Using the Solomon Four Design

Does neural face processing explain effects of an attachment-based intervention on maternal sensitivity? A randomized controlled study including pre- and postintervention measures

BACKGROUND

Although there is a large body of literature highlighting the behavioral effects of parenting interventions, studies on the neurocognitive mechanisms involved in such intervention effects remain scarce.

PURPOSE

The aim of the current study was to test whether changes in neural face processing (as reflected in N170 amplitudes) would act as a mediator in the association between the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and maternal sensitivity.

METHODS

A total of 66 mothers of whom a random 33% received the VIPP-SD and the others a "dummy" intervention participated in pre- and postintervention assessments. We recorded mothers' electroencephalographic (EEG) activity in response to photographs of children's neutral, happy, and angry facial expressions. Maternal sensitivity was observed while mothers interacted with their offspring in a semi-structured play situation.

RESULTS

In contrast with our expectations, we did not find evidence for mediation of intervention effects on maternal sensitivity by the N170.

CONCLUSION

We discuss that parenting support programs may yield different effects on neurocognitive processes depending on the population and provide recommendations for future research. Our study underscores the importance of reporting null findings and preregistering studies in the field of neurocognitive research.

Waiting list randomized controlled trial within a case-finding design: methodological considerations

RATIONALE, AIMS AND OBJECTIVES

Randomized controlled trials (RCTs) are widely used in health care research to provide high-quality evidence of effectiveness of an intervention. However, sometimes a study does not require an RCT in order to answer its primary objective; a case-finding design may be more appropriate. The aim of this paper was to introduce a new study design that nests a waiting list RCT within a case-finding study.

METHODS

An example of the new study design is the DOC Study, which primarily aims to determine the diagnostic accuracy of lung function tests for chronic obstructive pulmonary disease. It also investigates the impact of lung function tests on smoking behaviour through use of a waiting list design. The first step of the study design is to obtain participants' consent. Individuals are then randomized to one of two groups; either the 'intervention now' group or the 'intervention later' group, that is, participants are placed on a waiting list. All participants receive the same intervention; the only difference between the groups is the timing of the intervention.

RESULTS AND CONCLUSIONS

The design addresses patient preference issues and recruitment issues that can arise in other trial designs. Potential limitations include differential attrition between study groups and potential demoralization for the 'intervention later' group. The 'waiting list case-finding trial' design is a valuable method that could be applied to case-finding studies; the design enables the case-finding component of a study to be maintained while simultaneously exploring additional hypotheses through conducting a trial.

Impact of Pretest on Posttest Knowledge Scores With a Solomon Four Research Design

There is a paucity of research on the effects of pretest measurement with prostate cancer screening. What effect does a pretest measurement have on posttest outcomes? This research reports knowledge of prostate cancer screening among men randomized to an Enhanced decision aid versus an Usual Care decision aid. Using a Solomon Four research design, there were a total of 198 men in 4 groups. Most of the sample was African American (78%), with a mean age of 52 years. The greatest posttest knowledge occurred with the Enhanced decision aid in contrast to the Usual Care. The Enhanced/Usual Care groups that had both a pretest and posttest and had received a previous digital rectal examination had the highest means (P = .015), with means of 9.1 and 7.0, respectively. Among men who had a previous digital rectal examination, the greatest increase in score occurred among men randomized to the Enhanced decision aid in contrast to the Usual Care decision aid, 2.9 versus 0.4 (P = .008). The outcome varied based on the status of (1) random group assignment of the Solomon Four design and (2) status of previous digital rectal examination. Implications for nurses include consideration 1 of a pretest to increase posttest knowledge scores.

Life review: preventing despair in newly relocated nursing home residents short- and long-term effects

Relocation to a nursing home places frail elders at risk for developing depression and suicide ideation. This study followed two hundred and fifty-six newly relocated nursing home residents for five years. Using a Solomon Four research design, participants were divided into four groups, two control and two experimental, one each with pretesting and all with posttesting. Participants in the control groups received a friendly visit and those in the experimental groups received the intervention of life review. Immediate short-term results showed the life review to be an effective preventive intervention for clinical depression (p = .05). Additionally, when looking at long-term effects at one year, there were significant decrease in depression (p = .05), hopelessness (p = .01), and psychological well-being (p = .02) with measurable increases in life satisfaction (p = .08). These findings support the hypothesis that life review prevents despair in frail elders newly admitted to a nursing home.