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Pedersen ER, Davis JP, Hummer JF, Bouskill K, Buch KD, Shute IM, Fitzke RE, Tran DD, Neighbors C, Saba S. Reducing Alcohol Misuse and Promoting Treatment Initiation Among Veterans Through a Brief Internet-Based Intervention: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e59993. [PMID: 39173142 PMCID: PMC11377908 DOI: 10.2196/59993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/28/2024] [Accepted: 07/27/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Young adult veterans who served after the September 11 attacks on the United States in 2001 (ie, post-9/11) are at heightened risk for experiencing behavioral health distress and disorders including hazardous drinking, posttraumatic stress disorder, and depression. These veterans often face significant barriers to behavioral health treatment, and reaching them through brief mobile phone-based interventions may help reduce drinking and promote treatment engagement. OBJECTIVE Following a successful pilot study, this randomized controlled trial (RCT) aims to further test the efficacy of a brief (ie, single session) mobile phone-delivered personalized normative feedback intervention enhanced with content to promote treatment engagement. METHODS We will conduct an RCT with 800 post-9/11 young adult veterans (aged 18 to 40 years) with potentially hazardous drinking and who have not recently received treatment for any behavioral health problems. Participants will be randomly assigned to the personalized intervention or a control condition with resources for seeking care. The personalized normative feedback module in the intervention focuses on the correction of misperceived norms of peer alcohol use and uses empirically informed approaches to increase motivation to address alcohol use and co-occurring behavioral health problems. Past 30-day drinking, alcohol-related consequences, and treatment-seeking behaviors will be assessed at baseline and 3, 6, 9, and 12 months post intervention. Sex, barriers to care, posttraumatic stress disorder, depression, and severity of alcohol use disorder symptoms will be explored as potential moderators of outcomes. RESULTS We expect recruitment to be completed within 6 months, with data collection taking 12 months for each enrolled participant. Analyses will begin within 3 months of the final data collection point (ie, 12 months follow-up). CONCLUSIONS This RCT will evaluate the efficacy of a novel intervention for non-treatment-seeking veterans who struggle with hazardous drinking and possible co-occurring behavioral health problems. This intervention has the potential to improve veteran health outcomes and overcome significant barriers to treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04244461; https://clinicaltrials.gov/study/NCT04244461. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/59993.
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Affiliation(s)
- Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | | | | | | | - Keegan D Buch
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Ireland M Shute
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Reagan E Fitzke
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Denise D Tran
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Clayton Neighbors
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Shaddy Saba
- Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
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Walsh A, Friedman K, Morrissey BH, Godin S, Morgenstein J, Bryan CJ, Anestis MD, Foley SK, Johnson RL, Baker JC, Bryan A, Betz ME, Wright-Kelly E. Project Safe Guard: Evaluating a Lethal Means Safety Intervention to Reduce Firearm Suicide in the National Guard. Mil Med 2024; 189:510-516. [PMID: 39160836 DOI: 10.1093/milmed/usae172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/04/2024] [Accepted: 04/04/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION The purpose of this paper is to examine a scalable secure firearm storage intervention in the U.S. National Guard (NG) in preventing firearm injury and suicide. A study among firearm-owning members of the Mississippi NG testing Project Safe Guard (PSG), a 10 to 15 min lethal means counseling intervention, found that PSG increased self-reported secure firearm storage practices. Here, we sought to examine a "real world" rollout of a modified PSG program in the NG in which NG members were trained to understand the importance of lethal means safety and to deliver PSG to Guardsmen peers within their units. MATERIALS AND METHODS The PSG team collaborated with the NG to identify 4 states for the rollout; for each state, the NG was responsible for identifying key personnel ("facilitators") who would receive the training. Team members provided in-person training at 5 locations across 4 states (AZ, GA, IA, and NV) from January to April 2023. Attendees were provided with combination trigger locks or cable locks and evaluation instructions. Questionnaires were administered to training attendees via REDCap at pre-training and post-training. We conducted descriptive and comparison statistics of questionnaire data. RESULTS A total of 186 facilitators were trained at 5 in-person training locations across 4 states (AZ, GA, IA, and NV) from January to April 2023; data collection concluded in August 2023. There were 137 pre-training responses (74% pre-survey response rate) and 88 post-training responses (64% response rate from those who took the pre-training survey). Findings demonstrate increases in self-reported knowledge, attitudes, and beliefs regarding firearm injury and suicide and a reported desire to store personal firearms more securely. CONCLUSION The adapted version of PSG shows promise as a relevant and acceptable intervention among Guardsmen to enhance knowledge and attitudes regarding firearm suicide, increase secure firearm storage practices, and normalize conversations about firearm suicide prevention among peers. This intervention seeks to frame firearm suicide prevention within a culture of safety, complementary to the existing prevention methods and training within the NG.
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Affiliation(s)
- Adam Walsh
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Kaitlyn Friedman
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
- Injury and Violence Prevention Center, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Brooke Heintz Morrissey
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Shira Godin
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Joshua Morgenstein
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, NJ 08854, USA
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - S Kat Foley
- Injury and Violence Prevention Center, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Justin C Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - AnnaBelle Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
- Injury and Violence Prevention Center, Colorado School of Public Health, Aurora, CO 80045, USA
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO 80045, USA
| | - Erin Wright-Kelly
- Injury and Violence Prevention Center, Colorado School of Public Health, Aurora, CO 80045, USA
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO 80045, USA
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Valjanow A, Weis J. One-to-one peer-coaching for patients with cancer - results of a pilot study. J Cancer Res Clin Oncol 2024; 150:385. [PMID: 39110146 PMCID: PMC11306543 DOI: 10.1007/s00432-024-05913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE Cancer is a life threatening disease with negative impact on quality of life and psychological well-being. In international studies, one-to-one peer support and counseling have been shown to improve the psychological well-being of cancer patients. In the study presented, we developed and evaluated an innovative program of peer-coaching. In this program at the University Hospital of Freiburg, cancer survivors were trained to support peers by sharing experience. METHODS In the project, N = 25 cancer survivors were trained to conduct supportive one-to-one conversations with acute patients or patients in aftercare. Based on a prospective observational study, patients were interviewed using questionnaires before and after the conversations. We assessed expectations and experiences with the peer-coaching as well as psychosocial parameters (PHQ9, GAD7, SSUK, NCCN-distress thermometer). RESULTS A total of 52 patients had at least one contact with a peer-coach. Most of the patients attended 1-3 sessions. In total, 85 contacts pairing peer-coaches with patients were conducted. Patients showed on average a high level of distress but a low rate of psychiatric comorbidity. The supportive conversations met the patients` needs. Sharing experiences and empowerment were the most relevant benefits for the patients. Both patients and trained peers showed high satisfaction levels with the program. CONCLUSION Our findings support the feasibility and utility of a peer-coaching program in which trained cancer survivors, acting as peer-coaches, support other patients during or after their oncological treatment. In a further study, the efficacy of peer-coaching should be investigated based on a randomized-controlled trial. TRIAL REGISTRATION The trial was registered in the German Clinical Trials Register (No. DRKS DRKS00017500) on 12.12.2019.
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Affiliation(s)
- Alice Valjanow
- Comprehensive-Cancer Centre Freiburg (CCCF), Department of Self-Help Research University Clinic, Medical Faculty of the Albert-Ludwigs University, Hugstetterstr. 49, Freiburg, 79106, Germany
| | - Joachim Weis
- Comprehensive-Cancer Centre Freiburg (CCCF), Department of Self-Help Research University Clinic, Medical Faculty of the Albert-Ludwigs University, Hugstetterstr. 49, Freiburg, 79106, Germany.
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Aizpurua-Perez I, Arregi A, Gonzalez D, Urruticoechea A, Labaka A, Minguez-Alcaide X, Ugartemendia G, Pascual-Sagastizabal E, Echeverria R, Perez-Tejada J. A randomized controlled trial of the effectiveness of a one-to-one peer support intervention on resilience, social support, and salivary cortisol in recently diagnosed women with breast cancer. Eur J Oncol Nurs 2024; 71:102616. [PMID: 38885598 DOI: 10.1016/j.ejon.2024.102616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Peer support has been suggested as a way to help women diagnosed with breast cancer to better cope with their situation, but studies on its effectiveness have conflicting results. This randomized controlled trial aimed to study the effectiveness of a one-to-one peer support intervention on psychological resilience, social support, and salivary cortisol among breast cancer patients. METHODS The sample consisted of 121 newly diagnosed women at Onkologikoa Hospital. Patients who were prescribed chemotherapy were randomly assigned to Intervention Group 1 (IG1) or Control Group 1 (CG1). Similarly, those prescribed adjuvant radiotherapy were assigned to IG2 or CG2. Women in IG1 received 8 biweekly social support sessions from volunteer survivors who had successfully overcome breast cancer, while IG2 received 6 biweekly sessions. CG1 and CG2 only received standard care. Resilience, social support, and salivary cortisol were assessed at baseline (T1) and at the end of the intervention (T2). RESULTS We found a non-significant, yet a small to moderate size increase in resilience from T1 to T2 in IG1 (p = 0.246; dDc = 0.47). Upon regression analysis, we observed that this increase was determined by changes in cortisol (β = -0.658, p = 00.010), affective support (β = -0.997, p = 00.014), and emotional support (β = 0.935, p = 00.008). We also found a significant decrease in resilience levels in CG2 from T1 to T2 (p = 0.003; dDc = 0.88). CONCLUSION The present study suggests that peer support can exert a protective psychological influence on women diagnosed with breast cancer, and further indicates an exciting avenue for future intervention development in the breast cancer care continuum. TRIAL REGISTRATION ClinicalTrials.gov NCT05077371.
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Affiliation(s)
- Ibane Aizpurua-Perez
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
| | - Amaia Arregi
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
| | | | | | - Ainitze Labaka
- Department of Nursing II, University of the Basque Country, San Sebastian, Spain.
| | - Xavier Minguez-Alcaide
- Department of Social Psychology, University of the Basque Country, San Sebastian, Spain.
| | | | - Eider Pascual-Sagastizabal
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
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Percy C, Turner A, Orr C. Developing a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome: Mixed Methods Study With Patients and Health Care Professionals. JMIR Form Res 2024; 8:e52427. [PMID: 38451567 PMCID: PMC10958350 DOI: 10.2196/52427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/18/2023] [Accepted: 01/10/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) represents a significant global health burden requiring urgent attention. This common chronic endocrine and cardiometabolic condition affects around 1 in 10 women and individuals assigned female at birth, with significant adverse effects on well-being, quality of life, and mental health, as well as serious and complex long-term health consequences. International guidelines for best health care practice recommend the provision of comprehensive cognitive behavioral interventions to support self-management and improve health outcomes for those living with PCOS. Web-based health interventions have the potential to meet this need in an accessible and scalable way. OBJECTIVE We aim to identify barriers to self-management and psychological well-being in women with PCOS and adapt a web-based self-management program to provide a prototype digital support intervention for them. METHODS We adapted an existing support program (HOPE) for PCOS using the antecedent target measure approach. We conducted qualitative interviews with 13 adult women living with PCOS, 3 trustees of a patients with PCOS advocacy charity, and 4 endocrinologists to identify "antecedents" (barriers) to self-management and psychological well-being. Framework analysis was used to identify potentially modifiable antecedents to be targeted by the novel intervention. At a national conference, 58 key stakeholders (patients and health professionals) voted for the antecedents they felt were most important to address. We used research evidence and relevant theory to design a prototype for the PCOS intervention. RESULTS Voting identified 32 potentially modifiable antecedents, relating to knowledge, understanding, emotions, motivation, and behaviors, as priorities to be targeted in the new intervention. A modular, web-based prototype HOPE PCOS intervention was developed to address these, covering six broad topic areas (instilling HOPE for PCOS; managing the stress of PCOS; feeding your mind and body well; body image, intimacy, and close relationships; staying healthy with PCOS; and keeping PCOS in its place). CONCLUSIONS We identified barriers to self-management and psychological well-being in women with PCOS and used these to adapt a web-based self-management program, tailoring it for PCOS, which is a comprehensive group intervention combining education, empowerment, lifestyle management, peer support with cognitive behavioral tools, and goal-setting (to be delivered by peers or codelivered with health care professionals). The modular structure offers flexibility to adapt the program further as new clinical recommendations emerge. The intervention has the potential to be delivered, evaluated for feasibility, and, if effective, integrated into health care services. Self-management interventions are not designed to replace clinical care; rather, they serve as an additional source of support. The HOPE PCOS program conveys this message in its content and activities. Future research should evaluate the prototype intervention using primary outcomes such as measures of psychological well-being, self-management self-efficacy, depression, anxiety, and PCOS-related quality of life. They should also assess the intervention's acceptability, scalability, and cost-effectiveness.
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Affiliation(s)
- Carol Percy
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Andrew Turner
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Charys Orr
- Harris Church of England Academy, Diocese of Coventry Multi Academy Trust, Coventry, United Kingdom
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Joosten MMH, Maurice-Stam H, van Gorp M, Beek LR, Stremler-van Holten D, Scholten L, Grootenhuis MA. Efficacy of Op Koers Online, an online group intervention for parents of children with cancer: Results of a randomized controlled trial. Psychooncology 2024; 33:e6284. [PMID: 38282215 DOI: 10.1002/pon.6284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/29/2023] [Accepted: 12/19/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Parents of children with cancer are at risk for developing psychosocial problems. The present study aims to evaluate the effect of an online group intervention (Op Koers Online, in English: On Track Online) on psychosocial wellbeing and coping skills. METHODS Parents of a child with cancer (diagnosis <5 years ago) participated in a randomized controlled trial. In six consecutive (and one booster-) protocolled sessions in an online chatroom, trained psychologists and social workers taught coping skills using cognitive behavioral and acceptance and commitment techniques. Questionnaires assessed anxiety, depression, distress, situation-specific emotional reactions and coping skills (Op Koers Questionnaire/Cognitive Coping Strategies Scale Parent Form) and evaluated the intervention. Linear mixed-model analyses were performed to detect differences between the conditions in changes over time; T0-T1 and T0-T2 (6-week and 6-month follow-up), and to detect changes in scores T2-T3 (12-month follow-up) for the intervention group only. RESULTS 89 parents were included in analyses (mean age 41.9 years, 86% female, 62%/38% post/during treatment of their child). Beneficial intervention effects (p < 0.05) were found at T1 for anxiety, depression, distress, loneliness and relaxation, and at T2 for anxiety, uncertainty and relaxation. In the intervention condition, scores did not change from T2 to T3, except loneliness that decreased and relaxation that improved. All effect sizes were small to medium (β = -0.21 to 0.46). Parents were generally positive about the intervention. CONCLUSIONS Op Koers Online for parents of children with cancer has a positive effect on psychosocial wellbeing and the coping skill relaxation. Implementation is recommended to prevent psychosocial problems. CLINICAL TRIAL REGISTRATION Dutch Trial Register https://onderzoekmetmensen.nl/en NL73763.041.20.
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Affiliation(s)
- M M H Joosten
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - M van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - L R Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - L Scholten
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Kruger S, Deacon E, van Rensburg E, Segal D. Identification of psychological constructs for a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes. Front Psychol 2023; 14:1273586. [PMID: 37901094 PMCID: PMC10603242 DOI: 10.3389/fpsyg.2023.1273586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023] Open
Abstract
Aim Adolescents have been identified as the group who struggle most with successful adjustment to closed loop technology. This study aims to identify the psychological constructs that should form part of a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes. Method Qualitative document analysis was employed to integrate findings from two documents: a published ongoing intervention study and a recent phenomenological study by the authors. Reflexive thematic analysis was used to identify themes from the documents. Findings The following themes were identified as important psychological constructs that aid adjustment: the importance of knowledge and education; the process of positive adjustment to closed loop technology; a positive outlook; and building a relationship with diabetes. Conclusion Interventions are needed to assist adolescents in their adjustment to closed loop technology. The psychological constructs identified served as a starting point in designing an effective, evidence-based intervention grounded in data and theory. Knowledge and education, responsibility, identity, positive affect, gratitude, support, and trust are psychological constructs that need to be included in an intervention program.
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Affiliation(s)
- Sylvia Kruger
- Department of Psychosocial Health, North-West University, Potchefstroom, South Africa
| | - Elmari Deacon
- Optentia Research Focus Area, North-West University, Vaal Triangle Campus, Vanderbijlpark, South Africa
| | - Esmé van Rensburg
- Department of Psychosocial Health, North-West University, Potchefstroom, South Africa
| | - David Segal
- Optentia Research Focus Area, North-West University, Vaal Triangle Campus, Vanderbijlpark, South Africa
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Zhao M, Liu D, Gao MZ, Zhang MJ, Ma GY, Ding SR, Luo L, Gu RY, Zhang XL, Li Z. Investigation on psychological status of patients with cervical precancerous lesions and cancer among Han and Ethnic minority in Yunnan Province of China. Prev Med Rep 2023; 34:102273. [PMID: 37387727 PMCID: PMC10302125 DOI: 10.1016/j.pmedr.2023.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 07/01/2023] Open
Abstract
Objective The aim of this study was to explore the correlation and difference of influencing factors by analyzing the psychological status of patients with cervical precancerous lesions and cancer in Han and Ethnic minorities. So as to provide evidence for more targeted psychological intervention for categories types of patients. Methods The Chinese version of Kessler 10 scale was used to investigate 200 Han Chinese patients with cervical lesions and 100 ethnic minority patients with cervical lesions in Yunnan Cancer Center. Statistical analysis was performed using t-test, analysis of variance, and multivariable linear regression. Results There was no significant difference in the distribution of demographic characteristics between the two groups (P > 0.05).The results of univariate analysis showed that the impression of K10 score was statistically significant among the following factors: educational level, awareness of HPV vaccine, disease screening status, employee medical insurance, economic burden of disease, cancerous or not, pathological type, treatment modalities, marital status, and family genetic history of tumor (P < 0.05). After multivariate analysis and considering the influence of the number of independent variables, it indicates that the economic burden of the disease, occupation, and family genetic history of tumor had a greater impact on the total score of Han patients among many factors, accounting for a total of 8.1%(Adj R2 = 0.081).Treatment modalities had the greatest effect on the scores of ethnic minority patients, accounting for 8.4%(Adj R2 = 0.084). Conclusion The factors affecting the psychological status of patients between the two groups have similarities and differences. Multifactorial analysis showed that the main factors affecting the psychology of Han patients were: economic burden caused by the disease, occupation, and family genetic history of tumor; while the main factors affecting the psychology of minority patients were: treatment modalities. Therefore, targeted recommendations and policy measures can be proposed respectively.
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Affiliation(s)
- Min Zhao
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Dan Liu
- Department of Social Medicine and Health Management, College of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Ming-Zhu Gao
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Meng-jiao Zhang
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Guo-yu Ma
- Yunnan Cancer Center Office, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Song-rui Ding
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Lei Luo
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Rong-yan Gu
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Xing-Long Zhang
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
| | - Zheng Li
- Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), 519 Kun Zhou Road, Xi Shan County, Kunming 650118, Yunnan, China
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Gobbo ELS, Hanson C, Abunnaja KSS, van Wees SH. Do peer-based education interventions effectively improve vaccination acceptance? a systematic review. BMC Public Health 2023; 23:1354. [PMID: 37452295 PMCID: PMC10349425 DOI: 10.1186/s12889-023-16294-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Vaccination efforts are a vital part of controlling the spread of diseases, however, lack of vaccine acceptance undermines the efficacy of this public health effort. Current evidence suggests that the most effective interventions to support vaccination uptake and positive vaccination beliefs are multicomponent, and dialogue based. Peer-based education interventions are such a strategy that involves an individual within the same group to act as the vaccine educator. OBJECTIVE This review aims to consolidate the quantitative evidence surrounding the effectiveness and experience of peer-based education initiatives to improve vaccination beliefs and behaviors. METHODS We conducted a systematic search of PubMed, Web of Science, and a hand reference search. The search was conducted between April and June 2022. The inclusion criteria encompassed using peers, being education based, and being an intervention that addresses vaccination beliefs and behaviors (e.g. vaccination uptake). RESULTS Systematic screening revealed 16 articles in the final review. Half of the studies focused on students as their study population. The human papillomavirus vaccine was the most common vaccine assessed in the studies, followed by COVID and influenza vaccines. 11 out of 16 of the articles reported a positive impact of the peer intervention and two studies had mixed results. Six studies suggest a mixed peer- healthcare expert approach. CONCLUSIONS Despite reported positive effects of using peer-education based initiatives to improve vaccine uptake and beliefs, this systematic review reveals that there is limited existing research in support of this strategy. The strategies that initially appear the most effect are those with a combined peer and health-expert approach, and those that have more group specific and long-term peer interventions. More research is needed to confirm these results and to assess the effectiveness of a peer-based education intervention in a wider variety of settings and for other vaccine types.
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Affiliation(s)
- Elisa L. S. Gobbo
- Department of Global Public Health, Karolinska Institutet, Solna, 171 65 Sweden
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Solna, 171 65 Sweden
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Guo J, Liu X, Huang N, Yang F, Bai Y, Zhang B, Lodder P. School-based Psychosocial interventions on mental health among Chinese rural children with traumatic experiences: a protocol using cluster randomized controlled trial. BMC Psychol 2023; 11:148. [PMID: 37143099 PMCID: PMC10157979 DOI: 10.1186/s40359-023-01182-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The first aim of this study is to test the effectiveness of school-based psychosocial interventions for improving mental health in rural Chinese children with traumatic experiences. The second aim is to examine which individual, family and school related factors could explain the effectiveness of school-based psychosocial interventions. Third, we will investigate whether individual, family, and school related conditions play a moderator role on the effectiveness of school-based psychosocial interventions. METHODS This study will conduct a cluster randomized controlled trial (RCT) in a large sample of Chinese rural children. Four rural counties in Shandong (Central China), Henan (Central China), Inner Mongolia (Northern China), and Xinjiang (Western China) will be selected as study settings from which schools will be sampled. Each sampled school will be randomly allocated either the intervention groups or a control group. Randomization will be performed by the research member who is not involved in the intervention stage. In each school students in grade 5 or higher will be recruited to ensure that approximately 50 children aged 10 to 18 years will be included. In each county, one high school, one middle school, and one primary school will be randomly chosen as the intervention group, and the other three similar schools will be chosen as control (waiting list) groups. A standardized and uniform research protocol will be applied in all intervention schools. All school social workers and psychological teachers would receive one week of in-person training following procedures. School-based psychosocial interventions included 14 group sessions for 14 consecutive weeks. DISCUSSION This study would develop school-based mental health promotion policy recommendations to improve Chinese rural children's mental health. This study can provide solid evidence for the promotion of school-based intervention in general. TRIAL REGISTRATION ChiCTR2300069405, Registered on 15 March 2023.
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Affiliation(s)
- Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China.
| | - Xiaohan Liu
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Ning Huang
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Fan Yang
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Yashuang Bai
- Department of Health Policy and Management, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, P. R. China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Paul Lodder
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
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11
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Ochoa-Arnedo C, Arizu-Onassis A, Medina JC, Flix-Valle A, Ciria-Suarez L, Gómez-Fernández D, Souto-Sampera A, Brao I, Palmero R, Nadal E, González-Barboteo J, Serra-Blasco M. An eHealth ecosystem for stepped and early psychosocial care in advanced lung cancer: Rationale and protocol for a randomized control trial. Internet Interv 2023. [DOI: 10.1016/j.invent.2023.100620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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12
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Mercier JM, Hosseiny F, Rodrigues S, Friio A, Brémault-Phillips S, Shields DM, Dupuis G. Peer Support Activities for Veterans, Serving Members, and Their Families: Results of a Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3628. [PMID: 36834328 PMCID: PMC9964749 DOI: 10.3390/ijerph20043628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
For many, including military veterans and their families, support between individuals with shared lived experiences, or peer support, has long been utilized as a way to support each other through many different challenges. Building on other reviews and guided by the seven domains of well-being in the Canadian veteran well-being framework, the objective of this paper is to describe and catalogue the nature of peer support activities and related outcomes in the veteran, serving member, and family member populations. A scoping review following the five stages outlined by Arksey and O'Malley was conducted; it was guided by the question: What is currently known about peer support activities for veterans, serving members, and their families that has been evaluated in the literature? In total, 101 publications from 6 different countries were included in this review and catalogued based on publication characteristics, participant information, peer support activity information, and peer information. Peer support activities have the potential to positively influence the well-being of veterans, serving members, and their families on a holistic level across multiple domains. This scoping review highlights the existing gaps in the literature and provides an important foundation for future research on peer support for these populations, specifically in the Canadian context.
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Affiliation(s)
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Ottawa, ON K1Z 7K4, Canada
| | - Sara Rodrigues
- Atlas Institute for Veterans and Families, Ottawa, ON K1Z 7K4, Canada
| | - Anthony Friio
- National Police Federation, Ottawa, ON K2P 1P1, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Duncan M. Shields
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Gabrielle Dupuis
- Atlas Institute for Veterans and Families, Ottawa, ON K1Z 7K4, Canada
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13
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Sevelius JM, Castro DA, Warri V, Moreta Avila L, Chakravarty D, Zamudio-Haas S, Kramer K, Monico Klein K, Zack B. Adapting and Implementing an Evidence-Based Reentry Intervention for Incarcerated Transgender Women: Lessons Learned. JOURNAL OF CORRECTIONAL HEALTH CARE 2023; 29:71-80. [PMID: 36595355 PMCID: PMC10162574 DOI: 10.1089/jchc.21.12.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Incarceration is a significant public health issue that disproportionately impacts transgender (trans) women, particularly those of color. The cycle of incarceration interacts with high levels of substance use, mental illness, and HIV to produce a high disease burden among trans women, but, to date, there are no published studies of trans-specific reentry support interventions. Informed by the Model of Gender Affirmation, we systematically adapted and pilot tested the evidence-based Project START intervention to create Girlfriends Connect (GC), a reentry support intervention for trans women incarcerated in a county jail. Qualitative interviews with trans women (10 prerelease and 6 postrelease) and community social service providers and jail staff (n = 7) who serve justice-involved transgender women, as well as input from a community advisory board, informed our adaptation. We then conducted a pilot randomized controlled trial (n = 14) and a service implementation project (n = 16) of GC to examine its feasibility and acceptability. Lessons learned include the importance of peer facilitators, facilitated referral to gender-affirming community resources, and obtaining programmatic buy-in from jail staff and administration. Results indicate that GC is feasible and acceptable, and holds promise in improving the health of transgender women reentering the community after a period of incarceration.
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Affiliation(s)
- Jae M. Sevelius
- Center of Excellence for Transgender Health, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Danielle A. Castro
- Center of Excellence for Transgender Health, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Vanessa Warri
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | | | - Deepalika Chakravarty
- Center of Excellence for Transgender Health, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Sophia Zamudio-Haas
- Center of Excellence for Transgender Health, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | - Kate Monico Klein
- Jail Health Services, San Francisco Department of Public Health, San Francisco, California, USA
| | - Barry Zack
- The Bridging Group, Oakland, California, USA
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14
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Richard BO, Abadi MH, Drake CD, Rychener D, Bauer R. "A reinstilled hope that they can change": Facilitator perspectives on a self-care and health promotion peer group program for veterans. Front Public Health 2023; 10:968281. [PMID: 36684905 PMCID: PMC9851664 DOI: 10.3389/fpubh.2022.968281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/21/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction This study assessed the relevance, value, and effectiveness of "Taking Charge of My Life and Health" (TCMLH), a patient wellbeing peer group program for U.S. veterans focused on empowering them to identify what really matters in their lives and to work toward health goals that align with their mission, aspirations, or purpose in life. The potential of TCMLH to empower veterans to engage in self-care behaviors, make health behavior changes, and participate in health care decision making is important, as veterans are more likely than the general population to suffer from multiple chronic conditions that require ongoing self-management. Methods We conducted individual semi-structured interviews with 19 TCMLH facilitators serving in eight U.S. Veteran's Health Administration medical centers. Data were analyzed using an inductive approach to identify salient themes in facilitators' experiences. Results Facilitators reported that TCMLH participants demonstrated positive attitude changes (e.g., greater confidence and hope) and behavior changes (e.g., making healthcare appointments and implementing self-care practices) by program completion. Further, findings show that mindful awareness practices, the peer group setting, Whole Health assessment tools, and goal setting tools were perceived as the most impactful program elements leading to positive health behavior change. Conclusion Overall, findings suggest that this non-clinical peer group program can enhance patient wellbeing, and that there are certain program elements of TCMLH that are driving key attitudinal and behavioral changes.
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Affiliation(s)
- Bonnie O. Richard
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
| | - Melissa H. Abadi
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
| | - Connor D. Drake
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - David Rychener
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
| | - Rachel Bauer
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
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15
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Aterman S, Ghahari S, Kessler D. Characteristics of peer-based interventions for individuals with neurological conditions: a scoping review. Disabil Rehabil 2023; 45:344-375. [PMID: 35085058 DOI: 10.1080/09638288.2022.2028911] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE Peer-based interventions are increasingly popular and cost-effective therapeutic opportunities to support others experiencing similar life circumstances. However, little is known about the similarities and differences among peer-based interventions and their outcomes for people with neurological conditions. This scoping review aims to describe and compare the characteristics of existing peer-based interventions for adults with common neurological conditions. MATERIALS AND METHODS We searched MEDLINE, CINAHL, PsychInfo, and Embase for research on peer-based interventions for individuals with brain injury, Parkinson's, multiple sclerosis, spinal cord injury, and stroke up to June 2019. The search was updated in March 2021. Fifty-three of 2472 articles found were included. RESULTS Characteristics of peer-based intervention for this population vary significantly. They include individual and group-based formats delivered in-person, by telephone, or online. Content varied from structured education to tailored approaches. Participant outcomes included improved health, confidence, and self-management skills; however, these varied based on the intervention model. CONCLUSION Various peer-based interventions exist, each with its own definition of what it means to be a peer. Research using rigorous methodology is needed to determine the most effective interventions. Clear definitions of each program component are needed to better understand the outcomes and mechanism of action within each intervention.IMPLICATIONS FOR REHABILITATIONRehabilitation services can draw on various peer support interventions to add experiential knowledge and support based on shared experience to enhance outcomes.Fulfilling the role of peer mentor may be beneficial and could be encouraged as part of the rehabilitation process for people with SCI, TBI, Stroke, PD, or MS.In planning peer-based interventions for TBI, Stroke, SCI, PD, and MS populations, it is important to clearly define intervention components and evaluate outcomes to measure the impact of the intervention.
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Affiliation(s)
- Sarah Aterman
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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16
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van Erp LME, Maurice-Stam H, Beek LR, Kremer LCM, den Hartogh JG, van Gorp M, Huizinga GA, Grootenhuis MA. Online cognitive-behavioral group intervention for young adult survivors of childhood cancer: a pilot study. J Psychosoc Oncol 2022; 41:518-538. [PMID: 36537338 DOI: 10.1080/07347332.2022.2150110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Young adult childhood cancer survivors (YACCS) are a vulnerable group in need of psychosocial support, but tailored interventions are lacking. AIM To examine feasibility and satisfaction, and to explore preliminary effectiveness of an online group intervention (Op Koers Online for YACCS) aimed at teaching active coping skills and providing peer-contact, thereby reducing and preventing psychosocial problems in YACCS. The intervention is based on psycho-education, cognitive behavioral therapy, and aspects of acceptance and commitment therapy. METHODS YACCS completed questionnaires pre- and post-intervention. Feasibility was based on attendance, drop-out, and an evaluation questionnaire was administered to assess satisfaction. Preliminary effectiveness was evaluated with the Mastery Scale, Illness Cognition Questionnaire, Distress Thermometer, Impact of Cancer - Childhood Survivors, and Pediatric Quality of Life Inventory. Preliminary effectiveness was investigated by testing differences on the psychosocial outcomes (coping and psychosocial wellbeing) between T0 and T1 within respondents, using paired samples t tests and Cohen's d. RESULTS 10 YACCS participated in the intervention and completed all questionnaires. There was no drop-out; 90% of participants attended five out of six sessions. Overall, participants were satisfied with the intervention; 7.6 on a 0-10 scale. Distress (Cohen's d=-.6, p=.030) and feelings of helplessness (Cohen's d=-.8, p=.001) reduced from T0 to T1, while self-efficacy (Cohen's d=.8, p=.013,) improved. Other outcomes displayed small effects, but did not change significantly. CONCLUSIONS This first, small pilot study showed short-term decrease in distress and feelings of helplessness and improvement of self-efficacy. Op Koers Online was positively evaluated by YACCS and course leaders, filling a gap in psychosocial services for YACCS.
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Affiliation(s)
- Loes M E van Erp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Laura R Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap G den Hartogh
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Vereniging Kinderkanker Nederland, De Bilt, The Netherlands
| | - Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Gea A Huizinga
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Beatrix Children's Hospital, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
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17
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Skin Cancer Behavioral Risk Factors and Screening Among U.S. Adults in Same-Sex Relationships: A Population-Based Study from 2000 to 2015. LGBT Health 2022; 10:331-337. [DOI: 10.1089/lgbt.2022.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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18
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Amuthan R, Curtis AB. From background to solutions: Eliminating sex gaps in clinical electrophysiology practice. Heart Rhythm O2 2022; 3:817-826. [PMID: 36588992 PMCID: PMC9795315 DOI: 10.1016/j.hroo.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Sex, a biological construct, and gender, a sociocultural construct, both influence the epidemiology and outcomes of various cardiac arrhythmias, leading to disparities that have been observed in clinical practice. Addressing disparities is crucial to improve the quality of clinical care. We recognize gender equality as the ultimate goal to ensuring equitable health care and propose the following strategies to achieve the goal: sex- and gender-stratified research, quality improvement initiatives, implicit bias training, promotion of women into leadership positions in cardiology, peer support, and shared decision-making to help mitigate disparities. However, further research on how to improve the widespread adoption and implementation of such strategies in the clinical setting is required.
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Affiliation(s)
- Ram Amuthan
- Department of Medicine, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Anne B. Curtis
- Department of Medicine, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York
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Burns EJ, Hargreaves SC, Ure C, Hare S, Coffey M, Hidajat M, Audrey S, de Vocht F, Ardern K, Cook PA. 'A priori' external contextual factors and relationships with process indicators: a mixed methods study of the pre-implementation phase of 'Communities in Charge of Alcohol'. BMC Public Health 2022; 22:2224. [PMID: 36447172 PMCID: PMC9708132 DOI: 10.1186/s12889-022-14411-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/20/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND It is widely recognised that complex public health interventions roll out in distinct phases, within which external contextual factors influence implementation. Less is known about relationships with external contextual factors identified a priori in the pre-implementation phase. We investigated which external contextual factors, prior to the implementation of a community-centred approach to reducing alcohol harm called 'Communities in Charge of Alcohol' (CICA), were related to one of the process indicators: numbers of Alcohol Health Champions (AHCs) trained. METHODS A mixed methods design was used in the pre-implementation phase of CICA. We studied ten geographic communities experiencing both high levels of deprivation and alcohol-related harm in the North West of England. Qualitative secondary data were extracted from pre-implementation meeting notes, recorded two to three months before roll-out. Items were coded into 12 content categories using content analysis. To create a baseline 'infrastructure score', the number of external contextual factors documented was counted per area to a maximum score of 12. Descriptive data were collected from training registers detailing training numbers in the first 12 months. The relationship between the baseline infrastructure score, external contextual factors, and the number of AHCs trained was assessed using non-parametric univariable statistics. RESULTS There was a positive correlation between baseline infrastructure score and total numbers of AHCs trained (Rs = 0.77, p = 0.01). Four external contextual factors were associated with significantly higher numbers of lay people recruited and trained: having a health care provider to coordinate the intervention (p = 0.02); a pool of other volunteers to recruit from (p = 0.02); a contract in place with a commissioned service (p = 0.02), and; formal volunteer arrangements (p = 0.03). CONCLUSIONS Data suggest that there were four key components that significantly influenced establishing an Alcohol Health Champion programme in areas experiencing both high levels of deprivation and alcohol-related harm. There is added value of capturing external contextual factors a priori and then testing relationships with process indicators to inform the effective roll-out of complex interventions. Future research could explore a wider range of process indicators and outcomes, incorporating methods to rate individual factors to derive a mean score. TRIAL REGISTRATION ISRCTN81942890, date of registration 12/09/2017.
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Affiliation(s)
| | | | - Cathy Ure
- School of Health and Society, University of Salford, Manchester, UK
| | - Susan Hare
- Fallowfield Community Guardians c/o School of Health and Society, University of Salford, Manchester, UK
| | - Margaret Coffey
- School of Health and Society, University of Salford, Manchester, UK
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Ardern
- School of Health and Society, University of Salford, Manchester, UK
| | - Penny A. Cook
- School of Health and Society, University of Salford, Manchester, UK
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Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1264. [PMID: 36909883 PMCID: PMC9316011 DOI: 10.1002/cl2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and cost-effectiveness of the use of peer support in health and social care. Search Methods We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies. Selection Criteria Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role. Data Collection and Analysis Data were extracted on the type of peer support intervention and outcomes assessed in included studies. Standardised tools were used to assess study quality for all studies: assessing the methodological quality of systematic reviews 2 for systematic reviews; Cochrane risk of bias tool for randomised controlled trials; and consensus health economic criteria list for economic evaluations. Main Results We included 91 studies: 32 systematic reviews; 52 randomised controlled trials; and 7 economic evaluations. Whilst most included systematic reviews and economic evaluations were assessed to be of low or medium quality, the majority of randomised controlled trials were of higher quality. There were concentrations of evidence relating to different types of peer support, including education, psychological support, self-care/self-management and social support. Populations with long-term health conditions were most commonly studied. The majority of studies measured health-related indicators as outcomes; few studies assessed cost-effectiveness. Studies were unevenly distributed geographically, with most being conducted in the USA. Several gaps were evident regarding the delivery of peer support, particularly the integration of peers and professionals in delivering support and interventions of longer duration. Authors' Conclusions Although there is evidence available to inform the commissioning and delivery of peer support in health and social care, there are also clear gaps that need to be addressed to further support provision, particularly regarding cost-effectiveness. The effectiveness of peer support in different countries, with varying health and social care systems, is a priority for future research, as is the integration of peers with professionals in delivering peer support.
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Affiliation(s)
- Anna Price
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Siân de Bell
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
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Parent AA, Galindo MS, Lambert Y, Douine M. Combatting malaria disease among gold miners: a qualitative research within the Malakit project. Health Promot Int 2022; 37:6674364. [PMID: 36000529 DOI: 10.1093/heapro/daac058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Malaria is endemic in French Guiana, in particular, where illegal gold mining activities take place. Gold miners travel from Brazil to remote camps in the Guiana forest to carry out mining activities, exposing themselves to the presumed contamination area. This article presents the results of a qualitative case study of the Malakit project, an intervention where health facilitators offer appropriate training and distribution of self-diagnosis and self-treatment kits to manage an episode of malaria at resting sites on the French Guiana borders. The objectives were: (i) Determine the contextual elements influencing the use of Malakit; (ii) Understand the way gold miners perceive Malakit; (iii) Identify the elements that are favorable and unfavorable to the use of Malakit; (iv4) Identify what can be improved in the project. The data were collected using three methods: on-site observation, semi-structured individual interviews (n = 26), and group interviews (n = 2). The results indicate that Malakit responds to the need for treatment and facilitates access to care. Gold miners say they trust the facilitators and receive accurate explanations, the kit is easy to use and carry, and explanations given are sufficient. Nonetheless, the results lead us to believe that contextual elements influence exposure to numerous risk factors and that malaria among gold miners working illegally in French Guiana is a question of social inequalities in health. Thus, malaria intervention practices such as Malakit cannot be carried out without considering the complexity generated by social inequalities in health.
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Affiliation(s)
- André-Anne Parent
- CReSP and Interactions Research Centre, School of Social Work, Université de Montréal, Québec, Canada
| | | | - Yann Lambert
- Centre hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| | - Maylis Douine
- Centre hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
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22
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Yates E, Buckley L, Sterling M, Cruwys T, Ashton-James CE, Rankin R, Elphinston RA. Interest in Digital Peer-Delivered Interventions and Preferences to Improve Pain Self-Efficacy and Reduce Loneliness amongst Patients with Chronic Pain: A Mixed Methods Co-Design Study (Preprint). JMIR Form Res 2022; 7:e41211. [PMID: 37058351 PMCID: PMC10148220 DOI: 10.2196/41211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/21/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Two important factors that prolong and exacerbate chronic noncancer pain (CNCP) and disability are low pain self-efficacy and loneliness. Yet, few interventions have shown long-term sustained improvements in pain self-efficacy, and there are no evidence-based treatments that target social connectedness in people living with CNCP. More effective and accessible interventions designed to target self-efficacy and social connectedness could ease the burden of CNCP. OBJECTIVE To co-design accessible interventions to increase pain self-efficacy, social connection, pain-related outcomes, and quality of life, this study explored patients' interest and preferences for digital peer-delivered interventions for CNCP as well as implementation barriers and enablers. METHODS This cross-sectional mixed methods study was part of a larger longitudinal cohort study. Adult Australian residents (N=186) with CNCP diagnosed by a medical professional or pain specialist were included. Participants were initially recruited through advertising on professional pain social media accounts and websites. Questions examined whether patients were interested in digital peer-delivered interventions and their preferences for specific features (eg, Newsfeed). Pain self-efficacy and loneliness were assessed using validated questionnaires, and the association between these factors and interest in digital peer-delivered support was explored. Open-ended questions explored implementation barriers, enablers, and suggestions for consideration in intervention design. RESULTS There was interest in accessing digital peer-delivered interventions, with almost half of the sample indicating that they would access it if it was available. Those who indicated an interest in digital peer interventions reported both lower pain self-efficacy and greater loneliness than those who were not interested. Intervention content that incorporated education, links to health services and resources, and delivery of support by peer coaches were the most frequently preferred intervention features. Three potential benefits were identified: shared experience, social connection, and shared pain management solutions. Five potential barriers were identified: negative focus on pain, judgment, lack of engagement, negative impact on mental health, privacy and security concerns, and unmet personal preferences. Finally, there were 8 suggestions from participants: moderation of the group, interest subgroups, professional-led activities, psychological strategies, links to professional pain resources, newsletter, motivational content, live streaming, and online meetups. CONCLUSIONS Digital peer-delivered interventions were of particular interest to those with CNCP who had lower levels of pain self-efficacy and higher levels of loneliness. Future co-design work could tailor digital peer-delivered interventions to these unmet needs. Intervention preferences and implementation barriers and enablers identified in this study could guide further co-design and the development of such interventions.
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Affiliation(s)
- Eloise Yates
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
- Australian Pain Management Association, Brisbane, Australia
| | - Lisa Buckley
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
- National Health and Medical Research Council Centre for Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Brisbane, Australia
| | - Tegan Cruwys
- Research School of Psychology, The Australian National University, Canberra, Australia
| | | | - Renee Rankin
- Australian Pain Management Association, Brisbane, Australia
| | - Rachel A Elphinston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
- National Health and Medical Research Council Centre for Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Brisbane, Australia
- Metro South Addiction and Mental Health Service, Metro South Health Hospital and Health Service, Brisbane, Australia
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Peer-Led, Remote Intervention to Improve Mental Health Outcomes Using a Holistic, Spirituality-Based Approach: Results from a Pilot Study. Community Ment Health J 2022; 58:862-874. [PMID: 34561834 PMCID: PMC8475393 DOI: 10.1007/s10597-021-00893-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/12/2021] [Indexed: 11/18/2022]
Abstract
In the United States, Black communities face a complex mental health burden, with growing attention on addressing these disparities through the lens of holistic wellbeing. Given the dearth of research on faith-based interventions focused on mental health through the lens of holistic wellbeing, this study evaluates the impact of a spirituality-based, peer-led one-group pre-test post-test pilot intervention in a sample of Black individuals in the Bronx, New York City. The eight-session creating healthy culture curriculum, focused on improving mental health and spiritual wellbeing, was collaboratively developed through community partnerships. Post-intervention results indicated significantly reduced odds of moderate to severe depression (AOR:0.20), and increased sense of community, social support, role of religion in health, flourishing, and reduced trouble sleeping. In-depth interviews with participants further highlighted the interconnected role between psychosocial and mental health indicators. Findings support importance of holistically developing, implementing, and evaluating spirituality-based mental health interventions in Black communities.
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Topping KJ. Peer Education and Peer Counselling for Health and Well-Being: A Review of Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6064. [PMID: 35627601 PMCID: PMC9140904 DOI: 10.3390/ijerph19106064] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023]
Abstract
Peer education and peer counselling for health and wellbeing have been recognized as complementary approaches to professional intervention for over 50 years, but it is relatively recently that research into effects has become adequate. Potentially, they have advantages in reaching where professionals cannot, but it has not been clear if that potential is fulfilled, although the measurement of effects is difficult. The present paper examines 58 narrative and systematic reviews and meta-analyses on the topic. In peer education, there were many reviews of sexual health and of HIV/AIDS interventions, followed by reviews of various medical conditions and in the context of prisons. More general reviews covered a wider field. In peer counselling, there were several reviews of breast-feeding and mental health. Many early reviews complained of the lack of evaluation; then, later reviews found knowledge gains but not behavior gains; then, still later reviews found both knowledge and behavior gains. Thus, peer education and counselling appear effective but only if organizational factors are well managed and the cultural context of the country respected. The implications for future practice, policy and research were outlined.
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Wehner SK, Tjørnhøj-Thomsen T, Bonnesen CT, Madsen KR, Jensen MP, Krølner RF. Peer mentors' role in school-based health promotion: qualitative findings from the Young & Active study. Health Promot Int 2022; 37:daab089. [PMID: 34339490 PMCID: PMC9067443 DOI: 10.1093/heapro/daab089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Peer-led interventions are highlighted as promising strategies to promote health among adolescents, but little is known about the mechanisms underlying this approach. To better understand the role of peer mentors (PMs) as implementers in school-based health promotion, we combined participant observations, focus group interviews and video recordings to explore high school students' reception of a peer-led intervention component (Young & Active). Young & Active aimed to increase well-being among first-year high school students (∼16 years of age) through the promotion of movement and sense of community and was implemented during the school year 2016-2017 in a larger school-based intervention study, the Healthy High School study in Denmark. The Healthy High School study was designed as a cluster-randomized controlled trial with 15 intervention schools and 15 control schools. At each intervention school, university students in Sports Science and Health (members of the research group) facilitated an innovation workshop aiming at inspiring all first-year students to initiate movement activities at schools. The findings illustrate potentials and challenges implied in the PM role. The peer mentors' profound commitment, as well as their response and sensibility to situational contingencies, were found to be significant for the students' reception and experience of the intervention. In conclusion, the specific job of PMs as implementers seems to consist of simultaneously following a manual and situationally adjusting in an emerging context balancing commitment and identification to the target group and the intervention project.
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Affiliation(s)
- Stine Kjær Wehner
- Department of Health and social context, National
Institute of Public Health, University of Southern Denmark,
Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Tine Tjørnhøj-Thomsen
- Department of Health and social context, National
Institute of Public Health, University of Southern Denmark,
Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Camilla Thørring Bonnesen
- Department of Health and social context, National
Institute of Public Health, University of Southern Denmark,
Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Katrine Rich Madsen
- Department of Health and social context, National
Institute of Public Health, University of Southern Denmark,
Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Marie Pil Jensen
- Department of Health and social context, National
Institute of Public Health, University of Southern Denmark,
Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Rikke Fredenslund Krølner
- Department of Health and social context, National
Institute of Public Health, University of Southern Denmark,
Studiestræde 6, 1455 Copenhagen K, Denmark
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Welford P, Östh J, Hoy S, Diwan V, Hallgren M. Effects of yoga and aerobic exercise on wellbeing in physically inactive older adults: randomized controlled trial (FitForAge). Complement Ther Med 2022; 66:102815. [PMID: 35143970 DOI: 10.1016/j.ctim.2022.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the effects of yoga and aerobic exercise (AE) on wellbeing in physically inactive, but otherwise healthy older adults. A secondary objective was to assess and compare the frequency of adverse events associated with yoga and AE. DESIGN Twelve-week, three-group, parallel randomized controlled trial with blinded follow-up assessment. INTERVENTIONS Participants were supported to complete ≥3 Hatha yoga classes/week or ≥3 AE sessions/week. A wait-list control (WLC) group continued usual daily activities. MAIN OUTCOME MEASURE Change in wellbeing, assessed using the Satisfaction with Life Scale (SWLS) and Life Satisfaction Index-Z (LSI),at baseline and at 12-week follow up. RESULTS In total, 82 adults (mean age 72.5 years, range 65-85, 77% female) were recruited. Of these, 27 were randomized to yoga, 29 to aerobic exercise and 26 to wait-list control. Medium-magnitude treatment effects (Hedges' g) were seen for yoga versus WLC and AE versus WLC(SWLS, g = 0.65 and 0.56; LSI, g = 0.54 and 0.54, respectively). In per-protocol analyses, larger effect sizes were found (SWLS, g = 0.72 and 0.66; LSI, g = 0.76 and 0.76, respectively). Adverse events were less frequent in the yoga group (6/27; 22%) compared to AE (10/27; 37%). CONCLUSIONS Among physically inactive older adults, participation in yoga or AE was associated with beneficial effects on subjective wellbeing when compared to a non-active control group. Yoga was associated with fewer injuries and may be especially suitable for older adults (DRKS 00015093).
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Josefine Östh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Sara Hoy
- Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Vinod Diwan
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
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Dambrino KL, Green M. Antimicrobial Stewardship in College and University Health Settings: A Public Health Opportunity. Antibiotics (Basel) 2022; 11:89. [PMID: 35052966 PMCID: PMC8772865 DOI: 10.3390/antibiotics11010089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 12/04/2022] Open
Abstract
Antimicrobial resistance poses a significant threat to public health and safety across the globe. Many factors contribute to antibiotic resistance, most especially are the concerns of excessive prescribing and misuse of antibiotics. Because patient expectations for antibiotics may contribute to prescriber pressures, experts recommend targeting antimicrobial stewardship (AMS) education efforts towards prescribers as well as patients in outpatient settings. Undergraduate university students are a unique and promising target population for AMS efforts because they are in a transformative life stage of social, cognitive, and physical development in which they are learning to independently care for themselves without the presence or influence of parents. By introducing AMS education during this transition, university students may adopt positive antibiotic use behaviors that they will carry throughout their lives. Not only will their personal health be improved, but widespread adoption of AMS in university settings may have a broader effect on public health of present and future generations. Despite public health opportunities, minimal research has examined AMS in university health settings. This article explores current evidence on knowledge, attitudes, and use of antibiotics among university students and discusses opportunities for AMS initiatives in college and university health settings.
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Affiliation(s)
- Kathryn L. Dambrino
- College of Health Sciences and Nursing, Belmont University, Nashville, TN 37212, USA
| | - Montgomery Green
- College of Pharmacy, Belmont University, Nashville, TN 37212, USA;
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28
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Lim S, Lee WK, Tan A, Chen M, Tay CT, Sood S, Pirotta S, Moran LJ, Daivadanam M, Busija L, Skouteris H, Awoke MA, Hill B. Peer-supported lifestyle interventions on body weight, energy intake, and physical activity in adults: A systematic review and meta-analysis. Obes Rev 2021; 22:e13328. [PMID: 34387399 DOI: 10.1111/obr.13328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/01/2021] [Accepted: 07/16/2021] [Indexed: 11/26/2022]
Abstract
There is an increasing interest in peer interventions in the management of chronic conditions, but evidence on peer interventions for body weight is lacking. The aim of this study was to examine the efficacy of peer interventions on body weight, energy intake, and physical activity in adults. Interventions delivered by peer (lay member that participants identify with) were included. We searched 14 databases. Outcomes were combined in the meta-analysis using the inverse variance random-effects model. From 2435 articles, 65 articles were included in the systematic review and meta-analysis (n = 15,673). Peer interventions resulted in significant reduction in weight (mean difference [MD] -1.05 kg; 95% confidence interval [CI] -1.68, -0.43; 95% prediction interval [PI] -3.25, 1.14; 28 studies; 7142 participants), BMI (MD -0.24 kg/m2 ; 95% CI -0.44, -0.04; 95% PI -0.92, 0.45; 25 studies; 6672 participants), waist circumference (MD -0.75 cm; 95% CI -1.29, -0.21; 95% PI -1.36, -0.14; 12 studies; 4280 participants), and significant increase in physical activity (SMD 0.20; 95% CI 0.09, 0.32; 95% PI -0.46, 0.86; 41 studies; 10,778 participants) with no significant effect on energy intake. This study suggests peer interventions are effective in reducing waist circumference, but further research is needed to confirm its effect on other obesity-related outcomes.
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Affiliation(s)
- Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Wai Kit Lee
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Andy Tan
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Mingling Chen
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Surbhi Sood
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Stephanie Pirotta
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Meena Daivadanam
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Ljoudmila Busija
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Mamaru A Awoke
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
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Duplaga M, Grysztar M. Nutritional Behaviors, Health Literacy, and Health Locus of Control of Secondary Schoolers in Southern Poland: A Cross-Sectional Study. Nutrients 2021; 13:nu13124323. [PMID: 34959875 PMCID: PMC8709351 DOI: 10.3390/nu13124323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/28/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022] Open
Abstract
Nutritional behaviors remain an essential part of a healthy lifestyle. It seems obvious that unfavorable health behaviors adopted in adolescence are maintained late in adulthood and may have a profound effect on health status. The main aim of this study was to assess the association between nutritional behaviors and health literacy (HL), health locus of control (HLC), and socioeconomic variables in secondary school pupils from a voivodship (the main unit of territorial division) in southern Poland. The analysis was based on dataTable from a paper-and-pencil survey taken by 2223 pupils from schools selected as the result of cluster sampling. The survey questionnaire encompassed a set of five items asking about dietary patterns and the consumption of fruit and vegetables as well as fast food, a European Health Literacy Project Questionnaire consisting of 47 items, the Multidimensional Health Locus of Control (MHLC) scale, and items asking about sociodemographic and economic variables. Uni- and multivariate logistic regression models have been developed to assess the predictors of indicator nutrition behaviors. The adjusted models revealed that internal HLC was not significantly associated with any of analyzed nutritional behaviors. “Powerful other HLC” and “Chance HLC” (dimension of external HLC) were significant predictors of the selected dietary patterns. Furthermore, higher HL was associated with higher consumption of fruit and vegetables [odds ratio, 95% confidence interval (OR, 95% CI)]: 1.02 (1.01–1.04) and with lower consumption of fast food (OR, 95% CI, 0.98, 0.95–0.999). There was a significant relationship between gender, the size of the household, self-assessed economic situation, expenditures on mobile phones, and weekly duration of Internet use and selected nutrition behaviors. In conclusion, developed regression models confirmed a significant relationship between HL and the types of consumed food, but not with dieting patterns. Contrary to earlier studies, internal HLC was not associated with nutrition behaviors. In our study, boys showed more favorable nutritional behaviors than girls. More intense use of the Internet was associated with less beneficial nutritional behaviors. This study brings important results that should have an impact on health promotion interventions addressed to adolescents in southern Poland.
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Yoshikawa E, Fujisawa D, Hisamura K, Murakami Y, Okuyama T, Yoshiuchi K. The potential role of peer support interventions in treating depressive symptoms in cancer patients. J NIPPON MED SCH 2021; 89:16-23. [PMID: 34840208 DOI: 10.1272/jnms.jnms.2022_89-117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Depressive symptoms are prevalent in cancer patients and are one of the most distressing symptoms in this population. Although mental health professionals such as psychiatrists and psychologists are now engaged in cancer care, the management of depressive symptoms in cancer patients needs further improvement. Peer support interventions (PSIs) in cancer care have attracted substantial attention and have several advantages over support by medical professionals, potentially improving depressive symptoms in cancer patients. However, there may be some potential risks. Several strategies using PSIs have been developed to improve depressive symptoms and have been evaluated in randomized controlled trials. The strategies include education on stress management skills, promoting emotional support, counseling on specific topics that are difficult to discuss with others, helping patients navigate the use of resources, and promoting health-related behaviors to decrease depressive symptoms. In this paper, we present recent findings on PSIs in cancer, focusing on randomized controlled trials.
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Affiliation(s)
| | | | - Kazuho Hisamura
- Department of Medical Oncology, School of Medicine, Kanazawa Medical University
| | | | - Toru Okuyama
- Department of Psychiatry, Nagoya City University West Medical Center
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo
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Mahadzir MDA, Quek KF, Ramadas A. Group-Based Lifestyle Intervention Strategies for Metabolic Syndrome: A Scoping Review and Strategic Framework for Future Research. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111169. [PMID: 34833387 PMCID: PMC8624746 DOI: 10.3390/medicina57111169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Group-based lifestyle interventions reap social support benefits and have been implemented among individuals with various chronic diseases. However, there is a lack of consolidated evidence on its approaches to prevent or manage metabolic syndrome (MetS). This scoping review aims to assess the group-based lifestyle interventional strategies for MetS and provide a strategic framework for future research in this area. Materials and Methods: Scholarly databases (OVID Medline, SCOPUS, PUBMED, PsycINFO, EMBASE, and Cochrane Central Register of Controlled Trials) and reference lists of included publications were systematically searched using appropriate keywords and MeSH terms. Peer-reviewed articles published from the start of indexing to 31 December 2020 focused on individuals with or at risk for MetS were included. Results: Thirteen interventions were identified, with seven conducted among adults with MetS and six in the population at risk for MetS. Three study designs were reported-randomised controlled trials (RCTs), pre-post interventions, and quasi-experiments. Most of the interventions were based in the community or community organisations, multifaceted, led by a multidisciplinary healthcare team, and assisted by peer educators. Waist circumference showed the most promising MetS-related improvement, followed by blood pressure. Conclusions: There is growing evidence supporting group-based lifestyle interventions to improve MetS-related risk factors. In summary, four strategies are recommended for future research to facilitate group-based interventions in preventing and managing MetS.
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Fernández-Alvira JM, Fernández-Jiménez R, de Miguel M, Santos-Beneit G, Bodega P, Hill CA, Carral V, Rodríguez C, Carvajal I, Orrit X, de Cos-Gandoy A, Dal Re M, Robledo T, Fuster V. The challenge of sustainability: Long-term results from the Fifty-Fifty peer group-based intervention in cardiovascular risk factors. Am Heart J 2021; 240:81-88. [PMID: 34147462 DOI: 10.1016/j.ahj.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 06/13/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND The Fifty-Fifty trial demonstrated that a peer-group-based intervention was able to improve healthy behaviors in individuals with cardiovascular (CV) risk factors immediately post-intervention. OBJECTIVES To determine the long-term sustainability of a one-year peer-group-based intervention focused on CV health and behavior. METHODS A total of 543 adults aged 25 to 50 years with at least 1 CV risk factor were screened and recruited, received initial training through workshops, and were then randomized 1:1 to a peer-group-based intervention group (IG) or a self-management control group (CG) for 12 months. At a median of 52 months from baseline, 321 participants were re-assessed (~60% retention). The primary outcome was the mean change in a composite health score related to blood pressure, exercise, weight, alimentation, and tobacco use (Fuster-BEWAT score [FBS], range 0-15). Intervention effects were assessed using linear-mixed effects models. RESULTS The mean age of retained participants was 48.0 years (SD: 5.4), and 73% were female. Consistent with previous results, the change of overall FBS was significantly greater in the IG than in the CG at 12-month follow-up (between-group difference, 0.60 points; 95% CI, 0.08-1.12; P = .025). Assessment of long-term sustainability (52-month follow-up) showed that there were no between-group differences in the mean overall FBS (IG mean score, 8.52; 95% CI, 7.97-9.07 vs CG mean score, 8.51; 95% CI, 7.93-9.10; P = .972) or in the change of overall FBS from screening (IG mean change, 0.64; 95% CI, 0.00-1.28; CG mean change, 0.46; 95% CI, -0.20-1.12; P = .497). CONCLUSIONS A one-year peer-group-based intervention showed favorable results at immediate post-intervention but did not demonstrate significant differences between the IG and CG at 52 months. Combination of an initial training period (workshops) with the maintenance of peer-support groups or other re-intervention strategies may be required to achieve sustained effects on healthy behaviors. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02367963. Registered (https://clinicaltrials.gov/show/NCT02367963).
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Affiliation(s)
| | - Rodrigo Fernández-Jiménez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - Mercedes de Miguel
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Gloria Santos-Beneit
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Patricia Bodega
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Christopher A Hill
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Vanesa Carral
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Carla Rodríguez
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Isabel Carvajal
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Xavier Orrit
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Amaya de Cos-Gandoy
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Marian Dal Re
- Spanish Agency for Food Safety and Nutrition (AESAN), Madrid, Spain
| | - Teresa Robledo
- Spanish Agency for Food Safety and Nutrition (AESAN), Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
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Krist L, Dornquast C, Reinhold T, Icke K, Danquah I, Willich SN, Becher H, Keil T. Predictors of Changes in Physical Activity and Sedentary Behavior during the COVID-19 Pandemic in a Turkish Migrant Cohort in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189682. [PMID: 34574617 PMCID: PMC8472770 DOI: 10.3390/ijerph18189682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 12/24/2022]
Abstract
The new coronavirus (COVID-19) pandemic and the resulting response measures have led to severe limitations of people's exercise possibilities with diminished physical activity (PA) and increased sedentary behavior (SB). Since for migrant groups in Germany, no data is available, this study aimed to investigate factors associated with changes in PA and SB in a sample of Turkish descent. Participants of a prospective cohort study (adults of Turkish descent, living in Berlin, Germany) completed a questionnaire regarding COVID-19 related topics including PA and SB since February 2020. Changes in PA and SB were described, and sociodemographic, migrant-related, and health-related predictors of PA decrease and SB increase were determined using multivariable regression analyses. Of 106 participants, 69% reported a decline of PA, 36% reported an increase in SB. PA decrease and SB increase seemed to be associated with inactivity before the pandemic as well as with the female sex. SB increase appeared to be additionally associated with educational level and BMI. The COVID-19 pandemic and the response measures had persistent detrimental effects on this migrant population. Since sufficient PA before the pandemic had the strongest association with maintaining PA and SB during the crisis, the German government and public health professionals should prioritize PA promotion in this vulnerable group.
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Affiliation(s)
- Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
- Correspondence:
| | - Christina Dornquast
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
| | - Katja Icke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
| | - Ina Danquah
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
- Institute of Global Health (HIGH), University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Stefan N. Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
| | - Heiko Becher
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany;
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, 97688 Bad Kissingen, Germany
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Ogunwole SM, Mwinnyaa G, Wang X, Hong X, Henderson J, Bennett WL. Preeclampsia Across Pregnancies and Associated Risk Factors: Findings From a High-Risk US Birth Cohort. J Am Heart Assoc 2021; 10:e019612. [PMID: 34398644 PMCID: PMC8649269 DOI: 10.1161/jaha.120.019612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Preeclampsia increases women's risks for maternal morbidity and future cardiovascular disease. The aim of this study was to identify opportunities for prevention by examining the association between cardiometabolic risk factors and preeclampsia across 2 pregnancies among women in a high‐risk US birth cohort. Methods and Results Our sample included 618 women in the Boston Birth Cohort with index and subsequent pregnancy data collected using standard protocols. We conducted log‐binomial univariate regression models to examine the association between preeclampsia in the subsequent pregnancy (defined as incident or recurrent preeclampsia) and cardiometabolic risk factors (ie, obesity, hypertension, diabetes mellitus, preterm birth, low birth weight, and gestational diabetes mellitus) diagnosed before and during the index pregnancy, and between index and subsequent pregnancies. At the subsequent pregnancy, 7% (36/540) had incident preeclampsia and 42% (33/78) had recurrent preeclampsia. Compared with women without obesity, women with obesity had greater risk of incident preeclampsia (unadjusted risk ratio [RR], 2.2 [95% CI, 1.1–4.5]) and recurrent preeclampsia (unadjusted RR, 3.1 [95% CI, 1.5–6.7]). Preindex pregnancy chronic hypertension and diabetes mellitus were associated with incident, but not recurrent, preeclampsia (hypertension unadjusted RR, 7.9 [95% CI, 4.1–15.3]; diabetes mellitus unadjusted RR, 5.2 [95% CI, 2.5–11.1]. Women with new interpregnancy hypertension versus those without had a higher risk of incident and recurrent preeclampsia (incident preeclampsia unadjusted RR, 6.1 [95% CI, 2.9–13]); recurrent preeclampsia unadjusted RR, 2.4 [95% CI, 1.5–3.9]). Conclusions In this diverse sample of high‐risk US women, we identified modifiable and treatable risk factors, including obesity and hypertension for the prevention of preeclampsia.
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Affiliation(s)
- S Michelle Ogunwole
- Department of Medicine Division of General Internal MedicineJohns Hopkins University School of Medicine Baltimore MD
| | - George Mwinnyaa
- Department of International HealthJohns Hopkins University Bloomberg School of Public Health Baltimore MD
| | - Xiaobin Wang
- Department of PediatricsJohns Hopkins University School of Medicine Baltimore MD.,Center on the Early Life Origins of Disease Department of Population, Family and Reproductive Health Johns Hopkins University Bloomberg School of Public Health Baltimore MD
| | - Xiumei Hong
- Center on the Early Life Origins of Disease Department of Population, Family and Reproductive Health Johns Hopkins University Bloomberg School of Public Health Baltimore MD
| | - Janice Henderson
- Department of Gynecology and Obstetrics Johns Hopkins University School of Medicine Baltimore MD
| | - Wendy L Bennett
- Department of Medicine Division of General Internal MedicineJohns Hopkins University School of Medicine Baltimore MD.,Center on the Early Life Origins of Disease Department of Population, Family and Reproductive Health Johns Hopkins University Bloomberg School of Public Health Baltimore MD
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Fischer AR, Green SRM, Gunn HE. Social-ecological considerations for the sleep health of rural mothers. J Behav Med 2021; 44:507-518. [PMID: 33083923 PMCID: PMC7574991 DOI: 10.1007/s10865-020-00189-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/30/2020] [Indexed: 02/03/2023]
Abstract
Using a social-ecological framework, we identify social determinants that interact to influence sleep health, identify gaps in the literature, and make recommendations for targeting sleep health in rural mothers. Rural mothers experience unique challenges and protective factors in maintaining adequate sleep health during the postpartum and early maternal years. Geographic isolation, barriers to comprehensive behavioral medicine services, and intra-rural ethno-racial disparities are discussed at the societal (e.g., public policy), social (e.g., community) and individual levels (e.g., stress) of the social-ecological model. Research on sleep health would benefit from attention to methodological considerations of factors affecting rural mothers such as including parity in population-level analyses or applying community-based participatory research principles. Future sleep health programs would benefit from using existing social support networks to disseminate sleep health information, integrating behavioral health services into clinical care frameworks, and tailoring culturally-appropriate Telehealth/mHealth programs to enhance the sleep health of rural mothers.
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Affiliation(s)
- Alexandra R Fischer
- Department of Psychology, University of Alabama, Box 87034, Tuscaloosa, AL, 35487, USA
| | | | - Heather E Gunn
- Department of Psychology, University of Alabama, Box 87034, Tuscaloosa, AL, 35487, USA.
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Lussier MT, Kaczorowski J, Girard M, Arpin E. Volunteer engagement to inform research on cardiovascular health awareness, Canada. Health Promot Int 2021; 35:1570-1576. [PMID: 32191301 DOI: 10.1093/heapro/daaa015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Volunteers have been extensively used in health promotion programmes. However, they have been less frequently involved in the research process. In its most recent iterations, the Cardiovascular Health Awareness Program (CHAP) integrated volunteers (i) to facilitate CHAP sessions with participating patients for data collection and (ii) to evaluate the intervention. Drawing on the patient and public involvement literature, our research team included volunteers in the data collection and evaluation of CHAP sessions as part of the programme's implementation in the province of Quebec (Canada). We sought volunteers' formal feedback through individual online and phone interviews and through focus groups for each of the four projects conducted in Quebec. We found that volunteers provide valuable insight on the research protocol as well as patient needs. Their feedback led to several modifications to the research protocol and procedures of subsequent CHAP sessions. Changes included involving volunteers at earlier stages of the research process, adding more learning modules and practice sessions during the volunteer training and defining research priorities according to patient needs. Our methodology of engaging volunteers in the research process was useful to gain important and unique insight on patient needs and for future programme planning to modify the research process.
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Affiliation(s)
- Marie-Thérèse Lussier
- Équipe de recherche en soins de première ligne, Centre intégré de santé et de services sociaux de Laval, Laval, Canada.,Département de Médecine de Famille et de Médecine d'Urgence, Faculté de médecine, Université de Montréal, Montréal, Canada
| | - Janusz Kaczorowski
- Département de Médecine de Famille et de Médecine d'Urgence, Faculté de médecine, Université de Montréal, Montréal, Canada.,Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Magali Girard
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Emmanuelle Arpin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Wippold GM, Frary SG, Abshire D, Wilson DK. Peer-to-peer health promotion interventions among African American men: a scoping review protocol. Syst Rev 2021; 10:184. [PMID: 34154638 PMCID: PMC8218504 DOI: 10.1186/s13643-021-01737-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health promotion efforts among African American men have been met with significant challenges and have produced limited results. Interventions that do not align with the values, perspectives, and preferences of African American men often produce less effective results. Research among African American men has provided compelling evidence that these men prefer informal networks of health support. Recent successful health promotion efforts among these men have benefited from peer-to-peer models of implementation. To date, no known scoping or systematic review of peer-to-peer health promotion interventions among African American men has been conducted. The goal of this scoping review is to understand the extent of, design, implementation, and use of peer-to-peer interventions to promote health, improve quality of life, and prevent disease among African American men. METHODS A review of the literature will be performed in PubMED, EMBASE, PsycInfo, CINAHL, and Web of Science. The development of this protocol was guided by the work of Arksey and O'Malley and the PICOS statement. Reporting will be guided by the PRISMA-ScR checklist. Eligible studies include those testing the effects of a peer-to-peer health promotion intervention targeting African American men. A comparison group will not be required. For the purposes of the current review, "peers" will be limited to other African American men. An initial screening of the titles and abstracts of potentially eligible studies will be completed by two independent reviewers. The full text of records that appear to meet the eligibility criteria will be accessed and further screened. Data will then be extracted and collected using a custom Microsoft Excel spreadsheet. Extracted data will include authors' name and publication year, target health issue(s), design of the intervention, components of the intervention, peer-led components of the intervention, peer role, length and type of training for peer leaders, intervention duration, frequency of the intervention, study design and number of participants, and main outcomes. Finally, results will be presented in table format and summarized in text format. DISCUSSION Results will have implications for the design, implementation, and evaluation of health promotion interventions among African American men. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020198664.
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Affiliation(s)
- Guillermo M. Wippold
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, South Carolina 29208 USA
| | - Sarah Grace Frary
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, South Carolina 29208 USA
| | | | - Dawn K. Wilson
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, South Carolina 29208 USA
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Abadi M, Richard B, Shamblen S, Drake C, Schweinhart A, Bokhour B, Bauer R, Rychener D. Achieving Whole Health: A Preliminary Study of TCMLH, a Group-Based Program Promoting Self-Care and Empowerment Among Veterans. HEALTH EDUCATION & BEHAVIOR 2021; 49:347-357. [PMID: 34018443 DOI: 10.1177/10901981211011043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE An emerging literature suggests patients with chronic illnesses can benefit from integrated, person-centric approaches to health care, including group-based programs. However, much of the research in this area is disease specific. The objective of this study was to collect preliminary evidence on the efficacy of Taking Charge of My Life and Health (TCMLH), a Whole Health group-based program that emphasizes self-care and empowerment on the overall health and well-being of veterans, a population burdened with high rates of multiple chronic conditions. METHOD Self-reported outcomes, including standardized survey measures, were collected at pretest, posttest, and 2-month follow-up from 77 participants across 15 groups at four VA sites. Random intercept mixed-model regressions were used to analyze data. RESULTS Results from this initial study showed high satisfaction with the program and facilitators, and high attendance. There were significant pre-post gains in self-care attitudes and behaviors, patient motivation, meaning and purpose, mental health, perceived stress, goal progress, and goal-specific hope. Outcomes were maintained at 2-month follow-up for patient motivation, perceived stress, goal-specific hope, and goal progress. Significant gains were observed in health care empowerment and physical health from pretest to follow-up. CONCLUSIONS Preliminary findings support the efficacy of TCMLH, a Whole Health group-based program that emphasizes patient empowerment, self-care practices, and peer support. Future research priorities include a rigorous evaluation with a larger sample size and control group to assess effectiveness.
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Affiliation(s)
- Melissa Abadi
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - Bonnie Richard
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - Steve Shamblen
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | | | | | - Barbara Bokhour
- Center for Healthcare Organization and Implementation Research, Bedford, MA, USA.,Boston University School of Public Health, Boston, MA, USA
| | - Rachel Bauer
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - David Rychener
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
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Layton N, Harper K, Martinez K, Berrick N, Naseri C. Co-creating an assistive technology peer-support community: learnings from AT Chat. Disabil Rehabil Assist Technol 2021:1-7. [PMID: 33977806 DOI: 10.1080/17483107.2021.1897694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Inclusion is a core philosophy for health practitioners and human service users, and co-production is a way to achieve inclusion. Australia's assistive technology (AT) community seeks to include and amplify the voices of service and product users at multiple levels. Implementation of genuine partnerships for inclusion is however challenging. This paper describes the iterative co-design process undertaken to structure and deliver a peer-led information and support program, enabling AT users and supporters to build their AT decision making capability and share their expertise with each other and the broader community. METHODS A living labs approach was grounded in co-design principles and drew on the peer education, AT competency and capability-building knowledge base. Methods included embedding intersectional capabilities within the service, and the engagement of over 600 people in design thinking and program iterations through surveys, focus groups, journey mapping and think tanks. RESULTS A national, peer-led, co-designed online community for AT users was established and has been running since 2017. The community of 5000 users contribute to a peer-led information and support initiative geared to share expertise and build AT decision making capability. CONCLUSIONS Service delivery by the AT user community and for the AT user community requires a commitment to co-design, and an engagement with concepts of risk, competency, scope of practice and capability. The learnings from AT Chat have implications for AT services on this journey everywhere.Implications for rehabilitationActive co-design of AT services meets human rights and good practice benchmarks required by contemporary services.Foregrounding AT users within program design and delivery, brings a range of positive outcomes and possibilities for the way services are delivered.AT users have substantial untapped potential which brings tangible outcomes for other AT users, health professionals, service provider organizations and for society.Development of paid roles and pathways to recognize the skills of AT users, and indeed AT communities has potential to improve AT user self-efficacy as well as to contribute to the AT workforce.
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Affiliation(s)
- Natasha Layton
- RAIL Research Centre, Monash University, Frankston, Australia.,Swinburne University of Technology, Hawthorn, Australia
| | - Kristy Harper
- Independent Living Assessment Incorporated, Perth, Australia
| | | | - Neil Berrick
- Independent Living Assessment Incorporated, Perth, Australia
| | - Chiara Naseri
- Independent Living Assessment Incorporated, Perth, Australia.,Curtin University School of Physiotherapy & Exercise Science, Bentley, Australia
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Niese JR, Mepham T, Nielen M, Monninkhof EM, Kroese FM, de Ridder DTD, Corbee RJ. Evaluating the Potential Benefit of a Combined Weight Loss Program in Dogs and Their Owners. Front Vet Sci 2021; 8:653920. [PMID: 33959652 PMCID: PMC8093810 DOI: 10.3389/fvets.2021.653920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Little has been published on the psychological bond between the owner and the pet, and how this might influence shared habits that could lead to overweight and obesity. Another factor that could improve the effectiveness of a weight loss plan, is that the owner would see the dog as a weight loss partner and therefore this could increase the motivation to follow the assigned diet and exercise guidelines. Objective: The aim of this research was to evaluate the potential mutual effects of weight loss programs for both dogs and dog owners. Methods: Two studies were conducted: In the human-centered trial, 60 dog owners were enrolled, who signed up to receive dietary and exercise recommendations to lose weight themselves during an 8 week period, from which 29 were randomly assigned to also get recommendations for their dog. For the dog-centered trial, we selected 13 dog owners that wanted their dog to lose weight during a 6 week period, from which 7 were randomly assigned to also get recommendations for themselves. The average weight loss over the time period was recorded. A questionnaire was used to evaluate diet and exercise habits, as well as information about the relationship between the dog and owner. Results: The average human weight loss was 2.6% in the owner+dog group (n = 29) and 2.3% in the owner only group (n = 31; p > 0.05). Forty percent (24/60) of the dogs in the human-centered trial were overweight. The overweight dogs in the owner+dog group (n = 12/29) lost 3.7% of their body weight, compared to 1.2% in the overweight dogs from the owner only group (n = 12/31; p > 0.05). In the dog-centered trial, the 7 dogs in the dog+owner group lost 8.0% of their body weight, vs. 8.3% in the six dogs in the dog only group (p > 0.05). The owners in the dog+owner group lost 2.5% of their body weight, compared to 0.5% in the dog only group (p > 0.05). In both trials owners' perceived responsibility for both their own and their dogs' weight significantly increased. In addition, habit strength regarding unhealthy feeding and exercise behaviors in relation to the dogs decreased, and self-efficacy in relation to providing the dog with healthy food and exercise increased. Conclusion: Active weight loss in either dog owner or dog, seemed to lead to passive weight loss in the other, especially when some tools or guidelines were provided. These findings support mutual benefits of weight loss programs for dogs and dog owners, and support future weight loss programs to be a One Health approach.
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Affiliation(s)
- J Rebecca Niese
- Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Tierney Mepham
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Mirjam Nielen
- Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Floor M Kroese
- Social, Health and Organizational Psychology, Utrecht University, Utrecht, Netherlands
| | - Denise T D de Ridder
- Social, Health and Organizational Psychology, Utrecht University, Utrecht, Netherlands
| | - Ronald J Corbee
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
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Douma M, Maurice-Stam H, Gorter B, Krol Y, Verkleij M, Wiltink L, Scholten L, Grootenhuis MA. Online psychosocial group intervention for parents: Positive effects on anxiety and depression. J Pediatr Psychol 2021; 46:123-134. [PMID: 33230541 PMCID: PMC7896276 DOI: 10.1093/jpepsy/jsaa102] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 12/21/2022] Open
Abstract
Objective To evaluate the efficacy of an online psychosocial group intervention for parents of children with a chronic illness, in terms of anxiety and depression, and disease-related coping skills. Methods Parents (N = 73) participated in a parallel multicenter randomized controlled trial comparing an intervention group to a waitlist control group. In the group intervention Op Koers Online (English: On Track Online) parents learned how to use adaptive coping strategies taught with cognitive behavioral therapy and acceptance and commitment therapy techniques. Assessments (online questionnaires) took place at baseline (T0), 6-months (T1), and 12-months (T2) follow-up. Mixed-model analyses were performed to test the difference in change in outcomes between intervention (N = 34) and waitlist control group (N = 33). Results When compared with the waitlist control group, the intervention had a significant positive effect (p < .05) on changes in anxiety, depression, and total score T1 versus T0 (β = −.47 to −.51) and T2 versus T0 (β = −.39 to −.46), the coping skills open communication, relaxation, social support, acceptance, predictive control (β = .42–.88) and helplessness (β = −.47) T1 versus T0 and relaxation and positive thinking T2 versus T0 (β = .42–.53). Conclusions Parental anxiety and depression decreased, and use of adaptive coping skills improved after the intervention. The online character, the focus on parents themselves instead of on their child and the possibility for parents of children with rare illnesses to participate, are innovative and unique aspects of Op Koers Online for parents. The next step is to implement the intervention in clinical practice.
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Affiliation(s)
- Miriam Douma
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam
| | - Heleen Maurice-Stam
- Department of Psychosocial Research and Care Innovation, Psychosocial Research and Care Innovation, Princess Máxima Center for Pediatric Oncology
| | - Bianca Gorter
- Department of Medical Psychology, DeKinderKliniek, DeKinderGGZ
| | - Yvette Krol
- Department of Medical Psychology, Deventer Hospital
| | - Marieke Verkleij
- Department of Medical Psychology, Amsterdam University Medical Centers, location VUmc
| | - Lianne Wiltink
- Department of Medical Psychology, Canisius Wilhelmina Hospital
| | - Linde Scholten
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam
| | - Martha A Grootenhuis
- Department of Psychosocial Research and Care Innovation, Psychosocial Research and Care Innovation, Princess Máxima Center for Pediatric Oncology
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Øvretveit J. Innovations in self care and close care made during COVID 19 pandemic: a narrative review. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2021. [DOI: 10.1108/ijhg-02-2021-0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposePreviously, health self-care and informal or “close-care” for family and friends were receiving increasing attention, but became more important during the COVID-2019 pandemic. Sometimes, this was because formal services became less physically accessible to patients and were overburdened by patients ill with COVID-2019. The purpose of this paper is to give an overview of this phenomenon and consider the implications for clinical governance.Design/methodology/approachA five-step search and narrative review method were used, and case examples were selected to illustrate some of these developments.FindingsExamples discovered and described include innovations in websites, social media support groups, systems for matching volunteers to people needing of help, computer and mobile phone applications, digital devices and virtual health rooms run by peer volunteers to help others to learn and use digital technologies.Originality/valueIn response to their health self-care needs not being met, some patients and carers and their associations developed new digital technologies or adapted existing ones. This use and their innovation separate from health care have been largely unreported in the scientific and professional literature. This is the first review of grey literature and other reports of this growing phenomena.
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Baker JC, Bryan CJ, Bryan AO, Button CJ. The Airman's Edge Project: A Peer-Based, Injury Prevention Approach to Preventing Military Suicide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063153. [PMID: 33803772 PMCID: PMC8003198 DOI: 10.3390/ijerph18063153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 12/03/2022]
Abstract
In light of data indicating military personnel are more likely to reach out to peers during times of need, peer-to-peer (P2P) support programs have been implemented for military suicide prevention. Often designed to reduce suicidal thoughts and behaviors by reducing mental health symptom severity, existing data suggest that P2P programs have little to no effect on mental health symptoms. Conceptualizing suicide prevention from an occupational safety and injury prevention perspective to promote positive health-related behavior change at both the group and individual level may enhance the effectiveness of P2P programs and military suicide prevention efforts more broadly. To illustrate these concepts, the present article provides an overview of the Airman’s Edge project, a P2P program design based upon the occupational safety and injury prevention model of suicide prevention, and describes a program evaluation effort designed to test the effectiveness of this approach.
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Affiliation(s)
- Justin C. Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (C.J.B.); (A.O.B.)
- Correspondence:
| | - Craig J. Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (C.J.B.); (A.O.B.)
| | - AnnaBelle O. Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (C.J.B.); (A.O.B.)
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Jou K, Sterling MR, Ramos R, Antoine F, Nanus DM, Phillips E. Eliciting the Social Determinants of Cancer Prevention and Control in the Catchment of an Urban Cancer Center. Ethn Dis 2021; 31:23-30. [PMID: 33519152 DOI: 10.18865/ed.31.1.23] [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: 11/18/2022] Open
Abstract
Objective The objectives of this study were two-fold: 1) to engage community stakeholders in identifying the top three social determinant of health (SDOH) barriers to the early detection and treatment of cancer in their respective communities; and 2) to develop a tailored plan responsive to the potential social risks identified within the catchment of an urban academic cancer center. Methods Stakeholders from four neighborhoods in Brooklyn, New York with disproportionate cancer burden were recruited; the nominal group technique, a semi-quantitative research method, was used to elicit the SDOH barriers. Responses were consolidated into categories and ranked by points received. Results 112 stakeholders participated in four community-based meetings. The SDOH categories of economic stability, education, and community and social context were identified as the top barriers. The themes of lost wages/employment, competing priorities, and the inability to afford care embodied the responses about economic stability. The domain of education was best described by the themes of low health literacy, targeted health topics to fill gaps in knowledge, and recommendations on the best modalities for improving health knowledge. Lastly, within the category of community and social context, the themes of stigma, bias, and discrimination, eroding support systems, and cultural misconceptions were described. Conclusions The implications of our study are three-fold. First, they highlight the strengths of the nominal group technique as a methodology for engaging community stakeholders. Second, our analysis led to identifying a smaller set of social priorities for which tailored screening and practical solutions could be implemented within our health care system. Third, the results provide insight into the actual types of interventions and resources that communities expect from the health care sector.
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Affiliation(s)
- Katerina Jou
- Sophie Davis Biomedical Education Program at the CUNY School of Medicine, New York, NY
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Rosio Ramos
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Francesse Antoine
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - David M Nanus
- Division of Hematology and Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Erica Phillips
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
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Matching Psychosocial Support Needs of Parents of a Child with a Chronic Illness to a Feasible Intervention. Matern Child Health J 2020; 24:1238-1247. [PMID: 32613332 PMCID: PMC7476963 DOI: 10.1007/s10995-020-02925-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objectives Parents of children with a chronic illness (CI) are at risk for psychosocial problems. The aim of this study was to refine an existing face-to-face intervention into an online psychosocial group intervention for parents by (1) exploring which themes are important, (2) determine what type of intervention parents would like and (3) assess parents’ practical preferences. Methods Parents of children with a CI (0–18 years) were invited to complete an online questionnaire. To acquire more in-depth information, focus groups and telephone interviews were conducted. Descriptive statistics were used. Results 272 parents (mean age = 43.1 years, 85% female) participated. Three focus groups (15 parents) and seven telephone interviews were conducted. Most important themes were: the CI of the child, family functioning, taking care of yourself, relationships with others and practical support. Parents preferred a group with parents of children in the same age category. At first, parents preferred face-to-face contact. After an explanation and demonstration of an online intervention, parents became more positive about online support, mostly because they could participate from home. Conclusions for Practice Parents have a need for psychosocial support focusing on different themes. Professionals should explain and demonstrate an online intervention to parents. Based on these results, Op Koers Online for parents was developed. An RCT to assess feasibility and effectiveness of the intervention is currently running.
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Colson PW, Franks J, Wu Y, Winterhalter FS, Knox J, Ortega H, El-Sadr WM, Hirsch-Moverman Y. Adherence to Pre-exposure Prophylaxis in Black Men Who Have Sex with Men and Transgender Women in a Community Setting in Harlem, NY. AIDS Behav 2020; 24:3436-3455. [PMID: 32385678 DOI: 10.1007/s10461-020-02901-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
While oral pre-exposure prophylaxis (PrEP) has proven efficacious for HIV prevention, consistent use is necessary to achieve its intended impact. We compared effectiveness of enhanced PrEP (enPrEP) adherence support to standard of care (sPrEP) among Black MSM and TGW attending a community clinic in Harlem, NY. EnPrEP included peer navigation, in-person/online support groups, and SMS messages. Self-reported adherence over previous 30 days, collected in quarterly interviews, was defined as ≥ 57%. Crude and adjusted analyses examined factors associated with adherence. A total of 204 participants were enrolled and randomized; 35% were lost to follow-up. PrEP adherence was 30% at 12-months; no intervention effect was observed (p = 0.69). Multivariable regression analysis found that lower adherence was associated with low education and depressive symptoms. We found that an enhanced adherence intervention did not improve PrEP adherence. Findings point to the need for innovative methods to improve PrEP adherence among Black MSM and TGW.Clinical Trial Registration NCT02167386, June 19, 2014.
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van de Vijver P, Schalkwijk F, Numans ME, Slaets JPJ, van Bodegom D. Self-organizing peer coach groups to increase daily physical activity in community dwelling older adults. Prev Med Rep 2020; 20:101181. [PMID: 33088676 PMCID: PMC7567038 DOI: 10.1016/j.pmedr.2020.101181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 07/22/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022] Open
Abstract
Many older adults do not reach the recommended level of physical activity, despite many professional-delivered physical activity interventions. Here we study the implementation of a novel physical activity intervention for older adults that is self-sustainable (no financial support) and self-organizing (participants act as organizers) due to peer coaching. We implemented three groups and evaluated process and effect using participatory observations, questionnaires, six-minute walk tests and body composition measures from October 2016 to September 2018. The intervention was implemented by staff without experience in physical activity interventions. Facilitators were a motivated initiator and a non-professional atmosphere for participants to take ownership. Barriers were the absence of motivated participants to take ownership and insufficient participants to ensure the presence of participants at every exercise session. The groups exercised outside five days a week and were self-organizing after 114, 216 and 263 days. The initial investments were 170€ for sport equipment and 81–187 h. The groups reached 118 members and a retention of 86.4% in two years. The groups continue to exist at the time of writing and are self-sustainable. Quality of life increased 0.4 on a ten-point scale (95%CI 0.1–0.7; p = 0.02) and six-minute walk test results improved with 33 m (95%CI 18–48; p < 0.01) annually. Self-organizing peer coach groups for physical activity are feasible, have positive effects on health and require only a small investment at the start. It is a sustainable and potentially scalable intervention that could be a promising method to help many older adults age healthier.
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Affiliation(s)
- Paul van de Vijver
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Frank Schalkwijk
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Mattijs E Numans
- Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Joris P J Slaets
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,University Center for Geriatric Medicine, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, The Netherlands
| | - David van Bodegom
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
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MacKay C, Cimino SR, Guilcher SJT, Mayo AL, Devlin M, Dilkas S, Payne MW, Viana R, Hitzig SL. A qualitative study exploring individuals’ experiences living with dysvascular lower limb amputation. Disabil Rehabil 2020; 44:1812-1820. [DOI: 10.1080/09638288.2020.1803999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Crystal MacKay
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Stephanie R. Cimino
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sara J. T. Guilcher
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada
- MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Canada
| | - Amanda L. Mayo
- St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Toronto, Canada
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Canada
| | | | - Steven Dilkas
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Canada
| | - Michael W. Payne
- Parkwood Institute, St. Joseph’s Healthcare, London, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Ricardo Viana
- Parkwood Institute, St. Joseph’s Healthcare, London, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Sander L. Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Department of Occupational Science & Occupational Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
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Dugan J, Booshehri LG, Phojanakong P, Patel F, Brown E, Bloom S, Chilton M. Effects of a trauma-informed curriculum on depression, self-efficacy, economic security, and substance use among TANF participants: Evidence from the Building Health and Wealth Network Phase II. Soc Sci Med 2020; 258:113136. [DOI: 10.1016/j.socscimed.2020.113136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/22/2020] [Accepted: 06/06/2020] [Indexed: 01/08/2023]
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The Power of the Shared Experience: MTN-020/ASPIRE Trial Participants' Descriptions of Peer Influence on Acceptability of and Adherence to the Dapivirine Vaginal Ring for HIV Prevention. AIDS Behav 2020; 24:2387-2399. [PMID: 31980993 DOI: 10.1007/s10461-020-02799-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Women are disproportionately at risk of acquiring HIV in East and Southern Africa, despite global declines in incidence. Female-initiated HIV prevention methods, like the dapivirine vaginal ring, are needed to end the HIV epidemic. In-depth interviews and focus groups retrospectively explored peer influence on acceptability of and adherence to the ring during the ASPIRE trial, a phase III placebo-controlled trial. Results were analyzed using an inductive analytic approach. Study participants (peers) of all ages and adherence groups developed important interpersonal connections and reported being more open and honest with each other than with external peers or study staff. Study peers who knew each other prior to joining appeared to have a stronger influence on each other's adherence than peers who met in the study. External peers provided primarily negative input about the ring and study, which sometimes led to ring removals. Peers' influence on each other's behavior in both prosocial and detrimental manners could have repercussions on adherence to a biomedical intervention, and consequently, individual disease risk and clinical trial outcomes. Future ring demonstration and implementation studies could use peer networks to intentionally influence uptake and adherence to the ring.
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