151
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Byrne M, McSharry J, Meade O, Lavoie KL, Bacon SL. An international, Delphi consensus study to identify priorities for methodological research in behavioral trials in health research. Trials 2020; 21:292. [PMID: 32293510 PMCID: PMC7092577 DOI: 10.1186/s13063-020-04235-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Non-communicable chronic diseases are linked to behavioral risk factors (including smoking, poor diet and physical inactivity), so effective behavior change interventions are needed to improve population health. However, uptake and impact of these interventions is limited by methodological challenges. We aimed to identify and achieve consensus on priorities for methodological research in behavioral trials in health research among an international behavioral science community. Methods An international, Delphi consensus study was conducted. Fifteen core members of the International Behavioral Trials Network (IBTN) were invited to generate methodological items that they consider important. From these, the research team agreed a “long-list” of unique items. Two online surveys were administered to IBTN members (N = 306). Respondents rated the importance of items on a 9-point scale, and ranked their “top-five” priorities. In the second survey, respondents received feedback on others’ responses, before rerating items and re-selecting their top five. Results Nine experts generated 144 items, which were condensed to a long-list of 33 items. The four most highly endorsed items, in both surveys 1 (n = 77) and 2 (n = 57), came from two thematic categories:“Intervention development” (“Specifying intervention components” and “Tailoring interventions to specific populations and contexts”) and “Implementation” (“How to disseminate behavioral trial research findings to increase implementation” and “Methods for ensuring that behavioral interventions are implementable into practice and policy”). “Development of novel research designs to test behavioral interventions” also emerged as a highly ranked research priority. Conclusions From a wide array of identified methodological issues, intervention development, implementation and novel research designs are key themes to drive the future behavioral trials’ research agenda. Funding bodies should prioritize these issues in resource allocation.
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Affiliation(s)
- Molly Byrne
- Health Behavior Change Research Group, School of Psychology, National University of Ireland, Galway, H91 TK33, Ireland.
| | - Jenny McSharry
- Health Behavior Change Research Group, School of Psychology, National University of Ireland, Galway, H91 TK33, Ireland
| | - Oonagh Meade
- Health Behavior Change Research Group, School of Psychology, National University of Ireland, Galway, H91 TK33, Ireland
| | - Kim L Lavoie
- Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada.,Montreal Behavioral Medicine Centre, CIUSSS-NIM - Hôpital du Sacre-Coeur de Montreal, Montreal, QC, Canada
| | - Simon L Bacon
- Montreal Behavioral Medicine Centre, CIUSSS-NIM - Hôpital du Sacre-Coeur de Montreal, Montreal, QC, Canada.,Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, H4B 1R6, Canada
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152
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Thomas J, Thirlaway K, Bowes N, Meyers R. Effects of combining physical activity with psychotherapy on mental health and well-being: A systematic review. J Affect Disord 2020; 265:475-485. [PMID: 32090775 DOI: 10.1016/j.jad.2020.01.070] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Despite a vast evidence-base advocating the psychological benefits of physical activity, relatively little is understood about how combining physical activity with psychological therapies may influence these positive effects. The aim of this paper is to systematically analyse evidence from studies adopting a combined approach, and identify potential mechanisms of action on clinical outcomes. METHODS The Embase, PsycINFO and Medline (PubMed and OVID) databases were searched for applicable trials published up to December 2018. Relevant data was extracted from eligible studies, and the Effective Public Health Practice Project (EPHPP) tool was utilised to objectively assess the quality of each study. RESULTS Twenty-two studies met the inclusion criteria, seven of which were rated as methodologically `strong'. Combining physical activity with psychological therapy consistently engendered positive effects on outcomes compared with treatment as usual. Similar improvements in psychological outcomes were observed in most (7/8) groups receiving physical activity alone. Increased levels of physical activity were observed in psychologically-informed interventions, however this effect was unrelated to changes in psychological outcomes. LIMITATIONS Clinical and methodological heterogeneity precluded meta-analyses of results, while risk of bias detected in the studies may compromise overall validity of the findings. CONCLUSIONS Physical activity interventions may be a viable alternative to psychological therapies, provided psychological approaches are incorporated into the implementation design (i.e. behavioural activation). Improved psychological outcomes may be observed regardless of `dose' received, however further research is required to ascertain whether psychosocial mechanisms of change mediate positive effects.
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Affiliation(s)
- Jennifer Thomas
- School of Sport and Health Sciences, Cardiff Metropolitan University.
| | - Katie Thirlaway
- School of Sport and Health Sciences, Cardiff Metropolitan University
| | - Nicola Bowes
- School of Sport and Health Sciences, Cardiff Metropolitan University
| | - Robert Meyers
- School of Sport and Health Sciences, Cardiff Metropolitan University
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153
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Fenton SA, Duda JL, Veldhuijzen van Zanten JJ, Metsios GS, Kitas GD. Theory-informed interventions to promote physical activity and reduce sedentary behaviour in rheumatoid arthritis: a critical review of the literature. Mediterr J Rheumatol 2020; 31:19-41. [PMID: 32411931 PMCID: PMC7219651 DOI: 10.31138/mjr.31.1.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/11/2020] [Accepted: 03/22/2020] [Indexed: 01/03/2023] Open
Abstract
Moderate-intensity physical activity (PA) is recommended for the management of Rheumatoid Arthritis (RA). Recent evidence suggests that reducing sedentary behaviour (promoting 'sedentary breaks' and light intensity PA) may also offer potential for improving RA outcomes, independently of the benefits of moderate-intensity PA. Unfortunately, people living with RA engage in very little moderate-intensity PA, and the spend the majority of the day sedentary. Interventions to support PA and sedentary behaviour change in this population are therefore required. Psychological theory can provide a basis for the development and implementation of intervention strategies, and specify the cognitive processes or mechanisms assumed to result in behavioural change. Application of psychological theory to intervention development and evaluation, therefore, permits evaluation of "how things work", helping to identify optimal intervention strategies, and eliminate ineffective components. In this review, we provide an overview of existing PA and sedentary behaviour change interventions in RA, illustrating the extent to which current interventions have been informed by psychological theories of behaviour change. Recommendations are provided for future interventional research in this domain, serving as a reference point to encourage proper application of behavioural theories into intervention design, implementation and appraisal.
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Affiliation(s)
- Sally A.M. Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
| | - Joan L. Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Jet J.C.S. Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
| | - George S. Metsios
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
- Faculty of Education Health and Wellbeing, Institute of Sport and Human Science, University of Wolverhampton, Wolverhampton, United Kingdom
| | - George D. Kitas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
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154
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Hagger MS, Moyers S, McAnally K, McKinley LE. Known knowns and known unknowns on behavior change interventions and mechanisms of action. Health Psychol Rev 2020; 14:199-212. [DOI: 10.1080/17437199.2020.1719184] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Martin S. Hagger
- Psychological Sciences, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Susette Moyers
- Psychological Sciences, University of California, Merced, CA, USA
| | - Kaylyn McAnally
- Psychological Sciences, University of California, Merced, CA, USA
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155
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Donkers SJ, Chan K, Milosavljevic S, Pakosh M, Musselman KE. Informing the training of health care professionals to implement behavior change strategies for physical activity promotion in neurorehabilitation: a systematic review. Transl Behav Med 2020; 10:310-323. [PMID: 30496560 DOI: 10.1093/tbm/iby118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Initiatives to increase physical activity (PA) are most effective when combined with behavior change strategies (BCS). However, this is not routinely done and perhaps can be attributed to health care professionals' (HCP) lack of confidence and understanding of how to best apply BCS. This review aimed to identify and synthesize the existing literature describing methods used to train HCP to deliver BCS for PA promotion for individuals living with neurological conditions. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eight databases were searched for articles describing how HCP were trained on BCS targeting PA and/or exercise for neurological pathology. Two researchers independently screened abstracts and used third-party consensus when needed. Studies must have described the planning/implementation of BCS targeting PA in adults with neurological disorders, with interventions delivered by a HCP. A data extraction table based on the study objective and the Cochrane Consumers and Communication Review Group's data extraction template was used. Risk of bias was assessed using the Quality Assessment Tools for Quantitative and Qualitative Studies. Included studies were also evaluated using the Workgroup for Intervention Development and Evaluation Research (WIDER) recommendations for reporting behavior change intervention content. Extraction and evaluation of risk of bias were completed independently by two researchers. Data were synthesized according to a who, what, when, and how approach. The search yielded 2,616 articles after duplicates removed, with 13 articles, representing eight unique interventions in individuals with spinal cord injury, stroke, multiple sclerosis, and Parkinson's disease included. Methodological quality ranged from strong to weak. Methods used to increase HCP knowledge and use of BCS were heterogeneous. Common training features included multiple resources, multiple sessions, expert input, and ongoing support, but a lack of evaluation of training effectiveness. The BCS were based on Social Cognitive Theory in seven interventions. Physiotherapists were the most common HCP trained. There was considerable variety in how HCP were trained to use BCS and a lack of evaluation of training effectiveness. Future work should include more description of the content and structure of HCP training and a direct measure of effectiveness. Researchers should consider implementation strategies during development and reporting of behavior change interventions. This review was not registered with PROSPERO.
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Affiliation(s)
- Sarah J Donkers
- School of Rehabilitation Science, Faculty of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Katherine Chan
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Stephan Milosavljevic
- School of Rehabilitation Science, Faculty of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Maureen Pakosh
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Kristin E Musselman
- School of Rehabilitation Science, Faculty of Medicine, University of Saskatchewan, Saskatoon, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
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156
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Jacob Arriola KR, Ellis A, Webb-Girard A, Ogutu EA, McClintic E, Caruso B, Freeman MC. Designing integrated interventions to improve nutrition and WASH behaviors in Kenya. Pilot Feasibility Stud 2020; 6:10. [PMID: 32042436 PMCID: PMC6998333 DOI: 10.1186/s40814-020-0555-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 01/23/2020] [Indexed: 01/05/2023] Open
Abstract
Background Child stunting, an indicator of chronic malnutrition, is a global public health problem. Malnutrition during pregnancy and the first 2 years of life undermines the survival, growth, and development of children. Exposure to fecal pathogens vis-à-vis inadequate water, sanitation, and hygiene (WASH) has been implicated in the etiology of child stunting, highlighting the need to integrate WASH with nutrition-sensitive interventions to comprehensively address this complex problem. The aim of this study was to describe a systematic, theoretically informed approach (that drew from the Starr and Fornoff approach to the Theory of Change development and the Behavior Change Wheel approach) to design a multi-component and integrated social and behavior change intervention to improve WASH and nutrition-related behaviors in western Kenya. Methods This intervention was developed to be integrated into an existing project that utilized the care group model and aimed to create a culture of care and support for HIV/AIDS-affected children under two and their caregivers and was executed by local partners. We tested the newly created intervention packages in user-testing trials using an adapted Trials of Improved Practices approach to pilot acceptability and feasibility. Results Using authentic stakeholder engagement and relevant theories, we conducted an 8-step process: (1) conduct mixed methods formative research, (2) prioritize target behaviors, (3) use causal analysis to create problem trees, (4) develop solution trees and articulate assumptions and rationales for change, (5) link solution trees to intervention functions, (6) develop the intervention plan, (7) create the intervention packages, and (8) test and refine the intervention packages. Conclusions This study highlights the need to take a multi-sectorial, integrated approach that integrates contextually relevant behavior change theories with the experiential knowledge gleaned from stakeholders into the design of interventions that seek to reduce child stunting. This process resulted in the creation of intervention packages that grouped behaviors thematically to be most relevant and responsive to the population context. This work has the potential to make important contributions towards achievement of the United Nations’ sustainable development goals.
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Affiliation(s)
- Kimberly R Jacob Arriola
- 1Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Anna Ellis
- 2Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Amy Webb-Girard
- 3Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Emily Awino Ogutu
- 2Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Emilie McClintic
- 2Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Bethany Caruso
- 2Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Matthew C Freeman
- 2Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
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157
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The compendium of self-enactable techniques to change and self-manage motivation and behaviour v.1.0. Nat Hum Behav 2020; 4:215-223. [DOI: 10.1038/s41562-019-0798-9] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/22/2019] [Indexed: 11/08/2022]
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158
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Affiliation(s)
- Molly Byrne
- Health Behaviour Change Research Group, National University of Ireland Galway, Galway, Ireland
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159
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Tiitinen S, Ilomäki S, Laitinen J, Korkiakangas EE, Hannonen H, Ruusuvuori J. Developing theory- and evidence-based counseling for a health promotion intervention: A discussion paper. PATIENT EDUCATION AND COUNSELING 2020; 103:234-239. [PMID: 31447199 DOI: 10.1016/j.pec.2019.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/10/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Although the use of theories and evidence is often stressed in the development of health promotion interventions, this does not guarantee the success of an intervention. Thus, we need to reflect on intervention development processes that use different types of theories and evidence. In this paper, we provide a reflective discussion on how we identified evidence-based behavior change techniques and counseling themes for a health promotion intervention. In addition, we discuss the challenges that we encountered and what we learned during the process: a) a lack of previous research and meta-analyses, b) inconsistencies in evidence, c) integrating evidence and theories that have different starting points, and d) collaborating with researchers who represent different evidence and theories. During the process, we benefitted from having the clear goal of conducting evidence- and theory-based work. We solved the challenges by, for example, utilizing different types of evidence and being reflective about the reasons behind any inconsistencies in the evidence. In retrospect, we would have benefitted from closer collaboration between the teams that worked separately with different evidence. These kinds of reflective descriptions of development processes and the challenges encountered during them may help other researchers and professionals avoid encountering the same challenges.
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Affiliation(s)
- Sanni Tiitinen
- Tampere University, FI-33014 Tampere University, Tampere, Finland
| | - Sakari Ilomäki
- Tampere University, FI-33014 Tampere University, Tampere, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, 00032 Finnish Institute of Occupational Health, P.O. Box 18, Oulu, Finland
| | | | - Heli Hannonen
- Finnish Institute of Occupational Health, 00032 Finnish Institute of Occupational Health, P.O. Box 18, Oulu, Finland
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160
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de Barra M, Scott C, Johnston M, De Bruin M, Scott N, Matheson C, Bond C, Watson M. Do pharmacy intervention reports adequately describe their interventions? A template for intervention description and replication analysis of reports included in a systematic review. BMJ Open 2019; 9:e025511. [PMID: 31862736 PMCID: PMC6937059 DOI: 10.1136/bmjopen-2018-025511] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 05/28/2019] [Accepted: 06/25/2019] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Scientific progress and translation of evidence into practice is impeded by poorly described interventions. The Template for Intervention Description and Replication (TIDieR) was developed to specify the minimal intervention elements that should be reported. OBJECTIVES (1) To assess the extent to which outpatient pharmacy interventions were adequately reported. (2) To examine the dimension(s) across which reporting quality varies. (3) To examine trial characteristics that predict better reporting. METHODS The sample comprised 86 randomised controlled trials identified in a Cochrane review of the effectiveness of pharmacist interventions on patient health outcomes. Duplicate, independent application of a modified 15-item TIDieR checklist was undertaken to assess the intervention reporting. The reporting/non-reporting of TIDieR items was analysed with principal component analysis to evaluate the dimensionality of reporting quality and regression analyses to assess predictors of reporting quality RESULTS: In total, 422 (40%) TIDieR items were fully reported, 395 (38%) were partially reported and 231 (22%) were not reported. A further 242 items were deemed not applicable to the specific trials. Reporting quality loaded on one component which accounted for 26% of the variance in TIDieR scores. More recent trials reported a slightly greater number of TIDieR items (0.07 (95% CI 0.02 to 0.13) additional TIDieR items per year of publication). Trials reported an 0.09 (95% CI 0.04 to 0.14) additional TIDieR items per unit increase in impact factor (IF) of the journal in which the main report was published. CONCLUSIONS Most trials lacked adequate intervention reporting. This diminished the applied and scientific value of their research. The standard of intervention reporting is, however, gradually increasing and appears somewhat better in journals with higher IFs. The use of the TIDieR checklist to improve reporting could enhance the utility and replicability of trials, and reduce research waste.
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Affiliation(s)
- Mícheál de Barra
- Life Sciences, Brunel University London, Middlesex, UK
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Claire Scott
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Dental Clinical Effectiveness, NHS Education for Scotland, Dundee, UK
| | - Marie Johnston
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - M De Bruin
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud, The Netherlands
| | - Neil Scott
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Christine Bond
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Margaret Watson
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
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161
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Focht BC, Lucas AR, Grainger E, Simpson C, Fairman CM, Thomas-Ahner JM, Chaplow ZL, DeScenza VR, Bowman J, Clinton SK. Effects of a Group-Mediated Cognitive Behavioral Lifestyle Intervention on Select Social Cognitive Outcomes in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy. Integr Cancer Ther 2019; 18:1534735419893764. [PMID: 31838879 PMCID: PMC6913059 DOI: 10.1177/1534735419893764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective. To compare the effects of a group-mediated cognitive behavioral (GMCB) exercise and dietary (EX+D) intervention with those of standard-of-care (SC) treatment on select social cognitive outcomes in prostate cancer (PCa) patients undergoing androgen deprivation therapy (ADT). Methods. In the single-blind, 2-arm, randomized controlled Individualized Diet and Exercise Adherence–Pilot (IDEA-P) trial, 32 PCa patients (mean age = 66.2 years; SD = 7.8) undergoing ADT were randomly assigned to a 12-week EX+D intervention (n = 16) or SC treatment (n = 16). The exercise component of the personalized EX+D intervention integrated a combination of supervised resistance and aerobic exercise performed twice per week. The dietary component involved counseling and education to modify dietary intake and composition. Blinded assessments of social cognitive outcomes were obtained at baseline and 2-month and 3-month follow-up. Results. Intent-to-treat analysis of covariance demonstrated that the EX+D intervention resulted in significantly greater improvements in scheduling (P < .05), coping (P < .01), and exercise self-efficacy (P < .05), and satisfaction with function (P < .01) at 3 months relative to SC. Results of partial correlation analysis also demonstrated that select social cognitive outcomes were significantly correlated with primary trial outcomes of mobility performance and exercise participation (P < .05) at 3-month follow-up. Conclusions: The GMCB lifestyle intervention yielded more favorable improvements in relevant social cognitive outcomes relative to SC among PCa patients undergoing ADT. Additionally, more favorable social cognitive outcomes were associated with superior mobility performance and exercise participation following the independent maintenance phase of the EX+D intervention.
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Affiliation(s)
| | | | | | | | - Ciaran M Fairman
- Edith Cowan University, Joondalup, Australia Capital Territory, Australia
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162
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Kaufman J, Ryan R, Betsch C, Parkhill A, Shapiro G, Leask J, Menning L, Tugwell P, Costa DS, Danchin M, Rada G, Hill S. Instruments that measure psychosocial factors related to vaccination: a scoping review protocol. BMJ Open 2019; 9:e033938. [PMID: 31822547 PMCID: PMC6924734 DOI: 10.1136/bmjopen-2019-033938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/16/2019] [Accepted: 11/18/2019] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION As vaccine-preventable disease outbreaks increase, there is growing international interest in monitoring public attitudes towards vaccination and implementing and evaluating vaccine promotion interventions. Outcome selection and measurement are central to intervention evaluation. Measuring uptake rates alone cannot determine which elements in a multicomponent vaccine-promotion intervention are most effective, why specific populations are undervaccinated or when confidence in vaccines is wavering. To develop targeted and cost-effective interventions and policies, it is necessary to measure vaccination-related psychosocial factors such as knowledge, attitudes and aspects of decision-making. This scoping review aims to identify, compare and summarise the properties and validation of instruments for measuring vaccination-related psychosocial factors and identify gaps where no instruments exist. METHODS AND ANALYSIS We will search Medline OVID, Embase OVID, CINAHL and PsycINFO with no date restriction, using a pilot-tested search strategy of terms related to vaccination: knowledge, attitudes, trust, acceptance and decision-making and measurement, psychometric testing or validation. This search will be supplemented with manual search and expert consultation. We will include studies that describe instrument development, adaptation or testing and include evaluation of at least two measurement properties (eg, content, criterion, or construct validity; test-retest reliability; internal consistency; sensitivity; responsiveness). Instruments measuring a vaccination-related psychosocial factor in any population will be included. All studies will be screened by one reviewer, with a sample double-screened to confirm accuracy. Disagreements will be resolved with a third reviewer. Data will be synthesised narratively and through summary tables to chart and compare instrument characteristics such as factors measured, date and/or location of development or validation, measurement properties evaluated and population. ETHICS AND DISSEMINATION This scoping review aims to provide an overview of existing instruments and ascertain measurement gaps where no measurement instruments currently exist. The identified instruments will form the basis of an open-access online repository of instruments.
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Affiliation(s)
- Jessica Kaufman
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Cornelia Betsch
- Health Communication, Faculty of Philosophy, University of Erfurt, Erfurt, Germany
| | - Anne Parkhill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Gilla Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Julie Leask
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- Faculty of Nursing, University of Sydney, Camperdown, New South Wales, Australia
| | - Lisa Menning
- Immunization, Vaccines and Biologicals, World Health Organization, Geneve, GE, Switzerland
| | - Peter Tugwell
- Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Sj Costa
- Pain Management Research Institute, The University of Sydney, St Leonards, New South Wales, Australia
| | - Margaret Danchin
- Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Gabriel Rada
- Evidence-Based Healthcare Program, Pontificia Universidad Católica de Chile, Santiago, Chile
- Epistemonikos, Santiago, Chile
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
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163
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Fontaine G, Cossette S, Maheu-Cadotte MA, Deschênes MF, Rouleau G, Lavallée A, Pépin C, Ballard A, Chicoine G, Lapierre A, Lavoie P, Blondin J, Mailhot T. Effect of implementation interventions on nurses' behaviour in clinical practice: a systematic review, meta-analysis and meta-regression protocol. Syst Rev 2019; 8:305. [PMID: 31806051 PMCID: PMC6896305 DOI: 10.1186/s13643-019-1227-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/11/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Practitioner-level implementation interventions such as audit and feedback, communities of practice, and local opinion leaders have shown potential to change nurses' behaviour in clinical practice and improve patients' health. However, their effectiveness remains unclear. Moreover, we have a paucity of data regarding the use of theory in implementation studies with nurses, the causal processes-i.e. mechanisms of action-targeted by interventions to change nurses' behaviour in clinical practice, and the constituent components-i.e. behaviour change techniques-included in interventions. Thus, our objectives are threefold: (1) to examine the effectiveness of practitioner-level implementation interventions in changing nurses' behaviour in clinical practice; (2) to identify, in included studies, the type and degree of theory use, the mechanisms of action targeted by interventions and the behaviour change techniques constituting interventions and (3) to examine whether intervention effectiveness is associated with the use of theory or with specific mechanisms of action and behaviour change techniques. METHODS We will conduct a systematic review based on the Cochrane Effective Practice and Organization of Care (EPOC) Group guidelines. We will search six databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science) with no time limitation for experimental and quasi-experimental studies that evaluated practitioner-level implementation interventions aiming to change nurses' behaviour in clinical practice. We will also hand-search reference lists of included studies. We will perform screening, full-text review, risk of bias assessment, and data extraction independently with the Covidence systematic review software. We will assess the quality of evidence using the GRADEpro software. We will code included studies independently for theory use (Theory Coding Scheme), mechanisms of action (coding guidelines from Michie) and behaviour change techniques (Behaviour Change Technique Taxonomy v1) with QSR International's NVivo qualitative data analysis software. Meta-analyses will be performed using the Review Manager (RevMan) software. Meta-regression analyses will be performed with IBM SPSS Statistics software. DISCUSSION This review will inform knowledge users and researchers interested in designing, developing and evaluating implementation interventions to support nurses' behaviour change in clinical practice. Results will provide key insights regarding which causal processes-i.e. mechanisms of action-should be targeted by these interventions, and which constituent components-i.e. behaviour change techniques-should be included in these interventions to increase their effectiveness. SYSTEMATIC REVIEW REGISTRATION The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019130446).
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
| | - Marie-France Deschênes
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Center for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Geneviève Rouleau
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
- Faculty of Nursing, Université Laval, Québec, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, CHU Sainte-Justine, Montréal, Canada
| | - Catherine Pépin
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Institute of Public Health Research, Université de Montréal, Montréal, Canada
| | - Ariane Ballard
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, CHU Sainte-Justine, Montréal, Canada
| | - Gabrielle Chicoine
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
| | - Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Center for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Jérémie Blondin
- School of Librarianship and Information Science, Université de Montréal, Montréal, Canada
| | - Tanya Mailhot
- Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, USA
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164
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Focht BC, Lucas AR, Grainger E, Simpson C, Fairman CM, Thomas-Ahner JM, Buell J, Monk JP, Mortazavi A, Clinton SK. Effects of a Group-Mediated Exercise and Dietary Intervention in the Treatment of Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: Results From the IDEA-P Trial. Ann Behav Med 2019; 52:412-428. [PMID: 29684136 DOI: 10.1093/abm/kax002] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Although androgen-deprivation therapy (ADT) is the foundation of treatment for prostate cancer, the physiological impacts of ADT result in functional decline and enhanced risk of chronic disease and metabolic syndrome. Purpose The Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) is a single-blind, randomized, pilot trial comparing the effects of a group-mediated, cognitive-behavioral (GMCB) exercise and dietary intervention (EX+D) with those of a standard-of-care (SC) control during the treatment of prostate cancer patients undergoing ADT. Methods A total of 32 prostate cancer patients (M age = 66.28, SD = 7.79) undergoing ADT were randomly assigned to the 12-week EX+D intervention (n = 16) or control (n = 16). The primary outcome in IDEA-P was change in mobility performance with secondary outcomes including body composition and muscular strength. Blinded assessment of outcomes were obtained at baseline and at 2- and 3-month follow-ups. Results Favorable adherence and retention rates were observed, and no serious intervention-related adverse events were documented. Intent-to-treat ANCOVA controlling for baseline value and ADT duration demonstrated that EX+D resulted in significantly greater improvements in mobility performance (p < .02), muscular strength (p < .01), body fat percentage (p < .05), and fat mass (p < .03) at 3-month follow-up, relative to control. Conclusion Findings from the IDEA-P trial suggest that a GMCB-based EX+D intervention resulted in significant, clinically meaningful improvements in mobility performance, muscular strength, and body composition, relative to controls. Collectively, these results suggest that the EX+D was a safe and well-tolerated intervention for prostate cancer patients on ADT. The utility of implementing this approach in the treatment of prostate cancer patients on ADT should be evaluated in future large-scale efficacy trials. Clinical Trial information NCT02050906.
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Affiliation(s)
- Brian C Focht
- Exercise and Behavioral Medicine Laboratory, Kinesiology, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Alexander R Lucas
- Exercise and Behavioral Medicine Laboratory, Kinesiology, The Ohio State University, Columbus, OH, USA
| | - Elizabeth Grainger
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Christina Simpson
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Ciaran M Fairman
- Exercise and Behavioral Medicine Laboratory, Kinesiology, The Ohio State University, Columbus, OH, USA
| | - Jennifer M Thomas-Ahner
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Jackie Buell
- Medical Dietetics, The Ohio State University, Columbus, OH, USA
| | - J Paul Monk
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Amir Mortazavi
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Steven K Clinton
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
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165
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Koopmans E, Black T, Newton A, Dhugga G, Karduri N, Doan Q. Provincial dissemination of HEARTSMAP, an emergency department psychosocial assessment and disposition decision tool for children and youth. Paediatr Child Health 2019; 24:359-365. [PMID: 31528104 DOI: 10.1093/pch/pxz038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/19/2019] [Accepted: 03/02/2019] [Indexed: 01/20/2023] Open
Abstract
Background This article describes the provincial dissemination of HEARTSMAP, an evidence-based emergency department (ED) psychosocial assessment and disposition decision tool for clinician use with children and youth. Methods HEARTSMAP was disseminated in partnership with local, child and youth mental health teams, as part of a quality improvement initiative implemented in British Columbia EDs. The target audience of education sessions were clinicians working in ED settings responsible for paediatric psychosocial assessments. We used the RE-AIM framework to evaluate the reach, effectiveness, adoption, implementation, and maintenance of HEARTSMAP dissemination, analyzing data from session evaluation forms and online tool data. Results Education sessions reached 475 attendees, in 52 of 95 British Columbia EDs. HEARTSMAP training was well received by clinicians with 96% describing effective content including increased comfort in conducting paediatric psychosocial assessments and confidence in disposition planning after training. Clinicians identified unclear processes and lack of local resources as the main barriers to implementation. One-third of the attendees expressed willingness to use the tool, and 27% of registered clinicians have used the tool postimplementation. Conclusions Our approach reached and effectively trained clinicians from over half of the province's EDs to use HEARTSMAP for emergency paediatric psychosocial assessments. For some, this provided greater comfort and confidence for these assessments and the following disposition decisions. This evaluation provides valuable insights on training clinicians to use a paediatric mental health tool within diverse ED settings and emphasized the need for ongoing support and institutional engagement to facilitate local, infrastructural, and operational processes for adoption and maintenance, postdissemination.
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Affiliation(s)
- Erica Koopmans
- BC Children's Hospital Research Institute, Vancouver, British Columbia
| | - Tyler Black
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Amanda Newton
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Gurm Dhugga
- BC Children's Hospital Research Institute, Vancouver, British Columbia
| | - Naveen Karduri
- BC Children's Hospital Research Institute, Vancouver, British Columbia
| | - Quynh Doan
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia.,BC Children's Hospital Research Institute, Vancouver, British Columbia
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166
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Willmott T, Pang B, Rundle-Thiele S, Badejo A. Reported theory use in electronic health weight management interventions targeting young adults: a systematic review. Health Psychol Rev 2019; 13:295-317. [PMID: 31161877 DOI: 10.1080/17437199.2019.1625280] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This review assesses the extent of reported theory use in electronic health weight management interventions targeting young adults aged 18-35 years. Twenty-four eligible studies were identified. Two independent reviewers extracted data and coded for theory use using the Theory Coding Scheme. Overall, the mean total use of theory score was 6/23 (SD = 5; Min. = 0, Max. = 17); 17 studies were classified as having weak application of theory, five as moderate, and two as strong. The majority (N = 18) of studies mentioned theory, however, most (N = 14) did not report how intervention techniques related to theoretical base. No study used theory to select intervention recipients and only four used theory to tailor intervention techniques to recipients. Limited studies reported theory testing (N = 6) and no study used intervention results to build and/or refine theory. Results indicate that weight-related outcomes may be enhanced when at least one or more theoretical constructs are explicitly linked to an intervention technique and when theoretical constructs are included in evaluations. Increases in theory application and reporting are needed to assist the scientific research community in systematically identifying which theories work, for whom, how, why, and when; thereby delivering an advanced understanding of how best to apply theory to enhance intervention outcomes.
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Affiliation(s)
- Taylor Willmott
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Bo Pang
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Sharyn Rundle-Thiele
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Abi Badejo
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
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167
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Ersser S, Effah A, Dyson J, Kellar I, Thomas S, McNichol E, Caperon E, Hewitt C, Muinonen‐Martin A. Effectiveness of interventions to support the early detection of skin cancer through skin self‐examination: a systematic review and meta‐analysis. Br J Dermatol 2019; 180:1339-1347. [DOI: 10.1111/bjd.17529] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 02/05/2023]
Affiliation(s)
- S.J. Ersser
- Department of Health Sciences University of York YorkU.K
| | - A. Effah
- School of Healthcare University of Leeds LeedsU.K
| | - J. Dyson
- School of Health & Social Work University of Hull Hull U.K
| | - I. Kellar
- School of Psychology University of Leeds LeedsU.K
| | - S. Thomas
- Faculty of Health & Social Sciences Bournemouth University Bournemouth U.K
| | - E. McNichol
- School of Healthcare University of Leeds LeedsU.K
| | - E. Caperon
- Leeds Institute of Health Sciences University of Leeds Leeds U.K
| | - C. Hewitt
- Department of Health Sciences University of York YorkU.K
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168
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Alessa T, Hawley MS, Hock ES, de Witte L. Smartphone Apps to Support Self-Management of Hypertension: Review and Content Analysis. JMIR Mhealth Uhealth 2019; 7:e13645. [PMID: 31140434 PMCID: PMC6658295 DOI: 10.2196/13645] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 12/14/2022] Open
Abstract
Background Hypertension is a widespread chronic disease, and its effective treatment requires self-management by patients. Health-related apps provide an effective way of supporting hypertension self-management. However, the increasing range and variety of hypertension apps available on the market, owing to the global growth in apps, creates the need for patients and health care professionals to be informed about the effectiveness of these apps and the levels of privacy and security that they provide. Objective This study aimed to describe and assess all available apps supporting hypertension self-management in the most popular app stores and investigate their functionalities. Methods In January 2018, the UK Apple and Google Play stores were scanned for all free and paid apps supporting hypertension self-management. Apps were included if they were in English, had functionality supporting hypertension self-management, and targeted adult users with hypertension. The included apps were downloaded and their functionalities were investigated. Behavior change techniques (BCTs) linked with the theoretical domain framework (TDF) underpinning potentially effective apps were independently coded by two reviewers. The data privacy and security of the apps were also independently assessed. Results A total of 186 hypertension apps that met the inclusion criteria were included in this review. The majority of these apps had only one functionality (n=108), while the remainder offered different combinations of functionalities. A small number of apps had comprehensive functionalities (n=30) that are likely to be more effective in supporting hypertension self-management. Most apps lacked a clear theoretical basis, and 24 BCTs identified in these 30 apps were mapped to 10 TDF mechanisms of actions. On an average, 18.4 BCTs were mapped to 6 TDF mechanisms of actions that may support hypertension self-management behaviors. There was a concerning absence of evidence related to the effectiveness and usability of all 186 apps, and involvement of health care professionals in the app development process was minimal. Most apps did not meet the current standards of data security and privacy. Conclusions Despite the widespread accessibility and availability of smartphone apps with a range of combinations of functionalities that can support the self-management of hypertension, only a small number of apps are likely to be effective. Many apps lack security measures as well as a clear theoretical basis and do not provide any evidence concerning their effectiveness and usability. This raises a serious issue, as health professionals and those with hypertension have insufficient information to make decisions on which apps are safe and effective.
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Affiliation(s)
- Tourkiah Alessa
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.,Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mark S Hawley
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Emma S Hock
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Luc de Witte
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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169
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Matvienko-Sikar K, Toomey E, Delaney L, Flannery C, McHugh S, McSharry J, Byrne M, Queally M, Heary C, Kearney PM. Behaviour change techniques and theory use in healthcare professional-delivered infant feeding interventions to prevent childhood obesity: a systematic review. Health Psychol Rev 2019; 13:277-294. [DOI: 10.1080/17437199.2019.1605838] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Elaine Toomey
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Lisa Delaney
- School of Public Health, University College Cork, Cork, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork, Cork, Ireland
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Jenny McSharry
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Molly Byrne
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Michelle Queally
- Discipline of Economics, JE Cairnes School of Business and Economics, National University of Ireland Galway, Galway, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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170
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Hagger MS, Weed M. DEBATE: Do interventions based on behavioral theory work in the real world? Int J Behav Nutr Phys Act 2019; 16:36. [PMID: 31023328 PMCID: PMC6482531 DOI: 10.1186/s12966-019-0795-4] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/27/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Behavioral scientists suggest that for behavior change interventions to work effectively, and deliver population-level health outcomes, they must be underpinned by behavioral theory. However, despite implementation of such interventions, population levels of both health outcomes and linked behaviors have remained relatively static. We debate the extent to which interventions based on behavioral theory work in the real world to address population health outcomes. DISCUSSION Hagger argues there is substantive evidence supporting the efficacy and effectiveness of interventions based on behavioral theory in promoting population-level health behavior change in the 'real world'. However, large-scale effectiveness trials within existing networks are relatively scarce, and more are needed leveraging insights from implementation science. Importantly, sustained investment in effective behavioral interventions is needed, and behavioral scientists should engage in greater advocacy to persuade gatekeepers to invest in behavioral interventions. Weed argues there is no evidence to demonstrate behavioral theory interventions are genuinely effective in real world settings in populations that are offered them: they are merely efficacious for those that receive them. Despite behavioral volatility that is a normal part of maintaining steady-state population behavior levels creating the illusion of effectiveness, interventions fail in shifting the curve of population behaviors because they focus on individuals rather than populations. Hagger responds that behavioral interventions work in the 'real world' in spite of, not because of, flux in health behaviors, and that the contention that behavioral theory focuses solely on individual behavior change is inaccurate. Weed responds that the focus on extending the controls of efficacy trials into implementation is impractical, uneconomic and futile, and this has squandered opportunities to conduct genuine effectiveness trials in naturalistic settings. Hagger contends that interventions based on behavioral theory are effective in changing population-level behavior in 'real world' contexts, but more evidence on how best to implement them and how to engage policymakers and practitioners to provide sustained funding is needed. Weed argues for a paradigm shift, away from aggregative attempts to effect individual behavior change towards a focus on disrupting social practices, underpinned by understanding social and economic causation of the distribution and acceptance of behaviors in a population.
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Affiliation(s)
- Martin S Hagger
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, USA.
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
- School of Applied Psychology, Griffith University, Brisbane, Australia.
- Health Psychology and Behavioral Medicine Research Group, School of Psychology, Curtin University, Perth, Australia.
| | - Mike Weed
- Centre for Sport, Physical Education & Activity Research (SPEAR), Canterbury Christ Church University, Canterbury, UK.
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171
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Sarma EA, Silver MI, Kobrin SC, Marcus PM, Ferrer RA. Cancer screening: health impact, prevalence, correlates, and interventions. Psychol Health 2019; 34:1036-1072. [DOI: 10.1080/08870446.2019.1584673] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Elizabeth A. Sarma
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Michelle I. Silver
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Sarah C. Kobrin
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Pamela M. Marcus
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Rebecca A. Ferrer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
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172
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Sanaei Nasab H, Yazdanian M, Mokhayeri Y, Latifi M, Niksadat N, Harooni J, Armoon B. The role of psychological theories in oral health interventions: A systematic review and meta-analysis. Int J Dent Hyg 2019; 17:142-152. [PMID: 30702796 DOI: 10.1111/idh.12386] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/10/2019] [Accepted: 01/25/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In the present study, we attempted to assess how psychological theories (health belief model [HBM], theory of planned behaviour [TPB], social cognitive theory [SCT], clinical theories [CT] and other theories [OT]) influence oral health interventions. METHODS PubMed, Scopus, Cochrane and Web of Knowledge databases from 2000 to 2017 were searched. We defined psychological theories based on five subgroups: (A) HBM, (B) TPB, (C) SCT, (E) CT and (F) OT. RESULTS From the 156 identified studies, 19 studies based on PICO were included. Our findings indicated that the standardized mean difference (SMD) of HBM was 0.37 (95% CI: 0.24, 0.51), which was statistically significant in improving oral health. The SMD of SCT was not significant (0.05 [95% CI: -0.33, 0.44]) in improving oral health. The SMD of TPB was significant (1.66 [95% CI: 1.06, 2.27]) in improving oral health. The SMD of CT (-4.6 [95% CI: -6.49, -2.71]) and OT (2.93 [95% CI: 1.55, 4.32]) revealed significant differences in improving oral health. CONCLUSION The current meta-analysis showed that in general, psychological interventions that used OT, CT, HBM and TPB were effective in enhancing oral health status, and interventions that used SCT did not have an effect on improving oral health status. Oral health care providers who work with patients to take methods and improve behaviours that are related to appropriate oral health need to comprehend their applicability and strengths.
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Affiliation(s)
- Hormoz Sanaei Nasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Yaser Mokhayeri
- School of Public Health, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Marzieh Latifi
- Department of Health Education and Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin Niksadat
- Department of Public Health, Faculty of Health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.,Department of Health Education and Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Student Research Committee, Tehran, Iran
| | - Javad Harooni
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Bahram Armoon
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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173
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Fingleton N, Duncan E, Watson M, Matheson C. Specialist Clinicians' Management of Dependence on Non-Prescription Medicines and Barriers to Treatment Provision: An Exploratory Mixed Methods Study Using Behavioural Theory. PHARMACY 2019; 7:E25. [PMID: 30841493 PMCID: PMC6473901 DOI: 10.3390/pharmacy7010025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/15/2019] [Accepted: 02/28/2019] [Indexed: 12/01/2022] Open
Abstract
The aim of the study was to establish how non-prescription medicine (NPM) dependence is treated by doctors in specialist substance misuse treatment services and to identify perceived barriers to providing treatment. An online survey was conducted to establish current practice and whether changes to service provision are needed to facilitate treatment (n = 83). Semi-structured interviews, based on the Theoretical Domains Framework, were conducted to derive a detailed exploration of suggested changes (n = 11). Most survey respondents had encountered cases of NPM dependence. Analgesics containing codeine were the most frequently NPMs of dependence mentioned by respondents. Most respondents were unaware of specific guidelines for the treatment of NPM dependence. The most frequently identified barriers to providing treatment identified by interviewees were limited resources or capacity and the challenges presented by this client group. There was a perception that this client group could be difficult to treat due to comorbidities, and these this client group perceived themselves to be different from people dependent on alcohol or illicit drugs. This study identified a clear need for specific clinical guidelines for the treatment of NPM dependence. Such guidance should be appropriate for specialist and generalist clinicians as the current pressure on resources may force more treatment into general practice. Appropriate care pathways need to be established and defined, and sufficient resources allocated to accommodate this client group.
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Affiliation(s)
- Niamh Fingleton
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK.
| | - Eilidh Duncan
- Health Services Research Unit, University of Aberdeen, Aberdeen AB25 2ZD, UK.
| | - Margaret Watson
- Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, UK.
| | - Catriona Matheson
- Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK.
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174
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Ma J, Lewis MA, Smyth JM. Translational behavioral medicine for population and individual health: gaps, opportunities, and vision for practice-based translational behavior change research. Transl Behav Med 2019; 8:753-760. [PMID: 29669065 DOI: 10.1093/tbm/ibx032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this commentary, we propose a vision for "practice-based translational behavior change research," which we define as clinical and public health practice-embedded research on the implementation, optimization, and fundamental mechanisms of behavioral interventions. This vision intends to be inclusive of important research elements for behavioral intervention development, testing, and implementation. We discuss important research gaps and conceptual and methodological advances in three key areas along the discovery (development) to delivery (implementation) continuum of evidence-based interventions to improve behavior and health that could help achieve our vision of practice-based translational behavior change research. We expect our proposed vision to be refined and evolve over time. Through highlighting critical gaps that can be addressed by integrating modern theoretical and methodological approaches across disciplines in behavioral medicine, we hope to inspire the development and funding of innovative research on more potent and implementable behavior change interventions for optimal population and individual health.
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Affiliation(s)
- Jun Ma
- Department of Health Policy and Administration, Institute for Health Research and Policy, University of Illinois at Chicago, IL, USA
| | | | - Joshua M Smyth
- Department of Biobehavioral Health and Medicine, the Pennsylvania State University, PA, USA
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175
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Miller S, Ainsworth B, Yardley L, Milton A, Weal M, Smith P, Morrison L. A Framework for Analyzing and Measuring Usage and Engagement Data (AMUsED) in Digital Interventions: Viewpoint. J Med Internet Res 2019; 21:e10966. [PMID: 30767905 PMCID: PMC6396072 DOI: 10.2196/10966] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/17/2018] [Accepted: 10/30/2018] [Indexed: 01/23/2023] Open
Abstract
Trials of digital interventions can yield extensive, in-depth usage data, yet usage analyses tend to focus on broad descriptive summaries of how an intervention has been used by the whole sample. This paper proposes a novel framework to guide systematic, fine-grained usage analyses that better enables understanding of how an intervention works, when, and for whom. The framework comprises three stages to assist in the following: (1) familiarization with the intervention and its relationship to the captured data, (2) identification of meaningful measures of usage and specifying research questions to guide systematic analyses of usage data, and (3) preparation of datasheets and consideration of available analytical methods with which to examine the data. The framework can be applied to inform data capture during the development of a digital intervention and/or in the analysis of data after the completion of an evaluation trial. We will demonstrate how the framework shaped preparation and aided efficient data capture for a digital intervention to lower transmission of cold and flu viruses in the home, as well as how it informed a systematic, in-depth analysis of usage data collected from a separate digital intervention designed to promote self-management of colds and flu. The Analyzing and Measuring Usage and Engagement Data (AMUsED) framework guides systematic and efficient in-depth usage analyses that will support standardized reporting with transparent and replicable findings. These detailed findings may also enable examination of what constitutes effective engagement with particular interventions.
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Affiliation(s)
- Sascha Miller
- Center for Clinical and Community Applications of Health Psychology, Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Lucy Yardley
- Center for Clinical and Community Applications of Health Psychology, Department of Psychology, University of Southampton, Southampton, United Kingdom.,School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Alex Milton
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Mark Weal
- Web and Internet Science Group, School of Electronics and Computer Science, University of Southampton, Southampton, United Kingdom
| | - Peter Smith
- Department of Social Statistics and Demography, School of Economic, Social and Political Sciences, University of Southampton, Southampton, United Kingdom
| | - Leanne Morrison
- Center for Clinical and Community Applications of Health Psychology, Department of Psychology, University of Southampton, Southampton, United Kingdom.,Primary Care and Population Sciences, School of Medicine, University of Southampton, Southampton, United Kingdom
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176
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Bourne JE, Ivanova E, Gainforth HL, Jung ME. Mapping behavior change techniques to characterize a social cognitive theory informed physical activity intervention for adults at risk of type 2 diabetes mellitus. Transl Behav Med 2019; 10:705-715. [DOI: 10.1093/tbm/ibz008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
Behavior change techniques (BCTs) are used to target theoretical mechanisms of action predicted to bring about behavior change. Reporting BCTs and connecting them to mechanisms of action is critical to understanding intervention processes of change. This article identifies the BCTs associated with an exercise intervention for individuals at risk of type 2 diabetes and determines the extent to which these BCTs target associated mechanisms of action. BCTs were mapped onto social cognitive theory (SCT) and the theoretical domains framework (TDF) using published literature identifying links between BCTs and SCT/TDF and expert consensus. Two coders then used the 93-item BCT taxonomy (BCTTv1) to independently code BCTs within the intervention. The BCTs used in the current intervention enabled identification of the theoretical mechanisms of action targeted in the intervention. More than 70% of the intervention content incorporated at least one BCT. More than 50% of the BCTs used targeted SCT constructs and more than 70% of BCTs used targeted at least one of the 14 TDF domains. Five BCTs did not map onto either SCT or TDF. This research provides a systematic method of linking BCTs to mechanisms of action. This process increases the transparency of intervention content and identification of the mechanisms of action targeted in the current intervention. Reporting interventions in this manner will enable the most potent mechanisms of actions associated with long-term behavior change to be identified and utilized in future work.
Trial Registration: ClinicalTrials.gov # NCT02164474. Registered on June 12, 2014.
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, UK
| | - Elena Ivanova
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada
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177
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A scoping review of ontologies related to human behaviour change. Nat Hum Behav 2019; 3:164-172. [PMID: 30944444 DOI: 10.1038/s41562-018-0511-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 12/06/2018] [Indexed: 12/16/2022]
Abstract
Ontologies are classification systems specifying entities, definitions and inter-relationships for a given domain, with the potential to advance knowledge about human behaviour change. A scoping review was conducted to: (1) identify what ontologies exist related to human behaviour change, (2) describe the methods used to develop these ontologies and (3) assess the quality of identified ontologies. Using a systematic search, 2,303 papers were identified. Fifteen ontologies met the eligibility criteria for inclusion, developed in areas such as cognition, mental disease and emotions. Methods used for developing the ontologies were expert consultation, data-driven techniques and reuse of terms from existing taxonomies, terminologies and ontologies. Best practices used in ontology development and maintenance were documented. The review did not identify any ontologies representing the breadth and detail of human behaviour change. This suggests that advancing behavioural science would benefit from the development of a behaviour change intervention ontology.
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178
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Powell BJ, Fernandez ME, Williams NJ, Aarons GA, Beidas RS, Lewis CC, McHugh SM, Weiner BJ. Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda. Front Public Health 2019; 7:3. [PMID: 30723713 PMCID: PMC6350272 DOI: 10.3389/fpubh.2019.00003] [Citation(s) in RCA: 339] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/04/2019] [Indexed: 01/10/2023] Open
Abstract
The field of implementation science was developed to better understand the factors that facilitate or impede implementation and generate evidence for implementation strategies. In this article, we briefly review progress in implementation science, and suggest five priorities for enhancing the impact of implementation strategies. Specifically, we suggest the need to: (1) enhance methods for designing and tailoring implementation strategies; (2) specify and test mechanisms of change; (3) conduct more effectiveness research on discrete, multi-faceted, and tailored implementation strategies; (4) increase economic evaluations of implementation strategies; and (5) improve the tracking and reporting of implementation strategies. We believe that pursuing these priorities will advance implementation science by helping us to understand when, where, why, and how implementation strategies improve implementation effectiveness and subsequent health outcomes.
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Affiliation(s)
- Byron J Powell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| | | | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Rinad S Beidas
- Department of Psychiatry, Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
| | - Cara C Lewis
- MacColl Center for Healthcare Innovation, Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Sheena M McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Bryan J Weiner
- Department of Global Health, Department of Health Services, University of Washington, Seattle, WA, United States
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179
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Long H, Bartlett YK, Farmer AJ, French DP. Identifying Brief Message Content for Interventions Delivered via Mobile Devices to Improve Medication Adherence in People With Type 2 Diabetes Mellitus: A Rapid Systematic Review. J Med Internet Res 2019; 21:e10421. [PMID: 30626562 PMCID: PMC6329430 DOI: 10.2196/10421] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 09/25/2018] [Accepted: 10/03/2018] [Indexed: 01/12/2023] Open
Abstract
Background Current interventions to support medication adherence in people with type 2 diabetes are generally resource-intensive and ineffective. Brief messages, such as those delivered via short message service (SMS) systems, are increasingly used in digital health interventions to support adherence because they can be delivered on a wide scale and at low cost. The content of SMS text messages is a crucial intervention feature for promoting behavior change, but it is often unclear what the rationale is for chosen wording or any underlying mechanisms targeted for behavioral change. There is little guidance for developing and optimizing brief message content for use in mobile device–delivered interventions. Objective This review aimed to (1) identify theoretical constructs (ie, the targets that interventions aim to change) and behavioral strategies (ie, features of intervention content) found to be associated with medication adherence in patients with type 2 diabetes and (2) map these onto a standard taxonomy for behavior change techniques (BCTs, that is, active ingredients of interventions used to promote behavioral change, to produce an evidence-based set of approaches that have shown promise of improving adherence in previous studies and which could be further tested in digital health interventions. Methods A rapid systematic review of existing relevant systematic reviews was conducted. MEDLINE and PsycINFO databases were searched from inception to April 10, 2017. Inclusion criteria were (1) systematic reviews of quantitative data if the studies reviewed identified predictors of or correlates with medication adherence or evaluated medication adherence–enhancing interventions and included adult participants taking medication to manage a chronic physical health condition, and (2) systematic reviews of qualitative studies of experiences of medication adherence for adult participants with type 2 diabetes. Data were extracted on review characteristics and BCTs, theoretical constructs, or behavioral strategies associated with improved adherence. Constructs and strategies were mapped onto the BCT version 1 taxonomy. Results A total of 1701 references were identified; 25 systematic reviews (19 quantitative reviews, 3 qualitative reviews, and 3 mixed-method reviews) were included. Moreover, 20 theoretical constructs (eg, self-efficacy) and 19 behavioral strategies (eg, habit analysis) were identified in the included reviews. In total, 46 BCTs were identified as being related to medication adherence in type 2 diabetes (eg, habit formation, prompts or cues, and information about health consequences). Conclusions We identified 46 promising BCTs related to medication adherence in type 2 diabetes on which the content of brief messages delivered through mobile devices to improve adherence could be based. By using explicit systematic review methods and linking our findings to a standardized taxonomy of BCTs, we have described a novel approach for the development of digital message content. Future brief message interventions that aim to support medication adherence could incorporate the identified BCTs.
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Affiliation(s)
- Hannah Long
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Yvonne K Bartlett
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Andrew J Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
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180
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Levett DZH, Grimmett C. Psychological factors, prehabilitation and surgical outcomes: evidence and future directions. Anaesthesia 2019; 74 Suppl 1:36-42. [DOI: 10.1111/anae.14507] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2018] [Indexed: 12/23/2022]
Affiliation(s)
- D. Z. H. Levett
- Anaesthesia and Critical Care Research Area; Southampton NIHR Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Clinical and Experimental Sciences; Faculty of Medicine; University of Southampton; Southampton UK
| | - C. Grimmett
- School of Health Sciences; University of Southampton; Southampton UK
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181
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Rameshbabu A, Reddy DM, Ports KA. Learning to health yourself: a randomized, tailored self-regulation intervention among custodial employees. HEALTH EDUCATION RESEARCH 2018; 33:447-457. [PMID: 30184096 DOI: 10.1093/her/cyy027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 07/30/2018] [Indexed: 06/08/2023]
Abstract
This intervention sought to bring about a dietary behavior change among individuals who are vulnerable to negative health outcomes and behaviors. Using a randomized controlled trial, we examined the efficacy of a six-week Education + Self-Regulation intervention against an Education Only condition in reducing saturated fat intake among custodial workers (N = 54). Assessments were made at baseline, 4 weeks, 6 weeks and 6 months. The intervention group reported lower saturated fat intake and greater self-regulation than the Education Only control group throughout the intervention period and higher self-efficacy at week 6. Despite a fading of intervention effect at 6 months, Education + Self-Regulation participants continued to report lower saturated fat intake relative to their baseline. Supplementing health education with self-regulatory skills is an effective strategy for positive health behavior change. The authors provide recommendations for engaging non-clinical health psychologists in community-level chronic disease prevention and health promotion efforts.
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Affiliation(s)
- Anjali Rameshbabu
- University of Wisconsin-Milwaukee, Department of Psychology, 2441 E. Hartford Ave., Milwaukee, WI, USA
| | - Diane M Reddy
- University of Wisconsin-Milwaukee, Department of Psychology, 2441 E. Hartford Ave., Milwaukee, WI, USA
| | - Katie A Ports
- Virginia Commonwealth University, Department of Social and Behavioral Health, 830 East Main Street, Richmond, VA, USA
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182
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Gainforth HL, Lorencatto F, Erickson K, Baxter K, Owens K, Michie S, West R. Use of dynamic systems methods to characterize dyadic interactions in smoking cessation behavioural support sessions: A feasibility study. Br J Health Psychol 2018; 24:192-214. [PMID: 30489001 DOI: 10.1111/bjhp.12347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 10/24/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding how behaviour change techniques (BCTs) operate in practice requires a method for characterizing the reciprocal, dynamic, and real-time nature of behavioural support interactions between practitioners and clients. State space grids (SSGs) are an observational, dynamic systems methodology used to map the trajectory of dyadic interactions in real time. By mapping the flow of events in terms of practitioner and client actions, SSGs are potentially well suited to characterize behavioural support sessions. PURPOSE To develop reliable methods and examine the feasibility of using the SSG methodology for characterizing practitioners' delivery of and clients' response to BCTs in smoking cessation behavioural support sessions. METHODS Smoking cessation behavioural support sessions were video-recorded and transcribed verbatim (n = 6 recordings; 2,916 statements). All speech was coded independently by two researchers for content and duration using published frameworks for specifying practitioner-delivered and client-received BCTs in smoking cessation interactions. Inter-rater reliability was assessed. Indices of practitioner-client interaction dynamics were derived: (1) reciprocity (i.e., attractor states, content congruence, conditional pairing) and (2) temporal patterning (i.e., variability, inter-grid distance, combinatory micro-patterning, sessional macropatterning). The extent to which indices can describe differences between sessions involving different practitioners and clients was examined. RESULTS Inter-rater reliability was moderate at 72% agreement. Indices of reciprocity and temporal patterning characterized differences between sessions involving different practitioners and clients. CONCLUSIONS State space grids provide a method for characterizing the complexity and variability of practitioner-delivered and client-received BCTs in behavioural support sessions. This method has potential to add explanatory value to smoking cessation intervention outcomes. Statement of Contribution What is already known on this subject? Frameworks exist for characterizing practitioner-delivered and client-received behaviour change techniques (BCTs). Methods are still needed to investigate which BCTs are effective under what conditions. State space grids (SSGs) are a dynamic systems method that may better characterize behavioural support interactions. What does this study add? First reliable, dynamic systems, SSG coding procedures, methods, and measures to characterize behavioural support. A method for examining reciprocality and temporal patterning of BCT delivery and receipt. Establishes a dynamic systems method that adds explanatory value to the outcomes of interventions.
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Affiliation(s)
| | | | - Karl Erickson
- Michigan State University, East Lansing, Michigan, USA
| | - Kristy Baxter
- University of British Columbia, Kelowna, British Columbia, Canada
| | - Kailey Owens
- University of British Columbia, Kelowna, British Columbia, Canada
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183
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Phillips CJ, Wisdom AJ, McKinnon RA, Woodman RJ, Gordon DL. Interventions targeting the prescribing and monitoring of vancomycin for hospitalized patients: a systematic review with meta-analysis. Infect Drug Resist 2018; 11:2081-2094. [PMID: 30464551 PMCID: PMC6219104 DOI: 10.2147/idr.s176519] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Vancomycin prescribing requires individualized dosing and monitoring to ensure efficacy, limit toxicity, and minimize resistance. Although there are nationally endorsed guidelines from several countries addressing the complexities of vancomycin dosing and monitoring, there is limited consideration of how to implement these recommendations effectively. Methods We conducted a systematic search of multiple databases to identify relevant comparative studies describing the impact of interventions of educational meetings, implementation of guidelines, and dissemination of educational material on vancomycin dosing, monitoring, and nephrotoxicity. Effect size was assessed using ORs and pooled data analyzed using forest plots to provide overall effect measures. Results Six studies were included. All studies included educational meetings. Two studies used implementation of guidance, educational meetings, and dissemination of educational materials, one used guidance and educational meetings, one educational meetings and dissemination of educational materials, and two used educational meetings solely. Effect sizes for individual studies were more likely to be significant for multifaceted interventions. In meta-analysis, the overall effect of interventions on outcome measures of vancomycin dosing was OR 2.50 (95% CI 1.29–4.84); P< 0.01. A higher proportion of sampling at steady-state concentration was seen following intervention (OR 1.95, 95% CI 1.26–3.02; P<0.01). Interventions had no effect on appropriate timing of trough sample (OR 2.02, 95% CI 0.72–5.72; P=0.18), attaining target concentration in patients (OR 1.50, 95% CI 0.49–4.63; P=0.48, or nephrotoxicity (OR 0.75, 95% CI 0.42–1.34; P=0.33). Conclusion Multifaceted interventions are effective overall in improving the complex task of dosing vancomycin, as well as some vancomycin-monitoring outcome measures. However, the resulting impact of these interventions on efficacy and toxicity requires further investigation. These findings may be helpful to those charged with designing implementation strategies for vancomycin guidelines or complex prescribing processes in hospitals.
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Affiliation(s)
- Cameron J Phillips
- SA Pharmacy, Flinders Medical Centre, Bedford Park, Adelaide, SA 5042, Australia, .,College of Medicine and Public Health, Flinders University, Adelaide, SA 5000, Australia, .,School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia, .,Infectious Diseases and Immunity, Department of Medicine, Imperial College, London W12 0NN, UK,
| | - Alice J Wisdom
- SA Pharmacy, Lyell McEwin Hospital, Elizabeth Vale, Adelaide, SA 5112, Australia
| | - Ross A McKinnon
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5000, Australia, .,School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia, .,Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA 5000, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, SA 5000, Australia
| | - David L Gordon
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5000, Australia, .,SA Pathology, Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Bedford Park, Adelaide, SA 5042, Australia.,Division of Medicine, Flinders Medical Centre, Bedford Park, Adelaide, SA 5042, Australia
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Finne E, Glausch M, Exner AK, Sauzet O, Stölzel F, Seidel N. Behavior change techniques for increasing physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials. Cancer Manag Res 2018; 10:5125-5143. [PMID: 30464612 PMCID: PMC6215922 DOI: 10.2147/cmar.s170064] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose The purpose of this systematic review and meta-analysis is to investigate how physical activity (PA) can be effectively promoted in cancer survivors. The effect of PA-promoting interventions in general, behavior change techniques (BCTs), and further variables as moderators in particular are evaluated. Methods This study included randomized controlled trials of lifestyle interventions aiming at an increase in PA that can be carried out independently at home, published by December 2016, for adults diagnosed with cancer after completion of the main treatment. Primary outcomes were subjective and objective measures of PA prior to and immediately after the intervention. Meta-analysis and meta-regression were used to estimate effect sizes (ES) in terms of standardized mean differences, variation between ES in terms of heterogeneity indices (I2), and moderator effects in terms of regression coefficients. Results This study included 30 studies containing 45 ES with an overall significant small positive effect size of 0.28 (95% confidence interval=0.18–0.37) on PA, and I2=54.29%. The BCTs Prompts, Reduce prompts, Graded tasks, Non-specific reward, and Social reward were significantly related to larger effects, while Information about health consequences and Information about emotional consequences, as well as Social comparison were related to smaller ES. The number of BCTs per intervention did not predict PA effects. Interventions based on the Theory of Planned Behavior were associated with smaller ES, and interventions with a home-based setting component were associated with larger ES. Neither the duration of the intervention nor the methodological quality explained differences in ES. Conclusion Certain BCTs were associated with an increase of PA in cancer survivors. Interventions relying on BCTs congruent with (social) learning theory such as using prompts and rewards could be especially successful in this target group. However, large parts of between-study heterogeneity in ES remained unexplained. Further primary studies should directly compare specific BCTs and their combinations.
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Affiliation(s)
- Emily Finne
- School of Public Health, Bielefeld University, Bielefeld, Germany,
| | - Melanie Glausch
- University Cancer Center, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | | | - Odile Sauzet
- School of Public Health, Bielefeld University, Bielefeld, Germany, .,Center for Statistics (ZeSt), Bielefeld University, Bielefeld, Germany
| | - Friederike Stölzel
- University Cancer Center, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Nadja Seidel
- University Cancer Center, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
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185
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Caldwell AE, Masters KS, Peters JC, Bryan AD, Grigsby J, Hooker SA, Wyatt HR, Hill JO. Harnessing centred identity transformation to reduce executive function burden for maintenance of health behaviour change: the Maintain IT model. Health Psychol Rev 2018; 12:231-253. [PMID: 29402182 PMCID: PMC6124500 DOI: 10.1080/17437199.2018.1437551] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 02/02/2018] [Indexed: 01/12/2023]
Abstract
The inability to produce sustainable lifestyle modifications (e.g., physical activity, healthy diet) remains a major barrier to reducing morbidity and mortality from prevalent, preventable conditions. The objective of this paper is to present a model that builds on and extends foundational theory and research to suggest novel approaches that may help to produce lasting behaviour change. The model aims to integrate factors not typically examined together in order to elucidate potential processes underlying a shift from behaviour initiation to long-term maintenance. The central premise of the Maintain IT model builds on approaches demonstrating that in-tact executive function (EF) is critical for health behaviour initiation, for more complex behaviours beyond initiation, and in unsupportive environments and circumstances, but successful recruitment of EF is effortful and prone to error. Enduring changes are more likely if the underlying cognitive processes can become less effortful (non-conscious, automatic). The Maintain IT model posits that a centred identity transformation is one path leading to less effortful processing and facilitating successful recruitment of EF when necessary over the long term, increasing the sustainability of health behaviour change. A conceptual overview of the literature supporting the utility of this integrative model, future directions, and anticipated challenges are presented.
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Affiliation(s)
- Ann E. Caldwell
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
| | - Kevin S. Masters
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Psychology, University of Colorado, Denver
| | - John C. Peters
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Medicine, University of Colorado, Anschutz Medical Campus
| | - Angela D. Bryan
- Department of Psychology and Neuroscience, University of Colorado, Boulder
| | - Jim Grigsby
- Department of Psychology, University of Colorado, Denver
- Department of Medicine, University of Colorado, Anschutz Medical Campus
| | | | - Holly R. Wyatt
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Medicine, University of Colorado, Anschutz Medical Campus
| | - James O. Hill
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Medicine, University of Colorado, Anschutz Medical Campus
- Department of Pediatrics, University of Colorado, Anschutz Medical Campus
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186
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McHugh S, Sinnott C, Racine E, Timmons S, Byrne M, Kearney PM. 'Around the edges': using behaviour change techniques to characterise a multilevel implementation strategy for a fall prevention programme. Implement Sci 2018; 13:113. [PMID: 30126418 PMCID: PMC6102850 DOI: 10.1186/s13012-018-0798-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/23/2018] [Indexed: 12/03/2022] Open
Abstract
Background Implementation strategies are needed to ensure that evidence-based healthcare interventions are adopted successfully. However, strategies are generally poorly described and those used in everyday practice are seldom reported formally or fully understood. Characterising the active ingredients of existing strategies is necessary to test and refine implementation. We examined whether an implementation strategy, delivered across multiple settings targeting different stakeholders to support a fall prevention programme, could be characterised using the Behaviour Change Technique (BCT) Taxonomy. Methods Data sources included project plans, promotional material, interviews with a purposive sample of stakeholders involved in the strategy’s design and delivery and observations of staff training and information meetings. Data were analysed using TIDieR to describe the strategy and determine the levels at which it operated (organisational, professional, patient). The BCT Taxonomy identified BCTs which were mapped to intervention functions. Data were coded by three researchers and finalised through consensus. Results We analysed 22 documents, 6 interviews and 4 observation sessions. Overall, 21 out a possible 93 BCTs were identified across the three levels. At an organisational level, identifiable techniques tended to be broadly defined; the most common BCT was restructuring the social environment. While some activities were intended to encourage implementation, they did not have an immediate behavioural target and could not be coded using BCTs. The largest number and variety of BCTs were used at the professional level to target the multidisciplinary teams delivering the programme and professionals referring to the programme. The main BCTs targeting the multidisciplinary team were instruction on how to perform the (assessment) behaviour and demonstration of (assessment) behaviour; the main BCT targeting referrers was adding objects to the environment. At the patient level, few BCTs were used to target attendance. Conclusion In this study, several behaviour change techniques were evident at the individual professional level; however, fewer techniques were identifiable at an organisational level. The BCT Taxonomy was useful for describing components of a multilevel implementation strategy that specifically target behaviour change. To fully and completely describe an implementation strategy, including components that involve organisational or systems level change, other frameworks may be needed. Electronic supplementary material The online version of this article (10.1186/s13012-018-0798-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S McHugh
- School of Public, University College Cork, Cork, Ireland.
| | - C Sinnott
- THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK
| | - E Racine
- School of Public, University College Cork, Cork, Ireland
| | - S Timmons
- Center for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
| | - M Byrne
- Health Behaviour Change Research Group (HBCRG), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - P M Kearney
- School of Public, University College Cork, Cork, Ireland
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187
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Lamminpää R, Vehviläinen-Julkunen K, Schwab U. A systematic review of dietary interventions for gestational weight gain and gestational diabetes in overweight and obese pregnant women. Eur J Nutr 2018; 57:1721-1736. [PMID: 29128995 PMCID: PMC6060815 DOI: 10.1007/s00394-017-1567-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 10/13/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE The number of overweight and obese women is increasing in the obstetric population. The aim of this study was to review studies that reported results related to the efficacy of dietary interventions on gestational weight gain (GWG) or the prevention of gestational diabetes (GDM) in overweight and obese women. METHODS The search was performed using the CINAHL, PubMed, Scopus and Medic electronic databases and limited to the years between 2000 and March 2016. This systematic review includes 15 research articles of which 12 were randomized controlled trials, and three were controlled trials. Three main categories emerged as follows: (1) the types of interventions, (2) the contents of the interventions and (3) the efficacy of the intervention on GWG and the prevention of GDM. The quality of the selected studies was evaluated using the AHRQ Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews. RESULTS Of the selected 15 studies, eight included a specified diet with limited amounts of nutrients or energy, and the others included a dietary component along with other components. Ten studies reported significant differences in the measured outcomes regarding GWG or the prevention of GDM between the intervention and the control groups. CONCLUSIONS This review confirms the variability in the strategies used to deliver dietary interventions in studies aiming to limit GWG and prevent GDM in overweight and obese women. Inconsistency in the provider as well as the content of the dietary interventions leaves the difficulty of summarizing the components of effective dietary interventions.
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Affiliation(s)
- Reeta Lamminpää
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, P.O. BOX 1627, 70211, Kuopio, Finland.
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland and Kuopio University Hospital, 70029, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, 70211, Kuopio, Finland
- Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, 70029, Kuopio, Finland
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188
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McParland JL, Williams L, Gozdzielewska L, Young M, Smith F, MacDonald J, Langdridge D, Davis M, Price L, Flowers P. What are the 'active ingredients' of interventions targeting the public's engagement with antimicrobial resistance and how might they work? Br J Health Psychol 2018; 23:804-819. [PMID: 29804314 PMCID: PMC6175406 DOI: 10.1111/bjhp.12317] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/25/2018] [Indexed: 12/23/2022]
Abstract
Objectives Changing public awareness of antimicrobial resistance (AMR) represents a global public health priority. A systematic review of interventions that targeted public AMR awareness and associated behaviour was previously conducted. Here, we focus on identifying the active content of these interventions and explore potential mechanisms of action. Methods The project took a novel approach to intervention mapping utilizing the following steps: (1) an exploration of explicit and tacit theory and theoretical constructs within the interventions using the Theoretical Domains Framework (TDFv2), (2) retrospective coding of behaviour change techniques (BCTs) using the BCT Taxonomy v1, and (3) an investigation of coherent links between the TDF domains and BCTs across the interventions. Results Of 20 studies included, only four reported an explicit theoretical basis to their intervention. However, TDF analysis revealed that nine of the 14 TDF domains were utilized, most commonly ‘Knowledge’ and ‘Environmental context and resources’. The BCT analysis showed that all interventions contained at least one BCT, and 14 of 93 (15%) BCTs were coded, most commonly ‘Information about health consequences’, ‘Credible source’, and ‘Instruction on how to perform the behaviour’. Conclusions We identified nine relevant TDF domains and 14 BCTs used in these interventions. Only 15% of BCTs have been applied in AMR interventions thus providing a clear opportunity for the development of novel interventions in this context. This methodological approach provides a useful way of retrospectively mapping theoretical constructs and BCTs when reviewing studies that provide limited information on theory and intervention content. Statement of contribution What is already known on this subject? Evidence of the effectiveness of interventions that target the public to engage them with AMR is mixed; the public continue to show poor knowledge and misperceptions of AMR. Little is known about the common, active ingredients of AMR interventions targeting the public and information on explicit theoretical content is sparse. Information on the components of AMR public health interventions is urgently needed to enable the design of effective interventions to engage the public with AMR stewardship behaviour.
What does this study add? The analysis shows very few studies reported any explicit theoretical basis to the interventions they described. Many interventions share common components, including core mechanisms of action and behaviour change techniques. The analysis suggests components of future interventions to engage the public with AMR.
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Affiliation(s)
| | - Lynn Williams
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | | | - Mairi Young
- Institute for Applied Health, Glasgow Caledonian University, UK
| | - Fraser Smith
- Institute for Applied Health, Glasgow Caledonian University, UK
| | | | - Darren Langdridge
- Faculty of Arts and Social Sciences, The Open University, Milton Keynes, UK
| | - Mark Davis
- School of Sciences, Monash University, Melbourne, Victoria, Australia
| | - Lesley Price
- Institute for Applied Health, Glasgow Caledonian University, UK
| | - Paul Flowers
- Institute for Applied Health, Glasgow Caledonian University, UK
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189
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Masters KS. Introduction to the Special Section on Behavior Change Intervention Development: Theories, Methods, and Mechanisms. Ann Behav Med 2018; 52:4994552. [PMID: 29750245 DOI: 10.1093/abm/kay031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This manuscript introduces a special section of Annals of Behavioral Medicine consisting of six independent articles examining the development of theoretically based behavior change interventions as well as consideration of the associated mechanisms of behavior change. The specific behaviors that are the focus of the papers are of lesser importance than the more general information that may be applied in many different settings with various behaviors. Each of the six articles is briefly previewed along with introductory and concluding comments. The special section serves as a foundational discussion of behavior change that will influence ongoing efforts in this important endeavor.
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Affiliation(s)
- Kevin S Masters
- Department of Psychology and Anschutz Health and Wellness Center, University of Colorado, Denver Denver, CO, USA
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190
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Lewis CC, Klasnja P, Powell BJ, Lyon AR, Tuzzio L, Jones S, Walsh-Bailey C, Weiner B. From Classification to Causality: Advancing Understanding of Mechanisms of Change in Implementation Science. Front Public Health 2018; 6:136. [PMID: 29868544 PMCID: PMC5949843 DOI: 10.3389/fpubh.2018.00136] [Citation(s) in RCA: 291] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/20/2018] [Indexed: 11/20/2022] Open
Abstract
Background The science of implementation has offered little toward understanding how different implementation strategies work. To improve outcomes of implementation efforts, the field needs precise, testable theories that describe the causal pathways through which implementation strategies function. In this perspective piece, we describe a four-step approach to developing causal pathway models for implementation strategies. Building causal models First, it is important to ensure that implementation strategies are appropriately specified. Some strategies in published compilations are well defined but may not be specified in terms of its core component that can have a reliable and measureable impact. Second, linkages between strategies and mechanisms need to be generated. Existing compilations do not offer mechanisms by which strategies act, or the processes or events through which an implementation strategy operates to affect desired implementation outcomes. Third, it is critical to identify proximal and distal outcomes the strategy is theorized to impact, with the former being direct, measurable products of the strategy and the latter being one of eight implementation outcomes (1). Finally, articulating effect modifiers, like preconditions and moderators, allow for an understanding of where, when, and why strategies have an effect on outcomes of interest. Future directions We argue for greater precision in use of terms for factors implicated in implementation processes; development of guidelines for selecting research design and study plans that account for practical constructs and allow for the study of mechanisms; psychometrically strong and pragmatic measures of mechanisms; and more robust curation of evidence for knowledge transfer and use.
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Affiliation(s)
- Cara C Lewis
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States.,Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Predrag Klasnja
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Byron J Powell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Leah Tuzzio
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Salene Jones
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Callie Walsh-Bailey
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Bryan Weiner
- Department of Global Health, University of Washington, Seattle, WA, United States
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191
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Shannon S, Brennan D, Hanna D, Younger Z, Hassan J, Breslin G. The Effect of a School-Based Intervention on Physical Activity and Well-Being: a Non-Randomised Controlled Trial with Children of Low Socio-Economic Status. SPORTS MEDICINE - OPEN 2018; 4:16. [PMID: 29679164 PMCID: PMC5910444 DOI: 10.1186/s40798-018-0129-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/09/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Self-determination theory (SDT) has been used to predict children's physical activity and well-being. However, few school-based SDT intervention studies have been conducted, and no research exists with children of low socio-economic status (SES). Therefore, SDT-derived needs-supportive teaching techniques informed the design and analyses of the Healthy Choices Programme (HCP). The aim was to determine if the HCP could enhance moderate-to-vigorous physical activity (MVPA) and well-being among children of low SES through increasing autonomy-support, needs satisfaction and intrinsic motivation. METHOD A mixed factorial two (group) × two (time) wait-list controlled trial was conducted and reported using the TREND guidelines. A total of 155 children (56% females; intervention n = 84, control n = 71) took part and completed measures at baseline (week 0) and post-intervention (week 11). The effect of the intervention on MVPA (model 1) and well-being (model 2) was tested through serial mediation models with three mediators (i.e. autonomy-support, needs satisfaction and intrinsic motivation). RESULTS In comparison to the control group, the intervention was related to increases in MVPA (β = .45) and autonomy-support (β = .17). In model 1, analyses revealed partial mediation of the MVPA change through autonomy-support (β = .14), intrinsic motivation (β = .51) and all three SDT mediators in sequence (total r 2 = .34). In model 2, well-being was indirectly enhanced through autonomy-support (β = .38) and autonomy-support and needs satisfaction in sequence (total r 2 = .21). CONCLUSIONS The HCP enhanced MVPA and well-being by engendering a needs-supportive physical activity environment. The scientific and practical contribution of this study was the application of SDT in all aspects of the HCP intervention's design and analyses. Practitioners may consider integrating SDT principles, as implemented in the HCP, for health promotion. TRIAL REGISTRATION This study is registered on Research Registry (number researchregistry2852 ).
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Affiliation(s)
- Stephen Shannon
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, BT37 OQB, Northern Ireland.
| | - Deirdre Brennan
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, BT37 OQB, Northern Ireland
| | - Donncha Hanna
- School of Psychology, Queen's University Belfast, Belfast, BT9 5BN, Northern Ireland
| | - Zoe Younger
- School of Psychology, Queen's University Belfast, Belfast, BT9 5BN, Northern Ireland
| | - Jessica Hassan
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, BT37 OQB, Northern Ireland
| | - Gavin Breslin
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, BT37 OQB, Northern Ireland
- The Bamford Centre for Mental Health and Well-being, Belfast, BT15 1ED, Northern Ireland
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192
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Michie S, West R, Sheals K, Godinho CA. Evaluating the effectiveness of behavior change techniques in health-related behavior: a scoping review of methods used. Transl Behav Med 2018; 8:212-224. [PMID: 29381786 PMCID: PMC6062857 DOI: 10.1093/tbm/ibx019] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Behavior change interventions typically contain multiple potentially active components: behavior change techniques (BCTs). Identifying which specific BCTs or BCT combinations have the potential to be effective for a given behavior in a given context presents a major challenge. The aim of this study was to review the methods that have been used to identify effective BCTs for given behaviors in given contexts and evaluate their strengths and limitations. A scoping review was conducted of studies that had sought to identify effective BCTs. Articles referring to "behavio(u)r change technique(s)" in the abstract/text were located, and ones that involved identification of effective BCTs were selected. The methods reported were coded. The methods were analyzed in general terms using "PASS" criteria: Practicability (facility to apply the method appropriately), Applicability (facility to generalize from findings to contexts and populations of interest), Sensitivity (facility to identify effective BCTs), and Specificity (facility to rule out ineffective BCTs). A sample of 10% of the studies reviewed was then evaluated using these criteria to assess how far the strengths and limitations identified in principle were borne out in practice. One hundred and thirty-five studies were identified. The methods used in those studies were experimental manipulation of BCTs, observational studies comparing outcomes in the presence or absence of BCTs, meta-analyses of BCT comparisons, meta-regressions evaluating effect sizes with and without specific BCTs, reviews of BCTs found in effective interventions, and meta-classification and regression trees. The limitations of each method meant that only weak conclusions could be drawn regarding the effectiveness of specific BCTs or BCT combinations. Methods for identifying effective BCTs linked to target behavior and context all have important inherent limitations. A strategy needs to be developed that can systematically combine the strengths of the different methods and that can link these constructs in an ontology of behavior change interventions.
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Affiliation(s)
- Susan Michie
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, UK
| | - Robert West
- Department of Behavioural Science and Health, Cancer Research UK Health Behaviour Research Centre, University College London, UK
| | - Kate Sheals
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, UK
| | - Cristina A Godinho
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, UK
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193
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Dale J, Loew J, Nanton V, Grason Smith G. Coproduction of a Theory-Based Digital Resource for Unpaid Carers (The Care Companion): Mixed-Methods Study. JMIR Aging 2018; 1:e1. [PMID: 31518238 PMCID: PMC6716079 DOI: 10.2196/aging.9025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Family and other unpaid carers are crucial to supporting the growing population of older people that are living outside residential care with frailty and comorbidities. The burden associated with caring affects carers' well-being, thus limiting the sustainability of such care. There is a need for accessible, flexible, and responsive interventions that promote carers' coping and resilience, and hence support maintenance of the health, well-being, and independence of the cared-for person. OBJECTIVE This study aimed to coproduce a digital program for carers to promote resilience and coping through supporting effective use of information and other Web-based resources. Its overlapping stages comprised the following: understanding the ways in which Web-based interventions may address challenges faced by carers, identifying target behaviors for the intervention, identifying intervention components, and developing the intervention prototype. METHODS The study was informed by person-based theories of coproduction and involved substantial patient and public involvement. It drew on the Behavior Change Wheel framework to support a systematic focus on behavioral issues relevant to caring. It comprised scoping literature reviews, interviews, and focus groups with carers and organizational stakeholders, and an agile, lean approach to information technology development. Qualitative data were analyzed using a thematic approach. RESULTS Four behavioral challenges were identified: burden of care, lack of knowledge, self-efficacy, and lack of time. Local health and social care services for carers were only being accessed by a minority of carers. Carers appreciated the potential value of Web-based resources but described difficulty identifying reliable information at times of need. Key aspects of behavior change relevant to addressing these challenges were education (increasing knowledge and understanding), enablement (increasing means and reducing barriers for undertaking caring roles), and persuasion (changing beliefs and encouraging action toward active use of the intervention). In collaboration with carers, this was used to define requirements for the program. A resources library was created to link to websites, Web-based guidance, videos, and other material that addressed condition-specific and generic information. Each resource was classified according to a taxonomy itemizing over 30 different subcategories of need under the headings Care Needs (of the cared-for person), General Information and Advice, and Sustaining the Carer. In addition, features such as a journal and mood monitor were incorporated to address other enablement challenges. The need for proactive, personalized prompts emerged; the program regularly prompts the carer to revisit and update their profile, which, together with their previous use of the intervention, drives notifications about resources and actions that may be of value. CONCLUSIONS The person-based approach allowed an in-depth understanding of the biopsychosocial context of caring to inform the production of an engaging, relevant, applicable, and feasible Web-based intervention. User acceptance and feasibility testing is currently underway.
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Affiliation(s)
- Jeremy Dale
- Academic Primary Care Unit, Division of Health Sciences, Warwick Medical School, Coventry, United Kingdom
| | - Joelle Loew
- Academic Primary Care Unit, Division of Health Sciences, Warwick Medical School, Coventry, United Kingdom
| | - Veronica Nanton
- Academic Primary Care Unit, Division of Health Sciences, Warwick Medical School, Coventry, United Kingdom
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194
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Flowers P. Antimicrobial resistance: A biopsychosocial problem requiring innovative interdisciplinary and imaginative interventions. J Infect Prev 2018; 19:195-199. [PMID: 30013625 DOI: 10.1177/1757177418755308] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 12/10/2017] [Indexed: 11/17/2022] Open
Abstract
To date, antimicrobials have been understood through largely biomedical perspectives. There has been a tendency to focus upon the effectiveness of pharmaceuticals within individual bodies. However, the growing threat of antimicrobial resistance demands we reconsider how we think about antimicrobials and their effects. Rather than understanding them primarily within bodies, it is increasingly important to consider their effects between bodies, between species and across environments. We need to reduce the drivers of antimicrobial resistance (AMR) at a global level, focusing on the connections between prescribing in one country and resistance mechanisms in another. We need to engage with the ways antimicrobials within the food chain will impact upon human healthcare. Moreover, we need to realise what happens within the ward will impact upon the environment (through waste water). In the future, imaginative interventions will be required that must make the most of biomedicine but draw equally across a wider range of disciplines (e.g. engineering, ecologists) and include an ever-increasing set of professionals (e.g. nurses, veterinarians and farmers). Such collective action demands a shift to working in new interdisciplinary, inter-professional ways. Mutual respect and understanding is required to enable each perspective to be combined to yield synergistic effects.
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195
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Knittle K, Nurmi J, Crutzen R, Hankonen N, Beattie M, Dombrowski SU. How can interventions increase motivation for physical activity? A systematic review and meta-analysis. Health Psychol Rev 2018; 12:211-230. [DOI: 10.1080/17437199.2018.1435299] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Keegan Knittle
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
| | - Johanna Nurmi
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
- Behavioural Science Group, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Rik Crutzen
- Department of Health Promotion, Maastricht University/CAPHRI, Maastricht, Netherlands
| | - Nelli Hankonen
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences, University of Tampere/Linna, Tampere, Finland
| | - Marguerite Beattie
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
| | - Stephan U Dombrowski
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, UK
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196
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Yeager CM, Benight CC. If we build it, will they come? Issues of engagement with digital health interventions for trauma recovery. Mhealth 2018; 4:37. [PMID: 30363749 PMCID: PMC6182033 DOI: 10.21037/mhealth.2018.08.04] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/17/2018] [Indexed: 12/12/2022] Open
Abstract
Exposure to traumatic events is extremely common with nearly 75% reported to have experienced one or more traumatic events worldwide. A significant number of those exposed will develop posttraumatic stress disorder (PTSD) along with depression, anxiety, and substance use disorders. Globally, trauma-related mental health disorders are the leading cause of global disability burden, and many of these disorders are caused, or worsened, by exposure to wars, natural and human-caused disasters, and other traumatic events. Significant barriers to treatment exist including logistical, geographical, financial, stigma, and other attitudinal challenges. One opportune approach to overcoming these barriers is the provision of mental health interventions via technology that can be readily standardized for wide dissemination of evidence-based care. However, engagement with technology-based interventions is a concern and limited participation and high attrition rates are common. This may be especially true for trauma survivors who often experience symptoms of avoidance and hyperarousal. Engagement is regarded as an essential component of intervention efficacy and has been demonstrated to be associated with more positive clinical outcomes, yet theoretically based research in this area is sparse. This review focuses on the complex issue of engagement with digital health interventions (DHIs). Specifically, we review the conceptualization and measurement of engagement, predictors of engagement, and importantly, the relationship of engagement with intervention effectiveness. Finally, a theoretically based model of engagement is proposed that considers the unique challenges of trauma recovery. This review is not intended to provide a systematic or exhaustive set of recommendations, rather it is intended to highlight the challenges of engagement research including its definition, measurement, and modeling. Future engagement research that includes valid and reliable measures of engagement will enable consistent exploration of engagement predictors that can then inform methods for increasing engagement and, ultimately, intervention effectiveness.
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Affiliation(s)
- Carolyn M. Yeager
- Psychology Department, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA
- Trauma, Health, & Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA
| | - Charles C. Benight
- Psychology Department, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA
- Trauma, Health, & Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA
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Michie S, Thomas J, Johnston M, Aonghusa PM, Shawe-Taylor J, Kelly MP, Deleris LA, Finnerty AN, Marques MM, Norris E, O’Mara-Eves A, West R. The Human Behaviour-Change Project: harnessing the power of artificial intelligence and machine learning for evidence synthesis and interpretation. Implement Sci 2017; 12:121. [PMID: 29047393 PMCID: PMC5648456 DOI: 10.1186/s13012-017-0641-5] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 08/28/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Behaviour change is key to addressing both the challenges facing human health and wellbeing and to promoting the uptake of research findings in health policy and practice. We need to make better use of the vast amount of accumulating evidence from behaviour change intervention (BCI) evaluations and promote the uptake of that evidence into a wide range of contexts. The scale and complexity of the task of synthesising and interpreting this evidence, and increasing evidence timeliness and accessibility, will require increased computer support. The Human Behaviour-Change Project (HBCP) will use Artificial Intelligence and Machine Learning to (i) develop and evaluate a 'Knowledge System' that automatically extracts, synthesises and interprets findings from BCI evaluation reports to generate new insights about behaviour change and improve prediction of intervention effectiveness and (ii) allow users, such as practitioners, policy makers and researchers, to easily and efficiently query the system to get answers to variants of the question 'What works, compared with what, how well, with what exposure, with what behaviours (for how long), for whom, in what settings and why?'. METHODS The HBCP will: a) develop an ontology of BCI evaluations and their reports linking effect sizes for given target behaviours with intervention content and delivery and mechanisms of action, as moderated by exposure, populations and settings; b) develop and train an automated feature extraction system to annotate BCI evaluation reports using this ontology; c) develop and train machine learning and reasoning algorithms to use the annotated BCI evaluation reports to predict effect sizes for particular combinations of behaviours, interventions, populations and settings; d) build user and machine interfaces for interrogating and updating the knowledge base; and e) evaluate all the above in terms of performance and utility. DISCUSSION The HBCP aims to revolutionise our ability to synthesise, interpret and deliver evidence on behaviour change interventions that is up-to-date and tailored to user need and context. This will enhance the usefulness, and support the implementation of, that evidence.
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Affiliation(s)
- Susan Michie
- 0000000121901201grid.83440.3bUCL Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - James Thomas
- 0000000121901201grid.83440.3bEPPI-Centre, Department of Social Science, University College London, London, UK
| | - Marie Johnston
- 0000 0004 1936 7291grid.7107.1Health Psychology, University of Aberdeen, Scotland, UK
| | | | - John Shawe-Taylor
- 0000000121901201grid.83440.3bDepartment of Computer Science, UCL, London, UK
| | - Michael P. Kelly
- 0000000121885934grid.5335.0Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | | | - Ailbhe N. Finnerty
- 0000000121901201grid.83440.3bUCL Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Marta M. Marques
- 0000000121901201grid.83440.3bUCL Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Emma Norris
- 0000000121901201grid.83440.3bUCL Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Alison O’Mara-Eves
- 0000000121901201grid.83440.3bEPPI-Centre, Department of Social Science, University College London, London, UK
| | - Robert West
- 0000000121901201grid.83440.3bDepartment of Epidemiology and Public Health, University College London, London, UK
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Molloy GJ, O'Carroll RE. Medication adherence across the lifespan: Theory, methods, interventions and six grand challenges. Psychol Health 2017; 32:1169-1175. [PMID: 28992794 DOI: 10.1080/08870446.2017.1316850] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- G J Molloy
- a School of Psychology , National University of Ireland Galway , Galway , Ireland.,b Whitaker Institute for Innovation and Societal Change , National University of Ireland Galway , Galway , Ireland
| | - R E O'Carroll
- c Psychology, School of Natural Sciences , University of Stirling , Stirling, FK9 4LA, Scotland , UK
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Kwasnicka D, Vandelanotte C, Rebar A, Gardner B, Short C, Duncan M, Crook D, Hagger MS. Comparing motivational, self-regulatory and habitual processes in a computer-tailored physical activity intervention in hospital employees - protocol for the PATHS randomised controlled trial. BMC Public Health 2017; 17:518. [PMID: 28549476 PMCID: PMC5446723 DOI: 10.1186/s12889-017-4415-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/11/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Most people do not engage in sufficient physical activity to confer health benefits and to reduce risk of chronic disease. Healthcare professionals frequently provide guidance on physical activity, but often do not meet guideline levels of physical activity themselves. The main objective of this study is to develop and test the efficacy of a tailored intervention to increase healthcare professionals' physical activity participation and quality of life, and to reduce work-related stress and absenteeism. This is the first study to compare the additive effects of three forms of a tailored intervention using different techniques from behavioural theory, which differ according to their focus on motivational, self-regulatory and/or habitual processes. METHODS/DESIGN Healthcare professionals (N = 192) will be recruited from four hospitals in Perth, Western Australia, via email lists, leaflets, and posters to participate in the four group randomised controlled trial. Participants will be randomised to one of four conditions: (1) education only (non-tailored information only), (2) education plus intervention components to enhance motivation, (3) education plus components to enhance motivation and self-regulation, and (4) education plus components to enhance motivation, self-regulation and habit formation. All intervention groups will receive a computer-tailored intervention administered via a web-based platform and will receive supporting text-messages containing tailored information, prompts and feedback relevant to each condition. All outcomes will be assessed at baseline, and at 3-month follow-up. The primary outcome assessed in this study is physical activity measured using activity monitors. Secondary outcomes include: quality of life, stress, anxiety, sleep, and absenteeism. Website engagement, retention, preferences and intervention fidelity will also be evaluated as well as potential mediators and moderators of intervention effect. DISCUSSION This is the first study to examine a tailored, technology-supported intervention aiming to increase physical activity in healthcare professionals. The study will evaluate whether including additional theory-based behaviour change techniques aimed at promoting motivation, self-regulation and habit will lead to increased physical activity participation relative to information alone. The online platform developed in this study has potential to deliver efficient, scalable and personally-relevant intervention that can be translated to other occupational settings. TRIAL REGISTRATION Australian New-Zealand Clinical Trial Registry: ACTRN12616000462482, submitted 29/03/2016, prospectively registered 8/04/2016.
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Affiliation(s)
- Dominika Kwasnicka
- Health Psychology & Behavioural Medicine, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Australia
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Corneel Vandelanotte
- Health Psychology & Behavioural Medicine, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Australia.
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia.
| | - Amanda Rebar
- Health Psychology & Behavioural Medicine, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Australia
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Camille Short
- Freemasons Foundation Centre for Men's Health, South Australian Health and Medical Research Institute, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| | - Mitch Duncan
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, School of Medicine & Public Health, The University of Newcastle, Callaghan, Australia
| | - Dawn Crook
- St John of God Subiaco Hospital, Perth, Australia
| | - Martin S Hagger
- Health Psychology & Behavioural Medicine, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Australia
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
- Faculty of Sport and Health Sciences, University of Jyväkylä, Jyväkylä, Finland
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von Lengerke T, Lutze B, Krauth C, Lange K, Theodor Stahmeyer J, Freya Chaberny I. In Reply. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:329. [PMID: 28587711 PMCID: PMC5465847 DOI: 10.3238/arztebl.2017.0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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