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Brooker C, Sirdifield C, Parkhouse T. Identifying mental illness and monitoring mental health in probation service settings. EUROPEAN JOURNAL OF PROBATION 2022; 14:179-203. [PMID: 36794232 PMCID: PMC7614176 DOI: 10.1177/20662203221140646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
There is a need to improve a) identification and monitoring of people with mental illness on probation and b) understanding of the impact of interventions on mental health outcomes for the probation population. If data were routinely collected using validated screening tools and shared between agencies, this could inform practice and commissioning decisions, and ultimately it could improve health outcomes for people under supervision. The literature was reviewed to identify brief screening tools and outcome measures that have been used in prevalence and outcome studies conducted with adults on probation in Europe. This paper shares findings from the UK-based studies in which 20 brief screening tools and measures were identified. Recommendations are made based on this literature regarding suitable tools for use in probation to routinely identify a need for contact with mental health and/or substance misuse services and to measure change in mental health outcomes.
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Affiliation(s)
- Charlie Brooker
- Centre for Sociology and Criminology, Royal Holloway University of London, Egham, UK
| | - Coral Sirdifield
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Thomas Parkhouse
- School of Health and Social Care, University of Lincoln, Lincoln, UK
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2
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Paynter M, Heggie C, Low C, McKibbon S, Martin-Misener R. Community-based models of health care for women, trans and nonbinary people released from prisons: An international scoping review with implications for Canada. J Clin Nurs 2022. [PMID: 35941807 DOI: 10.1111/jocn.16464] [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: 02/16/2022] [Revised: 06/13/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To illustrate the scope of different types of transitional, community-based health interventions for formerly incarcerated women, trans and nonbinary people, the eligibility criteria for these interventions, and associated health outcomes. BACKGROUND Meeting the health needs of formerly incarcerated people in community, rather than through the criminal justice system, may prevent further experiences of criminalization. Research is needed to understand what community-based health interventions have been implemented internationally to inform the design of an intervention in Canada. DESIGN Scoping review using the Joanna Briggs Institute scoping review methodology. METHODS In consultation with a medical research librarian, key databases and journals were searched for English language articles, from any country, with no specified date range. Three authors independently screened titles and abstracts to identify articles for full-text review. The study adheres to PRISMA-EQUATOR guidelines. RESULTS Thirty-six studies met the present criteria and were reviewed in full text. Method, setting, participants, sample, relevant outcomes and relevant findings were extracted from each study for synthesis. Included studies had varied methods and were published from 1999 to 2020. Thirty-one studies were based in the United States, one in Puerto Rico and two each in Canada and the United Kingdom. The most common health issue focus was human immunodeficiency virus and/or hepatitis c virus. The most common outcome was uptake of offered services, such as a transitional clinic. CONCLUSIONS Gaps in the research pertain to a lack of attention to clinical outcomes and patient experience, and a lack of consideration of sexual and reproductive health concerns. Women were the minority population in all studies that included both men and women; transgender participants were mentioned in only four of thirty-six studies. The specific needs of women, trans and nonbinary people must be taken into consideration. RELEVANCE TO CLINICAL PRACTICE Nurses must be conscious of the elevated health risks associated with exposure to correctional institutions and the risks associated with the period of transition. PATIENT OR PUBLIC CONTRIBUTION A member of the research team brings lived experience expertise with respect to the criminal justice system.
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Affiliation(s)
- Martha Paynter
- Faculty of Nursing, University of New Brunswick, Fredericton, Canada
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3
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Newbury-Birch D, Ferguson J, Connor N, Divers A, Waller G. A Rapid Systematic Review of Worldwide Alcohol Use Disorders and Brief Alcohol Interventions in the Criminal Justice System. Front Psychiatry 2022; 13:900186. [PMID: 35873244 PMCID: PMC9301009 DOI: 10.3389/fpsyt.2022.900186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/31/2022] [Indexed: 11/21/2022] Open
Abstract
Although the relationship is complex, there is an association between alcohol use and offending behavior with an interplay between the amount drank, the pattern of drinking and individual and contextual factors. Alcohol brief interventions have been shown to be effective in primary healthcare, however there is currently a lack of compelling evidence in the criminal justice system. We carried out a rapid systematic review of the literature, which updated our review conducted in 2016. Following systematic searches, we included 36 papers on prevalence and 13 papers on effectiveness. Between 26 and 88% of individuals in the policy custody setting scored positive for an alcohol use disorder. In the magistrates court this was 95%; 31-86% in the probation setting and between 19 and 86% in the prison system. In relation to probable dependence, between 21 and 38% of individuals were shown to have probable alcohol dependence in the police custody suite setting; 39 per cent in the magistrate court system; 17-36% in the probation setting and between 18 and 48% in the prison system. This compares to 6% in the general population. We included 13 studies of effectiveness with differing outcome measures and outcomes. We conclude more studies are needed in the field to develop the current evidence base.
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Affiliation(s)
- Dorothy Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, United Kingdom
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4
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Bezabih AM, Gerling K, Abebe W, Abeele VV. Behavioral Theories and Motivational Features Underlying eHealth Interventions for Adolescent Antiretroviral Adherence: Systematic Review. JMIR Mhealth Uhealth 2021; 9:e25129. [PMID: 34890353 PMCID: PMC8709919 DOI: 10.2196/25129] [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: 10/19/2020] [Revised: 02/06/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background eHealth systems provide new opportunities for the delivery of antiretroviral therapy (ART) adherence interventions for adolescents. They may be more effective if grounded in health behavior theories and behavior change techniques (BCTs). Prior reviews have examined the effectiveness, feasibility, and acceptability of these eHealth systems. However, studies have not systematically explored the use of health behavior theories and BCTs in the design of these applications. Objective The purpose of this review was to explore whether health behavior theories and BCTs were considered to ground designs of eHealth systems supporting adolescents’ (10-24 years) ART adherence. More specifically, we examined which specific theories and BCTs were applied, and how these BCTs were implemented as design features. Additionally, we investigated the quality and effect of eHealth systems. Methods A systematic search was performed on IEEE Xplore, ACM, ScienceDirect, PubMed, Scopus, and Web of Science databases from 2000 to 2020. Theory use and BCTs were coded using the Theory Coding Scheme and the Behavior Change Technique Taxonomy version 1 (BCTTv1), respectively. Design features were identified using the lenses of motivational design for mobile health (mHealth). The number of BCTs and design features for each eHealth system and their prevalence across all systems were assessed. Results This review identified 16 eHealth systems aiming to support ART adherence among adolescents. System types include SMS text message reminders (n=6), phone call reminders (n=3), combined SMS text message and phone call reminders (n=1), electronic adherence monitoring devices (n=3), smartphone apps (n=1), smartphone serious games (n=1), gamified smartphone apps (n=1), leveraging existing social media (n=2), web-based applications (n=1), videoconferencing (n=1), and desktop applications (n=1). Nine were grounded in theory, of which 3 used theories extensively. The impact of adolescent developmental changes on ART adherence was not made explicit. A total of 42 different BCTs and 24 motivational design features were used across systems. Ten systems reported positive effects on 1 or more outcomes; however, of these ten systems, only 3 reported exclusively positive effects on all the outcomes they measured. As much as 6 out of 16 reported purely no effect in all the outcomes measured. Conclusions Basic applications (SMS text messaging and phone calls) were most frequent, although more advanced systems such as mobile apps and games are also emerging. This review indicated gaps in the use of theory and BCTs, and particularly the impact of developmental changes on ART adherence was not adequately considered. Together with adopting a developmental orientation, future eHealth systems should effectively leverage health theories and consider developing more advanced systems that open the door to using BCTs more comprehensively. Overall, the impact of eHealth systems on adolescent ART adherence and its mediators is promising, but conclusive evidence on effect still needs to be provided.
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Affiliation(s)
- Alemitu Mequanint Bezabih
- Department of Computer Science, e-Media Research Lab, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Kathrin Gerling
- Department of Computer Science, e-Media Research Lab, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Vero Vanden Abeele
- Department of Computer Science, e-Media Research Lab, Katholieke Universiteit Leuven, Leuven, Belgium
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5
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Ramponi F, Walker S, Griffin S, Parrott S, Drummond C, Deluca P, Coulton S, Kanaan M, Richardson G. Cost-effectiveness analysis of public health interventions with impacts on health and criminal justice: An applied cross-sectoral analysis of an alcohol misuse intervention. HEALTH ECONOMICS 2021; 30:972-988. [PMID: 33604984 DOI: 10.1002/hec.4229] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/23/2020] [Accepted: 01/14/2021] [Indexed: 05/13/2023]
Abstract
Cost-effectiveness analyses of health care programs often focus on maximizing health and ignore nonhealth impacts. Assessing the cost-effectiveness of public health interventions from a narrow health care perspective would likely underestimate their full impact, and potentially lead to inefficient decisions about funding. The aim of this study is to provide a practical application of a recently proposed framework for the economic evaluation of public health interventions, evaluating an intervention to reduce alcohol misuse in criminal offenders. This cross-sectoral analysis distinguishes benefits and opportunity costs for different sectors, makes explicit the value judgments required to consider alternative perspectives, and can inform heterogeneous decision makers with different objectives in a transparent manner. Three interventions of increasing intensity are compared: client information leaflet, brief advice, and brief lifestyle counseling. Health outcomes are measured in quality-adjusted life-years and criminal justice outcomes in reconvictions. Costs considered include intervention costs, costs to the NHS and costs to the criminal justice system. The results are presented for four different perspectives: "narrow" health care perspective; criminal justice system perspective; "full" health care perspective; and joint "full" health and criminal justice perspective. Conclusions and recommendations differ according to the normative judgment on the appropriate perspective for the evaluation.
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Affiliation(s)
- Francesco Ramponi
- Centre for Health Economics, Alcuin A Block, University of York, York, UK
| | - Simon Walker
- Centre for Health Economics, Alcuin A Block, University of York, York, UK
| | - Susan Griffin
- Centre for Health Economics, Alcuin A Block, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
| | - Colin Drummond
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Deluca
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simon Coulton
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | - Mona Kanaan
- Department of Health Sciences, University of York, York, UK
| | - Gerry Richardson
- Centre for Health Economics, Alcuin A Block, University of York, York, UK
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Holloway A, Guthrie V, Waller G, Smith J, Boyd J, Mercado S, Smith P, Stenhouse R, Sheikh A, Parker RA, Stoddart A, Conaglen P, Coulton S, Stadler G, Hunt K, Bray J, Ferguson J, Sondhi A, Lynch K, Rees J, Newbury-Birch D. A two-arm parallel-group individually randomised prison pilot study of a male remand alcohol intervention for self-efficacy enhancement: the APPRAISE study protocol. BMJ Open 2021; 11:e040636. [PMID: 33811049 PMCID: PMC8023744 DOI: 10.1136/bmjopen-2020-040636] [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: 11/25/2022] Open
Abstract
INTRODUCTION The prevalence of at-risk drinking is far higher among those in contact with the criminal justice system (73%) than the general population (35%). However, there is little evidence on the effectiveness of alcohol brief interventions (ABIs) in reducing risky drinking among those in the criminal justice system, including the prison system and, in particular, those on remand. Building on earlier work, A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE) is a pilot study designed to assess the feasibility and acceptability of an ABI, delivered to male prisoners on remand. The findings of APPRAISE should provide the information required to design a future definitive randomised controlled trial (RCT). METHODS AND ANALYSIS APPRAISE will use mixed methods, with two linked phases, across two prisons in the UK, recruiting 180 adult men on remand: 90 from Scotland and 90 from England. Phase I will involve a two-arm, parallel-group, individually randomised pilot study. The pilot evaluation will provide data on the likely impact of A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE), which will be used to inform a future definitive multicentre RCT. Phase II will be a process evaluation assessing how the ABI has been implemented to explore the change mechanisms underpinning the ABI (figure 1) and to assess the context within which the ABI is delivered. ETHICS AND DISSEMINATION The APPRAISE protocol has been approved by the East of Scotland Research Ethics Committee (19/ES/0068), National Offender Management System (2019-240), Health Board Research and Development (2019/0268), Scottish Prison Service research and ethics committee, and by the University of Edinburgh's internal ethics department. The findings will be disseminated via peer-reviewed journal publications, presentations at local, national and international conferences, infographics and shared with relevant stakeholders through meetings and events. TRIAL REGISTRATION NUMBER ISRCTN27417180.
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Affiliation(s)
- Aisha Holloway
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Victoria Guthrie
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Gillian Waller
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Jamie Smith
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- Institute for Gender Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Joanne Boyd
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
- Centre for Change, County Durham Drug and Alcohol Recovery Service, Durham, UK
| | - Sharon Mercado
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Pam Smith
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Rosie Stenhouse
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Division of Community Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Andrew Stoddart
- Edinburgh Health Services Research Unit, The University Of Edinburgh, Edinburgh, UK
| | | | - Simon Coulton
- Centre for Health Service Studies, University of Kent, Canterbury, UK
| | - Gertraud Stadler
- Institute for Gender Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
- University of Aberdeen, Aberdeen, UK
| | - Kate Hunt
- Institute of Social Marketing, University of Stirling, Stirling, UK
| | - Jeremy Bray
- Department of Economics, University of North Carolina at Greensboro, Greensborough, UK
| | - Jennifer Ferguson
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | | | - Kieran Lynch
- Criminal Justice, Alcohol, Drugs and Tobacco Division, Public Health England, London, UK
| | - Jessica Rees
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
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7
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Marques MM, Carey RN, Norris E, Evans F, Finnerty AN, Hastings J, Jenkins E, Johnston M, West R, Michie S. Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology. Wellcome Open Res 2021; 5:125. [PMID: 33824909 PMCID: PMC7993627 DOI: 10.12688/wellcomeopenres.15906.2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the Behaviour Change Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project. Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar with the ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) and publishing online. Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational , Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it. Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.
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Affiliation(s)
- Marta M. Marques
- Centre for Behaviour Change, University College London, London, UK
- ADAPT SFI Research Centre, Trinity College Dublin, Dublin, Ireland
- Trinity Centre for Healthcare and Practice Innovation, Trinity College Dublin, Dublin, Ireland
| | - Rachel N. Carey
- Centre for Behaviour Change, University College London, London, UK
| | - Emma Norris
- Centre for Behaviour Change, University College London, London, UK
| | - Fiona Evans
- Centre for Behaviour Change, University College London, London, UK
| | | | - Janna Hastings
- Centre for Behaviour Change, University College London, London, UK
| | - Ella Jenkins
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Aberdeen Health Psychology Group, University of Aberdeen, Aberdeen, Scotland, UK
| | - Robert West
- Research Department of Epidemiology & Public Health, University College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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Michie S, Johnston M, Rothman AJ, de Bruin M, Kelly MP, Carey RN, Bohlen LEC, Groarke HNK, Anderson NC, Zink S. Developing an evidence-based online method of linking behaviour change techniques and theoretical mechanisms of action: a multiple methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2021. [DOI: 10.3310/hsdr09010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background
Many global health challenges may be targeted by changing people’s behaviour. Behaviours including cigarette smoking, physical inactivity and alcohol misuse, as well as certain dietary behaviours, contribute to deaths and disability by increasing the risk of cancers, cardiovascular diseases and diabetes. Interventions have been designed to change these health behaviours with a view to reducing these health risks. However, the effectiveness of these interventions has been quite variable and further information is needed to enhance their success. More information is needed about the specific processes that underlie the effectiveness of intervention strategies.
Aim
Researchers have developed a taxonomy of 93 behaviour change techniques (i.e. the active components of an intervention that bring about behavioural change), but little is known regarding their potential mechanisms of action (i.e. the processes through which a behaviour change technique affects behaviour). We therefore aimed to examine links between behaviour change techniques and mechanisms of action.
Method
First, we conducted a literature synthesis study of 277 behaviour change intervention studies, from which we extracted information on links, described by authors, between behaviour change techniques and mechanisms of action, and identified an average of 10 links per intervention report. Second, behaviour change experts (n = 105) were engaged in a three-round consensus study in which they discussed and rated their confidence in the presence/absence of ‘links’ and ‘non-links’ between commonly used behaviour change techniques (n = 61) and a set of mechanisms of action (n = 26). Ninety links and 460 ‘non-links’ reached the pre-set threshold of 80% agreement. To enhance the validity of these results, a third study was conducted that triangulated the findings of the first two studies. Discrepancies and uncertainties between the studies were included in a reconciliation consensus study with a new group of experts (n = 25). The final results identified 92 definite behaviour change technique–mechanism of action links and 465 definite non-links. In a fourth study, we examined whether or not groups of behaviour change techniques used together frequently across interventions revealed shared theoretical underpinnings. We found that experts agreed on the underlying theory for three groups of behaviour change techniques.
Results
Our results are potentially useful to policy-makers and practitioners in selecting behaviour change techniques to include in behaviour change interventions. However, our data do not demonstrate that the behaviour change techniques are effective in targeting the mechanism of action; rather, the links identified may be the ‘best bets’ for interventions that are effective in changing mechanisms of action, and the non-links are unlikely to be effective. Researchers examining effectiveness of interventions in either primary studies or evidence syntheses may consider these links for further investigation.
Conclusion
To make our results usable by researchers, practitioners and policy-makers, they are available in an online interactive tool, which enables discussion and collaboration (https://theoryandtechniquetool.humanbehaviourchange.org/); accessed 1 March 2020. This work, building on previous work to develop the behaviour change technique taxonomy, is part of an ongoing programme of work: the Human Behaviour Change Project (www.humanbehaviourchange.org/; accessed 1 March 2020).
Funding
This project was funded by the Medical Research Council via its Methodology Panel: ‘Developing methodology for designing and evaluating theory-based complex interventions: an ontology for linking behaviour change techniques to theory’ (reference MR/L011115/1).
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Affiliation(s)
- Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK
| | | | - Marijn de Bruin
- Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - Michael P Kelly
- Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Rachel N Carey
- Centre for Behaviour Change, University College London, London, UK
| | - Lauren EC Bohlen
- Centre for Behaviour Change, University College London, London, UK
- Department of Kinesiology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Hilary NK Groarke
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Niall C Anderson
- Centre for Behaviour Change, University College London, London, UK
- National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Silje Zink
- Centre for Behaviour Change, University College London, London, UK
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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9
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Gamblin D, Tobutt C, Patton R. Alcohol identification and brief advice in England’s criminal justice system: a review of the evidence. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1745311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- David Gamblin
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom of Great Britain and Northern Ireland
| | - Clive Tobutt
- Department of Interprofessional Studies, University of Winchester, Winchester, United Kingdom of Great Britain and Northern Ireland
| | - Robert Patton
- School of Psychology, University of Surrey, Guildford, United Kingdom of Great Britain and Northern Ireland
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10
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Carey RN, Connell LE, Johnston M, Rothman AJ, de Bruin M, Kelly MP, Michie S. Behavior Change Techniques and Their Mechanisms of Action: A Synthesis of Links Described in Published Intervention Literature. Ann Behav Med 2020; 53:693-707. [PMID: 30304386 PMCID: PMC6636886 DOI: 10.1093/abm/kay078] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Despite advances in behavioral science, there is no widely shared understanding of the “mechanisms of action” (MoAs) through which individual behavior change techniques (BCTs) have their effects. Cumulative progress in the development, evaluation, and synthesis of behavioral interventions could be improved by identifying the MoAs through which BCTs are believed to bring about change. Purpose This study aimed to identify the links between BCTs and MoAs described by authors of a corpus of published literature. Methods Hypothesized links between BCTs and MoAs were extracted by two coders from 277 behavior change intervention articles. Binomial tests were conducted to provide an indication of the relative frequency of each link. Results Of 77 BCTs coded, 70 were linked to at least one MoA. Of 26 MoAs, all but one were linked to at least one BCT. We identified 2,636 BCT–MoA links in total (mean number of links per article = 9.56, SD = 13.80). The most frequently linked MoAs were “Beliefs about Capabilities” and “Intention.” Binomial test results identified up to five MoAs linked to each of the BCTs (M = 1.71, range: 1–5) and up to eight BCTs for each of the MoAs (M = 3.63, range: 1–8). Conclusions The BCT–MoA links described by intervention authors and identified in this extensive review present intervention developers and reviewers with a first level of systematically collated evidence. These findings provide a resource for the development of theory-based interventions, and for theoretical understanding of intervention evaluations. The extent to which these links are empirically supported requires systematic investigation.
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Affiliation(s)
- Rachel N Carey
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Lauren E Connell
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.,Department of Kinesiology, University of Rhode Island, 25 W Independence Way, Kingston, RI 02881, USA
| | - Marie Johnston
- Aberdeen Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Marijn de Bruin
- Aberdeen Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Michael P Kelly
- Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
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11
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Marques MM, Carey RN, Norris E, Evans F, Finnerty AN, Hastings J, Jenkins E, Johnston M, West R, Michie S. Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology. Wellcome Open Res 2020; 5:125. [PMID: 33824909 PMCID: PMC7993627 DOI: 10.12688/wellcomeopenres.15906.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the Behaviour Change Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project. Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar with the ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) language and publishing online. Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational , Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it. Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.
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Affiliation(s)
- Marta M. Marques
- Centre for Behaviour Change, University College London, London, UK
- ADAPT SFI Research Centre, Trinity College Dublin, Dublin, Ireland
- Trinity Centre for Healthcare and Practice Innovation, Trinity College Dublin, Dublin, Ireland
| | - Rachel N. Carey
- Centre for Behaviour Change, University College London, London, UK
| | - Emma Norris
- Centre for Behaviour Change, University College London, London, UK
| | - Fiona Evans
- Centre for Behaviour Change, University College London, London, UK
| | | | - Janna Hastings
- Centre for Behaviour Change, University College London, London, UK
| | - Ella Jenkins
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Aberdeen Health Psychology Group, University of Aberdeen, Aberdeen, Scotland, UK
| | - Robert West
- Research Department of Epidemiology & Public Health, University College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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12
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Callaghan L, Thompson TP, Creanor S, Quinn C, Senior J, Green C, Hawton A, Byng R, Wallace G, Sinclair J, Kane A, Hazeldine E, Walker S, Crook R, Wainwright V, Enki DG, Jones B, Goodwin E, Cartwright L, Horrell J, Shaw J, Annison J, Taylor AH. Individual health trainers to support health and well-being for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Little is known about the effectiveness or cost-effectiveness of interventions, such as health trainer support, to improve the health and well-being of people recently released from prison or serving a community sentence, because of the challenges in recruiting participants and following them up.
Objectives
This pilot trial aimed to assess the acceptability and feasibility of the trial methods and intervention (and associated costs) for a randomised trial to assess the effectiveness and cost-effectiveness of health trainer support versus usual care.
Design
This trial involved a pilot multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1 : 1 individual allocation to receive support from a health trainer and usual care or usual care alone, with a mixed-methods process evaluation, in 2017–18.
Setting
Participants were identified, screened and recruited in Community Rehabilitation Companies in Plymouth and Manchester or the National Probation Service in Plymouth. The intervention was delivered in the community.
Participants
Those who had been out of prison for at least 2 months (to allow community stabilisation), with at least 7 months of a community sentence remaining, were invited to participate; those who may have posed an unacceptable risk to the researchers and health trainers and those who were not interested in the trial or intervention support were excluded.
Interventions
The intervention group received, in addition to usual care, our person-centred health trainer support in one-to-one sessions for up to 14 weeks, either in person or via telephone. Health trainers aimed to empower participants to make healthy lifestyle changes (particularly in alcohol use, smoking, diet and physical activity) and take on the Five Ways to Well-being [Foresight Projects. Mental Capital and Wellbeing: Final Project Report. 2008. URL: www.gov.uk/government/publications/mental-capital-and-wellbeing-making-the-most-of-ourselves-in-the-21st-century (accessed 24 January 2019).], and also signposted to other options for support. The control group received treatment as usual, defined by available community and public service options for improving health and well-being.
Main outcome measures
The main outcomes included the Warwick–Edinburgh Mental Well-being Scale scores, alcohol use, smoking behaviour, dietary behaviour, physical activity, substance use, resource use, quality of life, intervention costs, intervention engagement and feasibility and acceptability of trial methods and the intervention.
Results
A great deal about recruitment was learned and the target of 120 participants was achieved. The minimum trial retention target at 6 months (60%) was met. Among those offered health trainer support, 62% had at least two sessions. The mixed-methods process evaluation generally supported the trial methods and intervention acceptability and feasibility. The proposed primary outcome, the Warwick–Edinburgh Mental Well-being Scale scores, provided us with valuable data to estimate the sample size for a full trial in which to test the effectiveness and cost-effectiveness of the intervention.
Conclusions
Based on the findings from this pilot trial, a full trial (with some modifications) seems justified, with a sample size of around 900 participants to detect between-group differences in the Warwick-Edinburgh Mental Well-being Scale scores at a 6-month follow-up.
Future work
A number of recruitment, trial retention, intervention engagement and blinding issues were identified in this pilot and recommendations are made in preparation of and within a full trial.
Trial registration
Current Controlled Trials ISRCTN80475744.
Funding
This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 20. See the National Institute for Health Research Journals Library website for further project information.
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Affiliation(s)
- Lynne Callaghan
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Tom P Thompson
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Siobhan Creanor
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Cath Quinn
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Jane Senior
- Faculty of Biology and Mental Health, University of Manchester, Manchester, UK
| | - Colin Green
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Annie Hawton
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Richard Byng
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Gary Wallace
- Trading Standards and Health Improvement, Plymouth City Council, Plymouth, UK
| | - Julia Sinclair
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Amy Kane
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Emma Hazeldine
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Samantha Walker
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Rebecca Crook
- Faculty of Biology and Mental Health, University of Manchester, Manchester, UK
| | - Verity Wainwright
- Faculty of Biology and Mental Health, University of Manchester, Manchester, UK
| | - Doyo Gragn Enki
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Ben Jones
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Elizabeth Goodwin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Lucy Cartwright
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Jane Horrell
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Jenny Shaw
- Faculty of Biology and Mental Health, University of Manchester, Manchester, UK
| | - Jill Annison
- Faculty of Business, University of Plymouth, Plymouth, UK
| | - Adrian H Taylor
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
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13
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Peña Barona EA. La reducción de riesgos y daños vs. el régimen internacional de control de drogas (1990-2017). DRUGS AND ADDICTIVE BEHAVIOR 2019. [DOI: 10.21501/24631779.2962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A pesar de la evidente efectividad de ciertos programas de Reducción de Riesgos y Daños de Drogas (RRDD), el Régimen Internacional de Control de Drogas (RICD) históricamente ha desincentivado su implementación, los defensores de la cara más rígida del RICD se han referido a la RRDD como el caballo de Troya de las facciones que defienden la legalización. No obstante, una gran cantidad de Estados han hecho uso del margen de flexibilidad interpretativo de las Convenciones internacionales de drogas para implementar en sus políticas nacionales estrategias de RRDD, algunas promovidas inclusive por órganos propio de Naciones Unidas como la OMS, UNODC y UNAIDS. A partir de una revisión de literatura, este documento evalúa las principales tensiones que han ocurrido dentro del RICD a causa de la perspectiva de RRDD entre 1990 y 2017.
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14
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Hall N, Mooney JD, Sattar Z, Ling J. Extending alcohol brief advice into non-clinical community settings: a qualitative study of experiences and perceptions of delivery staff. BMC Health Serv Res 2019; 19:11. [PMID: 30616659 PMCID: PMC6323768 DOI: 10.1186/s12913-018-3796-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background At a population level, the majority of alcohol-related harm is attributable to drinkers whose consumption exceeds recommended drinking levels, rather than those with severe alcohol dependency. Identification and Brief Advice (IBA) interventions offer a cost-effective approach for reducing this harm. Traditionally, IBA interventions have been delivered in healthcare settings and therefore contextual influences on their use in non-clinical settings are not well understood. Methods Qualitative face-to-face and telephone interviews with staff responsible for delivering a pilot IBA intervention across community settings in the UK. Interviews were recorded and transcribed verbatim. Inductive thematic analysis was used to identify key issues and the constant comparison method was employed to compare barriers and facilitators to implementation across and within settings. Results A number of facilitators and barriers to delivery and implementation was identified across settings. These included familiarity with the customer base, working within public spaces, and assimilation of the intervention within existing role boundaries. Despite underlying concerns relating to the sensitive nature of the topic, most delivery staff felt their respective settings were appropriate for the delivery of the intervention and had proactively engaged members of the public with varying levels of risky drinking and readiness for behaviour change. Perceptions of actual or potential intervention success were conceptualised in relation to existing day-to-day role boundaries and responsibilities and the contexts in which they took place. Conclusions Findings support the potential value of multi-setting community approaches to facilitate more inclusive engagement with IBA. By comparing experiences and views from staff responsible for delivering the intervention across different community settings, our findings provide insight into how intervention acceptability and success are framed across settings, and how the intervention is assimilated within everyday practice and role boundaries. This study also highlights key areas to be addressed when implementing IBAs in non-clinical community settings by staff with diverse levels of health-related knowledge, skills and support needs. Although essential, the need for adaptable training and delivery approaches across different setting types is likely to result in methodological challenges that need to be addressed when evaluating future interventions and setting-specific influences on behaviour change and health outcomes.
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Affiliation(s)
- Nicola Hall
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England.
| | - John D Mooney
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England
| | - Zeibeda Sattar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England.,Faculty of Health and Life Sciences, Northumbria University, Newcastle, NE1 8ST, UK, England
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England
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15
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Addison M, Mcgovern R, Angus C, Becker F, Brennan A, Brown H, Coulton S, Crowe L, Gilvarry E, Hickman M, Howel D, Mccoll E, Muirhead C, Newbury-Birch D, Waqas M, Kaner E. Alcohol Screening and Brief Intervention in Police Custody Suites: Pilot Cluster Randomised Controlled Trial (AcCePT). Alcohol Alcohol 2018; 53:548-559. [PMID: 29889245 PMCID: PMC6104624 DOI: 10.1093/alcalc/agy039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/23/2018] [Indexed: 01/27/2023] Open
Abstract
Aims There is a clear association between alcohol use and offending behaviour and significant police time is spent on alcohol-related incidents. This study aimed to test the feasibility of a trial of screening and brief intervention in police custody suites to reduce heavy drinking and re-offending behaviour. Short summary We achieved target recruitment and high brief intervention delivery if this occurred immediately after screening. Low rates of return for counselling and retention at follow-up were challenges for a definitive trial. Conversely, high consent rates for access to police data suggested at least some outcomes could be measured remotely. Methods A three-armed pilot Cluster Randomised Controlled Trial with an embedded qualitative interview-based process evaluation to explore acceptability issues in six police custody suites (north east and south west of the UK). Interventions included: 1. Screening only (Controls), 2. 10 min Brief Advice 3. Brief Advice plus 20 min of brief Counselling. Results Of 3330 arrestees approached: 2228 were eligible for screening (67%) and 720 consented (32%); 386 (54%) scored 8+ on AUDIT; and 205 (53%) were enroled (79 controls, 65 brief advice and 61 brief counselling). Follow-up rates at 6 and 12 months were 29% and 26%, respectively. However, routinely collected re-offending data were obtained for 193 (94%) participants. Indices of deprivation data were calculated for 184 (90%) participants; 37.6% of these resided in the 20% most deprived areas of UK. Qualitative data showed that all arrestees reported awareness that participation was voluntary, that the trial was separate from police work, and the majority said trial procedures were acceptable. Conclusion Despite hitting target recruitment and same-day brief intervention delivery, a future trial of alcohol screening and brief intervention in a police custody setting would only be feasible if routinely collected re-offending and health data were used for outcome measurement. Trial registration ISRCTN number: 89291046.
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Affiliation(s)
- Michelle Addison
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
| | - Ruth Mcgovern
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
| | - Colin Angus
- School of Health and Related Research, Health Economics and Decision Science, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK
| | - Frauke Becker
- Nuffield Department of Population Health, University of Oxford, UK
| | - Alan Brennan
- School of Health and Related Research, Health Economics and Decision Science, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK
| | - Heather Brown
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
| | - Simon Coulton
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | - Lisa Crowe
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
| | - Eilish Gilvarry
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
- Newcastle & North Tyneside Addictions Service, Plummer Court, Carliol Place, Newcastle upon Tyne, UK
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK
| | - Denise Howel
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
| | - Elaine Mccoll
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
| | - Colin Muirhead
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
| | | | - Muhammad Waqas
- Economics Division, Leeds University Business School, Leeds, UK
| | - Eileen Kaner
- Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, UK
- Corresponding author: Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK. Tel: +44 (0)191 208 7884; E-mail:
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16
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Newbury-Birch D, Ferguson J, Landale S, Giles EL, McGeechan GJ, Gill C, Stockdale KJ, Holloway A. A Systematic Review of the Efficacy of Alcohol Interventions for Incarcerated People. Alcohol Alcohol 2018; 53:412-425. [PMID: 29750413 DOI: 10.1093/alcalc/agy032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/20/2018] [Indexed: 11/13/2022] Open
Abstract
Aim The aim of this current study was to systematically review the literature on brief alcohol interventions for incarcerated individuals to ascertain the efficacy or effectiveness in making changes to either consumption of alcohol or other social outcomes. Short summary Levels of risky drinking and dependency are high amongst incarcerated individuals. Eleven studies from nine articles were included in the systematic review. Six of the studies included brief intervention and three extended interventions. Interventions have the potential to positively impact on risky drinking. More studies are needed in this setting. Introduction It has been shown that around three times as many incarcerated individuals are risky drinkers and alcohol dependency is ten times higher than in the general population. Methods Systematic review of randomised controlled trials or matched group trials of the efficacy of psychosocial alcohol interventions for incarcerated individuals: we searched seven databases, with no restrictions on language, year or location from inception through to August 2017. The Critical Appraisal Skills Programme tool was used to assess the quality of included studies. The Template for Intervention Description and Replication checklist was used to ascertain intervention descriptions. Results Nine studies from 11 papers were included in the analysis. Six of the studies included brief interventions and three extended interventions. Every study used a different measure of alcohol consumption. Three of the studies that looked at brief interventions and all of the three extended intervention studies found significant reductions in relation to alcohol outcomes. Conclusions Results show that interventions in the prison setting have the potential to positively impact on alcohol use; however, because of small numbers and the use of different outcome measures we could not conduct a meta-analysis or generalise findings. Future studies are needed to standardise approaches to ensure greater rigour and efficacy.
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Affiliation(s)
| | - Jennifer Ferguson
- School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - Sarah Landale
- School of Health in Social Science, Edinburgh University, Edinburgh, UK
| | - Emma L Giles
- School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - Grant J McGeechan
- School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - Charlotte Gill
- Department of Criminology, Law and Society, George Mason University, Fairfax, VA, USA
| | - Kelly J Stockdale
- School of Psychological and Social Sciences, York St Johns University, York, UK
| | - Aisha Holloway
- School of Health in Social Science, Edinburgh University, Edinburgh, UK
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17
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McGovern R, Stamp E, Javanbakht M, McColl E, Hickman M, Kaner E. Promoting Alcohol Reduction in Non-Treatment Seeking parents (PAReNTS): a protocol for a pilot feasibility cluster randomised controlled trial of alcohol screening and brief interventions to reduce parental alcohol use disorders in vulnerable families. Pilot Feasibility Stud 2018; 4:111. [PMID: 29930865 PMCID: PMC5994069 DOI: 10.1186/s40814-018-0305-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/25/2018] [Indexed: 11/20/2022] Open
Abstract
Background Research estimates that 30% of children under the age of 16 years in the UK live with at least one parent with an alcohol use disorder (AUD). Parental AUDs are associated with adverse childhood experiences and poorer outcomes for children. The PAReNTS (Promoting Alcohol Reduction in Non-Treatment Seeking parents) trial aims to examine the feasibility and acceptability of a randomised controlled trial of brief alcohol interventions to reduce parental alcohol misuse. Methods The cluster randomised controlled trial will be conducted within early help family support and children’s social care services in three local authorities in the North East of England: Newcastle, Durham and North Tyneside. All eligible parents the caseloads of participating practitioners will be screened for an AUD using the Alcohol Use Disorder Identification Test – Consumption (AUDIT-C) screening tool by the social care practitioners within routine appointments. All parents who score 5 or more on the AUDIT-C will be invited to participate in the trial. Consenting participants will complete a baseline questionnaire before receiving one of three randomised interventions: (i) healthy lifestyle leaflet (control intervention); (ii) a brief alcohol advice intervention delivered by the social care practitioner plus healthy lifestyle leaflet; (iii) a brief alcohol advice intervention delivered by the social care practitioner, healthy lifestyle leaflet plus a 40-min behaviour change intervention with an optional review session delivered by the local alcohol service. Follow-up data will be collected 6 and 12 months post recruitment. A linked qualitative study will explore participating parent and practitioner views on the acceptability of trial processes and interventions. Discussion The PAReNTS trial will provide a robust estimate of recruitment, retention and consent rates in order to inform the design of a future definitive study examining the effectiveness and cost-effectiveness of alcohol screening and brief interventions to reduce parental AUDs within vulnerable families. Trial registration ISRCTN registry ISRCTN60291091; protocol version 2; 17.10.2016 Electronic supplementary material The online version of this article (10.1186/s40814-018-0305-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ruth McGovern
- 1Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine Stamp
- 1Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Mehdi Javanbakht
- 1Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- 1Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Matthew Hickman
- 2School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Eileen Kaner
- 1Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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18
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Coulton S, Bland M, Crosby H, Dale V, Drummond C, Godfrey C, Kaner E, Sweetman J, McGovern R, Newbury-Birch D, Parrott S, Tober G, Watson J, Wu Q. Effectiveness and Cost-effectiveness of Opportunistic Screening and Stepped-care Interventions for Older Alcohol Users in Primary Care. Alcohol Alcohol 2018; 52:655-664. [PMID: 29016980 DOI: 10.1093/alcalc/agx065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/22/2017] [Indexed: 11/12/2022] Open
Abstract
Aims To compare the clinical effectiveness and cost-effectiveness of a stepped-care intervention versus a minimal intervention for the treatment of older hazardous alcohol users in primary care. Method Multi-centre, pragmatic RCT, set in Primary Care in UK. Patients aged ≥ 55 years scoring ≥ 8 on the Alcohol Use Disorders Identification Test were allocated either to 5-min of brief advice or to 'Stepped Care': an initial 20-min of behavioural change counselling, with Step 2 being three sessions of Motivational Enhancement Therapy and Step 3 referral to local alcohol services (progression between each Step being determined by outcomes 1 month after each Step). Outcome measures included average drinks per day, AUDIT-C, alcohol-related problems using the Drinking Problems Index, health-related quality of life using the Short Form 12, costs measured from a NHS/Personal Social Care perspective and estimated health gains in quality adjusted life-years measured assessed EQ-5D. Results Both groups reduced alcohol consumption at 12 months but the difference between groups was small and not significant. No significant differences were observed between the groups on secondary outcomes. In economic terms stepped care was less costly and more effective than the minimal intervention. Conclusions Stepped care does not confer an advantage over a minimal intervention in terms of reduction in alcohol use for older hazardous alcohol users in primary care. However, stepped care has a greater probability of being more cost-effective. Trial Registration Current controlled trials ISRCTN52557360. Short summary A stepped care approach was compared with brief intervention for older at-risk drinkers attending primary care. While consumption reduced in both groups over 12 months there was no significant difference between the groups. An economic analysis indicated the stepped care which had a greater probability of being more cost-effective than brief intervention.
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Affiliation(s)
- Simon Coulton
- Centre for Health Service Studies, University of Kent, Canterbury CT2 7NZ, UK
| | - Martin Bland
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | | | - Veronica Dale
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Colin Drummond
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College, London SE5 8BB, UK
| | - Christine Godfrey
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle NE2 4AX, UK
| | - Jennifer Sweetman
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Ruth McGovern
- Institute of Health and Society, Newcastle University, Newcastle NE2 4AX, UK
| | | | - Steve Parrott
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | | | - Judith Watson
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Qi Wu
- Department of Health Sciences, University of York, York YO10 5DD, UK
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19
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Thompson TP, Callaghan L, Hazeldine E, Quinn C, Walker S, Byng R, Wallace G, Creanor S, Green C, Hawton A, Annison J, Sinclair J, Senior J, Taylor AH. Health trainer-led motivational intervention plus usual care for people under community supervision compared with usual care alone: a study protocol for a parallel-group pilot randomised controlled trial (STRENGTHEN). BMJ Open 2018; 8:e023123. [PMID: 29866736 PMCID: PMC5988189 DOI: 10.1136/bmjopen-2018-023123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION People with experience of the criminal justice system typically have worse physical and mental health, lower levels of mental well-being and have less healthy lifestyles than the general population. Health trainers have worked with offenders in the community to provide support for lifestyle change, enhance mental well-being and signpost to appropriate services. There has been no rigorous evaluation of the effectiveness and cost-effectiveness of providing such community support. This study aims to determine the feasibility and acceptability of conducting a randomised trial and delivering a health trainer intervention to people receiving community supervision in the UK. METHODS AND ANALYSIS A multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1:1 individual allocation to receive support from a health trainer and usual care or usual care alone, with mixed methods process evaluation. Participants receive community supervision from an offender manager in either a Community Rehabilitation Company or the National Probation Service. If they have served a custodial sentence, then they have to have been released for at least 2 months. The supervision period must have at least 7 months left at recruitment. Participants are interested in receiving support to change diet, physical activity, alcohol use and smoking and/or improve mental well-being. The primary outcome is mental well-being with secondary outcomes related to smoking, physical activity, alcohol consumption and diet. The primary outcome will inform sample size calculations for a definitive trial. ETHICS AND DISSEMINATION The study has been approved by the Health and Care Research Wales Ethics Committee (REC reference 16/WA/0171). Dissemination will include publication of the intervention development process and findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals. Results will also be disseminated to stakeholders and trial participants. TRIAL REGISTRATION NUMBERS ISRCTN80475744; Pre-results.
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Affiliation(s)
- Tom P Thompson
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Lynne Callaghan
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Emma Hazeldine
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Cath Quinn
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Samantha Walker
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Richard Byng
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | | | - Siobhan Creanor
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Colin Green
- University of Exeter Medical School, Exeter, UK
| | | | - Jill Annison
- School of Law, Criminology, and Government (Faculty of Business), Plymouth University, Plymouth, UK
| | | | - Jane Senior
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Adrian H Taylor
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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20
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Crombie IK, Irvine L, Williams B, Sniehotta FF, Petrie DJ, Jones C, Norrie J, Evans JMM, Emslie C, Rice PM, Slane PW, Humphris G, Ricketts IW, Melson AJ, Donnan PT, McKenzie A, Huang L, Achison M. Text message intervention to reduce frequency of binge drinking among disadvantaged men: the TRAM RCT. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Socially disadvantaged men are more likely to binge drink frequently and to experience high levels of alcohol-related harm.
Objectives
To test the effectiveness and cost-effectiveness of a text message intervention in reducing the frequency of binge drinking among disadvantaged men.
Study design
A four-centre, parallel-group, pragmatic, individually randomised controlled trial was conducted. Randomisation was carried out using a secure remote web-based system. It was stratified by participating centre and recruitment method and restricted using block sizes of randomly varying lengths.
Setting
The study was conducted in the community. Members of the public helped to develop the study methods.
Participants
Participants were men aged 25–44 years who had ≥ 2 episodes of binge drinking (> 8 units of alcohol in a single session) in the preceding 28 days. Men were recruited from areas of high deprivation.
Interventions
An empirically and theoretically based text message intervention was delivered by 112 interactive text messages over a 12-week period. The control group received an attentional control comprising 89 text messages on general health.
Primary outcome measure
The primary outcome measure was the proportion of men consuming > 8 units of alcohol on ≥ 3 occasions (in the previous 28 days) at 12 months post intervention.
Results
The recruitment target of 798 was exceeded and 825 men were randomised. Retention was high and similar in the intervention (84.9%) and control (86.5%) groups. Most men in the intervention group engaged enthusiastically with the text messages: almost all (92%) replied to text messages and over two-thirds (67%) replied more than 10 times. The intervention was estimated to have had a modest, statistically non-significant effect on the primary outcome at the 12-month follow-up [odds ratio 0.79, 95% confidence interval (CI) 0.57 to 1.08]. This corresponds to a net reduction of 5.7% in regular binge drinking. Five secondary outcomes showed small non-significant and inconsistent effects on alcohol consumption, with one suggesting a positive effect and four suggesting an adverse effect. Both the short- and the long-term cost per quality-adjusted life-year (QALY) analysis suggested that the brief intervention was dominated by a ‘do-nothing’ option. The intervention’s impacts on patterns of alcohol consumption, QALYs and downstream costs were inconsistent and uncertain.
Limitations
The study used an active control that, combined with the recruitment procedures and baseline assessments, could have biased the treatment effect towards the null. The measurement of alcohol consumption relied on self-reported drinking.
Conclusions
The trial has demonstrated that it is possible to recruit and retain large numbers of socially disadvantaged men in a research study. The text messages delivered a complex theoretically and empirically based intervention that fostered enthusiastic engagement with the key components of the behaviour change sequence. The intervention produced a modest, statistically non-significant effect on the primary outcome, with wide CIs. Further research is needed to reduce uncertainty about the treatment effect. The methods developed for this study provide a platform for the design and testing of interventions to reduce inequalities in health.
Future work
A future trial could reduce the uncertainty around the treatment effect of the intervention.
Trial registration
Current Controlled Trials ISRCTN07695192.
Funding
This study was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 6. See NIHR Journals Library website for further information.
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Affiliation(s)
- Iain K Crombie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Linda Irvine
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Brian Williams
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Dennis J Petrie
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - John Norrie
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Josie MM Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Carol Emslie
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Peter M Rice
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Peter W Slane
- Erskine Practice, Arthurstone Medical Centre, Dundee, UK
| | - Gerry Humphris
- School of Medicine, Medical and Biological Sciences, University of St Andrews, St Andrews, UK
| | | | - Ambrose J Melson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Peter T Donnan
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Andrew McKenzie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Li Huang
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Marcus Achison
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
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21
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Michie S, Carey RN, Johnston M, Rothman AJ, de Bruin M, Kelly MP, Connell LE. From Theory-Inspired to Theory-Based Interventions: A Protocol for Developing and Testing a Methodology for Linking Behaviour Change Techniques to Theoretical Mechanisms of Action. Ann Behav Med 2018; 52:501-512. [PMID: 27401001 PMCID: PMC6367898 DOI: 10.1007/s12160-016-9816-6] [Citation(s) in RCA: 190] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Understanding links between behaviour change techniques (BCTs) and mechanisms of action (the processes through which they affect behaviour) helps inform the systematic development of behaviour change interventions. Purpose This research aims to develop and test a methodology for linking BCTs to their mechanisms of action. Methods Study 1 (published explicit links): Hypothesised links between 93 BCTs (from the 93-item BCT taxonomy, BCTTv1) and mechanisms of action will be identified from published interventions and their frequency, explicitness and precision documented. Study 2 (expert-agreed explicit links): Behaviour change experts will identify links between 61 BCTs and 26 mechanisms of action in a formal consensus study. Study 3 (integrated matrix of explicit links): Agreement between studies 1 and 2 will be evaluated and a new group of experts will discuss discrepancies. An integrated matrix of BCT-mechanism of action links, annotated to indicate strength of evidence, will be generated. Study 4 (published implicit links): To determine whether groups of co-occurring BCTs can be linked to theories, we will identify groups of BCTs that are used together from the study 1 literature. A consensus exercise will be used to rate strength of links between groups of BCT and theories. Conclusions A formal methodology for linking BCTs to their hypothesised mechanisms of action can contribute to the development and evaluation of behaviour change interventions. This research is a step towards developing a behaviour change 'ontology', specifying relations between BCTs, mechanisms of action, modes of delivery, populations, settings and types of behaviour.
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Affiliation(s)
- Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rachel N Carey
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | | | | | | | - Lauren E Connell
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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22
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Dienes Z, Coulton S, Heather N. Using Bayes factors to evaluate evidence for no effect: examples from the SIPS project. Addiction 2018; 113:240-246. [PMID: 28804980 DOI: 10.1111/add.14002] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/20/2017] [Accepted: 08/08/2017] [Indexed: 11/29/2022]
Abstract
AIMS To illustrate how Bayes factors are important for determining the effectiveness of interventions. METHOD We consider a case where inappropriate conclusions were drawn publicly based on significance testing, namely the SIPS project (Screening and Intervention Programme for Sensible drinking), a pragmatic, cluster-randomized controlled trial in each of two health-care settings and in the criminal justice system. We show how Bayes factors can disambiguate the non-significant findings from the SIPS project and thus determine whether the findings represent evidence of absence or absence of evidence. We show how to model the sort of effects that could be expected, and how to check the robustness of the Bayes factors. RESULTS The findings from the three SIPS trials taken individually are largely uninformative but, when data from these trials are combined, there is moderate evidence for a null hypothesis (H0) and thus for a lack of effect of brief intervention compared with simple clinical feedback and an alcohol information leaflet (B = 0.24, P = 0.43). CONCLUSION Scientists who find non-significant results should suspend judgement-unless they calculate a Bayes factor to indicate either that there is evidence for a null hypothesis (H0) over a (well-justified) alternative hypothesis (H1), or that more data are needed.
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Affiliation(s)
- Zoltan Dienes
- School of Psychology, University of Sussex, Brighton, UK
| | - Simon Coulton
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Nick Heather
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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23
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Shorter GW, Heather N, Bray JW, Giles EL, Holloway A, Barbosa C, Berman AH, O'Donnell AJ, Clarke M, Stockdale KJ, Newbury-Birch D. The 'Outcome Reporting in Brief Intervention Trials: Alcohol' (ORBITAL) framework: protocol to determine a core outcome set for efficacy and effectiveness trials of alcohol screening and brief intervention. Trials 2017; 18:611. [PMID: 29273070 PMCID: PMC5741954 DOI: 10.1186/s13063-017-2335-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/31/2017] [Indexed: 11/12/2022] Open
Abstract
Background The evidence base to assess the efficacy and effectiveness of alcohol brief interventions (ABI) is weakened by variation in the outcomes measured and by inconsistent reporting. The ‘Outcome Reporting in Brief Intervention Trials: Alcohol’ (ORBITAL) project aims to develop a core outcome set (COS) and reporting guidance for its use in future trials of ABI in a range of settings. Methods/design An international Special Interest Group was convened through INEBRIA (International Network on Brief Interventions for Alcohol and Other Drugs) to inform the development of a COS for trials of ABI. ORBITAL will incorporate a systematic review to map outcomes used in efficacy and effectiveness trials of ABI and their measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. This will support a multi-round Delphi study to prioritise outcomes. Delphi panellists will be drawn from a range of settings and stakeholder groups, and the Delphi study will also be used to determine if a single COS is relevant for all settings. A consensus meeting with key stakeholder representation will determine the final COS and associated guidance for its use in trials of ABI. Discussion ORBITAL will develop a COS for alcohol screening and brief intervention trials, with outcomes stratified into domains and guidance on outcome measurement instruments. The standardisation of ABI outcomes and their measurement will support the ongoing development of ABI studies and a systematic synthesis of emerging research findings. We will track the extent to which the COS delivers on this promise through an exploration of the use of the guidance in the decade following COS publication.
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Affiliation(s)
- G W Shorter
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK.,Psychotraumatology, Mental Health & Suicidal Behaviour Research Group, Psychology Research Institute, Ulster University, Coleraine, UK.,Inspire, Belfast, UK.,College of Medicine, Biology and Environment, Australian National University, Canberra, ACT, Australia
| | - N Heather
- Faculty of Health and Life Science, Northumbria University, Newcastle upon Tyne, UK
| | - Jeremy W Bray
- Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, NC, USA.
| | - E L Giles
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - A Holloway
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - C Barbosa
- Behavioral Health Economics Program, RTI International, Chicago, IL, USA
| | - A H Berman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - A J O'Donnell
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK
| | - M Clarke
- Northern Ireland Methodology Hub, Queen's University of Belfast, Belfast, UK
| | - K J Stockdale
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK.,School of Psychological and Social Sciences, York St. John University, York, UK
| | - D Newbury-Birch
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK
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24
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Crombie IK, Cunningham KB, Irvine L, Williams B, Sniehotta FF, Norrie J, Melson A, Jones C, Briggs A, Rice PM, Achison M, McKenzie A, Dimova E, Slane PW. Modifying Alcohol Consumption to Reduce Obesity (MACRO): development and feasibility trial of a complex community-based intervention for men. Health Technol Assess 2017; 21:1-150. [PMID: 28414020 DOI: 10.3310/hta21190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Obese men who consume alcohol are at a greatly increased risk of liver disease; those who drink > 14 units of alcohol per week have a 19-fold increased risk of dying from liver disease. OBJECTIVES To develop an intervention to reduce alcohol consumption in obese men and to assess the feasibility of a randomised controlled trial (RCT) to investigate its effectiveness. DESIGN OF THE INTERVENTION The intervention was developed using formative research, public involvement and behaviour change theory. It was organised in two phases, comprising a face-to-face session with trained laypeople (study co-ordinators) followed by a series of text messages. Participants explored how alcohol consumption contributed to weight gain, both through direct calorie consumption and through its effect on increasing food consumption, particularly of high-calorie foodstuffs. Men were encouraged to set goals to reduce their alcohol consumption and to make specific plans to do so. The comparator group received an active control in the form of a conventional alcohol brief intervention. Randomisation was carried out using the secure remote web-based system provided by the Tayside Clinical Trials Unit. Randomisation was stratified by the recruitment method and restricted using block sizes of randomly varying lengths. Members of the public were involved in the development of all study methods. SETTING Men were recruited from the community, from primary care registers and by time-space sampling (TSS). The intervention was delivered in community settings such as the participant's home, community centres and libraries. PARTICIPANTS Men aged 35-64 years who had a body mass index (BMI) of > 30 kg/m2 and who drank > 21 units of alcohol per week. RESULTS The screening methods successfully identified participants meeting the entry criteria. Trial recruitment was successful, with 69 men (36 from 419 approached in primary care, and 33 from 470 approached via TSS) recruited and randomised in 3 months. Of the 69 men randomised, 35 were allocated to the intervention group and 34 to the control group. The analysis was conducted on 31 participants from the intervention group and 30 from the control group. The participants covered a wide range of ages and socioeconomic statuses. The average alcohol consumption of the men recruited was 47.2 units per week, more than twice that of the entry criterion (> 21 units per week). Most (78%) engaged in binge drinking (> 8 units in a session) at least weekly. Almost all (95%) exceeded the threshold for a 19-fold increase in the risk of dying from liver disease (BMI of > 30 kg/m2 and > 14 units of alcohol per week). Despite this, they believed that they were at low risk of harm from alcohol, possibly because they seldom suffered acute harms (e.g. hangovers) and made few visits to a general practitioner or hospital. INTERVENTION The intervention was delivered with high fidelity. A high follow-up rate was achieved (98%) and the outcomes for the full RCT were measured. A process evaluation showed that participants engaged with the main components of the intervention. The acceptability of the study methods was high. CONCLUSIONS This feasibility study developed a novel intervention and evaluated all of the stages of a RCT that would test the effectiveness of the intervention. The main stages of a trial were completed successfully: recruitment, randomisation, intervention delivery, follow-up and measurement of study outcomes. Most of the men recruited drank very heavily and were also obese. This places them at a very high risk of liver disease, making them a priority for intervention. FUTURE WORK A RCT to test the effectiveness and cost-effectiveness of the intervention. TRIAL REGISTRATION Current Controlled Trials ISRCTN55309164. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 19. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Iain K Crombie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Kathryn B Cunningham
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Linda Irvine
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Brian Williams
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK.,School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Medical Faculty, Newcastle University, Newcastle upon Tyne, UK
| | - John Norrie
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK.,Edinburgh Clinical Trials Unit (ECTU), University of Edinburgh, Edinburgh, UK
| | - Ambrose Melson
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Claire Jones
- Health Informatics Centre, School of Medicine, University of Dundee, Dundee, UK
| | - Andrew Briggs
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Peter M Rice
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Marcus Achison
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Andrew McKenzie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Elena Dimova
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK.,Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Peter W Slane
- Erskine Practice, Arthurstone Medical Centre, Dundee, UK
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25
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Burton R, Henn C, Lavoie D, O'Connor R, Perkins C, Sweeney K, Greaves F, Ferguson B, Beynon C, Belloni A, Musto V, Marsden J, Sheron N. A rapid evidence review of the effectiveness and cost-effectiveness of alcohol control policies: an English perspective. Lancet 2017; 389:1558-1580. [PMID: 27919442 DOI: 10.1016/s0140-6736(16)32420-5] [Citation(s) in RCA: 204] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 02/09/2023]
Abstract
This paper reviews the evidence for the effectiveness and cost-effectiveness of policies to reduce alcohol-related harm. Policies focus on price, marketing, availability, information and education, the drinking environment, drink-driving, and brief interventions and treatment. Although there is variability in research design and measured outcomes, evidence supports the effectiveness and cost-effectiveness of policies that address affordability and marketing. An adequate reduction in temporal availability, particularly late night on-sale availability, is effective and cost-effective. Individually-directed interventions delivered to at-risk drinkers and enforced legislative measures are also effective. Providing information and education increases awareness, but is not sufficient to produce long-lasting changes in behaviour. At best, interventions enacted in and around the drinking environment lead to small reductions in acute alcohol-related harm. Overall, there is a rich evidence base to support the decisions of policy makers in implementing the most effective and cost-effective policies to reduce alcohol-related harm.
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Affiliation(s)
- Robyn Burton
- Public Health England, London, UK; Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | | | | | | | | | - Felix Greaves
- Public Health England, London, UK; Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Brian Ferguson
- Public Health England, London, UK; Department of Health Sciences, University of York, York, UK
| | | | | | | | - John Marsden
- Public Health England, London, UK; Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nick Sheron
- Public Health England, London, UK; Faculty of Medicine, University of Southampton, Southampton, UK
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26
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Coulton S, Stockdale K, Marchand C, Hendrie N, Billings J, Boniface S, Butler S, Deluca P, Drummond C, Newbury-Birch D, Pellatt-Higgins T, Stevens A, Sutherland A, Wilson E. Pragmatic randomised controlled trial to evaluate the effectiveness and cost effectiveness of a multi-component intervention to reduce substance use and risk-taking behaviour in adolescents involved in the criminal justice system: A trial protocol (RISKIT-CJS). BMC Public Health 2017; 17:246. [PMID: 28284187 PMCID: PMC5346206 DOI: 10.1186/s12889-017-4170-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/04/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Adolescence is a critical developmental stage when young people make lifestyle choices that have the potential to impact on their current and future health and social wellbeing. The relationship between substance use and criminal activity is complex but there is clear evidence that the prevalence of problematic substance use is far higher among adolescent offenders than the general adolescent population. Adolescent offenders are a marginalized and vulnerable population who are significantly more likely to experience health and social inequalities in later life than their non-offending peers. There is a paucity of evidence on effective interventions to address substance use and risk-taking behaviours in adolescent offender populations but it is clear that preventative or abstinence orientated interventions are not effective. RISKIT-CJS is an intervention developed in collaboration with young people taking account of the current best evidence. Feasibility and pilot studies have found the intervention addresses the needs of adolescents, is acceptable and has demonstrated potential in reducing substance use and risk-taking behavior. METHODS The study is a mixed method, two-armed, prospective, pragmatic randomized controlled trial with individual randomisation to either treatment as usual alone or the RISKIT-CJS intervention in addition to treatment as usual. Adolescents, aged 13 to 17 years inclusive, engaged with the criminal justice system who are identified as having problematic substance use are eligible to participate. The study will be conducted across three geographical areas; South and South East England, London and North East England between March 2017 and February 2019. DISCUSSION The study represents an ambitious programme of work to address an area of need for a marginalized and vulnerable population. TRIAL REGISTRATION ISRCTN77037777 registered 15/09/2016.
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Affiliation(s)
- Simon Coulton
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Kelly Stockdale
- Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | | | - Nadine Hendrie
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Jenny Billings
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Sadie Boniface
- Institute of Psychiatry Psychology and Neurosciences, Kings College, London, UK
| | - Steve Butler
- Addaction Young Peoples Service, Canterbury, Kent UK
| | - Paolo Deluca
- Institute of Psychiatry Psychology and Neurosciences, Kings College, London, UK
| | - Colin Drummond
- Institute of Psychiatry Psychology and Neurosciences, Kings College, London, UK
| | | | | | - Alex Stevens
- School of Sociology, Social Policy and Social Research, University of Kent, Canterbury, Kent UK
| | | | - Ed Wilson
- Dept. of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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27
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A randomized study of the use of screening, brief intervention, and referral to treatment (SBIRT) for drug and alcohol use with jail inmates. J Subst Abuse Treat 2016; 74:54-64. [PMID: 28132701 DOI: 10.1016/j.jsat.2016.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/14/2016] [Accepted: 12/28/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based practice that has been shown to reduce alcohol and drug use in healthcare, educational, and other settings, but research on the effectiveness of SBIRT with populations involved in the criminal justice system is limited. These populations have high rates of substance use but have limited access to interventions. METHODS The study randomized 732 jail inmates from a large urban jail to the SBIRT intervention or to the control group. Using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), the intervention assessed the risk level for drug and alcohol misuse by inmates and provided those who were at low or medium risk with a brief intervention in jail and referred those at high risk to community treatment following release, including the opportunity to participate in a brief treatment (eight sessions) protocol. Using interview and records data from a 12-month follow-up, analyses compared the two groups with respect to the primary study outcomes of reductions in drug and alcohol use and the secondary outcomes of participation in treatment, rearrest, reduction in HIV risk behaviors, and quality of life. In addition, the costs of delivering the SBIRT intervention were calculated. RESULTS When baseline differences were controlled, the groups did not differ at follow-up on any of the primary or secondary outcomes. CONCLUSIONS Future research should develop and evaluate SBIRT models that are specifically adapted to the characteristics and needs of the jail population. Until more favorable results emerge, attempts to use SBIRT with jail inmates should be implemented with caution, if at all. TRIAL REGISTRATION NUMBER NCT01683643.
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28
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Giles EL, Coulton S, Deluca P, Drummond C, Howel D, Kaner E, McColl E, McGovern R, Scott S, Stamp E, Sumnall H, Tate L, Todd L, Vale L, Albani V, Boniface S, Ferguson J, Frankham J, Gilvarry E, Hendrie N, Howe N, McGeechan GJ, Stanley G, Newbury-Birch D. Multicentre individual randomised controlled trial of screening and brief alcohol intervention to prevent risky drinking in young people aged 14-15 in a high school setting (SIPS JR-HIGH): study protocol. BMJ Open 2016; 6:e012474. [PMID: 28011807 PMCID: PMC5223663 DOI: 10.1136/bmjopen-2016-012474] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/23/2016] [Accepted: 10/12/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Drinking has adverse impacts on health, well-being, education and social outcomes for adolescents. Adolescents in England are among the heaviest drinkers in Europe. Recently, the proportion of adolescents who drink alcohol has fallen, although consumption among those who do drink has actually increased. This trial seeks to investigate how effective and efficient an alcohol brief intervention is with 11-15 years olds to encourage lower alcohol consumption. METHODS AND ANALYSIS This is an individually randomised two-armed trial incorporating a control arm of usual school-based practice and a leaflet on a healthy lifestyle (excl. alcohol), and an intervention arm that combines usual practice with a 30 min brief intervention delivered by school learning mentors and a leaflet on alcohol. At least 30 schools will be recruited from four regions in England (North East, North West, London, Kent and Medway) to follow-up 235 per arm. The primary outcome is total alcohol consumed in the last 28 days, using the 28 day Timeline Follow Back questionnaire measured at the 12-month follow-up. The analysis of the intervention will consider effectiveness and cost-effectiveness. A qualitative study will explore, via 1:1 in-depth interviews with (n=80) parents, young people and school staff, intervention experience, intervention fidelity and acceptability issues, using thematic narrative synthesis to report qualitative data. ETHICS AND DISSEMINATION Ethical approval was granted by Teesside University. Dissemination plans include academic publications, conference presentations, disseminating to local and national education departments and the wider public health community, including via Fuse, and engaging with school staff and young people to comment on whether and how the project can be improved. TRIAL REGISTRATION TRIAL ISRCTN45691494; Pre-results.
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Affiliation(s)
- Emma L Giles
- Health and Social Care Institute, Alcohol and Public Health Team, Teesside University, Middlesbrough, UK
| | - Simon Coulton
- Centre for Health Services Research, George Allen Wing, University of Kent, Canterbury, UK
| | - Paolo Deluca
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Colin Drummond
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Denise Howel
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Stephanie Scott
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine Stamp
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Harry Sumnall
- Centre for Public Health, Liverpool John Moores University, Liverpool, UK
| | - Les Tate
- Young People's Drug and Alcohol Department, North Tyneside Council, Tyne and Wear, UK
| | - Liz Todd
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Viviana Albani
- Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Sadie Boniface
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jennifer Ferguson
- Health and Social Care Institute, Alcohol and Public Health Team, Teesside University, Middlesbrough, UK
| | - Jo Frankham
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, UK
| | - Eilish Gilvarry
- Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Newcastle upon Tyne, UK
| | - Nadine Hendrie
- Centre for Health Services Research, George Allen Wing, University of Kent, Canterbury, UK
| | - Nicola Howe
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Grant J McGeechan
- Health and Social Care Institute, Alcohol and Public Health Team, Teesside University, Middlesbrough, UK
| | - Grant Stanley
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, UK
| | - Dorothy Newbury-Birch
- Health and Social Care Institute, Alcohol and Public Health Team, Teesside University, Middlesbrough, UK
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Heather N. Spreading alcohol brief interventions from health care to non-health care settings: Is it justified? DRUGS: EDUCATION, PREVENTION AND POLICY 2016. [DOI: 10.1080/09687637.2016.1187113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Climbing down the steps from the ivory tower: how UK academics and criminal justice practitioners need to work together on alcohol studies. Int J Prison Health 2016; 12:129-34. [DOI: 10.1108/ijph-06-2016-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Evidence in the UK tells us that risky drinking is high amongst those in contact with the criminal justice system. The purpose of this paper is to explore the reasons why carrying out research around risky drinking in this setting is so difficult.
Design/methodology/approach
A commentary on the issues of carrying out research in the criminal justice setting.
Findings
There are issues of carrying out research in the criminal justice setting. The authors argue, that as academics we can be more proactive in working with practitioners in the design and carrying out of studies. By examining what the primary outcome of interest is to those that work in the field rather than what funding agencies tell us academics must use, academics may engage in a more co-productive way that enables everyone to achieve what they need. Moreover more work is needed to show how this approach can be achieved both in the UK and internationally.
Originality/value
This editorial explores some of the difficulties of carrying out alcohol research in the criminal justice system and postulates ways that this could be made easier.
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Platt L, Melendez-Torres GJ, O'Donnell A, Bradley J, Newbury-Birch D, Kaner E, Ashton C. How effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metaregression analysis. BMJ Open 2016; 6:e011473. [PMID: 27515753 PMCID: PMC4985973 DOI: 10.1136/bmjopen-2016-011473] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/15/2016] [Accepted: 07/14/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND While the efficacy and effectiveness of brief interventions for alcohol (ABI) have been demonstrated in primary care, there is weaker evidence in other settings and reviews do not consider differences in content. We conducted a systematic review to measure the effect of ABIs on alcohol consumption and how it differs by the setting, practitioner group and content of intervention. METHODS We searched MEDLINE, EMBASE, PsycINFO; CINAHL, Social Science Citation Index, Cochrane Library and Global Health up to January 2015 for randomised controlled trials that measured effectiveness of ABIs on alcohol consumption. We grouped outcomes into measures of quantity and frequency indices. We used multilevel meta-analysis to estimate pooled effect sizes and tested for the effect of moderators through a multiparameter Wald test. Stratified analysis of a subset of quantity and frequency outcomes was conducted as a sensitivity check. RESULTS 52 trials were included contributing data on 29 891 individuals. ABIs reduced the quantity of alcohol consumed by 0.15 SDs. While neither the setting nor content appeared to significantly moderate intervention effectiveness, the provider did in some analyses. Interventions delivered by nurses had the most effect in reducing quantity (d=-0.23, 95% CI (-0.33 to -0.13)) but not frequency of alcohol consumption. All content groups had statistically significant mean effects, brief advice was the most effective in reducing quantity consumed (d=-0.20, 95% CI (-0.30 to -0.09)). Effects were maintained in the stratified sensitivity analysis at the first and last assessment time. CONCLUSIONS ABIs play a small but significant role in reducing alcohol consumption. Findings show the positive role of nurses in delivering interventions. The lack of evidence on the impact of content of intervention reinforces advice that services should select the ABI tool that best suits their needs.
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Affiliation(s)
- Lucy Platt
- Department of Social and Environmental Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - G J Melendez-Torres
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Amy O'Donnell
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Jennifer Bradley
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | | | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Charlotte Ashton
- Camden & Islington Public Health, London Boroughs of Islington and Camden, London, UK
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Newbury-Birch D, McGovern R, Birch J, O'Neill G, Kaner H, Sondhi A, Lynch K. A rapid systematic review of what we know about alcohol use disorders and brief interventions in the criminal justice system. Int J Prison Health 2016; 12:57-70. [DOI: 10.1108/ijph-08-2015-0024] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to review the evidence of alcohol use disorders within the different stages of the criminal justice system in the UK. Furthermore it reviewed the worldwide evidence of alcohol brief interventions in the various stages of the criminal justice system.
Design/methodology/approach
– A rapid systematic review of publications was conducted from the year 2000 to 2014 regarding the prevalence of alcohol use disorders in the various stages of the criminal justice system. The second part of the work was a rapid review of effectiveness studies of interventions for alcohol brief interventions. Studies were included if they had a comparison group. Worldwide evidence was included that consisted of up to three hours of face-to-face brief intervention either in one session or numerous sessions.
Findings
– This review found that 64-88 per cent of adults in the police custody setting; 95 per cent in the magistrate court setting; 53-69 per cent in the probation setting and 5,913-863 per cent in the prison system and 64 per cent of young people in the criminal justice system in the UK scored positive for an alcohol use disorder. There is very little evidence of effectiveness of brief interventions in the various stages of the criminal justice system mainly due to the lack of follow-up data.
Social implications
– Brief alcohol interventions have a large and robust evidence base for reducing alcohol use in risky drinkers, particularly in primary care settings. However, there is little evidence of effect upon drinking levels in criminal justice settings. Whilst the approach shows promise with some effects being shown on alcohol-related harm as well as with young people in the USA, more robust research is needed to ascertain effectiveness of alcohol brief interventions in this setting.
Originality/value
– This paper provides evidence of alcohol use disorders in the different stages of the criminal justice system in the UK using a validated tool as well as reviewing the worldwide evidence for short (
<
three hours) alcohol brief intervention in this setting.
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Lygidakis C, Wallace P, Tersar C, Marcatto F, Ferrante D, Della Vedova R, Scafuri F, Scafato E, Struzzo P. Download Your Doctor: Implementation of a Digitally Mediated Personal Physician Presence to Enhance Patient Engagement With a Health-Promoting Internet Application. JMIR Res Protoc 2016; 5:e36. [PMID: 26944482 PMCID: PMC4799428 DOI: 10.2196/resprot.5232] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 11/28/2015] [Accepted: 01/03/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Brief interventions delivered in primary health care are effective in reducing excessive drinking; online behavior-changing technique interventions may be helpful. Physicians may actively encourage the use of such interventions by helping patients access selected websites (a process known as "facilitated access"). Although the therapeutic working alliance plays a significant role in the achievement of positive outcomes in face-to-face psychotherapy and its development has been shown to be feasible online, little research has been done on its impact on brief interventions. Strengthening patients' perception of their physician's endorsement of a website could facilitate the development of an effective alliance between the patient and the app. OBJECTIVE We describe the implementation of a digitally mediated personal physician presence to enhance patient engagement with an alcohol-reduction website as part of the experimental online intervention in a noninferiority randomized controlled trial. We also report the feedback of the users on the module. METHODS The Download Your Doctor module was created to simulate the personal physician presence for an alcohol-reduction website that was developed for the EFAR-FVG trial conducted in the Italian region of Friuli-Venezia-Giulia. The module was designed to enhance therapeutic alliance and thus improve outcomes in the intervention group (facilitated access to the website). Participating general and family practitioners could customize messages and visual elements and upload a personal photo, signature, and video recordings. To assess the perceptions and attitudes of the physicians, a semistructured interview was carried out 3 months after the start of the trial. Participating patients were invited to respond to a short online questionnaire 12 months following recruitment to investigate their evaluation of their online experiences. RESULTS Nearly three-quarters (23/32, 72%) of the physicians interviewed chose to customize the contents of the interaction with their patients using the provided features and acknowledged the ease of use of the online tools. The majority of physicians (21/32, 57%) customized at least the introductory photo and video. Barriers to usage among those who did not customize the contents were time restrictions, privacy concerns, difficulties in using the tools, and considering the approach not useful. Over half (341/620, 55.0%) of participating patients completed the optional questionnaire. Many of them (240/341, 70.4%) recalled having noticed the personalized elements of their physicians, and the majority of those (208/240, 86.7%) reacted positively, considering the personalization to be of either high or the highest importance. CONCLUSIONS The use of a digitally mediated personal physician presence online was both feasible and welcomed by both patients and physicians. Training of the physicians seems to be a key factor in addressing perceived barriers to usage. Further research is recommended to study the mechanisms behind this approach and its impact. TRIAL REGISTRATION Clinicaltrials.gov NCT 01638338; https://clinicaltrials.gov/ct2/show/NCT01638338 (Archived by WebCite at http://www.webcitation.org/6f0JLZMtq).
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Patton R, Boniface S. Prevalence of Hazardous Drinking Among UK 18–35 Year Olds; the Impact of a Revision to the AUDIT Cut Score: Table 1. Alcohol Alcohol 2015; 51:281-2. [DOI: 10.1093/alcalc/agv115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/16/2015] [Indexed: 11/13/2022] Open
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Farrell M, Marsden J, Strang J. Griffith Edwards, the Addiction Research Unit and research on the criminal justice system. Addiction 2015; 110 Suppl 2:54-8. [PMID: 26042570 DOI: 10.1111/add.12910] [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: 11/30/2022]
Abstract
BACKGROUND This paper reviews the early work of Griffith Edwards and his colleagues on alcohol in the criminal justice system and outlines the direction of research in this area in the Addiction Research Unit in the 1960s and 1970s. The paper outlines the link between that work and work undertaken in the more recent past in this area. METHODS The key papers of the authors are reviewed and the impact of this work on policy and practice is discussed. CONCLUSIONS There is a rich seam of work on deprived and incarcerated populations that has been under way at the Addiction Research Unit and subsequently the National Addiction Centre, Institute of Psychiatry, London. Griffith Edwards initiated this work that explores the risks and problems experienced by people moving between the health and criminal justice system, and demonstrated the need for better care and continuity across this system.
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Affiliation(s)
- Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia1
| | - John Marsden
- Institute of Psychiatry, National Addiction Centre, London, UK2
| | - John Strang
- Institute of Psychiatry, National Addiction Centre, London, UK2
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Birch J, Scott S, Newbury-Birch D, Brennan A, Brown H, Coulton S, Gilvarry E, Hickman M, McColl E, McGovern R, Muirhead C, Kaner E. A pilot feasibility trial of alcohol screening and brief intervention in the police custody setting (ACCEPT): study protocol for a cluster randomised controlled trial. Pilot Feasibility Stud 2015; 1:6. [PMID: 27965786 PMCID: PMC5066519 DOI: 10.1186/s40814-015-0001-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 01/19/2015] [Indexed: 11/14/2022] Open
Abstract
Background There is evidence of an association between alcohol use and offending behaviour and around a quarter of police time is spent on alcohol-related incidents. Police custody, therefore, provides an important opportunity to intervene. This pilot trial aims to investigate whether a definitive evaluation of screening and brief interventions aimed at reducing risky drinking in arrestees is acceptable and feasible in the custody suite setting. Methods Screening will be carried out by trained detention officers or drug and alcohol workers in four police forces across two geographical areas (North East and South West England). Detention officers (or drug and alcohol workers) will be cluster randomised to one of three conditions: screening only (control group), screening followed immediately by 10 min of manualised brief structured advice delivered by the individual responsible for screening (intervention 1) or screening followed by 10 min of manualised brief structured advice delivered by the individual responsible for screening plus the offer of a subsequent 20-min session of behaviour change counselling delivered by a trained alcohol health worker (intervention 2). Participants will be arrestees aged 18+ who screen positive on the Alcohol Use Disorders Identification Test. Participants will be followed up at 6 and 12 months post-intervention. An embedded qualitative process evaluation will explore acceptability of alcohol screening and brief intervention to staff and arrestees as well as facilitators and barriers to the delivery of such approaches in this setting. Results Recruitment is currently underway and due to end May 2015. Conclusion Results from this pilot trial will determine if a definitive evaluation is possible in the future and will provide stakeholder input to its design. Trial registration Reference number: ISRCTN89291046.
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Affiliation(s)
- Jennifer Birch
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Stephanie Scott
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Dorothy Newbury-Birch
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Alan Brennan
- Health Economics and Decision Science, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Heather Brown
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Simon Coulton
- Centre for Health Services Studies, University of Kent, Canterbury, Kent CT2 7NZ7NZ UK
| | - Eilish Gilvarry
- Newcastle & North Tyneside Addictions Service, Plummer Court, Carliol Place, Newcastle upon Tyne, NE1 6UR UK
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Elaine McColl
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Ruth McGovern
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Colin Muirhead
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
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