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Wang D, Zeng H, Wu P, Zhou Y, Chen H, Zhao F, Liu S. Path analysis of the awareness status and influencing factors of sarcopenia in older adults in the community: based on structural equation modeling. Front Public Health 2024; 12:1391383. [PMID: 39114524 PMCID: PMC11304347 DOI: 10.3389/fpubh.2024.1391383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Background Sarcopenia is a progressive geriatric syndrome that impacts older adults' quality of life. Insufficient focus has been given to sarcopenia among Chinese residents, resulting in low level of sarcopenia awareness. This study aims to investigate awareness of sarcopenia and its influencing factors and the influencing pathways among older adults in Hangzhou. Methods A stratified random sample of 942 community-dwelling older adults was evaluated using the SARC-CalF screening tool, along with a questionnaire based on health ecology theory to assess awareness of sarcopenia and its influencing factors and the influencing pathways. Descriptive statistics, linear regression analysis, and path analysis were conducted using SPSS 25.0 and Amos 23.0 to analyze the data. Results The mean awareness score for sarcopenia was 60.26 ± 7.31. Self-rated physical health, daily intake of high-quality protein, exercise frequency, smoking status, self-efficacy, religious beliefs, social support, education level, occupation, participation in community free medical examinations, and awareness of nutrition policy were all factors affecting scores for sarcopenia awareness (p < 0.05). Except for negative effects observed in social support, smoking status, and self-rated physical health, all others exhibit positive effects. Conclusion Community healthcare institutions should target populations with low awareness of sarcopenia and focus on these key factors. Diverse health education programs and multi-channel screening activities can promote awareness, guide healthy lifestyles and prevent or delay the onset of sarcopenia in the older.
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Affiliation(s)
| | | | | | | | | | | | - Shucong Liu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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Akkawi El Edelbi R, Eksborg S, Kreicbergs U, Lövgren M, Ekman J, Lindemalm S. Parents' experiences on handling paediatric anticancer drugs at home after an educational intervention. J Eval Clin Pract 2024. [PMID: 38993024 DOI: 10.1111/jep.14089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/29/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND The shift of treatment of paediatric cancer patients to include more care at home puts a lot of pressure on health care professionals (HCPs) to prepare and train parents on safe and correct drug handling at home. Parents must take in and understand the information presented to them while coping with their own fear related to their child's cancer diagnosis. In Sweden, parents are expected to handle and manipulate oral anticancer drugs (OADs) in the home setting. There is however a lack of a standardized method to inform and educate parents on how to handle OADs in a correct way at home. AIM To describe parents' experiences of handling OADs at home after participating in an educational intervention. METHOD Educational intervention in the present study aimed to improve parents' knowledge in key concepts that is, handling OADs at home by using information presented in different forms. Fifteen parents to 12 children with cancer were recruited from a paediatric oncology ward in Sweden to participate in an interview. The interviews were transcribed verbatim and subjected to qualitative content analysis. RESULTS Parents' experiences are presented in categories: Relieved stress, Awareness of own exposure, Facilitated my everyday life, Parents need continued support individually. The educational intervention resulted in both positive and negative feelings, increased awareness of drug exposure and correct drug handling at home. Practical training and information presented in different ways facilitated the process of drug handling. To handle the drug correctly at home parents requested to be trained and informed in the beginning of their child's oral drug treatment. In addition, parents requested to be individually approached by HCP to get answers to questions and concerns. CONCLUSIONS This educational intervention study shows promising results for the method used by HCPs to inform and educate parents on complicated topics such as handling OADs at home.
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Affiliation(s)
- Ranaa Akkawi El Edelbi
- Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
- Division of Pediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Staffan Eksborg
- Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
- Division of Pediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Advanced Pediatric Home Care, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Jennie Ekman
- Division of Pediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Synnöve Lindemalm
- Division of Pediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Silveira A, Lima C, Beaupre L, Chepeha J, Jones A. Shoulder specific exercise therapy is effective in reducing chronic shoulder pain: A network meta-analysis. PLoS One 2024; 19:e0294014. [PMID: 38683828 PMCID: PMC11057978 DOI: 10.1371/journal.pone.0294014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/24/2023] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Exercise therapy (ET) is frequently an early treatment of choice when managing shoulder pain, yet evidence on its efficacy to expedite recovery is inconsistent. Moreover, the value of adding adjunct therapies (i.e. injections, manual therapy, electrotherapy) to ET is currently unclear. This study combined both direct and indirect evidence across studies on the effectiveness of ET with/without adjunct therapies compared to usual medical care for adults with chronic shoulder pain. METHODS AND FINDINGS Using a network meta-analysis, randomized control trials comparing ET along with adjunct therapies were identified in MEDLINE, Embase, CINAHL, Sportdiscus, CENTRAL, Conference Proceedings Citation Index-Science, clinicaltrials.gov, and association websites. Outcomes included pain, range of motion (ROM), and health-related quality of life (HRQL) measures in adult patients with chronic shoulder pain. Data analysis used a Frequentist hierarchical model. CINeMA tool assessed the confidence in the results and Cochrane Risk of Bias tool assessed quality of studies. 54 studies primarily from Europe (40.38%) included 3,893 participants who were followed up to 52 weeks. Shoulder-specific ET (Mean difference (MD) = -2.1; 95% confidence interval (CI) = -3.5 to -0.7) or in combination with electro-physical agents (MD = -2.5; 95% CI = -4.2 to -0.7), injections (MD = -2.4; 95% CI = -3.9 to-1.04) or manual therapy (MD = -2.3; 95% CI = -3.7 to -0.8) decreased pain compared to usual medical care. Trends with ROM and HRQL scores were seen; however, only Manual Therapy (MD = -12.7 and 95% CI = -24.4 to -1.0) achieved meaningfully important changes. Sensitivity analysis excluding studies with high risk of bias showed similar results, with exception of injections that did not reach significance (MD = -1.3; 95% CI = -4.3 to 1.7). CONCLUSION(S) Shoulder-specific ET provided pain relief up to 52 weeks. Adjunct therapies to shoulder-specific ET added little value in reducing pain. The quality of evidence varied between moderate and very low.
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Affiliation(s)
- Anelise Silveira
- University of Alberta, School of Public Health, Edmonton, Alberta, Canada
| | - Camila Lima
- University of Alberta, School of Public Health, Edmonton, Alberta, Canada
| | - Lauren Beaupre
- University of Alberta, Faculty of Rehabilitation Sciences, Edmonton, Alberta, Canada
- University of Alberta, Collaborative Orthopaedic Research, Edmonton, Alberta, Canada
| | - Judy Chepeha
- University of Alberta, Collaborative Orthopaedic Research, Edmonton, Alberta, Canada
| | - Allyson Jones
- University of Alberta, Faculty of Rehabilitation Sciences, Edmonton, Alberta, Canada
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4
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Ismail F, Myburgh C, Downing C. Interprofessional education interventions in undergraduate students of musculoskeletal healthcare professions: a scoping review protocol. BMJ Open 2024; 14:e078483. [PMID: 38458779 PMCID: PMC10928785 DOI: 10.1136/bmjopen-2023-078483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/05/2023] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Enhancing interprofessional education (IPE) fosters collaborative efforts among healthcare professionals specializing in musculoskeletal (MSK) care. This approach presents a valuable opportunity to address the pressing MSK disease burden in developing countries, with high prevalence rates and limited resources. While an abundance of literature on the various elements of IPE among healthcare students and professionals exists, shared contexts of practice of South African MSK disciplines are not currently developed through IPE at higher education level, establishing a need for South African formalised curricular IPE interventions with an explicit focus on undergraduate students of MSK healthcare professions. METHODS AND ANALYSIS The intended scoping review protocol is guided by the framework set out by Arksey and O'Malley, where the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will guide the process of reporting. English sources (qualitative and quantitative methodological studies, conference papers and proceedings, systematic reviews, grey literature, unpublished materials, theses and dissertations) from the electronic databases PubMed, Scopus, ERIC and ProQuest with no date restriction will be included. A researcher, an independent reviewer and research librarian will search and extract data from abstracts and full texts for this scoping review, where any arising disagreements will be resolved by discussion. Reference lists of relevant literature will be scrutinised. Relevant literature will be recorded on a referencing software and deduplicated. The data collection will take place between May and October 2023. The findings will be reported narratively with the use of tables. ETHICS AND DISSEMINATION This scoping review does not require ethical approval as all literature used already exists in the public domain with no involvement of human participants. The findings from this planned review will be submitted to peer-reviewed journals and will be presented at higher education conferences. This scoping review protocol was registered on Open Science Framework with the registration osf.io/c27n4.
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Affiliation(s)
- Fatima Ismail
- Department of Chiropractic, University of Johannesburg, Doornfontein, Johannesburg, Gauteng, South Africa
| | - Cornelius Myburgh
- Department of Chiropractic, University of Johannesburg, Doornfontein, Johannesburg, Gauteng, South Africa
| | - Charlene Downing
- Department of Nursing, University of Johannesburg, Doornfontein, Johannesburg, Gauteng, South Africa
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Godara K, Phakey N, Garg D, Sharma S, Das RR. Interventions to Improve Medication Adherence in Children With Epilepsy: A Systematic Review. Cureus 2024; 16:e54680. [PMID: 38523977 PMCID: PMC10960523 DOI: 10.7759/cureus.54680] [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] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Low medication adherence remains a major challenge in the treatment of epilepsy, particularly in children. In recent years, several approaches and interventions have been employed to promote medication adherence in children with epilepsy (CWE). In this study, we aimed to summarize the evidence on these interventions. In this systematic review, major medical electronic databases were searched for relevant literature from January 2005 till July 2023, including PsycINFO, Medline (via PubMed), Google Scholar, Taylor & Francis databases, and CENTRAL by the Cochrane Library. We planned to include observational studies (with a control arm) and clinical trials involving children/adolescents (<19 years) with epilepsy and/or their caregivers/families who underwent any intervention to improve adherence to anti-seizure medications. Out of 536 articles searched, eight (six randomized trials and two non-randomized intervention studies) were included in the systematic review. A total of 2,685 children/adolescents along with their caregivers participated in these studies. Six studies used educational and two used behavioral interventions to improve adherence to anti-seizure medications. Four studies showed variable levels of adherence improvement, ranging from 2-20% up to 73.9% post-intervention. To conclude, the findings suggest the potential for educational interventions to promote medication adherence in CWE. The class of evidence was II to III among the included studies, as per American Academy of Neurology guidelines.
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Affiliation(s)
- Karishma Godara
- Psychology, Jindal School of Psychology & Counselling, O.P. Jindal Global University, Sonipat, IND
| | - Nisha Phakey
- Psychology, Chitkara School of Psychology & Counselling, Chitkara University, Rajpura, IND
| | - Divyani Garg
- Neurology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Suvasini Sharma
- Pediatrics (Neurology Division), Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, IND
| | - Rashmi R Das
- Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Hoffman AF, Laspro M, Verzella AN, Tran DL, Rodriguez ED. Facial Masculinization Surgery: An Analysis of Interest Trends Using Search Term Analysis. Ann Plast Surg 2024; 92:5-8. [PMID: 37856242 DOI: 10.1097/sap.0000000000003707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Facial masculinization surgery (FMS) is increasingly popular among cisgender and transgender men. The benefits of FMS are focused on facial identity and have been proven to decrease gender dysphoria in this population. Previous research showed increasing interest in gender affirmation surgery and facial feminization surgery, but the prevalence of FMS has not been explored. It is difficult to find these data based on surgical records alone because institutions do not have standardized methods of reporting and lack publications in the field. Our study aimed to analyze public interest in FMS by using worldwide Google Trends to quantify these trends. METHODS A worldwide Google Trends search was completed from January 1, 2008, to December 31, 2022, for terms focused on FMS. Then, search terms were analyzed for nonfacial masculinization procedures and were aggregated. Lastly, a PubMed search was conducted for the terms "transgender" and "facial masculinization" from January 1, 2008, to December 31 st , 2022, to compare publication rates. RESULTS Our data showed an increasing interest in FMS through Google search trends since the year 2008. A similar trend was demonstrated for non-FMS gender-affirming terms. PubMed analysis showed "transgender" medicine publishing rates were approximately 39.65 times greater than "facial masculinization" publishing rates, although "facial masculinization" medicine did produce a positive trend over the study period of approximately 4 publications per year. The medical literature on transgender surgeries rapidly outpaces publications specifically focusing on FMS. CONCLUSION Our study showed increasing interest in gender affirmation surgery over time, particularly FMS. These increasing trends should encourage greater scientific exploration of FMS and research to properly quantify and assess surgical outcomes in this special population. Additional educational interventions for both the general public and medical providers, to increase awareness of unique challenges that impact this community and highlight changes in health care coverage over time, should be created to keep pace with increasing patient demand and address the physical, systemic, and psychosocial issues faced by people who identify as transgender.
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Affiliation(s)
| | - Matteo Laspro
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY
| | - Alexandra N Verzella
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY
| | - David L Tran
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY
| | - Eduardo D Rodriguez
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY
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Abstract
Background The Informed Health Choices (IHC) Key Concepts is a framework that provides a basis for developing educational resources and evaluating people's ability to think critically about health actions. We developed the original Key Concepts framework by reviewing texts and checklists for the public, journalists, and health professionals and collecting structured feedback from an international advisory group. We revised the original 2015 framework yearly from 2016 to 2018 based on feedback and experience using the framework. The objectives of this paper are to describe the development of the framework since 2018 and summarise their basis. Methods For the 2019 version, we responded to feedback on the 2018 version. For the current 2022 version, in addition to responding to feedback on the 2019 version, we reviewed the evidence base for each of the concepts. Whenever possible, we referenced systematic reviews that provide a basis for a concept. We screened all Cochrane methodology reviews and searched Epistemonikos, PubMed, and Google Scholar for methodology reviews and meta-epidemiological studies. Results The original framework included 32 concepts in six groups. The 2019 version and the current 2022 version include 49 concepts in the same three main groups that we have used since 2016. There are now 10 subgroups or higher-level concepts. For each concept, there is an explanation including one or more examples, the basis for the concept, and implications. Over 600 references are cited that support the concepts, and over half of the references are systematic reviews. Conclusions There is a large body of evidence that supports the IHC key concepts and we have received few suggestions for changes since 2019.
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Affiliation(s)
- Andrew D. Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Iain Chalmers
- Centre for Evidence-Based Medicine, Department of Primary Care, University of Oxford, Oxford, UK
| | - Astrid Dahlgren
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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8
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Carey S, Men M, Cunich M. The impact of targeted interventions aimed to improve quality of life in patients receiving home parenteral nutrition: A systematic literature review. J Hum Nutr Diet 2023; 36:1741-1750. [PMID: 37539458 DOI: 10.1111/jhn.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Home parenteral nutrition (HPN) is a specialised therapy offered to people suffering from intestinal failure. Underlying disease, HPN complications and limitations of HPN can significantly impact a person's quality-of-life (QOL). The aim of this review was to evaluate the evidence on existing non-surgical/non-pharmacological interventions aimed at improving QOL, clinical, patient-reported and economic outcomes for patients receiving parenteral nutrition therapy at home across adult and paediatric settings. METHODS Online databases Medline (Ovid), Embase and Cinahl were searched to identify studies published between 1937 and 31 March 2022. Identified studies were appraised using the Cochrane Collaboration risk of bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment. RESULTS Nine studies were included in this review. Interventions were focused on education (n = 4), telemedicine (n = 2), preparation of infusion mixtures (n = 1), mindfulness-based cognitive therapy (n = 1) and a multi-modal approach (n = 1). Only one study measured QOL before and after the intervention using a validated QOL tool. All studies were assessed at either some, high or critical risk of bias, resulting in low or very low-quality evidence for the interventions evaluated. CONCLUSIONS The findings from this review highlight the lack of high-quality non-surgical/non-pharmacological studies seeking to improve QOL for people on HPN. Because the majority of people receiving HPN are not eligible for surgical or pharmaceutical treatments, higher quality research using clinical trial design, and research focused on improving QOL is needed to inform healthcare managers about the effectiveness (and value) of alternative service delivery models for this vulnerable patient group.
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Affiliation(s)
- Sharon Carey
- Faculty of Medicine and Health, Central Clinical School, Sydney, NSW, Australia
- Nutrition and Dietetics Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Institute of Academic Surgery, Camperdown, NSW, Australia
| | - Mohan Men
- Faculty of Medicine and Health, Central Clinical School, Sydney, NSW, Australia
| | - Michelle Cunich
- Sydney Health Economics Collaborative, Sydney Local Health District, Sydney, NSW, Australia
- Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), Sydney, NSW, Australia
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Cusack L, Jones M, Desha L, Hoffmann TC. Teaching Australian high school students to think critically about health claims: a cluster randomized trial. HEALTH EDUCATION RESEARCH 2023; 38:412-425. [PMID: 37428473 PMCID: PMC10516377 DOI: 10.1093/her/cyad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/28/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Abstract
Making informed health decisions requires knowledge and skills in appraising health claims, and teaching adolescents these skills may prepare them for future decision-making. This cluster randomized trial evaluated the effectiveness of an educational intervention on students' ability to identify and appraise health claims. Nine Australian high schools (4 control and 5 intervention) were recruited, comprising 974 students (382 control and 592 intervention) in Grades 7-10. Intervention impact was evaluated through baseline and follow-up evaluation. Follow-up mean scores on questions (maximum score of 25) from the Claim Evaluation Tools database (primary outcome) showed minimal between-group difference (intervention versus control: 14.4 versus 13.6; difference 0.8, 95% confidence interval [CI] -1.6 to 3.1; P = 0.52). Change scores were only slightly higher in the intervention group (difference 1.2 [95% CI -0.7 to 3.1; P = 0.21]). Between-group differences for secondary outcomes were also minimal. Most intervention group students 'trusted' and 'liked' the programme and found the content 'easy' and 'helpful'. Most teacher feedback was positive, some noting challenges of covering content in allocated time and maintaining student engagement. It is unlikely that the assessed educational intervention had a large effect. Future research priorities are suggested.
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Affiliation(s)
- L Cusack
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, 14 University Dr, Robina, Queensland 4226, Australia
| | - M Jones
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, 14 University Dr, Robina, Queensland 4226, Australia
| | - L Desha
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, 14 University Dr, Robina, Queensland 4226, Australia
| | - T C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, 14 University Dr, Robina, Queensland 4226, Australia
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Mugisha M, Nyirazinyoye L, Simbi CMC, Chesire F, Senyonga R, Oxman M, Nsangi A, Semakula D, Rose CJ, Moberg J, Dahlgren A, Kaseje M, Lewin S, Sewankambo NK, Rosenbaum S, Oxman AD. Effects of the Informed Health Choices secondary school intervention on the ability of students in Rwanda to think critically about health choices: A cluster-randomized trial. J Evid Based Med 2023; 16:264-274. [PMID: 37735809 DOI: 10.1111/jebm.12551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
AIM The aim of this trial was to evaluate the effects of the Informed Health Choices intervention on the ability of students in Rwandan to think critically and make Informed Health Choices. METHODS We conducted a two-arm cluster-randomized trial in 84 lower secondary schools from 10 districts representing five provinces of Rwanda. We used stratified randomization to allocate schools to the intervention or control. One class in each intervention school had ten 40-min lessons taught by a trained teacher in addition to the usual curriculum. Control schools followed the usual curriculum. The primary outcome was a passing score (≥ 9 out of 18 questions answered correctly) for students on the Critical Thinking about Health Test completed within 2 weeks after the intervention. We conducted an intention-to-treat analysis using generalized linear mixed models, accounting for the cluster design using random intercepts. RESULTS Between February 25 and March 29, 2022, we recruited 3,212 participants. We assigned 1,572 students and 42 teachers to the intervention arm and 1,556 students and 42 teachers to the control arm. The proportion of students who passed the test in the intervention arm was 915/1,572 (58.2%) compared to 302/1,556 (19.4%) in the control arm, adjusted odds ratio 10.6 (95% CI: 6.3-17.8), p < 0.0001, adjusted difference 37.2% (95% CI: 29.5%-45.0%). CONCLUSIONS The intervention is effective in helping students think critically about health choices. It was possible to improve students' ability to think critically about health in the context of a competence-based curriculum in Rwanda, despite challenging postpandemic conditions.
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Affiliation(s)
- Michael Mugisha
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Faculty of Medicine, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Laetitia Nyirazinyoye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Faith Chesire
- Faculty of Medicine, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Tropical Institute of Community Health and Development, Kisumu, Kenya
| | - Ronald Senyonga
- Faculty of Medicine, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Matt Oxman
- Centre for Epidemic Intervention Research, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Allen Nsangi
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Daniel Semakula
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Christopher James Rose
- Centre for Epidemic Intervention Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Jenny Moberg
- Centre for Epidemic Intervention Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Astrid Dahlgren
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Margaret Kaseje
- Tropical Institute of Community Health and Development, Kisumu, Kenya
| | - Simon Lewin
- Centre for Epidemic Intervention Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of Health Sciences Ålesund, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nelson K Sewankambo
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Sarah Rosenbaum
- Centre for Epidemic Intervention Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Andrew D Oxman
- Centre for Epidemic Intervention Research, Norwegian Institute of Public Health, Oslo, Norway
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11
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Ssenyonga R, Oxman AD, Nakyejwe E, Chesire F, Mugisha M, Nsangi A, Semakula D, Oxman M, Rose CJ, Rosenbaum SE, Moberg J, Kaseje M, Nyirazinyoye L, Dahlgren A, Lewin S, Sewankambo NK. Use of the informed health choices educational intervention to improve secondary students' ability to think critically about health interventions in Uganda: A cluster-randomized trial. J Evid Based Med 2023; 16:285-293. [PMID: 37725488 DOI: 10.1111/jebm.12553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Abstract
AIM The aim was to evaluate the effect of the Informed Health Choices (IHC) educational intervention on secondary students' ability to assess health-related claims and make informed choices. METHODS In a cluster-randomized trial, we randomized 80 secondary schools (students aged 13-17 years) in Uganda to the intervention or control (usual curriculum). The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in one school term. The lesson plans were developed for classrooms equipped with a blackboard or a blackboard and projector. The lessons addressed nine prioritized concepts. We used two multiple-choice questions for each concept to evaluate the students' ability to assess claims and make informed choices. The primary outcome was the proportion of students with a passing score (≥9 of 18 questions answered correctly). RESULTS Eighty schools consented and were randomly allocated. A total of 2477 students in the 40 intervention schools and 2376 students in the 40 control schools participated in this trial. In the intervention schools, 1364 (55%) of students that completed the test had a passing score compared with 586 (25%) of students in the control schools (adjusted difference 33%, 95% CI 26%-39%). CONCLUSIONS The IHC secondary school intervention improved students' ability to think critically and make informed choices. Well-designed digital resources may improve access to educational material, even in schools without computers or other information and communication technology (ICT). This could facilitate scaling-up use of the resources and help to address inequities associated with limited ICT access.
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Affiliation(s)
- Ronald Ssenyonga
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Andrew D Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Esther Nakyejwe
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Faith Chesire
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Tropical Institute of Community Health and Development in Africa, Kisumu, Kenya
| | - Michael Mugisha
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Allen Nsangi
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Daniel Semakula
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Matt Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Christopher James Rose
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Sarah E Rosenbaum
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Jenny Moberg
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Margaret Kaseje
- Tropical Institute of Community Health and Development in Africa, Kisumu, Kenya
| | - Laetitia Nyirazinyoye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Astrid Dahlgren
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Simon Lewin
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nelson K Sewankambo
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Chesire F, Mugisha M, Ssenyonga R, Rose CJ, Nsangi A, Kaseje M, Sewankambo NK, Oxman M, Rosenbaum SE, Moberg J, Dahlgren A, Lewin S, Oxman AD. Effects of the Informed Health Choices secondary school intervention: A prospective meta-analysis. J Evid Based Med 2023; 16:321-331. [PMID: 37735807 DOI: 10.1111/jebm.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
AIM The aim of this prospective meta-analysis was to synthesize the results of three cluster-randomized trials of an intervention designed to teach lower-secondary school students (age 14-16) to think critically about health choices. METHODS We conducted the trials in Kenya, Rwanda, and Uganda. The intervention included a 2- to 3-day teacher training workshop, digital resources, and ten 40-min lessons. The lessons focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥9 of 18 multiple-choice questions answered correctly). We performed random effects meta-analyses to estimate the overall adjusted odds ratios. Secondary outcomes included effects of the intervention on teachers. RESULTS Altogether, 244 schools (11,344 students) took part in the three trials. The overall adjusted odds ratio was 5.5 (95% CI: 3.0-10.2; p < 0.0001) in favor of the intervention (high certainty evidence). This corresponds to 33% (95% CI: 25-40%) more students in the intervention schools passing the test. Overall, 3397 (58%) of 5846 students in intervention schools had a passing score. The overall adjusted odds ratio for teachers was 13.7(95% CI: 4.6-40.4; p < 0.0001), corresponding to 32% (95% CI: 6%-57%) more teachers in the intervention schools passing the test (moderate certainty evidence). Overall, 118 (97%) of 122 teachers in intervention schools had a passing score. CONCLUSIONS The intervention led to a large improvement in the ability of students and teachers to think critically about health choices, but 42% of students in the intervention schools did not achieve a passing score.
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Affiliation(s)
- Faith Chesire
- Tropical Institute of Community Health and Development, Kisumu, Kenya
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Michael Mugisha
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ronald Ssenyonga
- College of Health Sciences, Makerere University, Kampala, Uganda
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Christopher J Rose
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Allen Nsangi
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Margaret Kaseje
- Tropical Institute of Community Health and Development, Kisumu, Kenya
| | | | - Matt Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Sarah E Rosenbaum
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Jenny Moberg
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Astrid Dahlgren
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Simon Lewin
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Medicine and Health Sciences, Department of Health Sciences Ålesund, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Andrew D Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
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Chesire F, Kaseje M, Ochieng M, Ngatia B, Mugisha M, Ssenyonga R, Oxman M, Nsangi A, Semakula D, Rose CJ, Nyirazinyoye L, Dahlgren A, Lewin S, Sewankambo NK, Rosenbaum S, Oxman AD. Effects of the informed health choices secondary school intervention on the ability of students in Kenya to think critically about health choices: A cluster-randomized trial. J Evid Based Med 2023; 16:275-284. [PMID: 37735827 DOI: 10.1111/jebm.12556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023]
Abstract
AIM There is an overabundance of claims about the advantages and disadvantages of health interventions. People need to be able to appraise the reliability of these claims. The aim of this two-arm cluster-randomized trial was to evaluate the Informed Health Choices secondary school intervention designed to teach students to assess claims about the effects of health actions and make informed decisions. METHODS We conducted the trial among students from 80 secondary schools in five subcounties in Kenya. We used stratified randomization to allocate schools to the intervention or control arm. The intervention included a 2-day teacher training workshop and 10 lessons that addressed nine prioritized key concepts for assessing claims about treatment effects. We did not intervene in the control schools. The primary outcome was the proportion of students with a passing score (≥ 9/18 correct answers) on the Critical Thinking about Health test, which included two multiple-choice questions for each concept. RESULTS Between May 11, 2022, and July 8, 2022, we recruited 3362 students and 80 teachers. We allocated 1863 students and 40 teachers to the intervention and 1499 students and 40 teachers to the control arm. In the intervention schools, 1149/1863 (61.7%) of students achieved a passing score compared to 511/1499 (34.1%) in the control schools (odds ratio 3.6 (95% CI 2.5-5.2), p < 0.0001). CONCLUSIONS The intervention had a large effect on students' ability to think critically about health interventions. It is possible to integrate the learning of critical thinking about health within Kenya secondary school curriculum.
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Affiliation(s)
- Faith Chesire
- Department of Community Health and Development, Tropical Institute of Community Health and Development, Kisumu, Kenya
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Margaret Kaseje
- Department of Community Health and Development, Tropical Institute of Community Health and Development, Kisumu, Kenya
| | - Marlyn Ochieng
- Department of Community Health and Development, Tropical Institute of Community Health and Development, Kisumu, Kenya
| | - Benson Ngatia
- Department of Community Health and Development, Tropical Institute of Community Health and Development, Kisumu, Kenya
| | - Michael Mugisha
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Ronald Ssenyonga
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Matt Oxman
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Allen Nsangi
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Daniel Semakula
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Christopher James Rose
- Centre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway
| | - Laetitia Nyirazinyoye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Astrid Dahlgren
- Centre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway
| | - Simon Lewin
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | | | - Sarah Rosenbaum
- Centre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway
| | - Andrew D Oxman
- Centre for Epidemic Interventions Research, (CEIR), Norwegian Institute of Public Health, Oslo, Norway
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Muenchamnan N, Naksen W, Ong-Artborirak P. A Two-Pronged Educational Intervention for Caregivers to Prevent Residential Pesticide Exposure Among Thai Young Children Living in Agricultural Area. J Multidiscip Healthc 2023; 16:2339-2350. [PMID: 37601328 PMCID: PMC10439776 DOI: 10.2147/jmdh.s422259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023] Open
Abstract
Background Residential pesticide exposure can be harmful to the health of young children, particularly in agricultural areas. It is critical to educate their caregivers on pesticide exposure prevention. The purpose of this study was to determine the effectiveness of a two-pronged education intervention for caregivers in preventing pesticide exposure among Thai young children living in agricultural areas. Methods This was an experimental study with 90 primary caregivers of young children aged 6 months to 5 years. Thirty caregivers each were assigned to one of three groups: booklet plus lecture intervention, only booklet intervention, and control. Caregivers in both interventions received a booklet that educated them on residential pesticide exposure and prevention. The caregivers in the booklet plus lecture group also attended a 2-hour lecture with the same content as the booklet. A questionnaire was developed to assess caregivers' knowledge, attitudes, intention, and behaviors regarding residential pesticide exposure and prevention in children. Face-to-face interviews were conducted at their homes three times: baseline, post-intervention, and follow-up (three weeks after the end of the intervention). Results Linear mixed models showed that, from baseline to post-intervention, the intervention effect on knowledge and attitude in both intervention groups, as well as intention in the booklet plus lecture group, was significant (p<0.05). From baseline to follow-up, the knowledge, attitude, intention, and behavior scores in both intervention groups increased significantly more than the control group (p<0.01). Only the attitude score increased more in the booklet plus lecture group than in the booklet group at post-intervention (p=0.009) and follow-up (p=0.003). Conclusion Both the booklet plus lecture method and the booklet method alone have a positive effect on improving the caregiver's knowledge and behaviors regarding pesticide exposure prevention at home. Thus, providing a booklet to caregivers to reduce children's risk of pesticide exposure is recommended.
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Affiliation(s)
| | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | - Parichat Ong-Artborirak
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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15
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Trivedi KK, Schaffzin JK, Deloney VM, Aureden K, Carrico R, Garcia-Houchins S, Garrett JH, Glowicz J, Lee GM, Maragakis LL, Moody J, Pettis AM, Saint S, Schweizer ML, Yokoe DS, Berenholtz S. Implementing strategies to prevent infections in acute-care settings. Infect Control Hosp Epidemiol 2023; 44:1232-1246. [PMID: 37431239 PMCID: PMC10527889 DOI: 10.1017/ice.2023.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
This document introduces and explains common implementation concepts and frameworks relevant to healthcare epidemiology and infection prevention and control and can serve as a stand-alone guide or be paired with the "SHEA/IDSA/APIC Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2022 Updates," which contain technical implementation guidance for specific healthcare-associated infections. This Compendium article focuses on broad behavioral and socio-adaptive concepts and suggests ways that infection prevention and control teams, healthcare epidemiologists, infection preventionists, and specialty groups may utilize them to deliver high-quality care. Implementation concepts, frameworks, and models can help bridge the "knowing-doing" gap, a term used to describe why practices in healthcare may diverge from those recommended according to evidence. It aims to guide the reader to think about implementation and to find resources suited for a specific setting and circumstances by describing strategies for implementation, including determinants and measurement, as well as the conceptual models and frameworks: 4Es, Behavior Change Wheel, CUSP, European and Mixed Methods, Getting to Outcomes, Model for Improvement, RE-AIM, REP, and Theoretical Domains.
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Affiliation(s)
| | - Joshua K. Schaffzin
- Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Valerie M. Deloney
- Society for Healthcare Epidemiology of America (SHEA), Arlington, Virginia
| | | | - Ruth Carrico
- Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | | | - J. Hudson Garrett
- Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | - Janet Glowicz
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Grace M. Lee
- Stanford Children’s Health, Stanford, California
| | | | - Julia Moody
- Clinical Services Group, HCA Healthcare, Nashville, Tennessee
| | | | - Sanjay Saint
- VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, Michigan
| | | | - Deborah S. Yokoe
- University of California San Francisco School of Medicine, UCSF Medical Center, San Francisco, California
| | - Sean Berenholtz
- Clinical Services Group, HCA Healthcare, Nashville, Tennessee
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Riera R, de Oliveira Cruz Latorraca C, Padovez RCM, Pacheco RL, Romão DMM, Barreto JOM, Machado MLT, Gomes R, da Silva SF, Martimbianco ALC. Strategies for communicating scientific evidence on healthcare to managers and the population: a scoping review. Health Res Policy Syst 2023; 21:71. [PMID: 37430348 DOI: 10.1186/s12961-023-01017-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Health evidence needs to be communicated and disseminated in a manner that is clearly understood by decision-makers. As an inherent component of health knowledge translation, communicating results of scientific studies, effects of interventions and health risk estimates, in addition to understanding key concepts of clinical epidemiology and interpreting evidence, represent a set of essential instruments to reduce the gap between science and practice. The advancement of digital and social media has reshaped the concept of health communication, introducing new, direct and powerful communication platforms and gateways between researchers and the public. The objective of this scoping review was to identify strategies for communicating scientific evidence in healthcare to managers and/or population. METHODS We searched Cochrane Library, Embase®, MEDLINE® and other six electronic databases, in addition to grey literature, relevant websites from related organizations for studies, documents or reports published from 2000, addressing any strategy for communicating scientific evidence on healthcare to managers and/or population. RESULTS Our search identified 24 598 unique records, of which 80 met the inclusion criteria and addressed 78 strategies. Most strategies focused on risk and benefit communication in health, were presented by textual format and had been implemented and somehow evaluated. Among the strategies evaluated and appearing to yield some benefit are (i) risk/benefit communication: natural frequencies instead of percentages, absolute risk instead relative risk and number needed to treat, numerical instead nominal communication, mortality instead survival; negative or loss content appear to be more effective than positive or gain content; (ii) evidence synthesis: plain languages summaries to communicate the results of Cochrane reviews to the community were perceived as more reliable, easier to find and understand, and better to support decisions than the original summaries; (iii) teaching/learning: the Informed Health Choices resources seem to be effective for improving critical thinking skills. CONCLUSION Our findings contribute to both the knowledge translation process by identifying communication strategies with potential for immediate implementation and to future research by recognizing the need to evaluate the clinical and social impact of other strategies to support evidence-informed policies. Trial registration protocol is prospectively available in MedArxiv (doi.org/10.1101/2021.11.04.21265922).
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Affiliation(s)
- Rachel Riera
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Carolina de Oliveira Cruz Latorraca
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | | | - Rafael Leite Pacheco
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil.
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.
| | - Davi Mamblona Marques Romão
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Instituto Veredas, São Paulo, Brazil
| | - Jorge Otávio Maia Barreto
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Fundação Oswaldo Cruz, Brasília, Brazil
| | - Maria Lúcia Teixeira Machado
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Carlos, São Carlos, Brazil
| | - Romeu Gomes
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Fundação Oswaldo Cruz, Brasília, Brazil
| | | | - Ana Luiza Cabrera Martimbianco
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Metropolitna de Santo (Unimes), Santos, Brazil
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17
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Ruggeri SY, Emerson A, Russell CL. A concept analysis of routines for improving health behaviors. Int J Nurs Sci 2023; 10:277-287. [PMID: 37545771 PMCID: PMC10401352 DOI: 10.1016/j.ijnss.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/09/2023] [Accepted: 06/17/2023] [Indexed: 08/08/2023] Open
Abstract
Objective Chronic disease patients often have unhealthy routines, especially when away from health care professionals. These patients need clear guidance about establishing and maintaining routines. This study aimed to synthesize a definition of the concept of routines for improving health behaviors based on its uses in the literature. Methods We searched CINAHL, Medline, Scopus, and Google Scholar from January to May, 2022 for articles that included definitions of routines in the context of improving health behavior. We applied no date restriction. The systematic analytic method and Rodgers' evolutionary concept analysis method were used. We charted the attributes, antecedents, and consequences of routines for improving health behaviors, analyzed their uses in the literature, and synthesized the results in a definition of the concept. Result At total of 24 articles were included. Attributes of the concept were repeated patterns, controllable by the patient, goal-oriented health, and integration into an overarching lifestyle. Antecedents were individual characteristics and environmental factors. Consequences were psychological, physical, and social well-being at individual and environmental levels. Conclusion This clarified definition of routines for improving health behaviors will provide a starting point for future research and, eventually, a basis for clinical nursing interventions to support patients in developing and maintaining healthy routines to promote better patient outcomes.
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Affiliation(s)
- Sunny Y. Ruggeri
- School of Nursing and Health Studies, University of Missouri-Kansas City, Missouri, USA
- Dr. Lillian R. Goodman Department of Nursing, Worcester State University, Massachusetts, USA
| | - Amanda Emerson
- University of Kansas Medical Center, University of Kansas School of Nursing, Kansas, USA
| | - Cynthia L. Russell
- School of Nursing and Health Studies, University of Missouri-Kansas City, Missouri, USA
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18
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Alharbi RW, Kaki A, Tabassum S. Effectiveness of an Educational Intervention on Status Epilepticus Among the Caregivers of Children With Epilepsy: An Interventional Study. Cureus 2023; 15:e40735. [PMID: 37485175 PMCID: PMC10361145 DOI: 10.7759/cureus.40735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Background Status epilepticus (SE) is one of the most common and well-known neurological emergencies in pediatrics, especially among kids under two years of age. Early identification and treatment are crucial in the prevention of neurological complications and morbidities. This study aimed to assess the effectiveness of an educational intervention about SE among caregivers of pediatric patients with epilepsy. Methodology This interventional study was conducted among a convenient sample of 206 caregivers of pediatric patients with epilepsy in King Fahad Medical City, Riyadh, Saudi Arabia, from November 2020 to July 2021. We included patients who were aged 14 years or less and received rescue medication prescriptions in 2020. The educational intervention was applied to caregivers, and knowledge was compared before and after the intervention. A self-administered questionnaire was utilized. Results The mean (±SD) age of children was 7.5 (±3.7) years. The mean (±SD) age of caregivers was 36.4 (±6.1) years. About 51.5% of the children were males. The majority of caregivers were mothers (89.8%). The mean (±SD) score of total knowledge was 12.3/20 (±2.6) before the intervention which increased to 15.7/20 (±3.1) after the intervention, and the difference was found to be statically significant (p = 0.001). This indicates that the educational intervention was effective. Conclusions The educational intervention administered in this study significantly improved the knowledge of caregivers of pediatric patients with epilepsy and can help in providing better care to the patients.
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Affiliation(s)
- Riyadh W Alharbi
- Pediatric Neurology, Prince Sultan Military Medical City, Riyadh, SAU
| | - Ahmed Kaki
- Pediatric Neurology, King Fahad Medical City, Riyadh, SAU
| | - Sadia Tabassum
- Pediatric Neurology, King Fahad Medical City, Riyadh, SAU
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19
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Alashram AR, Annino G. A Novel Neurorehabilitation Approach for Neural Plasticity
Overstimulation and Reorganization in Patients with Neurological
Disorders. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2023. [DOI: 10.1055/a-2004-5836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
AbstractNeurological disorders are those that are associated with impairments in the
nervous system. These impairments affect the patient’s activities of
daily living. Recently, many advanced modalities have been used in the
rehabilitation field to treat various neurological impairments. However, many of
these modalities are available only in clinics, and some are expensive. Most
patients with neurological disorders have difficulty reaching clinics. This
review was designed to establish a new neurorehabilitation approach based on the
scientific way to improve patients’ functional recovery following
neurological disorders in clinics or at home. The human brain is a network, an
intricate, integrated system that coordinates operations among billions of
units. In fact, grey matter contains most of the neuronal cell bodies. It
includes the brain and the spinal cord areas involved in muscle control, sensory
perception, memory, emotions, decision-making, and self-control. Consequently,
patients’ functional ability results from complex interactions among
various brain and spinal cord areas and neuromuscular systems. While white
matter fibers connect numerous brain areas, stimulating or improving non-motor
symptoms, such as motivation, cognitive, and sensory symptoms besides motor
symptoms may enhance functional recovery in patients with neurological
disorders. The basic principles of the current treatment approach are
established based on brain connectivity. Using motor, sensory, motivation, and
cognitive (MSMC) interventions during rehabilitation may promote neural
plasticity and maximize functional recovery in patients with neurological
disorders. Experimental studies are strongly needed to verify our theories and
hypothesis.
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Affiliation(s)
- Anas R. Alashram
- Department of Physiotherapy, Middle East University, Amman,
Jordan
- Applied Science Research Center, Applied Science Private
University
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor
Vergata”, Rome, Italy
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20
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Correia JC, Waqas A, Assal JP, Davies MJ, Somers F, Golay A, Pataky Z. Effectiveness of therapeutic patient education interventions for chronic diseases: A systematic review and meta-analyses of randomized controlled trials. Front Med (Lausanne) 2023; 9:996528. [PMID: 36760883 PMCID: PMC9905441 DOI: 10.3389/fmed.2022.996528] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 12/27/2022] [Indexed: 01/26/2023] Open
Abstract
Background Chronic disorders are highly prevalent and are a major contributor to death and disability worldwide. Evidence has shown that therapeutic patient education (TPE) interventions are effective in improving a range of biomedical and psychological outcomes for a variety of chronic disorders. This has been demonstrated in scores of randomized controlled and evidence-synthesis studies. However, no quantitative evidence has been published so far on the content and effective teaching strategies in TPE programs. The present systematic review and meta-analysis aim to bridge this gap by answering the who, what, and how of TPE programs. Methods Using a pretested search strategy, we searched the Web of Science, MEDLINE, CINAHL, PsycINFO, and the COCHRANE databases, from inception to August 2019. The search strategy was based on four comprehensive search concepts (patient education, chronic diseases, study design, and outcomes). After a careful screening for eligible studies, two reviewers extracted qualitative and quantitative data from the randomized controlled trials on the TPE interventions. We also developed a taxonomy of curriculum skills and intervention delivery techniques to aid the extraction of data in these domains. Results We found that these interventions were effective in improving biological outcomes (SMD = 0.48; 95% CI: 0.38-0.57), adherence to the treatment regimen (SMD = 0.73; 95% CI: 0.46-1.002), knowledge (SMD = 1.22; 95% CI: 0.79-1.65), self-efficacy (SMD = 0.43; 95% CI: 0.30-0.56), and psychological health (SMD = -0.41; 95% CI: -0.53 to -0.29). This effectiveness was consistent across different delivery formats (individual, group, and electronic) and delivery agents (non-specialists vs. specialists). Conclusion The flexibility in the choice of mode of delivery and curriculum development gives stakeholders an opportunity to scale up TPE interventions in healthcare settings. Systematic review registration Identifier: CRD42019141294.
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Affiliation(s)
- Jorge César Correia
- Unit of Therapeutic Patient Education, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, World Health Organization Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland,*Correspondence: Jorge César Correia ✉
| | - Ahmed Waqas
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Jean-Philippe Assal
- Fondation recherche et formation pour l'enseignement du malade, Geneva, Switzerland
| | - Melanie J. Davies
- Diabetes Research Centre, National Institute for Health Research Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Florence Somers
- Unit of Therapeutic Patient Education, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, World Health Organization Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Alain Golay
- Unit of Therapeutic Patient Education, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, World Health Organization Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Zoltan Pataky
- Unit of Therapeutic Patient Education, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, World Health Organization Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Crane ME, Purtle J, Becker SJ. Amplifying consumers as partners in dissemination and implementation science and practice. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231205894. [PMID: 37936968 PMCID: PMC10571676 DOI: 10.1177/26334895231205894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Background This Viewpoint argues for consumers (people with lived experience and their families) to be amplified as key partners in dissemination and implementation science and practice. Method We contend that consumer opinion and consumer demand can be harnessed to influence practitioners and policymakers. Results Amplifying consumers' voices can improve the fit of evidence-based interventions to the intended end user. We offer recommendations of frameworks to engage consumers in the dissemination and implementation of health interventions. We discuss the primary types of evidence consumers may rely upon, including testimonials and lived experience. Conclusions Our intention is for this Viewpoint to continue the momentum in dissemination and implementation science and practice of engaging consumers in our work.
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Affiliation(s)
- Margaret E. Crane
- Department of Psychology, Temple University, Philadelphia, PA, USA
- Department of Psychiatry and Human Behavior Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Public Health Policy & Management, New York University School of Global Public Health, New York, NY, USA
| | - Jonathan Purtle
- Department of Public Health Policy & Management, New York University School of Global Public Health, New York, NY, USA
| | - Sara J. Becker
- Institute for Public Health and Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA
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Board of Chiropractic. Dela J Public Health 2022; 8:22-26. [PMID: 36751617 PMCID: PMC9894069 DOI: 10.32481/djph.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Githinji P, Dawson JA, Appiah D, Rethorst CD. A Culturally Sensitive and Theory-Based Intervention on Prevention and Management of Diabetes: A Cluster Randomized Control Trial. Nutrients 2022; 14:nu14235126. [PMID: 36501157 PMCID: PMC9737926 DOI: 10.3390/nu14235126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
Type 2 diabetes is an emerging concern in Kenya. This clustered-randomized trial of peri-urban communities included a theory-based and culturally sensitive intervention to improve diabetes knowledge, health beliefs, dietary intake, physical activity, and weight status among Kenyan adults. Those in the intervention group (IG) received a culturally sensitive diabetes education intervention which applied the Health Belief Model in changing knowledge, health beliefs and behavior. Participants attended daily education sessions for 5 days, each lasting 3 h and received mobile phone messages for an additional 4 weeks. The control group (CG) received standard education on COVID-19. Data was collected at baseline, post-intervention (1 week), and follow-up assessment (5 weeks). Linear mixed effect analysis was performed to assess within and across group differences. Compared to the control, IG significantly increased diabetes knowledge (p < 0.001), health beliefs including perceived susceptibility (p = 0.05), perceived benefits (p = 0.04) and self-efficacy (p = 0.02). IG decreased consumption of oils (p = 0.03), refined grains (p = 0.01), and increased intake of fruits (p = 0.01). Perceived barriers, physical activity, and weight status were not significantly different between both groups. The findings demonstrate the potential of diabetes education in improving diabetes knowledge, health beliefs, and in changing dietary intake of among adults in Kenya.
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Affiliation(s)
- Phrashiah Githinji
- Department of Nutritional Science, Texas Tech University, 1301 Akron Ave., Lubbock, TX 79409, USA
- Institute of Advancing Health through Agriculture, Texas A&M AgriLife Research, 17360 Coit Rd., 17360, Dallas, TX 77843, USA
- Correspondence:
| | - John A. Dawson
- Department of Nutritional Science, Texas Tech University, 1301 Akron Ave., Lubbock, TX 79409, USA
- Department of Economics, Applied Statistics, and International Business, New Mexico State University, 127, Las Cruces, NM 88003, USA
| | - Duke Appiah
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79410, USA
| | - Chad D. Rethorst
- Institute of Advancing Health through Agriculture, Texas A&M AgriLife Research, 17360 Coit Rd., 17360, Dallas, TX 77843, USA
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Racism in Medicine:. Dela J Public Health 2022; 8:66-72. [PMID: 36340947 PMCID: PMC9621581 DOI: 10.32481/djph.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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25
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Testing a Pediatric Palliative Care Education Workplace Intervention. J Hosp Palliat Nurs 2022; 24:E166-E171. [PMID: 35470315 DOI: 10.1097/njh.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pediatric palliative care is aimed at pain and symptom management, reducing hospitalization, promoting psychosocial care, and improving quality of life for children with serious illness. As a professional caregiver, nurses play an essential role in the provision of appropriate pediatric palliative care in clinical care settings. The purpose of this quality improvement study was to improve pediatric nurses' awareness and perceptions of palliative care. A 1-group pretest-posttest design was used in the study. A 20-minute education video was used as an intervention to enhance nurses' awareness and perception about pediatric palliative care. Twenty-one pediatric medical-surgical nurses participated in the intervention. Posttest results indicated raised awareness about palliative care, more nurses were able to define palliative care correctly, and nurses were more likely to encourage a palliative care consult. Future studies are needed using larger sample sizes with robust measures to further evaluate the effectiveness of the intervention on enhancing pediatric palliative care awareness among nurses.
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Fulone I, Barreto JOM, Barberato-Filho S, Bergamaschi CDC, Lopes LC. Improving the adherence to COVID-19 preventive measures in the community: Evidence brief for policy. Front Public Health 2022; 10:894958. [PMID: 35979464 PMCID: PMC9376604 DOI: 10.3389/fpubh.2022.894958] [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] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To identify evidence-based strategies to improve adherence to the preventive measures against the coronavirus disease (COVID-19) at the community level. Method This is an evidence brief for policy, combining research evidence specific to contextual knowledge from stakeholders. A systematic search was performed in 18 electronic databases, gray literature, and a handle search, including only secondary and tertiary studies that focused on the adherence of the general population to COVID-19 preventive measures in the community. Two reviewers, independently, performed the study selection, data extraction, and assessment of the quality of the studies. Relevant evidence has been synthesized to draft evidence-based strategies to improve adherence. These strategies were circulated for external endorsement by stakeholders and final refinement. Endorsement rates >80%, 60-80% and <60% were considered high, moderate, and low respectively. Results Eleven studies, with varying methodological qualities were included: high (n = 3), moderate (n = 3), low (n = 1), and critically low (n = 4). Three evidence based strategies were identified: i. Risk communication; ii. Health education to the general public, and iii. Financial support and access to essential supplies and services. The rates of endorsement were: 83% for risk communication, 83% for health education, and 92% for financial support and access to essential supplies and services. The evidence showed that an increase in knowledge, transparent communication, and public awareness about the risks of COVID-19 and the benefits of adopting preventive measures results in changes in people's attitudes and behavior, which can increase adherence. In addition, the guarantee of support and assistance provides conditions for people to adopt and sustain such measures. Conclusions These strategies can guide future actions and the formulation of public policies to improve adherence to preventive measures in the community during the current COVID-19 pandemic and other epidemics.
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Affiliation(s)
- Izabela Fulone
- Graduate Course in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
| | | | | | | | - Luciane Cruz Lopes
- Graduate Course in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
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Effects of Internet-Based Nutrition and Exercise Interventions on the Prevention and Treatment of Sarcopenia in the Elderly. Nutrients 2022; 14:nu14122458. [PMID: 35745187 PMCID: PMC9229368 DOI: 10.3390/nu14122458] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/02/2022] [Accepted: 06/12/2022] [Indexed: 12/12/2022] Open
Abstract
Effective nutrition and exercise interventions may improve sarcopenia in the elderly. The purpose of our study was to investigate the effectiveness of Internet-based nutrition and exercise interventions in the elderly with sarcopenia. Participants were divided into 4 groups: control, nutrition, exercise, and comprehensive (nutrition plus exercise) groups; there was at least 50 participants in each group. Our trial lasted 12 weeks. We conducted dietary and exercise interventions through an app and collected feedback from the participants every three weeks. Information on the diet, skeletal muscle mass, and muscle function was collected before and after the interventions. The comprehensive group had higher high-quality protein intake than the control (p = 0.017) and exercise (p = 0.012) groups. After the interventions, we obtained differences in skeletal muscle mass, skeletal muscle mass/height2, skeletal muscle mass/weight, muscle mass/BMI, and skeletal muscle mass/body fat percentage (p < 0.05). Changes in average daily energy and total daily protein intakes were not significantly different; however, there was an overall improvement in the intervention groups relative to baseline data. There were no changes in the average daily time of moderate physical activity. The Internet was an effective tool of nutrition intervention in the elderly with sarcopenia. The Internet-based nutrition intervention improved high-quality protein intake and skeletal muscle mass in the elderly with sarcopenia.
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Thomas D, Zachariah S, Baker D, Cooper J, Sreedharan J, Khalifa S. Impact of educational intervention in evidence-based drug information in interprofessional practice at a tertiary-level care hospital. JOURNAL OF INTERPROFESSIONAL EDUCATION & PRACTICE 2022; 27:100496. [DOI: 10.1016/j.xjep.2022.100496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Bennett G, Bardon LA, Gibney ER. A Comparison of Dietary Patterns and Factors Influencing Food Choice among Ethnic Groups Living in One Locality: A Systematic Review. Nutrients 2022; 14:nu14050941. [PMID: 35267916 PMCID: PMC8912306 DOI: 10.3390/nu14050941] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/16/2022] [Accepted: 02/20/2022] [Indexed: 01/23/2023] Open
Abstract
Globally, the number of minority ethnic groups in high-income countries is increasing. However, despite this demographic change, most national food consumption surveys are not representative of ethnically diverse populations. In consequence, many ethnic minorities' dietary intakes are underreported, meaning that accurate analysis of food intake and nutrient status among these groups is not possible. This systematic review aims to address these gaps and understand differences in dietary intakes and influencers of dietary habits of ethnic groups worldwide. A systematic search was conducted through three databases (Pubmed, Web of Science and Scopus) and manual searches, generating n = 56,647 results. A final search of these databases was completed on 13 September 2021, resulting in a total of 49 studies being included in this review. Overall, food group intakes-particularly fruit, vegetable and fish intake-and diet quality scores were seen to differ between ethnicities. Overall Black/African American groups were reported to be among the poorest consumers of fruit and vegetables, whilst Asian groups achieved high diet quality scores due to higher fish intakes and lower fat intakes compared to other groups. Limited data investigated how nutrient intakes, dietary and meal patterns compared between groups, meaning that not all aspects of dietary intake could be compared. Socioeconomic status and food availability appeared to be associated with food choice of ethnic groups, however, confounding factors should be considered more closely. Future work should focus on comparing nutrient intakes and meal patterns between ethnicities and investigate potential targeted interventions which may support adherence to food-based dietary guidelines by all ethnic groups.
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Affiliation(s)
- Grace Bennett
- Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (G.B.); (L.A.B.)
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Laura A. Bardon
- Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (G.B.); (L.A.B.)
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Eileen R. Gibney
- Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (G.B.); (L.A.B.)
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- Correspondence:
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Modenese A, Loney T, Rocholl M, Symanzik C, Gobba F, John SM, Straif K, Silva Paulo M. Protocol for a Systematic Review on the Effectiveness of Interventions to Reduce Exposure to Occupational Solar UltraViolet Radiation (UVR) Among Outdoor Workers. Front Public Health 2021; 9:756566. [PMID: 34858932 PMCID: PMC8632259 DOI: 10.3389/fpubh.2021.756566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/22/2021] [Indexed: 01/15/2023] Open
Abstract
Background: Solar UltraViolet Radiation (UVR) is considered the most relevant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers) and UVR-induced skin cancers are among the most frequent types of occupational cancers worldwide. This review aims to collect and evaluate all the available preventive interventions conducted on outdoor workers to reduce their solar UVR related risk, with the final purpose of reducing the burden of occupational skin cancers for outdoor workers. Methods: We will search the following databases for peer-reviewed original research published: MEDLINE (through PubMed), Scopus, and EMBASE. We will include only interventional studies, both randomized and non-randomized, with an adequate comparison group, therefore excluding cross-sectional studies, as well as case-reports/series, reviews, and letters/comments. The systematic review will adhere to the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) guidelines for reporting systematic reviews. After the literature search, studies to be included will be independently reviewed by two Authors, first based on title and abstract, then based on the full text, according to the inclusion criteria. Conflicts will be solved by a third Author. Two authors will independently extract the required data from included studies and perform quality assessment according to the relevant domain for Risk of Bias assessment proposed by the Cochrane collaboration group. In case of sufficient homogeneity of interventions and outcomes evaluated, results from subgroups of studies will be pooled together in a meta-analysis. Discussion: Following the principles for the evaluation of interventions for cancer prevention established by the International Agency for Research on Cancer, this systematic review will investigate the effectiveness of the interventions, and consequently it will provide reliable indications for the actual reduction of skin cancer incidence in outdoor workers.
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Affiliation(s)
- Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Marc Rocholl
- Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Cara Symanzik
- Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Kurt Straif
- Instituto Salud Global (ISGlobal), Barcelona, Spain.,Department of Biology, Boston College, Chestnut Hill, MA, United States
| | - Marilia Silva Paulo
- Institute of Public Health - College of Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
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Mugisha M, Uwitonze AM, Chesire F, Senyonga R, Oxman M, Nsangi A, Semakula D, Kaseje M, Lewin S, Sewankambo N, Nyirazinyoye L, Oxman AD, Rosenbaum S. Teaching critical thinking about health using digital technology in lower secondary schools in Rwanda: A qualitative context analysis. PLoS One 2021; 16:e0248773. [PMID: 33750971 PMCID: PMC7984628 DOI: 10.1371/journal.pone.0248773] [Citation(s) in RCA: 5] [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: 02/01/2021] [Accepted: 03/04/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction Adolescents encounter misleading claims about health interventions that can affect their health. Young people need to develop critical thinking skills to enable them to verify health claims and make informed choices. Schools could teach these important life skills, but educators need access to suitable learning resources that are aligned with their curriculum. The overall objective of this context analysis was to explore conditions for teaching critical thinking about health interventions using digital technology to lower secondary school students in Rwanda. Methods We undertook a qualitative descriptive study using four methods: document review, key informant interviews, focus group discussions, and observations. We reviewed 29 documents related to the national curriculum and ICT conditions in secondary schools. We conducted 8 interviews and 5 focus group discussions with students, teachers, and policy makers. We observed ICT conditions and use in five schools. We analysed the data using a framework analysis approach. Results Two major themes found. The first was demand for teaching critical thinking about health. The current curriculum explicitly aims to develop critical thinking competences in students. Critical thinking and health topics are taught across subjects. But understanding and teaching of critical thinking varies among teachers, and critical thinking about health is not being taught. The second theme was the current and expected ICT conditions. Most public schools have computers, projectors, and internet connectivity. However, use of ICT in teaching is limited, due in part to low computer to student ratios. Conclusions There is a need for learning resources to develop critical thinking skills generally and critical thinking about health specifically. Such skills could be taught within the existing curriculum using available ICT technologies. Digital resources for teaching critical thinking about health should be designed so that they can be used flexibly across subjects and easily by teachers and students.
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Affiliation(s)
- Michael Mugisha
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Anne Marie Uwitonze
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Faith Chesire
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Tropical Institute of Community Health and Development, Kisumu, Kenya
| | - Ronald Senyonga
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Allen Nsangi
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Daniel Semakula
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Margaret Kaseje
- Tropical Institute of Community Health and Development, Kisumu, Kenya
| | - Simon Lewin
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nelson Sewankambo
- Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Laetitia Nyirazinyoye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Andrew D. Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
- * E-mail:
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Nwangwu H, de Peralta SS, Birman S, Hicks RW. Implementation of the standardized, evidence-based three-stage suicide risk screening: Experience of a large Veterans Affairs medical center. J Am Assoc Nurse Pract 2021; 33:838-846. [PMID: 33534288 DOI: 10.1097/jxx.0000000000000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 09/28/2020] [Indexed: 11/25/2022]
Abstract
ABSTRACT Suicide is a global public health concern and may be preventable with early identification. The suicide rate among US veterans is increasing. In response to the increase, Veterans Health Administration recommended a new standardized three-step, evidence-based suicide risk screening process across all Veterans Health Administration sites. The purpose of this project was to implement the new three-step suicide screening method and evaluate the rate of provider adherence. The implementation occurred in seven clinical sites in the Veterans Affairs Greater Los Angeles Health care System. Following initial implementation, two Plan-Do-Study-Act (PDSA) evaluated provider adherence to the screening processes. Staff members at each site received suicide prevention education. Staff members had the option of using an embedded template in the course of normal patient care workflow. Plan-Do-Study-Act 1 measured the early results. Staff members achieved a performance adherence rate of 18%, indicating that staff were less likely to proactively screen for risk of suicide. In PDSA-2, the mandatory use of screening replaced the optional use. Staff members achieved a 95% adherence rate after 3 months. Changing the workflow within the electronic health record from optional to mandatory utilization brought forth improvements in suicide prevention screening.
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Affiliation(s)
- Helen Nwangwu
- VA Long Beach Healthcare System, Long Beach, California
- School of Nursing, Azusa Pacific University, Azusa, California
| | - Shelly S de Peralta
- VA Greater Los Angeles Healthcare System, Los Angeles, California
- College of Graduate Nursing, Western University of Health Sciences, Pomona, California
| | - Sharon Birman
- VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Rodney W Hicks
- College of Graduate Nursing, Western University of Health Sciences, Pomona, California
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Shatenko S, Harder S, Gair J. Why you should Mini-Med School: Mini-Med School as an intervention to increase health literacy. CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e72-e78. [PMID: 33349756 PMCID: PMC7749679 DOI: 10.36834/cmej.67817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health literacy is an increasingly important topic in healthcare given that low health literacy is widely prevalent and linked to poorer health outcomes and higher healthcare costs. We sought to determine if a Mini-Med School delivered by medical students could prove to be an effective intervention to improve health literacy in the elderly. METHODS This study took place in the context of the University of British Columbia Medical Doctorate Undergraduate Program's Flexible and Enhanced Learning course. It aimed to evaluate the effectiveness of a Mini-Med School lecture series as an intervention to increase health literacy in 24 volunteer participants from the University of Victoria Retirees Association. This was a cross sectional study comparing health literacy pre- and post-intervention using the validated Health Literacy Questionnaire. RESULTS There was a statistically significant improvement in seven of nine scales of health literacy when participants repeated the Health Literacy Questionnaire six weeks post-intervention as well as positive outcomes from both a student learning and community outreach perspective. DISCUSSION This study demonstrates that a Mini-Med School program is an effective way to increase health literacy; adds to the minimal research surrounding Mini-Med Schools; and should further encourage Canadian medical schools to use Mini-Medical Schools as a method of engagement and advocacy with their communities.
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Affiliation(s)
- Sergiy Shatenko
- Island Medical Program, University of Victoria, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Samuel Harder
- Island Medical Program, University of Victoria, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Jane Gair
- Island Medical Program, University of Victoria, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, British Columbia, Canada
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Han G, Mayer M, Canner J, Lindsley K, Datar R, Le J, Bar-Cohen A, Bowie J, Dickersin K. Development, implementation and evaluation of an online course on evidence-based healthcare for consumers. BMC Health Serv Res 2020; 20:928. [PMID: 33032599 PMCID: PMC7542874 DOI: 10.1186/s12913-020-05759-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence-based healthcare (EBHC) principles are essential knowledge for patient and consumer ("consumer") engagement as research and research implementation stakeholders. The aim of this study was to assess whether participation in a free, self-paced online course affects confidence in explaining EBHC topics. The course comprises six modules and evaluations which together take about 6 h to complete. METHODS Consumers United for Evidence-based Healthcare (CUE) designed, tested and implemented a free, online course for consumers, Understanding Evidence-based Healthcare: A Foundation for Action ("Understanding EBHC"). The course is offered through the Johns Hopkins Bloomberg School of Public Health. Participants rated their confidence in explaining EBHC topics on a scale of 1 (lowest) to 5 (highest), using an online evaluation provided before accessing the course ("Before") and after ("After") completing all six course modules. We analyzed data from those who registered for the course from May 31, 2007 to December 31, 2018 (n = 15,606), and among those persons, the 11,522 who completed the "Before" evaluation and 4899 who completed the "After" evaluation. Our primary outcome was the overall mean of within-person change ("overall mean change") in self-reported confidence levels on EBHC-related topics between "Before" and "After" evaluations among course completers. Our secondary outcomes were the mean within-person change for each of the 11 topics (mean change by topic). RESULTS From May 31, 2007 to December 31, 2018, 15,606 individuals registered for the course: 11,522 completed the "Before" evaluation, and 4899 of these completed the "After" evaluation (i.e., completed the course). The overall mean change in self-reported confidence levels (ranging from 1 to 5) from the "Before" to "After" evaluation was 1.27 (95% CI, 1.24-1.30). The mean change by topic ranged from 1.00 (95% CI, 0.96-1.03) to 1.90 (95% CI, 1.87-1.94). CONCLUSION Those who seek to involve consumer stakeholders can offer Understanding EBHC as a step toward meaningful consumer engagement. Future research should focus on long-term impact assessment of online course such as ours to understand whether confidence is retained post-course and applied appropriately.
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Affiliation(s)
- Genie Han
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, 707, Baltimore, MD, 21205, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E6012, Baltimore, MD, 21205, USA.
| | - Musa Mayer
- Metastatic Breast Cancer Alliance, New York, USA
| | | | | | - Reva Datar
- School of Public Health, University of Maryland College Park, College Park, USA
| | - Jimmy Le
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, 707, Baltimore, MD, 21205, USA
| | | | - Janice Bowie
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, 707, Baltimore, MD, 21205, USA
| | - Kay Dickersin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, 707, Baltimore, MD, 21205, USA
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Aufegger L, Bùi KH, Bicknell C, Darzi A. Designing a paediatric hospital information tool with children, parents, and healthcare staff: a UX study. BMC Pediatr 2020; 20:469. [PMID: 33032549 PMCID: PMC7542856 DOI: 10.1186/s12887-020-02361-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The hospital patient pathway for having treatment procedures can be daunting for younger patients and their family members, especially when they are about to undergo a complex intervention. Opportunities to mentally prepare young patients for their hospital treatments, e.g. for surgical procedures, include tools such as therapeutic clowns, medical dolls, or books and board games. However, while promising in reducing pre-operative anxiety and negative behaviours, they may be resource intensive, costly, and not always readily available. In this study, we co-designed a digital hospital information system with children, parents and clinicians, in order to prepare children undergoing medical treatment. METHOD The study took place in the UK and consisted of two parts: In part 1, we purposively sampled 37 participants (n=22 parents, and n=15 clinicians) to understand perceptions and concerns of an hospital information platform specifically design for and addressed to children. In part 2, 14 children and 11 parents attended an audio and video recorded co-design workshop alongside a graphic designer and the research team to have their ideas explored and reflected on for the design of such information technology. Consequently, we used collected data to conduct thematic analysis and narrative synthesis. RESULTS Findings from the survey were categorised into four themes: (1) the prospect of a hospital information system (parents' inputs); (2) content-specific information needed for the information system (parents' and clinicians' inputs); (3) using the virtual information system to connect young patients and parents (parents' inputs); and (4) how to use the virtual hospital information system from a clinician's perspective (clinicians' inputs). In contrast, the workshop highlighted points in times children were most distressed/relaxed, and derived the ideal hospital visit in both their and their parents' perspectives. CONCLUSIONS The findings support the use of virtual information systems for children, in particular to explore and learn about the hospital, its facilities, and the responsibilities of healthcare professionals. Our findings call for further investigations and experiments in developing safer and more adequate delivery of care for specific age groups of healthcare users. Practical and theoretical implications for improving the quality and safety in healthcare delivery are discussed.
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Affiliation(s)
- Lisa Aufegger
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK.
| | - Khánh Hà Bùi
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
| | - Colin Bicknell
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
| | - Ara Darzi
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
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Büchter RB, Betsch C, Ehrlich M, Fechtelpeter D, Grouven U, Keller S, Meuer R, Rossmann C, Waltering A. Communicating Uncertainty in Written Consumer Health Information to the Public: Parallel-Group, Web-Based Randomized Controlled Trial. J Med Internet Res 2020; 22:e15899. [PMID: 32773375 PMCID: PMC7445603 DOI: 10.2196/15899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/14/2020] [Accepted: 06/21/2020] [Indexed: 12/02/2022] Open
Abstract
Background Uncertainty is integral to evidence-informed decision making and is of particular importance for preference-sensitive decisions. Communicating uncertainty to patients and the public has long been identified as a goal in the informed and shared decision-making movement. Despite this, there is little quantitative research on how uncertainty in health information is perceived by readers. Objective The aim of this study was to examine the impact of different uncertainty descriptions regarding the evidence for a treatment effect in a written research summary for the public. Methods We developed 8 versions of a research summary on a fictitious drug for tinnitus with varying degrees (Q1), sources (Q2), and magnitudes of uncertainty (Q3). We recruited 2099 members of the German public from a web-based research panel. Of these, 1727 fulfilled the inclusion criteria and were randomly presented with one of these research summaries. Randomization was conducted by using a centralized computer with a random number generator. Web-based recruitment and data collection were fully automated. Participants were not aware of the purpose of the study and alternative presentations. We measured the following outcomes: perception of the treatment effectiveness (primary), certainty in the judgement of treatment effectiveness, perception of the body of evidence, text quality, and intended decision. The outcomes were self-assessed. Results For the primary outcome, we did not find a global effect for Q1 and Q2 (P=.25 and P=.73), but we found a global effect for Q3 (P=.048). Pairwise comparisons showed a weaker perception of treatment effectiveness for the research summary with 3 sources of uncertainty compared to the version with 2 sources of uncertainty (P=.04). Specifically, the proportion of the participants in the group with 3 sources of uncertainty that perceived the drug as possibly beneficial was 9% lower than that of the participants in the group with 2 sources of uncertainty (92/195, 47.2% vs 111/197, 56.3%, respectively). The proportion of the participants in the group with 3 sources of uncertainty that considered the drug to be of unclear benefit was 8% higher than that of the participants in the group with 2 sources of uncertainty (72/195, 36.9% vs 57/197, 28.9%, respectively). However, there was no significant difference compared to the version with 1 source of uncertainty (P=.31). We did not find any meaningful differences between the research summaries for the secondary outcomes. Conclusions Communicating even a large magnitude of uncertainty for a treatment effect had little impact on the perceived effectiveness. Efforts to improve public understanding of research are needed to improve the understanding of evidence-based health information. Trial Registration German Clinical Trials Register DRKS00015911, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015911 International Registered Report Identifier (IRRID) RR2-10.2196/13425
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Affiliation(s)
- Roland B Büchter
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Cornelia Betsch
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Martina Ehrlich
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Dennis Fechtelpeter
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Ulrich Grouven
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Sabine Keller
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - Regina Meuer
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | | | - Andreas Waltering
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
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Effect of Health-Promoting Lifestyle Modification Education on Knowledge, Attitude, and Quality of Life of Postmenopausal Women. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3572903. [PMID: 32550229 PMCID: PMC7256760 DOI: 10.1155/2020/3572903] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/24/2020] [Accepted: 05/02/2020] [Indexed: 01/22/2023]
Abstract
Limited knowledge and negative attitudes about menopause among postmenopausal women (PMW) create a multitude of health-related issues leading to impaired quality of life (QOL) among them. This study evaluated the impact of a health-promoting lifestyle education intervention (HPLEI) on knowledge, attitude, and QOL in a group of PMW in Sri Lanka. A quasi-experimental study was conducted with 72 PMW, matched for sociodemographic status of the community from two geographically separated areas in Galle, and they were allocated to intervention (n = 37) and control (n = 35) groups. HPLEI is comprised of health education sessions focused on postmenopausal health management with lifestyle modifications provided only for the intervention group for 8 weeks and follow-up for 6 months. The control group was not given any planned education programme and was allowed to proceed with the usual lifestyle during this period. Knowledge, attitude, menopause-specific QOL (MENQOL), and overall QOL were evaluated in both groups with self-administered questionnaires at the baseline, after 8 weeks of education sessions and at the end of 6 months of follow-up. The mean (SD) ages of the intervention and control groups were 54.6 (4.5) and 56.5 (3.4) (p = 0.06) years, respectively. All evaluated variable scores were not different between the intervention and control groups (p > 0.05) at the baseline. In the intervention group, knowledge (mean ± SD; 21.70 ± 1.05) and attitude (mean ± SD; 44.02 ± 5.33) scores increased at the end (p < 0.001). In the control group, a marginal increase in all dimensions of knowledge scores (mean ± SD; 9.71 ± 2.21) and unchanged attitude scores (mean ± SD; 23.91 ± 7.56) were seen. All MENQOL scores decreased during the follow-up in the intervention group (mean ± SD; 138.51 ± 18.47) (p < 0.001) except the sexual domain (p = 0.32). MENQOL scores were increased in the control group (mean ± SD; 92.05 ± 28.87) (p < 0.001) with time. Overall QOL scores increased (mean ± SD; 74.85 ± 9.71) (p < 0.001) in the intervention group during the study period and in the control group overall QOL (mean ± SD; 51.03 ± 13.61) showed a reduction (p < 0.001) at the end. Health education focused on health-promoting lifestyle modifications was effective in improving knowledge, attitude, MENQOL, and overall QOL of PMW.
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Semakula D, Nsangi A, Oxman AD, Oxman M, Austvoll-Dahlgren A, Rosenbaum S, Morelli A, Glenton C, Lewin S, Nyirazinyoye L, Kaseje M, Chalmers I, Fretheim A, Rose CJ, Sewankambo NK. Effects of the Informed Health Choices podcast on the ability of parents of primary school children in Uganda to assess the trustworthiness of claims about treatment effects: one-year follow up of a randomised trial. Trials 2020; 21:187. [PMID: 32059694 PMCID: PMC7023790 DOI: 10.1186/s13063-020-4093-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/18/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Earlier, we designed and evaluated an educational mass media intervention for improving people's ability to think more critically and to assess the trustworthiness of claims (assertions) about the benefits and harms (effects) of treatments. The overall aims of this follow-up study were to evaluate the impact of our intervention 1 year after it was administered, and to assess retention of learning and behaviour regarding claims about treatments. METHODS We randomly allocated consenting parents to listen to either the Informed Health Choices podcast (intervention) or typical public service announcements about health issues (control) over 7-10 weeks. Each intervention episode explained how the trustworthiness of treatment claims can be assessed by using relevant key concepts of evidence-informed decision-making. Participants listened to two episodes per week, delivered by research assistants. We evaluated outcomes immediately, and a year after the intervention. Primary outcomes were mean score and the proportion with a score indicating a basic ability to apply the key concepts (> 11 out of 18 correct answers) on a tool measuring people's ability to critically appraise the trustworthiness of treatment claims. Skills decay/retention was estimated by calculating the relative difference between the follow-up and initial results in the intervention group, adjusting for chance. Statistical analyses were performed using R (R Core Team, Vienna, Austria; version 3.4.3). RESULTS After 1 year, the mean score for parents in the intervention group was 58.9% correct answers, compared to 52.6% in the control (adjusted mean difference of 6.7% (95% CI 3.3% to 10.1%)). In the intervention group, 47.2% of 267 parents had a score indicating a basic ability to assess treatment claims compared to 39.5% of 256 parents in the control (adjusted difference of 9.8% more parents (95% CI 0.9% to 18.9%). These represent relative reductions of 29% in the mean scores and 33% in the proportion of parents with a score indicating a basic ability to assess the trustworthiness of claims about treatment effects. CONCLUSIONS Although listening to the Informed Health Choices podcast initially led to a large improvement in the ability of parents to assess claims about the effects of treatments, our findings show that these skills decreased substantially over 1 year. More active practice could address the substantial skills decay observed over 1 year. TRIAL REGISTRATION Pan African Clinical Trial Registry (www.pactr.org), PACTR201606001676150. Registered on 12 June 2016.
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Affiliation(s)
- Daniel Semakula
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Allen Nsangi
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Andrew D. Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Astrid Austvoll-Dahlgren
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | | | - Claire Glenton
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Simon Lewin
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Laetitia Nyirazinyoye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | - Atle Fretheim
- University of Oslo, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Christopher J. Rose
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
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Nsangi A, Semakula D, Oxman AD, Austvoll-Dahlgren A, Oxman M, Rosenbaum S, Morelli A, Glenton C, Lewin S, Kaseje M, Chalmers I, Fretheim A, Ding Y, Sewankambo NK. Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects, 1-year follow-up: a cluster-randomised trial. Trials 2020; 21:27. [PMID: 31907013 PMCID: PMC6945419 DOI: 10.1186/s13063-019-3960-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/04/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION We evaluated an intervention designed to teach 10- to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report outcomes measured 1 year after the intervention. METHODS In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year 5 children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books and a teachers' guide). The primary outcomes, measured at the end of the school term and again after 1 year, were the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. RESULTS We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n = 60 schools; 76 teachers and 6383 children) or the control group (n = 60 schools; 67 teachers and 4430 children). After 1 year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared with 53.0% for the control schools (adjusted mean difference 16.7%; 95% CI, 13.9 to 19.5; P < 0.00001). In the intervention schools, 3160 (80.1%) of 3943 children who completed the test after 1 year achieved a predetermined passing score (≥ 13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference, 39.5%; 95% CI, 29.9 to 47.5). CONCLUSION Use of the learning resources led to a large improvement in the ability of children to assess claims, which was sustained for at least 1 year. TRIAL REGISTRATION Pan African Clinical Trial Registry (www.pactr.org), PACTR201606001679337. Registered on 13 June 2016.
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Affiliation(s)
- Allen Nsangi
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Daniel Semakula
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Andrew D. Oxman
- University of Oslo, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Astrid Austvoll-Dahlgren
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | | | - Claire Glenton
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Simon Lewin
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Margaret Kaseje
- Tropical Institute of Community Health & Development, Kisumu, Kenya
| | | | - Atle Fretheim
- University of Oslo, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Yunpeng Ding
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
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Trethewey SP. Strategies to combat medical misinformation on social media. Postgrad Med J 2019; 96:4-6. [PMID: 31732511 DOI: 10.1136/postgradmedj-2019-137201] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/03/2019] [Indexed: 01/14/2023]
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Nordheim LV, Pettersen KS, Espehaug B, Flottorp SA, Guttersrud Ø. Lower secondary school students' scientific literacy and their proficiency in identifying and appraising health claims in news media: a secondary analysis using large-scale survey data. BMJ Open 2019; 9:e028781. [PMID: 31630100 PMCID: PMC6803159 DOI: 10.1136/bmjopen-2018-028781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Scientific literacy is assumed necessary for appraising the reliability of health claims. Using a national science achievement test, we explored whether students located at the lower quartile on the latent trait (scientific literacy) scale were likely to identify a health claim in a fictitious brief news report, and whether students located at or above the upper quartile were likely to additionally request information relevant for appraising that claim. DESIGN Secondary analysis of cross-sectional survey data. SETTING AND PARTICIPANTS 2229 Norwegian 10th grade students (50% females) from 97 randomly sampled lower secondary schools who performed the test during April-May 2013. OUTCOME MEASURES Using Rasch modelling, we linked item difficulty and student proficiency in science to locate the proficiencies associated with different percentiles on the latent trait scale. Estimates of students' proficiency, the difficulty of identifying the claim and the difficulty of making at least one request for information to appraise that claim, were reported in logits. RESULTS Students who reached the lower quartile (located at -0.5 logits) on the scale were not likely to identify the health claim as their proficiency was below the difficulty estimate of that task (0.0 logits). Students who reached the upper quartile (located at 1.4 logits) were likely to identify the health claim but barely proficient at making one request for information (task difficulty located at 1.5 logits). Even those who performed at or above the 90th percentile typically made only one request for information, predominantly methodological aspects. CONCLUSIONS When interpreting the skill to request relevant information as expressing students' proficiency in critical appraisal of health claims, we found that only students with very high proficiency in science possessed that skill. There is a need for teachers, healthcare professionals and researchers to collaborate to create learning resources for developing these lifelong learning skills.
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Affiliation(s)
- Lena Victoria Nordheim
- Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway
- Faculty of Medicine and Dentistry, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Birgitte Espehaug
- Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway
| | - Signe Agnes Flottorp
- Norwegian Institute of Public Health, Oslo, Norway
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Øystein Guttersrud
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Mathematics and Natural Sciences, Norwegian Centre for Science Education, University of Oslo, Oslo, Norway
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Aujla N, Yates T, Dallosso H, Kai J. Users' experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study. BMJ Open 2019; 9:e028491. [PMID: 31377701 PMCID: PMC6687001 DOI: 10.1136/bmjopen-2018-028491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To explore service-user and provider experience of the acceptability and value of the Let's Prevent Diabetes programme, a pragmatic 6-hour behavioural intervention using structured group education, introduced into primary care practice. DESIGN Qualitative interview-based study with thematic analysis. SETTING Primary care and community. PARTICIPANTS Purposeful sample of 32 participants, including 22 people at high risk of diabetes who either attended, defaulted from or declined the intervention; and 10 stakeholder professionals involved in implementation. RESULTS Participants had low prior awareness of their elevated risk and were often surprised to be offered intervention. Attenders were commonly older, white, retired and motivated to promote their health; who found their session helpful, particularly for social interaction, raising dietary awareness, and convenience of community location. However attenders highlighted lack of depth, repetition within and length of session, difficulty meeting culturally diverse needs and no follow-up as negative features. Those who defaulted from, or who declined the intervention were notably apprehensive, uncertain or unconvinced about whether they were at risk of diabetes; sought more specific information about the intervention, and were deterred by its group nature and day-long duration, with competing work or family commitments. Local providers recognised inadequate communication of diabetes risk to patients. They highlighted significant challenges for implementation, including resource constraints, and facilitation at individual general practice or locality level. CONCLUSIONS This pragmatic diabetes prevention intervention was acceptable in practice, particularly for older, white, retired and health-motivated people. However, pre-intervention information and communication of diabetes risk should be improved to increase engagement and reduce potential fear or uncertainty, with closer integration of services, and more appropriate care pathways, to facilitate uptake and follow-up. Further development of this, or other interventions, is needed to enable wider, and more socially diverse, engagement of people at risk. Balancing a locality and individual practice approach, and how this is resourced are considerations for long-term sustainability.
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Affiliation(s)
- Navneet Aujla
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Thomas Yates
- Diabetes Reseach Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Helen Dallosso
- University Hospitals of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Joe Kai
- Division of Primary Care, University of Nottingham, Nottingham, UK
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Van Ancum JM, Meskers CGM, Reijnierse EM, Yeung SSY, Jonkman NH, Trappenburg MC, Pijnappels M, Maier AB. Lack of Knowledge Contrasts the Willingness to Counteract Sarcopenia Among Community-Dwelling Adults. J Aging Health 2019; 32:787-794. [DOI: 10.1177/0898264319852840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: Sarcopenia is highly prevalent in older adults. Knowledge among community-dwelling adults is important for effective prevention and treatment of sarcopenia. This study aims to assess current knowledge about sarcopenia, investigate willingness for treatment and prevention, and awareness of muscle health. Method: Participants who attended health educational events completed a questionnaire on knowledge about sarcopenia. Self-perceived muscle health was assessed by visual analog scale. Objective muscle measures included muscle mass, handgrip strength, and gait speed. Results: Included participants were 197 (median aged 67.9 years [interquartile range = 57.0-75.1]). Eighteen participants (9%) reported to know what sarcopenia is. Participants’ self-perceived muscle health showed a low correlation with all objective muscle measures. 76% were willing, in case of sarcopenia diagnosis, to start treatment and 71% were willing to prevent sarcopenia. Discussion: Knowledge about sarcopenia is limited while participants were willing to start treatment and prevention. Strategies to increase knowledge among community-dwelling adults are needed.
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Affiliation(s)
- Jeanine M. Van Ancum
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Carel G. M. Meskers
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esmee M. Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Suey S. Y. Yeung
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nini H. Jonkman
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marijke C. Trappenburg
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Andrea B. Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
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