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Vaisson G, Provencher T, Dugas M, Trottier MÈ, Chipenda Dansokho S, Colquhoun H, Fagerlin A, Giguere AMC, Hakim H, Haslett L, Hoffman AS, Ivers NM, Julien AS, Légaré F, Renaud JS, Stacey D, Volk RJ, Witteman HO. User Involvement in the Design and Development of Patient Decision Aids and Other Personal Health Tools: A Systematic Review. Med Decis Making 2021; 41:261-274. [PMID: 33655791 DOI: 10.1177/0272989x20984134] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND When designing and developing patient decision aids, guidelines recommend involving patients and stakeholders. There are myriad ways to do this. We aimed to describe how such involvement occurs by synthesizing reports of patient decision aid design and development within a user-centered design framework and to provide context by synthesizing reports of user-centered design applied to other personal health tools. METHODS We included articles describing at least one development step of 1) a patient decision aid, 2) user- or human-centered design of another personal health tool, or 3) evaluation of these. We organized data within a user-centered design framework comprising 3 elements in iterative cycles: understanding users, developing/refining prototype, and observing users. RESULTS We included 607 articles describing 325 patient decision aid projects and 65 other personal health tool projects. Fifty percent of patient decision aid projects reported involving users in at least 1 step for understanding users, 35% in at least 1 step for developing/refining the prototype, and 84% in at least 1 step for observing users' interaction with the prototype. In comparison, other personal health tool projects reported 91%, 49%, and 92%, respectively. A total of 74% of patient decision aid projects and 92% of other personal health tool projects reported iterative processes, both with a median of 3 iterative cycles. Preliminary evaluations such as usability or feasibility testing were reported in 66% of patient decision aid projects and 89% of other personal health tool projects. CONCLUSIONS By synthesizing design and development practices, we offer evidence-based portraits of user involvement. Those wishing to further align patient decision aid design and development with user-centered design methods could involve users earlier, design and develop iteratively, and report processes in greater detail.
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Affiliation(s)
| | | | - Michèle Dugas
- Universite Laval Faculte de Medicine, Quebec City, QC, Canada
| | | | | | | | - Angela Fagerlin
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Anik M C Giguere
- McMaster University Faculty of Health Sciences, Quebec, QC, Canada
| | - Hina Hakim
- Universite Laval Faculte de Medicine, Quebec City, QC, Canada
| | - Lynne Haslett
- East End Community Health Centre, Toronto, ON, Canada
| | - Aubri S Hoffman
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - France Légaré
- Universite Laval Faculte de Medicine, Quebec City, QC, Canada
| | | | - Dawn Stacey
- University of Ottawa Faculty of Health Sciences, Ottawa, ON, Canada
| | - Robert J Volk
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Lincoln KD, Chow TW, Gaines BF. BrainWorks: A Comparative Effectiveness Trial to Examine Alzheimer's Disease Education for Community-Dwelling African Americans. Am J Geriatr Psychiatry 2019; 27:53-61. [PMID: 30409550 DOI: 10.1016/j.jagp.2018.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/08/2018] [Accepted: 09/13/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To test a culturally tailored intervention to improve Alzheimer's disease (AD) literacy among African Americans. DESIGN A 3-arm randomized comparative effectiveness trial. SETTING Community sites in Los Angeles, CA. PARTICIPANTS 193 African American community-dwelling adults, ages 45 to 95 years old. INTERVENTION All groups attended BrainWorks Live, a culturally tailored, 60-minute talk show and received standard printed educational materials on AD. From there: a) the BrainWorks Live group received no further contact until the post-test; b) one intervention group received a 1-month, culturally tailored, unidirectional, daily text-message program; and c) a second intervention group received daily text messages based on the printed educational materials that the general public would receive. AD literacy was measured at baseline and one month post intervention. MEASUREMENTS Alzheimer's disease literacy and demographic and health covariates. RESULTS At one month, participants who received culturally tailored text messages had the highest increase in AD literacy levels, followed by those in the BrainWorks Live arm. Participants who received general text messages had a lower overall increase in AD literacy levels compared to the other arms, but had higher mean AD literacy levels than the BrainWorks Live arm. There was a significantly greater increase in AD literacy levels among participants who received culturally tailored text messages compared with those who attended BrainWorks Live only. There were no other statistically significant differences between arms. CONCLUSIONS AD literacy among African Americans can be improved after only one month through culturally competent, economically feasible educational formats.
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Affiliation(s)
- Karen D Lincoln
- University of Southern California, Suzanne Dworak-Peck School of Social Work.
| | - Tiffany W Chow
- University of Southern California, Alzheimer's Therapeutic Research Institute
| | - Bryan F Gaines
- University of Southern California, Suzanne Dworak-Peck School of Social Work
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Ownby RL, Acevedo A, Waldrop-Valverde D, Caballero J, Simonson M, Davenport R, Kondwani K, Jacobs RJ. A Mobile App for Chronic Disease Self-Management: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e53. [PMID: 28381395 PMCID: PMC5399224 DOI: 10.2196/resprot.7272] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/05/2017] [Accepted: 02/08/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Health literacy is a critically important skill that helps people become active participants in their health care. Multiple studies in the United States and across the world have documented the association of health literacy with multiple health outcomes. In particular, the elderly and many members of minority groups have been shown to have low levels of health literacy; the same groups are disproportionately affected by chronic illnesses. These twin burdens affect the people most in need of the skills and knowledge required for coping with chronic illnesses. Chronic disease self-management (CDSM) is a logical target for a general health literacy intervention. In an approach that spans across specific diseases, CDSM targets problems and skills needed to cope with issues such as fatigue, pain, stress, depression, sleep disturbance, and treatment adherence. In a previous study, we showed that a computer-delivered tailored information intervention targeting health literacy could improve treatment and adherence and be cost effective, but it is not clear that this same strategy will be effective in persons with low health literacy and multiple chronic conditions. OBJECTIVE The purpose of this study is to develop a computer-delivered mobile intervention that will provide individuals with chronic conditions the necessary information to cope with their conditions. METHODS In this project, we will complete a qualitative study on the status and needs of individuals with more than one chronic condition. Results of this study will be used to develop a mobile tailored information app that will address self-management challenges in the areas of pain, sleep, fatigue, depression, anger, stress, memory problems, and treatment adherence. The impact of the intervention on patient quality of life, patient-provider relationships, health literacy, and patient activation will be assessed. We will also explore the extent to which health literacy mediates important outcomes, such as health-related quality of life and health service utilization. RESULTS We are currently completing the preliminary qualitative and usability studies that will inform the content and design of the intervention. We anticipate that the intervention will be complete in 2017, and the clinical trial of its efficacy will also commence in 2017. CONCLUSIONS Results will provide evidence on the usefulness of a mobile tailored information app for improving health literacy, patient activation, health-related quality of life, and self-reported health in patients with multiple chronic conditions. TRIAL REGISTRATION Clinicaltrials.gov NCT02922439; https://clinicaltrials.gov/ct2/show/NCT02922439 (Archived by WebCite at http://www.webcitation.org/6pTiqDAyN).
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Affiliation(s)
- Raymond L Ownby
- Nova Southeastern University, Department of Psychiatry and Behavioral Medicine, Fort Lauderdale, FL, United States
| | - Amarilis Acevedo
- Nova Southeastern University, College of Psychology, Fort Lauderdale, FL, United States
| | | | - Joshua Caballero
- Larkin Health Sciences Institute, Department of Clinical and Administrative Sciences, College of Pharmacy, Miami, FL, United States
| | - Michael Simonson
- Department of Instructional Design and Technology, Fischler College of Education, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Rosemary Davenport
- Nova Southeastern University, Department of Psychiatry and Behavioral Medicine, Fort Lauderdale, FL, United States
| | - Kofi Kondwani
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, United States
| | - Robin J Jacobs
- Baylor College of Medicine, Department of Family and Community Medicine--Research Programs, Houston, TX, United States
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Almeida FA, Pardo KA, Seidel RW, Davy BM, You W, Wall SS, Smith E, Greenawald MH, Estabrooks PA. Design and methods of "diaBEAT-it!": a hybrid preference/randomized control trial design using the RE-AIM framework. Contemp Clin Trials 2014; 38:383-96. [PMID: 24956325 DOI: 10.1016/j.cct.2014.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/12/2014] [Accepted: 06/13/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diabetes prevention is a public health priority that is dependent upon the reach, effectiveness, and cost of intervention strategies. However, understanding each of these outcomes within the context of randomized controlled trials is problematic. PURPOSE To describe the methods and design of a hybrid preference/randomized control trial using the RE-AIM framework. METHODS The trial, which was developed using the RE-AIM framework, will contrast the effects of 3 interventions: (1) a standard care, small group, diabetes prevention education class (SG), (2) the small group intervention plus 12 months of interactive voice response telephone follow-up (SG-IVR), and (3) a DVD version of the small group intervention with the same IVR follow-up (DVD-IVR). Each intervention includes personal action planning with a focus on key elements of the lifestyle intervention from the Diabetes Prevention Program (DPP). Adult patients at risk for diabetes will be randomly assigned to either choice or RCT. Those assigned to choice (n=240) will have the opportunity to choose between SG-IVR and DVD-IVR. Those assigned to RCT group (n=360) will be randomly assigned to SG, SG-IVR, or DVD-IRV. Assessment of primary (weight loss, reach, & cost) and secondary (physical activity, & dietary intake) outcomes will occur at baseline, 6, 12, and 18 months. CONCLUSION This will be the first diabetes prevention trial that will allow the research team to determine the relationships between reach, effectiveness, and cost of different interventions.
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Affiliation(s)
- Fabio A Almeida
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Kimberlee A Pardo
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Richard W Seidel
- Department of Psychiatry, Carilion Clinic, Roanoke, VA 24014, United States.
| | - Brenda M Davy
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Wen You
- Department of Agriculture and Applied Economics, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Sarah S Wall
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Erin Smith
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Mark H Greenawald
- Department of Family and Community Medicine, Carilion Clinic, Roanoke, VA 24013, United States.
| | - Paul A Estabrooks
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States; Department of Family and Community Medicine, Carilion Clinic, Roanoke, VA 24013, United States.
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Jacobs RJ, Lou JQ, Ownby RL, Caballero J. A systematic review of eHealth interventions to improve health literacy. Health Informatics J 2014; 22:81-98. [PMID: 24916567 DOI: 10.1177/1460458214534092] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Implementation of eHealth is now considered an effective way to address concerns about the health status of health care consumers. The purpose of this study was to review empirically based eHealth intervention strategies designed to improve health literacy among consumers in a variety of settings. A computerized search of 16 databases of abstracts (e.g. Biomedical Reference Collection, Cochrane Central Register of Controlled Trials, Computers & Applied Sciences Complete, Health Technology Assessments, MEDLINE) were explored in a systematic fashion to assess the presence of eHealth applications targeting health literacy. Compared to control interventions, the interventions using technology reported significant outcomes or showed promise for future positive outcomes regarding health literacy in a variety of settings, for different diseases, and with diverse samples. This review has indicated that it is feasible to deliver eHealth interventions specifically designed to improve health literacy skills for people with different health conditions, risk factors, and socioeconomic backgrounds.
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Paterson BL, Brewer J, Stamler LL. Engagement of parents in on-line social support interventions. J Pediatr Nurs 2013; 28:114-24. [PMID: 22710151 DOI: 10.1016/j.pedn.2012.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 04/28/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
Abstract
The purpose of this scoping review was to determine what the relevant research informs us about which parents of children with chronic disease and/or disability are likely to engage in an on-line social support program and why they choose to be engaged. The review included 16 peer-reviewed research reports about on-line social support offered to parents of children with chronic disease and/or disability. It was conducted using scoping review approaches recommended by H. Arskey and L. O'Malley (2005). A key finding of this review is that it appears that the development of on-line social support interventions for parents may not have integrated what is known in the field of Internet technology as necessary to engage users. This has implications for nurses wishing to provide on-line social support for parents. As well, it highlights future directions for research, including investigations of which parents are likely to engage in on-line social support interventions and the features of the intevention that will attract and sustain them as participants.
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Boudreaux ED, Bedek KL, Byrne NJ, Baumann BM, Lord SA, Grissom G. The Computer-Assisted Brief Intervention for Tobacco (CABIT) program: a pilot study. J Med Internet Res 2012. [PMID: 23208070 PMCID: PMC3799483 DOI: 10.2196/jmir.2074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Health care providers do not routinely carry out brief counseling for tobacco cessation despite the evidence for its effectiveness. For this intervention to be routinely used, it must be brief, be convenient, require little investment of resources, require little specialized training, and be perceived as efficacious by providers. Technological advances hold much potential for addressing the barriers preventing the integration of brief interventions for tobacco cessation into the health care setting. Objective This paper describes the development and initial evaluation of the Computer-Assisted Brief Intervention for Tobacco (CABIT) program, a web-based, multimedia tobacco intervention for use in opportunistic settings. Methods The CABIT uses a self-administered, computerized assessment to produce personalized health care provider and patient reports, and cue a stage-matched video intervention. Respondents interested in changing their tobacco use are offered a faxed referral to a “best matched” tobacco treatment provider (ie, dynamic referral). During 2008, the CABIT program was evaluated in an emergency department, an employee assistance program, and a tobacco dependence program in New Jersey. Participants and health care providers completed semistructured interviews and satisfaction ratings of the assessment, reports, video intervention, and referrals using a 5-point scale. Results Mean patient satisfaction scores (n = 67) for all domains ranged from 4.00 (Good) to 5.00 (Excellent; Mean = 4.48). Health care providers completed satisfaction forms for 39 patients. Of these 39 patients, 34 (87%) received tobacco resources and referrals they would not have received under standard care. Of the 45 participants offered a dynamic referral, 28 (62%) accepted. Conclusions The CABIT program provided a user-friendly, desirable service for tobacco users and their health care providers. Further development and clinical trial testing is warranted to establish its effectiveness in promoting treatment engagement and tobacco cessation.
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Affiliation(s)
- Edwin D Boudreaux
- University of Massachusetts Medical School, Emergency Medicine, Worcester, United States.
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Vidrine DJ, Fletcher FE, Danysh HE, Marani S, Vidrine JI, Cantor SB, Prokhorov AV. A randomized controlled trial to assess the efficacy of an interactive mobile messaging intervention for underserved smokers: Project ACTION. BMC Public Health 2012; 12:696. [PMID: 22920991 PMCID: PMC3585470 DOI: 10.1186/1471-2458-12-696] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 08/21/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Despite a significant decrease in smoking prevalence over the past ten years, cigarette smoking still represents the leading cause of preventable morbidity and mortality in the United States. Moreover, smoking prevalence is significantly higher among those with low levels of education and those living at, or below, the poverty level. These groups tend to be confronted with significant barriers to utilizing more traditional smoking cessation intervention approaches. The purpose of the study, Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods), is to utilize a mobile clinic model, a network of community sites (i.e., community centers and churches) and an interactive mobile messaging system to reach and deliver smoking cessation treatment to underserved, low-income communities. METHODS/DESIGN We are using a group-randomized design, with the community site as the sampling unit, to compare the efficacy of three smoking cessation interventions: 1) Standard Care--brief advice to quit smoking, nicotine replacement therapy (NRT), and self-help materials; 2) Enhanced Care--standard care components plus a cell phone-delivered text/graphical messaging component; and 3) Intensive Care--enhanced care components plus a series of 11 cell phone-delivered proactive counseling sessions. An economic evaluation will also be performed to evaluate the relative cost effectiveness of the three treatment approaches. We will recruit 756 participants (252 participants in each of the 3 intervention groups). At the time of randomization, participants complete a baseline assessment, consisting of smoking history, socio-demographic, and psychosocial variables. Monthly cell phone assessments are conducted for 6 months-post enrollment, and a final 12-month follow-up is conducted at the original neighborhood site of enrollment. We will perform mixed-model logistic regression to compare the efficacy of the three smoking cessation intervention treatment groups. DISCUSSION It is hypothesized that the intensive care approach will most successfully address the needs of the target population and result in the highest smoking cessation rates. In addition to increasing cessation rates, the intervention offers several features (including neighborhood outreach and use of mHealth technology) that are likely to reduce treatment barriers while enhancing participant engagement and retention to treatment. TRIAL REGISTRATION This randomized controlled trial is registered with clinicaltrials.gov registration number NCT00948129.
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Affiliation(s)
- Damon J Vidrine
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX, 77030-1439, USA
| | - Faith E Fletcher
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX, 77030-1439, USA
| | - Heather E Danysh
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX, 77030-1439, USA
| | - Salma Marani
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX, 77030-1439, USA
| | - Jennifer Irvin Vidrine
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, P.O. Box 303906, Unit 1440, Houston, TX, 77030-3906, USA
| | - Scott B Cantor
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Unit 1411, Houston, TX, 77230-1402, USA
| | - Alexander V Prokhorov
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX, 77030-1439, USA
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Jerant A, Sohler N, Fiscella K, Franks B, Franks P. Tailored interactive multimedia computer programs to reduce health disparities: opportunities and challenges. PATIENT EDUCATION AND COUNSELING 2011; 85:323-330. [PMID: 21146950 PMCID: PMC3070866 DOI: 10.1016/j.pec.2010.11.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 09/10/2010] [Accepted: 11/21/2010] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To review the theory and research evidence suggesting that tailored interactive multimedia computer programs (IMCPs) aimed at optimizing patient health behaviors could lessen socio-demographic health disparities. METHODS Selective critical review of research regarding IMCPs tailored to psychological mediators of behavior and their effects on health behavior and outcomes among socio-demographically disadvantaged patients. RESULTS Tailored IMCPs can address patient factors (e.g. language barriers, low self-efficacy) and buffer provider (e.g. cognitive bias) and health system (e.g. office visit time constraints) factors that contribute to poor provider-patient communication and, thereby, suboptimal health behaviors. Research indicates disadvantaged individuals' interactions with providers are disproportionately affected by such factors, and that their behaviors respond favorably to tailored information, thus suggesting tailored IMCPs could mitigate disparities. However, no randomized controlled trials (RCTs) have examined this question. The optimal design and deployment of tailored IMCPs for disadvantaged patients also requires further study. CONCLUSION Preliminary research suggests tailored IMCPs have the potential to reduce health disparities. RCTs designed expressly to examine this issue are warranted. PRACTICE IMPLICATIONS Many socio-demographic health disparities exist, and there is a dearth of proven disparity-reducing interventions. Thus, if tailored IMCPs were shown to lessen disparities, the public health implications would be considerable.
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Affiliation(s)
- Anthony Jerant
- Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, CA, USA.
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Newman MG, Szkodny LE, Llera SJ, Przeworski A. A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: Is human contact necessary for therapeutic efficacy? Clin Psychol Rev 2011; 31:178-86. [DOI: 10.1016/j.cpr.2010.10.002] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Revised: 10/01/2010] [Accepted: 10/13/2010] [Indexed: 11/25/2022]
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Bonevski B, Paul C, D'Este C, Sanson-Fisher R, West R, Girgis A, Siahpush M, Carter R. RCT of a client-centred, caseworker-delivered smoking cessation intervention for a socially disadvantaged population. BMC Public Health 2011; 11:70. [PMID: 21281519 PMCID: PMC3038158 DOI: 10.1186/1471-2458-11-70] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 01/31/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disadvantaged groups are an important target for smoking cessation intervention. Smoking rates are markedly higher among severely socially disadvantaged groups such as indigenous people, the homeless, people with a mental illness or drug and alcohol addiction, and the unemployed than in the general population. This proposal aims to evaluate the efficacy of a client-centred, caseworker delivered cessation support intervention at increasing validated self reported smoking cessation rates in a socially disadvantaged population. METHODS/DESIGN A block randomised controlled trial will be conducted. The setting will be a non-government organisation, Community Care Centre located in New South Wales, Australia which provides emergency relief and counselling services to predominantly government income assistance recipients. Eligible clients identified as smokers during a baseline touch screen computer survey will be recruited and randomised by a trained research assistant located in the waiting area. Allocation to intervention or control groups will be determined by time periods with clients randomised in one-week blocks. Intervention group clients will receive an intensive client-centred smoking cessation intervention offered by the caseworker over two face-to-face and two telephone contacts. There will be two primary outcome measures obtained at one, six, and 12 month follow-up: 1) 24-hour expired air CO validated self-reported smoking cessation and 2) 7-day self-reported smoking cessation. Continuous abstinence will also be measured at six and 12 months follow up. DISCUSSION This study will generate new knowledge in an area where the current information regarding the most effective smoking cessation approaches with disadvantaged groups is limited. TRIAL REGISTRATION NUMBER ISRCTN: ISRCTN85202510.
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Affiliation(s)
- Billie Bonevski
- Centre for Health Research & Psycho-oncology (CHeRP), Cancer Council NSW & University of Newcastle, Newcastle, Australia.
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Stewart MJ, Kushner KE, Greaves L, Letourneau N, Spitzer D, Boscoe M. Impacts of a support intervention for low-income women who smoke. Soc Sci Med 2010; 71:1901-9. [PMID: 20970232 DOI: 10.1016/j.socscimed.2010.08.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Revised: 03/12/2010] [Accepted: 08/23/2010] [Indexed: 11/19/2022]
Abstract
The objective of this pilot study was to implement and evaluate the impact of a support intervention tailored to the assessed support needs, resources and preferences of low-income women who smoke in three Canadian cities. The support intervention, informed by theoretical foundations, provided holistic one-to-one and group support over 14 weeks. The support intervention was facilitated by trained professional and peer facilitators. The impact was evaluated through analysis of qualitative and quantitative data collected at pre-, post-, and delayed post-test contacts. This analysis revealed that the intervention exerted positive impacts on smoking reduction/cessation, social networks, coping, and health behaviors. Participants reported satisfaction with the intervention.
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Affiliation(s)
- Miriam J Stewart
- University of Alberta, Faculty of Nursing, 3rd Floor Clinical Sciences Building, Edmonton, AB, Canada
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Wang YZ, Chen HH, Yeh ML, Lin SD. Auricular acupressure combined with multimedia instruction or alone for quitting smoking in young adults: A quasi-experimental study. Int J Nurs Stud 2010; 47:1089-95. [PMID: 20381046 DOI: 10.1016/j.ijnurstu.2010.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 12/14/2009] [Accepted: 02/13/2010] [Indexed: 01/04/2023]
Abstract
BACKGROUND Smoking plays a disease-related risk factor and is however the principal cause of preventable death. Many studies support the use of combined rather than single interventions to stop smoking. OBJECTIVE This study aimed to evaluate the effects of auricular acupressure combined with multimedia instruction in comparison with auricular acupressure alone on smoking cessation in young adults. METHOD A quasi-experimental research design was used and participants were assigned to experimental groups according to their preference. Group 1 received the 10-week program with auricular acupressure plus multimedia instruction; Group 2 received auricular acupressure alone. Thirty-two participants were in each group were recruited from universities in Taiwan. The physical and psychological data were collected right before and after the program. RESULTS This study demonstrated the effects of smoking cessation on physical and psychological factors in each group. Statistical between-group differences existed in psychological factors of smoking cessation self-efficacy and nicotine dependence, but not in physical factors of carbon monoxide and cotinine. CONCLUSIONS This study adds to the body of research on the benefits of using auricular acupressure combined with or without multimedia instruction for smoking cessation in adolescents. The combined intervention was more effective especially in increasing smoking cessation self-efficacy and decreasing nicotine dependence. Further study is suggested adding control groups such as placebo in order to understand a single effect of smoking cessation.
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Affiliation(s)
- Yi-Zen Wang
- National Taiwan University Hospital-Kungkuan Region, No. 57 Ln. 155 Sec. 3, Keelung Rd., Taipei, Taiwan, ROC.
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Murray RL, Bauld L, Hackshaw LE, McNeill A. Improving access to smoking cessation services for disadvantaged groups: a systematic review. J Public Health (Oxf) 2009; 31:258-77. [PMID: 19208688 DOI: 10.1093/pubmed/fdp008] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Smoking is a main contributor to health inequalities. Identifying strategies to find and support smokers from disadvantaged groups is, therefore, of key importance. METHODS A systematic review was carried out of studies identifying and supporting smokers from disadvantaged groups for smoking cessation, and providing and improving their access to smoking-cessation services. A wide range of electronic databases were searched and unpublished reports were identified from the national research register and key experts. RESULTS Over 7500 studies were screened and 48 were included. Some papers were of poor quality, most were observational studies and many did not report findings for disadvantaged smokers. Nevertheless, several methods of recruiting smokers, including proactively targeting patients on General Physician's registers, routine screening or other hospital appointments, were identified. Barriers to service use for disadvantaged groups were identified and providing cessation services in different settings appeared to improve access. We found preliminary evidence of the effectiveness of some interventions in increasing quitting behaviour in disadvantaged groups. CONCLUSIONS There is limited evidence on effective strategies to increase access to cessation services for disadvantaged smokers. While many studies collected socioeconomic data, very few analysed its contribution to the results. However, some potentially promising interventions were identified which merit further research.
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Affiliation(s)
- Rachael L Murray
- Division of Epidemiology and Public Health, UK Centre for Tobacco Control Studies, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK.
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Estabrooks PA, Smith-Ray RL. Piloting a behavioral intervention delivered through interactive voice response telephone messages to promote weight loss in a pre-diabetic population. PATIENT EDUCATION AND COUNSELING 2008; 72:34-41. [PMID: 18282679 DOI: 10.1016/j.pec.2008.01.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Revised: 12/27/2007] [Accepted: 01/06/2008] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To pilot test the feasibility and effectiveness of interactive voice response (IVR) calls targeting physical activity and healthful eating as strategies for weight loss for patients with pre-diabetes. METHODS Participants (N=77) who engaged in a 90-min diabetes prevention class were randomly assigned to receive IVR support targeting physical activity and nutrition weight loss strategies or to a no-contact control. Physical activity, dietary intake, and body weight were assessed prior to and following the 3-month intervention. RESULTS Eighty-five percent of the intervention participants completed at least half of the intervention. Participants assigned to receive the intervention lost an average of 2.6% of body weight during the 3 months while control participants lost an average of 1.6%. To determine the effect of the calls when used we found that those who used the system lost approximately 3% of body weight which approached significance when compared to controls (p<.06). CONCLUSION IVR holds promise for follow-up encounters with patients with pre-diabetes. PRACTICE IMPLICATIONS IVR can be used to provide physical activity and nutrition counseling that can enhance the potential reach and effectiveness of health professionals working with patients who have diabetes while placing a minimal burden on financial resources and staff time.
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Affiliation(s)
- Paul A Estabrooks
- Virginia Polytechnic Institute and State University, Human Nutrition, Foods, & Exercise, Roanoke, VA 24016, United States.
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