1
|
von Ash T, Dunsiger SI, Williams DM, Larsen BA, Bohlen LC, Pekmezi D, Mendoza-Vasconez AS, Benitez TJ, Bock BC, Hartman SJ, Marquez B, Marcus BH. Pasos Hacia La Salud II: A Superiority RCT Utilizing Technology to Promote Physical Activity in Latinas. Am J Prev Med 2024; 67:220-230. [PMID: 38490284 DOI: 10.1016/j.amepre.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION Latinas face an increased risk for chronic diseases associated with insufficient physical activity (PA). The researchers previously showed that a website-based intervention could increase PA among insufficiently active Latinas, yet rates of meeting national PA guidelines were low. The original intervention was enhanced by adding additional features, content, and points of contact, including via text messaging. This study tests the efficacy of the enhanced intervention compared with the original, aimed at maximizing and sustaining PA gains across 24 months. It also examines if increases in PA differed by baseline PA. STUDY DESIGN The researchers conducted a superiority randomized controlled trial (data collected 2018-2022, analyzed 2023). SETTING/PARTICIPANTS Participants were 195 Spanish-speaking Latinas ages 18-65 in the Providence, RI area. INTERVENTION The original intervention is an empirically supported Spanish-language, individually-tailored, website-delivered PA intervention. The enhanced intervention includes text messaging and additional data-driven content and interactive features. MAIN OUTCOME MEASURES Total weekly minutes of moderate to vigorous PA (MVPA) was measured via accelerometry and self-report at 6, 12, 18, and 24 months. RESULTS Participants in both groups increased their MVPA over 24 months. There were no significant between-group differences at 6 or 12 months; at 18 months the enhanced intervention group had higher levels of self-reported (mean (sd): 90.35 (43.55) vs 70.18 [9.99]) and accelerometer-measured (66.21 [18.26] vs 60.27 [16.00]) MVPA compared to the original intervention group. They also had higher levels of self-reported (111.17 [23.35] vs 81.44 [1.82]) and accelerometer-measured (63.76 [15.12] vs 54.86 [14.59]) MVPA at 24 months. Baseline PA moderated the intervention effect. CONCLUSIONS This study demonstrates the potential to enhance the efficacy of website-based PA interventions by utilizing text messaging, and adding more interactive features, content, and phone support. These enhancements may be particularly beneficial in supporting long-term PA maintenance. TRIAL REGISTRATION This study is registered at www. CLINICALTRIAL gov (NCT03491592).
Collapse
Affiliation(s)
- Tayla von Ash
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island.
| | - Shira I Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - David M Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Britta A Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Lauren Connell Bohlen
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Dori Pekmezi
- Department of Health Behavior, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama
| | - Andrea S Mendoza-Vasconez
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Tanya J Benitez
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Beth C Bock
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Becky Marquez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| |
Collapse
|
2
|
Beauchemin J, Krueger D, Yates T, Ding X. Effects of a Brief, Solution-Focused, Digital Intervention on Social Wellness Among College Students: A Pilot Study. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:349-362. [PMID: 37982300 DOI: 10.1080/26408066.2023.2284918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
PURPOSE Current trends among college students include compromised mental health and wellness which have been exacerbated due to COVID-19. This pilot study examined the effectiveness of a brief, digital intervention focused on social wellness among college students on wellness-related outcomes including perceived wellness, life satisfaction, and happiness. MATERIALS AND METHODS A longitudinal, explanatory mixed-methods design was utilized. Quantitative data were collected from a total of 133 participants using questionnaires at baseline and one-week post-intervention. RM-ANOVA and post-hoc pairwise comparisons were employed to assess quantitative data. Qualitative data collection was obtained via semi-structured interviews at six weeks post-intervention and evaluated using Applied Thematic Analysis. A sub-sample (n = 23) from the participant pool (N = 133) completed the interviews. RESULTS Results indicated intervention effectiveness as participants experienced significant positive change in perceived wellness, the primary outcome variable. Significant relationships were detected between wellness outcomes and goal attainment (e.g. I am confident in my ability to complete my goals) items. Qualitative analysis revealed themes related to accessibility and convenience of the intervention, increased self-awareness, and increased intentionality of participants. DISCUSSION This study demonstrates the utility of a brief, digital intervention on wellness-related outcomes. Benefits were shown of a preventative, self-directed and solution-focused approach in enhancing wellness among college students. CONCLUSION From a social work perspective, employing a salutogenic approach to support college students' wellbeing aligns with the field's core values. Specifically, this social wellness-focused intervention encourages self-determination, dignity and worth of the person, and emphasizes the importance of human relationships.
Collapse
Affiliation(s)
| | - Danya Krueger
- School of Social Work, University of North Carolina, Chapel Hill, North Corolina, US
| | - Taylor Yates
- School of Social Work, University of North Carolina, Wilmington, North Corolina, US
| | - Xiao Ding
- School of Social Work, University of Texas, Austin, Texas, US
| |
Collapse
|
3
|
Staguhn ED, Kirkhart T, Allen L, Campbell CM, Wegener ST, Castillo RC. Predictors of participation in online self-management programs: A longitudinal observational study. Rehabil Psychol 2024; 69:102-109. [PMID: 37956087 PMCID: PMC11059776 DOI: 10.1037/rep0000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE/OBJECTIVE Lack of patient participation and engagement remains a barrier to implementing effective online self-management and behavioral health interventions. Identifying patient characteristics associated with engagement rates may lead to interventions that improve engagement in traditional and online self-management programs. In this study, two online self-management and recovery programs were evaluated to identify factors that predict patient engagement. RESEARCH METHOD/DESIGN Predictors were collected in a questionnaire at baseline before 435 participants started either of the two interventions. One or two online lessons were completed per week with seven or eight total lessons to complete in each program, and each lesson took about 20-30 min to finish. Full patient engagement was defined as completing all lessons and assessments in the program and partial engagement as attempting at least one lesson or assessment. RESULTS Predictors of full patient engagement were self-rated confidence in completing the program or being over 60 years of age. Predictors of at least partial patient engagement were experienced ordering online or being over 50 years of age. CONCLUSIONS/IMPLICATIONS Identifying profiles of individuals who predict poor engagement may improve implementation and the health outcomes of intervention programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
Affiliation(s)
- Elena D. Staguhn
- Department of Health Policy and Management, Johns Hopkins
Bloomberg School of Public Health
- Physical Medicine and Rehabilitation, Johns Hopkins
Medicine
| | - Tricia Kirkhart
- Physical Medicine and Rehabilitation, Johns Hopkins
Medicine
| | - Lauren Allen
- Department of Health Policy and Management, Johns Hopkins
Bloomberg School of Public Health
| | | | | | - Renan C. Castillo
- Department of Health Policy and Management, Johns Hopkins
Bloomberg School of Public Health
| |
Collapse
|
4
|
Brame J, Kohl J, Centner C, Wurst R, Fuchs R, Tinsel I, Maiwald P, Fichtner UA, Sehlbrede M, Farin-Glattacker E, Gollhofer A, König D. Effects of a Web-Based Lifestyle Intervention on Physical Fitness and Health in Physically Inactive Adults: A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:2847. [PMID: 37957992 PMCID: PMC10649962 DOI: 10.3390/healthcare11212847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Web-based lifestyle interventions are a new area of health research. This randomized controlled trial evaluated the effectiveness of an interactive web-based health program on physical fitness and health. N = 189 healthy adults participated in a 12-week interactive (intervention) or non-interactive (control) web-based health program. The intervention provided a web-based lifestyle intervention to promote physical activity and fitness through individualized activities as part of a fully automated, multimodal health program. The control intervention included health information. Cardiorespiratory fitness measured as maximum oxygen uptake (VO2max) was the primary outcome, while musculoskeletal fitness, physical activity and dietary behavior, and physiological health outcomes were assessed as secondary outcomes (t0: 0 months, t1: 3 months, t2: 9 months, t3: 15 months). Statistical analysis was performed with robust linear mixed models. There were significant time effects in the primary outcome (VO2max) (t0-t1: p = 0.018) and individual secondary outcomes for the interactive web-based health program, but no significant interaction effects in any of the outcomes between the interactive and non-interactive web-based health program. This study did not demonstrate the effectiveness of an interactive compared with a non-interactive web-based health program in physically inactive adults. Future research should further develop the evidence on web-based lifestyle interventions.
Collapse
Affiliation(s)
- Judith Brame
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.B.)
| | - Jan Kohl
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.B.)
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.B.)
- Praxisklinik Rennbahn, 4132 Muttenz, Switzerland
| | - Ramona Wurst
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.B.)
| | - Reinhard Fuchs
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.B.)
| | - Iris Tinsel
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center–University of Freiburg, 79106 Freiburg, Germany
| | - Phillip Maiwald
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center–University of Freiburg, 79106 Freiburg, Germany
| | - Urs A. Fichtner
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center–University of Freiburg, 79106 Freiburg, Germany
| | - Matthias Sehlbrede
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center–University of Freiburg, 79106 Freiburg, Germany
| | - Erik Farin-Glattacker
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center–University of Freiburg, 79106 Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.B.)
| | - Daniel König
- Centre for Sport Science and University Sports, Department of Sport Science, Division for Nutrition, Exercise and Health, University of Vienna, 1150 Vienna, Austria
- Faculty of Life Sciences, Department of Nutritional Sciences, Division for Nutrition, Exercise and Health, University of Vienna, 1090 Vienna, Austria
| |
Collapse
|
5
|
Martin-Payo R, Leirós-Díaz C, Armes J, Fu MR, Cachero-Rodríguez J, del Mar Fernandez-Alvarez M. The "Breast-4Y" web app for breast cancer prevention at young age: Development, evaluation, and validation. Internet Interv 2023; 33:100651. [PMID: 37555074 PMCID: PMC10404991 DOI: 10.1016/j.invent.2023.100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Improving knowledge of risk factors, signs and symptoms positively influence an individual's intention to acquire healthy lifestyle behaviors to prevent breast cancer, to identify breast cancer risk early and seek health advice early. The aim of the present study was to develop and to assess the usability and quality of a web-app (Breast-4Y) designed specifically for younger women to improve their knowledge about breast cancer risk factors and symptoms as well as protective behaviors to reduce their risk. METHODS The development of the Breast-4Y web-app, based on Health Belief Model and the Behaviour Change Wheel, comprised four steps: i) analysis of scientific literature regarding breast cancer risk factors, symptoms and preventive lifestyle behaviors; ii) design of web-app; iii) content review by experts; iv) quality and usability assessment by the end-users (n = 20). Web-app usability was evaluated using the Spanish version of the System Usability Scale for the Assessment of Electronic Tools and the quality using the Spanish version of uMARS. RESULTS The contents were rated 4.25 or above, indicating high content quality. The mean usability score was 84.9 (SD 12.4), the mean rating for objective quality and subjective quality dimensions mean were 4.2 (SD 0.4) and 3.4 (0.777) respectively, indicating excellent usability and quality. Positive associations (p < .05) were observed between numbers of app used and attitudes to change (r = 0.479), and intention to change (r = 0.539). Strong positive associations (p < .001) were also observed between usability satisfaction and attitudes to change (r = 0.584), intention to change (r = 0.656), and help-seeking (r = 0.656). CONCLUSIONS This study provided evidence that Breast-4Y has adequate contents, high quality, and usability. Breast-4Y can be tested in pragmatic trials to assess their effectiveness to reduce the risk of breast cancer, raise women's awareness of breast cancer risk factors, increase women's knowledge of breast cancer symptoms, and adopt protective lifestyle behaviors.
Collapse
Affiliation(s)
- Ruben Martin-Payo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - Claudia Leirós-Díaz
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Spain
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, United Kingdom
| | - Mei Rosemary Fu
- The Dorothy and Dale Thompson School of Nursing, University of Missouri-Kansas, United States of America
| | - Judit Cachero-Rodríguez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - María del Mar Fernandez-Alvarez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| |
Collapse
|
6
|
DeBolt CL, Rheuban KS, Harris D. Telehealth Services: Improving Equity in Pulmonary Health Outcomes. Clin Chest Med 2023; 44:651-660. [PMID: 37517842 DOI: 10.1016/j.ccm.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Expansion of telehealth services has the potential to attenuate health inequities in pulmonary medicine, by improving access to care and health outcomes in patients with lung disease. These telehealth services include remote patient monitoring, synchronous telemedicine, and remote pulmonary rehabilitation. Currently, patients who are White, well-educated, wealthy, and from urban areas are the most likely to benefit from telehealth services. Without clear policy decisions and planning to overcome the "Digital Divide," telehealth services will only exacerbate existing disparities within the pulmonary disease. We describe the benefits and limitations of these new technologies and their impact on improving equity in pulmonary medicine.
Collapse
Affiliation(s)
| | - Karen S Rheuban
- Department of Pediatrics, University of Virginia, Center for Telehealth, Charlottesville, VA, USA
| | - Drew Harris
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
7
|
Monnet F, Dupont C, Smets T, De Vleminck A, Van Audenhove C, Van den Block L, Pivodic L. Advance Care Planning Website for People With Dementia and Their Family Caregivers: Protocol for a Development and Usability Study. JMIR Res Protoc 2023; 12:e46935. [PMID: 37494084 PMCID: PMC10413243 DOI: 10.2196/46935] [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: 03/02/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Web-based tools for people with dementia and their family caregivers have considerably increased over the years and offer promising solutions to several unmet needs such as supporting self-care in daily life, facilitating treatment delivery, or ensuring their ability to communicate. The use of web-based tools in the field of advance care planning (ACP) for people with dementia and their family caregivers has yet to be explored and requires careful consideration, given the sensitive topic and the specific needs of people with dementia and their families. OBJECTIVE This paper reports the protocol for a study aiming to develop and simultaneously test the usability of an ACP website designed for, and with, people with dementia and their families. METHODS The development of the website is based on a process map for the development of web-based decision support interventions and on the Medical Research Council framework for complex intervention development and evaluation. Additionally, we apply a user-centered approach in combination with patient and public involvement (PPI) throughout the development process. We describe our iterative development approach to the website. Participants and a PPI group give feedback on 4 prototypes of the ACP website. For each iteration, we aim to include 12 participants (3 people with dementia, 3 family caregivers, and 3 dyads) in usability testing. In the first 3 iterations, usability testing includes (1) a think-aloud exercise, (2) researcher observations, and (3) the System Usability Scale questionnaire. The last iteration of usability testing is composed of a semistructured interview assessing the layout, content, face validity, and readability of the website. Qualitative data from the think-aloud exercises and interviews are analyzed using thematic analysis. Mean scores are calculated for the System Usability Scale questionnaire. RESULTS This study received approval from the Ethical Review Board of Brussels University Hospital of the Vrije Universiteit Brussel. Recruitment began in October 2021. The target date for paper submission of the results of the development and usability testing will be in 2023. CONCLUSIONS The methods in this protocol describe a feasible and inclusive approach to the development of an ACP website together with people with dementia, their family caregivers, and other stakeholders. We provide a clear overview of how to combine PPI input and user-centered development methods, leading to a transparent and reliable development process. This protocol might stimulate the active participation of people with dementia, their caregivers, and regional stakeholders in future studies on web-based technologies. The results of this study will be used to refine the design and create a relevant and user-friendly ACP website that is ready to be tested in a larger evaluation study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46935.
Collapse
Affiliation(s)
- Fanny Monnet
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Charlèss Dupont
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tinne Smets
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Aline De Vleminck
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lara Pivodic
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
8
|
Kohl J, Brame J, Centner C, Wurst R, Fuchs R, Sehlbrede M, Tinsel I, Maiwald P, Fichtner UA, Armbruster C, Farin-Glattacker E, Gollhofer A, König D. Effects of a Web-Based Lifestyle Intervention on Weight Loss and Cardiometabolic Risk Factors in Adults With Overweight and Obesity: Randomized Controlled Clinical Trial. J Med Internet Res 2023; 25:e43426. [PMID: 37368484 DOI: 10.2196/43426] [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: 10/12/2022] [Revised: 03/17/2023] [Accepted: 04/20/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The high proportion of people with overweight and obesity has become a worldwide problem in recent decades, mainly due to health consequences, such as cardiovascular diseases, neoplasia, and type 2 diabetes mellitus. Regarding effective countermeasures, the digitization of health services offers numerous potentials, which, however, have not yet been sufficiently evaluated. Web-based health programs are becoming increasingly interactive and can provide individuals with effective long-term weight management support. OBJECTIVE The purpose of this randomized controlled clinical trial was to evaluate the effectiveness of an interactive web-based weight loss program on anthropometric, cardiometabolic, and behavioral variables and to compare it with a noninteractive web-based weight loss program. METHODS The randomized controlled trial included people who were aged between 18 and 65 years (mean 48.92, SD 11.17 years) and had a BMI of 27.5 to 34.9 kg/m2 (mean 30.71, SD 2.13 kg/m2). Participants (n=153) were assigned to either (1) an interactive and fully automated web-based health program (intervention) or (2) a noninteractive web-based health program (control). The intervention program focused on dietary energy density and allowed for dietary documentation with appropriate feedback on energy density and nutrients. The control group only received information on weight loss and energy density, but the website did not contain interactive content. Examinations were performed at baseline (t0), at the end of the 12-week intervention (t1), and at 6 months (t2) and 12 months (t3) thereafter. The primary outcome was body weight. The secondary outcomes were cardiometabolic variables as well as dietary and physical activity behaviors. Robust linear mixed models were used to evaluate the primary and secondary outcomes. RESULTS The intervention group showed significant improvements in anthropometric variables, such as body weight (P=.004), waist circumference (P=.002), and fat mass (P=.02), compared with the control group over the course of the study. The mean weight loss after the 12-month follow-up was 4.18 kg (4.7%) in the intervention group versus 1.29 kg (1.5%) in the control group compared with the initial weight. The results of the nutritional analysis showed that the energy density concept was significantly better implemented in the intervention group. Significant differences in cardiometabolic variables were not detected between the 2 groups. CONCLUSIONS The interactive web-based health program was effective in reducing body weight and improving body composition in adults with overweight and obesity. However, these improvements were not associated with relevant changes in cardiometabolic variables, although it should be noted that the study population was predominantly metabolically healthy. TRIAL REGISTRATION German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.3390/ijerph19031393.
Collapse
Affiliation(s)
- Jan Kohl
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Judith Brame
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Ramona Wurst
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Reinhard Fuchs
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Matthias Sehlbrede
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Iris Tinsel
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Phillip Maiwald
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Urs Alexander Fichtner
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Armbruster
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Daniel König
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
- Department of Sport Science, Institute for Nutrition, Exercise and Health, University of Vienna, Vienna, Austria
- Department of Nutritional Sciences, Institute for Nutrition, Exercise and Health, University of Vienna, Vienna, Austria
| |
Collapse
|
9
|
Keawtep P, Kamnardsiri T, Boripuntakul S, Wichayanrat W, Worakul P, Sungkarat S. Feasibility of Internet-Based Physical-Cognitive Exercise for Health Benefits of Middle-Aged Obese Women. J Prim Care Community Health 2023; 14:21501319231189961. [PMID: 37522590 PMCID: PMC10392207 DOI: 10.1177/21501319231189961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Obesity in middle-aged women markedly increases the risk for non-communicable diseases, neurodegenerative diseases, and physical and cognitive problems. Exercise, particularly combined physical-cognitive exercise, has been demonstrated to have beneficial effects on both physical and cognitive health. However, middle-aged women often face barriers to engaging in exercise, which include time constraints, lack of motivation, and enjoyment. Incorporating an exercise program into a technology-based intervention in the home environment may help overcome these barriers and promote health benefits. Therefore, this study aimed to assess the feasibility of home-based, physical-cognitive internet-based exercise for middle-aged obese women. METHODS A total of 33 middle-aged obese women were enrolled in the study. Participants performed an intervention for 60 min/day, 3 days/week for 3 months. Feasibility outcomes (adherence, adverse events, physical performances, obesity parameters, and enjoyment of the program) were measured. RESULTS Average exercise adherence was 91.67%, and no adverse events were reported in this feasibility study. At the end of the training period, body weight and BMI were significantly decreased compared to baseline. As for physical performances, both cardiorespiratory fitness and lower limb muscle power were significantly improved at post-training when compared to baseline. Furthermore, the participants experienced a high level of exercise enjoyment, and it was maintained over the 3-month training period. CONCLUSION These findings suggest that home-based, internet-based physical-cognitive exercise was safe and feasible for reducing obesity parameters, improving physical function, maintaining enjoyment over the course of training, and facilitating adherence to exercise in middle-aged obese women.
Collapse
|
10
|
Kohl J, Brame J, Hauff P, Wurst R, Sehlbrede M, Fichtner UA, Armbruster C, Tinsel I, Maiwald P, Farin-Glattacker E, Fuchs R, Gollhofer A, König D. Effects of a Web-Based Weight Loss Program on the Healthy Eating Index-NVS in Adults with Overweight or Obesity and the Association with Dietary, Anthropometric and Cardiometabolic Variables: A Randomized Controlled Clinical Trial. Nutrients 2022; 15:7. [PMID: 36615666 PMCID: PMC9823428 DOI: 10.3390/nu15010007] [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: 11/28/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
This randomized, controlled clinical trial examined the impact of a web-based weight loss intervention on diet quality. Furthermore, it was investigated whether corresponding changes in diet quality were associated with changes in measures of cardiovascular risk profile. Individuals with a body mass index (BMI) of 27.5 to 34.9 kg/m2 and an age of 18 to 65 y were assigned to either an interactive and fully automated web-based weight loss program focusing on dietary energy density (intervention) or a non-interactive web-based weight loss program (control). Examinations were performed at baseline (t0), after the 12-week web-based intervention (t1), and after an additional 6 (t2) and 12 months (t3). Based on a dietary record, the Healthy Eating Index-NVS (HEI-NVS) was calculated and analyzed using a robust linear mixed model. In addition, bootstrapped correlations were performed independently of study group to examine associations between change in HEI-NVS and change in dietary, anthropometric, and cardiometabolic variables. A total of n = 153 participants with a mean BMI of 30.71 kg/m2 (SD 2.13) and an average age of 48.92 y (SD 11.17) were included in the study. HEI-NVS improved significantly in the intervention group from baseline (t0) to t2 (p = 0.003) and to t3 (p = 0.037), whereby the course was significantly different up to t2 (p = 0.013) and not significantly different up to t3 (p = 0.054) compared to the control group. Independent of study group, there was a significant negative association between change in HEI-NVS and dietary energy density. A higher total score in HEI-NVS did not correlate with improvements in cardiovascular risk profile. The interactive and fully automated web-based weight loss program improved diet quality. Independent of study group, changes in HEI-NVS correlated with changes in energy density, but there was no association between improvements in HEI-NVS and improvements in cardiovascular risk profile.
Collapse
Affiliation(s)
- Jan Kohl
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Judith Brame
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Pascal Hauff
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Ramona Wurst
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Matthias Sehlbrede
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Urs Alexander Fichtner
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Christoph Armbruster
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Iris Tinsel
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Phillip Maiwald
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research (SEVERA), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Reinhard Fuchs
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Daniel König
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
- Department of Sport Science, Institute for Nutrition, Exercise and Health, University of Vienna, 1150 Vienna, Austria
- Department of Nutritional Sciences, Institute for Nutrition, Exercise and Health, University of Vienna, 1090 Vienna, Austria
| |
Collapse
|
11
|
Tang Y, Gierc M, Lam RW, Liu S, Faulkner G. The Effectiveness of Internet-Guided Self-help Interventions to Promote Physical Activity Among Individuals With Depression: Systematic Review. JMIR Ment Health 2022; 9:e38049. [PMID: 36508243 PMCID: PMC9793299 DOI: 10.2196/38049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/01/2022] [Accepted: 11/13/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Depression is a prevalent and debilitating mental disorder and a leading cause of disability worldwide. Physical activity (PA) interventions have been shown to alleviate depressive symptoms. However, not all patients have access to PA programing tailored for depression. Internet-guided self-help (IGSH) interventions may be an effective option for increasing PA among people with depression who cannot or prefer not to access supervised exercise treatment. OBJECTIVE We aimed to evaluate the effectiveness of IGSH interventions in increasing PA and alleviating depressive symptoms in people with depression. METHODS A systematic literature search was conducted for randomized controlled trials and quasiexperimental studies using 9 electronic databases. The review was registered in PROSPERO (2020 CRD42020221713). RESULTS A total of 4 randomized controlled trials (430 participants) met the inclusion criteria. Of these, 3 were web-based and 1 was app-based. Three studies found IGSH interventions to have medium to large effects on decreasing depressive symptoms but not on increasing PA compared with waitlist or usual care. One study showed increased self-reported PA but no significant difference in depressive symptoms in the intervention group compared with the control group. Goal setting was the most common behavior change technique used in the interventions. Dropout rates within the intervention groups were relatively low (0%-19%). CONCLUSIONS Our findings suggested that IGSH PA interventions are feasible and have the potential to reduce depressive symptoms in people with depression. More well-designed and tailored interventions with different combinations of behavior change techniques, particularly those targeting the emotion domain, are needed to assess the overall effectiveness and feasibility of using IGSH interventions to increase PA among people with depression. TRIAL REGISTRATION PROSPERO CRD42020221713; https://tinyurl.com/ysaua5bu.
Collapse
Affiliation(s)
- Yiling Tang
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Madelaine Gierc
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Sam Liu
- School of Exercise Science, Physical & Health Education, University of Victoria, Vancouver, BC, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
12
|
Development and Evaluation of a Mobile Web-based Food Allergy and Anaphylaxis Management Educational Program for Parents of School-aged Children with Food Allergy: A Randomized Controlled Trial. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:265-274. [PMID: 36334689 DOI: 10.1016/j.anr.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
Abstract
PURPOSE This study aimed to develop a mobile web-based food allergy (FA) and anaphylaxis management educational program for parents of school-aged children with food allergies and evaluate its effectiveness. METHODS A mobile program was developed based on a web-based teaching-learning system model. Its effectiveness was subsequently evaluated using a parallel, randomized controlled pre- and post-test design. This study included 73 parents of school-aged children with food allergies. These parents were randomly assigned to either the experimental (n = 37) or control (n = 36) groups. The experimental group participated in a 2-week mobile web-based educational program that covered major topics in FA and anaphylaxis management. These topics included an understanding of food allergies and anaphylaxis, learning techniques for using an epinephrine auto-injector, and developing an emergency action plan. An educational booklet was provided to the control group. Participants completed a pre-test and two post-test questionnaires to evaluate the impact of the program. The assessment tools were the Food Allergy Knowledge Test, Food Allergy Self-Efficacy for Parents, and Food Management and Adaptation Scale. The data were analyzed using descriptive statistics, a test of homogeneity for the pre-test, an independent t-test, and repeated measures ANOVA. RESULTS The experimental group experienced greater improvement in the knowledge of FA (post-intervention t = 14.51, p < .001; 2 weeks post-intervention, t = 16.15, p < .001), FA self-efficacy (post-intervention t = 77.99, p < .001; 2 weeks post-intervention, t = 76.09, p < .001), and practice behavior in FA management (post-intervention t = 28.10, p < .001; 2 weeks post-intervention, t = 27.98, p < .001) after web-based FA education. CONCLUSION This study revealed improvements in the knowledge, self-efficacy, and practice behaviors of parents regarding FA and anaphylaxis management. Therefore, the mobile web-based educational program can contribute to the effective management of food allergies and anaphylaxis for parents of school-aged children. CRIS registration: KCT0007491.
Collapse
|
13
|
Soto-Ruiz N, Escalada-Hernández P, Martín-Rodríguez LS, Ferraz-Torres M, García-Vivar C. Web-Based Personalized Intervention to Improve Quality of Life and Self-Efficacy of Long-Term Breast Cancer Survivors: Study Protocol for a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12240. [PMID: 36231542 PMCID: PMC9564785 DOI: 10.3390/ijerph191912240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Long-term breast cancer survivors (>5 years free of disease) may suffer late sequelae of cancer that impact on their quality of life. The use of telehealth for cancer care is recommended but little is known about the effectiveness of digital interventions for long-term cancer survivors. This study aims to evaluate the effectiveness of a web-based personalized intervention based on artificial intelligence instead of usual primary health care to improve the quality of life of long-term survivors of breast cancer and self-efficacy for the management of late sequelae. A randomized controlled trial will be conducted. The sample will consist of long-term breast cancer survivors recruited from primary health centers. Women will be randomly assigned to the intervention group to receive a web-based personalized intervention or to the control group to receive standard primary health care by nurses. Data on quality of life of cancer survivors and self-efficacy for the management of late sequelae of cancer will be collected and assessed at preintervention, and at 3, 6, and 9 months. It is expected that, at the end of the programme, the experimental group will have improved quality of life and improved self-efficacy for the management of late sequelae of cancer.
Collapse
Affiliation(s)
- Nelia Soto-Ruiz
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Paula Escalada-Hernández
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Leticia San Martín-Rodríguez
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Marta Ferraz-Torres
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Cristina García-Vivar
- Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| |
Collapse
|
14
|
Hohberg V, Fuchs R, Gerber M, Künzler D, Paganini S, Faude O. Blended Care Interventions to Promote Physical Activity: A Systematic Review of Randomized Controlled Trials. SPORTS MEDICINE - OPEN 2022; 8:100. [PMID: 35907158 PMCID: PMC9339043 DOI: 10.1186/s40798-022-00489-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 07/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Blended care interventions combine therapeutic guidance with digital care. Current research results show the promising role of the blended care approach in clinical care. This new way of delivering health care could have the potential to effectively promote physical activity in different public health settings. OBJECTIVE The aim of the systematic review is to investigate the varieties of intervention characteristics of blended care interventions to promote physical activity in terms of structure, behavior change goals, behavior change techniques, and effectiveness of blended care interventions compared to a control group. METHODS We searched for randomized controlled trials published from 2000 to March 2021 in MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycINFO, and Web of Science according to the PRISMA guidelines. Risk of bias was assessed using the Cochrane Collaboration tool. Study characteristics, intervention characteristics, and outcome data were extracted. Furthermore, the effect size on the outcome of physical activity was examined or calculated. RESULTS In total, the number of reports identified from the database searches was 4828. Of these, 25 studies were included in the review, with a total of 5923 study participants. Results indicated that the characteristics of blended care interventions showed a high heterogeneity. The combinations of therapist-guided interventions and digital interventions allowed the identification of specific subgroups, but they varied in length (range 8-52 weeks, SD 16.6), intensity, and the combination of the components. The most used combination of blended care interventions to promote physical activity was the combination of one-on-one meetings via telephone and Web-based interventions. Motivational models of behavior change were used most frequently as underlying theoretical foundations. Certain behavior change techniques were used consistently across the individual components, e.g., "problem solving" in the therapist-guided component and "feedback on behavior" in the digital component. Considering the effect size of blended care interventions compared with control groups, most studies showed a small effect. CONCLUSIONS It can be concluded that blended care interventions have potential to promote physical activity. In the future, further high-quality studies should investigate which type of blended care intervention is effective for which target group. Additionally, insights are required on which intervention characteristics are most effective, taking into account new evidence on behavior change. Registration This systematic literature review was registered in PROSPERO ( CRD42020188556 ).
Collapse
Affiliation(s)
- Vivien Hohberg
- Department of Sports, Exercise and Health, University of Basel, Basel, Switzerland
| | - Reinhard Fuchs
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Markus Gerber
- Department of Sports, Exercise and Health, University of Basel, Basel, Switzerland
| | - David Künzler
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Sarah Paganini
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Oliver Faude
- Department of Sports, Exercise and Health, University of Basel, Basel, Switzerland
| |
Collapse
|
15
|
de Sousa D, Fogel A, Azevedo J, Padrão P. The Effectiveness of Web-Based Interventions to Promote Health Behaviour Change in Adolescents: A Systematic Review. Nutrients 2022; 14:nu14061258. [PMID: 35334915 PMCID: PMC8954163 DOI: 10.3390/nu14061258] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Although web-based interventions are attractive to researchers and users, the evidence about their effectiveness in the promotion of health behaviour change is still limited. Our aim was to review the effectiveness of web-based interventions used in health behavioural change in adolescents regarding physical activity, eating habits, tobacco and alcohol use, sexual behaviour, and quality of sleep. Studies published from 2016 till the search was run (May-to-June 2021) were included if they were experimental or quasi-experimental studies, pre-post-test studies, clinical trials, or randomized controlled trials evaluating the effectiveness of web-based intervention in promoting behaviour change in adolescents regarding those health behaviours. The risk of bias assessment was performed by using the Effective Public Health Practice Project (EPHPP)-Quality Assessment Tool for Quantitative Studies. Fourteen studies were included. Most were in a school setting, non-probabilistic and relatively small samples. All had a short length of follow-up and were theory driven. Thirteen showed significant positive findings to support web-based interventions' effectiveness in promoting health behaviour change among adolescents but were classified as low evidence quality. Although this review shows that web-based interventions may contribute to health behaviour change among adolescents, these findings rely on low-quality evidence, so it is urgent to test these interventions in larger controlled trials with long-term maintenance.
Collapse
Affiliation(s)
- Daniela de Sousa
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - Adriana Fogel
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - José Azevedo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Faculdade de Letras, Universidade do Porto, 4150-564 Porto, Portugal
| | - Patrícia Padrão
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- Correspondence: ; Tel.: +351-22-5074320
| |
Collapse
|
16
|
Yadav M, Neate S, Hassed C, Chambers R, Connaughton S, Nag N. Mining the Gems of a Web-Based Mindfulness Intervention: Qualitative Analysis of Factors Aiding Completion and Implementation (Preprint). JMIR Form Res 2022; 6:e37406. [PMID: 36197709 PMCID: PMC9582916 DOI: 10.2196/37406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 07/21/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Digital health interventions provide a cost effective and accessible means for positive behavior change. However, high participant attrition is common and facilitators for implementation of behaviors are not well understood. Objective The goal of the research was to identify elements of a digital mindfulness course that aided in course completion and implementation of teachings. Methods Inductive thematic analysis was used to assess participant comments regarding positive aspects of the online mindfulness course Mindfulness for Well-being and Peak Performance. Participants were aged 18 years and older who had self-selected to register and voluntarily completed at least 90% the course. The course comprised educator-guided lessons and discussion forums for participant reflection and feedback. Participant comments from the final discussion forum were analyzed to identify common themes pertaining to elements of the course that aided in course completion and implementation of teachings. Results Of 3355 course completers, 283 participants provided comments related to the research question. Key themes were (1) benefits from the virtual community, (2) appeal of content, (3) enablers to participation and implementation, and (4) benefits noted in oneself. Of subthemes identified, some, such as community support, variety of easily implementable content, and free content access, align with that reported previously in the literature, while other subthemes, including growing together, repeating the course, evidence-based teaching, and immediate benefits on physical and mental well-being, were novel findings. Conclusions Themes identified as key elements for aiding participant completion of a mindfulness digital health intervention and the implementation of teachings may inform the effective design of future digital health interventions to drive positive health behaviors. Future research should focus on understanding motivations for participation, identification of effective methods for participant retention, and behavior change techniques to motivate long-term adherence to healthy behaviors.
Collapse
Affiliation(s)
- Muskan Yadav
- Department of General Practice, Monash University, Melbourne, Australia
| | - Sandra Neate
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Craig Hassed
- Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, Australia
| | - Richard Chambers
- Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, Australia
| | - Sherelle Connaughton
- Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, Australia
| | - Nupur Nag
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
17
|
Redesign of a brief PTSD treatment in safety net integrated primary care: Supporting implementation in the context of the COVID-19 pandemic. Gen Hosp Psychiatry 2022; 74:94-101. [PMID: 34924217 PMCID: PMC8662839 DOI: 10.1016/j.genhosppsych.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/23/2021] [Accepted: 12/07/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We conducted a formative evaluation to understand the impact of the COVID-19 pandemic on the safety net integrated primary care setting and to identify (and respond to) new implementation barriers prior to a hybrid type I effectiveness-implementation trial of a posttraumatic stress disorder (PTSD) treatment. METHOD We used surveys and qualitative interviews with employee stakeholders (N = 27) to (1) understand pandemic-related factors that may influence implementation, including changes in patient needs, provider experiences, and the practice, and (2) assess the need for augmentation to study design, implementation plan, or intervention. RESULTS Conventional content analysis and survey findings suggest that patient acuity and volume increased provider burden, leading to high burnout. Although the shift to telehealth improved behavioral health access, issues with technology access and literacy were common. Changes to the study design and implementation plan, based on findings, included the provision of multi-modality treatments (in person, telehealth, web-administered), technology and administrative support, and other strategies for reducing provider burnout. CONCLUSIONS This study describes how an ongoing research study adapted to major changes to the implementation setting during the pandemic. Changes to study design and implementation plan were responsive to the shift to telehealth and therapist burden (and burnout) concerns.
Collapse
|
18
|
Bovbjerg K, Graves K, Waltz M, Farrell D, Yanez B, Chicaiza A, Omar R, Thompson R, Kop M, Van Denburg AN, Lorch D, Rowley SD, Rini C. Expanding access to cancer peer support: development of a website to deliver written peer support that meets patients' individual emotional and informational needs while reducing potential harms. PROCEDIA COMPUTER SCIENCE 2022; 206:195-205. [PMID: 36567868 PMCID: PMC9788802 DOI: 10.1016/j.procs.2022.09.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Cancer patients often want information from "peers" with the same diagnosis or treatment. To increase access to this valuable resource, we developed a website to deliver written peer support to cancer patients undergoing stem cell transplant. Because little evidence describes how to optimize benefits or reduce potential harms of written peer support, we gathered multiple forms of stakeholder feedback to inform the website's ethical approach, personalization, design, function, and content: a Community Advisory Board; a longitudinal study of patients' written peer support needs and motivations; focus groups; semi-structured interviews; and usability testing. Findings provide a rich foundation for website development.
Collapse
Affiliation(s)
- Katrin Bovbjerg
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Kristi Graves
- Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, 2115 Wisconsin Ave N, Ste. 300, Washington, DC 20007 USA
| | - Margaret Waltz
- University of North Carolina School of Medicine, Department of Social Medicine, 333 S Columbia St, Chapel Hill, NC 27516 USA
| | - David Farrell
- People Designs, Inc., 1304 Broad Street, Durham, NC 27705 USA
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, 675 N St Clair St. Floor 21, Suite 100, Chicago, IL 60611 USA
| | - Anthony Chicaiza
- Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, 2115 Wisconsin Ave N, Ste. 300, Washington, DC 20007 USA
| | - Rahma Omar
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Rebecca Thompson
- John Theurer Cancer Center at Hackensack University Medical Center, 92 2nd Street, Hackensack, NJ 07601 USA
| | - Mariska Kop
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA,John Theurer Cancer Center at Hackensack University Medical Center, 92 2nd Street, Hackensack, NJ 07601 USA
| | - Alyssa N. Van Denburg
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Danielle Lorch
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA
| | - Scott D. Rowley
- Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, 2115 Wisconsin Ave N, Ste. 300, Washington, DC 20007 USA,John Theurer Cancer Center at Hackensack University Medical Center, 92 2nd Street, Hackensack, NJ 07601 USA
| | - Christine Rini
- Northwestern University Feinberg School of Medicine, Dept of Medical Social Sciences, 625 N. Michigan Ave, 21-00, Chicago, IL, 60611 USA,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, 675 N St Clair St. Floor 21, Suite 100, Chicago, IL 60611 USA,Corresponding author
| |
Collapse
|
19
|
Tzelepis F, Mitchell A, Wilson L, Byrnes E, Haschek A, Leigh L, Oldmeadow C. The Long-Term Effectiveness of Internet-Based Interventions on Multiple Health Risk Behaviors: Systematic Review and Robust Variance Estimation Meta-analysis. J Med Internet Res 2021; 23:e23513. [PMID: 34931990 PMCID: PMC8734928 DOI: 10.2196/23513] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/09/2020] [Accepted: 11/22/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Smoking tobacco, poor nutrition, risky alcohol use, and physical inactivity (SNAP) behaviors tend to cluster together. Health benefits may be maximized if interventions targeted multiple health risk behaviors together rather than addressing single behaviors. The internet has wide reach and is a sustainable mode for delivery of interventions for multiple health behaviors. However, no systematic reviews have examined the long-term effectiveness of internet-based interventions on any combination of or all SNAP behaviors in adults aged 18 years or older. OBJECTIVE This systematic review examined, among adults (aged ≥18 years), the effectiveness of internet-based interventions on SNAP behaviors collectively in the long term compared with a control condition. METHODS The electronic databases Medline, PsycINFO, Embase, CINAHL, and Scopus were searched to retrieve studies describing the effectiveness of internet-based interventions on ≥2 SNAP behaviors published by November 18, 2019. The reference lists of retrieved articles were also checked to identify eligible publications. The inclusion criteria were randomized controlled trials or cluster randomized controlled trials with adults examining an internet-based intervention measuring the effect on ≥2 SNAP behaviors at least 6 months postrecruitment and published in English in a peer-reviewed journal. Two reviewers independently extracted data from included studies and assessed methodological quality using the Quality Assessment Tool for Quantitative Studies. A robust variance estimation meta-analysis was performed to examine the long-term effectiveness of internet-based interventions on all 4 SNAP risk behavior outcomes. All SNAP outcomes were coded so they were in the same direction, with higher scores equating to worse health risk behaviors. RESULTS The inclusion criteria were met by 11 studies: 7 studies measured the effect of an internet-based intervention on nutrition and physical activity; 1 study measured the effect on smoking, nutrition, and physical activity; and 3 studies measured the effect on all SNAP behaviors. Compared with the control group, internet-based interventions achieved an overall significant improvement across all SNAP behaviors in the long term (standardized mean difference -0.12 [improvement as higher scores = worse health risk outcomes], 95% CI -0.19 to -0.05; I2=1.5%, P=.01). The global methodological quality rating was "moderate" for 1 study, while the remaining 10 studies were rated as "weak." CONCLUSIONS Internet-based interventions were found to produce an overall significant improvement across all SNAP behaviors collectively in the long term. Internet-based interventions targeting multiple SNAP behaviors have the potential to maximize long-term improvements to preventive health outcomes.
Collapse
Affiliation(s)
- Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Aimee Mitchell
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
| | - Louise Wilson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Alexandra Haschek
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- The Cooperative Research Centre for Living with Autism, Brisbane, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | | |
Collapse
|
20
|
Calvache-Mateo A, López-López L, Heredia-Ciuró A, Martín-Núñez J, Rodríguez-Torres J, Ortiz-Rubio A, Valenza MC. Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312692. [PMID: 34886418 PMCID: PMC8657261 DOI: 10.3390/ijerph182312692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 01/16/2023]
Abstract
Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = −1.26, 95% CI = −1.65, −0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.
Collapse
|
21
|
Consumer preferences for the use of an innovative digital menu solution in public food service settings in four European countries. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
22
|
Kvillemo P, Hiltunen L, Demetry Y, Carlander AK, Hansson T, Gripenberg J, Elgán TH, Einhorn K, Skoglund C. How to prevent alcohol and illicit drug use among students in affluent areas: a qualitative study on motivation and attitudes towards prevention. Subst Abuse Treat Prev Policy 2021; 16:83. [PMID: 34743737 PMCID: PMC8573923 DOI: 10.1186/s13011-021-00420-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of alcohol and illicit drugs during adolescence can lead to serious short- and long-term health related consequences. Despite a global trend of decreased substance use, in particular alcohol, among adolescents, evidence suggests excessive use of substances by young people in socioeconomically affluent areas. To prevent substance use-related harm, we need in-depth knowledge about the reasons for substance use in this group and how they perceive various prevention interventions. The aim of the current study was to explore motives for using or abstaining from using substances among students in affluent areas as well as their attitudes to, and suggestions for, substance use prevention. METHODS Twenty high school students (age 15-19 years) in a Swedish affluent municipality were recruited through purposive sampling to take part in semi-structured interviews. Qualitative content analysis of transcribed interviews was performed. RESULTS The most prominent motive for substance use appears to be a desire to feel a part of the social milieu and to have high social status within the peer group. Motives for abstaining included academic ambitions, activities requiring sobriety and parental influence. Students reported universal information-based prevention to be irrelevant and hesitation to use selective prevention interventions due to fear of being reported to authorities. Suggested universal prevention concerned reliable information from credible sources, stricter substance control measures for those providing substances, parental involvement, and social leisure activities without substance use. Suggested selective prevention included guaranteed confidentiality and non-judging encounters when seeking help. CONCLUSIONS Future research on substance use prevention targeting students in affluent areas should take into account the social milieu and with advantage pay attention to students' suggestions on credible prevention information, stricter control measures for substance providers, parental involvement, substance-free leisure, and confidential ways to seek help with a non-judging approach from adults.
Collapse
Affiliation(s)
- Pia Kvillemo
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden.
| | - Linda Hiltunen
- Department of Social Studies, Linnaeus university, Växjö, Sweden
| | - Youstina Demetry
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Liljeholmstorget 7, 117 63, Stockholm, Sweden
| | | | - Tim Hansson
- Psychiatry North West, Region Stockholm, Sollentunavägen 84, SE-191 22, Sollentuna, Sweden
| | - Johanna Gripenberg
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden
| | - Tobias H Elgán
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden
| | - Kim Einhorn
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Charlotte Skoglund
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| |
Collapse
|
23
|
Naccache B, Mesquida L, Raynaud JP, Revet A. Smartphone application for adolescents with anorexia nervosa: an initial acceptability and user experience evaluation. BMC Psychiatry 2021; 21:467. [PMID: 34563166 PMCID: PMC8466747 DOI: 10.1186/s12888-021-03478-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Anorexia Nervosa (AN) is a key target for E-Health programs considering the many barriers hindering patients' access to care and the disorder's severity. Although these programs have become more common and effective, they often have low adherence, especially among youth. This can hinder their implementation and effectiveness in real-world settings. User experience partly overlaps with the acceptability field and may provide insight into factors affecting adherence and adoption of E-Health programs. This study aimed to explore early acceptability and user experience of a companion app prototype for adolescents with AN using user-centered design methods. METHODS We developed a prototype containing self-help material and emotions and behaviors evaluation and management features. Then we conducted a mixed evaluation combining semi structured focus group interviews and questionnaires in a clinician group and an AN patient group. We analyzed data using thematic analysis and descriptive statistics. RESULTS The app's overall appeal was adequate. The user experience questionnaire revealed the weakest dimensions, including novelty, dependability, and efficiency versus stimulation (i.e., ability to induce motivation to use the product) and perspicuity (i.e., easy to understand, to get familiar with). The qualitative data analysis revealed three central axes: acceptability, features, and use. We identified acceptability barriers and facilitators such as the importance of design and customization, especially for adolescents. Psychoeducation was a major feature for participants, as patients highlighted the difficulties they encountered when seeking disorders-related information. CONCLUSIONS This study shows the importance of including users in the different stages of an e-health intervention development, in order to identify their needs, general use and compliance patterns, to improve adherence and adoption of the program and its effectiveness.
Collapse
Affiliation(s)
- Benjamin Naccache
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059, Toulouse cedex 9, France.
| | - Laure Mesquida
- grid.414282.90000 0004 0639 4960Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - Jean-Philippe Raynaud
- grid.414282.90000 0004 0639 4960Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France ,grid.15781.3a0000 0001 0723 035XCERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Alexis Revet
- grid.414282.90000 0004 0639 4960Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France ,grid.15781.3a0000 0001 0723 035XCERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France ,grid.411175.70000 0001 1457 2980CIC 1436, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS », Toulouse University Hospital, Toulouse, France
| |
Collapse
|
24
|
Ezran M, Trude ACB, Hepworth AD, Black MM. Parent Website Engagement and Health Equity Implications in a Child Care-Based Wellness Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:654-662. [PMID: 33947627 PMCID: PMC8355035 DOI: 10.1016/j.jneb.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/28/2021] [Accepted: 03/07/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate demographic differences in parent website engagement in a child care-based wellness intervention. DESIGN Parent-reported demographic characteristics and observed website engagement were averaged by child care centers participating in the web-based intervention arm of a cluster randomized controlled trial of wellness interventions. SETTING AND PARTICIPANTS Parents of preschoolers in 17 Maryland child care centers. MAIN OUTCOME MEASURES Website engagement: (1) webpage views, (2) average time on webpage, and (3) intervention activity completion. INTERVENTION Parents received access to a website containing content on wellness-promoting topics (eg, parenting, nutrition, physical activity) and their child care center's activities. ANALYSIS Cross-sectional differences in website engagement by demographic characteristics were assessed using ANOVA. RESULTS Centers with a high proportion of parents who identified as other than non-Hispanic White and had less than a bachelor's degree had significantly fewer webpage views, and completed significantly fewer intervention activities compared with centers with parents who were predominantly non-Hispanic White and had more than a bachelor's degree. CONCLUSIONS AND IMPLICATIONS Demographic differences in parents' child care center website engagement represent disparities that could contribute to health inequities in parents' access to wellness-promoting material. Future efforts could identify factors that eliminate demographic disparities in parent engagement in web-based interventions.
Collapse
Affiliation(s)
- Marie Ezran
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Angela C B Trude
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Allison D Hepworth
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD; RTI International, Research Triangle Park, NC.
| |
Collapse
|
25
|
van der Hout A, van Uden-Kraan C, Holtmaat K, Jansen F, Lissenberg-Witte B, Nieuwenhuijzen G, Hardillo J, Baatenburg de Jong R, Tiren-Verbeet N, Sommeijer D, de Heer K, Schaar C, Sedee R, Bosscha K, van den Brekel M, Petersen J, Westerman M, Honings J, Takes R, Houtenbos I, van den Broek W, de Bree R, Jansen P, Eerenstein S, Leemans C, Zijlstra J, Cuijpers P, van de Poll-Franse L, Verdonck-de Leeuw I. Reasons for not reaching or using web-based self-management applications, and the use and evaluation of Oncokompas among cancer survivors, in the context of a randomised controlled trial. Internet Interv 2021; 25:100429. [PMID: 34401388 PMCID: PMC8350584 DOI: 10.1016/j.invent.2021.100429] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/22/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The web-based self-management application Oncokompas was developed to support cancer survivors to monitor health-related quality of life and symptoms (Measure) and to provide tailored information (Learn) and supportive care options (Act). In a previously reported randomised controlled trial (RCT), 68% of 655 recruited survivors were eligible, and of those 45% participated in the RCT. Among participants of the RCT that were randomised to the intervention group, 52% used Oncokompas as intended. The aim of this study was to explore reasons for not participating in the RCT, and reasons for not using Oncokompas among non-users, and the use and evaluation of Oncokompas among users. METHODS Reasons for not participating were assessed with a study-specific questionnaire among 243 survivors who declined participation. Usage was investigated among 320 participants randomised to the intervention group of the RCT via system data and a study-specific questionnaire that was assessed during the 1 week follow-up (T1) assessment. RESULTS Main reasons for not participating were not interested in participation in scientific research (40%) and not interested in scientific research and Oncokompas (28%). Main reasons for not being interested in Oncokompas were wanting to leave the period of being ill behind (29%), no symptom burden (23%), or lacking internet skills (18%). Out of the 320 participants in the intervention group 167 (52%) used Oncokompas as intended. Among 72 non-users, main reasons for not using Oncokompas were no symptom burden (32%) or lack of time (26%). Among 248 survivors that activated their account, satisfaction and user-friendliness were rated with a 7 (scale 0-10). Within 3 (IQR 1-4) sessions, users selected 32 (IQR 6-37) topics. Main reasons for not using healthcare options in Act were that the information in Learn was already sufficient (44%) or no supportive care needs (32%). DISCUSSION Main reasons for not reaching or using Oncokompas were no symptom burden, no supportive care needs, or lack of time. Users selected many cancer-generic and tumour-specific topics to address, indicating added value of the wide range of available topics.
Collapse
Affiliation(s)
- A. van der Hout
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
| | - C.F. van Uden-Kraan
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
| | - K. Holtmaat
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
| | - F. Jansen
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
| | - B.I. Lissenberg-Witte
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
| | | | - J.A. Hardillo
- Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Centre, Erasmus Medical Center, Rotterdam, the Netherlands
| | - R.J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Centre, Erasmus Medical Center, Rotterdam, the Netherlands
| | - N.L. Tiren-Verbeet
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - D.W. Sommeijer
- Department of Internal Medicine, Flevoziekenhuis, Almere, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands
| | - K. de Heer
- Department of Internal Medicine, Flevoziekenhuis, Almere, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, the Netherlands
| | - C.G. Schaar
- Department of Internal Medicine, Gelre ziekenhuis, Apeldoorn, the Netherlands
| | - R.J.E. Sedee
- Department of Otolaryngology, Head and Neck Surgery, Haaglanden MC, The Hague, the Netherlands
| | - K. Bosscha
- Department of Surgery, Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands
| | - M.W.M. van den Brekel
- Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - J.F. Petersen
- Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - M. Westerman
- Department of Hematology, Northwest Clinics, Alkmaar, the Netherlands
| | - J. Honings
- Department of Otorhinolaryngology – Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - R.P. Takes
- Department of Otorhinolaryngology – Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - I. Houtenbos
- Department of Hematology, Spaarne Gasthuis, Hoofddorp, the Netherlands
| | | | - R. de Bree
- Department of Head and Neck Surgical Oncology, Utrecht University Medical Center, Utrecht, the Netherlands
| | - P. Jansen
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - S.E.J. Eerenstein
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
| | - C.R. Leemans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
| | - J.M. Zijlstra
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Amsterdam, the Netherlands
| | - P. Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - L.V. van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation, Eindhoven, the Netherlands
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, the Netherlands
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - I.M. Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
- Corresponding author at: Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
| |
Collapse
|
26
|
Mifsud A, Pehlivan MJ, Fam P, O’Grady M, van Steensel A, Elder E, Gilchrist J, Sherman KA. Feasibility and pilot study of a brief self-compassion intervention addressing body image distress in breast cancer survivors. Health Psychol Behav Med 2021; 9:498-526. [PMID: 34104572 PMCID: PMC8158280 DOI: 10.1080/21642850.2021.1929236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/09/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The majority of breast cancer survivors (BCSs) experience body image concerns following treatment. Body Image distress (BID) is associated with psychological distress and diminished quality of life. A web-based self-compassion focused writing activity (My Changed Body - MyCB) reduces BID in BCSs, yet limited research exists on participant characteristics associated with such intervention adherence. Self-compassion-based meditations are also efficacious in reducing BID in non-BCS populations. This parallel, double-blind pilot randomised controlled trial aimed to assess the feasibility and acceptability of MyCB, with and without an additional meditation component, on BID and related psychological outcomes in BCSs. The trial was registered with the Australian and New Zealand Clinical Trials Registry (#ACTRN12619001693112). METHODS BCSs were randomly allocated to MyCB (n = 39), MyCB + Meditation (MyCB + M) (n = 17) or an expressive writing (EW) active control arm (n = 23). The primary outcome was BID. Secondary outcomes were body appreciation, affect (positive and negative), psychological distress (depression, anxiety and stress) and self-compassion (state and trait). Assessments were completed online at baseline, post-intervention and 1-month. RESULTS Adherence to the MyCB writing (45%) and meditation (50%) was modest, and acceptability was high for both MyCB and MyCB + M. Intent to treat linear mixed model analyses indicated: Post-intervention - state self-compassion and positive affect increased for MyCB compared to EW; 1-month: BID scores decreased across all conditions; trait self-compassion increased and anxiety decreased for MyCB + M compared to MyCB and EW. CONCLUSION These findings provide preliminary evidence for the efficacy and potential clinical use of the MyCB brief web-based self-compassion intervention alone and with the addition of meditation, to increase self-compassion and psychological wellbeing in BCSs.
Collapse
Affiliation(s)
- Angela Mifsud
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Melissa J. Pehlivan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Paul Fam
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Maddison O’Grady
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Annamiek van Steensel
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Elisabeth Elder
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | | | - Kerry A. Sherman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| |
Collapse
|
27
|
Lal S, Siafa L, Lee H, Adair CE. Priority Given to Technology in Government-Based Mental Health and Addictions Vision and Strategy Documents: Systematic Policy Review. J Med Internet Res 2021; 23:e25547. [PMID: 33949955 PMCID: PMC8135019 DOI: 10.2196/25547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/01/2021] [Accepted: 04/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background The use of information and communication technologies (ICTs) to deliver mental health and addictions (MHA) services is a global priority, especially considering the urgent shift towards virtual delivery of care in response to the COVID-19 pandemic. It is important to monitor the evolving role of technology in MHA services. Given that MHA policy documents represent the highest level of priorities for a government’s vision and strategy for mental health care, one starting point is to measure the frequency with which technology is mentioned and the terms used to describe its use in MHA policy documents (before, during, and after COVID-19). Yet, to our knowledge, no such review of the extent to which ICTs are referred to in Canadian MHA policy documents exists to date. Objective The objective of this systematic policy review was to examine the extent to which technology is addressed in Canadian government–based MHA policy documents prior to the COVID-19 pandemic to establish a baseline for documenting change. Methods We reviewed 22 government-based MHA policy documents, published between 2011 and 2019 by 13 Canadian provinces and territories. We conducted content analysis to synthesize the policy priorities addressed in these documents into key themes, and then systematically searched for and tabulated the use of 39 technology-related keywords (in English and French) to describe and compare jurisdictions. Results Technology was addressed in every document, however, to a varying degree. Of the 39 searched keywords, we identified 22 categories of keywords pertaining to the use of technology to deliver MHA services and information. The 6 most common categories were tele (n=16/22), phone (n=12/22), tech (n=11/22), online (n=10/22), line (n=10/22), and web (n=10/22), with n being the number of policy documents in which the category was mentioned out of 22 documents. The use of terms referring to advanced technologies, such as virtual (n=6/22) and app (n= 4/22), were less frequent. Additionally, policy documents from some provinces and territories (eg, Alberta and Newfoundland and Labrador) mentioned a diverse range of ICTs, whereas others described only 1 form of ICT. Conclusions This review indicates that technology has been given limited strategic attention in Canadian MHA policy. Policy makers may have limited knowledge on the evidence and potential of using technology in this field, highlighting the value for knowledge translation and collaborative initiatives among policy makers and researchers. The development of a pan-Canadian framework for action addressing the integration and coordination of technology in mental health services can also guide initiatives in this field. Our findings provide a prepandemic baseline and replicable methods to monitor how the use of technology-supported services and innovations emerge relative to other priorities in MHA policy during and after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Shalini Lal
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.,Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada.,Prevention and Early Intervention Program for Psychosis and ACCESS Open Minds, Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Lyna Siafa
- Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada.,Department of Medicine, McGill University, Montréal, QC, Canada
| | - Hajin Lee
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.,Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada
| | - Carol E Adair
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
28
|
Diestelkamp S, Schulz AL, Thomasius R. [Technology-based interventions for alcohol prevention among children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:714-721. [PMID: 33950365 PMCID: PMC8187222 DOI: 10.1007/s00103-021-03338-5] [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: 12/02/2020] [Accepted: 04/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early onset and excessive alcohol use in childhood and adolescence is associated with an elevated risk of experiencing short-, mid-, and long-term negative consequences caused by, e.g., accidents, violent acts, and conflicts. Face-to-face prevention approaches show significant effects on the reduction of alcohol use. However, service utilization is often low among children and adolescents. Technology-based alcohol prevention has the potential to reach this target group with potentially cost-effective, standardized, and low-threshold measures. AIM AND METHOD This narrative review provides an overview of different approaches of technology-based interventions for the prevention and early intervention of risky alcohol use among children and adolescents, their effectiveness, and settings for implementation. RESULTS Technology-based alcohol prevention can be implemented in a variety of settings, e.g., school, community, primary care, or hospital. Implementation is often realized via websites with or without embedding face-to-face modules, apps, or SMS messages. While the cumulative evidence of the effectiveness of technology-based alcohol prevention is strong for adults and young adults, evidence for the effectiveness among children and adolescents is heterogeneous. DISCUSSION Technology-based alcohol prevention has great theoretical potential with regards to reach, cost-effectiveness, and user engagement. Study replications are needed and evaluations of the effects of single elements, such as the individualization of content, user engagement through multiple contacts, and the use of multimedia elements and functions, should be addressed by future research.
Collapse
Affiliation(s)
- Silke Diestelkamp
- DZSKJ - Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Anna-Lena Schulz
- DZSKJ - Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Rainer Thomasius
- DZSKJ - Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| |
Collapse
|
29
|
Turnbull S, Lucas PJ, Hay AD, Cabral C. The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study. BMC Public Health 2021; 21:293. [PMID: 33546661 PMCID: PMC7863320 DOI: 10.1186/s12889-021-10325-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 01/25/2021] [Indexed: 11/23/2022] Open
Abstract
Background Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity. Study aims To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups. Methods A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically. Results A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender. Conclusion This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10325-7.
Collapse
Affiliation(s)
- Sophie Turnbull
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Patricia J Lucas
- School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Alastair D Hay
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Christie Cabral
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| |
Collapse
|
30
|
Vrijsen J, Abu-Hanna A, Maeckelberghe EL, De Deyn PP, de Winter AF, Reesink FE, Oude Voshaar RC, Buskens E, de Rooij SE, Smidt N. Uptake and effectiveness of a tailor-made online lifestyle programme targeting modifiable risk factors for dementia among middle-aged descendants of people with recently diagnosed dementia: study protocol of a cluster randomised controlled trial (Demin study). BMJ Open 2020; 10:e039439. [PMID: 33067294 PMCID: PMC7569992 DOI: 10.1136/bmjopen-2020-039439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Descendants of patients with dementia have a higher risk to develop dementia. This study aims to investigate the uptake and effectiveness of an online tailor-made lifestyle programme for dementia risk reduction (DRR) among middle-aged descendants of people with recently diagnosed late-onset dementia. METHODS AND ANALYSIS Demin is a cluster randomised controlled trial, aiming to include 21 memory clinics of which 13 will be randomly allocated to the passive (poster and flyer in a waiting room) and 8 to the active recruitment strategy (additional personal invitation by members of the team of the memory clinic). We aim to recruit 378 participants (40-60 years) with a parent who is recently diagnosed with Alzheimer's disease or vascular dementia at one of the participating memory clinics. All participants receive a dementia risk assessment (online questionnaire, physical examination and blood sample) and subsequently an online tailor-made lifestyle advice regarding protective (Mediterranean diet, low/moderate alcohol consumption and high cognitive activity) and risk factors (physical inactivity, smoking, loneliness, cardiovascular diseases (CVD), hypertension, high cholesterol, diabetes, obesity, renal dysfunction and depression) for dementia. The primary outcome is the difference in uptake between the two recruitment strategies. Secondary outcomes are change(s) in (1) the Lifestyle for Brain Health score, (2) individual health behaviours, (3) health beliefs and attitudes towards DRR and (4) compliance to the tailor-made lifestyle advice. Outcomes will be measured at 3, 6, 9 and 12 months after baseline. The effectiveness of this online tailor-made lifestyle programme will be evaluated by comparing Demin participants to a matched control group (lifelines cohort). ETHICS AND DISSEMINATION This study has been approved by the Dutch Ministry of Health, Welfare and Sport according to the Population Screening Act. All participants have to give online informed consent using SMS-tan (transaction authentication number delivered via text message). Findings will be disseminated through peer-reviewed journals and (inter)national conferences. TRIAL REGISTRATION NUMBER NTR7434.
Collapse
Affiliation(s)
- Joyce Vrijsen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ameen Abu-Hanna
- Department of Medical Informatics, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Els Lm Maeckelberghe
- Wenckebach Institute for Training and Education, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Peter Paul De Deyn
- Department of Neurology and Alzheimer Centre Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Andrea F de Winter
- Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Fransje E Reesink
- Department of Neurology and Alzheimer Centre Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sophia E de Rooij
- Medical School Twente, Medical Spectrum Twente, Enschede, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|
31
|
Day W, Shaw R. When benefit eligibility and patient-led care intersect. Living in the UK with chronic illness: Experiences of the work capability assessment. J Health Psychol 2020; 27:456-469. [PMID: 32859136 PMCID: PMC8793312 DOI: 10.1177/1359105320953476] [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] [Indexed: 11/16/2022] Open
Abstract
Individuals living with chronic physical health conditions are more likely to be out-of-work than other groups. Often framed as a 'response' to these statistics, many countries have introduced policy instruments for promoting the employment of individuals with chronic conditions. This qualitative study sought to explore the impact of welfare reforms on UK individuals. Employing a phenomenological approach, semi-structured interviews were conducted with five participants living with chronic conditions. Three themes were generated using Interpretative Phenomenological Analysis: 'intersubjective sense making of the condition'; 'battles for control' and 'the fluidity and strengthening of identity'. Implications for further, holistic, policy reform are explored.
Collapse
Affiliation(s)
- William Day
- Aston University, Birmingham, West Midlands, UK
| | - Rachel Shaw
- Aston University, Birmingham, West Midlands, UK
| |
Collapse
|
32
|
Coster S, Li Y, Norman IJ. Cochrane reviews of educational and self-management interventions to guide nursing practice: A review. Int J Nurs Stud 2020; 110:103698. [PMID: 32726709 DOI: 10.1016/j.ijnurstu.2020.103698] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The burden of chronic disease on healthcare services worldwide continues to grow, and the increased development of educational interventions which help patients to better manage their own condition is evident internationally. OBJECTIVES This paper reports on findings of an updated review of Cochrane systematic reviews of interventions designed to improve patients' knowledge and skills to manage chronic disease, with particular reference to nursing contribution and practice. METHODS A broad search strategy was used to search the Cochrane Database of Systematic Reviews to identify reviews of patient education, self-management, and self-care studies. Two reviewers independently assessed eligibility for inclusion and extracted data from the reviews. FINDINGS From a total of 882 reviews, 63 met the inclusion criteria, and 900 studies were identified. Most (68%, n = 43) of the 63 reviews were judged by Cochrane reviewers to provide inadequate evidence of the effectiveness of the interventions reviewed. Information on the profession of the person delivering the intervention was often not available, although 78% (n = 49) of reviews mentioned that nurses were involved in a proportion of studies delivering interventions either independently or as part of a multi-professional team. CONCLUSION Educational programmes have definite benefits for patients suffering from asthma, chronic obstructive pulmonary disorder and stroke, and are promising in areas such as diabetes, epilepsy, cancer care, and mental health. However, it still is not clear what the active ingredients of many successful interventions are. Further research is needed to establish the impact of technology on programme delivery, and to develop programmes tailored for patients with multiple health problems.
Collapse
Affiliation(s)
- Samantha Coster
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
| | - Yan Li
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Ian James Norman
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| |
Collapse
|
33
|
Furness K, Sarkies MN, Huggins CE, Croagh D, Haines TP. Impact of the Method of Delivering Electronic Health Behavior Change Interventions in Survivors of Cancer on Engagement, Health Behaviors, and Health Outcomes: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e16112. [PMID: 32574147 PMCID: PMC7381039 DOI: 10.2196/16112] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/19/2019] [Accepted: 04/09/2020] [Indexed: 12/14/2022] Open
Abstract
Background Increased accessibility to the internet and mobile devices has seen a rapid expansion in electronic health (eHealth) behavior change interventions delivered to patients with cancer and survivors using synchronous, asynchronous, and combined delivery methods. Characterizing effective delivery methods of eHealth interventions is required to enable improved design and implementation of evidence-based health behavior change interventions. Objective This study aims to systematically review the literature and synthesize evidence on the success of eHealth behavior change interventions in patients with cancer and survivors delivered by synchronous, asynchronous, or combined methods compared with a control group. Engagement with the intervention, behavior change, and health outcomes, including quality of life, fatigue, depression, and anxiety, were examined. Methods A search of Scopus, Ovid MEDLINE, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature Plus, PsycINFO, Cochrane CENTRAL, and PubMed was conducted for studies published between March 2007 and March 2019. We looked for randomized controlled trials (RCTs) examining interventions delivered to adult cancer survivors via eHealth methods with a measure of health behavior change. Random-effects meta-analysis was performed to examine whether the method of eHealth delivery impacted the level of engagement, behavior change, and health outcomes. Results A total of 24 RCTs were included predominantly examining dietary and physical activity behavior change interventions. There were 11 studies that used a synchronous approach and 11 studies that used an asynchronous approach, whereas 2 studies used a combined delivery method. Use of eHealth interventions improved exercise behavior (standardized mean difference [SMD] 0.34, 95% CI 0.21-0.48), diet behavior (SMD 0.44, 95% CI 0.18-0.70), fatigue (SMD 0.21, 95% CI −0.08 to 0.50; SMD change 0.22, 95% CI 0.09-0.35), anxiety (SMD 1.21, 95% CI: 0.36-2.07; SMD change 0.15, 95% CI −0.09 to 0.40), depression (SMD 0.15, 95% CI 0.00-0.30), and quality of life (SMD 0.12, 95% CI −0.10 to 0.34; SMD change 0.14, 95% CI 0.04-0.24). The mode of delivery did not influence the amount of dietary and physical activity behavior change observed. Conclusions Physical activity and dietary behavior change eHealth interventions delivered to patients with cancer or survivors have a small to moderate impact on behavior change and a small to very small benefit to quality of life, fatigue, depression, and anxiety. There is insufficient evidence to determine whether asynchronous or synchronous delivery modes yield superior results. Three-arm RCTs comparing delivery modes with a control with robust engagement reporting are required to determine the most successful delivery method for promoting behavior change and ultimately favorable health outcomes.
Collapse
Affiliation(s)
- Kate Furness
- Nutrition and Dietetics, Monash Medical Centre, Monash Health, Melbourne, Australia.,School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Mitchell N Sarkies
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia.,Centre for Healthcare Resilience and Implementation Science Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Catherine E Huggins
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Daniel Croagh
- Upper Gastrointestinal and Hepatobiliary Surgery, Monash Medical Centre, Monash Health, Melbourne, Australia.,Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Terry P Haines
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| |
Collapse
|
34
|
Yamada J, Ballantyne M, Kron AT, Sidani S. Parents' Perceptions of the Acceptability of Evidence-Based Interventions to Support Transition From Neonatal to Rehabilitation Services. Can J Nurs Res 2020; 53:292-302. [PMID: 32522114 DOI: 10.1177/0844562120931661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Parents of children born preterm with a disability often experience profound psychological distress with transition from neonatal to rehabilitation services. Four interventions were found effective to support parents throughout this critical transition period whereby parental stress can threaten the child's development. PURPOSE To examine parents' perceptions of the acceptability of four evidence-based interventions to support their transition. METHODS A quantitative design using survey methods was employed with 24 parents with experience in transition to rehabilitation services. Each participant rated the acceptability of the interventions using the Treatment Perception and Preference scale. Descriptive statistics and repeated measures analysis of variance were used for data analysis. RESULTS Mean overall acceptability scores differed across the four interventions (p = .042); the difference was of moderate size (η2 = .11). Parents perceived psychoeducation and narrative therapy as most acceptable, followed by website consultation with healthcare providers and parent support program, then parent self-help program. CONCLUSIONS Psychoeducation and narrative therapy should be accessible to parents experiencing transition from neonatal to rehabilitation services.
Collapse
Affiliation(s)
- Janet Yamada
- Daphne Cockwell School of Nursing-Ryerson University, Toronto, ON, Canada
| | - Marilyn Ballantyne
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing-University of Toronto, Toronto, ON, Canada
| | - Amie T Kron
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Souraya Sidani
- Daphne Cockwell School of Nursing-Ryerson University, Toronto, ON, Canada
| |
Collapse
|
35
|
Turnbull S, Cabral C, Hay A, Lucas PJ. Health Equity in the Effectiveness of Web-Based Health Interventions for the Self-Care of People With Chronic Health Conditions: Systematic Review. J Med Internet Res 2020; 22:e17849. [PMID: 32459632 PMCID: PMC7305554 DOI: 10.2196/17849] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/17/2022] Open
Abstract
Background Web-based self-care interventions have the potential to reduce health inequalities by removing barriers to access to health care. However, there is a lack of evidence about the equalizing effects of these interventions on chronic conditions. Objective This study investigated the differences in the effectiveness of web-based behavioral change interventions for the self-care of high burden chronic health conditions (eg, asthma, chronic obstructive pulmonary disease [COPD], diabetes, and osteoarthritis) across socioeconomic and cultural groups. Methods A systematic review was conducted, following Cochrane review guidelines. We conducted searches in Ovid Medical Literature Analysis and Retrieval System Online and Cumulative Index to Nursing and Allied Health Literature databases. Studies with any quantitative design were included (published between January 1, 2006, and February 20, 2019) if they investigated web-based self-care interventions targeting asthma, COPD, diabetes, and osteoarthritis; were conducted in any high-income country; and reported variations in health, behavior, or psychosocial outcomes across social groups. Study outcomes were investigated for heterogeneity, and the possibility of a meta-analysis was explored. A narrative synthesis was provided together with a novel figure that was developed for this review, displaying heterogeneous outcomes. Results Overall, 7346 records were screened and 18 studies were included, most of which had a high or critical risk of bias. Important study features and essential data were often not reported. The meta-analysis was not possible due to the heterogeneity of outcomes. There was evidence that intervention effectiveness was modified by participants’ social characteristics. Minority ethnic groups were found to benefit more from interventions than majority ethnic groups. Single studies with variable quality showed that those with higher education, who were employed, and adolescents with divorced parents benefited more from interventions. The evidence for differences by age, gender, and health literacy was conflicting (eg, in some instances, older people benefited more, and in others, younger people benefited more). There was no evidence of differences in income, numeracy, or household size. Conclusions There was evidence that web-based self-care interventions for chronic conditions can be advantageous for some social groups (ie, minority ethnic groups, adolescents with divorced parents) and disadvantageous for other (ie, low education, unemployed) social groups who have historically experienced health inequity. However, these findings should be treated with caution as most of the evidence came from a small number of low-quality studies. The findings for gender and health literacy were mixed across studies on diabetes, and the findings for age were mixed across studies on asthma, COPD, and diabetes. There was no evidence that income, numeracy, or the number of people living in the household modified intervention effectiveness. We conclude that there appear to be interaction effects, which warrant exploration in future research, and recommend a priori consideration of the predicted interaction effects. Trial Registration PROSPERO CRD42017056163; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=56163
Collapse
Affiliation(s)
- Sophie Turnbull
- Centre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Christie Cabral
- Centre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Alastair Hay
- Centre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Patricia J Lucas
- School for Policy Studies, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
36
|
Kvillemo P, Strandberg AK, Gripenberg J, Berman AH, Skoglund C, Elgán TH. Effects of an automated digital brief prevention intervention targeting adolescents and young adults with risky alcohol and other substance use: study protocol for a randomised controlled trial. BMJ Open 2020; 10:e034894. [PMID: 32404390 PMCID: PMC7228518 DOI: 10.1136/bmjopen-2019-034894] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Adolescence and young adulthood is a period in life when individuals may be especially vulnerable to harmful substance use. Several critical developmental processes are occurring in the brain, and substance use poses both short-term and long-term risks with regard to mental health and social development. From a public health perspective, it is important to prevent or delay substance use to reduce individual risk and societal costs. Given the scarcity of effective interventions targeting substance use among adolescents and young adults, cost-effective and easily disseminated interventions are warranted. The current study will test the effectiveness of a fully automated digital brief intervention aimed at reducing alcohol and other substance use in adolescents and young adults aged 15 to 25 years. METHODS AND ANALYSIS A two-arm, double-blind, randomised controlled trial design is applied to assess the effectiveness of the intervention. Baseline assessment, as well as 3-month and 6-month follow-up, will be carried out. The aim is to include 800 participants with risky substance use based on the screening tool CRAFFT (Car,Relax, Alone, Forget, Friends, Trouble). Recruitment, informed consent, randomisation, intervention and follow-up will be implemented online. The primary outcome is reduction in alcohol use, measured by Alcohol Use Disorders Identification Test total score. Secondary outcomes concern binge drinking, frequency of alcohol consumption, amount of alcohol consumed a typical day when alcohol is consumed, average daily drinks per typical week, other substance use, mental health, sexual risk behaviours and perceived peer pressure. Moreover, the study involves analyses of potential moderators including perfectionism, openness to parents, help-seeking and background variables. ETHICS AND DISSEMINATION The study was approved by the Swedish Ethical Review Authority (no. 2019-03249). The trial is expected to expand the knowledge on digital preventive interventions for substance using adolescents and young adults. Results will be disseminated in research journals, at conferences and via the media. TRIAL REGISTRATION NUMBER 24 September 2019, ISRCTN91048246; Pre-results.
Collapse
Affiliation(s)
- Pia Kvillemo
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anna K Strandberg
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Johanna Gripenberg
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anne H Berman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Charlotte Skoglund
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Tobias H Elgán
- STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| |
Collapse
|
37
|
Hadjiconstantinou M, Schreder S, Brough C, Northern A, Stribling B, Khunti K, Davies MJ. Using Intervention Mapping to Develop a Digital Self-Management Program for People With Type 2 Diabetes: Tutorial on MyDESMOND. J Med Internet Res 2020; 22:e17316. [PMID: 32391797 PMCID: PMC7248797 DOI: 10.2196/17316] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 01/20/2023] Open
Abstract
Digital health interventions (DHIs) are increasingly becoming integrated into diabetes self-management to improve behavior. Despite DHIs becoming available to people with chronic conditions, the development strategies and processes undertaken are often not well described. With theoretical frameworks available in current literature, it is vital that DHIs follow a shared language and communicate a robust development process in a comprehensive way. This paper aims to bring a unique perspective to digital development, as it describes the systematic process of developing a digital self-management program for people with type 2 diabetes, MyDESMOND. We provide a step-by-step guide, based on the intervention mapping (IM) framework to illustrate the process of adapting an existing face-to-face self-management program (diabetes education and self- management for ongoing and newly diagnosed, DESMOND) and translating it to a digital platform (MyDESMOND). Overall, this paper describes the 4 IM steps that were followed to develop MyDESMOND—step 1 to establish a planning group and a patient and public involvement group to describe the context of the intervention and program goals, step 2 to identify objectives and determinants at early design stages to maintain a focus on the strategies adopted, step 3 to generate the program components underpinned by appropriate psychological theories and models, and step 4 to develop the program content and describe the iterative process of refining the content and format of the digital program for implementation. This paper concludes with a number of key learnings collated throughout our development process, which we hope other researchers may find useful when developing DHIs for chronic conditions.
Collapse
Affiliation(s)
| | - Sally Schreder
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Christopher Brough
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Alison Northern
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Bernie Stribling
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| |
Collapse
|
38
|
Koneska E, Appelbe D, Williamson PR, Dodd S. Usage Metrics of Web-Based Interventions Evaluated in Randomized Controlled Trials: Systematic Review. J Med Internet Res 2020; 22:e15474. [PMID: 32297870 PMCID: PMC7193439 DOI: 10.2196/15474] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/24/2019] [Accepted: 01/26/2020] [Indexed: 11/21/2022] Open
Abstract
Background The evaluation of web-based interventions (defined as an intervention that can be downloaded or accessed on the internet through a web browser) in randomized controlled trials (RCTs) has increased over the past two decades. Little is known about how participants’ use of the intervention is measured, reported, and analyzed in these studies. Objective This study aimed to review the evaluation of web-based interventions in RCTs, assessing study characteristics and the methods used to record, and adjust for, intervention usage. Methods A systematic review of the literature was undertaken to identify all published reports of RCTs that involved a web-based intervention. A random sample of 100 published trials was selected for detailed data extraction. Information on trial characteristics was extracted, including whether web usage data were recorded, and if so, the methods used to gather these data and whether these data were used to inform efficacy analyses. Results A PubMed search identified 812 trials of web-based interventions published up to the end of 2017 and demonstrated a growing trend over time. Of the 100 studies reviewed, 90 studies collected web usage data, but more than half (49/90, 54%) of these studies did not state the method used for recording web usage. Only four studies attempted to check on the reliability of their web usage data collection methods. A total of 39% (35/90) studies reported patterns or levels of web intervention use, of which 21% (19/90) studies adjusted for intervention use in their outcome analysis, but only two of these used appropriate statistical methods. Conclusions Trialists frequently report a measure of web-based intervention usage but do not always report the collection method or provide enough detail on their analysis of web usage. Appropriate statistical methods to account for intervention use are rarely used and are not well reported even in the very few trials in which they are used. The number of trialists who attempt to check on the reliability of their web usage collection methods is extremely low.
Collapse
Affiliation(s)
- Elena Koneska
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
| | - Duncan Appelbe
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom.,Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Paula R Williamson
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
| | - Susanna Dodd
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
39
|
Huéscar Hernández E, Andrés Fabra JA, Moreno-Murcia JA. Effect of autonomy support and dialogic learning on school children's physical activity and sport. Scand J Psychol 2020; 61:402-409. [PMID: 32207859 DOI: 10.1111/sjop.12637] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 02/16/2020] [Indexed: 11/30/2022]
Abstract
This study applies an intervention based on autonomy support through dialogic learning to examine effects on motivation and the promotion of physical activity and sport involvement during schoolchildren's leisure time. One hundred and two primary school students, aged 11-13 years, participated (M = 10.93, SD = 0.75). The sample was divided into two groups: an experimental group (49 students) and a control group (53 students). A quasi-experimental study was conducted in physical education classes over the course of 9 months. Assessments of autonomy support from teachers, family, and peers; basic psychological needs; self-determined motivation in physical education and during leisure time; planned behavior variables; physical activity intention; and estimated and actual physical exercise behavior time were included in the model. Following the intervention, the results revealed that greater autonomy support by the teacher, the family and peers, satisfaction of the basic psychological needs, self-determined motivation during physical education class and during free time, greater perceived control, favorable attitude and intention to engage in physical activity contributed to the explanation of student physical activity involvement. These results suggest that when students receive extensive social support from diverse social agents that essential precursors to physical activity are strengthened and contribute to increased motivation and actual physical activity involvement. Efforts to promote effective communications with students and other pedagogical efforts, such as providing dialogic learning opportunities, should be considered in order to strengthen physical activity motivation and involvement in students.
Collapse
|
40
|
Budrionis A, Wynn R, Marco-Ruiz L, Yigzaw KY, Bergvik S, Oyeyemi SO, Bellika JG. Impact of the Use of Electronic Health Tools on the Psychological and Emotional Well-Being of Electronic Health Service Users (The Seventh Tromsø Study - Part 3): Population-Based Questionnaire Study. J Med Internet Res 2020; 22:e13118. [PMID: 32134396 PMCID: PMC7082736 DOI: 10.2196/13118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/24/2019] [Accepted: 08/31/2019] [Indexed: 01/18/2023] Open
Abstract
Background Electronic health (eHealth) has been described as a silver bullet for addressing how challenges of the current health care system may be solved by technological solutions in future strategies and visions for modern health care. However, the evidence of its effects on service quality and cost effectiveness remains unclear. In addition, patients’ psychological and emotional reactions to using eHealth tools are rarely addressed by the scientific literature. Objective This study aimed to assess how the psychological and emotional well-being of eHealth service users is affected by the use of eHealth tools. Methods We analyzed data from a population-based survey in Norway, conducted in the years 2015-2016 and representing 10,604 eHealth users aged over 40 years, to identify how the use of eHealth tools was associated with feeling anxious, confused, knowledgeable, or reassured. Associations between these four emotional outcomes and the use of four types of eHealth services (Web search engines, video search engines, health apps, and social media) were analyzed using logistic regression models. Results The use of eHealth tools made 72.41% (6740/9308) of the participants feel more knowledgeable and 47.49% (4421/9308) of the participants feel more reassured about their health status. However, 25.69% (2392/9308) reported feeling more anxious and 27.88% (2595/9308) reported feeling more confused using eHealth tools. A high level of education and not having a full-time job were associated with positive reactions and emotions (feeling more knowledgeable and reassured), whereas low self-reported health status and not having enough friends who could provide help and support predicted negative reactions and emotions (ie, feeling anxious and confused). Overall, the positive emotional effects of eHealth use (feeling knowledgeable and reassured) were relatively more prevalent among users aged over 40 years than the negative emotional effects (ie, feeling anxious and confused). About one-fourth of eHealth users reported being more confused and anxious after using eHealth services. Conclusions The search for health information on the internet can be motivated by a range of factors and needs (not studied in this study), and people may experience a range of reactions and feelings following health information searching on the Web. Drawing on prior studies, we categorized reactions as positive and negative reactions. Some participants had negative reactions, which is challenging to resolve and should be taken into consideration by eHealth service providers when designing services (ie, including concrete information about how users can get more help and support). There is a need for more studies examining a greater range of reactions to online health information and factors that might predict negative reactions to health information on the Web.
Collapse
Affiliation(s)
- Andrius Budrionis
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway
| | - Luis Marco-Ruiz
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | | | - Svein Bergvik
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sunday Oluwafemi Oyeyemi
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johan Gustav Bellika
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
41
|
Nieto R, Boixadós M, Ruiz G, Hernández E, Huguet A. Effects and Experiences of Families Following a Web-Based Psychosocial Intervention for Children with Functional Abdominal Pain and Their Parents: A Mixed-Methods Pilot Randomized Controlled Trial. J Pain Res 2020; 12:3395-3412. [PMID: 32099447 PMCID: PMC6997197 DOI: 10.2147/jpr.s221227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/31/2019] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate post-treatment efficacy of DARWeb (online psychosocial intervention for children with functional abdominal pain) using a randomized clinical trial design and combining quantitative and qualitative data. Patients and methods Twenty-five families with children with FAP in the experimental group (EG: accessed to DARWeb) and 36 in the control group (CG: wait-list) were compared. Children and parents completed measures of abdominal pain severity (primary outcome), quality of life, and satisfaction. Moreover, children completed measures of depression, functional disability, catastrophizing and coping strategies; parents completed measures about parental responses to their children's pain. Families also answered open questions and were interviewed. Results A higher percentage of children in the EG achieved a significant clinical change in abdominal pain severity from the parents' perspective (28% in the EG vs 8.33% in the CG). There was a significantly greater reduction in pain frequency in the EG compared to the CG (both from the children's and parents' perspectives) from mixed repeated-measures analyses of variance (there was not a significant interaction in total scores of pain severity). A higher percentage of children in the EG improved in quality of life and depression compared to the CG (results from mixed methods repeated-measures analyses of variances were not significant). However, there were no differences for disability, pain catastrophizing or the coping strategies assessed from the children's perspective; neither from the parents' assessment of quality of life. There were significant interactions for parents' solicitousness responses and promotion of well behaviors in the expected directions. Families were quite satisfied with the intervention, and the qualitative results confirmed an improvement in pain and having learned important coping strategies. Conclusion Our results support the efficacy of our intervention, but future studies are needed with different profiles of initial severity of the pain problem, longer follow-ups, and other conditions.
Collapse
Affiliation(s)
- Rubén Nieto
- eHealth Lab, Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Mercè Boixadós
- PSiNET Research Group, Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Gemma Ruiz
- eHealth Lab, Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Eulàlia Hernández
- PSiNET Research Group, Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | | |
Collapse
|
42
|
Irani E, Niyomyart A, Hickman RL. Systematic Review of Technology-Based Interventions Targeting Chronically Ill Adults and Their Caregivers. West J Nurs Res 2020; 42:974-992. [PMID: 31941418 DOI: 10.1177/0193945919897011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this systematic review is to synthesize the study design features as well as the attributes and outcomes of technology-based health interventions targeting chronically ill adults and their family caregivers. Twenty papers representing 19 studies met the inclusion criteria. Various theoretical foundations or approaches guided the interventions in 11 studies. Interventions either aimed to support patient self-management and improve patient outcomes or enhance shared illness management and improve patient and caregiver outcomes. The interventions included educational, behavioral, and support components and were delivered using various technologies ranging from text messaging to using the Internet. Overall, patients and caregivers expressed improvements in self-management outcomes (or support) and quality of life. Interventions with a dyadic focus reported on interpersonal outcomes, with improvements noted mostly in patients. This review captures an emerging area of science, and findings should be interpreted in light of the methodological limitations of the included studies.
Collapse
Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Atsadaporn Niyomyart
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Ronald L Hickman
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
43
|
Aromatario O, Van Hoye A, Vuillemin A, Foucaut AM, Pommier J, Cambon L. Using theory of change to develop an intervention theory for designing and evaluating behavior change SDApps for healthy eating and physical exercise: the OCAPREV theory. BMC Public Health 2019; 19:1435. [PMID: 31675951 PMCID: PMC6824130 DOI: 10.1186/s12889-019-7828-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/22/2019] [Indexed: 11/12/2022] Open
Abstract
Background Connected health devices and applications (referred to hereafter as “SDApps” - Smart devices and applications) are being portrayed as a new way for prevention, with the promise of accessibility, effectiveness and personalization. Many effectiveness evaluations (experimental designs) with strong internal validity exist. While effectiveness does appear to vary, the mechanisms used by these devices have not yet been thoroughly investigated. This article seeks to unpack this black box, and describes the process of elaboration of an intervention theory for healthy eating and physical activity SDApps. It includes a set of requirements relative to their impact on social health inequalities. Methods To build this theory, we drew on theory-driven approaches and in particular on the theory of change (ToC) method. To this end, we developed a cumulative and iterative process combining scientific data from the literature with knowledge from experts (researchers and practitioners) and from patients or users. It was a 3-step process, as follows: 1 - identifying the evidence base; 2 - developing the theory through design intervention and creating realistic expectations, including in our case specific work on social health inequalities (SHIs); 3 - modeling process and outcome. Results We produced an evidence-based theory according to the ToC model, based on scientific evidence and knowledge from experts and users. It sets out a causal pathway leveraging 11 key mechanisms - theoretical domains - with which 50 behavior change techniques can be used towards 3 ultimate goals: Capacity, Opportunity, Motivation – Behavior (COM-B). Furthermore, the theory specifically integrates requirements relative to the impact on SHIs. Conclusions This theory is an aid to SDAapp design and evaluation and it can be used to consider the question of the possible impact of SDApps on the increase in inequalities. Firstly, it enables developers to adopt a more overarching and thorough approach to supporting behavior change, and secondly it encourages comprehensive and contributive evaluations of existing SDApps. Lastly, it allows health inequalities to be fully considered.
Collapse
Affiliation(s)
- Olivier Aromatario
- UMR 6051 ARENES, EHESP, 20 avenue George Sand, La Plaine Saint Denis, 93210, Paris, France.
| | | | | | - Aude-Marie Foucaut
- Université Paris 13, Sorbonne Paris Cité, Laboratoire Educations et Pratiques de Santé (LEPS) EA 3412, UFR SMBH, F-93017, Bobigny, France
| | - Jeanine Pommier
- UMR 6051 ARENES, EHESP, 20 avenue George Sand, La Plaine Saint Denis, 93210, Paris, France
| | - Linda Cambon
- Chaire de Prévention, ISPED, Centre de recherche U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
| |
Collapse
|
44
|
Sanci L, Kauer S, Thuraisingam S, Davidson S, Duncan AM, Chondros P, Mihalopoulos C, Buhagiar K. Effectiveness of a Mental Health Service Navigation Website (Link) for Young Adults: Randomized Controlled Trial. JMIR Ment Health 2019; 6:e13189. [PMID: 31625945 PMCID: PMC6913099 DOI: 10.2196/13189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/31/2019] [Accepted: 06/11/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Mental health and substance use disorders are the main causes of disability among adolescents and young adults yet fewer than half experiencing these problems seek professional help. Young people frequently search the Web for health information and services, suggesting that Web-based modalities might promote help-seeking among young people who need it. To support young people in their help-seeking, we developed a Web-based mental health service navigation website called Link. Link is based on the Theory of Planned Behavior and connects young people with treatment based on the type and severity of mental health symptoms that they report. OBJECTIVE The study aimed to investigate the effect of Link on young people's positive affect (PA) compared with usual help-seeking strategies immediately post intervention. Secondary objectives included testing the effect of Link on negative affect (NA), psychological distress, barriers to help-seeking, and help-seeking intentions. METHODS Young people, aged between 18 and 25 years, were recruited on the Web from an open access website to participate in a randomized controlled trial. Participants were stratified by gender and psychological distress into either the intervention arm (Link) or the control arm (usual help-seeking strategies). Baseline, immediate postintervention, 1-month, and 3-month surveys were self-reported and administered on the Web. Measures included the PA and NA scales, Kessler psychological distress scale (K10), barriers to adolescent help-seeking scale (BASH), and the general help-seeking questionnaire (GHSQ). RESULTS In total 413 young people were recruited to the trial (intervention, n=205; control, n=208) and 78% (160/205) of those randomized to the intervention arm visited the Link website. There was no evidence to support a difference between the intervention and control arms on the primary outcome, with PA increasing equally by approximately 30% between baseline and 3 months in both arms. NA decreased for the intervention arm compared with the control arm with a difference of 1.4 (95% CI 0.2-2.5) points immediately after the intervention and 2.6 (95% CI 1.1-4.1) at 1 month. K10 scores were unchanged and remained high in both arms. No changes were found on the BASH or GHSQ; however, participants in the intervention arm appeared more satisfied with their help-seeking process and outcomes at 1 and 3 months postintervention. CONCLUSIONS The process of prompting young people to seek mental health information and services appears to improve their affective state and increase help-seeking intentions, regardless of whether they use a Web-based dedicated youth-focused tool, such as Link, or their usual search strategies. However, young people report greater satisfaction using tools designed specifically for them, which may encourage future help-seeking. The ability of Web-based tools to match mental health needs with appropriate care should be explored further. CLINICAL TRIAL Australian New Zealand Clinical Trials Registry ACTRN12614001223628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366731.
Collapse
Affiliation(s)
- Lena Sanci
- Department of General Practice, University of Melbourne, Parkville, Australia
| | - Sylvia Kauer
- Department of General Practice, University of Melbourne, Parkville, Australia
| | | | - Sandra Davidson
- Department of General Practice, University of Melbourne, Parkville, Australia
| | - Ann-Maree Duncan
- Department of General Practice, University of Melbourne, Parkville, Australia
| | - Patty Chondros
- Department of General Practice, University of Melbourne, Parkville, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Australia
| | | |
Collapse
|
45
|
Davies N, Hopwood J, Walker N, Ross J, Iliffe S, Walters K, Rait G. Designing and developing a co-produced theoretical and evidence-based online support for family caregivers of people with dementia at the end of life. BMC Palliat Care 2019; 18:71. [PMID: 31409329 PMCID: PMC6693100 DOI: 10.1186/s12904-019-0455-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/31/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Caring for someone with dementia can be physically and emotionally difficult. Acting as a caregiver can make it difficult to access sources of support, particularly in the later stages of dementia. This paper reports the development and presents the targets (subject areas) and components of a prototype website to support family caregivers of a person with dementia towards the end of life. METHODS Adopting an iterative approach and co-production methods the development process consisted of four stages: Stage1-Synthesis of data: three sources of data (interviews, systematic review and theory) were synthesised using tabulation, to identify the targets of the prototype; Stage2-Identifying intervention targets and components: a research development group (health practitioners, a family caregiver and academic experts) met to discuss the development, using a modified nominal group process, refining the synthesis from stage 1; Stage3-Developing the intervention prototype: an outline of the prototype was developed based on stage 1 and 2; and Stage4-User testing: interviews with caregivers testing the prototype website. RESULTS Qualitative interviews with caregivers identified four targets for the intervention: 1) feeling prepared and equipped; 2) feeling connected and supported; 3) valuing themselves as a caregiver and as an individual; 4) maintaining control of the caring situation and being the coordinator of care. The systematic review provided evidence on how and what components could address these targets, including providing information, peer support, contact with professionals, and psychological support. Theory helped to narrow the focus within each of these targets. Active discussion with the research development group and end users provided an outline of the prototype website. The prototype website presented addresses these targets with written information, videos from other caregivers, and peer and professional support sections. The subject areas covered included expectations at the end of life, support with day-to-day caring, care planning, and communication. CONCLUSIONS This paper provides a detailed account of the development process of a prototype website for caregiver support. The transparent methodology and key lessons learnt from developing the prototype should help those who are developing similar interventions, across complex, progressive conditions and not just limited to dementia.
Collapse
Affiliation(s)
- Nathan Davies
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
- Centre for Dementia Palliative Care Research, Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Jenny Hopwood
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Nina Walker
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Jamie Ross
- eHealth Unit, Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Steve Iliffe
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Kate Walters
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Greta Rait
- Priment Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| |
Collapse
|
46
|
How do mobile health applications support behaviour changes? A scoping review of mobile health applications relating to physical activity and eating behaviours. Public Health 2019; 175:8-18. [PMID: 31374453 DOI: 10.1016/j.puhe.2019.06.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/03/2019] [Accepted: 06/19/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this review was to analyse how researchers conducting studies about mobile health applications (MHApps) effectiveness assess the conditions of this effectiveness. STUDY DESIGN A scoping review according to PRIMSA-ScR checklist. METHODS We conducted a scoping review of efficacy/effectiveness conditions in high internal validity studies assessing the efficacy of MHApps in changing physical activity behaviours and eating habits. We used the PubMed, Web of Science, SPORTDiscus and PsycINFO databases and processed the review according to the O'Malley and PRISMA-ScR recommendations. We selected studies with high internal validity methodologies (randomised controlled trials, quasi-experimental studies, systematic reviews and meta-analyses), dealing with dietary and/or physical activity behaviours; covering primary, secondary or tertiary prevention and dealing with behaviour change (uptake, maintenance). We excluded articles on MHApps relating to high-level sport and telemedicine. The process for selecting studies followed a set protocol with two authors who independently appraised the studies. RESULTS Twenty-two articles were finally selected and analysed. We noted that the mechanisms and techniques to support behaviour changes were poorly reported and studied. There was no explanation of how these MHApps work and how they could be transferred or not. Indeed, the main efficacy conditions reported by authors refer to practical aspects of the tools. Moreover, the issue of social inequalities was essentially reduced to access to the technology (the shrinking access divide), and literacy was poorly studied, even though it is an important consideration in digital prevention. All in all, even when they dealt with behaviours, the evaluations were tool-focused rather than intervention-focused and did not allow a comprehensive assessment of MHApps. CONCLUSION To understand the added value of MHApps in supporting behaviour changes, it seems important to draw on the paradigms relating to health technology assessment considering the characteristics of the technologies and on the evaluation of complex interventions considering the characteristics of prevention. This combined approach may help to clarify how these patient-focused MHApps work and is a condition for improved assessment of MHApps in terms of effectiveness, transferability and scalability.
Collapse
|
47
|
van Schaaijk A, Nieuwenhuijsen K, Frings-Dresen M. Work Ability and Vitality in Coach Drivers: An RCT to Study the Effectiveness of a Self-Management Intervention during the Peak Season. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122214. [PMID: 31234547 PMCID: PMC6616472 DOI: 10.3390/ijerph16122214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 01/10/2023]
Abstract
Background: This randomized controlled trial (RCT) evaluates the effectiveness of a self-management toolbox designed to maintain work ability and vitality in coach drivers over their peak season. Methods: The intervention group received a self-management intervention providing advice aimed at increasing work ability and vitality. These suggestions targeted three specific domains: work–recovery–rest balance, food and drink intake, and physical activity. At the beginning (March), middle (July), and end (October) of the coach sector peak season, work ability, vitality, work-related fatigue, psychosomatic health, sleep complaints, and perceived mental exertion of coach drivers were assessed through questionnaires. Results: A total of 96 drivers participated in the study. Access to the toolbox did not result in significant differences between groups. Work ability and vitality decreased significantly in both groups, falling from 7.8 ± 1.3 to 7.3 ± 1.6 and from 63 ± 16.7 to 55 ± 18.7, respectively. Work-related fatigue increased from 35 ± 31.9 to 52 ± 35.3. Psychosomatic health complaints, sleep complaints, and perceived mental exertion also increased significantly. Conclusions: The uptake of the intervention was too low to determine if this toolbox can maintain work ability and vitality in coach drivers when compared with a control group. Overall work ability and vitality decrease significantly as the peak season progresses, while work-related fatigue accumulates. Other interventions should be explored to ensure sustainable employability in this population.
Collapse
Affiliation(s)
- Art van Schaaijk
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, P.O. Box 22660, 1100 DE Amsterdam, The Netherlands.
| | - Karen Nieuwenhuijsen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, P.O. Box 22660, 1100 DE Amsterdam, The Netherlands.
| | - Monique Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, P.O. Box 22660, 1100 DE Amsterdam, The Netherlands.
| |
Collapse
|
48
|
Mailey EL, Irwin BC, Joyce JM, Hsu W. InDependent but not Alone: A Web‐Based Intervention to Promote Physical and Mental Health among Military Spouses. Appl Psychol Health Well Being 2019; 11:562-583. [DOI: 10.1111/aphw.12168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
49
|
Lin J, Klatt LI, McCracken LM, Baumeister H. Psychological flexibility mediates the effect of an online-based acceptance and commitment therapy for chronic pain: an investigation of change processes. Pain 2019; 159:663-672. [PMID: 29320375 DOI: 10.1097/j.pain.0000000000001134] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
One way to improve treatment effects of chronic pain is to identify and improve control over mechanisms of therapeutic change. One treatment approach that includes a specific proposed mechanism is acceptance and commitment therapy (ACT) with its focus on increasing psychological flexibility (PF). The aim of the present study was to examine the role of PF as a mechanism of change in ACT. This is based on mediation analyses of data from a previously reported randomized controlled trial, evaluating the effectiveness of an ACT-based online intervention for chronic pain (ACTonPain). We performed secondary analyses on pretreatment, posttreatment, and follow-up data from 302 adults, receiving a guided (n = 100) or unguided (n = 101) version of ACTonPain, or allocated to the waitlist control group (n = 101). Structural equation modelling and a bias-corrected bootstrap approach were applied to examine the indirect effects of the treatment through pretreatment and posttreatment changes in the latent construct reflecting PF. The latent construct consisted of data from the Chronic Pain Acceptance Questionnaire and the Acceptance and Action Questionnaire. The outcomes were pretreatment to follow-up changes in pain interference, anxiety, depression, pain, and mental and physical health. Structural equation modelling analyses revealed that changes in PF significantly mediated pretreatment to follow-up changes in all outcomes in the intervention groups compared with waitlist (standardized estimates ranged from I0.16I to I0.69I). Global model fit yielded modest but acceptable results. Findings are consistent with the theoretical framework behind ACT and contribute to growing evidence, supporting a focus on PF to optimize treatment effects.
Collapse
Affiliation(s)
- Jiaxi Lin
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg im Breisgau, Germany.,Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Laura-Isabelle Klatt
- Department of Ergonomics, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Lance M McCracken
- Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,INPUT Pain Management, Guy's and St Thomas' NHS Foundation Trust London, London, United Kingdom
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Ulm, Ulm, Germany
| |
Collapse
|
50
|
Tilga H, Hein V, Koka A. Effects of a Web-Based Intervention for PE Teachers on Students' Perceptions of Teacher Behaviors, Psychological Needs, and Intrinsic Motivation. Percept Mot Skills 2019; 126:559-580. [PMID: 30939994 DOI: 10.1177/0031512519840150] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Interventions based on self-determination theory to help teachers support their students' autonomy have measured teachers' autonomy-supportive and controlling behaviors as unidimensional constructs. This study investigated whether a Web-Based Autonomy-Supportive Intervention Program (WB-ASIP) for physical education (PE) teachers would alter their students' perceptions of (a) the teachers' multidimensional autonomy-supportive and controlling behaviors, (b) their own psychological need satisfaction and frustration, and (c) perceived intrinsic motivation. We found that WB-ASIP significantly increased students' perceptions of all autonomy-supportive teacher behaviors and students' need satisfaction. At follow-up, we found that WB-ASIP led to a significant decrease in students' perception of teacher intimidation behaviors and students' autonomy frustration. These results suggest that a web-based intervention program to enhance PE teachers' autonomy-supportive behavior and minimize their controlling behavior was partially effective in positively changing their students' perceptions.
Collapse
Affiliation(s)
- Henri Tilga
- 1 Faculty of Medicine, Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
| | - Vello Hein
- 1 Faculty of Medicine, Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
| | - Andre Koka
- 1 Faculty of Medicine, Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
| |
Collapse
|