function.

The effect of cryotherapy on oral mucositis management in patients undergoing stem cell transplantation: A systematic review of randomized controlled trials

AIM

This study aimed to investigate the effect of cryotherapy on oral mucositis management in patients undergoing stem cell transplantation.

BACKGROUND

Oral mucositis is among the most common symptoms of stem cell transplantation. Cryotherapy may be an important treatment option in the oral mucositis process.

DESIGN

A systematic review.

DATA SOURCES

A literature review of studies published in the English language was conducted on Web of Science, Springer Link, Science Direct, Cochrane Library, PubMed, Scopus, ProQuest, Ovid, EBSCOhost/CINAHL Complete and MEDLINE databases until April 2022. The studies reviewed covered the years between 2006 and 2020. The data were summarized narratively.

REVIEW METHODS

This systematic review was organized in accordance with the Cochrane 2022 guidelines and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

RESULTS

Nine studies were included in the systematic review. No significant publication bias was found in the main results. The results showed that the cryotherapy intervention had a positive effect on oral mucositis in patients undergoing stem cell transplantation.

CONCLUSIONS

In this systematic review of nine randomized controlled trials, the majority of the studies show that cryotherapy intervention can be an effective method for reducing oral mucositis in patients undergoing stem cell transplantation.

Social Accountability Reporting for Research (SAR4Research): checklist to strengthen reporting on studies on social accountability in the literature

BACKGROUND

An increasing number of evaluations of social accountability (SA) interventions have been published in the past decade, however, reporting gaps make it difficult to summarize findings. We developed the Social Accountability Reporting for Research (SAR4Research) checklist to support researchers to improve the documentation of SA processes, context, study designs, and outcomes in the peer reviewed literature and to enhance application of findings.

METHODS

We used a multi-step process, starting with an umbrella review of reviews on SA to identify reporting gaps. Next, we reviewed existing guidelines for reporting on behavioral interventions to determine whether one could be used in its current or adapted form. We received feedback from practitioners and researchers and tested the checklist through three worked examples using outcome papers from three SA projects.

RESULTS

Our umbrella review of SA studies identified reporting gaps in all areas, including gaps in reporting on the context, intervention components, and study methods. Because no existing guidelines called for details on context and the complex processes in SA interventions, we used CONSORT-SPI as the basis for the SAR4Research checklist, and adapted it using other existing checklists to fill gaps. Feedback from practitioners, researchers and the worked examples suggested the need to eliminate redundancies, add explanations for items, and clarify reporting for quantitative and qualitative study components.

CONCLUSIONS

Results of SA evaluations in the peer-reviewed literature will be more useful, facilitating learning and application of findings, when study designs, interventions and their context are described fully in one or a set of papers. This checklist will help authors report better in peer-reviewed journal articles. With sufficient information, readers will better understand whether the results can inform accountability strategies in their own contexts. As a field, we will be better able to identify emerging findings and gaps in our understanding of SA.

Chronic Kidney Disease Awareness Campaign and Mobile Health Education to Improve Knowledge, Quality of Life, and Motivation for a Healthy Lifestyle Among Patients With Chronic Kidney Disease in Bangladesh: Randomized Controlled Trial

BACKGROUND

Chronic kidney disease (CKD) is linked to major health consequences and a poor quality of life. Despite the fact that CKD is becoming more prevalent, public knowledge of the disease remains low.

OBJECTIVE

This study aimed to evaluate the outcome of a health education intervention designed to enhance knowledge, health-related quality of life (QOL), and motivation about healthy lifestyle among adults with CKD.

METHODS

This study was a parallel-group (1:1), randomized controlled trial in the Mirzapur subdistrict of Bangladesh that compared 2 groups of patients with CKD. Adults with CKD (stages 1-3) were enrolled in November 2020 and randomly assigned the intervention or control group. The intervention group received health education through a CKD awareness campaign and mobile health technologies and was observed for 6 months, whereas the control group received standard treatment. The primary outcome was the evaluation of improved scores on the CKD knowledge questionnaire, and the secondary outcomes were improved QOL and changes in the levels of blood pressure (BP), BMI, serum creatinine, fasting blood sugar (FBS), hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen (BUN), and albumin-to-creatinine ratio.

RESULTS

The study enrolled 126 patients (control: n=63; intervention: n=63) and performed intention-to-treat analysis. The analyses included repeated measures ANOVA, and the results were observed to be significantly different from within groups (P<.001), between groups (P<.001), and the interaction of group × time factor (P<.001) for knowledge score. Diastolic BP and BMI showed significant differences arising from within groups (P<.001 and P=.01, respectively) and the interaction of group × time factor (P=.001 and P=.02, respectively); food salinity and hip circumferences showed significant differences arising from within groups (P=.001 and P=.03, respectively) and between groups (P=.001 and P=.02, respectively). Moreover, systolic BP and waist circumference showed significant differences from within groups (P<.001 and P=.003, respectively). However, no significant differences were found arising from within groups, between groups, and the interactions of group × time for QOL, urine salinity, and mid-upper arm circumference. Regarding the laboratory findings, from baseline to 6 months, the mean (SD) FBS decreased by 0.51 (3.77) mmol/L in the intervention group and 0.10 (1.44) mmol/L in the control group (P=.03); however, blood urea nitrogen increased by 3.64 (7.17) mg/dL in the intervention group and 1.68 (10.10) mg/dL in the control group (P=.01).

CONCLUSIONS

The health education strategy, which included a campaign and mobile health, showed promise for enhancing CKD knowledge among patients with CKD. This strategy may also aid patients with CKD in controlling their FBS and BP. The combined health education initiatives give evidence for scaling them up in Bangladesh and possibly other low- and middle-income countries, particularly in rural and peri-urban settings.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/30191.

A Randomized Clinical Trial to Assess the Efficacy of a Psychological Treatment to Quit Smoking Assisted with an App: Study Protocol

Numerous studies have shown the efficacy of smoking cessation interventions. However, some challenges, such as relapse rates, remain. The availability of information technologies (ICTs) offers promising opportunities to address such challenges. The aim of this paper is to describe the protocol followed to assess the efficacy of a face-to-face cognitive-behavioral intervention for smoking cessation using a smartphone application as a complement, compared with a control group. A single blind, two-arm, randomized controlled trial is proposed (NCT04765813). The participants will be smokers over 18 years old, who smoke at least eight cigarettes per day. Participants will be randomized to one of two conditions, using a 1:1 allocation ratio: (1) cognitive-behavioral smoking cessation treatment along with an App with active therapeutic components (SinHumo App); or (2) cognitive-behavioral treatment along with the use of a control App (without active components). The experimental App will be used during the eight treatment sessions and for 12 months after the end of treatment. The primary outcome measures will be 7-days point-prevalence abstinence at 12-months follow-up. We expect the experimental App to obtain higher abstinence rates at the end of treatment and at one-year post-treatment follow-ups and lower relapse rates, compared to the control App.

Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial

OBJECTIVES

To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology.

METHODS

Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index).

RESULTS

The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed.

CONCLUSIONS

Results provide evidence of the HEPPI's feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology.

CLINICAL IMPLICATIONS

Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.

Effects of cognitive interventions on quality of life among adults with mild cognitive impairment: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

There is considerable research exploring the impact of cognitive interventions on cognition in people with mild cognitive impairment (MCI). However, the impact on quality of life (QOL) is not routinely reported. As QOL is a key predictor of health outcomes, it is important to determine the evidence supporting cognitive interventions for improving QOL in people with MCI.

OBJECTIVE

To evaluate the evidence on the effectiveness of cognitive interventions for improving QOL among people with MCI.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic database search was conducted from inception to December 11, 2021, using four databases. Quality assessment was conducted, and data on the characteristics of the studies and the effects on QOL were extracted. Subgroup analyses and meta-regression were conducted to elucidate the effects of potential moderator variables on QOL measures.

RESULTS

Of the 1550 records initially identified, 17 studies met the criteria for the final meta-analysis. The findings revealed that cognitive interventions produced moderate gains in overall QOL compared to the control group at the posttest (standardized mean difference (SMD): 0.53, 95% confidence interval (CI): [0.23, 0.84]), but no statistically significant differences were found at the end of follow-up (SMD: 0.40, 95% CI: [-0.15,0.94]). Furthermore, the effects of cognitive interventions were moderated by intervention duration, session duration, and study location. However, intervention types, session frequency, intervention components, control condition, total number of sessions, types of QOL measures, and responders to QOL-AD had no statistically significant effects on QOL outcome.

CONCLUSIONS

Cognitive interventions have positive effects on QOL among adults with MCI. However, the high heterogeneity of the included studies calls for more well-designed cognitive intervention trials to examine the association between QOL and relevant moderators.

Mindfulness-Based Stress Reduction in Breast Cancer Survivors with Chronic Neuropathic Pain: A Randomized Controlled Trial

Objectives

The purpose of this study was to compare the effects of group-delivered mindfulness-based stress reduction as compared to a waitlist control group among breast cancer survivors living with CNP.

Methods

A randomized controlled trial design was applied, and outcomes collected included pain, emotional function, quality of life, and global impression of change.

Results

A total of 98 women were randomized and included in analyses. The sample included 49 women in the mindfulness-based stress reduction group, and 49 women in the waitlist control group. The intervention group participants (mean age 51.3 years, standard deviation = 11.4) and waitlist participants (mean age 55.1 years, standard deviation = 9.6) reported an average pain duration of approximately three years. No significant differences were found on the primary outcome of the proportions of women with reduced pain interference scores from the time of randomization to 3 months after the intervention was received. No significant changes were found among secondary outcomes.

Conclusion

Our randomized clinical trial did not find significant benefits of group-based mindfulness-based stress reduction for the management of CNP. The current study findings should be replicated and are important to consider given ongoing concerns that nonsignificant results of mindfulness-based stress reduction are often unpublished.

Clearinghouse Standards of Evidence on the Transparency, Openness, and Reproducibility of Intervention Evaluations

Clearinghouses are influential repositories of information on the effectiveness of social interventions. To identify which interventions are "evidence-based," clearinghouses review intervention evaluations using published standards of evidence that focus primarily on internal validity and causal inferences. Open science practices can improve trust in evidence from evaluations on the effectiveness of social interventions. Including open science practices in clearinghouse standards of evidence is one of many efforts that could increase confidence in designations of interventions as "evidence-based." In this study, we examined the policies, procedures, and practices of 10 federal evidence clearinghouses that review preventive interventions-an important and influential subset of all evidence clearinghouses. We found that seven consider at least one open science practice when evaluating interventions: replication (6 of 10 clearinghouses), public availability of results (6), investigator conflicts of interest (3), design and analysis transparency (3), study registration (2), and protocol sharing (1). We did not identify any policies, procedures, or practices related to analysis plan registration, data sharing, code sharing, material sharing, and citation standards. We provide a framework with specific recommendations to help federal and other evidence clearinghouses implement the Transparency and Openness Promotion (TOP) Guidelines. Our proposed "TOP Guidelines for Clearinghouses" includes reporting whether evaluations used open science practices, incorporating open science practices in their standards for receiving "evidence-based" designations, and verifying that evaluations used open science practices. Doing so could increase the trustworthiness of evidence used for policy making and support improvements throughout the evidence ecosystem.

Psychological interventions for inflammatory bowel disease: a systematic review and component network meta-analysis protocol

INTRODUCTION

Patients with inflammatory bowel diseases (IBD) often report psychological problems, unemployment, disability, sick leave and compromised quality of life. The effect of psychological interventions on health-related outcomes in IBD is controversial as previous reviews faced the obstacle of high heterogeneity among provided multimodular interventions. The heterogeneity can be addressed with network meta-analysis (NMA) and (multi)component NMA (CNMA). We aim to investigate whether psychological interventions can improve quality of life, clinical and social outcomes in IBD using NMA and CNMA. This is the study protocol.

METHODS AND ANALYSIS

We will consider randomised, quasi-randomised and non-randomised controlled trials, including cluster randomised and cross-over trials with 2 months of minimum follow-up. The conditions to be studied comprise Crohn's disease and ulcerative colitis in children, adolescents and adults. We will include any psychological intervention aiming to change the health status of the study participant.We will search Medline, Embase, Web of Science, CENTRAL, LILACS, Psyndex, PsycINFO, Google Scholar and trial registries from inception (the search will be updated before the review completion). Two authors will independently screen all references based on titles and abstracts. For data extraction, standard forms are developed and tested before extraction. All information will be assessed independently by at least two reviewers, and disagreements solved by consensus discussion or a third rater if necessary.The data synthesis will include a pairwise meta-analysis supported by meta-regression. We will conduct NMA (all treatments will constitute single nodes of the network) and CNMA (we will define all treatments as sums of core components, eg, cognitive +behaviour, or cognitive +behaviour + relaxation, and additionally consider interactions) using the R Package netmeta.

ETHICS AND DISSEMINATION

No ethical approval is required. Reports will include the final report to the funder, conference presentation, peer-reviewed publication and a patient report.

PROSPERO REGISTRATION NUMBER

CRD42021250446.

A pilot randomized controlled trial comparing THUNDERBEAT to the Maryland LigaSure energy device in laparoscopic left colon surgery

BACKGROUND

The THUNDERBEAT is a multi-functional energy device which delivers both ultrasonic and bipolar energy, but there are no randomized trials which can provide more rigorous evaluation of the clinical performance of THUNDERBEAT compared to other energy-based devices in colorectal surgery. The aim of this study was to compare the clinical performance of THUNDERBEAT energy device to Maryland LigaSure in patients undergoing left laparoscopic colectomy.

METHODS

Prospective randomized trial with two groups: Group 1 THUNDERBEAT and Group 2 LigaSure in a single university hospital. 60 Subjects, male and female, of age 18 years and above undergoing left colectomy for cancer or diverticulitis were included. The primary outcome was dissection time to specimen removal (DTSR) measured in minutes from the start of colon mobilization to specimen removal from the abdominal cavity. Versatility (composite of five variables) was measured by a score system from 1 to 5 (1 being worst and 5 the best), and adjusted/weighted by coefficient of importance with distribution of the importance as follow: hemostasis 0.275, sealing 0.275, cutting 0.2, dissection 0.15, and tissue manipulation 0.1. Other variables were: dryness of surgical field, intraoperative and postoperative complications, and mortality. Follow-up time was 30 days.

RESULTS

60 Patients completed surgery, 31 in Group 1 and 29 in Group 2. There was no difference in the DTSR between the groups, 91 min vs. 77 min (p = 0.214). THUNDERBEAT showed significantly higher score in dissecting and tissue manipulation in segment 3 (omental dissection), and in overall versatility score (p = 0.007) as well as versatility score in Segment 2 (retroperitoneal dissection p = 0.040) and Segment 3 (p = 0.040). No other differences were noted between the groups.

CONCLUSIONS

Both energy devices can be employed effectively and safely in dividing soft tissue and sealing mesenteric blood vessels during laparoscopic left colon surgery, with THUNDERBEAT demonstrating some advantages over LigaSure during omental dissection and tissue manipulation.

CLINICALTRIAL

gov # NCT02628093.

A randomised multiple baseline case series of a novel imagery rescripting protocol for intrusive trauma memories in people with psychosis

BACKGROUND AND OBJECTIVES

There has been limited investigation of therapies targeting trauma-related psychological mechanisms hypothesised to play a role in post-traumatic and psychosis symptoms. Imagery rescripting (ImRs) is a therapeutic technique which involves transforming images, such as episodic memories, to modify associated distressing beliefs. This study is the first ImRs study for psychosis to incorporate experimental controls. We used a novel ImRs protocol, targeting present-focused, self-referential distressing meanings associated with intrusive trauma memories. A multiple baseline case series design investigated whether the protocol was feasible, safe, acceptable and effective.

METHODS

12 participants with a psychosis diagnosis and intrusive trauma memories were assessed and randomised to a monitoring period (one, two or three weeks), followed by three ImRs sessions (over three weeks), a further two-week monitoring period with a post-therapy assessment a week after completing therapy. Memory phenomenology was assessed daily during monitoring. Post-traumatic stress symptoms and wellbeing were assessed pre and post therapy.

RESULTS

ImRs was feasible, safe and rated as highly acceptable. No participants dropped-out of the brief, targeted intervention. There were moderate effects on the frequency, distress, controllability and appraisals of trauma memories. Notably, ten participants showed reliable change, and seven clinically significant change, in post-traumatic stress symptoms.

LIMITATIONS

Assessments were not blinded and impact on psychosis was not examined.

CONCLUSIONS

The study indicates that a brief, novel ImRs protocol targeting present-focused, self-referential meanings is a promising intervention for intrusive trauma memories. Future research should investigate its integration into trauma-focused therapy for psychosis and impact on psychosis severity.

Multisite randomised controlled trial of trauma-focused cognitive behaviour therapy for psychosis to reduce post-traumatic stress symptoms in people with co-morbid post-traumatic stress disorder and psychosis, compared to treatment as usual: study protocol for the STAR (Study of Trauma And Recovery) trial

Background

People with psychosis have high rates of trauma, with a post-traumatic stress disorder (PTSD) prevalence rate of approximately 15%, which exacerbates psychotic symptoms such as delusions and hallucinations. Pilot studies have shown that trauma-focused (TF) psychological therapies can be safe and effective in such individuals. This trial, the largest to date, will evaluate the clinical effectiveness of a TF therapy integrated with cognitive behaviour therapy for psychosis (TF-CBTp) on post-traumatic stress symptoms in people with psychosis. The secondary aims are to compare groups on cost-effectiveness; ascertain whether TF-CBTp impacts on a range of other meaningful outcomes; determine whether therapy effects endure; and determine acceptability of the therapy in participants and therapists.

Methods

Rater-blind, parallel arm, pragmatic randomised controlled trial comparing TF-CBTp + treatment as usual (TAU) to TAU only. Adults (N = 300) with distressing post-traumatic stress and psychosis symptoms from five mental health Trusts (60 per site) will be randomised to the two groups. Therapy will be manualised, lasting 9 months (m) with trained therapists. We will assess PTSD symptom severity (primary outcome); percentage who show loss of PTSD diagnosis and clinically significant change; psychosis symptoms; emotional well-being; substance use; suicidal ideation; psychological recovery; social functioning; health-related quality of life; service use, a total of four times: before randomisation; 4 m (mid-therapy); 9 m (end of therapy; primary end point); 24 m (15 m after end of therapy) post-randomisation. Four 3-monthly phone calls will be made between 9 m and 24 m assessment points, to collect service use over the previous 3 months. Therapy acceptability will be assessed through qualitative interviews with participants (N = 35) and therapists (N = 5–10). An internal pilot will ensure integrity of trial recruitment and outcome data, as well as therapy protocol safety and adherence. Data will be analysed following intention-to-treat principles using generalised linear mixed models and reported according to Consolidated Standards of Reporting Trials-Social and Psychological Interventions Statement.

Discussion

The proposed intervention has the potential to provide significant patient benefit in terms of reductions in distressing symptoms of post-traumatic stress, psychosis, and emotional problems; enable clinicians to implement trauma-focused therapy confidently in this population; and be cost-effective compared to TAU through reduced service use.

Trial registration

ISRCTN93382525 (03/08/20)

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06215-x.

A group resilience training program for people with multiple sclerosis: Study protocol of a multi-centre cluster-randomized controlled trial (multi-READY for MS)

Introduction

REsilience and Activities for every DaY (READY) is an Acceptance and Commitment Therapy-based group resilience-training program that has preliminary empirical support in promoting quality of life and other psychosocial outcomes in people with multiple sclerosis (PwMS). Consistent with the Medical Research Council framework for developing and evaluating complex interventions, we conducted a pilot randomized controlled trial (RCT), followed by a phase III RCT. The present paper describes the phase III RCT protocol.

Methods and analysis

This is a multi-centre cluster RCT comparing READY with a group relaxation program (1:1 ratio) in 240 PwMS from eight centres in Italy (trial registration: isrctn.org Identifier: ISRCTN67194859). Both interventions are composed of 7 weekly sessions plus a booster session five weeks later. Resilience (primary outcome), mood, health-related quality of life, well-being and psychological flexibility will be assessed at baseline, after the booster session, and at three and six month follow-ups. If face-to-face group meetings are interrupted because of COVID-19 related-issues, participants will be invited to complete their intervention via teleconferencing. Relevant COVID-19 information will be collected and the COVID-19 Peritraumatic Distress scale will be administered (ancillary study) at baseline and 3-month follow-up. Analysis will be by intention-to-treat to show superiority of READY over relaxation. Longitudinal changes will be compared between the two arms using repeated-measures, hierarchical generalized linear mixed models.

Conclusion

It is expected that his study will contribute to the body of evidence on the efficacy and effectiveness of READY by comparing it with an active group intervention in frontline MS rehabilitation and clinical settings. Results will be disseminated in peer-reviewed journals and at other relevant conferences.

A Coach Development Program: A Guided Online Reflective Practice Intervention Study

Coaches can influence athlete outcomes, such as performance and personal development; yet, coaches themselves are learners in their own right, who seek to develop their coaching craft. Reflective practice is essential for coaches' development; however, coaches might engage and benefit from reflective practice in myriad ways. This study aimed to evaluate if online reflective journaling (ORJ) enhances the depth of reflection of sports coaches in a 4-week coach development programme (CDP). Participants were a convenience sample of 83 sports coaches from several sports, divided into an intervention group (N = 42) and a control group (N = 41). Data collection used a mixed-methods approach, examining a CDP focused on the coaches' reflective practice. The results revealed that reflection was the only dependent variable that showed significant differences over time. Participation in ORJ showed positive effects on reflection in both groups; however, only the experimental group was statistically significant. For this sample, ORJ was found to help enhance coaches' reflection towards critical reflection. All texts included in pre-, post-, and follow-up tests were coded for trustworthiness purposes. This finding supports the potential of ORJ in nurturing reflective practice, which is considered a core competency in becoming a successful sports coach.

Registry versus publication: discrepancy of primary outcomes and possible outcome reporting bias in child and adolescent mental health

Outcome reporting bias is one of the fundamental forms of publication bias. It implies publishing only outcomes that have positive results. The aim of this observational study was to explore primary outcome discrepancies between registry of clinical trials and their corresponding publications, since these can indicate outcome reporting bias in child mental health. Data were extracted from completed interventional clinical trials from ClinicalTrial.gov registry and its Archive site. Trials were registered under "Behaviours and Mental Disorders" category, and conducted on underage participants (0-17 years). Their primary outcomes were compared to those published in publication which had a corresponding NCT number stated in the text. Sixteen percent of trials did not have the minimum information on primary outcome stated in the registry-neither the measure used nor the measurement time points; 38.9% of trials had the minimum information stated to describe primary outcome, while only 3.3% of trials had all the necessary elements stated in the registry. Most of the publication in our sample had positive results (66.4%). Half of the trials registered before completion had non-matching primary outcomes in the registry and publication; 85.4% of trials with non-matching outcomes indicated possible outcome reporting bias for some of the primary outcome. Middle-sized trials and industry-funded trials were related with higher quality of primary outcome registration. Industry funding was related with positive findings in publication. Non-industry funding proved to be the only significant predictor of discrepancy between registered and published primary outcomes, and possible outcome reporting bias. Journal impact factor was not related with any of the outcome measures. The main limitation of the study is that it primarily offers an insight into discrepancy of registered and published outcomes. The methodology does not imply an access to results of unpublished outcomes - therefore, it was not possible to determine the presence of the bias with sufficient certainty in large number of trials. Further research should be done with improved methodology and additional data.

Randomised controlled trials of occupational therapy interventions for adults with a mental health condition or dementia: A systematic review of study methods and outcome measurement

Introduction

High-quality randomised controlled trials (RCTs) of interventions are essential for determining whether an intervention is effective. However, many RCTs that examine the effectiveness of occupational therapy interventions for adults with mental health conditions or dementia have methodological limitations that reduce confidence in their results. We aimed to systematically review the quality of methods and outcome measures used in RCTs of occupational therapy interventions for adults with a mental health condition or dementia. This will inform future research in this area and enable practitioners to appraise the evidence when selecting interventions.

Method

We searched peer-reviewed English language publications from 2000 to 2021 in MEDLINE, PsycINFO, ASSIA, CINAHL and e-thos, and hand-searched 12 journals. We included papers that met pre-specified inclusion criteria, appraised quality using a validated tool and extracted data. We conducted a narrative synthesis.

Results

Of thirty-three included papers, 26 reported full or pilot RCTs, two reported secondary analysis or secondary outcomes of included RCTs, three reported process evaluations and two reported economic evaluations. Methodological limitations were found in many studies and outcome measures varied in their psychometric quality.

Conclusion

High-quality RCTs of occupational therapy interventions are needed for adults with mental health conditions and dementia. Researchers should follow international guidelines for rigorously developing and evaluating interventions and reporting studies. Practitioners should critically apply RCT evidence when selecting occupational therapy interventions.

A workplace Acceptance and Commitment Therapy (ACT) intervention for improving healthcare staff psychological distress: A randomised controlled trial

The levels of psychological distress and burnout among healthcare staff are high, with negative implications for patient care. A growing body of evidence indicates that workplace programmes based on Acceptance and Commitment Therapy (ACT) are effective for improving employees' general psychological health. However, there is a paucity of research examining the specific psychological and/or behavioural processes through which workplace ACT programmes transmit their beneficial effects. The aim of this randomised controlled trial was to investigate the outcomes and putative processes of change in a 4-session ACT training programme designed to reduce psychological distress among healthcare staff (n = 98). Ninety-eight employees of a healthcare organisation were randomly allocated to the ACT intervention or to a waiting list control group. Study measures were administered on four occasions (baseline, mid-intervention, post-intervention, and follow-up) over a three-month evaluation period. Results showed that the ACT intervention led to a significant decrease in symptoms of psychological distress and a less pronounced reduction in burnout. These effects were mediated primarily via an improvement in mindfulness skills and values-based behaviour and moderated by participants' initial levels of distress. At four-week post-intervention, 48% of participants who received the ACT intervention showed reliable improvements in psychological distress, with just under half of the aforementioned improvements (46.15%) meeting criteria for clinically significant change. The results advance ACT as an effective stress management intervention for healthcare staff. The findings should be confirmed in a large scale randomised controlled trial with longer follow-up and cost-effectiveness analyses.

Corrective exercises administered online vs at the workplace for pain and function in the office workers with upper crossed syndrome: randomized controlled trial

Objective

To evaluate the effects of online-supervised versus workplace corrective exercises on neck–shoulder pain (NSP), sick leave, posture, workability, and muscular activity among office workers with the upper crossed syndrome (UCS).

Methods

We performed a parallel-group randomized control trial at Shahid Beheshti University, Tehran, Iran, assigning 36 office workers to online-supervised, workplace, and control groups (mean (SD) age 38.91 ± 3.87, 38.58 ± 7.34, 37.00 ± 8.12). Inclusion criteria were alignment alteration (forward head (≥ 45°), rounding shoulder (≥ 52°), rounding back (≥ 42°), and pain intensity ≥ 3 in neck and shoulder. The two intervention groups performed 8-week exercise program, while the control group continued usual activities. Primary (NSP and sick leave) and secondary outcomes [postural angles, workability, and muscular activity were measured by VAS, outcome evaluation questionnaire (OEQ), photogrammetry, workability index, and EMG, respectively, at the baseline and an 8-week follow-up].

Results

ANCOVA results revealed improvements for the online-supervised group versus control for NSP (P = 0.007), postural angles (P = 0.000, P = 0.001, P = 0.005), workability (P = 0.048, P = 0.042), and upper trapezius activation (P = 0.024, P = 0.016), respectively. Using paired t tests, both intervention groups improved from baseline to follow-up for NSP (P = 0.000, P = 0.002), forward head posture (P = 0.000, P = 0.000), round shoulders (P = 0.001, P = 0.031), and round back (P = 0.034, P = 0.008), respectively. Related parameters of workability (P = 0.041, P = 0.038), upper trapezius (P = 0.005, P = 0.005, P = 0.022), and serratus anterior (P = 0.020, P = 0.015) changed only in the online-supervised group.

Conclusion

Online-supervised corrective exercise seems to improve a range of parameters related to work performance. These findings are highly applicable in light of the ongoing COVID pandemic; many workers have to work from home.

Randomized, Triple-Blinded, Placebo-Controlled Trial of SA3X (Spilanthes acmella) for the Management of Erectile Dysfunction

Introduction Spilanthes acmella has been used as an aphrodisiac in India and other countries. However, studies concerning humans have been limited. This randomized controlled trial was carried out to evaluate the effect of SA3X capsules containing 500 mg of S. acmella on sexual function domain scores in sexually active men with symptoms of erectile dysfunction (ED) using the Men's Sexual Health Questionnaire (MSHQ). Materials and methods This triple-blind, placebo-controlled, parallel-group was conducted at two centres in Hyderabad and Secunderabad from May to December 2021. Patients were randomized 1:1 to SA3X therapy or placebo for one month along with an observational cohort. The change of MSHQ score and its subdomains from baseline to month 1 (primary endpoint) and one-month post-treatment (secondary outcome) was assessed using a mixed model repeated measures analysis. Additional secondary outcomes measured were the change in the International Index of Erectile Function (IIEF) and duration of penile erection. Safety was evaluated. Results The intention-to-treat population included 448 patients (152 - SA3X therapy; 146 - placebo; 150 - observational cohort). A significant increase was observed with SA3X therapy versus placebo on the total MSHQ score (17.24 vs 4.72; SE: 2.11, 1.98; P<0.001) along with the sub-domains at the end of one month of therapy. At one-month post-treatment, the increase in MSHQ score with SA3X therapy was significant (18.48 vs 3.78; SE 2.81, 1.39; P<0.001). The IIEF scores and duration of penile erection also increased significantly in the SA3X therapy group. Dysgeusia (3.94%) was the most common drug-related adverse effect. No serious adverse effects were noted. Conclusion SA3X was concluded to be safe and effective as a potential treatment for ED.

Effect of Evening Primrose Oil Supplementation on Biochemical Parameters and Nutrition of Patients Treated with Isotretinoin for Acne Vulgaris: A Randomized Double-Blind Trial

Background: Acne vulgaris is one of the most common skin diseases. One of the therapeutic options recommended for severe acne or acne that has not responded to previous therapies is isotretinoin. However, its use may lead to adverse changes in the serum lipid profile and increased levels of transaminases. In this study, we evaluated the effect of supplementation with evening primrose oil in acne vulgaris patients treated with isotretinoin on blood lipid parameters and transaminase activity. Methods: Study participants were randomly assigned to two treatments: conventional with isotretinoin (25 patients) and novel with isotretinoin combined with evening primrose oil (4 × 510 mg/day; 25 patients) for 9 months. Results: Compared to isotretinoin treatment, isotretinoin treatment combined with evening primrose oil had a positive effect on TCH concentrations (mean: 198 vs. 161, p < 0.001), LDL (95.9 vs. 60.2, p < 0.001), HDL (51.0 vs. 48.0, p < 0.001), TG (114 vs. 95.0, p < 0.001), ALT (24.0 vs. 22.0, p < 0.001), and AST (28.0 vs. 22.0, p < 0.001), but had no effect on the energy and ingredient content of the diets (p > 0.05) after treatment. Conclusion: Evening primrose oil was found to have beneficial effects on lipid profiles and transaminase activity during isotretinoin treatment. However, longer studies are needed to make more reliable decisions regarding the use of evening primrose oil and its safety in clinical practice. The evening primrose oil treatment group also showed a reduction in dietary energy due to a reduction in dietary protein and carbohydrates.

Transparent, Open, and Reproducible Prevention Science

The field of prevention science aims to understand societal problems, identify effective interventions, and translate scientific evidence into policy and practice. There is growing interest among prevention scientists in the potential for transparency, openness, and reproducibility to facilitate this mission by providing opportunities to align scientific practice with scientific ideals, accelerate scientific discovery, and broaden access to scientific knowledge. The overarching goal of this manuscript is to serve as a primer introducing and providing an overview of open science for prevention researchers. In this paper, we discuss factors motivating interest in transparency and reproducibility, research practices associated with open science, and stakeholders engaged in and impacted by open science reform efforts. In addition, we discuss how and why different types of prevention research could incorporate open science practices, as well as ways that prevention science tools and methods could be leveraged to advance the wider open science movement. To promote further discussion, we conclude with potential reservations and challenges for the field of prevention science to address as it transitions to greater transparency, openness, and reproducibility. Throughout, we identify activities that aim to strengthen the reliability and efficiency of prevention science, facilitate access to its products and outputs, and promote collaborative and inclusive participation in research activities. By embracing principles of transparency, openness, and reproducibility, prevention science can better achieve its mission to advance evidence-based solutions to promote individual and collective well-being.

Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: a randomised controlled trial

OBJECTIVES

To evaluate the effectiveness of a tailored multidimensional intervention in reducing the care burden of family caregivers of stroke survivors. This intervention considered caregivers' perceived needs and incorporated three evidence-based dimensions (psychoeducation, skill-building and peer support).

DESIGN

A prospective randomised control trial.

SETTING

A community-based study conducted in Egypt.

PARTICIPANTS

A total of 110 caregivers aged ≥18 years who cared for a survivor within 6 months of stroke, with modified Rankin Scale scores of 3-5, and without other physical disabilities or terminal illnesses were recruited between December 2019 and May 2020. Participants were assigned to the intervention group (IG; n=55) and control group (CG; n=55) through open-label, parallel 1:1 randomisation.

INTERVENTION

The IG was provided with tailored multidimensional interventions for 6 months until November 2020, including three home visits, six home-based telephone calls and one peer-support session. The CG received simple educational instructions at a single visit.

OUTCOME

The participants completed the Zarit Burden Interview (primary outcome) and the WHO Quality of Life-BREF (secondary outcome) before the intervention (T0), at 3 months (T1) and at 6 months (T2).

RESULTS

No differences were observed between the characteristics of the groups at baseline (T0). The independent t-test showed no significant differences in the care burden and Quality of Life (QoL) at T1 and T2 between the groups. The intervention had no significant effect on the outcomes between or within groups over time, as shown by the repeated-measures analysis of variance. However, the group and time interaction had significant main effects on caregivers' QoL (psychological and social domains).

CONCLUSION

The main results showed that participants in the IG did not experience an improvement in the main outcomes. Nevertheless, the improvement in the psychological and social domains may have been attributed to our intervention.

TRIAL REGISTRATION NUMBER

NCT04211662.

Six practical recommendations for improved implementation outcomes reporting

BACKGROUND

Implementation outcomes research spans an exciting mix of fields, disciplines, and geographical space. Although the number of studies that cite the 2011 taxonomy has expanded considerably, the problem of harmony in describing outcomes persists. This paper revisits that problem by focusing on the clarity of reporting outcomes in studies that examine them. Published recommendations for improved reporting and specification have proven to be an important step in enhancing the rigor of implementation research. We articulate reporting problems in the current implementation outcomes literature and describe six practical recommendations that address them.

RECOMMENDATIONS

Our first recommendation is to clearly state each implementation outcome and provide a definition that the study will consistently use. This includes providing an explanation if using the taxonomy in a new way or merging terms. Our second recommendation is to specify how each implementation outcome will be analyzed relative to other constructs. Our third recommendation is to specify "the thing" that each implementation outcome will be measured in relation to. This is especially important if you are concurrently studying interventions and strategies, or if you are studying interventions and strategies that have multiple components. Our fourth recommendation is to report who will provide data and the level at which data will be collected for each implementation outcome, and to report what kind of data will be collected and used to assess each implementation outcome. Our fifth recommendation is to state the number of time points and frequency at which each outcome will be measured. Our sixth recommendation is to state the unit of observation and the level of analysis for each implementation outcome.

CONCLUSION

This paper advances implementation outcomes research in two ways. First, we illustrate elements of the 2011 research agenda with concrete examples drawn from a wide swath of current literature. Second, we provide six pragmatic recommendations for improved reporting. These recommendations are accompanied by an audit worksheet and a list of exemplar articles that researchers can use when designing, conducting, and assessing implementation outcomes studies.

The effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure: a systematic review and meta-analysis

AIM

The aim of this study was to determine the effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure.

METHOD

All studies published in the English language between the years 2000 and 2020 were screened on relevant databases. The study protocol was registered on PROSPERO. Randomised controlled studies (RCTs) and quasi-experimental studies meeting the inclusion and exclusion criteria according to the PICOS criteria were included. In line with the PRISMA flow diagram, 38 studies were included in the systematic review and meta-analysis. Risk of bias was assessed with the Cochrane risk-of-bias assessment tool. A random-effects model was applied and Hedge's g was used to calculate effect size.

FINDINGS

Five of the included studies are RCTs, two are cluster RCTs, 17 are quasi-experimental studies with experimental and control groups, and 14 have single-group pretest-posttest study designs. Educational interventions had a large effect on knowledge level (Hedge's g = 0.890), a medium effect on behaviour level (Hedge's g = 0.707), and a small effect on risk perception (Hedge's g = 0.377). No publication bias was detected. The largest effect of educational interventions on both knowledge and behaviour levels belonged to studies grounded on a theoretical basis and carried out between the years 2011 and 2020.

CONCLUSION

It was determined that educational interventions are an appropriate method for reducing the pesticide exposure risks of agricultural workers. To increase the effectiveness of these interventions, it is recommended that consideration is given to a theoretical basis, the use of multiple education components, and evidence-based practices.

Strategies to promote health behaviors in parents with small children-A systematic review and realist synthesis of behavioral interventions

In this systematic review and realist synthesis, we aimed to identify strategies to improve dietary and physical activity behaviors for parents with small children. A systematic literature search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO in July 2021. Included studies had to: (i) target one or both parents with at least one child (0-3 years), (ii) aim to improve diet and physical activity, and (iii) report on diet and physical activity outcomes. Intervention context, delivery, and outcomes were extracted, and behavior change techniques were coded. A program theory was developed, and context-mechanism-outcome configurations were identified. In total, 17 interventions reported in 28 studies (19 effectiveness studies; nine protocols) were included. Nine interventions showed small improvements: in diet (n = 5), physical activity (n = 2), or both (n = 2) in mothers. The realist synthesis revealed three strategies to improve health behaviors: (1) using knowledge and role modelling to improve family dynamics, (2) providing various home-based activities to change home environment, and (3) offering flexible delivery, for example, phone or website-based to increase social support. Future interventions for parents with small children should consider involving the whole family, focusing on home-based and practical components, and offering various delivery modes. The protocol for the systematic review and realist synthesis was registered in Research Registry (registration ID: reviewregistry860) March 30th, 2020.

Applied relaxation and cortisol secretion: findings from a randomized controlled indicated prevention trial in adults with stress, anxiety, or depressive symptoms

Previous research has shown that relaxation interventions can reduce distress, anxiety, and depression. The exact mechanisms that underlie the efficacy of relaxation interventions remain unresolved. This study aimed to investigate whether applied relaxation (AR) leads to changes in cortisol secretion and whether these effects mediate fewer symptoms due to AR. Data come from a randomized controlled preventive interventional trial (N = 277) with elevated tension/distress, anxiety, or depressive symptomatology. Participants were randomized to an intervention group (IG; n = 139, received AR training), or a non-interventional control group (CG, n = 138). Psychopathological symptoms were assessed with DASS-21 and diagnoses of mental disorders via DIA-X-5. Cortisol was measured as short-term index in saliva (six times/d for 2 d at pre-, post-, and follow-up [FU] assessment) and long-term index in hair samples (once at pre-assessment and FU, respectively). Data were analyzed as pre-specified secondary analyses of the randomized controlled trial (RCT) on completer basis (n = 134 CG, n = 102 IG), using multivariable-adjusted linear regression models and mediation analyses (the DASS-21 change in the IG vs. CG with cortisol (area under the curve [AUC]) as mediator). From pre- to post-assessment, total daily salivary cortisol (AUC) decreased more strongly in the IG vs. CG (β-coefficient: -13.83, 95% confidence interval [CI]: -26.85 to -0.81), but was rendered non-significant when adjusting for pre-assessment AUC. This effect was not found for the cortisol awakening response (CAR) or hair cortisol. There was no evidence for a mediation of cortisol (AUC). These findings provide little support for the idea that cortisol reductions explain the beneficial effects of AR on mental health.

The impact of Juvenile Drug Treatment Courts (JDTC) implementing Federal Evidence-Based Guidelines on recidivism and substance use: multisite Randomized Controlled Trial (RCT) and Regression Discontinuity (RDD) Designs

BACKGROUND

Juvenile drug treatment courts (JDTC) have struggled to define themselves since their inception in 1995. Early courts followed a format similar to adult drug courts, but these did not address the unique needs of juveniles, which led to the creation of 16 Strategies by a consensus panel of practitioners and researchers. But, like the first JDTCs, research with courts following these strategies failed to provide convincing evidence that this "model" was associated with significant reductions in recidivism or drug use. More recently, a new set of evidence-based guidelines were developed through meta-analyses commissioned by the Office of Juvenile Justice and Delinquency Prevention (OJJDP, 2016).

METHOD

OJJDP provided funding for a rigorous multi-site evaluation of the guidelines. This study protocol paper for the Juvenile Drug Treatment Court (JDTC) Guidelines Cross-Site Evaluation presents research designs for the comparison of youth outcomes from 10 JDTCs compared with 10 Traditional Juvenile Courts (TJCs) in the same jurisdictions. Two sites opted into a randomized controlled trial (RCT) and eight sites chose to follow a regression discontinuity design (RDD). Youth data are captured at baseline, and at 6- and 12-month follow-ups using an interview comprised of several standardized assessments. The youths' official records also are abstracted for recidivism and substance use information. The degree to which the evidence-based guidelines are implemented at each site is assessed via an in-depth court self-assessment collected at baseline and again 2 years later and via structured site visits conducted once during implementation.

DISCUSSION

As a field-based trial, using both RCT and RDD designs, findings will provide important, policy-relevant information regarding the implementation of the OJJDP evidence-based guidelines, including the degree to which JDTCs adopted and/or modified these practices, their relative impact on recidivism and substance use, as well as the degree to which JDTCs differ from TJCs. Specific inferences may be drawn about whether following or not following specific guidelines differentially impact youth outcomes, yielding recommendations about the translation of this information from research-to-practice for potentiating the broader adoption of these guidelines by JDTCs nationwide.

CLINICAL TRIALS REGISTRATION

This was not an NIH supported trial. The funder, OJJDP/NIJ, instead required publishing the design with even more information at https://www.ojp.gov/ncjrs/virtual-library/abstracts/juvenile-drug-treatment-court-jdtc-guidelines-cross-site-evaluation .

HomeStyles-2: Randomized controlled trial protocol for a web-based obesity prevention program for families with children in middle childhood

BACKGROUND

Parents are children's primary role models, are food and physical activity gatekeepers, and create the home structure/lifestyle environment. Thus, parents strongly influence children's weight-related behaviors and have the opportunity to cultivate a "culture of health" within the home. Yet, there is a dearth of evidence-based obesity prevention intervention programs, especially for families with children aged 6-11 years, commonly called middle childhood.

METHODS

The aim of the HomeStyles-2 online learning mode RCT is to determine whether this novel, age-appropriate, family intervention enables and motivates parents to shape home environments and weight-related lifestyle practices (i.e.,diet, exercise, sleep) to be more supportive of optimal health and reduced obesity risk in middle childhood youth more than those in the control condition. The RCT will include the experimental group and an attention control group. The participants will be parents with school-age children who are systematically randomly assigned by computer to study condition. The HomeStyles intervention is predicated on the social cognitive theory and a social ecological framework. The RCT will collect sociodemographic characteristics of the participant, child, and partner/spouse; child and parent health status; parent weight-related cognitions; weight-related behaviors of the parent and child; and weight-related characteristics of the home environment. Deliverables Enrollment for this study will begin in 2022.

DISCUSSION

This paper describes these aspects of the HomeStyles-2 intervention: rationale; sample eligibility criteria and recruitment; study design; experimental group intervention theoretical and philosophical underpinnings, structure, content, and development process; attention control intervention; survey instrument development and components; outcome measures; and planned analyses.

TRIAL REGISTRATION

ClinicalTrials.gov, Protocol #NCT04802291, Registered March 14, 2021.