Introduction to the Special Issue. Randomized Controlled Trials (RCTs) in Clinical and Community Settings: Challenges, Alternatives, and Supplementary Designs

Typicality of Level Change (TLC) as an Additional Effect Measure to NAP and Tau-U in Single Case Research

Single case research is a viable way to obtain evidence for social and psychological interventions on an individual level. Across single case research studies various analysis strategies are employed, varying from visual analysis to the calculation of effect sizes. To calculate effect sizes in studies with few measurements per time period (<40 data points with a minimum of five data points in each phase), non-parametric indices such as Nonoverlap of All Pairs (NAP) and Tau-U are recommended. However, both indices have restrictions. This article discusses the restrictions of NAP and Tau-U and presents the description, calculation, and benefits of an additional effect size, called the Typicality of Level Change (TLC) index. In comparison to NAP and Tau-U, the TLC index is more aligned to visual analysis, not restricted by a ceiling effect, and does not overcompensate for problematic trends in data. The TLC index is also sensitive to the typicality of an effect. TLC is an important addition to ease the restrictions of current nonoverlap methods when comparing effect sizes between cases and studies.

Drawing causal inferences from randomized controlled trials in psychotherapy research

OBJECTIVE

Randomized control trials (RCTs) have played a critical role in psychotherapy research. This article discusses RCTs in the context of the criteria for drawing causal inferences in psychotherapy and intervention research more generally. The article also highlights underused variations of RCTs and how they not only establish causal relations but also address critical questions that can improve our intervention portfolio and patient care.

CONCLUSION

Random assignment is discussed in terms of what it can and cannot do in relation to drawing conclusions about the effects of interventions. Finally, RCTs are examined in the context of multiple questions that can guide therapy research, improve patient care, and develop treatments that reach people in need of psychological services.

Sexual and Dating Violence Prevention Programs for Male Youth: A Systematic Review of Program Characteristics, Intended Psychosexual Outcomes, and Effectiveness

Sexual and dating violence (SDV) by male youth (≤ 25 years)-including sexual harassment, emotional partner violence, and rape-is a worldwide problem. The goal of this preregistered (PROSPERO, ID: CRD42022281220) systematic review was to map existing SDV prevention programs aimed at male youth, including their characteristics (e.g., content, intensity), intended psychosexual outcomes, and empirically demonstrated effectiveness, guided by the principles of the theory of planned behavior (TPB). We conducted searches in six online databases for published, peer-reviewed quantitative effectiveness studies on multi-session, group focused, and interaction based SDV prevention programs for male youth ending March 2022. After screening of 21,156 hits using PRISMA guidelines, 15 studies on 13 different programs, from four continents were included. Narrative analysis showed, first, broad ranges in program intensity (2-48 h total), and few program curricula included explicit discussion of relevant aspects of the TPB. Second, programs' main intended psychosexual outcomes were to change SDV experiences, or related attitudes, or norms. Third, significant effects were found mostly on longer term behaviors and short-term attitudes. Other theoretical proxies of SDV experiences, such as social norms and perceived behavioral control, were sparsely investigated; thus, program effectiveness on these outcomes remains largely unknown. Assessed with the Cochrane Risk of Bias Tool, moderate to serious risk of bias arose in all studies. We present concrete suggestions for program content, such as explicit attention to victimization and masculinity and discuss best practices for evaluation research, including assessments of program integrity, and examining relevant theoretical proxies of SDV.

Effectiveness of Interventions on Improving Balance in Children and Adolescents With Hearing Impairment: A Systematic Review

Although children and adolescents with hearing impairment are at risks of falls from balance problems, reliable information on effects of interventions are scare. Therefore, the purpose of this review is to systematically summarize studies on the evidence of interventions to improve balance ability in children and adolescents with hearing impairment. A systematic literature search was conducted on five major electronic databases. Studies were included if: 1) interventions or trials focusing on improving balance in children and adolescents with hearing impairment; 2) research targeting children with hearing impairment (samples with a mean age below 18 years); 3) studies were published in English peer-reviewed journals due to language barriers and resource limitations; and 4) study designs were randomized controlled trial or quasi-experiment. A nine-item tool adapted from the Consolidated Standards of Reporting Trials Statement was used to assess the quality of the studies. Through the search strategy, 373 articles were identified, and 15 studies published between 1981 and 2021 met the inclusion criteria. Most of the studies reviewed were categorized as medium or low quality, and only three were identified as high quality. Exercise interventions were adopted in 80% of the included studies, whereas studies that employed music + vibration, motor, and game as the intervention modalities accounted for the remaining 20.0%. The results of this review showed that the included trials with exercise interventions had a positive influence on the balance among children and adolescents with hearing impairment (the post-intervention scores were significantly higher than the pre-intervention or the control group scores). In addition, the interventions with duration of 8–16 weeks were more effective than those with less than 8 weeks. However, due to most of the reviewed studies were of low methodological quality, the trials results analyzed by this systematic review should be interpreted with caution. Further investigations of high-quality studies are therefore needed to prove the effectiveness of interventions on improving balance performance in children and adolescents with hearing impairment.

Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], PROSPERO [308803].

Transparency on Platelet Transfusion in Routine Cancer Care: The Key for Optimal Blood Usage?

INTRODUCTION

In Germany, up to 75% of platelet concentrates (PC) are administered to haematological and oncological patients. Only limited transparency exists on the characteristics of haematological/oncological patients receiving PC transfusions, treatment patterns and guideline adherence in daily clinical routine care. This information would be key for managing platelet supply and optimal platelet usage strategies. This study aimed to analyse data from clinical routine transfusions to fill the aforementioned information gaps and to create an inventory as a blueprint for electronic data capturing systems that allow simplified, recurring analyses.

METHODS

Prospective open-label, single-centre, observational study in a German tertiary teaching haematological/oncological setting. All in-patients who received any transfusion of PCs in routine use over a period of 3 months (03.2015-05.2015) were consecutively included. Except for age (≥18 years), no exclusion criteria were applied. For guideline adherence, the Cross-Sectional Guidelines for Therapy with Blood Components and Plasma Derivatives - amended edition 2020 were used. An inventory blueprint was created through a narrative literature review and the data collected in this study.

RESULTS

Ninety-four patients received 942 PCs. The mean (± SD) age was 54.6 (± 13.9) years, 68% were male and 86% were diagnosed with a haematological disease. Thirteen patients received 42% of all transfused PCs. The mean ± SD number of transfused PC per patient was 10.81 ±9.24. Five (0.5% per transfusion) minor adverse events were documented. Approximately 19% of PCs were not administered according to existing guidelines. The mean transfusion interval was 1.71 ±1.1 days, and the mean increment was 12.62 ±14.7 G/l. The inventory showed which platelet transfusion-specific data should be documented for answering questions in terms of quality, effectiveness and management of PC transfusions.

CONCLUSIONS

Platelet transfusions in a haematological/oncology setting are highly individual in terms of the total number of transfusions and transfusion intervals. The majority of all PC transfusions was given to only a small group of patients. Continuous, structured real-world data collection/evaluation and benchmarking with data from more centres seems essential in determining specific needs in this vulnerable patient group, assessing quality of transfusion practices, determining effectiveness and anticipating future demand for platelets and a sustainable blood supply. So far, not all relevant data are collected routinely. The advancing digitisation of health systems offers opportunities to collect and link data and thus make them more accessible and evaluable.

Preventive interventions for children in organized team sport tackling aggression: Results from the pilot evaluation of "Fairplayer.Sport"

Current reviews revealed that there is a lack of effective programs and valuable effectiveness studies related to prevention of aggressive behavior and fostering of social competence in early adolescents participating in organized team sports (e.g., ball sports, such as soccer). Using a randomized controlled design, the present pilot study presents first results regarding the effectiveness of the preventive intervention program "Fairplayer.Sport" that was implemented with preadolescent soccer players (N = 145 preadolescents; aged 9-14 years; mean = 12.2 years) in organized team sport (13 soccer teams). Results revealed a reduction of aggressive behavior in the intervention groups compared to waiting-control groups (small effect size). This effect remained stable 3 months after program implementation. Implications for planning and implementing preventive intervention programs are discussed.

Effectiveness of a social problem solving training in youth in detention or on probation: An RCT and pre-post community implementation

The effectiveness of a 10-session social problem-solving training (SPST) was evaluated in two independent studies in a juvenile justice (JJ) setting. In both studies, we aimed to examine main intervention effects on social problem-solving skills and recidivism, as well as differential effects as modulated by anger, anger regulation, and single nucleotide polymorphisms in the COMT gene. In Study 1, a randomized controlled trial (RCT), 289 male detainees (M_age= 14.95 years) were randomly assigned to SPST or treatment-as-usual (TAU). In Study 2, a pre-post community implementation, 187 youth (M_age = 16.03 years) on probation were assessed before and after SPST. No significant main effects of SPST on social problem solving or recidivism were shown in either study. With regard to differential effects, among youth in detention,COMT haplotypes predicted intervention effects on state anger. Moreover, independent of SPST, inward anger expression was associated with an increase in state anger from pre- to post and an increase in state anger with a decrease in social problem solving. Among youth on probation, COMT haplotypes predicted social problem-solving skills, and, in turn, an increase in social problem-solving skills decreased the odds of recidivism after SPST. The lack of main effects of SPST may be due to low program integrity in JJ settings. Juveniles' emotional and genetic characteristics might modulate the effectiveness of interventions in JJ settings. We recommend studying large samples to substantiate this observation.

Manifesto for new directions in developmental science

Although developmental science has always been evolving, these times of fast-paced and profound social and scientific changes easily lead to disorienting fragmentation rather than coherent scientific advances. What directions should developmental science pursue to meaningfully address real-world problems that impact human development throughout the lifespan? What conceptual or policy shifts are needed to steer the field in these directions? The present manifesto is proposed by a group of scholars from various disciplines and perspectives within developmental science to spark conversations and action plans in response to these questions. After highlighting four critical content domains that merit concentrated and often urgent research efforts, two issues regarding "how" we do developmental science and "what for" are outlined. This manifesto concludes with five proposals, calling for integrative, inclusive, transdisciplinary, transparent, and actionable developmental science. Specific recommendations, prospects, pitfalls, and challenges to reach this goal are discussed.