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Francisco IM, Tozzo MC, Martins J, de Oliveira AS. Adherence of individuals with shoulder pain to home exercise booklets: Barriers, facilitators, and the impact of disability, self-efficacy, and treatment expectations. Musculoskelet Sci Pract 2024; 72:102956. [PMID: 38691980 DOI: 10.1016/j.msksp.2024.102956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND home exercise booklets offer several benefits to individuals with shoulder pain. However, it is necessary to investigate the factors that determine adherence to home exercises. OBJECTIVES 1) To investigate the level of adherence of individuals with chronic shoulder pain to a home exercise booklet conducted without the mediation of a healthcare professional, 2) To describe the barriers and facilitators to adherence, and 3) to determine if shoulder disability, self-efficacy, and treatment expectations are predictors of the level of adherence. DESIGN prospective longitudinal study. METHODS A total of 47 individuals with chronic shoulder pain were recruited. The Numeric Pain Rating Scale (NPRS) was used to assess pain intensity, the Shoulder Pain and Disability Index (SPADI) to measure shoulder disability, the Pain Self-Efficacy Questionnaire (PSEQ-10) for self-efficacy, and a likert scale to measure treatment expectations. Adherence was measured by Exercise Adherence Assessment Scale (EAAE-Br). RESULTS A total of 23 individuals (48.93%) adhered to the home exercise program. The most commonly cited barriers were pain and health-related issues, while the most cited facilitators were pain improvement and symptom relief. Barriers associated with adherence were time constraints and other commitments, while the facilitator associated with adherence was enjoying the exercises. Binary logistic regression analysis revealed that shoulder disability, self-efficacy, and treatment expectations were unable to predict adherence to home exercises in individuals with shoulder pain [F (1,47) = 2.384; p = 0.130; R2 = 0.056]. CONCLUSION The study revealed barriers and facilitators to home exercise in individuals with shoulder pain. Disability, self-efficacy, and treatment expectations were not able to predict adherence.
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Affiliation(s)
- Isabela Maria Francisco
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcela Camargo Tozzo
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Jaqueline Martins
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Anamaria Siriani de Oliveira
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
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Cooney E, Toomey E, Ryan K, Meade O, McSharry J. What's different about digital? A qualitative interview study exploring experiences of adapting in-person behaviour change interventions for digital delivery. Br J Health Psychol 2024. [PMID: 39075024 DOI: 10.1111/bjhp.12741] [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: 12/08/2023] [Accepted: 07/08/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVES Digital health behaviour change interventions may be adapted from in-person interventions, without appropriate consideration of how the digital context might differ. Drawing on the wider literature on behaviour change intervention development, this research aims to explore the digital adaptation process of health behaviour change interventions and the specific considerations for digital modes of delivery. DESIGN A qualitative interview study. METHODS Interviews with 15 intervention developers/facilitators were analysed using inductive thematic analysis. RESULTS Findings highlight a continuum of digitalization, where variation in technology available and human support influences considerations for digital adaptation. 'What vs how: "trying to do the impossible"' describes the balance between retaining the intervention's active ingredients while modifying for digital delivery. Through 'Trial and error', participants described an iterative process based on experience of delivery. 'Creating connection and engagement' emphasizes the importance of social support and the challenges of replicating this. CONCLUSIONS Several considerations for digital adaptations are proposed including the involvement of end-users (facilitators and recipients) during adaptation, the need to understand the original intervention and new context for use, and the different motivational needs of digital intervention recipients.
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Affiliation(s)
- Eva Cooney
- School of Psychology, University of Galway, Galway, Ireland
- S3 Connected Health, Dublin, Ireland
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Elaine Toomey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Centre for Health Research Methods, University of Galway, Galway, Ireland
| | - Kathleen Ryan
- School of Psychology, Dublin City University, Galway, Ireland
| | - Oonagh Meade
- School of Psychology, University of Galway, Galway, Ireland
- S3 Connected Health, Dublin, Ireland
| | - Jenny McSharry
- School of Psychology, University of Galway, Galway, Ireland
- S3 Connected Health, Dublin, Ireland
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Strohacker K, Sudeck G, Keegan R, Ibrahim AH, Beaumont CT. Contextualising flexible nonlinear periodization as a person-adaptive behavioral model for exercise maintenance. Health Psychol Rev 2024; 18:285-298. [PMID: 37401403 DOI: 10.1080/17437199.2023.2233592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 06/30/2023] [Indexed: 07/05/2023]
Abstract
There is a growing focus on developing person-adaptive strategies to support sustained exercise behaviour, necessitating conceptual models to guide future research and applications. This paper introduces Flexible nonlinear periodisation (FNLP) - a proposed, but underdeveloped person-adaptive model originating in sport-specific conditioning - that, pending empirical refinement and evaluation, may be applied in health promotion and disease prevention settings. To initiate such efforts, the procedures of FNLP (i.e., acutely and dynamically matching exercise demand to individual assessments of mental and physical readiness) are integrated with contemporary health behaviour evidence and theory to propose a modified FNLP model and to show hypothesised pathways by which FNLP may support exercise adherence (e.g., flexible goal setting, management of affective responses, and provision of autonomy/variety-support). Considerations for future research are also provided to guide iterative, evidence-based efforts for further development, acceptability, implementation, and evaluation.
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Affiliation(s)
- Kelley Strohacker
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, USA
| | - Gorden Sudeck
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfacultary Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Richard Keegan
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, Australia
| | - Adam H Ibrahim
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, USA
| | - Cory T Beaumont
- Department of Allied Health, Sport, and Wellness, Baldwin Wallace University, Berea, OH, USA
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Brown MC, Araújo-Soares V, Skinner R, Brown J, Glaser AW, Hanratty H, McCabe MG, Amariutei AE, Mauri S, Sharp L. Protocol for the 'Supporting Young Cancer Survivors who Smoke' study (PRISM): Informing the development of a smoking cessation intervention for childhood, adolescent and young adult cancer survivors in England. PLoS One 2024; 19:e0299321. [PMID: 38748708 PMCID: PMC11095735 DOI: 10.1371/journal.pone.0299321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Childhood, adolescent and young adult (CAYA) cancer survivors are vulnerable to adverse late-effects. For CAYA cancer survivors, tobacco smoking is the most important preventable cause of ill-health and early death. Yet, effective strategies to support smoking cessation in this group are lacking. The PRISM study aims to undertake multi-method formative research to explore the need for, and if appropriate, inform the future development of an evidence-based and theory-informed tobacco smoking cessation intervention for CAYA cancer survivors. MATERIALS AND METHODS PRISM involves three phases of: 1) an environmental scan using multiple strategies to identify and examine a) smoking cessation interventions for CAYA cancer survivors that are published in the international literature and b) current smoking cessation services in England that may be available to, or tailorable to, CAYA cancer survivors; 2) a qualitative study involving semi-structured interviews with CAYA cancer survivors (aged 16-29 years and who are current or recent ex-smokers and/or current vapers) to explore their views and experiences of smoking, smoking cessation and vaping; and 3) stakeholder workshops with survivors, healthcare professionals and other stakeholders to consider the potential for a smoking cessation intervention for CAYA cancer survivors and what such an intervention would need to target and change. Findings will be disseminated to patient groups, healthcare professionals and researchers, through conference presentations, journal papers, plain English summaries and social media. DISCUSSION PRISM will explore current delivery of, perceived need for, and barriers and facilitators to, smoking cessation advice and support to CAYA cancer survivors from the perspective of both survivors and healthcare professionals. A key strength of PRISM is the user involvement throughout the study and the additional exploration of survivors' views on vaping, a behaviour which often co-occurs with smoking. PRISM is the first step in the development of a person-centred, evidence- and theory-based smoking cessation intervention for CAYA cancer survivors who smoke, which if effective, will reduce morbidity and mortality in the CAYA cancer survivor population.
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Affiliation(s)
- Morven C. Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Vera Araújo-Soares
- Centre for Preventive Medicine and Digital Health (CPD), Division for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Paediatric and Adolescent Haematology and Oncology, Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Adam W. Glaser
- Department of Paediatric Oncology, Leeds Children’s Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
- Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
| | - Helena Hanratty
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Martin G. McCabe
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - Sabrina Mauri
- Patient and Public Representatives for the Study, United Kingdom
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom
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Vinogradov R, Holden E, Patel M, Grigg R, Errington L, Araújo-Soares V, Rankin J. Barriers and facilitators of adherence to low-dose aspirin during pregnancy: A co-produced systematic review and COM-B framework synthesis of qualitative evidence. PLoS One 2024; 19:e0302720. [PMID: 38701053 PMCID: PMC11068207 DOI: 10.1371/journal.pone.0302720] [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: 01/11/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION Women at increased risk of developing pre-eclampsia are advised to take a daily low-dose of aspirin from 12 weeks of pregnancy to reduce their risks. Despite the well-established prophylactic effect of aspirin, adherence to this therapy is low. This systematic review aimed to summarise evidence on the barriers and facilitators of adherence to low-dose aspirin to inform intervention development to support decision making and persistence with aspirin use for pre-eclampsia prevention. MATERIALS AND METHODS A systematic review and meta-synthesis of qualitative research was co-produced by representatives from charities, and public, clinical and academic members. Eight electronic databases (MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, EMBASE, Prospero, OpenGrey), archives of charities and professional organisations were searched (between October and November 2023 and re-run in August 2023) using predefined search terms. Studies containing qualitative components related to barriers and facilitators of adherence to low-dose aspirin during pregnancy were included. Quality assessment was performed using the Critical Appraisal Skills Programme checklist for qualitative research. A combination of the COM-B framework with phases of adherence process as defined by international taxonomy was used as the coding framework. Co-production activities were facilitated by use of 'Zoom' and 'Linoit'. RESULTS From a total of 3377 papers identified through our searches, five published studies and one dissertation met our inclusion criteria. Studies were published from 2019 to 2022 covering research conducted in the USA, Canada, UK, Netherlands and Australia. Barriers and facilitators to adherence were mapped to six categories of the COM-B for three phases of adherence: initiation, implementation, and discontinuation. The discontinuation phase of adherence was only mentioned by one author. Four key themes were identified relating to pregnancy: 'Insufficient knowledge', 'Necessity concerns balance', 'Access to medicine', 'Social influences', and 'Lack of Habit'. CONCLUSIONS The COM-B framework allowed for detailed mapping of key factors shaping different phases of adherence in behavioural change terms and now provides a solid foundation for the development of a behavioural intervention. Although potential intervention elements could be suggested based on the results of this synthesis, additional co-production work is needed to define elements and plan for the delivery of the future intervention. TRIAL REGISTRATION PROSPERO CRD42022359718. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022359718.
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Affiliation(s)
- Raya Vinogradov
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- National Institute of Health and Care Research Applied Research Collaboration North East and North Cumbria, Newcastle, United Kingdom
- Research Directorate, Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle, United Kingdom
| | - Eleanor Holden
- Public Contributor and Expert by Experience, London, United Kingdom
| | - Mehali Patel
- Public Contributor and Expert by Experience, London, United Kingdom
- Stillbirth and Neonatal Death Society (Sands), Charitable Organisation, London, United Kingdom
| | - Rowan Grigg
- Public Contributor and Expert by Experience, London, United Kingdom
- Action on Pre-eclampsia (APEC), Charitable Organisation, Evesham, United Kingdom
| | - Linda Errington
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Vera Araújo-Soares
- Medical Faculty Mannheim, Division of Prevention, Center for Preventive Medicine and Digital Health (CPD), Heidelberg University, Heidelberg, Germany
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
- National Institute of Health and Care Research Applied Research Collaboration North East and North Cumbria, Newcastle, United Kingdom
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Fundoiano-Hershcovitz Y, Ritholz MD, Horwitz DL, Behar E, Manejwala O, Goldstein P. The Impact of Digital Self-Monitoring of Weight on Improving Diabetes Clinical Outcomes: Quasi-Randomized Study. J Med Internet Res 2024; 26:e54940. [PMID: 38564266 PMCID: PMC11022133 DOI: 10.2196/54940] [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: 11/28/2023] [Revised: 02/18/2024] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The management of type 2 diabetes (T2D) and obesity, particularly in the context of self-monitoring, remains a critical challenge in health care. As nearly 80% to 90% of patients with T2D have overweight or obesity, there is a compelling need for interventions that can effectively manage both conditions simultaneously. One of the goals in managing chronic conditions is to increase awareness and generate behavioral change to improve outcomes in diabetes and related comorbidities, such as overweight or obesity. There is a lack of real-life evidence to test the impact of self-monitoring of weight on glycemic outcomes and its underlying mechanisms. OBJECTIVE This study aims to assess the efficacy of digital self-monitoring of weight on blood glucose (BG) levels during diabetes management, investigating whether the weight changes may drive glucose fluctuations. METHODS In this retrospective, real-world quasi-randomized study, 50% of the individuals who regularly used the weight monitoring (WM) feature were propensity score matched with 50% of the users who did not use the weight monitoring feature (NWM) based on demographic and clinical characteristics. All the patients were diagnosed with T2D and tracked their BG levels. We analyzed monthly aggregated data 6 months before and after starting their weight monitoring. A piecewise mixed model was used for analyzing the time trajectories of BG and weight as well as exploring the disaggregation effect of between- and within-patient lagged effects of weight on BG. RESULTS The WM group exhibited a significant reduction in BG levels post intervention (P<.001), whereas the nonmonitoring group showed no significant changes (P=.59), and both groups showed no differences in BG pattern before the intervention (P=.59). Furthermore, the WM group achieved a meaningful decrease in BMI (P<.001). Finally, both within-patient (P<.001) and between-patient (P=.008) weight variability was positively associated with BG levels. However, 1-month lagged back BMI was not associated with BG levels (P=.36). CONCLUSIONS This study highlights the substantial benefits of self-monitoring of weight in managing BG levels in patients with diabetes, facilitated by a digital health platform, and advocates for the integration of digital self-monitoring tools in chronic disease management. We also provide initial evidence of testing the underlying mechanisms associated with BG management, underscoring the potential role of patient empowerment.
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Affiliation(s)
| | - Marilyn D Ritholz
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States
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Stough CO, Rabin J, Gates T, Garr K, Combs A, Edwards ZT, Summer SS, Woo JG, Folger AT, Ammerman RT, Nuñez M, Berndsen J, Clark MJ, Frey JR, Vaughn LM. Infant Obesity Prevention Programs for Underrepresented Mothers in a Home Visiting Program: A Qualitative and Community-Engaged Needs Assessment. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:265-279. [PMID: 37202859 PMCID: PMC10983836 DOI: 10.1177/2752535x231176730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
A qualitative, community-engaged assessment was conducted to identify needs and priorities for infant obesity prevention programs among mothers participating in home visiting programs. Thirty-two stakeholders (i.e., community partners, mothers, home visitors) affiliated with a home visiting program serving low-income families during the prenatal to age three period participated in group level assessment sessions or individual qualitative interviews. Results indicated families face many challenges to obesity prevention particularly in terms of healthy eating. An obesity prevention program can address these challenges by offering realistic feeding options and non-judgmental peer support, improving access to resources, and tailoring program content to individual family needs and preferences. Informational needs, family factors in healthy eating outcomes, and the importance of access and awareness of programs were also noted. To ensure the cultural- and contextual-relevance of infant obesity prevention programs for underserved populations, needs and preferences among community stakeholders and the focal population should be used as a roadmap for intervention development.
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Affiliation(s)
| | - Julia Rabin
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Taylor Gates
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Katlyn Garr
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Angela Combs
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | | | - Suzanne S. Summer
- Schubert Research Clinic, Cincinnati Children’s Hospital Medical Center
| | - Jessica G. Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Alonzo T. Folger
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Robert T. Ammerman
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Miguel Nuñez
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Jennifer Berndsen
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Margaret J. Clark
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Jennifer R. Frey
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Lisa M. Vaughn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Educational and Community-Based Action Research, University of Cincinnati College of Education, Criminal Justice & Human Services, Cincinnati, OH
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Teran-Escobar C, Becu N, Champollion N, Gratiot N, Hingray B, Panthou G, Ruin I. A pilot randomised controlled trial comparing the effectiveness of the MaTerre180' participatory tool including a serious game versus an intervention including carbon footprint awareness-raising on behaviours among academia members in France. PLoS One 2024; 19:e0301124. [PMID: 38547300 PMCID: PMC10977882 DOI: 10.1371/journal.pone.0301124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/08/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Activities embedded in academic culture (international conferences, field missions) are an important source of greenhouse gas emissions. For this reason, collective efforts are still needed to lower the carbon footprint of Academia. Serious games are often used to promote ecological transition. Nevertheless, most evaluations of their effects focus on changes in knowledge and not on behaviour. The main objectives of this study are to 1) Evaluate the feasibility of a control and an experimental behaviour change intervention and, 2) Evaluate the fidelity (the extent to which the implementation of the study corresponds to the original design) of both interventions. METHODS People employed by a French research organisation (N = 30) will be randomised to one of the two arms. The experimental arm consists in a 1-hour group discussion for raising awareness about climate change, carrying out a carbon footprint assessment and participating to a serious game called "Ma terre en 180 minutes." The control arm consists of the same intervention (1h discussion + carbon footprint assessment) but without participating to the serious game. On two occasions over one month, participants will be asked to fill in online surveys about their behaviours, psychological constructs related to behaviour change, sociodemographic and institutional information. For every session of intervention, the facilitators will assess task completion, perceived complexity of the tasks and the perceived responsiveness of participants. Descriptive statistics will be done to analyse percentages and averages of the different outcomes. DISCUSSION Ma-terre EVAL pilot study is a 1-month and a half pilot randomised controlled trial aiming to evaluate the feasibility and the fidelity of a 24-month randomised controlled trial. This study will provide more information on the levers and obstacles to reducing the carbon footprint among Academia members, so that they can be targeted through behaviour change interventions or institutional policies.
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Affiliation(s)
- Claudia Teran-Escobar
- IGE, Univ. Grenoble Alpes, IRD, CNRS, INRAE, Grenoble INP, Grenoble, France
- Department of Psychology, University Paris Nanterre, Nanterre, France
| | | | | | - Nicolas Gratiot
- IGE, Univ. Grenoble Alpes, IRD, CNRS, INRAE, Grenoble INP, Grenoble, France
| | - Benoît Hingray
- IGE, Univ. Grenoble Alpes, CNRS, IRD, G-INP, Grenoble, France
| | - Gérémy Panthou
- IGE, Univ. Grenoble Alpes, CNRS, IRD, G-INP, Grenoble, France
| | - Isabelle Ruin
- IGE, Univ. Grenoble Alpes, CNRS, IRD, G-INP, Grenoble, France
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Rimmer B, Balla M, Dutton L, Williams S, Araújo-Soares V, Gallagher P, Finch T, Lewis J, Burns R, Menger F, Sharp L. Barriers and facilitators to self-management in people living with a lower-grade glioma. J Cancer Surviv 2024:10.1007/s11764-024-01572-9. [PMID: 38512564 DOI: 10.1007/s11764-024-01572-9] [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: 02/21/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Self-management can have clinical and quality-of-life benefits. However, people with lower-grade gliomas (LGG) may face chronic tumour- and/or treatment-related symptoms and impairments (e.g. cognitive deficits, seizures), which could influence their ability to self-manage. Our study aimed to identify and understand the barriers and facilitators to self-management in people with LGG. METHODS We conducted semi-structured interviews with 28 people with LGG across the United Kingdom, who had completed primary treatment. Sixteen participants were male, mean age was 50.4 years, and mean time since diagnosis was 8.7 years. Interviews were audio-recorded and transcribed. Following inductive open coding, we deductively mapped codes to Schulman-Green et al.'s framework of factors influencing self-management, developed in chronic illness. RESULTS Data suggested extensive support for all five framework categories ('Personal/lifestyle characteristics', 'Health status', 'Resources', 'Environmental characteristics', 'Healthcare system'), encompassing all 18 factors influencing self-management. How people with LGG experience many of these factors appears somewhat distinct from other cancers; participants described multiple, often co-occurring, challenges, primarily with knowledge and acceptance of their incurable condition, the impact of seizures and cognitive deficits, transport difficulties, and access to (in)formal support. Several factors were on a continuum, for example, sufficient knowledge was a facilitator, whereas lack thereof, was a barrier to self-management. CONCLUSIONS People with LGG described distinctive experiences with wide-ranging factors influencing their ability to self-manage. IMPLICATIONS FOR CANCER SURVIVORS These findings will improve awareness of the potential challenges faced by people with LGG around self-management and inform development of self-management interventions for this population.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England.
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England
| | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | | | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle Upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Fiona Menger
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Ridley Building 1, Newcastle Upon Tyne, NE1 7RU, England
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Vafaei S, Alkhrait S, Yang Q, Ali M, Al-Hendy A. Empowering Strategies for Lifestyle Interventions, Diet Modifications, and Environmental Practices for Uterine Fibroid Prevention; Unveiling the LIFE UP Awareness. Nutrients 2024; 16:807. [PMID: 38542717 PMCID: PMC10975324 DOI: 10.3390/nu16060807] [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: 01/04/2024] [Revised: 02/28/2024] [Accepted: 03/07/2024] [Indexed: 04/01/2024] Open
Abstract
Uterine fibroids (UFs) are the most common prevalent benign tumor among women of reproductive age, disproportionately affecting women of color. This paper introduces an innovative management strategy for UFs, emphasizing the curbing of disease prevention and progression. Traditionally, medical intervention is deferred until advanced stages, necessitating invasive surgeries such as hysterectomy or myomectomy, leading to high recurrence rates and increased healthcare costs. The strategy, outlined in this review, emphasizes UF disease management and is named LIFE UP awareness-standing for Lifestyle Interventions, Food Modifications, and Environmental Practices for UF Prevention. These cost-effective, safe, and accessible measures hold the potential to prevent UFs, improve overall reproductive health, reduce the need for invasive procedures, and generate substantial cost savings for both individuals and healthcare systems. This review underscores the importance of a proactive UF management method, paving the way for future research and policy initiatives in this domain.
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Affiliation(s)
| | | | | | - Mohamed Ali
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (S.V.); (S.A.); (Q.Y.)
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (S.V.); (S.A.); (Q.Y.)
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Astaire E, Jennings L, Khundakar M, Silverio SA, Flynn AC. General practitioners' experiences of providing lifestyle advice to patients with depression: A qualitative focus group study. PLoS One 2024; 19:e0299934. [PMID: 38466705 PMCID: PMC10927082 DOI: 10.1371/journal.pone.0299934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 02/17/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE Depression is an increasingly common mental health disorder in the UK, managed predominantly in the community by GPs. Emerging evidence suggests lifestyle medicine is a key component in the management of depression. We aimed to explore GPs' experiences, attitudes, and challenges to providing lifestyle advice to patients with depression. METHOD Focus groups were conducted virtually with UK GPs (May-July 2022). A topic guide facilitated the discussion and included questions on experiences, current practices, competence, challenges, and service provision. Data were analysed using template analysis. RESULTS 'Supporting Effective Conversations'; 'Willing, but Blocked from Establishing Relational Care'; 'Working Towards Patient Empowerment'; and 'Control Over the Prognosis' were all elements of how individualised lifestyle advice was key to the management of depression. Establishing a doctor-patient relationship by building trust and rapport was fundamental to having effective conversations about lifestyle behaviours. Empowering patients to make positive lifestyle changes required tailoring advice using a patient-centred approach. Confidence varied across participants, depending on education, experience, type of patient, and severity of depression. CONCLUSIONS GPs play an important role in managing depression using lifestyle medicine and a patient-centred approach. Organisational and educational changes are necessary to facilitate GPs in providing optimal care to patients with depression.
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Affiliation(s)
- Emma Astaire
- School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Laura Jennings
- School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Martina Khundakar
- Pharmacy Department, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom
- School of Pharmacy, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Sergio A. Silverio
- School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Angela C. Flynn
- School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
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von Klinggraeff L, Pfledderer CD, Burkart S, Ramey K, Smith M, McLain AC, Armstrong B, Weaver RG, Okely A, Lubans D, Ioannidis JPA, Jago R, Turner-McGrievy G, Thrasher J, Li X, Beets MW. Are the Risk of Generalizability Biases Generalizable? A Meta-Epidemiological Study. RESEARCH SQUARE 2024:rs.3.rs-3897976. [PMID: 38464006 PMCID: PMC10925410 DOI: 10.21203/rs.3.rs-3897976/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Preliminary studies (e.g., pilot/feasibility studies) can result in misleading evidence that an intervention is ready to be evaluated in a large-scale trial when it is not. Risk of Generalizability Biases (RGBs, a set of external validity biases) represent study features that influence estimates of effectiveness, often inflating estimates in preliminary studies which are not replicated in larger-scale trials. While RGBs have been empirically established in interventions targeting obesity, the extent to which RGBs generalize to other health areas is unknown. Understanding the relevance of RGBs across health behavior intervention research can inform organized efforts to reduce their prevalence. Purpose The purpose of our study was to examine whether RGBs generalize outside of obesity-related interventions. Methods A systematic review identified health behavior interventions across four behaviors unrelated to obesity that follow a similar intervention development framework of preliminary studies informing larger-scale trials (i.e., tobacco use disorder, alcohol use disorder, interpersonal violence, and behaviors related to increased sexually transmitted infections). To be included, published interventions had to be tested in a preliminary study followed by testing in a larger trial (the two studies thus comprising a study pair). We extracted health-related outcomes and coded the presence/absence of RGBs. We used meta-regression models to estimate the impact of RGBs on the change in standardized mean difference (ΔSMD) between the preliminary study and larger trial. Results We identified sixty-nine study pairs, of which forty-seven were eligible for inclusion in the analysis (k = 156 effects), with RGBs identified for each behavior. For pairs where the RGB was present in the preliminary study but removed in the larger trial the treatment effect decreased by an average of ΔSMD=-0.38 (range - 0.69 to -0.21). This provides evidence of larger drop in effectiveness for studies containing RGBs relative to study pairs with no RGBs present (treatment effect decreased by an average of ΔSMD =-0.24, range - 0.19 to -0.27). Conclusion RGBs may be associated with higher effect estimates across diverse areas of health intervention research. These findings suggest commonalities shared across health behavior intervention fields may facilitate introduction of RGBs within preliminary studies, rather than RGBs being isolated to a single health behavior field.
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McAlpine RG, Sacchet MD, Simonsson O, Khan M, Krajnovic K, Morometescu L, Kamboj SK. Development of a digital intervention for psychedelic preparation (DIPP). Sci Rep 2024; 14:4072. [PMID: 38374177 PMCID: PMC10876638 DOI: 10.1038/s41598-024-54642-4] [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: 11/28/2023] [Accepted: 02/14/2024] [Indexed: 02/21/2024] Open
Abstract
Psychedelic substances induce profound alterations in consciousness. Careful preparation is therefore essential to limit adverse reactions, enhance therapeutic benefits, and maintain user safety. This paper describes the development of a self-directed, digital intervention for psychedelic preparation. Drawing on elements from the UK Medical Research Council (MRC) framework for developing complex interventions, the design was informed by a four-factor model of psychedelic preparedness, using a person-centred approach. Our mixed-methods investigation consisted of two studies. The first involved interviews with 19 participants who had previously attended a 'high-dose' psilocybin retreat, systematically exploring their preparation behaviours and perspectives on the proposed intervention. The second study engaged 28 attendees of an ongoing psilocybin retreat in co-design workshops, refining the intervention protocol using insights from the initial interviews. The outcome is a co-produced 21-day digital course (Digital Intervention for Psychedelic Preparation (DIPP)), that is organised into four modules: Knowledge-Expectation, Psychophysical-Readiness, Safety-Planning, and Intention-Preparation. Fundamental components of the course include daily meditation practice, supplementary exercises tied to the weekly modules, and mood tracking. DIPP provides a comprehensive and scalable solution to enhance psychedelic preparedness, aligning with the broader shift towards digital mental health interventions.
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Affiliation(s)
- Rosalind G McAlpine
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Otto Simonsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Maisha Khan
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
| | - Katarina Krajnovic
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
| | - Larisa Morometescu
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sunjeev K Kamboj
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
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Papies EK, Nielsen KS, Soares VA. Health psychology and climate change: time to address humanity's most existential crisis. Health Psychol Rev 2024:1-31. [PMID: 38320578 DOI: 10.1080/17437199.2024.2309242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024]
Abstract
Climate change is an ongoing and escalating health emergency. It threatens the health and wellbeing of billions of people, through extreme weather events, displacement, food insecurity, pathogenic diseases, societal destabilisation, and armed conflict. Climate change dwarfs all other challenges studied by health psychologists. The greenhouse gas emissions driving climate change disproportionately originate from the actions of wealthy populations in the Global North and are tied to excessive energy use and overconsumption driven by the pursuit of economic growth. Addressing this crisis requires significant societal transformations and individual behaviour change. Most of these changes will benefit not only the stability of the climate but will yield significant public health co-benefits. Because of their unique expertise and skills, health psychologists are urgently needed in crafting climate change mitigation responses. We propose specific ways in which health psychologists at all career stages can contribute, within the spheres of research, teaching, and policy making, and within organisations and as private citizens. As health psychologists, we cannot sit back and leave climate change to climate scientists. Climate change is a health emergency that results from human behaviour; hence it is in our power and responsibility to address it.
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Affiliation(s)
- Esther K Papies
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, United Kingdom
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Chang WJ, Chang PC, Chang YH. The gamification and development of a chatbot to promote oral self-care by adopting behavior change wheel for Taiwanese children. Digit Health 2024; 10:20552076241256750. [PMID: 38798886 PMCID: PMC11119524 DOI: 10.1177/20552076241256750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Background Oral health is closely related to general health and quality of life. School-aged children are at a critical stage for developing their self-care ability in oral health. Digital interventions can encourage and facilitate oral self-care in children. Objective This study aims to present the development of an educational chatbot for school-aged children to address their oral self-care and evaluate its usability. Methods The development and evaluation of the chatbot for oral self-care consisted of four stages: target behavior analysis, intervention design, system development, and the chatbot evaluation. The target behavior analysis identified barriers to children's engagement in oral self-care based on dentists' clinical observations; hence, the requirements for achieving the desired behavior were categorized according to the capability-opportunity-motivation behavior model. Interventional functions were created following the behavior change wheel. A menu-driven chatbot was created and evaluated for usability as well as likeability. Results The barriers and requirements for achieving good behavior in school-aged children's oral self-care were identified by the dental professionals. Intervention strategy incorporated specific functions enriched with gamification features to support school-aged children in developing their abilities for engaging in oral self-care. The intervention functions consist of capability establishment, motivation enhancement, and opportunity creation, which were designed to support children in their oral self-care practices. The designed chatbot was piloted with a convenient sample of 30 school-aged children and their accompanying parents at the pediatric dental clinic. The results indicated good usability, with a mean usability score of 79.91, and high likeability with a mean score of 4.32 out of 5 for the designed chatbot. Conclusions The educational chatbot incorporated a combination of clinical dentistry practice and guidelines, aiming to promote oral self-care behavior in school-aged children. The designed chatbot achieved high scores for its usability and user likability.
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Affiliation(s)
- Wen-Jen Chang
- Department of Information Management, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Pei-Ching Chang
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Yen-Hsiang Chang
- Department of Dentistry, Linko Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Alsaidan AA, Thirunavukkarasu A, Alhassan HH, Bin Ahmed IA, Alnasiri AS, Alhirsan WM, Alazmi NNM, Alkhlaf AK, Alderbas JM, Alkhaldi MA. Evaluation of Self-Management Behaviors and Its Correlation with the Metabolic Syndrome among the Type 2 Diabetes Mellitus Patients of Northern Saudi Arabia. J Clin Med 2023; 13:118. [PMID: 38202125 PMCID: PMC10779580 DOI: 10.3390/jcm13010118] [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: 11/25/2023] [Revised: 12/16/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Self-management behavior among diabetes patients is essential to monitor blood sugar levels, make necessary lifestyle changes, and help patients reduce their risk of complications from diabetes. We assessed the prevalence of metabolic syndrome (MS) and its association with self-management behavior and sociodemographic characteristics among 310 patients with type 2 diabetes mellitus (T2DM) attending different diabetes care centers in northern Saudi Arabia. We evaluated the self-management behaviors of patients with T2DM using a validated Arabic version of the Summary of Diabetes Self-Care Activities Scale. Regarding MS, we applied the National Cholesterol Education Program (NCEP) Adult Treatment Plan-3 (ATP-3) guidelines. A logistic regression analysis was used to identify the predictors of MS. We found that more than one-third (36.5%) of patients had MS according to the NCEP ATP-3 criteria. The prevalence of MS was significantly associated with unsatisfactory self-management behaviors. Regarding sociodemographic predictors for MS, we found a significant association between gender (ref: female: Adjusted OR (AOR) = 1.89, 95%CI = 1.17-2.95, p = 0.007) and body mass index (ref.: normal range: AOR = 2.98, 95%CI = 1.31-5.07, p = 0.003). Our findings suggest a tailor-made multifaceted intervention to improve the self-management behaviors of T2DM patients, which, in turn, can reduce MS.
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Affiliation(s)
- Aseel Awad Alsaidan
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Ashokkumar Thirunavukkarasu
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Hassan H. Alhassan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Ibrahim Abdullah Bin Ahmed
- Department of Family Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia;
| | - Anas Salem Alnasiri
- King Abdulaziz Specialist Hospital, Ministry of Health, Sakaka 72345, Saudi Arabia;
| | - Wejdan Madallah Alhirsan
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Nouf Nashmi M. Alazmi
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Abdalaziz Khaled Alkhlaf
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Jumanah Mohammed Alderbas
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Motaz Abdulsalam Alkhaldi
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
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Keurulainen M, Holma J, Wallenius E, Pänkäläinen M, Hintikka J, Partinen M. 'I became more aware of my actions'-A qualitative longitudinal study of a health psychological group intervention for patients with myalgic encephalomyelitis/chronic fatigue syndrome. Health Expect 2023; 26:2312-2324. [PMID: 37528544 PMCID: PMC10632634 DOI: 10.1111/hex.13833] [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: 04/26/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVES To explore myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients' experiences of a health psychological group intervention and its usefulness, non-usefulness or harmfulness for illness management and adjustment. DESIGN A qualitative longitudinal study using inductive content analysis. METHODS Semistructured interviews were conducted with 10 adults. Interviews were conducted before the 16-week intervention, immediately after its completion, and at 3 months after completion. RESULTS Participants reported that the intervention was useful and not harmful. The model improved their ability to cope with ME/CFS by providing them with useful information about the illness along with peer support and professional guidance. Participants reported improved illness management and adjustment, which they perceived as an outcome of achieving new ways of thinking, feeling and acting. CONCLUSIONS Participants viewed the health psychological approach to group intervention as meeting their needs. To achieve better illness management and adjustment, more consideration should be given to supportive interactional processes with peers and healthcare professionals. PATIENT OR PUBLIC CONTRIBUTION The intervention was developed to meet patients' needs of finding ways to manage their illness. The research team consulted eight patients with ME/CFS and three clinical centres working with ME/CFS treatment and rehabilitation at the intervention planning stage. Their comments influenced the planning and content of the intervention as well as ethical issues that should be considered, such as potential harm to participants. All participants were informed about the theoretical foundations of the study and the principles guiding the intervention. Participants were not involved in the data analysis. CLINICAL TRIAL REGISTRATION NCT04151693.
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Affiliation(s)
- Meeri Keurulainen
- Department of PsychologyUniversity of JyväskyläJyväskyläFinland
- Wellbeing Services County of Päijät‐Häme, General Hospital Psychiatry Outpatient ClinicLahtiFinland
| | - Juha Holma
- Department of PsychologyUniversity of JyväskyläJyväskyläFinland
| | - Elina Wallenius
- Wellbeing Services County of Päijät‐Häme, General Hospital Psychiatry Outpatient ClinicLahtiFinland
| | - Mikko Pänkäläinen
- Wellbeing Services County of Päijät‐Häme, General Hospital Psychiatry Outpatient ClinicLahtiFinland
| | - Jukka Hintikka
- Faculty of Medicine and Health TechnologyUniversity of TampereTampereFinland
| | - Markku Partinen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Terveystalo Helsinki Sleep ClinicHelsinkiFinland
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Vinogradov R, Smith V, Hiu S, McParlin C, Farnworth A, Araújo-Soares V. Let's talk aspirin: A survey of barriers and facilitators faced by midwives when engaging in conversations about aspirin with women at risk of pre-eclampsia. Midwifery 2023; 127:103860. [PMID: 37931460 DOI: 10.1016/j.midw.2023.103860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/06/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE Adherence to low-dose aspirin is key in preventing pre-eclampsia. Midwives are well positioned to support women to take aspirin as prescribed. This study aimed to understand the barriers and facilitators that midwives face during consultations with pregnant women about prophylactic aspirin. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, UK-wide, quantitative and qualitative study of midwives was conducted between November 2020 and April 2021 using social media platforms. The survey was designed using the Theoretical Domains Framework by a team of researchers experienced in using it. An open-ended question was embedded in the survey to allow midwives to expand on matters related to the study subject. FINDINGS Out of 160 responders, 37.5 % indicated inadequate engagement in conversations with women about aspirin prophylaxis. Domains 'Knowledge' (OR 13.7, 95 %CI 5.7-32.7, p < 0.001), 'Professional role and Identity' (OR 15.3, 95 %CI 6.4-36.7, p < 0.001) and 'Beliefs about capabilities' (OR 13.6, 95 %CI 6.1-30.6, p < 0.001) were most prominently associated with effective engagement. Best fit model was comprised of 'Beliefs about Capabilities', 'Social/professional role and identity', and 'Knowledge'. Midwives' comments focused on barriers within 'environmental context' related to 'conflicting views' and 'deficit in resources' that compromise positive reinforcement of aspirin use. Responders also provided helpful 'Top tips' that streamline their daily practice. CONCLUSION AND IMPLICATIONS FOR PRACTICE Beliefs about Capabilities, Social/professional role and identity, Knowledge, and Environmental Context and resources are key domains related to midwives' engagement in conversations about aspirin in pregnancy. Clear, up-to date information for midwives and the public should be available in an easy access format to allow provision of unequivocal advice related to the use of aspirin in pregnancy.
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Affiliation(s)
- Raya Vinogradov
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Reproductive Health & Neonates, Research Midwives Office, Level 6, Leazes Wing, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK; The National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC), UK.
| | - Vikki Smith
- Department of Nursing, Midwifery & Health, Northumbria University, UK
| | - Shaun Hiu
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine McParlin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Department of Nursing, Midwifery & Health, Northumbria University, UK
| | - Allison Farnworth
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Vera Araújo-Soares
- Division of Prevention, Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Germany
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Herbert J, Schumacher T, Brown LJ, Clarke ED, Collins CE. Delivery of telehealth nutrition and physical activity interventions to adults living in rural areas: a scoping review. Int J Behav Nutr Phys Act 2023; 20:110. [PMID: 37715234 PMCID: PMC10504780 DOI: 10.1186/s12966-023-01505-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/20/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Lifestyle behaviours related to smoking, alcohol, nutrition, and physical activity are leading risk factors for the development of chronic disease. For people in rural areas, access to individualised lifestyle services targeting behaviour change may be improved by using telehealth. However, the scope of literature investigating telehealth lifestyle behaviour change interventions for rural populations is unknown, making it difficult to ascertain whether telehealth interventions require adaptation for rural context via a systematic review. This scoping review aimed to address this gap, by mapping existing literature describing telehealth lifestyle interventions delivered to rural populations to determine if there is scope for systematic review of intervention effectiveness in this research topic. METHODS The PRISMA extension for scoping review checklist guided the processes of this scoping review. A search of eight electronic databases reported in English language until June 2023 was conducted. Eligible studies included adults (18 years and over), who lived in rural areas of high-income countries and undertook at least one synchronous (video or phone consultation) telehealth intervention that addressed either addictive (smoking or alcohol), or non-addictive lifestyle behaviours (nutrition or physical activity). Studies targeting addictive and non-addictive behaviours were separated after full text screening to account for the involvement of addictive substances in smoking and alcohol studies that may impact behaviour change interventions described. Studies targeting nutrition and/or physical activity interventions are presented here. RESULTS The search strategy identified 17179 citations across eight databases, with 7440 unique citations once duplicates were removed. Full texts for 492 citations were retrieved and screened for inclusion with 85 publications reporting on 73 studies eligible for data extraction and analysis. Of this, addictive behaviours were comprised of 15 publications from 13 studies. Non-addictive behaviours included 70 publications from 58 studies and are reported here. Most interventions were delivered within the United States of America (n = 43, 74.1%). The most common study design reported was Randomised Control Trial (n = 27, 46.6%). Included studies involved synchronous telehealth interventions targeting nutrition (11, 18.9%), physical activity (5, 8.6%) or nutrition and physical activity (41, 70.7%) and were delivered predominately via videoconference (n = 17, 29.3%). CONCLUSIONS Despite differences in intervention characteristics, the number of randomised control trials published suggests sufficient scope for future systematic reviews to determine intervention effectiveness related to nutrition and physical activity telehealth interventions for rural populations. TRIAL REGISTRATION The scoping review protocol was not pre-registered.
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Affiliation(s)
- Jaimee Herbert
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Tracy Schumacher
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Leanne J Brown
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Erin D Clarke
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 205, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia
| | - Clare E Collins
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 310, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia.
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Amirova A, Taylor L, Volkmer B, Ahmed N, Chater AM, Fteropoulli T. Informing behaviour change intervention design using systematic review with Bayesian meta-analysis: physical activity in heart failure. Health Psychol Rev 2023; 17:456-484. [PMID: 35701235 DOI: 10.1080/17437199.2022.2090411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 06/02/2022] [Indexed: 12/11/2022]
Abstract
Embracing the Bayesian approach, we aimed to synthesise evidence regarding barriers and enablers to physical activity in adults with heart failure (HF) to inform behaviour change intervention. This approach helps estimate and quantify the uncertainty in the evidence and facilitates the synthesis of qualitative and quantitative studies. Qualitative evidence was annotated using the Theoretical Domains Framework and represented as a prior distribution using an expert elicitation task. The maximum a posteriori probability (MAP) for the probability distribution for the log OR was used to estimate the relationship between physical activity and each determinant according to qualitative, quantitative, and qualitative and quantitative evidence combined. The probability distribution dispersion (SD) was used to evaluate uncertainty in the evidence. Three qualitative and 16 quantitative studies were included (N = 2739). High pro-b-type natriuretic peptide (MAP = -1.16; 95%CrI: [-1.21; -1.11]) and self-reported symptoms (MAP = - 0.48; 95%CrI: [ -0.40; -0.55]) were suggested as barriers to physical activity with low uncertainty (SD = 0.18 and 0.19, respectively). Modifiable barriers were symptom distress (MAP = -0.46; 95%CrI: [-0.68; -0.24], SD = 0.36), and negative attitude (MAP = -0.40; 95%CrI: [-0.49; -0.31], SD = 0.26). Modifiable enablers were social support (MAP = 0.56; 95%CrI: [0.48; 0.63], SD = 0.26), self-efficacy (MAP = 0.43; 95%CrI: [0.32; 0.54], SD = 0.37), positive physical activity attitude (MAP = 0.92; 95%CrI: [0.77; 1.06], SD = 0.36).
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Affiliation(s)
- Aliya Amirova
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lauren Taylor
- Department of Psychology, University of Surrey, Guildford, UK
| | - Brittannia Volkmer
- Psychology department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nafiso Ahmed
- Mental Health Policy Research Unit, UCL Division of Psychiatry, London, UK
| | - Angel M Chater
- Centre for Behaviour Change, Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, UCL, London, UK
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, UK
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Rimmer B, Balla M, Dutton L, Lewis J, Brown MC, Burns R, Gallagher P, Williams S, Araújo-Soares V, Finch T, Menger F, Sharp L. Identifying and understanding how people living with a lower-grade glioma engage in self-management. J Cancer Surviv 2023:10.1007/s11764-023-01425-x. [PMID: 37450254 DOI: 10.1007/s11764-023-01425-x] [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: 03/28/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Lower-grade gliomas (LGG) are mostly diagnosed in working-aged adults and rarely cured. LGG patients may face chronic impairments (e.g. fatigue, cognitive deficits). Self-management can improve clinical and psychosocial outcomes, yet how LGG patients self-manage the consequences of their tumour and its treatment is not fully understood. This study, therefore, aimed to identify and understand how LGG patients engage in the self-management of their condition. METHODS A diverse group of 28 LGG patients (age range 22-69 years; male n = 16, female n = 12; mean time since diagnosis = 8.7 years) who had completed primary treatment, were recruited from across the United Kingdom. Semi-structured interviews were conducted. Informed by a self-management strategy framework developed in cancer, directed content analysis identified and categorised self-management types and strategies used by patients. RESULTS Overall, 20 self-management strategy types, comprising 123 self-management strategies were reported; each participant detailed extensive engagement in self-management. The most used strategy types were 'using support' (n = 28), 'creating a healthy environment' (n = 28), 'meaning making' (n = 27), and 'self-monitoring' (n = 27). The most used strategies were 'accepting the tumour and its consequences' (n = 26), 'receiving support from friends (n = 24) and family' (n = 24), and 'reinterpreting negative consequences' (n = 24). CONCLUSIONS This study provides a comprehensive understanding of the strategies used by LGG patients to self-manage their health and wellbeing, with a diverse, and substantial number of self-management strategies reported. IMPLICATIONS FOR CANCER SURVIVORS The findings will inform the development of a supported self-management intervention for LGG patients, which will be novel for this patient group.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England.
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Morven C Brown
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | | | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle Upon Tyne, England
| | - Fiona Menger
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle Upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
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Luque B, Farhane-Medina NZ, Villalba M, Castillo-Mayén R, Cuadrado E, Tabernero C. Positivity and Health Locus of Control: Key Variables to Intervene on Well-Being of Cardiovascular Disease Patients. J Pers Med 2023; 13:873. [PMID: 37241043 PMCID: PMC10220922 DOI: 10.3390/jpm13050873] [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: 04/01/2023] [Revised: 05/13/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Psychological well-being is a good predictor of several health outcomes in cardiovascular disease patients (adherence, quality of life, and healthy behaviors). The perception of health control and a positive orientation seem to have a beneficial effect on health and well-being. Therefore, the aim of this study was to investigate the role of the health locus of control and positivity in the psychological well-being and quality of life of cardiovascular patients. A total of 593 cardiac outpatients completed the Multidimensional Health Locus of Control Scale, the Positivity Scale and the Hospital Anxiety and Depression Scale at baseline (January 2017) and 9 m later (follow-up; n = 323). A Spearman rank correlation coefficient and a structural equation modeling approach were determined to explore the relationships between those variables both cross-sectionally and longitudinally. A cross-sectional correlation analysis at baseline revealed that the internal health locus of control and positivity were negatively associated with anxiety (rs = -0.15 and -0.44, ps < 0.01) and depression (rs = -0.22 and -0.55, ps < 0.01) and positively associated with health-related quality of life (rs = 0.16 and 0.46, ps < 0.01). Similar outcomes were found at follow-up and in longitudinal correlations. According to the path analysis, positivity was found to be negatively associated with anxiety and depression level at baseline (β = -0.42 and -0.45, ps < 0.001). Longitudinally, positivity was negatively associated with depression (β = 0.15, p < 0.01) and together with the internal health locus of control, was positively associated with health-related quality of life (β = 0.16 and 0.10, respectively, ps < 0.05). These findings suggest that focusing on the health locus of control and especially positivity may be crucial in enhancing the psychological well-being of patients in the context of cardiac care. The potential impact of these results on future interventions is discussed.
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Affiliation(s)
- Bárbara Luque
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (B.L.); (N.Z.F.-M.); (E.C.); (C.T.)
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
| | - Naima Z. Farhane-Medina
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (B.L.); (N.Z.F.-M.); (E.C.); (C.T.)
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
| | - Marta Villalba
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
| | - Rosario Castillo-Mayén
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (B.L.); (N.Z.F.-M.); (E.C.); (C.T.)
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
| | - Esther Cuadrado
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (B.L.); (N.Z.F.-M.); (E.C.); (C.T.)
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain; (B.L.); (N.Z.F.-M.); (E.C.); (C.T.)
- Institute of Neurosciences of Castilla y León (INCYL), University of Salamanca, 37007 Salamanca, Spain
- Department of Social Psychology and Anthropology, University of Salamanca, 37005 Salamanca, Spain
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Grigoropoulou M, Attilakos A, Charalampopoulos A, Fessatou S, Vamvakas E, Dimopoulou A, Zavras N. Measuring Children's Stress via Saliva in Surgical and Endoscopic Procedures and Its Measurement Intention in the Community: Reality-Future Prospects. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050853. [PMID: 37238401 DOI: 10.3390/children10050853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: Children who undergo surgical or endoscopic procedures display high levels of stress, and various means are applied to reduce their anxiety. Salivary cortisol (S Cortisol) and salivary alpha-amylase (SAA) are often used as a valid biomarker of stress. The primary purpose of the study was the investigation of stress levels through S Cortisol and S amylase after intervention in surgical or endoscopic procedures (gastroscopy-colonoscopy). The secondary outcomes were the investigation of the intention to adopt new methods of saliva sampling. We collected saliva samples from children subjected to invasive medical procedures, with the aim of applying the Theory of Planned Behavior (TPB) as an intervention means to provide information and education to both parents and children undergoing stressful situations, and assess its efficacy in reducing stress levels. We also aimed at acquiring a better understanding of the acceptability of noninvasive biomarker collection in community settings. (2) Methods: The sample of this prospective study comprised 81 children who underwent surgical or endoscopic procedures at the Attikon General University Hospital, Athens, Greece and 90 parents. The sample was divided into two groups. The first, 'Group Unexplained', was not provided any information or education about the procedures, while the second, 'Group Explained', was informed and educated based on TPB. Thereafter, 8-10 weeks after intervention, the Theory of Planned Behavior questions were re-completed by the 'Group Explained'. (3) Results: Significant differences were detected in cortisol and amylase values between the two groups postoperatively after applying the TPB intervention. Saliva cortisol was reduced by 8.09 ng/mL in the 'Group Explained' while in the 'Group Unexplained' it was reduced by 4.45 ng/mL (p < 0.001). Salivary amylase values decreased by 9.69 ng/mL in the 'Group Explained' after the intervention phase of the study, while in the 'Group Unexplained' they increased by 35.04 ng/mL (p < 0.001). The regression explains 40.3% (baseline) and 28.5% (follow-up) of parental intention. The predictive factor of parental intention (baseline) is attitude (p < 0.001) and follow-up is behavioral control (p < 0.028) and attitude (p < 0.001). (4) Conclusions: Providing proper education and information for parents has a positive effect on reducing children's stress levels. Changing parental attitudes towards saliva collection plays the most important role, since a positive attitude can influence intention and ultimately participation in these procedures.
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Affiliation(s)
| | - Achilleas Attilakos
- Department of Pediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Anestis Charalampopoulos
- Department of Surgery, Attikon University General Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Smaragdi Fessatou
- Department of Pediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Efstratios Vamvakas
- Second Critical Care Department, Attikon University General Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Anastasia Dimopoulou
- Department of Pediatric Surgery, Attikon University General Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Nikolaos Zavras
- Department of Pediatric Surgery, Attikon University General Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
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Chalabaev A, Cheval B, Maltagliati S, Saoudi I, Sniehotta FF. Beyond Individual Cognitions: Time for Intervention Science to Focus on Health Context and Audience. J Phys Act Health 2023; 20:465-470. [PMID: 37076243 DOI: 10.1123/jpah.2023-0072] [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: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 04/21/2023]
Abstract
Intervention science faces a hazardous paradox: on the one hand, vulnerable populations (eg, patients, people from low socioeconomic background, older adults) are those for whom adoption of healthy behaviors is most urgent; on the other hand, behavior change models are less predictive, and interventions less successful, in these populations. This commentary presents 4 reasons that may explain this issue: (1) research mostly focuses on what causes behavior and how to change it, at the expense of investigating among whom and under what conditions models are valid; (2) models put an undue emphasis on individual cognitions; (3) most studies are not conducted on vulnerable populations; and (4) most researchers are from high-income countries. Several avenues are proposed to address this issue: (1) providing a central place to the context and audience in health behavior change modelization, through collaborations with researchers from other disciplines and countries, and with members of the targeted audience; (2) better reporting samples' sociodemographic characteristics and increasing samples' diversity; and (3) using more rigorous and innovative designs (eg, powered randomized controlled trials, N-of-1 trials, intensive longitudinal studies). In conclusion, it becomes urgent to change the way we do research: the social utility and credibility of intervention science depend on it.
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Affiliation(s)
| | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva,Switzerland
- Department of Psychology, Switzerland Department of Public Health, Social and Environmental Determinants of Health, Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), University of Geneva, Geneva,Switzerland
| | | | | | - Falko F Sniehotta
- Department of Public Health, Social and Preventive Medicine, CPD, Medical Faculty Mannheim, University of Heidelberg, Mannheim,Germany
- NIHR Policy Research Unit Behavioural Science, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne,United Kingdom
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25
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Veliz PT, Zhou W, Smith S, Larson JL. Substance Use and the Self-Management of Persistent Symptoms of COVID-19. Subst Use Misuse 2023; 58:835-840. [PMID: 36942996 DOI: 10.1080/10826084.2023.2184208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background: Understanding the self-management practices of persistent symptoms of SARS-Cov-2 (COVID-19) is critical given the misinformation that has been presented about this disease in the U.S. The purpose of this descriptive study is to assess the self-management of persistent symptoms of COVID-19 with commonly used and misused substances (i.e., alcohol, marijuana and commonly prescribed medications) among adults in the U.S. Methods: The data for this study comes from a cross-sectional survey of U.S. adults that was designed to broadly assess symptom burden, persistent symptom patterns, self-efficacy for symptom management and self-management strategies among people who experienced persistent/Long COVID. Multiple logistic regression analyses were used to assess how symptom length of COVID-19 was associated with the use of several substances to manage these persistent symptoms. Results: The analysis found that adults who had COVID-19 symptoms that persisted for 13 weeks or longer had higher rates of using alcohol (27.3%), marijuana (30.9%) and prescription tranquilizers (21.4%) to manage these symptoms when compared to their adult peers who had COVID-19 symptoms persist for only 4 weeks or less. For instance, the odds of indicating the use of marijuana (AOR = 4.21 95% CI = 1.68,10.5) to manage COVID-19 related symptoms was roughly four times higher for respondents who had COVID-19 symptoms persist for 13 weeks or longer when compared to respondents whose COVID-19 symptoms persisted for only 4 weeks or less. Conclusion: The findings suggest that screening of substance use disorders should be considered among healthcare providers who are treating adults who have persistent symptoms of COVID-19.
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Affiliation(s)
- Philip T Veliz
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Weijiao Zhou
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sheree Smith
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Janet L Larson
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
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26
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Yang L, Kuang A, Xu C, Shewchuk B, Singh S, Quan H, Zeng Y. Design Principles in mHealth Interventions for Sustainable Health Behavior Changes: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e39093. [PMID: 36811938 PMCID: PMC9996417 DOI: 10.2196/39093] [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: 04/28/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND In recent years, mHealth has increasingly been used to deliver behavioral interventions for disease prevention and self-management. Computing power in mHealth tools can provide unique functions beyond conventional interventions in provisioning personalized behavior change recommendations and delivering them in real time, supported by dialogue systems. However, design principles to incorporate these features in mHealth interventions have not been systematically evaluated. OBJECTIVE The goal of this review is to identify best practices for the design of mHealth interventions targeting diet, physical activity, and sedentary behavior. We aim to identify and summarize the design characteristics of current mHealth tools with a focus on the following features: (1) personalization, (2) real-time functions, and (3) deliverable resources. METHODS We will conduct a systematic search of electronic databases, including MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science for studies published since 2010. First, we will use keywords that combine mHealth, interventions, chronic disease prevention, and self-management. Second, we will use keywords that cover diet, physical activity, and sedentary behavior. Literature found in the first and second steps will be combined. Finally, we will use keywords for personalization and real-time functions to limit the results to interventions that have reported these design features. We expect to perform narrative syntheses for each of the 3 target design features. Study quality will be evaluated using the Risk of Bias 2 assessment tool. RESULTS We have conducted a preliminary search of existing systematic reviews and review protocols on mHealth-supported behavior change interventions. We have identified several reviews that aimed to evaluate the efficacy of mHealth behavior change interventions in a range of populations, evaluate methodologies for assessing mHealth behavior change randomized trials, and assess the diversity of behavior change techniques and theories in mHealth interventions. However, syntheses on the unique features of mHealth intervention design are absent in the literature. CONCLUSIONS Our findings will provide a basis for developing best practices for designing mHealth tools for sustainable behavior change. TRIAL REGISTRATION PROSPERO CRD42021261078; https://tinyurl.com/m454r65t. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/39093.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Angela Kuang
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Claire Xu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Brittany Shewchuk
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Shaminder Singh
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada
| | - Hude Quan
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yong Zeng
- Concordia Institute for Information Systems Engineering, Concordia University, Montreal, QC, Canada
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Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies. Auton Neurosci 2023; 244:103052. [PMID: 36525900 DOI: 10.1016/j.autneu.2022.103052] [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: 05/18/2022] [Revised: 10/27/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Postural Orthostatic Tachycardia Syndrome (POTS) is a chronic health condition affecting mostly women of childbearing age, and significantly impacting their health and quality of life. It is currently poorly understood with no approved licensed treatments. The aim of this systematic review was to contextualize the symptom burden of POTS, and review factors associated with this burden that may guide future treatments. The specific questions were (1) How does symptom burden in POTS compare to the burden in other long term conditions (LTCs), (2) Which factors are associated with POTS symptom burden, and (3) Which interventions show promise in reducing symptom burden in POTS. DATABASES AND DATA TREATMENT Electronic databases (CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, APA PsycArticles, OpenGrey) were searched from inception to January 2022 for observational studies reporting on the association between any biological, psychological or social factors and symptom burden, and randomized controlled trials reporting on interventions for symptom burden in adults with POTS. Two reviewers independently conducted eligibility screening, data extraction and quality assessment. A narrative synthesis was undertaken. RESULTS/CONCLUSION 5159 entries were screened for eligibility. Twenty-nine studies were included (1372 participants with POTS of a total sample size of 2314, 17 High-, 12 Medium-quality), seventeen were observational and twelve were randomized controlled experimental and intervention trials. Overall methodological quality of the evidence was medium-high but heterogeneity was high and sample sizes modest, allowing moderately robust conclusions. Orthostatic symptom burden was higher in POTS than other LTCs. Serum activity against adrenergic α1 receptors, physical functioning, depression, catastrophizing, prolonged cognitive stress testing and anxiety were significantly associated with symptom burden in medium-high quality studies. Preliminary medium-high quality evidence from predominantly proof-of-concept (n = 11) studies and one 3-month 2 × 2 factorial design trial suggest that compression garments, propranolol, pyridostigmine, desmopressin, and bisoprolol may hold promise in reducing symptom burden. Directions for future research include investigating associated factors over time, the development of complex interventions which address both biological and psychosocial factors associated with symptom burden, and effectiveness trials of these interventions. SIGNIFICANCE POTS symptom burden is high, particularly in relation to orthostatic intolerance when compared to other long-term conditions (LTCs). Despite this burden, there are no effectiveness randomized controlled trials of treatment to reduce symptoms in POTS. This review provides a starting point to understanding researched biological and psychosocial factors associated with this burden. There was however inconsistency in the measurement of symptom burden, lowering the confidence of cross-study inferences. A coherent definition of POTS symptom range, severity and impact along with a validated and reliable POTS-specific instrument is currently lacking. A standardized questionnaire to assess POTS symptom burden as a core outcome measure will help clarify future research and clinical practice.
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Zhou L, Chu Y, Wei L, Wang J, Zhu X. Diet self-management: A qualitative study of college students' experiences and perspectives. Front Public Health 2022; 10:1059818. [PMID: 36579070 PMCID: PMC9790922 DOI: 10.3389/fpubh.2022.1059818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
Background Overweight and obesity among college students have become an emergent public health concern, which may be effectively prevented by diet self-management (DSM). The purpose of this explorative study was to explore college students' experiences and perspectives on diet self-management (DSM), as well as its influencing factors. Method Thirty-three college students were recruited from different universities in China. A qualitative method was used to conduct semi-structured interviews with audio recording to explore their DSM experience and factors that influence DSM. Data were analyzed using thematic analysis to develop themes related to DSM. Result In the perception of what "good DSM" means, three themes and ten subthemes were identified: characteristics of good DSM (including 5 subthemes: regularity, balanced diet, no picky eating, good eating habits, and scientificity), method of good DSM (including three subthemes: self-control, adjusting, and making plans), and content of good DSM (including two subthemes: nutrition management and safety management). The influencing factors of DSM can be categorized into four levels of themes and 34 subthemes: individual, family, school, and social levels. Conclusion The results of this qualitative research highlighted the complexity and multi-dimension of DSM and its influencing factors. Our findings may help to inform diverse and needs-based intervention approaches to improve DSM and promote healthy diet among college students so as to prevent overweight and obesity.
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29
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He X, Wang Y, Feng C, Luo L, Khaliq U, Rehman FU, Zhang X. Preferring self-management behavior of patients with chronic kidney disease. Front Public Health 2022; 10:973488. [PMID: 36530662 PMCID: PMC9755185 DOI: 10.3389/fpubh.2022.973488] [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: 06/20/2022] [Accepted: 10/31/2022] [Indexed: 12/04/2022] Open
Abstract
This study explores the preferred behavior of self-management among chronic kidney disease (CKD) patients and offers suggestions for different patients from personalized medicine. According to some related references, a questionnaire was designed in 2020 to collect data from 131 patients with CKD in a general hospital. The Sampling patients showed no difference in their disease progress. The questionnaire covered two aspects of demographic and behavior with 29 items on six dimensions. Statistical methods such as a descriptive analysis of the F test in behavior dimensions on demographic characteristics and Principal component analysis from items have been applied to classify some kinds of self-management behavior into different groups. In the demographic insight, employment status closely relates to self-management behavior, and income is insignificant. In the behavior aspects, according to some key items, we found four types of self-management behavior preferred in the sorting: cognitive-knowledge, Diet-exercise-medical, emotion management, and exercise-medical, which were defined by behavior dimensions. Although patients had the same disease progress, their self-management behavior mainly existed in four types based on critical factors. According to their favorite behavior and personality group, healthcare stakeholders can offer lean support for improving patients' self-management of CKD in China.
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Affiliation(s)
- Xiaoli He
- West China School of Nursing/Department of Outpatient, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Wang
- Department of Industry Engineering and Management, Business School, Sichuan University, Chengdu, China
| | - Chenchen Feng
- West China School of Nursing/Department of Outpatient, West China Hospital, Sichuan University, Chengdu, China
| | - Le Luo
- School of Civil Engineering and Geomatics, Southwest Petroleum University, Chengdu, China
| | - Usama Khaliq
- Department of Industry Engineering and Management, Business School, Sichuan University, Chengdu, China
| | | | - Xinli Zhang
- Department of Industry Engineering and Management, Business School, Sichuan University, Chengdu, China,*Correspondence: Xinli Zhang
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30
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Sheldon EM, Lillington G, Simpson K, Gibson K, Chambers L, D'Afflitto M, Greig N, Stearn T, Hind D, Ainley R, Winsor G, Ridsdale K, Totton N, Lobo A. Development of an inflammatory bowel disease (IBD) Patient-Reported Experience Measure (PREM): A patient-led consensus work and 'think aloud' study for a quality improvement programme. Health Expect 2022; 26:213-225. [PMID: 36335578 PMCID: PMC9854292 DOI: 10.1111/hex.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Patient-Reported Experience Measures (PREMs) are key in improving healthcare quality, but no PREM exists for inflammatory bowel disease (IBD). This study aimed to co-produce a PREM with IBD service users for IBD service evaluation and quality improvement programme. METHODS A pool of 75 items was drawn from published survey instruments covering interactions with services and aspects of living with IBD. In Stage 1, during two workshops, eight expert service users reduced candidate items through a ranked-choice voting exercise and suggested further items. During Stage 2, 18 previously uninvolved people with IBD assessed the face and content validity of the candidate items in 'Think Aloud' interviews. During two final workshops (Stage 3), the expert service users removed, modified and added items based on the interview findings to produce a final version of the PREM. RESULTS Stage 1 generated a draft working PREM mapped to the following four domains: Patient-Centred Care; Quality; Accessibility; Communication and Involvement. The PREM included a set of nine items created by the expert group which shifted the emphasis from 'self-management' to 'living with IBD'. Stage 2 interviews showed that comprehension of the PREM was very good, although there were concerns about the wording, IBD-relevance and ambiguity of some items. During the final two workshops in Stage 3, the expert service users removed 7 items, modified 15 items and added seven new ones based on the interview findings, resulting in a 38-item PREM. CONCLUSIONS This study demonstrates how extensive service user involvement can inform PREM development. PATIENT OR PUBLIC CONTRIBUTION Patients were involved as active members of the research team and as research participants to co-produce and validate a PREM for IBD services. In Stage 1, eight expert service users ('the expert group') reduced candidate items for the PREM through a voting exercise and suggested new items. During Stage 2, 18 previously uninvolved people with IBD (the 'think aloud' participants) assessed the validity of the candidate items in 'Think Aloud' interviews as research participants. In Stage 3, the expert group removed, changed and added items based on the interview findings to produce a final version of the 38-item PREM. This study shows how service user involvement can meaningfully inform PREM development.
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Affiliation(s)
- Elena M. Sheldon
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - George Lillington
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Kati Simpson
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Kirsty Gibson
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Lucy Chambers
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | | | - Nancy Greig
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Theresa Stearn
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Daniel Hind
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | | | | | - Katie Ridsdale
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Nikki Totton
- Sheffield Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Alan Lobo
- Gastroenterology and Liver Unit, Royal Hallamshire HospitalSheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
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ProHealth eCoach: user-centered design and development of an eCoach app to promote healthy lifestyle with personalized activity recommendations. BMC Health Serv Res 2022; 22:1120. [PMID: 36057715 PMCID: PMC9440769 DOI: 10.1186/s12913-022-08441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Regular physical activity (PA), healthy habits, and an appropriate diet are recommended guidelines to maintain a healthy lifestyle. A healthy lifestyle can help to avoid chronic diseases and long-term illnesses. A monitoring and automatic personalized lifestyle recommendation system (i.e., automatic electronic coach or eCoach) with considering clinical and ethical guidelines, individual health status, condition, and preferences may successfully help participants to follow recommendations to maintain a healthy lifestyle. As a prerequisite for the prototype design of such a helpful eCoach system, it is essential to involve the end-users and subject-matter experts throughout the iterative design process. Methods We used an iterative user-centered design (UCD) approach to understend context of use and to collect qualitative data to develop a roadmap for self-management with eCoaching. We involved researchers, non-technical and technical, health professionals, subject-matter experts, and potential end-users in design process. We designed and developed the eCoach prototype in two stages, adopting different phases of the iterative design process. In design workshop 1, we focused on identifying end-users, understanding the user’s context, specifying user requirements, designing and developing an initial low-fidelity eCoach prototype. In design workshop 2, we focused on maturing the low-fidelity solution design and development for the visualization of continuous and discrete data, artificial intelligence (AI)-based interval forecasting, personalized recommendations, and activity goals. Results The iterative design process helped to develop a working prototype of eCoach system that meets end-user’s requirements and expectations towards an effective recommendation visualization, considering diversity in culture, quality of life, and human values. The design provides an early version of the solution, consisting of wearable technology, a mobile app following the “Google Material Design” guidelines, and web content for self-monitoring, goal setting, and lifestyle recommendations in an engaging manner between the eCoach app and end-users. Conclusions The adopted iterative design process brings in a design focus on the user and their needs at each phase. Throughout the design process, users have been involved at the heart of the design to create a working research prototype to improve the fit between technology, end-user, and researchers. Furthermore, we performed a technological readiness study of ProHealth eCoach against standard levels set by European Union (EU). Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08441-0.
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O'Shea A, Drennan J, Littlewood C, Slater H, Sim J, McVeigh JG. Barriers and facilitators related to self-management of shoulder pain: a systematic review and qualitative synthesis. Clin Rehabil 2022; 36:1539-1562. [PMID: 35733369 PMCID: PMC9515516 DOI: 10.1177/02692155221108553] [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: 11/17/2022]
Abstract
OBJECTIVE The objective of this review was to identify barriers and facilitators related to self-management from the perspectives of people with shoulder pain and clinicians involved in their care. DATA SOURCES CINAHL, MEDLINE, PsycINFO, SPORTDiscus, Embase, ProQuest Health, Web of Science, and Scopus were searched from inception to March 2022. REVIEW METHODS A meta-aggregative approach to the synthesis of qualitative evidence was used. Two independent reviewers identified eligible articles, extracted the data, and conducted a critical appraisal. Two reviewers independently identified and developed categories, with validation by two further researchers. Categories were discussed among the wider research team and a comprehensive set of synthesized findings was derived. RESULTS Twenty studies were included. From the perspective of patients, three synthesized findings were identified that influenced self-management: (1) support for self-management, including subthemes related to patient-centred support, knowledge, time, access to equipment, and patient digital literacy; (2) personal factors, including patient beliefs, patient expectations, patient motivation, pain, and therapeutic response; and (3) external factors, including influence of the clinician and therapeutic approach. From the perspective of clinicians, two synthesized findings were identified that influenced self-management: (1) support for self-management, including education, patient-centred support, patient empowerment, time, and clinician digital literacy; and (2) preferred management approach, including clinician beliefs, expectations, motivation, therapeutic approach, and therapeutic response. CONCLUSION The key barriers and facilitators were patient-centred support, patient beliefs, clinician beliefs, pain, and therapeutic response. Most of the included studies focused on exercise-based rehabilitation, and therefore might not fully represent barriers and facilitators to broader self-management.
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Affiliation(s)
- Aidan O'Shea
- Discipline of Physiotherapy, College of Medicine and Health, 8795University College Cork, Cork, Ireland
| | - Jonathan Drennan
- School of Nursing and Midwifery, College of Medicine and Health, 8795University College Cork, Cork, Ireland
| | - Chris Littlewood
- Faculty of Health, Social Care & Medicine, 6249Edge Hill University, Ormskirk, UK
| | - Helen Slater
- Curtin School of Allied Health, enAble Institute, 168274Curtin University, Perth, Australia
| | - Julius Sim
- School of Medicine, Faculty of Medicine and Health Sciences, 4212Keele University, Keele, UK
| | - Joseph G McVeigh
- Discipline of Physiotherapy, College of Medicine and Health, 8795University College Cork, Cork, Ireland
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Rodrigues AM, Wearn A, Haste A, Mallion V, Evison M, Howle F, Haighton C. Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis. BMJ Open 2022; 12:e054739. [PMID: 35701059 PMCID: PMC9198791 DOI: 10.1136/bmjopen-2021-054739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 05/08/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project implemented an evidence-based intervention that offers a combination of pharmacotherapy and behavioural support to tobacco-dependent inpatients. Understanding key characteristics of CURE's implementation strategy, and identifying areas for improvement, is important to support the roll-out of nationwide tobacco dependence services. This study aimed to (1) specify key characteristics of CURE's exiting implementation strategy and (2) develop theoretical-informed and stakeholder-informed recommendations to optimise wider roll-out. DESIGN AND METHODS Data were collected via document review and secondary analysis of interviews with 10 healthcare professionals of a UK hospital. Intervention content was specified through behaviour change techniques (BCTs) and intervention functions within the Behaviour Change Wheel. A logic model was developed to specify CURE's implementation strategy and its mechanisms of impact. We explored the extent to which BCTs and intervention functions addressed the key theoretical domains influencing implementation using prespecified matrices. The development of recommendations was conducted over a two-round Delphi exercise. RESULTS We identified six key theoretical domains of influences: 'environmental context and resources', 'goals', 'social professional role and identity', 'social influences', 'reinforcement' and 'skills'. The behavioural analysis identified 26 BCTs, 4 intervention functions and 4 policy categories present within the implementation strategy. The implementation strategy included half the relevant intervention functions and BCTs to target theoretical domains influencing CURE implementation, with many BCTs focusing on shaping knowledge. Recommendations to optimise content were developed following stakeholder engagement. CONCLUSIONS CURE offers a strong foundation from which a tobacco dependence treatment model can be developed in England. The exiting strategy could be strengthened via the inclusion of more theoretically congruent BCTs, particularly relating to 'environmental context and resources'. The recommendations provide routes to optimisation that are both theoretically grounded and stakeholder informed. Future research should assess the feasibility/acceptability of these recommendations in the wider secondary-care context.
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Affiliation(s)
- Angela M Rodrigues
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Angela Wearn
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anna Haste
- Centre for Applied Psychological Science, Department of Psychology, School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Verity Mallion
- Behavioural Insights Team, Public Health England, London, UK
| | - Matthew Evison
- The CURE Project Team, The Christie NHS Foundation Trust, Manchester, UK
| | - Freya Howle
- The CURE Project Team, The Christie NHS Foundation Trust, Manchester, UK
| | - Catherine Haighton
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
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Blanford JI, Jong NBD, Schouten SE, Friedrich AW, Araújo-Soares V. Navigating travel in Europe during the pandemic: from mobile apps, certificates and quarantine to traffic-light system. J Travel Med 2022; 29:6520892. [PMID: 35134215 PMCID: PMC9155998 DOI: 10.1093/jtm/taac006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/14/2021] [Accepted: 01/26/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Ever since 2020, travelling has become complex, and increasingly so as the COVID-19 pandemic continues. To reopen Europe safely, a consensus of travel measures has been agreed between countries to enable movement between countries with as few restrictions as possible. However, communication of these travel measures and requirements for entry are not always clear and easily available. The aim of this study was to assess the availability, accessibility and harmonization of current travel information available in Europe. METHODS We performed a systematic documental analysis of online publicly available information and synthesized travel entry requirements for all countries in the European Union and Schengen Area (N = 31). For each country we assessed entry requirements, actions after entry, how risk was assessed, and how accessible the information was. RESULTS We found varying measures implemented across Europe for entry and a range of exemptions and restrictions, some of which were consistent between countries. Information was not always easy to find taking on average 10 clicks to locate. Twenty-one countries required pre-travel forms to be completed. Forty apps were in use, 11 serving as digital certification checkers. All countries required some form of COVID-19 certification for entry with some exemptions (e.g. children). Nineteen percent (n = 6) of countries used the ECDC risk assessment system; 80% (n = 25) defined their own. Forty-eight percent (n = 15) of countries used a traffic-light system with 2-5 risk classifications. CONCLUSION A comprehensive set of measures has been developed to enable continued safe travel in Europe. However further refinements and coordination is needed to align travel measures throughout the EU to minimize confusion and maximize adherence to requested measures. We recommend that, along with developing travel measures based on a common set of rules, a standard approach is taken to communicate what these measures are.
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Affiliation(s)
- Justine I Blanford
- Faculty of Geoinformation Science and Earth Observation, University of Twente, Enschede, the Netherlands
| | - Nienke Beerlage-de Jong
- Section of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Stephanie E Schouten
- Section of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Alex W Friedrich
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, the Netherlands
| | - Vera Araújo-Soares
- Section of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
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Baillot A, St-Pierre M, Lapointe J, Bernard P, Bond D, Romain AJ, Garneau PY, Biertho L, Tchernof A, Blackburn P, Langlois MF, Brunet J. Acceptability and feasibility of the TELEhealth BARIatric behavioural intervention to increase physical ACTIVity (TELE-BariACTIV): A single-case experimental study protocol (Preprint). JMIR Res Protoc 2022; 11:e39633. [PMID: 36173668 PMCID: PMC9562082 DOI: 10.2196/39633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Regular physical activity (PA) is recommended to optimize weight and health outcomes in patients who have undergone metabolic and bariatric surgery (MBS). However, >70% of patients have low PA levels before MBS that persist after MBS. Although behavioral interventions delivered face-to-face have shown promise for increasing PA among patients who have undergone MBS, many may experience barriers, preventing enrollment into and adherence to such interventions. Delivering PA behavior change interventions via telehealth to patients who have undergone MBS may be an effective strategy to increase accessibility and reach, as well as adherence. Objective This paper reports the protocol for a study that aims to assess the feasibility and acceptability of the protocol or methods and the Telehealth Bariatric Behavioral Intervention (TELE-BariACTIV). The intervention is designed to increase moderate-to-vigorous intensity PA (MVPA) in patients awaiting bariatric surgery and is guided by a multitheory approach and a patient perspective. Another objective is to estimate the effect of the TELE-BariACTIV intervention on presurgical MVPA to determine the appropriate sample size for a multicenter trial. Methods This study is a multicenter trial using a repeated (ABAB’A) single-case experimental design. The A phases are observational phases without intervention (A1=pre-MBS phase; A2=length personalized according to the MBS date; A3=7 months post-MBS phase). The B phases are interventional phases with PA counseling (B1=6 weekly pre-MBS sessions; B2=3 monthly sessions starting 3 months after MBS). The target sample size is set to 12. Participants are inactive adults awaiting sleeve gastrectomy who have access to a computer with internet and an interface with a camera. The participants are randomly allocated to a 1- or 2-week baseline period (A1). Protocol and intervention feasibility and acceptability (primary outcomes) will be assessed by recording missing data, refusal, recruitment, retention, attendance, and attrition rates, as well as via web-based acceptability questionnaires and semistructured interviews. Data collected via accelerometry (7-14 days) on 8 occasions and via questionnaires on 10 occasions will be analyzed to estimate the effect of the intervention on MVPA. Generalization measures assessing the quality of life, anxiety and depressive symptoms, and theory-based constructs (ie, motivational regulations for PA, self-efficacy to overcome barriers to PA, basic psychological needs satisfaction and frustration, PA enjoyment, and social support for PA; secondary outcomes for a future large-scale trial) will be completed via web-based questionnaires on 6-10 occasions. The institutional review board provided ethics approval for the study in June 2021. Results Recruitment began in September 2021, and all the participants were enrolled (n=12). Data collection is expected to end in fall 2023, depending on the MBS date of the recruited participants. Conclusions The TELE-BariACTIV intervention has the potential for implementation across multiple settings owing to its collaborative construction that can be offered remotely. International Registered Report Identifier (IRRID) DERR1-10.2196/39633
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Affiliation(s)
- Aurélie Baillot
- Nursing Department, Université du Québec en Outaouais, Gatineau, QC, Canada
- Institut du savoir de l'hôpital Montfort-recherche, Ottawa, ON, Canada
- Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services Sociaux de l'Outaouais, Gatineau, QC, Canada
| | - Maxime St-Pierre
- Basic Science Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Josyanne Lapointe
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Dale Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, United States
| | - Ahmed Jérôme Romain
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Pierre Y Garneau
- Department of Surgery, Université de Montréal, Montréal, QC, Canada
| | - Laurent Biertho
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - André Tchernof
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - Patricia Blackburn
- Division of Kinesiology, Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Marie-France Langlois
- CHUS Research Center and Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jennifer Brunet
- Institut du savoir de l'hôpital Montfort-recherche, Ottawa, ON, Canada
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Tan S, Phan P, Law JY, Choi E, Chandran NS. Qualitative analysis of topical corticosteroid concerns, topical steroid addiction and withdrawal in dermatological patients. BMJ Open 2022; 12:e060867. [PMID: 35296492 PMCID: PMC8928312 DOI: 10.1136/bmjopen-2022-060867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore the phenomenon of topical corticosteroid (TCS) phobia and comprehensively understand the factors driving TCS concerns, in particular pertaining to steroid addiction and withdrawal. DESIGN Prospective qualitative study using 1:1 in-depth semistructured interviews and analysed using grounded theory. PARTICIPANTS Patients with a prior experience of TCS use for a dermatological condition recruited from a tertiary academic dermatology clinic, or through word of mouth and online social media platforms. RESULTS 26 participants encompassing those with positive, neutral and negative opinions towards TCS were interviewed. 13 reported having topical steroid addiction or withdrawal. The drivers of TCS concerns could be categorised into seven themes: attitudes towards TCS (comprising beliefs and knowledge about TCS), availability of alternatives, treatment inconvenience, personality, patient's ongoing evaluation of clinical response to TCS, doctor-patient relationship and healthcare-seeking behaviour. Of mention, patients placed high value and trust on their own experiences with TCS, such as their perceived experienced side effects. The doctor who failed to acknowledge the patient's opinions and instead emphasised the safety of TCS was often viewed as dismissive, resulting in a deteriorating patient-doctor relationship. CONCLUSION Provision of knowledge and education is important but may be ineffective if the basis for TCS concern regarding safety is reasonable, or when the patient has a firmly established belief supporting his/her concern. In such instances, failure to acknowledge and respect the patient's decision to avoid TCS could worsen the doctor-patient relationship.
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Affiliation(s)
- Sean Tan
- Dermatology, National University Healthcare System, Singapore
| | - Phillip Phan
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Johns Hopkins Carey Business School, Baltimore, Maryland, USA
- Medicine, National University of Singapore, Singapore
| | - Je Yin Law
- Medicine, National University of Singapore, Singapore
| | - Ellie Choi
- Dermatology, National University Healthcare System, Singapore
- Medicine, National University of Singapore, Singapore
| | - Nisha Suyien Chandran
- Dermatology, National University Healthcare System, Singapore
- Medicine, National University of Singapore, Singapore
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Teshome DF, Alemu S, Ayele TA, Atnafu A, Gelaye KA. Effect of health extension workers led home-based intervention on hypertension management in Northwest Ethiopia, 2021: study protocol for a cluster randomised controlled trial. BMJ Open 2022; 12:e051178. [PMID: 35246416 PMCID: PMC8900019 DOI: 10.1136/bmjopen-2021-051178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Although hypertension is highly prevalent in Ethiopia, it is poorly diagnosed, treated and controlled. Poor access to care and a shortage of healthcare providers are major barriers. This study aims to evaluate the effects of health extension workers' led home-based intervention on hypertension management in patients with hypertension in rural districts of northwest Ethiopia. METHODS AND ANALYSIS A two-arm cluster randomised controlled trial will be conducted among 456 hypertensive patients. Adults aged ≥25 years who have a diagnosis of hypertension both in the home-based hypertension screening study and at another measurement prior to recruitment will be eligible for the study. Randomisation will be done at the kebele level. In the intervention clusters, trained health extension workers will provide home-based intervention for hypertensive patients every 2 months for 9 months. The primary outcomes of the trial will be clinical linkage and blood pressure changes, whereas the secondary outcomes will be lifestyle modification, medication adherence and blood pressure control. Intention-to-treat analysis will be used for all primary analyses. A linear mixed-effect regression model will be used to model the change in blood pressure, while a mixed effect logistic regression model will be used to evaluate the intervention's effect on the binary outcomes. Effect sizes such as mean difference for the continuous outcomes and relative risk, attributable risk and population attributable risk for binary outcomes will be used. All statistical analyses are two sided and a p<0.05 will be used. ETHICS AND DISSEMINATION This study has been approved by institutional review board of the University of Gondar (Ref. No: V/P/RCS/05/2293/2020). The district's health office will grant permission for cluster randomisation, and each participant will provide written informed consent for participation. The findings will be presented at scientific conferences and published in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER PACTR202102729454417.
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Affiliation(s)
- Destaw Fetene Teshome
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Shitaye Alemu
- Internal Medicine, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Health System and policy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Hanrahan C, Broderick J, O’Connor TM, McVeigh JG. Behaviour change and physical activity interventions for physical activity engagement in community dwelling adults with chronic obstructive pulmonary disease: protocol for a systematic review. HRB Open Res 2022; 4:110. [PMID: 35079692 PMCID: PMC8753571 DOI: 10.12688/hrbopenres.13399.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a complex respiratory disease and the third leading cause of death worldwide. Pulmonary rehabilitation is recognised as the gold standard of care in the management of COPD, however engagement with pulmonary rehabilitation is low and maintenance of a physically active lifestyle in community dwelling adults with COPD is poor. Supporting positive behaviour change in people with COPD could help to increase their engagement with physical activity. This systematic review will examine behaviour change and physical activity interventions delivered to community dwelling adults with COPD with the aim of increasing physical activity engagement. Interventions will be mapped against Michie’s theoretical domains framework (TDF) to inform clinical practice and health policy. Methods: The following databases will be searched from inception until December 2021: Web of Science, CENTRAL, MEDLINE (via EBSCO), EMBASE, APA PsychINFO, CINAHL (via EBSCO), AMED, PROSPERO, Cochrane Airways Trials Register. Reference lists of the relevant studies and grey literature will be searched using Grey Literature Report, Open Grey and Google Scholar search engines. Relevant studies will be systematically reviewed and subject to quality appraisal to determine the impact of behaviour change and physical activity interventions on outcomes of community-dwelling adults with COPD. Interventions will be mapped to Michie’s TDF and a narrative synthesis with respect to nature, effectiveness on target population and setting/environment will be provided. Findings will be reported in relation to the generalisability of the primary results and research question, and will include secondary findings on quality of life, self-reported participation in physical activity, exercise capacity, adverse events and intervention adherence. The review will be presented according to the PRISMA guidelines 2020. Conclusions: This systematic review is necessary to explain the impact of behaviour change and physical activity interventions on outcomes of community dwelling people with COPD. PROSPERO registration: CRD42021264965 (29.06.2021)
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Affiliation(s)
- Ciara Hanrahan
- Discipline of Physiotherapy, College of Medicine and Health, University College Cork, Cork, T12 X70A, Ireland
| | - Julie Broderick
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, D08 W9RT, Ireland
| | - Terence M. O’Connor
- Department of Respiratory Medicine, Mercy University Hospital, Cork, Ireland
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - Joseph G. McVeigh
- Discipline of Physiotherapy, College of Medicine and Health, University College Cork, Cork, T12 X70A, Ireland
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Beets MW, von Klinggraeff L, Burkart S, Jones A, Ioannidis JPA, Weaver RG, Okely AD, Lubans D, van Sluijs E, Jago R, Turner-McGrievy G, Thrasher J, Li X. Impact of risk of generalizability biases in adult obesity interventions: A meta-epidemiological review and meta-analysis. Obes Rev 2022; 23:e13369. [PMID: 34779122 PMCID: PMC8755584 DOI: 10.1111/obr.13369] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/02/2021] [Accepted: 08/18/2021] [Indexed: 01/14/2023]
Abstract
Biases introduced in early-stage studies can lead to inflated early discoveries. The risk of generalizability biases (RGBs) identifies key features of feasibility studies that, when present, lead to reduced impact in a larger trial. This meta-study examined the influence of RGBs in adult obesity interventions. Behavioral interventions with a published feasibility study and a larger scale trial of the same intervention (e.g., pairs) were identified. Each pair was coded for the presence of RGBs. Quantitative outcomes were extracted. Multilevel meta-regression models were used to examine the impact of RGBs on the difference in the effect size (ES, standardized mean difference) from pilot to larger scale trial. A total of 114 pairs, representing 230 studies, were identified. Overall, 75% of the pairs had at least one RGB present. The four most prevalent RGBs were duration (33%), delivery agent (30%), implementation support (23%), and target audience (22%) bias. The largest reductions in the ES were observed in pairs where an RGB was present in the pilot and removed in the larger scale trial (average reduction ES -0.41, range -1.06 to 0.01), compared with pairs without an RGB (average reduction ES -0.15, range -0.18 to -0.14). Eliminating RGBs during early-stage testing may result in improved evidence.
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Affiliation(s)
- Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Alexis Jones
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Anthony D Okely
- Faculty of the Arts, Social Sciences and Humanities, School of Education, University of Wollongong, Wollongong, New South Wales, Australia
| | - David Lubans
- School of Education, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Esther van Sluijs
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Russell Jago
- Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - James Thrasher
- Department of Health Promotion, Education, and Behavior Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Agbejule OA, Hart NH, Ekberg S, Crichton M, Chan RJ. Self-management support for cancer-related fatigue: a systematic review. Int J Nurs Stud 2022; 129:104206. [DOI: 10.1016/j.ijnurstu.2022.104206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/14/2022] [Accepted: 02/10/2022] [Indexed: 11/26/2022]
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Brandão MP, Sa-Couto P, Gomes G, Beça P, Reis J. Factors Associated with Cardiovascular Disease Risk among Employees at a Portuguese Higher Education Institution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:848. [PMID: 35055670 PMCID: PMC8775385 DOI: 10.3390/ijerph19020848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 01/15/2023]
Abstract
This study aimed to estimate the prevalence of risk factors for cardiovascular disease (CVD) and to assess the CVD risk (CVDRisk) in a sample of workers at a specific workplace: a higher education institution in Portugal. Data were collected using a questionnaire (e.cuidHaMUs.QueST®) with 345 HEI workers from June 2017-June 2018 with a high response rate (93.3%). Two constructs of risks for CVD were considered: (i) metabolic risk and hypertension (CVDRisk1); and (ii) modifiable behavioural risk (CVDRisk2). Logistic regression analyses were used to establish a relationship between risk indexes/constructs (CVDRisk1 and CVDRisk2) and groups of selected variables. The most prevalent CVD risk factor was hypercholesterolaemia (43.2%). Sixty-eight percent of participants were in the construct CVDRisk1 while almost half of the respondents were in CVDRisk2 (45.2%). The consumption of soft drinks twice a week or more contributed to a significantly increased risk of CVD in CVDRisk1. Lack of regular exercise and lack of daily fruit consumption significantly increased the risk of CVD in CVDRisk2. The challenge to decision makers and the occupational medical community is to incorporate this information into the daily practices of health surveillance with an urgent need for health promotional education campaigns in the workplace.
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Affiliation(s)
- Maria Piedade Brandão
- School of Health [ESSUA], Agras do Crasto-Campus Universitário de Santiago, University of Aveiro, Edifício 30, 3810-193 Aveiro, Portugal
- Center for Health Technology and Services Research [CINTESIS], Campus Universitário de Santiago, University of Aveiro, 3800-193 Aveiro, Portugal
| | - Pedro Sa-Couto
- Department of Mathematics [DMAT], University of Aveiro, 3810-193 Aveiro, Portugal; (P.S.-C.); (J.R.)
- Center for Research and Development in Mathematics and Applications [CIDMA], University of Aveiro, 3810-193 Aveiro, Portugal
| | - Gonçalo Gomes
- Department of Communication and Art [DECA], University of Aveiro, 3810-193 Aveiro, Portugal; (G.G.); (P.B.)
- Research Institute for Design, Media and Culture [ID+], University of Aveiro, 3810-193 Aveiro, Portugal
| | - Pedro Beça
- Department of Communication and Art [DECA], University of Aveiro, 3810-193 Aveiro, Portugal; (G.G.); (P.B.)
- Digital Media and Interaction [DigiMedia], University of Aveiro, 3810-193 Aveiro, Portugal
| | - Juliana Reis
- Department of Mathematics [DMAT], University of Aveiro, 3810-193 Aveiro, Portugal; (P.S.-C.); (J.R.)
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Gosak L, Štiglic G, Budler LC, Félix IB, Braam K, Fijačko N, Guerreiro MP, Lorber M. Digital Tools in Behavior Change Support Education in Health and Other Students: A Systematic Review. Healthcare (Basel) 2021; 10:healthcare10010001. [PMID: 35052165 PMCID: PMC8774876 DOI: 10.3390/healthcare10010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/26/2022] Open
Abstract
Due to the increased prevalence of chronic diseases, behavior changes are integral to self-management. Healthcare and other professionals are expected to support these behavior changes, and therefore, undergraduate students should receive up-to-date and evidence-based training in this respect. Our work aims to review the outcomes of digital tools in behavior change support education. A secondary aim was to examine existing instruments to assess the effectiveness of these tools. A PIO (population/problem, intervention, outcome) research question led our literature search. The population was limited to students in nursing, sports sciences, and pharmacy; the interventions were limited to digital teaching tools; and the outcomes consisted of knowledge, motivation, and competencies. A systematic literature review was performed in the PubMed, CINAHL, MEDLINE, Web of Science, SAGE, Scopus, and Cochrane Library databases and by backward citation searching. We used PRISMA guidelines 2020 to depict the search process for relevant literature. Two authors evaluated included studies using the Mixed Methods Appraisal Tool (MMAT) independently. Using inclusion and exclusion criteria, we included 15 studies in the final analysis: six quantitative descriptive studies, two randomized studies, six mixed methods studies, and one qualitative study. According to the MMAT, all studies were suitable for further analysis in terms of quality. The studies resorted to various digital tools to improve students’ knowledge of behavior change techniques in individuals with chronic disease, leading to greater self-confidence, better cooperation, and practical experience and skills. The most common limitations that have been perceived for using these tools are time and space constraints.
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Affiliation(s)
- Lucija Gosak
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (L.G.); (G.Š.); (L.C.B.); (N.F.)
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (L.G.); (G.Š.); (L.C.B.); (N.F.)
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia
- Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK
| | - Leona Cilar Budler
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (L.G.); (G.Š.); (L.C.B.); (N.F.)
| | - Isa Brito Félix
- Nursing Research, Innovation and Development Centre of Lisbon, Nursing School of Lisbon, 1600-190 Lisbon, Portugal; (I.B.F.); (M.P.G.)
| | - Katja Braam
- Faculty of Healthcare, Sports and Welfare, Inholland University of Applied Sciences, 3521 Haarlem, The Netherlands;
| | - Nino Fijačko
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (L.G.); (G.Š.); (L.C.B.); (N.F.)
| | - Mara Pereira Guerreiro
- Nursing Research, Innovation and Development Centre of Lisbon, Nursing School of Lisbon, 1600-190 Lisbon, Portugal; (I.B.F.); (M.P.G.)
| | - Mateja Lorber
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (L.G.); (G.Š.); (L.C.B.); (N.F.)
- Correspondence:
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Catlow J, Bhardwaj-Gosling R, Sharp L, Rutter MD, Sniehotta FF. Using a dark logic model to explore adverse effects in audit and feedback: a qualitative study of gaming in colonoscopy. BMJ Qual Saf 2021; 31:704-715. [PMID: 34893545 PMCID: PMC9510430 DOI: 10.1136/bmjqs-2021-013588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/17/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Audit and feedback (A&F) interventions improve patient care but may result in unintended consequences. To evaluate plausible harms and maximise benefits, theorisation using logic models can be useful. We aimed to explore the adverse effects of colonoscopy A&F using a feedback intervention theory (FIT) dark logic model before the National Endoscopy Database Automated Performance Reports to Improve Quality Outcomes Trial study. METHODS We undertook a qualitative study exploring A&F practices in colonoscopy. Interviews were undertaken with endoscopists from six English National Health Service endoscopy centres, purposively sampled for professional background and experience. A thematic framework analysis was performed, mapping paradoxical effects and harms using FIT and the theory of planned behaviour. RESULTS Data saturation was achieved on the 19th participant, with participants from nursing, surgical and medical backgrounds and a median of 7 years' experience.When performance was below aspirational targets participants were falsely reassured by social comparisons. Participants described confidence as a requirement for colonoscopy. Negative feedback without a plan to improve risked reducing confidence and impeding performance (cognitive interference). Unmet targets increased anxiety and prompted participants to question messages' motives and consider gaming.Participants described inaccurate documentation of subjective measures, including patient comfort, to achieve targets perceived as important. Participants described causing harm from persevering to complete procedures despite patient discomfort and removing insignificant polyps to improve detection rates without benefiting the patient. CONCLUSION Our dark logic model highlighted that A&F interventions may create both desired and adverse effects. Without a priori theorisation evaluations may disregard potential harms. In colonoscopy, improved patient experience measures may reduce harm. To address cognitive interference the motivation of feedback to support improvement should always be clear, with plans targeting specific behaviours and offering face-to-face support for confidence. TRIAL REGISTRATION NUMBER ISRCTN11126923.
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Affiliation(s)
- Jamie Catlow
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK .,Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, UK
| | - Rashmi Bhardwaj-Gosling
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Faculty of Health Sciences and Wellbeing, The University of Sunderland, Sunderland, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Matthew David Rutter
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, UK
| | - Falko F Sniehotta
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, The Netherlands
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Rimmer B, Sharp L. Implementation of Self-Management Interventions in Cancer Survivors: Why Are We Not There Yet? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1355-1358. [PMID: 33934312 PMCID: PMC8605969 DOI: 10.1007/s13187-021-02021-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 06/12/2023]
Abstract
Despite the growing evidence base for supported self-management for the improvement of quality of life, there is a lack of widespread implementation of self-management interventions for cancer survivors. We propose five key areas that, if addressed, would optimise the development and evaluation of these interventions, namely: (1) improving intervention adaptability to different survivor populations; (2) establishing intervention acceptability (and feasibility); (3) ensuring systematic description of interventions, their content, and active ingredients; (4) conducting process evaluations; and (5) assessing cost-effectiveness. These areas are an essential prerequisite for translation of self-management interventions from research into routine cancer care.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Ridley Building 1, Newcastle upon Tyne, NE1 7RU, England, UK.
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Ridley Building 1, Newcastle upon Tyne, NE1 7RU, England, UK
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Hanrahan C, Broderick J, O’Connor TM, McVeigh JG. Behaviour change and physical activity interventions for physical activity engagement in community dwelling adults with chronic obstructive pulmonary disease: protocol for a systematic review. HRB Open Res 2021; 4:110. [DOI: 10.12688/hrbopenres.13399.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a complex respiratory disease and the third leading cause of death worldwide. Pulmonary rehabilitation is recognised as the gold standard of care in the management of COPD, however engagement with pulmonary rehabilitation is low and maintenance of a physically active lifestyle in community dwelling adults with COPD is poor. Supporting positive behaviour change in people with COPD could help to increase their engagement with physical activity. This systematic review will examine behaviour change and physical activity interventions delivered to community dwelling adults with COPD with the aim of increasing physical activity engagement. Interventions will be mapped against Michie’s theoretical domains framework (TDF) to inform clinical practice and health policy. Methods: The following databases will be searched from inception until December 2021: Web of Science, CENTRAL, MEDLINE (via EBSCO), EMBASE, APA PsychINFO, CINAHL (via EBSCO), AMED, PROSPERO, Cochrane Airways Trials Register. Reference lists of the relevant studies and grey literature will be searched using Grey Literature Report, Open Grey and Google Scholar search engines. Relevant studies will be systematically reviewed and subject to quality appraisal to determine the impact of behaviour change and physical activity interventions on outcomes of community-dwelling adults with COPD. Interventions will be mapped to Michie’s TDF and a narrative synthesis with respect to nature, effectiveness on target population and setting/environment will be provided. Findings will be reported in relation to the generalisability of the primary results and research question, and will include secondary findings on quality of life, self-reported participation in physical activity, exercise capacity, adverse events and intervention adherence. The review will be presented according to the PRISMA guidelines 2020. Conclusions: This systematic review is necessary to explain the impact of behaviour change and physical activity interventions on outcomes of community dwelling people with COPD. PROSPERO registration: CRD42021264965 (29.06.2021)
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Sidani S, Guruge S, Illanko K. The Experiences and Determinants of Sleep Problems of Immigrant and Canadian-Born Older Adults-Analysis of Canadian Longitudinal Study on Aging Baseline Data. Can J Nurs Res 2021; 54:168-176. [PMID: 34482751 DOI: 10.1177/08445621211009405] [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: 11/15/2022] Open
Abstract
BACKGROUND Although prevalent, limited knowledge is available on the experience of sleep problems (i.e., disturbance in sleep latency and in sleep maintenance) and their determinants in immigrant older adults. PURPOSE To compare immigrant and Canadian-born older adults' experiences of: 1) sleep problems, 2) determinants of sleep problems, categorized into precipitating and perpetuating factors, and 3) determinants most significantly contributing to each sleep problem. METHODS Baseline data obtained by the comprehensive cohort of the Canadian Longitudinal Study on Aging were analyzed. Participants 55+ years of age and with complete data on their country of birth comprised the sample, with 18,245 Canadian-born and 4,257 immigrant older adults. Single or multiple items were used to assess the precipitating (chronic condition, sleep disorders, pain, depressive symptoms, psychological distress, education, marital and socio-economic status) and perpetuating (smoking, alcohol consumption, physical activity) factors. Chi-square test and independent sample t-test were used in the comparison and multiple regression was applied to determine the most significant determinant of each sleep problem in each group of older adults. RESULTS Despite differences in a few determinants of sleep problems, the set of factors contributing to disturbance in sleep latency and maintenance was comparable for Canadian-born and immigrant older adults, and included: having a sleep disorder and high level of depressive symptoms and psychological distress. CONCLUSION The findings highlight the importance of public health campaigns to increase older adults' awareness of sleep problems, the factors that may contribute to disturbance in sleep, and strategies to prevent and/or manage sleep problems.
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Affiliation(s)
- Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sepali Guruge
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Kandasamy Illanko
- Department of Computer and Electrical Engineering, Ryerson University, Toronto, ON, Canada
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Bayless AK, Wyatt TH, Raynor H. Obese-Asthma Phenotype Self-Management: A Literature Review. J Pediatr Nurs 2021; 60:154-163. [PMID: 33989853 DOI: 10.1016/j.pedn.2021.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/24/2021] [Accepted: 04/24/2021] [Indexed: 10/21/2022]
Abstract
PROBLEM Recent identification of the early-onset obese-asthma phenotype has spurred exploration of ways to promote effective, long-term management behaviors for children with this comorbid presentation. Few studies have examined the needs of children with both asthma and obesity and little is known about optimal management options for this unique population. Therefore, the authors aimed to review, critique, and synthesize existing published research on health-management programs designed for children with comorbid asthma and obesity in order to describe the state of the science and recommend next steps in creating pediatric management programs. ELIGIBILITY CRITERIA Articles selected for a full-text review were pediatric-focused, included children with both asthma and obesity diagnoses, and discussed the implementation and evaluation of a management program or the evaluation of a management behavior. SAMPLE Fifteen articles were selected for review based on the inclusion criteria. RESULTS Studies that included current evidence-based elements had better results than those that did not include such elements. CONCLUSIONS Based on this review, it is recommended that researchers use theory based, multicomponent, multimodal, family-focused, behaviorally-based interventions that address systems-level influences, social determinates of health, and children's developmental needs over time. Additionally, there is a need for studies with sample sizes adequate for power analyses that include the youngest children with asthma and obesity. IMPLICATIONS The need for effective programs for pediatric obese-asthma phenotype management creates the opportunity for nursing-led research and interventions to foster long-term health promotion for affected children and families.
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Affiliation(s)
- Adaya Kirk Bayless
- University of Tennessee, Knoxville: College of Nursing, TN, United States of America.
| | - Tami H Wyatt
- University of Tennessee, Knoxville: College of Nursing, TN, United States of America.
| | - Hollie Raynor
- University of Tennessee, Knoxville: College of Education, Health, and Human Sciences, United States of America.
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Currie CC, Araujo-Soares V, Stone SJ, Beyer F, Durham J. Promoting regular dental attendance in problem-orientated dental attenders: A systematic review of potential interventions. J Oral Rehabil 2021; 48:1183-1191. [PMID: 34398460 PMCID: PMC9292277 DOI: 10.1111/joor.13244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/08/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Problem-orientated dental attenders account for around one-third of the UK population, these being patients who do not seek regular dental care, instead only attending with dental pain. In order to develop intervention(s) to encourage regular dental attendance in these patients, any previous intervention development should be identified to aid idea generation or retrofitting of interventions. OBJECTIVE To identify previous interventions which have been developed targeted at problem-orientated dental attenders to facilitate the development and co-design of a new intervention. METHODS Eight electronic databases were searched for studies which included an intervention targeted at adult problem-orientated or irregular dental attenders to encourage regular dental attendance. Data on the intervention design mapped to the theoretical domains framework were extracted, alongside effectiveness and patient views where available. RESULTS Three studies fitted the inclusion criteria for the review. Interventions identified were attendance at a dental anxiety clinic, and a large advertising campaign promoting a free dental update where members of the public could visit local dental practices to look around and meet the dentists. One study looked at the effect of policy change by introducing free dental check-ups in Scotland. Interventions were poorly reported, with significant omissions in their description and a lack of clear identification of what composed the intervention. CONCLUSION There are very few interventions developed targeted at problem-orientated dental attendance, but important areas to consider in future intervention development include the following: dentist communication; dentist-patient relationship; increasing the awareness of need; the effect of free dental check-ups.
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Affiliation(s)
- Charlotte C Currie
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK
| | - Vera Araujo-Soares
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Simon J Stone
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK
| | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK
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Guruge S, Sidani S, Man G, Matsuoka A, Kanthasamy P, Leung E. Elder abuse risk factors: Perceptions among older Chinese, Korean, Punjabi, and Tamil immigrants in Toronto. J Migr Health 2021; 4:100059. [PMID: 34405199 PMCID: PMC8352184 DOI: 10.1016/j.jmh.2021.100059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 06/17/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives Elder abuse is a significant concern worldwide. Several factors are reported to increase the risk for elder abuse, but little is known about which factors are most relevant to immigrant communities. This study explored perceptions of risk factors for elder abuse among older immigrants, which is the first step toward designing effective interventions. Methods This cross-sectional quantitative study was conducted between 2017 and 2019 in the Greater Toronto Area, Ontario, Canada and involved a convenience sample (N = 173) of older women and men from Chinese, Korean, Punjabi, and Tamil immigrant communities. Participants completed a questionnaire about the frequency and importance of risk factors of elder abuse in their respective community. Descriptive statistics were used to analyze the data within each immigrant community and analysis of variance to compare the factor ratings across communities. Results The immigrant communities differed (p < .05) in their perception of the risk factors. Factors rated as frequent and important (x̅ > 2.0 – midpoint of the rating scale) were social isolation, financial dependence, and lack of knowledge of English for Korean; financial dependence, physical dependence, and emotional dependence for Chinese; lack of knowledge of English, emotional dependence, and physical dependence for Tamil; and social isolation for Punjabi. Conclusion The findings highlight the need for collaboration among public health and social services to work with immigrant communities in co-designing interventions to address these key risk factors and thereby reduce the risk of elder abuse.
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Affiliation(s)
- Sepali Guruge
- Daphne Cockwell School of Nursing, Ryerson University, 350 Victoria Street, ON M5B 2K3, Canada
- Corresponding author at: DCC579C, Ryerson University, 350 Victoria Street, ON M5B 2K3, Canada.
| | - Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, 350 Victoria Street, ON M5B 2K3, Canada
| | - Guida Man
- Department of Sociology, 2060 Vari Hall, York University, 4700 Keele Street, Toronto, ON , M3J 1P3, Canada
| | - Atsuko Matsuoka
- School of Social Work, S880 Ross Building, York University, 4700 Keele Street, Toronto, ON , M3J 1P3, Canada
| | - Parvathy Kanthasamy
- Daphne Cockwell School of Nursing, Ryerson University, 350 Victoria Street, ON M5B 2K3, Canada
| | - Ernest Leung
- Daphne Cockwell School of Nursing, Ryerson University, 350 Victoria Street, ON M5B 2K3, Canada
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Sidani S, Fox M, El-Masri MM. Guidance for the Reporting of an Intervention's Theory. Res Theory Nurs Pract 2021; 34:35-48. [PMID: 31937635 DOI: 10.1891/1541-6577.34.1.35] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Interventions in clinical trials should be clearly and completely described to inform their evaluation in replication studies and implementation in clinical practice. Guidelines were developed to standardize the reporting of interventions, but failed to provide guidance on reporting of the theory of interventions. Further, space constraints imposed by many research journals often limit the comprehensive description of both the theoretical and operational aspects of interventions. PURPOSE To address these gaps, we propose that the theory of interventions be published in separate conceptual papers that would provide an in-depth description of the health problem targeted by an intervention, the components comprising an intervention, the causal mechanism responsible for an intervention's impact on the outcomes, and the conditions necessary for the proper implementation and the effectiveness of an intervention. IMPLICATIONS Such papers would assist in the critical appraisal of the adequacy, implementation, and evaluation of interventions. A description of the theory of interventions clarifies to health professionals what the interventions are about, who is likely to benefit from the interventions, how the interventions work and under what context.
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Affiliation(s)
| | - Mary Fox
- School of Nursing, York University
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