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Myllykangas K, Härkönen H, Kääriäinen M, Kärppä M, Jansson M. Patient experiences on the quality of cerebrovascular diseases counselling using digital solutions in hospital-A qualitative research study. J Clin Nurs 2024; 33:2259-2273. [PMID: 38413773 DOI: 10.1111/jocn.17025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 12/29/2023] [Accepted: 01/15/2024] [Indexed: 02/29/2024]
Abstract
AIM To describe patients' experiences of the quality of counselling to develop new digital counselling solutions for patients with cerebrovascular disease. DESIGN A descriptive, qualitative approach. METHODS Semi-structured in-person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and treated as inpatients at a single university hospital in Finland between September 2021 and February 2022. Data were analysed using deductive and inductive content analysis. RESULTS The identified facilitators, barriers and possible solutions for the development of new digital counselling solutions were deductively categorized into five main categories: (1) background factors, (2) resources, (3) implementation, (4) sufficiency, and (5) effects and 12 generic categories. Patients with cerebrovascular diseases worry about symptoms affecting their ability to receive information and valued a supportive atmosphere. Staff should have more time for counselling and use motivational digital counselling solutions in plain language, moderate length and with multimedia content. Patients desired reminders, easy search functions and possibilities for two-way communication. CONCLUSION New digital counselling solutions could be beneficial in supporting the patients' knowledge, emotions and adherence. For the success of such solutions, patients' special needs concerning different levels of cognitive impairment need to be considered. IMPACT The results of this study may benefit healthcare organizations in the development of digital counselling solutions that meet the patients' needs. REPORTING METHOD We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION Patients were involved as the study population.
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Affiliation(s)
- Kirsi Myllykangas
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Henna Härkönen
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Mikko Kärppä
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital and Research Unit of Clinical Medicine, Neurology, Oulu University, Oulu University Hospital, Oulu, Finland
| | - Miia Jansson
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Royal Melbourne Institute of Technology RMIT University, Melbourne, Australia
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Aloy Dos Santos T, Chites VS, Riboldi BP, Marcadenti A, Bersch-Ferreira ÂC, Vieira Machado RH, Marchioni DML, Carnevale de Almeida J. Could the Wheel of Cardiovascular Health Diet Be a Tool for Diet Quality in Nutritional Counseling? Comparison with Healthy Eating Index-2020. J Am Nutr Assoc 2024; 43:376-383. [PMID: 38175725 DOI: 10.1080/27697061.2023.2297888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE The Wheel of Cardiovascular Health Diet was recently elaborated based on current nutritional recommendations for healthy eating and was made for person-centered nutritional counseling, thus it may be an interesting tool to improve food awareness. However, its validity is yet to be tested. We hypothesized that the self-perception of patients diagnosed with chronic diseases, evaluated by the Wheel of Cardiovascular Health Diet, is satisfactory in assessing the quality of their diets, compared with the Healthy Eating Index-2020. METHODS This is a cross-sectional analysis of adults with uncontrolled hypertension or type 2 diabetes. The patients answered the Wheel of Cardiovascular Health Diet, and then, based on the food frequency questionnaire, we analyzed the Healthy Eating Index-2020. RESULTS A total of 330 patients were included in the study: 91.5% had hypertension, 58.5% had type 2 diabetes, and the median age was 58 (50-65) years. The mean difference observed between the percentage of the graphic area assessed by the patients' self-perception from the Wheel of Cardiovascular Health Diet and Healthy Eating Index-2020 was -10.0% (95%CI -35.3 to 15.3), and a moderate correlation was observed. Linear Regression models showed that a 10-point increase in patients' self-perception in the Wheel of Cardiovascular Health Diet is associated with a 2.9% increase (95%CI 2.08 to 3.70) in the diet quality by the Healthy Eating Index-2020 and is associated with lower BMI values: β = -0.42 kg/m2 (95%CI -0.83 to -0.01). CONCLUSION The Wheel of Cardiovascular Health Diet performed satisfactorily regarding validity and reliability by BMI and was associated with higher overall dietary quality, with the Healthy Eating Index-2020 as a relative reference.
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Affiliation(s)
- Tainara Aloy Dos Santos
- Medical Sciences Graduate Program in Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Rio Grande do Sul, Brazil
| | - Victória Silva Chites
- Medical Sciences Graduate Program in Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Rio Grande do Sul, Brazil
| | - Bárbara Pelicioli Riboldi
- Medical Sciences Graduate Program in Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Rio Grande do Sul, Brazil
| | - Aline Marcadenti
- Hcor Research Institute, Associação Beneficente Síria (Hcor), São Paulo, Brazil
- Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | | | | | - Dirce Maria Lobo Marchioni
- Department of Nutrition, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, São Paulo, Brazil São Paulo, Brazil
| | - Jussara Carnevale de Almeida
- Medical Sciences Graduate Program in Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Rio Grande do Sul, Brazil
- Department of Nutrition, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Rio Grande do Sul, Brazil
- Nutrition and Dietetics Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil Rio Grande do Sul, Brazil
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Steenekamp BL, Barker SL. Exploring the Experiences of Compassion Fatigue Amongst Peer Support Workers in Homelessness Services. Community Ment Health J 2024; 60:772-783. [PMID: 38285087 PMCID: PMC11001661 DOI: 10.1007/s10597-024-01234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
Peer support workers have lived experiences of the challenges their clients face. While research has shown peer work can benefit recovery, the negative consequences have not been clearly addressed. This study aimed to explore the experiences of compassion fatigue amongst peer support workers in homelessness services, and the coping strategies used. An explorative qualitative design was adopted. Six peer support workers, in homelessness services, were recruited via snowball sampling. Data was collected using semi-structured interviews and analysed using thematic analysis. Five themes were identified: relentless nature of working in homelessness services, change, making meaning of past experiences, organisational support, and personal coping strategies. There were two novel findings: (1) multiple clients recounting traumatic experiences, and (2) being unfairly blamed for lack of progress, exacerbating compassion fatigue. The findings of this study furthers limited research on compassion fatigue and can be used to develop protocols and practices for organisations that utilise peer support.
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Kentab BY, Barry HE, Al-Aqeel SA, Hughes CM. Improving medication dispensing and counselling for patients with vision impairment: a qualitative study of pharmacist-reported barriers and facilitators. BMC Health Serv Res 2024; 24:534. [PMID: 38671437 PMCID: PMC11046806 DOI: 10.1186/s12913-024-11009-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND People with vision impairment encounter many difficulties when it comes to medicines use. However, evidence indicates that there are major gaps in pharmaceutical care service provision worldwide and limited research on interventions to optimise medication use for this patient population. The Theoretical Domains Framework (TDF) provides a method for theoretically understanding individuals' behaviour and informing development of interventions. The aim of this research was to (a) identify the barriers and facilitators to the provision of medication dispensing and counselling services by pharmacists to patients with vision impairment, and (b) identify key TDF domains to be targeted in a future intervention. METHODS Semi-structured interviews were conducted with pharmacists from different pharmacy practice settings/areas in Saudi Arabia. The 14-domain TDF was utilised as the theoretical lens through which pharmacists' behaviours were examined. Interviews were conducted in Arabic or English, either face-to-face or over the telephone based on the participant's preference. Following transcription, interviews conducted in Arabic were translated into English before analysis. Data analysis involved using the framework method and content analysis to identify important barriers and facilitators to the provision of dispensing and counselling services to those with vision impairment. Key TDF domains that could be targeted in a future intervention were then identified using a consensus-based approach. RESULTS Twenty-six pharmacists were interviewed. Pharmacists' experience in pharmacy practice ranged from two to 28 years. A range of barriers and facilitators were highlighted as important in providing services to those with vision impairment. Eight domains were identified as 'key domains' including: 'Knowledge', 'Skills', 'Beliefs about capabilities', 'Goals', 'Memory, attention, and decision processes', 'Environmental context and resources', 'Social influences', and 'Behavioural regulation'. CONCLUSIONS Barriers and facilitators identified by pharmacists will inform the development of an intervention to ensure its applicability to everyday practice. Future research will focus on the process of developing the proposed intervention through targeting key TDF domains to improve medication dispensing and counselling by pharmacists to patients with vision impairment.
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Affiliation(s)
- Basma Y Kentab
- Primary Care Research Group, School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Heather E Barry
- Primary Care Research Group, School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK
| | - Sinaa A Al-Aqeel
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Carmel M Hughes
- Primary Care Research Group, School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK.
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Brooks D, Wyles K, Pachana NA, Beattie E, Gaugler JE. Tailored videoconferencing counselling program to support family carers of people living with dementia during the transition to permanent residential care: a pilot and feasibility randomised trial. BMC Geriatr 2024; 24:375. [PMID: 38671367 PMCID: PMC11055339 DOI: 10.1186/s12877-024-04907-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Decisions surrounding the permanent residential care placement of people living with dementia can be stressful and distressing; however, providing access to targeted information and support prior to placement may help carers better cope. This mixed methods study aimed to test the feasibility, acceptability, and potential benefits of providing a tailored, individual counselling program (the Residential Care Transition Module), delivered via videoconferencing, to Australian family carers of a relative with dementia during the transition to permanent residential care. METHODS A total of 18 family carers were randomly allocated to receive either the counselling intervention (six sessions delivered over 12 weeks) or a check-in call, delivered by a trained Transition Counsellor. Both groups received help-sheets about residential care, coping with placement, and managing feelings. Carers completed online surveys about stress, guilt, anxiety, depression, grief, and support for caring at baseline and four months post-baseline. Carers were also invited to participate in semi-structured exit interviews, conducted after follow-up surveys were completed. Process data relating to recruitment, retention, intervention dose and delivery were collected via logs. Quantitative data were analysed using descriptive statistics and repeated measures ANOVA. Qualitative data, relating to feasibility, acceptability, and perceived benefits of the program, were analysed using the 'framework' approach developed by the Medical Research Council to inform the process evaluation of complex interventions. RESULTS Qualitative findings indicated that delivery of the counselling program during the transition period was deemed by participants to be feasible and acceptable. Delivery via videoconferencing was deemed convenient and acceptable, with few technical issues. The skills and knowledge of the Transition Counsellor were perceived to be important mechanisms of impact. Though not statistically significant, promising quantitative findings were identified in terms of reduced carer stress and guilt and improved support for caring. CONCLUSIONS Delivery of a tailored counselling program via videoconferencing to family carers of people living with dementia during the transition to residential care was feasible and acceptable. The program has the potential to improve transitional support to family carers. TRIAL REGISTRATION This study was registered in the Australian New Zealand Clinical Trials Registry: ACTRN12621001462875.
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Affiliation(s)
- Deborah Brooks
- School of Nursing, Queensland University of Technology, Brisbane, Australia.
- The University of Queensland Centre for Clinical Research, Brisbane, Australia.
| | - Katy Wyles
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Elizabeth Beattie
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Joseph E Gaugler
- School of Psychology, The University of Queensland, Brisbane, Australia
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Awosemusi Y, Keenan-Devlin L, Martinez NG, Yee LM, Borders AEB. The role of clinic-based breastfeeding peer counseling on breastfeeding rates among low-income patients. BMC Pregnancy Childbirth 2024; 24:312. [PMID: 38664768 PMCID: PMC11044488 DOI: 10.1186/s12884-024-06395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/05/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Despite the benefits of breastfeeding (BF), rates remain lower than public health targets, particularly among low-income Black populations. Community-based breastfeeding peer counselor (BPC) programs have been shown to increase BF. We sought to examine whether implementation of a BPC program in an obstetric clinical setting serving low-income patients was associated with improved BF initiation and exclusivity. METHODS This is a quasi-experimental time series study of pregnant and postpartum patients receiving care before and after implementation of a BPC program in a teaching hospital affiliated prenatal clinic. The role of the BPC staff included BF classes, prenatal counseling and postnatal support, including in-hospital assistance and phone triage after discharge. Records were reviewed at each of 3 time points: immediately before the hire of the BPC staff (2008), 1-year post-implementation (2009), and 5 years post-implementation (2014). The primary outcomes were rates of breastfeeding initiation and exclusivity prior to hospital discharge, secondary outcomes included whether infants received all or mostly breastmilk during inpatient admission and by 6 weeks post-delivery. Bivariable and multivariable analyses were utilized as appropriate. RESULTS Of 302 patients included, 52.3% identified as non-Hispanic Black and 99% had Medicaid-funded prenatal care. While there was no improvement in rates of BF initiation, exclusive BF during the postpartum hospitalization improved during the 3 distinct time points examined, increasing from 13.7% in 2008 to 32% in 2014 (2009 aOR 2.48, 95%CI 1.13-5.43; 2014 aOR 1.82, 95%CI 1.24-2.65). This finding was driven by improved exclusive BF for patients who identified as Black (9.4% in 2008, 22.9% in 2009, and 37.9% in 2014, p = 0.01). CONCLUSION Inpatient BF exclusivity significantly increased with the tenure of a BPC program in a low-income clinical setting. These findings demonstrate that a BPC program can be a particularly effective method to address BF disparities among low-income Black populations.
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Affiliation(s)
- Yetunde Awosemusi
- Women's Health of Las Colinas, Medical City Healthcare, 6750 N MacArthur Blvd, Suite 100, Irving, TX, 75039, USA.
| | - Lauren Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen Building Suite 1507, Evanston, IL, 60201, USA
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Noelle Griffin Martinez
- Department of Family and Community Medicine, University of California San Francisco, 995 Potrero Avenue Ward 83, San Francisco, CA, 94110, USA
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St, Suite 5-2145, Chicago, IL, 60611, USA
| | - Ann E B Borders
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen Building Suite 1507, Evanston, IL, 60201, USA
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
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Lyimo A, Mmbaga B, Mahmoud A, Eliamini WS, Ngowi NB, Mitao M, Pancras G, Malindisa E, Kidayi P, Conserve DF, Bartlett J, Sunguya B, Lyamuya E, Kidenya B, Balandya E, Ngocho JS. Efficacy of mobile phone intervention to increase male partner antenatal care attendance for HIV testing in Moshi municipal, Tanzania: a randomized controlled trial. BMC Pregnancy Childbirth 2024; 24:306. [PMID: 38658860 PMCID: PMC11040948 DOI: 10.1186/s12884-024-06337-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND HIV partner counselling and testing in antenatal care (ANC) is a crucial strategy to raise the number of males who know their HIV status. However, in many settings like Tanzania, male involvement in antenatal care remains low, and there is a definite need for innovative strategies to increase male partner involvement. This study was designed to evaluate the efficacy of mobile phone intervention increase male partner ANC attendance for HIV testing in Moshi municipal, Tanzania. METHODS Between April and July 2022, we enrolled pregnant women presenting to a first ANC visit at Majengo and St. Joseph reproductive health facilities without their male partners. Eligible pregnant women were randomly assigned to invitation of their male partners either via phone calls, text messages from clinic staff and verbal invites from pregnant partners (intervention arm) or verbal invites only from the pregnant partners (control arm). Neither healthcare provider nor participant were blinded. The primary outcome was the proportion of male partners who attended ANC with their pregnant partners during a follow-up period of two consecutive visits. The secondary outcome measure was HIV testing among male partners following the invitation. Participants were analyzed as originally assigned (intention to treat). RESULTS A total of 350 pregnant women presenting to ANC for the first time were enrolled, with 175 women enrolled in each arm. The efficacy of male attendance with their pregnant women following the invitations was 83.4% (147/175) in the intervention arm and 46.3% (81/175) in the control arm. Overall, the results suggest a positive and statistically significant average treatment effect among men who received mobile phone intervention on ANC attendance. For the secondary outcome, the percent of male partners who accepted HIV counselling and testing was 99.3% (146/147) in the intervention arm and 93.8% (76/81) in the control arm. Married men were having higher odds of ANC attendance compared with single men (aOR:6.40(3.26-12.56), Males with multigravida women were having lower odds of ANC attendance compared with primigravida women (aOR:0.17(0.09-0.33). CONCLUSION The study demonstrates that supplementing verbal invitations with mobile phone calls and text messages from clinic staff can significantly increase male partner ANC attendance and HIV testing. This combined approach is recommended in improving ANC attendance and HIV testing of male partners who do not accompany their pregnant partners to antenatal clinics in the first visits. TRIAL REGISTRATION PACTR202209769991162.
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Affiliation(s)
- Angela Lyimo
- Faculty of Nursing, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania.
| | - Blandina Mmbaga
- Kilimanjaro Clinical Research Institute, Box 2236, Moshi, Tanzania
| | - Ashraf Mahmoud
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
| | - Wilson Saimon Eliamini
- Faculty of Nursing, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
| | | | - Modesta Mitao
- Kilimanjaro Clinical Research Institute, Box 2236, Moshi, Tanzania
| | - Godwin Pancras
- Muhimbili University of Health and Allied Science, Box 65001, Dar es Salam, Tanzania
| | | | - Paulo Kidayi
- Faculty of Nursing, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
| | - Donaldson F Conserve
- Milken Institute of Public Health, The George Washington University, Washington, DC, USA
| | | | - Bruno Sunguya
- Muhimbili University of Health and Allied Science, Box 65001, Dar es Salam, Tanzania
| | - Eligius Lyamuya
- Muhimbili University of Health and Allied Science, Box 65001, Dar es Salam, Tanzania
| | - Benson Kidenya
- Catholic University of Health and Allied Science, Box 1464, Mwanza, Tanzania
| | - Emmanuel Balandya
- Muhimbili University of Health and Allied Science, Box 65001, Dar es Salam, Tanzania
| | - James Samwel Ngocho
- Department of Epidemiology and Applied Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
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Bendotti H, Ireland D, Lawler S, Oates D, Gartner C, Marshall HM. Introducing Quin: The Design and Development of a Prototype Chatbot to Support Smoking Cessation. Nicotine Tob Res 2024; 26:612-620. [PMID: 37936253 PMCID: PMC11033568 DOI: 10.1093/ntr/ntad217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/16/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION Chatbots emulate human-like interactions and may usefully provide on-demand access to tailored smoking cessation support. We have developed a prototype smartphone application-based smoking cessation chatbot, named Quin, grounded in real-world, evidence-, and theory-based smoking cessation counseling sessions. METHODS Conversation topics and interactions in Quitline counseling sessions (N = 30; 18 h) were characterized using thematic, content, and proponent analyses of transcripts. Quin was created by programming this content using a chatbot framework which interacts with users via speech to text. Reiterative changes and additions were made to the conversation structure and dialogue following regular consultation with a multidisciplinary team from relevant fields, and from evidence-based resources. RESULTS Chatbot conversations were encoded into initial and scheduled follow-up "appointments." Collection of demographic information, and smoking and quit history, informed tailored discussion about pharmacotherapy preferences, behavioral strategies, and social and professional support to form a quit plan. Follow-up appointments were programmed to check in on user progress, review elements of the quit plan, answer questions, and solve issues. Quin was programmed to include teachable moments and educational content to enhance health literacy and informed decision-making. Personal agency is encouraged through exploration and self-reflection of users' personal behaviors, experiences, preferences, and ideas. CONCLUSIONS Quin's successful development represents a movement toward improving access to personalized smoking cessation support. Qualitative foundations of Quin provide greater insight into the smoking cessation counseling relationship and enhances the conversational ability of the technology. The prototype chatbot will be refined through beta-testing with end users and stakeholders prior to evaluation in a clinical trial. IMPLICATIONS Our novel study provides transparent description of the translation of qualitative evidence of real-world smoking cessation counseling sessions into the design and development of a prototype smoking cessation chatbot. The successful iterative development of Quin not only embodies the science and art of health promotion, but also a step forward in expanding the reach of tailored, evidence based, in-pocket support for people who want to quit smoking.
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Affiliation(s)
- Hollie Bendotti
- Thoracic Research Centre, Faculty of Medicine, University of Queensland, Chermside, Queensland, Australia
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - David Ireland
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Sheleigh Lawler
- School of Public Health, Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - David Oates
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - Henry M Marshall
- Thoracic Research Centre, Faculty of Medicine, University of Queensland, Chermside, Queensland, Australia
- Department of Thoracic Medicine, The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, Queensland, Australia
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Rabeipoor S, Khademvatani K, Barjasteh S, Ghafuri D. Investigating the impact of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction: a study protocol. Reprod Health 2024; 21:55. [PMID: 38641824 PMCID: PMC11027360 DOI: 10.1186/s12978-024-01776-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/16/2024] [Indexed: 04/21/2024] Open
Abstract
INTRODUCTION Cardiovascular diseases are a common chronic illness in adults, with implications for health and psychological well-being. These implications not only affect the patients themselves but also impact family members, especially the spouses of patients. One significant issue and consequence of this disease is its impact on marital relationships and sexual satisfaction, which can also influence other dimensions of quality of life. The aim of the current study is to determine the effect of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction. METHOD This study is a clinical randomized controlled trial. Sampling will be done on a convenience basis. Participants will be randomly allocated into two groups: control (50 couples) and intervention (50 couples). Couples in 6 groups of 8 members each will attend counseling sessions based con the CHARMS model, with sessions held weekly and lasting for 60 min. Data collection tools will include Demographic information questionnaire, Women's Sexual Quality of Life Questionnaire, Enrich Marital Satisfaction Questionnaire, Sexual Compatibility Questionnaire and Perceived Quality of Relationship Dimensions Questionnaire, which will be completed by women in both groups before and after the intervention. Data will be analyzed using appropriate statistical tests and SPSS software. DISCUSSION This trial will evaluate whether a counseling intervention based on the CHARMS model can enhance sexual quality of life and marital satisfaction of wives of men with myocardial infarction in Urmia city. TRIAL REGISTRATION IRCT code: IRCT20240218061046N1.
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Affiliation(s)
- Soheila Rabeipoor
- Reproductive health, Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Kamal Khademvatani
- Department of Cardiology, School of Medicine, Urmia University of medical sciences, Urmia, Iran
| | - Samira Barjasteh
- Reproductive Health Researcher Center, Clinical Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Delniya Ghafuri
- Nursing & Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11KM Road Sero, Urmia, West Azarbaijan, Iran.
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Bryan JL, Wittkower D, Walker L, Ozanian A, Fisher M, Asghar-Ali AA. Veterans Administration Readjustment Counseling Service Counselors' Training Needs: Results of a National Needs Assessment. J Cogn Psychother 2024; 38:157-168. [PMID: 38631716 DOI: 10.1891/jcp-2023-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
The Department of Veteran Affairs established Readjustment Counseling Service (RCS) to meet the mental health needs of active-duty service members, veterans, and their families. A diverse therapeutic skill set is needed to serve this complex population. To assess training needs, a national mixed-methods needs assessment consisting of a survey for RCS counselors and focus groups among counselors, RCS educational trainers, and national leadership was conducted. Survey results (n = 681) showed that RCS counselors were most interested in trainings on moral injury, acceptance and commitment therapy, and military sexual trauma (MST). Desired trainings aligned with populations served. Themes from focus groups revealed the need for foundational trainings so that all RCS counselors are adept in treating MST, moral injury, and posttraumatic disorder and proficient in caring for couples. Additionally, counselors desired advanced trainings tailored to individual counselors' needs. RCS counselors identified multiple trainings to help them treat those they serve.
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Affiliation(s)
- Jennifer L Bryan
- VA South Central Mental Illness Research, Education and Clinical Center (A Virtual Center), Houston, TX, USA
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David Wittkower
- VA South Central Mental Illness Research, Education and Clinical Center (A Virtual Center), Houston, TX, USA
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Lisa Walker
- Readjustment Counseling Service, Veterans Health Administration, Washington, DC, USA
| | - Alfred Ozanian
- Readjustment Counseling Service, Veterans Health Administration, Washington, DC, USA
| | - Michael Fisher
- Readjustment Counseling Service, Veterans Health Administration, Washington, DC, USA
| | - Ali A Asghar-Ali
- VA South Central Mental Illness Research, Education and Clinical Center (A Virtual Center), Houston, TX, USA
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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11
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Sineke T, Bor J, King R, Mokhele I, Dukashe M, Bokaba D, Inglis R, Kgowedi S, Richman B, Kinker C, Blandford J, Ruiter RAC, Onoya D. Integrating 'undetectable equals untransmittable' into HIV counselling in South Africa: the development of locally acceptable communication tools using intervention mapping. BMC Public Health 2024; 24:1052. [PMID: 38622528 PMCID: PMC11020191 DOI: 10.1186/s12889-024-18471-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The global campaign for "Undetectable equals Untransmittable" (U = U) seeks to spread awareness of HIV treatment as prevention, aiming to enhance psychological well-being and diminish stigma. Despite its potential benefits, U = U faces challenges in Sub-Saharan Africa, with low awareness and hesitancy to endorse it. We sought to develop a U = U communications intervention to support HIV counselling in primary healthcare settings in South Africa. METHODS We used Intervention Mapping (IM), a theory-based framework to develop the "Undetectable and You" intervention for the South African context. The six steps of the IM protocol were systematically applied to develop the intervention including a needs assessment consisting of a systematic review and qualitative research including focus group discussions (FGD) and key informant (KI) interviews. Program objectives and target population were determined before designing the intervention components and implementation plan. RESULTS The needs assessment indicated low global U = U awareness, especially in Africa, and scepticism about its effectiveness. Lay counsellors and clinic managers stressed the need for a simple and standardized presentation of U = U addressing both patients' needs for encouragement and modelling of U = U success but also clear guidance toward ART adherence behaviour. Findings from each step of the process informed successive steps. Our final intervention consisted of personal testimonials of PLHIV role models and their partners, organized as an App to deliver U = U information to patients in primary healthcare settings. CONCLUSIONS We outline an intervention development strategy, currently in evaluation stage, utilizing IM with formative research and input from key U = U stakeholders and people living with HIV (PLHIV).
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Affiliation(s)
- Tembeka Sineke
- Health Economics and Epidemiology Research Office, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Jacob Bor
- Health Economics and Epidemiology Research Office, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Rachel King
- Institute for Global Health Sciences, University of California, San Francisco, USA
| | - Idah Mokhele
- Health Economics and Epidemiology Research Office, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mandisa Dukashe
- South African National AIDS Council (SANAC), Johannesburg, South Africa
| | - Dorah Bokaba
- Tshwane Department of Health, City of Tshwane, South Africa, City of Tshwane, South Africa
| | | | - Sharon Kgowedi
- Health Economics and Epidemiology Research Office, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Bruce Richman
- Prevention Access Campaign, United States of America, New York City, USA
| | - Cameron Kinker
- Prevention Access Campaign, United States of America, New York City, USA
| | - John Blandford
- Centers for Disease Control and Prevention, Johannesburg, South Africa
| | - Robert A C Ruiter
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Dorina Onoya
- Health Economics and Epidemiology Research Office, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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12
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Hollenberger JC, Madden EE. "At the End of the Day it's Their choice": An Exploratory Qualitative Study of Pregnancy Options Counseling. Soc Work Public Health 2024; 39:234-249. [PMID: 38421683 DOI: 10.1080/19371918.2024.2322594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
This study's purpose was to explore the current models and approaches of pregnancy options counseling across three types of agency settings in a Northeastern state. Additionally, this study aimed to determine if individuals who receive pregnancy options counseling obtained medically factual, non-directive, and non-biased information needed to make informed decisions related to their pregnancy decisions. Using qualitative research methodology, semi-structured interviews were conducted with 10 participants across three different agency settings in one state in the Northeastern United States. Results indicated agencies shared a definition of pregnancy options counseling. Outcomes also suggest agency type impacted how pregnancy options counseling was delivered, as variations were found in education provided to patients. Lastly, the interviews imply no standardized model or training for pregnancy options counselors is currently being used.
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Affiliation(s)
| | - Elissa E Madden
- Diana Garland School of Social Work, Baylor University, Waco, TX
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Leon-Larios F, Alonso Llamazares MJ, Mausbach Reisen H, Parra Ribes I, Rey Novoa M, Lahoz-Pascual I. Impact of the hands-on clinical training program for subdermic implant on contraceptive counseling and users' choice in Spain: A 6-month follow-up study. Contraception 2024; 132:110372. [PMID: 38237672 DOI: 10.1016/j.contraception.2024.110372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The study aimed to evaluate the impact of a structured subdermic implant training program on healthcare providers and its effect on the integration of this contraceptive method into patient counselling. STUDY DESIGN The study was a longitudinal experiment with an intervention group, assessing changes at three points: before the training, immediately after, and six months later. The training consisted of a four-hour session combining theory and practical application, conducted by experts in contraception. RESULTS Out of the participants, 376 healthcare professionals (a 34.3% response rate) completed the training and subsequent questionnaires. Post-training, there was an increase in the inclusion of the implant in contraceptive advice and a rise in the monthly number of implants. Knowledge about the implant, including insertion, positioning, removal, and replacement, significantly improved after six months (p<0.05), particularly among general practitioners. CONCLUSIONS The training program successfully enhanced knowledge and handling of the contraceptive implant, leading to its increased recommendation by healthcare providers and selection by patients. Theoretical and practical training in contraception should be compulsory for healthcare providers involved in contraceptive counselling. IMPLICATIONS A training program that includes lectures, video material, and hands-on demonstrations is effective for developing skills in administering the subdermic implant and its integration into contraceptive counselling. Such training should be regular and required for all healthcare professionals providing contraceptive advice.
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Affiliation(s)
- Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Facultad de Enfermería, Fisioterapia y Podología, Sevilla, España.
| | - Maria Jesus Alonso Llamazares
- Unidad de Salud Sexual y Reproductiva, Distrito Sanitario Málaga-Guadalhorce, Servicio Andaluz de Salud, Málaga, España
| | | | | | - Modesto Rey Novoa
- Departamento de Obstetricia y Ginecología, Complejo Asistencial Universitario de Burgos, Burgos, España
| | - Isabel Lahoz-Pascual
- Departamento de Obstetricia y Ginecología, Hospital Universitario Lozano Blesa, Zaragoza, España
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14
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Sheth AN, Momplaisir F, Dumond JB. Shifting the Narrative of Preexposure Prophylaxis Adherence Counseling for Cisgender Women. JAMA 2024; 331:912-914. [PMID: 38427361 DOI: 10.1001/jama.2024.0432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Anandi N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Ponce de Leon Center, Grady Health System, Atlanta, Georgia
| | - Florence Momplaisir
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Julie B Dumond
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
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15
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Kim SS, Prasad A, Nayak MM, Chen H, Srisoem C, DeMarco RF, Castaldi P, Cooley ME. Predictors of Nicotine Replacement Therapy Adherence: Mixed-Methods Research With a Convergent Parallel Design. Ann Behav Med 2024; 58:275-285. [PMID: 38401531 DOI: 10.1093/abm/kaae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Few studies have examined the effect of baseline attitudes toward nicotine replacement therapy (NRT) on its actual adherence in a smoking cessation intervention. PURPOSE This study (i) examined the predictability of baseline variables (quantitative data) on NRT adherence and (ii) explored the congruence of participants' statements about NRT products (qualitative data) during counseling sessions with their baseline attitudes. METHODS This is a mixed-methods research study using a convergent parallel design. Participants included 74 individuals in the treatment group who received behavioral counseling and combination NRT. A Poisson regression analysis was performed to identify baseline variables predicting NRT adherence. Thematic analysis was completed with a subset of participants (n = 38) who varied in NRT attitude scores and adherence. A joint display was created to integrate quantitative and qualitative data and discover convergence. RESULTS Approximately 59% of the participants (41/74) used NRT continuously for ≥5 weeks. Having negative attitudes toward NRT and depressive symptoms predicted NRT adherence even after controlling for education and anxiety symptoms. Thematic analysis revealed that NRT adherence is a learning process that consists of the following three distinctive but interrelated phases: (i) information needs, (ii) comprehensive readiness, and (iii) experiential learning. Of the 38 participants, 34 (89.5%) showed convergence between baseline attitude scores and statements about NRT made during counseling sessions. CONCLUSIONS Individuals who have negative attitudes toward NRT are less likely to use the products in a smoking cessation intervention. Counselors should assess attitudes toward NRT at baseline and address them proactively during counseling sessions.
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Affiliation(s)
- Sun S Kim
- Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Anyah Prasad
- Department of Gerontology, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Manan M Nayak
- Department of Psychosocial Oncology and Palliative Care, The Phyllis F. Cantor Center Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Hua Chen
- Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Chaowalit Srisoem
- Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Rosanna F DeMarco
- Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Peter Castaldi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary E Cooley
- Phyllis F. Cantor Center, Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
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16
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Petra T, Wischmann T, Mayer-Lewis B. Evaluation of infertility counselling in Germany. Arch Gynecol Obstet 2024; 309:1065-1073. [PMID: 38172455 DOI: 10.1007/s00404-023-07316-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE This paper reports on the first evaluation of infertility counselling in Germany. METHODS Sixty-nine infertility counsellors provided feedback via 524 survey sheets and 182 questionnaires were filled in by clients. RESULTS The results show a high level of satisfaction on behalf of the clients. They valued the emotional support, information, and exploration of family-building options with and without medical assistance and the counsellors' expertise. During counselling, coping with the emotional burden of infertility was an important issue, but in more than half of all counselling sessions, future parental issues were addressed. The group of clients seeking support can be described to be very heterogeneous, and counselling issues comprise a wide range of aspects. CONCLUSIONS This piece of research suggests that the following issues need to be considered to improve infertility counselling. Better integration of counselling in infertility clinics, more awareness for infertility counselling for other medical and non-medical professions Better funding for counselling so that its uptake is not dependent upon the financial resources of clients Awareness for new groups of clients and counselling issues such as single and transgender individuals, co-parenting families There is a need for more research and the development of counselling concepts.
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Affiliation(s)
- Thorn Petra
- Praxis für Paar- und Familientherapie, Langener Strasse 37, 64546, Moerfelden, Germany.
| | - Tewes Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Birgit Mayer-Lewis
- Lutheran University of Applied Sciences-Evangelische Hochschule Nürnberg, Bärenschanzstraße 4, 90429, Nuremberg, Germany
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Houlihan TH, Combs J, Smith E, Coulter E, Figueroa L, Falkensammer C, Savla J, Goldmuntz E, Degenhardt K, Szwast A, Shillingford A, Rychik J. Parental Impressions and Perspectives of Efficacy in Prenatal Counseling for Single Ventricle Congenital Heart Disease. Pediatr Cardiol 2024; 45:605-613. [PMID: 38112807 PMCID: PMC10891191 DOI: 10.1007/s00246-023-03355-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023]
Abstract
Although commonly performed, optimal techniques, strategies, and content to achieve the most effective prenatal counseling have not been explored. We investigate the efficacy of prenatal counseling via survey feedback of parents of children with prenatally diagnosed single ventricle. Grades of counseling using a Likert scale (1-5) were solicited to assess: (1) overall impression of quantity of counseling, (2) explanation of the heart defect, (3) preparation for heart surgery, (4) preparation for hospital course and care, (5) preparation for complications and outcomes of a Fontan circulation, and (6) preparation for neurological, school-related, or behavioral problems. Impressions were solicited concerning specific providers. A comprehensive fetal counseling score was calculated for each participant. Burden of care including length of hospitalization was explored as impacting prenatal counseling grades. There were 59 survey respondents. Average age of the children at the time of survey was 4.6 ± 3.3 years (range 1-10 years). Highest grades were for explanation of the heart condition, with lowest grades for preparation for neurological, school-related, or behavioral problems. Cardiac surgeon received the highest with social worker lowest grade for provider. Negative correlation was found between the composite fetal counseling score and parental recollection of length of hospitalization (Pearson r = - 0.357, p < 0.01). Prenatal counseling for neurological, school-related, and behavioral problems in single ventricle is deficient. Further studies analyzing prenatal counseling techniques and content can help improve upon the delivery of this important aspect of prenatal care.
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Affiliation(s)
- Taylor Hartzel Houlihan
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Jill Combs
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Elizabeth Smith
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Elizabeth Coulter
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Lucia Figueroa
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Christine Falkensammer
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Jill Savla
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Elizabeth Goldmuntz
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Karl Degenhardt
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Anita Szwast
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Amanda Shillingford
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Jack Rychik
- Fetal Heart Program, Cardiac Center at the Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
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18
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Hildingsson I, Berterö C, Hultcrantz M, Kärrman Fredriksson M, Peira N, Silverstein RA, Persson M, Sveen J. Support interventions to reduce psychological distress in families experiencing stillbirth in high income countries: A systematic review. Women Birth 2024; 37:296-302. [PMID: 38242808 DOI: 10.1016/j.wombi.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Previous research indicates disparities in the care of bereaved parents and siblings following a stillbirth in the family. The aim of this systematic review was to assess the effects of interventions aimed at reducing psychological distress among parents or siblings in high-income countries after experiencing a stillbirth. METHODS The databases CINAHL, Medline, PsycInfo, Cochrane Library, and EMBASE were searched in August 2022. RESULTS Four intervention studies from the United States (US), the United Kingdom (UK), Finland, and Australia, met the inclusion criteria. The interventions comprised a perinatal grief support team; a perinatal counselling service; a grief support program; and a support package including contacts with peer supporters and health care staff. No studies of interventions for siblings were found. The results could not be synthesised due to disparities in interventions and outcome measures. The risk of bias was assessed as high in all four studies and the certainty for all outcomes was rated as very low. CONCLUSION More controlled trials with rigorous methods are needed to evaluate the effect of bereavement support interventions in parents and siblings after stillbirth. Future studies should include a core outcome set to make them more comparable. Most of the studies in this review were assessed to have an overall high risk of bias, mainly due to problems with missing outcome data; thus, future studies could specifically target this problem.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Nursing, Umeå University, Umeå, Sweden.
| | - Carina Berterö
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Monica Hultcrantz
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Maja Kärrman Fredriksson
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | - Nathalie Peira
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Rebecca A Silverstein
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | | | - Josefin Sveen
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Crisis Psychology, University of Bergen, Bergen, Norway
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19
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Godfrey EM, Zhang Y, Glass S, Wilson ML. Reproductive Planning: Unintended Pregnancy. FP Essent 2024; 538:30-39. [PMID: 38498327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Unintended pregnancy is seen commonly in the family medicine setting. It is defined as a pregnancy that is mistimed (occurring sooner than wanted) or unwanted (not desired at that time or any time in the future). Approximately 45% of all US pregnancies are unintended. Childbirth resulting from an undesired pregnancy has been associated with adverse maternal and child health outcomes. Clinicians should be prepared to manage unplanned pregnancies, including dating pregnancies and discussing pregnancy options. Pregnancy options counseling entails discussing the options to parent, make an adoption plan, or undergo an abortion. Because of the complexity around pregnancy intentions, a framework that places patients at the center of their reproductive decisions and engages them in collaborative decision-making during options counseling is paramount. Patients commonly seek abortion, which is considered essential health care. Because of the current legal climate surrounding abortion in many states, patients may opt to use abortion drugs without licensed clinician oversight, called self-managed medication abortion, which has been shown to be safe and effective. No states require clinicians to report known or suspected self-managed medication abortion.
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Affiliation(s)
- Emily M Godfrey
- Departments of Family Medicine and Obstetrics and Gynecology - University of Washington, Seattle
| | - Ying Zhang
- Reproductive Health and Advocacy Fellowship - Department of Family Medicine - University of Washington, Seattle
| | - Samantha Glass
- Department of Family Medicine and Community Health - Institute for Family Health-Harlem Family Medicine Residency, New York
| | - Megan L Wilson
- Department of Family Medicine - University of Washington, Seattle
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20
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Maspero S, Delle S, Kraus L, Pogarell O, Hoch E, Bachner J, Lochbühler K. Short-term effectiveness of the national German quitline for smoking cessation: results of a randomized controlled trial. BMC Public Health 2024; 24:588. [PMID: 38395782 PMCID: PMC10893695 DOI: 10.1186/s12889-024-18104-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The objective of the present study was to examine the short-term effectiveness of the national German quitline for smoking cessation. METHODS A parallel-group, two-arm, superiority, randomized controlled trial with data collection at baseline and post-intervention (three months from baseline) was conducted. Individuals were randomized to either the intervention group, receiving up to six telephone counselling calls, or the control group, receiving an active control intervention (self-help brochure). The primary outcome was the seven-day point prevalence abstinence at post-assessment. Secondary outcomes included changes in smoking-related cognitions and coping strategies from pre- to post-assessment, the perceived effectiveness of intervention components, and the satisfaction with the intervention. RESULTS A total of n = 905 adult daily smokers were assigned to either the intervention group (n = 477) or the control group (n = 428). Intention-to-treat analyses demonstrated that individuals allocated to the telephone counselling condition were more likely to achieve seven-day point prevalence abstinence at post-assessment compared to those allocated to the self-help brochure condition (41.1% vs. 23.1%; OR = 2.3, 95% CI [1.7, 3.1]). Participants who received the allocated intervention in both study groups displayed significant improvements in smoking-related cognitions and coping strategies with the intervention group showing greater enhancements than the control group. This pattern was also found regarding the perceived effectiveness of intervention components and the satisfaction with the intervention. CONCLUSION The present study provides first empirical evidence on the short-term effectiveness of the national German quitline for smoking cessation, highlighting its potential as an effective public health intervention to reduce the burden of disease associated with smoking. TRIAL REGISTRATION This study is registered in the German Clinical Trials Register (DRKS00025343). Date of registration: 2021/06/07.
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Affiliation(s)
- Simona Maspero
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
| | - Simone Delle
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
| | - Ludwig Kraus
- Department of Public Health Science, Centre for Social Research On Alcohol and Drugs, Stockholm University, Stockholm, Sweden
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva Hoch
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Joachim Bachner
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Kirsten Lochbühler
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany.
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany.
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Bendotti H, Lawler S, Gartner C, Ireland D, Marshall HM. Smoking Cessation Counseling in Practice: A Qualitative Analysis of Quitline Conversations in Queensland, Australia. Health Educ Behav 2024; 51:43-53. [PMID: 37846946 PMCID: PMC10785561 DOI: 10.1177/10901981231206068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Telephone-based services are a practical and effective behavioral support for smoking cessation, yet no in-depth analyses of this counseling have been conducted. Understanding the general content of Quitline conversations can help to improve current practices and may inform future interventions. Therefore, we aimed to independently explore conversation themes, topics, and client questions during Quitline counseling sessions with Quitline clients in Queensland, Australia. A purposive sample of 30 recorded counseling sessions, completed between January and March 2019, were de-identified, transcribed, and thematically analyzed. Seven themes, encompassing 35 topics, were derived from 26 initial calls and four follow-up calls: (1) Client details and building rapport; (2) Client history and motivation to quit; (3) Pharmacotherapy; (4) Behavioral aspects of quitting and relationship with smoking; (5) Understanding nicotine dependence and other important considerations; (6) Additional support and smoking cessation resources; and (7) Planning, goal setting and follow-up. Three themes emerged from 18 client questions including (1) Pharmacotherapy safety and contraindications; (2) Pharmacotherapy instructions and mechanism of action; and (3) Physiology of nicotine dependence. This is the first qualitative analysis of the content of Quitline counseling sessions in Australia. Counselors collect and deliver a breadth of information to provide tailored, evidence-based health care, while building rapport and trust. Findings may be translatable into personalized self-help interventions that are more accessible or appealing to people reluctant to contact Quitline. Harnessing educational opportunities regarding pharmacotherapy adherence and misconceptions can improve client confidence in the product and smoking cessation outcomes. Further research will map conversations to motivational interviewing and behavior change techniques.
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Affiliation(s)
- Hollie Bendotti
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Sheleigh Lawler
- School of Public Health, The University of Queensland, Herston, Australia
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - David Ireland
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Henry M. Marshall
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, Queensland, Australia
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22
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Farahi Z, HashemZadeh M, Farnam F. Sexual counseling for female sexual interest/arousal disorders: a randomized controlled trial based on the "good enough sex" model. J Sex Med 2024; 21:153-162. [PMID: 38181124 DOI: 10.1093/jsxmed/qdad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/08/2023] [Accepted: 12/05/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships. AIM This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD. METHODS A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3. OUTCOMES Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction. RESULTS After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01). CLINICAL IMPLICATIONS This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support. STRENGTHS AND LIMITATIONS The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners. CONCLUSION The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.
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Affiliation(s)
- Zahra Farahi
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 1416634793, Iran
| | - Mozhgan HashemZadeh
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 1416634793, Iran
| | - Farnaz Farnam
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 1416634793, Iran
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23
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Harris E. Tool Could Help Counsel Patients With Liver Disease Who Drink Alcohol. JAMA 2024; 331:281. [PMID: 38170556 DOI: 10.1001/jama.2023.26115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
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24
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Peavy KM, Klipsch A, Soma CS, Pace B, Imel ZE, Tanana MJ, Soth S, Ricardo-Bulis E, Atkins DC. Improving the quality of counseling and clinical supervision in opioid treatment programs: how can technology help? Addict Sci Clin Pract 2024; 19:8. [PMID: 38245783 PMCID: PMC10799386 DOI: 10.1186/s13722-024-00435-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The opioid epidemic has resulted in expanded substance use treatment services and strained the clinical workforce serving people with opioid use disorder. Focusing on evidence-based counseling practices like motivational interviewing may be of interest to counselors and their supervisors, but time-intensive adherence tasks like recording and feedback are aspirational in busy community-based opioid treatment programs. The need to improve and systematize clinical training and supervision might be addressed by the growing field of machine learning and natural language-based technology, which can promote counseling skill via self- and supervisor-monitoring of counseling session recordings. METHODS Counselors in an opioid treatment program were provided with an opportunity to use an artificial intelligence based, HIPAA compliant recording and supervision platform (Lyssn.io) to record counseling sessions. We then conducted four focus groups-two with counselors and two with supervisors-to understand the integration of technology with practice and supervision. Questions centered on the acceptability of the clinical supervision software and its potential in an OTP setting; we conducted a thematic coding of the responses. RESULTS The clinical supervision software was experienced by counselors and clinical supervisors as beneficial to counselor training, professional development, and clinical supervision. Focus group participants reported that the clinical supervision software could help counselors learn and improve motivational interviewing skills. Counselors said that using the technology highlights the value of counseling encounters (versus paperwork). Clinical supervisors noted that the clinical supervision software could help meet national clinical supervision guidelines and local requirements. Counselors and clinical supervisors alike talked about some of the potential challenges of requiring session recording. CONCLUSIONS Implementing evidence-based counseling practices can help the population served in OTPs; another benefit of focusing on clinical skills is to emphasize and hold up counselors' roles as worthy. Machine learning technology can have a positive impact on clinical practices among counselors and clinical supervisors in opioid treatment programs, settings whose clinical workforce continues to be challenged by the opioid epidemic. Using technology to focus on clinical skill building may enhance counselors' and clinical supervisors' overall experiences in their places of work.
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Affiliation(s)
- K Michelle Peavy
- PRISM, Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | | | | | | | - Zac E Imel
- Lyssn.Io, Seattle, Washington, USA
- University of Utah, Salt Lake City, UT, USA
| | | | - Sean Soth
- Evergreen Treatment Services, Seattle, Washington, USA
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25
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McGovern R, Smart D, Alderson H, Fouweather T, Kaner E. Promoting Alcohol Reduction in Non-Treatment Seeking parents (PAReNTS): a pilot feasibility cluster randomized controlled trial of brief alcohol interventions with parents in contact with child safeguarding services. Alcohol Alcohol 2024; 59:agad076. [PMID: 37950898 PMCID: PMC10783945 DOI: 10.1093/alcalc/agad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023] Open
Abstract
Many parents who come into contact with early help and children's social care services are risky drinkers. This study aimed to investigate the feasibility and acceptability of conducting a trial of brief alcohol interventions within this setting. We conducted a three-arm pilot feasibility cluster randomised controlled trial in the North-East of England. The additive interventions were: i) screening and a healthy lifestyle leaflet (control); ii) brief advice; iii) extended brief intervention. The trial was later reduced to two-arm due to the extended brief intervention being infeasible. Of the 1769 parents that were approached, 429 consented to be screened (24%), the majority were eligible to participate (n = 415; 97%), 147 of which (35%) scored ≥5 on the AUDIT-C screening tool. There were 108 parents (74%) who consented to participate in the trial (n = 50 control; n = 58 brief advice). Follow-up rates at 6 and 12-months were 61% and 43%. The TLFB30 was found to be a suitable tool to measure the primary outcome of heavy episodic drinking. Qualitative data showed that parents and practitioners largely found trial procedures to be acceptable, however, care should be taken when discussing alcohol risk with parents in this setting. Most of the a-priori success criteria were met in this pilot feasibility trial. The findings suggest that it may be feasible to conduct a two-arm randomised controlled trial of brief alcohol interventions to parents in contact with early help and social care. The TLFB30 was found to be a suitable tool to measure the primary outcome of heavy episodic drinking.
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Affiliation(s)
- Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Deborah Smart
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Tony Fouweather
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
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Castillo-Hernandez KG, Espinosa A, Molina-Segui F, Ayuso-Peraza G, Mena-Macossay L, Mendez-Dominguez N, Bastarrachea RA, Laviada-Molina H. Lessons learned from a peer-supported diabetes education program in two dissimilar Mayan communities. Front Endocrinol (Lausanne) 2024; 14:1280539. [PMID: 38239980 PMCID: PMC10794663 DOI: 10.3389/fendo.2023.1280539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/16/2023] [Indexed: 01/22/2024] Open
Abstract
Background A steady rise in type 2 diabetes (T2D) in Mexico over the last 30 years has led to 11.5 million Mexicans being affected by this condition. There is an urgent need to develop interventions to prevent complications of T2D. Diabetes self-management education is the cornerstone of promoting self-care. Among all educational strategies, peer support has shown to be an effective method to encourage ongoing self-management. However, customization of interventions for distinct communities is imperative, as failure to do so can hinder the intervention's effectiveness. Methods We implemented a two-year prospective randomized controlled community-based trial in Conkal, a Mayan community from Yucatan, Mexico. The intervention consisted of receiving either a culturally sensitive peer support on top of a diabetes self-management education group (PLG); or a diabetes self-management education group only (EOG; control group). The primary outcome was changes in glycated hemoglobin, while secondary outcomes encompassed changes in systolic and diastolic blood pressure, body mass index, and diabetes self-care practices. Data collection was performed at baseline and every four months during the study period. Discussion Our experiences have highlighted the significance of peer-leader support in cultivating diabetes self-care skills, particularly within smaller, underserved communities characterized by strong social and cultural ties. However, when applied in larger or suburban settings, selecting peer leaders should be meticulous, considering sectorization within specific neighborhoods to foster a sense of belonging and familiarity among natural community clusters. In larger settlemnts, factors such as transportation challenges, time limitations, caregiving obligations, limited venue access, and changes in session locations can drive program discontinuation. Additionally, individuals with lower educational attainment are more susceptible to abandonment. Notably, those with lower education, uncontrolled diabetes, and extended diabetes duration exhibit a greater potential for improving glycemic control than their counterparts. Clinical registration https://www.isrctn.com/ISRCTN96897082.
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Affiliation(s)
- Karen G. Castillo-Hernandez
- Department of Human Nutrition and Metabolism Research, Health Sciences School, Universidad Marista de Mérida, Merida, Mexico
| | - Alan Espinosa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Fernanda Molina-Segui
- Department of Human Nutrition and Metabolism Research, Health Sciences School, Universidad Marista de Mérida, Merida, Mexico
| | - Giselle Ayuso-Peraza
- Department of Human Nutrition and Metabolism Research, Health Sciences School, Universidad Marista de Mérida, Merida, Mexico
| | - Leticia Mena-Macossay
- Department of Human Nutrition and Metabolism Research, Health Sciences School, Universidad Marista de Mérida, Merida, Mexico
| | | | - Raúl A. Bastarrachea
- Samsun Diabetes Research Institute, Santa Barbara, California, CA, United States
| | - Hugo Laviada-Molina
- Department of Human Nutrition and Metabolism Research, Health Sciences School, Universidad Marista de Mérida, Merida, Mexico
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Elswick A, Murdock M, Fallin-Bennett A. Enhancing Role Integrity for Peer Workers. Community Ment Health J 2024; 60:124-130. [PMID: 37401957 PMCID: PMC10799832 DOI: 10.1007/s10597-023-01156-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/10/2023] [Indexed: 07/05/2023]
Abstract
Although informal peer support has been a central feature of recovery for people with substance use disorder (SUD), more recently there has been a stark increase in formal models of peer support. In the infancy of formalized peer support, researchers warned of potential threats to the integrity of the peer support role. Now, almost two decades into the rapid expansion of peer support, research has yet to evaluate the extent to which peer support is being implemented with fidelity and role integrity. The present study aimed to assess peer workers' perceptions of peer role integrity. Qualitative interviews were conducted with 21 peer workers in Central Kentucky. Results suggest that the role of peers is not well understood by onboarding organizations, and thus, the integrity of peer support is diluted. Findings from this study suggest room for improvement in the training, supervision, and implementation of peer support.
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Affiliation(s)
- Alex Elswick
- Department of Family Sciences , University of Kentucky, Lexington, USA.
- Voices of Hope-Lexington, Inc., Lexington, USA.
| | - Melinda Murdock
- Department of Family Sciences , University of Kentucky, Lexington, USA
| | - Amanda Fallin-Bennett
- Voices of Hope-Lexington, Inc., Lexington, USA
- College of Nursing, University of Kentucky, Lexington, USA
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Kane JC, Figge C, Paniagua-Avila A, Michaels-Strasser S, Akiba C, Mwenge M, Munthali S, Bolton P, Skavenski S, Paul R, Simenda F, Whetten K, Cohen J, Metz K, Murray LK. Effectiveness of trauma-focused cognitive behavioral therapy compared to psychosocial counseling in reducing HIV risk behaviors, substance use, and mental health problems among orphans and vulnerable children in Zambia: a community-based randomized controlled trial. AIDS Behav 2024; 28:245-263. [PMID: 37812272 DOI: 10.1007/s10461-023-04179-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/10/2023]
Abstract
Orphans and vulnerable children (OVC) in sub-Saharan Africa are at high risk for HIV infection and transmission. HIV prevention and treatment efforts with OVC are hindered by mental health and substance use problems. This randomized controlled trial compared a mental health intervention, Trauma Focused Cognitive Behavioral Therapy (TF-CBT), to an enhanced version of an existing HIV Psychosocial Counseling (PC+) program among 610 adolescents who met PEPFAR criteria for OVC and had HIV risk behaviors in Lusaka, Zambia. Outcomes included HIV risk behaviors (e.g., risky sexual behaviors), mental health (internalizing symptoms, externalizing behaviors, PTSD) and substance use. At 12-month follow-up, there were significant within group reductions in both groups for all outcomes, with the only significant between group difference being for substance use, in which OVC who received TF-CBT had significantly greater reductions than OVC who received PC+. In a subgroup analysis of OVC with high levels of PTSD symptoms, TF-CBT was superior to PC + in reducing internalizing symptoms, functional impairment, and substance use. Findings support TF-CBT for reducing substance use among OVC. Subgroup analysis results suggest that a robust intervention such as TF-CBT is warranted for OVC with significant mental and behavioral health comorbidities. The similar performance of TF-CBT and PC + in the overall sample for risky sexual behavior and mild mental health problems indicates that enhancing existing psychosocial programs, such as PC, with standard implementation factors like having a defined training and supervision schedule (as was done to create PC+) may improve the efficacy of HIV risk reduction efforts.Clinical Trials Number: NCT02054780.
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Affiliation(s)
- Jeremy C Kane
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Caleb Figge
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alejandra Paniagua-Avila
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Susan Michaels-Strasser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- ICAP, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Christopher Akiba
- Department of Health Behavior, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA
| | - Mwamba Mwenge
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Saphira Munthali
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Paul Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephanie Skavenski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ravi Paul
- School of Medicine, University of Zambia, University Teaching Hospital, Lusaka, Zambia
| | | | - Kathryn Whetten
- Duke Global Health Instittute, Durham, NC, USA
- Duke Sanford School of Public Policy, Durham, NC, USA
- Center for Health Policy and Inequalities Research, Durham, NC, USA
| | - Judith Cohen
- Drexel University College of Medicine, Allegheny Health Network/Allegheny General Hospital, Pittsburgh, PA, USA
| | - Kristina Metz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laura K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Zinsou C, Guedegbe G, Dossou L, Ognin J, Raobelison AT, Flomen L, Bouanchaud P. Lessons Learned in Improving the Quality of a Free Reproductive Health Hotline in Benin. Glob Health Sci Pract 2023; 11:e2200296. [PMID: 38123953 PMCID: PMC10749658 DOI: 10.9745/ghsp-d-22-00296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Since 2006, the Ligne Verte project-a toll-free national hotline that provides counseling and provider linkages to family planning, HIV, and sexually transmitted infection services-has been implemented by the Association Béninoise pour le Marketing Social et la Communication pour la Santé (ABMS) in Benin. Annual evaluations have been conducted to monitor client satisfaction, with feedback mechanisms to learn from callers and staff, aiming to continually improve the program. We document lessons learned from these evaluations, outline the adaptation process to improve the quality of the hotline, present results from Ligne Verte caller and counselor studies, and describe how the studies fed client-driven changes to the project. METHODS Annual rounds of semistructured phone interviews with Ligne Verte callers and call center advisors were conducted. The sample of clients interviewed included consenting men and women aged 18 years and older who had used Ligne Verte services in the 3 months preceding the evaluation. All advisors working on the helpline were also eligible for inclusion in qualitative interviews. RESULTS From 2013 to 2020, most callers were satisfied with the Ligne Verte project. Users reported appreciating the accurate, timely, and confidential support they received from the helpline but noted the need to expand the service to other local languages and improve call quality. Call center advisors requested mental health support. In employing a systematic approach to program improvement, ABMS was able to add extended language services, upgrade their telecommunication hardware, and provide a psychologist for call center advisors. These program adaptations have increased caller satisfaction by 20 percentage points, and in 2020, 95% of callers reported being satisfied with their Ligne Verte experience. CONCLUSION Taking a consumer-centered approach, listening to user feedback, and making evidence-based recommendations to improve the Ligne Verte project has led to an overall increase in caller satisfaction.
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Affiliation(s)
- Cyprien Zinsou
- Association Béninoise pour le Marketing Social et la Communication pour la Santé, Cotonou, Benin
| | - Ghyslain Guedegbe
- Association Béninoise pour le Marketing Social et la Communication pour la Santé, Cotonou, Benin
| | - Leonce Dossou
- Association Béninoise pour le Marketing Social et la Communication pour la Santé, Cotonou, Benin
| | - Judith Ognin
- Association Béninoise pour le Marketing Social et la Communication pour la Santé, Cotonou, Benin
| | - Ando Tiana Raobelison
- Association Béninoise pour le Marketing Social et la Communication pour la Santé, Cotonou, Benin
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Close ED, Gunn AO, Cooke A. Preconception Counseling and Care. Am Fam Physician 2023; 108:605-613. [PMID: 38215421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Primary care for women and other patients with similar reproductive potential can include a discussion about pregnancy and, depending on the patient's intent, contraceptive care or preconception care. Folic acid supplementation of at least 400 mcg per day is recommended to reduce the risk of neural tube defects, because many pregnancies are unplanned. Having a body mass index of 18.5 to 24.9 kg per m2 before pregnancy also reduces complications. Patients with a history of bariatric surgery should delay pregnancy for at least 12 months post-procedure and ensure that their nutritional status is adequate before conception. It is essential to review the patient's medications and chronic medical conditions to avoid teratogens and optimize treatment before conception to reduce maternal and fetal morbidity and mortality. Having a prepregnancy A1C level of less than 6.5% is strongly recommended for patients with diabetes mellitus to minimize congenital anomalies and complications. Vaccinations should be updated to prevent adverse outcomes related to infections. Infectious disease screenings should be updated before conception to allow for treatment, prophylaxis, or timing of pregnancy to avoid complications. Screening and counseling should be provided for substance use and potential environmental exposures to identify and mitigate detrimental exposures before pregnancy.
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Affiliation(s)
- Elizabeth D Close
- University of Tennessee Health Science Center College of Medicine-Chattanooga, Chattanooga, Tennessee
| | - April O Gunn
- University of Tennessee Health Science Center College of Medicine-Chattanooga, Chattanooga, Tennessee
| | - Alexandria Cooke
- University of Tennessee Health Science Center College of Medicine-Chattanooga, Chattanooga, Tennessee
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Freeman E, Paul R, Dorsey M, Madden T. Comparison of interpersonal quality of contraceptive counseling delivered via telehealth versus in person. Contraception 2023; 128:110129. [PMID: 37499735 DOI: 10.1016/j.contraception.2023.110129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/11/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES This study aimed to compare the interpersonal quality of contraceptive counseling between telehealth and in-person visits. STUDY DESIGN Patients at a single Title X-funded clinic selected their preferred counseling modality (in person or telehealth via video or telephone) when scheduling an appointment for contraception. After counseling, we invited patients to complete a survey and recorded their desired contraceptive method. We assessed the quality of counseling using the Interpersonal Quality in Family Planning scale. We reviewed the electronic medical record to identify any subsequent clinician visit. We performed between-group comparisons using Mann-Whitney U, χ2, and Fisher exact tests. RESULTS From March 2021 to June 2022, 360 patients were eligible to participate, and 296 (82%) completed the survey and were included in the analysis; 150 (51%) completed counseling in person, and 146 (49%) completed counseling via telehealth. In the telehealth group, 102 (70%) chose telephone, and 44 (30%) chose video. Respondent characteristics were similar between groups. The majority of respondents in both groups reported high quality of counseling, defined as a top score on the Interpersonal Quality in Family Planning scale (75.0% telehealth respondents and 80.0% in person, p = 0.30). Compared to respondents completing in-person counseling, telehealth respondents were less likely to have a subsequent clinician visit (89.0% versus 100.0%, p < 0.001). CONCLUSIONS The majority of respondents reported high-quality contraceptive counseling without significant difference between the modalities. However, respondents choosing telehealth were less likely to have a subsequent clinician visit. Given the higher uptake of telephone compared to video, telehealth via telephone may be more accessible or acceptable to some patients. IMPLICATIONS Contraceptive counseling via telehealth has similar high interpersonal quality when compared to traditional, in-person visits. However, barriers may exist for patients who choose telehealth contraceptive counseling to access subsequent in-person care. Utilization of telehealth for contraceptive visits may provide opportunities for more equitable health care and to expand contraceptive access.
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Affiliation(s)
- Emily Freeman
- Divisions of Clinical Research & Family Planning, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Department of Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH, United States.
| | - Rachel Paul
- Divisions of Clinical Research & Family Planning, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Megan Dorsey
- Divisions of Clinical Research & Family Planning, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Tessa Madden
- Divisions of Clinical Research & Family Planning, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Division of Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
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Goldschmidt L, Mncina B, Langa M, Rebello S, Budaza T, Tshabalala J, Achoki T. Lay counsellors' experiences of administering the AUDIT-C as a brief screening tool in a South African township. BMC Health Serv Res 2023; 23:1227. [PMID: 37946216 PMCID: PMC10633970 DOI: 10.1186/s12913-023-10230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND South Africa presents one of the riskiest patterns of alcohol consumption, with per capita consumption above the African regional average. Globally, there has been an increased focus on the potential of appointing lay counsellors to administer alcohol intervention strategies in resource-limited contexts. Given the increasing need for relevant and efficient intervention strategies in response to high-risk alcohol consumption, screening instruments such as the AUDIT-C have gained increased attention. METHODS This paper explores the experiences of 15 lay counsellors in response to the training received on how to administer the AUDIT-C instrument, as well as provide interventions such as brief advice or an appropriate referral, in the resource-limited South African township of Alexandra, Johannesburg. A focus group was facilitated for this purpose and, thereafter, a thematic content analysis was applied to identify the themes most central to the lay counsellors' experiences. RESULTS The research findings suggest that the lay counsellors perceived the training to be adequate in preparing them for administrating the AUDIT-C and for providing any relevant interventions, and that their confidence in administering the instrument developed as the project progressed. However, recruitment and administration challenges were experienced in primary healthcare and community settings, and lay counsellors perceived home visits to be more appropriate with respect to issues related to confidentiality and stigmatisation. CONCLUSION Overall, while lay counsellors feel that the training they received on the tool and the tool itself is useful for effectively implementing the AUDIT-C in low-resource communities, the availability and efficiency of alcohol treatment services in Alexandra Township need to be improved.
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Affiliation(s)
- Lynne Goldschmidt
- Department of Psychology, University of the Witwatersrand, Johannesburg, South Africa.
| | - Buyisile Mncina
- Department of Psychology, University of the Witwatersrand, Johannesburg, South Africa
| | - Malose Langa
- Department of Psychology, University of the Witwatersrand, Johannesburg, South Africa
- Centre for the Study of Violence and Reconciliation, CSVR, Johannesburg, South Africa
| | | | | | | | - Tom Achoki
- ABInBev Foundation, New York, USA
- Africa Institute for Health Policy, Nairobi, Kenya
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Forrest LE, Tutty E, De Silva AP, Petelin L, Ruscigno A, Purvis R, Monohan K, Kentwell M, Sexton A, Stafford L, James PA. Personalising genetic counselling (POETIC) trial: Protocol for a hybrid type II effectiveness-implementation randomised clinical trial of a patient screening tool to improve patient empowerment after cancer genetic counselling. Trials 2023; 24:712. [PMID: 37941026 PMCID: PMC10631179 DOI: 10.1186/s13063-023-07723-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Genetic counselling aims to identify, and address, patient needs while facilitating informed decision-making about genetic testing and promoting empowerment and adaptation to genetic information. Increasing demand for cancer genetic testing and genetic counsellor workforce capacity limitations may impact the quality of genetic counselling provided. The use of a validated genetic-specific screening tool, the Genetic Psychosocial Risk Instrument (GPRI), may facilitate patient-centred genetic counselling. The aim of this study is to assess the effectiveness and implementation of using the GPRI in improving patient outcomes after genetic counselling and testing for an inherited cancer predisposition. METHODS The PersOnalising gEneTIc Counselling (POETIC) trial is a hybrid type 2 effectiveness-implementation trial using a randomised control trial to assess the effectiveness of the GPRI in improving patient empowerment (primary outcome), while also assessing implementation from the perspective of clinicians and the healthcare service. Patients referred for a cancer risk assessment to the conjoint clinical genetics service of two metropolitan hospitals in Victoria, Australia, who meet the eligibility criteria and consent to POETIC will be randomised to the usual care or intervention group. Those in the intervention group will complete the GPRI prior to their appointment with the screening results available for the clinicians' use during the appointment. Appointment audio recordings, clinician-reported information about the appointment, patient-reported outcome measures, and clinical data will be used to examine the effectiveness of using the GPRI. Appointment audio recordings, health economic information, and structured interviews will be used to examine the implementation of the GPRI. DISCUSSION The POETIC trial takes a pragmatic approach by deploying the GPRI as an intervention in the routine clinical practice of a cancer-specific clinical genetics service that is staffed by a multidisciplinary team of genetics and oncology clinicians. Therefore, the effectiveness and implementation evidence generated from this real-world health service setting aims to optimise the relevance of the outcomes of this trial to the practice of genetic counselling while enhancing the operationalisation of the screening tool in routine practice. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry registration number 12621001582842p. Date of registration: 19th November 2021.
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Affiliation(s)
- Laura E Forrest
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia.
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Erin Tutty
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
| | - Anurika P De Silva
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Methods and Implementation Support for Clinical and Health (MISCH) research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Lara Petelin
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Camperdown, Australia
| | - Amy Ruscigno
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Rebecca Purvis
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Katrina Monohan
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Maira Kentwell
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adrienne Sexton
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lesley Stafford
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paul A James
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, Melbourne, Victoria, 3008, Australia
- Parkville Familial Cancer Centre & Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
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Xu Y, Chan CS, Tsang C, Cheung F, Chan E, Yip PSF. Evaluating the effectiveness of concurrent sessions and counselors' attention allocation in online counseling. J Consult Clin Psychol 2023; 91:640-651. [PMID: 37616124 DOI: 10.1037/ccp0000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
OBJECTIVE With its anonymity and accessibility, text-based online counseling has shown great potential in reaching people with mental health needs. One strategy adopted to meet the service gap is concurrent counseling, that is, each counselor attending to more than one client at a time. To date, there is no reported evidence supporting its rationality and effectiveness. This study investigated the potential opportunities, effectiveness, and caveats in concurrent service delivery and identified the optimal cutoff number of concurrent sessions while maintaining the quality of service at or above a set threshold. METHOD We analyzed the transcript of 54,716 online counseling sessions from Open Up, a free, 24/7 text-based counseling service, to develop an attention score that measures the attention allocation of counselors and examined the impact of the counselor's attention allocation on client satisfaction and service outcomes. RESULTS On average, compared to nonconcurrent sessions, concurrent sessions were longer, more likely to end prematurely, and had lower client satisfaction. We also identified an optimal attention score of approximately 0.4 (out of 1.0, which denotes full attention), which translates to two to three concurrent sessions. CONCLUSIONS This study provides empirical evidence for the feasibility of conducting multiple text-based sessions concurrently without compromising service quality and client experience. Our method of measuring the counselor attention allocation offers a way to systematically assess and evaluate concurrent sessions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Yucan Xu
- Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong
| | | | - Christy Tsang
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong
| | - Florence Cheung
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong
| | - Evangeline Chan
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong
| | - Paul S F Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong
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Moylan CB, Marcussen B, Carr LJ, Daly JM, Slayman TG. Personal and Professional Physical Activity Practices among Sports Medicine Physicians. Curr Sports Med Rep 2023; 22:387-394. [PMID: 37921392 DOI: 10.1249/jsr.0000000000001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
ABSTRACT Less than a quarter of the population achieves the recommended Physical Activity Guidelines for Americans. Physicians who achieve the guidelines themselves may be more likely to promote them to patients given strong evidence physicians' personal health habits influence their patient counseling practices. We surveyed primary care and sports medicine specialty physicians about personal exercise habits and beliefs and patient counseling practices. Sports medicine physicians were significantly more likely to meet the Physical Activity Guidelines for Americans and believe that as physicians, they have an obligation to do so. They also were more likely to ask about, counsel, and refer patients to physical activity resources than other primary care physicians. Our results are consistent with previous evidence that physicians' personal habits influence their practice recommendations. This provides support that physicians' personal beliefs about the importance of exercise and sense of obligation to achieve recommended levels themselves plays a strong role in their patient care practices.
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Affiliation(s)
| | - Britt Marcussen
- University of Iowa, Department of Family Medicine, Iowa Sports Medicine, Iowa City, IA
| | - Lucas J Carr
- University of Iowa, Department of Health and Human Physiology, Iowa City, IA
| | - Jeanette M Daly
- University of Iowa, Department of Family Medicine, Iowa Sports Medicine, Iowa City, IA
| | - Tyler G Slayman
- University of Iowa, Department of Family Medicine, Iowa Sports Medicine, Iowa City, IA
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Algarni SS, Alqahtani MM, Alanazi FD, Alruqayti AA, Aghanem IS, Alajimi KA, Alnkhali AD, Alshahri RA, Alhadlaq T, Alruwaili A, Mumenah N, Siraj RA, Alwadeai KS, Alossaimi SH, Alqarni AA, Alahmari AD, Alotaibi TF, Aljohani H, Ismaeil T, Alanazi AM. Knowledge, practice, counseling confidence, and intention to use AAR model of smoking cessation among respiratory therapists: A cross-sectional study. Medicine (Baltimore) 2023; 102:e35816. [PMID: 37904391 PMCID: PMC10615525 DOI: 10.1097/md.0000000000035816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
There is a paucity of research on knowledge, practice, counseling confidence, and intention to use ask, advice, and refer (AAR) model of smoking cessation among respiratory therapists (RTs). Thus, we aimed to analyze the characteristics and factors that may influence them. We collected data using online questionnaires from convenience sample of active licensed RTs in Saudi Arabia. We included 206 participants. A descriptive analysis of the demographic information and characteristics of smoking cessation counseling practices and confidence were conducted. Multiple linear regression was used to test whether demographic variables and AAR model components significantly predicted the RTs' calculated cumulative score of tobacco counseling confidence skills. Our results showed a deficiency in tobacco knowledge among RTs. Most RTs did not have certifications or attend lectures or seminars related to tobacco treatment. RTs were unfamiliar with the smoking cessation program contact information and mobile smoking cessation clinics but reported a high tobacco counseling confidence score. Clinical experience (P = .008), familiarity with smoking cessation program contact information (P = .02), inquiry regarding smoking status (P < .001), and advice regarding smoking status (P = .03) significantly predicted tobacco counseling confidence levels in RTs. RT experience, knowledge, and awareness of smoking cessation programs could enhance the confidence level among them in implementing AAR model.
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Affiliation(s)
- Saleh S. Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed M. Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Fares D. Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz A. Alruqayti
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ibrahem S. Aghanem
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Khalid A. Alajimi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulhamed D. Alnkhali
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Raed A. Alshahri
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Turki Alhadlaq
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Arwa Alruwaili
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Noora Mumenah
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Rayan A. Siraj
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Hasa, Saudi Arabia
| | - Khalid S. Alwadeai
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sami H. Alossaimi
- Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Abdullah A. Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayedh D. Alahmari
- Department of Respiratory Therapy, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Tareq F. Alotaibi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Hassan Aljohani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Taha Ismaeil
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Abdullah M. Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
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Burr C, Schnackenberg J, Richter D, Weidner F. [Pilot study of Experience Focused Counselling by nurses with people who hear voices: Evaluation of the implementation of the study protocol]. Pflege 2023; 36:341-348. [PMID: 37840265 DOI: 10.1024/1012-5302/a000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Pilot study of Experience Focused Counselling by nurses with people who hear voices: Evaluation of the implementation of the study protocol Abstract: Background: Hearing voices and the treatment and support of people who hear voices and are distressed by the experience are defined differently in psychiatry. In contrast to the medical approach to define and treat voices as symptoms of a disease, the EFC counselling approach developed with voice-hearers focuses on non-pathologizing acceptance and a constructive relationship to voices. Mental health nurses with their focus on everyday life are predestined for the dissemination and application of alternative therapeutic approaches in practice. Aim: The aim was to evaluate the study protocol as part of a pilot study regarding its suitability for a larger trial. Method: The multi centre pilot study had a single-blind randomised controlled design. The intervention consisted of EFC counselling by nurses with people who hear voices. The control group received Treatment As Usual (TAU). The suitability of the study design was evaluated in terms of recruitment, burden on study participants, suitability of assessment tools, the application of EFC counselling and the use of study nurses. Results: As planned 21 participants could be included in the study within fifteen months across the two study sites. Overall, the participants rated the study as not very burdensome and the intervention as helpful. The application of EFC by the nurses as well as the use of study nurses was assessed as good and suitable respectively. Discussion: The evaluation of the study protocol shows that with minor adjustments it is suitable for conducting a larger study.
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Affiliation(s)
- Christian Burr
- Departement Gesundheit, Berner Fachhochschule, Schweiz
- Universitäre Psychiatrische Dienste UPD, Universitätsklinik für Psychiatrie und Psychotherapie, Bern, Schweiz
- Vinzenz-Pallotti University, Vallendar, Deutschland
| | | | - Dirk Richter
- Departement Gesundheit, Berner Fachhochschule, Schweiz
- Universitäre Psychiatrische Dienste UPD, Zentrum Psychiatrische Rehabilitation, Bern, Schweiz
| | - Frank Weidner
- Vinzenz-Pallotti University, Vallendar, Deutschland
- Universität Koblenz, Deutschland
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Agarwal S, Venkatesan C, Tarui T, Gano D. Advancing the Field of Fetal Neurology: A Call for Global Collaborations. Indian Pediatr 2023; 60:795-799. [PMID: 37818807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Fetal Neurology continues to grow as a distinct subspecialty informed by evolving precision diagnosis with advancements in prenatal neuroimaging, genetic and infectious testing. While there are inherent limitations and challenges in prenatal diagnostic testing and prognostic counseling, the interdisciplinary approach allows comprehensive guidance for perinatal and postnatal management of neurological disorders detected early in development. The current practice of fetal neurology is heterogenous and variable across centers. In low- and middle-income countries (LMICs), fetal neurology practice is under the umbrella of neonatal and perinatal medicine. Since infrastructure and capacity for prenatal diagnostic and prognostic counseling may be variable, the practice approach may have to be modified regionally based on resources, education, and setting. There is a need for collaborative development of educational opportunities, training, guidelines, and research exploring short- and long-term outcome of prenatally identified neurological conditions. Interdisciplinary collaborations and global professional networks are crucial to advance this unique subspecialty.
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Affiliation(s)
- Sonika Agarwal
- Division of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Correspondence to: Sonika Agarwal, Division of Neurology and Pediatrics, Children's Hospital of Philadelphia, 3401, Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Charu Venkatesan
- Division of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Tomo Tarui
- Division of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Dawn Gano
- Division of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Ibrahim AK, Syed Sulaiman SA, Awaisu A, Shafie AA. Impact of brief smoking cessation intervention on quitting rate and glycemic control in patients with diabetes: a randomized controlled trial. J Int Med Res 2023; 51:3000605231208598. [PMID: 37890143 PMCID: PMC10612461 DOI: 10.1177/03000605231208598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE We aimed to evaluate the impact of a brief smoking cessation intervention among patients with diabetes. METHODS This randomized interventional clinical trial involved patients with diabetes who smoked tobacco and attended the outpatient diabetes clinic at Penang Hospital, Malaysia. Participants were randomized into a control group that usual care for patients with diabetes, or an intervention group that received a 5-minute physician-delivered brief counseling session on tobacco cessation using the 5A's strategy, in addition to usual care. Primary outcome measures were assessed over three visits (every 3-4 months) including mean glycated hemoglobin level, quitting rate, blood pressure, and mean number of cigarettes smoked per day. RESULTS In total, 126 participants were finally enrolled in the study, with 63 patients each in the intervention and control groups. There was no significant difference between the two groups with respect to glycemic control, blood pressure, and quitting rate. However, patients in both groups reduced their cigarette consumption. CONCLUSIONS The present brief smoking cessation intervention did not result in better glycemic control, blood pressure, or quitting rates among patients with diabetes. This patient group may require more intensive guidance for better outcomes.Trial registration: This study is registered in ClinicalTrials.gov (NCT04864327); https://clinicaltrials.gov/ct2/results?pg=1&load=cart&id=NCT04864327.
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Affiliation(s)
| | | | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Asrul Akmal Shafie
- School of Pharmaceutical Science, Universiti Sains Malaysia, Penang, Malaysia
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Gray D, Manning R. Examining the impact of a Volunteer-Delivered counselling service for people experiencing sight loss: a mixed methods evaluation. Disabil Rehabil 2023; 45:3352-3358. [PMID: 36131628 DOI: 10.1080/09638288.2022.2125591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/17/2022] [Accepted: 09/13/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This article describes a mixed methods evaluation of a volunteer-delivered counselling service for people experiencing sight loss, to identify the outcomes, benefits, and challenges of this model of service provision within rehabilitation services. MATERIALS AND METHOD A mixed methods approach was used, with both outcome and process evaluation components. Outcomes for 817 service users were assessed pre-and-post service use, using standardised (CORE10) measures. Semi-structured interviews and surveys with 22 volunteer counsellors and 4 senior counsellors were conducted, to understand their experiences of the format, content, and delivery of the service. RESULTS Clients presenting for counselling experienced significant levels of self-reported depression, anxiety, and feelings of bereavement. Analysis showed a significant positive change in clinical outcomes for service users who received volunteer-delivered counselling services. Volunteer counsellors saw the unique and specialist nature of the service as critical for its impact on clients, and reported benefits of volunteering for this service, including developing their skills with this client group. CONCLUSIONS Volunteer-delivered counselling can be effective for people affected by sight loss, providing accessible and much-needed psychological support, which is relevant given current pressures on health and social care services. There are key lessons for future models of this type.Implications for RehabilitationVision loss can have a profound negative impact on people's emotional and mental well-being, with many advocating for counselling and emotional support (CESS) to be included in low vision rehabilitative services.Despite this, access to psychological support is often overlooked in low vision rehabilitation, and access to CESS services is often poor.This study evaluated a volunteer-delivered CESS service, demonstrating that this model of service delivery is effective for this group.There are clear advantages to a volunteer-delivered model for those with sight loss, in terms of widening access, supporting integrated rehabilitative care, and reducing health inequalities.
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Affiliation(s)
- Debra Gray
- Department of Psychology, University of Winchester, Winchester, UK
| | - Rachel Manning
- School of Psychology, University of Buckingham, Buckingham, UK
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Gutman S, Connor H, Mumford SL, Gilmore E, Roe AH, Schreiber CA. Feasibility and acceptability of virtual group contraceptive counseling prior to abortion care. Contraception 2023; 126:110114. [PMID: 37467921 DOI: 10.1016/j.contraception.2023.110114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES This study aimed to evaluate the feasibility and acceptability of virtual group contraceptive counseling in the abortion care setting. STUDY DESIGN Patients seeking abortion care at an urban university hospital were invited to participate in this cohort study. Prior to their clinical appointments, groups of two to six patients participated in 45-minute virtual contraceptive counseling visits facilitated by study staff. Contraceptive method use, effectiveness, and side effects were reviewed according to group interest. Participant satisfaction scores were collected immediately following the sessions. After their appointments, providers estimated the time spent on contraceptive counseling during the clinical visit. RESULTS Of 195 patients approached, 86 (44%) were enrolled. Fifty-seven (66%) enrolled patients completed a session. The most common reason for declining enrollment was concern about the time commitment. Most (93%) participants reported being "satisfied" or "very satisfied" overall, and 96% would recommend group contraceptive counseling to a friend. Providers reported that compared to typical counseling, participants required a shorter amount of time during the clinical visit than nonparticipants (time spent <5 minutes: 74% vs 54%). CONCLUSIONS Virtual group contraceptive counseling for patients seeking abortion was feasible and acceptable in this study. Group virtual visits may reduce provider time burden, add value when virtual care delivery is desired or required, and deserve further study. IMPLICATIONS Family planning clinics can consider incorporating virtual group counseling as a person-centered and efficient approach to contraceptive counseling at the time of abortion care.
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Affiliation(s)
- Sarah Gutman
- Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States.
| | - Hannah Connor
- Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Sunni L Mumford
- Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Emma Gilmore
- Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Andrea H Roe
- Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Courtney A Schreiber
- Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
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Li X, Carney JJ, Li F. Therapist self-efficacy developmental profiles, supervisory working alliance, and client outcome: A growth mixture analysis. J Couns Psychol 2023; 70:548-561. [PMID: 37384488 DOI: 10.1037/cou0000695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The aims of this study were to investigate the overall, and subgroups of, developmental profiles of the three domains of counseling self-efficacy (CSE) among beginning therapist trainees in China. Further, the associations between the different CSE developmental profiles and the trainees' perceived supervisory working alliance (SWA) and their clients' reported symptom distress were also examined. Participants included 258 beginning therapist trainees in a master's level counseling training program in China, who completed measures of CSE in three waves throughout the practicum and rated SWA after every supervision session. Clients rated their symptom distress before and after treatment. Growth mixture analysis results indicated that overall, trainees showed the highest initial confidence in helping skills use, followed by in session management, and last in handling counseling challenges, and there were significant increases in all three aspects of self-efficacy. Second, four subgroups of developmental profiles emerged, including beginning moderate with no changes, beginning moderate with moderate increases, beginning low with marked increases, and beginning high with partial minor increase. Third, the beginning moderate with no changes subgroup showed lower ratings of SWA and the lowest average client symptom improvement. Recommendations for future research and implications for training are presented. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Xu Li
- Department of Educational Psychology, University of Wisconsin-Milwaukee
| | - Jalen J Carney
- Department of Educational Psychology, University of Wisconsin-Milwaukee
| | - Feihan Li
- Faculty of Psychology, Beijing Normal University
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Shirwani A, Kuller JA, Dotters-Katz SK, Addae-Konadu K. Nicotine Use During Pregnancy: Cessation and Treatment Strategies. Obstet Gynecol Surv 2023; 78:589-597. [PMID: 37976314 DOI: 10.1097/ogx.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Abstract The use of tobacco and nicotine products during pregnancy is known to increase the risk of adverse effects on the fetus. Increased education and research have resulted in greater rates of smoking cessation during pregnancy, with a decline from 13.2% of pregnant individuals smoking in 2006 to 7.2% in 2016. However, smoking while pregnant still proves to be a prevalent issue that is associated with numerous adverse outcomes, including low birth weight, preterm birth, and developmental delays. Smoking cessation before or during pregnancy can help mitigate these effects, but the appropriate treatment can be challenging to ascertain. Accordingly, clinicians should look to provide individualized care composed of behavioral counseling in conjunction with pharmacotherapies when indicated, combined with ongoing support and education.
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Affiliation(s)
- Avan Shirwani
- Medical Student, Campbell University School of Osteopathic Medicine, Lillington, NC
| | - Jeffrey A Kuller
- Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC
| | - Sarah K Dotters-Katz
- Associate Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC
| | - Kateena Addae-Konadu
- Private Practice, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Southeast Permanente Medical Group, Atlanta, GA
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Krishnamoorthy Y, Elangovan V, Rajaa S. Non-pharmacological Interventions for Tobacco Cessation in India: A Systematic Review and Network Meta-analysis. Nicotine Tob Res 2023; 25:1701-1708. [PMID: 37195879 DOI: 10.1093/ntr/ntad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/17/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Non-pharmacological management of tobacco cessation has been reported to yield a high level of abstinence from tobacco usage. However, it is unclear which type of non-pharmacological intervention to be adopted in national tobacco control program. Hence, we undertook this review to identify the best non-pharmacological tobacco cessation therapies for tobacco cessation. AIMS AND METHODS Systematic literature search was performed in EMBASE, SCOPUS, PubMed Central, CENTRAL, MEDLINE, Google Scholar, ScienceDirect, and Clinicaltrials.gov from 1964 until September 2022. Randomized controlled trials assessing the effectiveness of non-pharmacological intervention for tobacco cessation in India were eligible for inclusion. Comparative intervention effect estimates obtained from network meta-analyses were represented as pooled odds ratio (OR) with 95% confidence interval (CI). RESULTS 21 studies were eligible for the analysis. More than half of the studies had high risk of bias. E-Health intervention had the highest OR (pooled OR = 9.90; 95% CI: 2.01 to 48.86) in terms of tobacco cessation rate followed by group counseling (pooled OR = 3.61; 95% CI: 1.48 to 8.78) and individual counseling (pooled OR = 3.43; 95% CI: 1.43 to 8.25). Brief advice or self-help intervention or comparison between each of these interventions against each other (both direct and indirect network) did not yield any significant results. CONCLUSIONS E-Health intervention was the best intervention followed by group intervention and individual face-to-face counseling intervention for tobacco cessation in India. Nonetheless, more high-quality large-scale RCTs either individual or by combining the e-Health, individual, or group counseling interventions are required to provide conclusive evidence and subsequent adoption into the national health programs in India. IMPLICATIONS This study would aid the policymakers, clinicians, and public health researchers in choosing the right tobacco cessation therapy to be offered across various levels of the healthcare delivery system, including major health facilities providing drug therapy (ie, concurrently with pharmacological treatment for tobacco cessation) in India. The study findings can be adopted by the national tobacco control program to decide the appropriate intervention package and identify the areas of focus to perform tobacco-related research in the country.
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Affiliation(s)
| | - Venmathi Elangovan
- Department of Community Medicine, ESIC Medical College and Hospital, Chennai, India
| | - Sathish Rajaa
- Department of Community Medicine, ESIC Medical College and Hospital, Chennai, India
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Fu SS, Nelson D, Do T, Burgess DJ, Patten CA, Zhu SH, Martinson BC. Connecting Vietnamese-Speaking Immigrants who Smoke to the Asian Smokers Quitline: A Feasibility Pilot of Proactive Outreach Interventions. Nicotine Tob Res 2023; 25:1691-1697. [PMID: 37294675 DOI: 10.1093/ntr/ntad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Cigarette smoking is highly prevalent among Asian American immigrant subgroups. Previously, Asian-language telephone Quitline services were only available in California. In 2012, the Centers for Disease Control and Prevention (CDC) funded the national Asian Smokers' Quitline (ASQ) to expand Asian-language Quitline services nationally. However, there are relatively few calls to the ASQ from outside California. AIMS AND METHODS This pilot study assessed the feasibility of two proactive outreach interventions to connect Vietnamese-speaking participants who smoke to the ASQ. Both interventions, (1) proactive telephone outreach with a counselor trained in motivational interviewing (PRO-MI) and (2) proactive telephone outreach with interactive voice response (PRO-IVR), were adapted to be culturally and linguistically appropriate for Vietnamese-speaking participants. Participants were randomly assigned 2:1 to PRO-IVR versus PRO-MI. Assessments were conducted at baseline and 3 months post-enrollment. Feasibility indicators were the recruitment rate and initiation of ASQ treatment. RESULTS Using the HealthPartners electronic health record, a large health system in Minnesota, we identified approximately 343 potentially eligible Vietnamese participants who were mailed invitation letters and baseline surveys with telephone follow-up. We enrolled 86 eligible participants (25% recruitment rate). In the PRO-IVR group 7/58 participants were directly transferred to the ASQ (12% initiation rate) and in the PRO-MI group 8/28 participants were warm transferred to the ASQ (29% initiation rate). CONCLUSIONS This pilot study demonstrates the feasibility of our recruitment methods and of implementing proactive outreach interventions to promote the initiation of smoking cessation treatment with the ASQ. IMPLICATIONS This pilot study contributes novel data on the uptake of Asian Smokers' Quitline (ASQ) services among Vietnamese-speaking people who smoke (PWS) with two proactive outreach interventions: (1) proactive telephone outreach with a counselor trained in motivational interviewing (PRO-MI) and (2) proactive telephone outreach with interactive voice response (PRO-IVR). We found that it is feasible to implement these proactive outreach interventions to promote the initiation of ASQ cessation treatment among Vietnamese-language speaking PWS. Future large trials are needed to rigorously compare PRO-MI and PRO-IVR and conduct budget impact analyses to understand the most efficient strategies for incorporation into health system settings.
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Affiliation(s)
- Steven S Fu
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Dave Nelson
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Tam Do
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Diana J Burgess
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Brian C Martinson
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- HealthPartners Institute for Education and Research, Minneapolis, MN, USA
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Xu M, Guo K, Shang X, Zhou L, E F, Yang C, Wu Y, Li X, Yang K. Network Meta-Analysis of Behavioral Programs for Smoking Cessation in Healthy People. Am J Prev Med 2023; 65:327-336. [PMID: 36893951 DOI: 10.1016/j.amepre.2023.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Smoking is a risk factor for most chronic diseases and premature death, with a global prevalence of more than 1 billion people who smoke. This network meta-analysis aimed to investigate the impact of different behavioral interventions on smoking cessation. METHODS Four electronic databases were searched for RCTs from inception to August 29, 2022. The risk of bias for the included RCTs was evaluated using the revised version of Cochrane tool for assessing risk of bias and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. The network meta-analysis was performed using Stata 16SE and R 4.1.3 software. RESULTS A total of 119 included RCTs enrolled 118,935 participants. For the 7-day-point prevalence abstinence rate, video counseling had a best intervention effect than brief advice, followed by financial incentives, self-help materials plus telephone counseling, motivational interview, health education, telephone counseling, and text messages. For the 30-day-point prevalence abstinence rate, face-to-face cognitive education and financial incentives were superior to brief advice. For the continuous abstinence rate, motivational interview and financial incentives were more effective than brief advice. The certainty of evidence was very low to moderate for these studies. DISCUSSION From the results of the network meta-analysis, different behavioral interventions resulted in positive impacts on smoking cessation compared with that of brief advice, especially video counseling, face-to-face cognitive education, and motivational interviews. Owing to the poor quality of evidence, high-quality trials should be conducted in the future to provide more robust evidence.
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Affiliation(s)
- Meng Xu
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
| | - Kangle Guo
- Gansu Provincial Hospital, Lanzhou, China
| | - Xue Shang
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Liying Zhou
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Fenfen E
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Chaoqun Yang
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yanan Wu
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiuxia Li
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
| | - Kehu Yang
- Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
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Litvak I, Nguyen K, Pezzino NC. Community pharmacists' perceptions on their role in counseling patients on lifestyle modifications. J Am Pharm Assoc (2003) 2023; 63:S57-S63.e2. [PMID: 36621402 DOI: 10.1016/j.japh.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/08/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients need an accessible health care provider who can assist in lifestyle counseling for chronic disease states. Pharmacists are easily accessible in the community, as a recent study found that nearly 90% of Americans live within 5 miles of a community pharmacy. Thus, pharmacists are ideally positioned to offer counseling on lifestyle modifications at this health care access point. OBJECTIVES The study's primary objective was to identify common barriers that community pharmacists may face in regard to provision of lifestyle counseling. Secondary objectives included determining strategies to overcome barriers and examining community pharmacists' willingness and level of comfort in providing lifestyle counseling to their patients. METHODS The study used mixed methods where pharmacists completed a survey and opted into a semi-structured interview. Survey results were analyzed with descriptive statistics and a paired t test. Interviews were recorded and transcribed in April and May 2022 until saturation. Three investigators coded each interview and conducted thematic analysis. Study design and procedures were approved by an institutional review board in December 2021. RESULTS One hundred forty-one pharmacists completed the survey to yield a 53.2% response rate. A paired t test revealed a statistically significant difference between level of comfort and willingness to counsel (P < 0.001). Willingness to provide lifestyle counseling was higher than the level of comfort in counseling in all areas (alcohol moderation, exercise, nutrition, tobacco cessation, and weight loss). Thematic analysis of the semi-structured interviews revealed 5 dominant themes: increasing patient awareness, counseling due to a patient inquiry, increasing educational materials, aligning corporate measures, and counseling patients with an established relationship. CONCLUSION Community pharmacists are willing to counsel on lifestyle modifications, however there is a gap between their willingness and comfort in counseling. The top 3 barriers to community pharmacists counseling on lifestyle modifications included time, workflow, and patient willingness. Further studies should explore strategies for implementing lifestyle counseling.
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Chan CS, Yang CT, Xu Y, He L, Yip PSF. Variability in the psychological impact of four waves of COVID-19: a time-series study of 60 000 text-based counseling sessions. Psychol Med 2023; 53:3920-3931. [PMID: 35229711 PMCID: PMC8961070 DOI: 10.1017/s0033291722000587] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/06/2022] [Accepted: 02/16/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Continuous exposure to stressors can lead to vulnerability and, in some cases, resilience. This study examined the variation in its psychological impact across the first four waves of COVID-19 in Hong Kong. METHODS Transcripts from Open Up, an online text-based counseling service, between January 2019 and January 2021 were analyzed (N = 60 775). We identified COVID-19 mentioned sessions using keywords and further categorized them into those that also mentioned symptoms of common mental disorders (CMDs) and those that did not. Autoregressive integrated moving average models were used to analyze the associations between the severity of the outbreak and the mention of COVID-19 and CMDs. RESULTS Results revealed that the pandemic led to increased psychological distress. Compared to prior to its advent, more people sought help in the initial months of the outbreak. Furthermore, associations were found between the severity of the outbreak and the number of help-seeker mentioning the pandemic, as well as between the outbreak severity and the number of help-seekers disclosing psychological distress. However, these relationships were not uniform across the four waves of outbreaks; a dissociation between outbreak severity and help-seekers' concern was found in the fourth wave. CONCLUSION As the pandemic waxes and wanes, people may become habituated to its psychological toll. This may be interpreted as a form of resilience. Instead of worsening with time, the psychological impact of COVID-19 may reduce with repeated exposure.
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Affiliation(s)
| | - Chi-Ting Yang
- Center for Suicide Research and Prevention, HKU, Hong Kong
| | - Yucan Xu
- Center for Suicide Research and Prevention, HKU, Hong Kong
| | - Lihong He
- Center for Suicide Research and Prevention, HKU, Hong Kong
| | - Paul S. F. Yip
- Center for Suicide Research and Prevention, HKU, Hong Kong
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Pearson M, Dawson A, Raubenheimer J, Senerathna L, Conigrave K, Lee KSK, Rajapakse T, Pushpakumara PHGJ, Siribaddana S, Soerensen JB, Konradsen F, Jan S, Dawson AJ, Buckley N, Abeysinghe R, Siriwardhana P, Priyadarshana C, Haber PS, Dzidowska M, Abeykoon P, Glozier N. Community-based alcohol education intervention (THEATRE) study to reduce harmful effects of alcohol in rural Sri Lanka: design and adaptation of a mixed-methods stepped wedge cluster randomised control trial. BMJ Open 2023; 13:e064722. [PMID: 37321807 PMCID: PMC10276966 DOI: 10.1136/bmjopen-2022-064722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 04/19/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Alcohol consumption is a leading cause of mortality, morbidity and adverse social sequelae in Sri Lanka. Effective community-based, culturally adapted or context-specific interventions are required to minimise these harms. We designed a mixed-methods stepped wedge cluster randomised control trial of a complex alcohol intervention. This paper describes the initial trial protocol and subsequent modifications following COVID-19. METHODS AND ANALYSIS We aimed to recruit 20 villages (approximately n=4000) in rural Sri Lanka. The proposed intervention consisted of health screening clinics, alcohol brief intervention, participatory drama, film, and public health promotion materials to be delivered over 12 weeks.Following disruptions to the trial resulting from the Easter bombings in 2019, COVID-19 and a national financial crisis, we adapted the study in two main ways. First, the interventions were reconfigured for hybrid delivery. Second, a rolling pre-post study evaluating changes in alcohol use, mental health, social capital and financial stress as the primary outcome and implementation and ex-ante economic analysis as secondary outcomes. ETHICS AND DISSEMINATION The original study and amendments have been reviewed and granted ethical approval by Rajarata University of Sri Lanka (ERC/2018/21-July 2018 and February 2022) and the University of Sydney (2019/006). Findings will be disseminated locally in collaboration with the community and stakeholders.The new hybrid approach may be more adaptable, scalable and generalisable than the planned intervention. The changes will allow a closer assessment of individual interventions while enabling the evaluation of this discontinuous event through a naturalistic trial design. This may assist other researchers facing similar disruptions to community-based studies. TRIAL REGISTRATION The trial is registered with the Sri Lanka Clinical Trials Registry; https://slctr.lk/trials/slctr-2018-037.
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Affiliation(s)
- Melissa Pearson
- Centre for Pesticide Suicide Prevention, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Andrew Dawson
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Jacques Raubenheimer
- Biomedical Informatics and Digital Health, University of Sydney, Sydney, New South Wales, Australia
| | - Lalith Senerathna
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Health Promotion, Faculty of Applied Sciences, Rajarata University of Sri Lanka, Mihintale, Sri Lanka
| | - Katherine Conigrave
- Sydney Medical School, Royal Prince Albert Hospital, Camperdown, New South Wales, Australia
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, New South Wales, Australia
| | - K S Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Thilini Rajapakse
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Pahala Hangidi Gedara Janaka Pushpakumara
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Family Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Peradeniya, Sri Lanka
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Jane Brandt Soerensen
- Global Health Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Konradsen
- Global Health Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stephen Jan
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Angela J Dawson
- Faculty of Health, World Health Collaborating Centre, University of Technology, Sydney, Sydney, New South Wales, Australia
| | - Nicholas Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Biomedical Informatics and Digital Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ranil Abeysinghe
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Prabash Siriwardhana
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Health Promotion, Faculty of Applied Sciences, Rajarata University of Sri Lanka, Mihintale, Sri Lanka
| | - Chamil Priyadarshana
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Paul S Haber
- Sydney Medical School, Royal Prince Albert Hospital, Camperdown, New South Wales, Australia
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Monika Dzidowska
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Nick Glozier
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
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Wolff JM, McQueen A, Garg R, Thompson T, Fu Q, Brown DS, Kegler M, Carpenter KM, Kreuter MW. Expanding population-level interventions to help more low-income smokers quit: Study protocol for a randomized controlled trial. Contemp Clin Trials 2023; 129:107202. [PMID: 37080354 DOI: 10.1016/j.cct.2023.107202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Low-income Americans have higher rates of smoking and a greater burden of smoking-related disease. In the United States, smokers in every state can access evidence-based telephone counseling through free tobacco quitlines. However, quitlines target smokers who are ready to quit in the next 30 days, which can exclude many low-income smokers. A smoke-free homes intervention may help engage smokers in tobacco control services who are not yet ready to quit. Previous research in low-income populations suggests that receiving a smoke-free homes intervention is associated with higher quit rates. This study tests whether, at a population level, expanding on quitlines to include a smoke-free homes intervention for smokers not ready to quit could engage more low-income smokers and increase long-term cessation rates. METHODS In a Hybrid Type 2 design, participants are recruited from 211 helplines in 9 states and randomly assigned to standard quitline or quitline plus smoke-free homes intervention arms. Participants in both arms are initially offered quitline services. In the quitline plus smoke-free homes condition, participants who decline the quitline are then offered a smoke-free homes intervention. Participants complete a baseline and follow-up surveys at 3 and 6 months. Those who have not yet quit at the 3-month follow-up are re-offered the interventions, which differ by study arm. The primary study outcome is self-reported 7-day point prevalence abstinence from smoking at 6-month follow-up. CONCLUSION This real-world cessation trial involving 9 state tobacco quitlines will help inform whether offering smoke-free homes as an alternative intervention could engage more low-income smokers with evidence-based interventions and increase overall cessation rates. This study has been registered at ClinicalTrials.gov (Study Identifier: NCT04311983).
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Affiliation(s)
- Jennifer M Wolff
- Washington University in St. Louis, Brown School, Health Communication Research Laboratory, United States of America.
| | - Amy McQueen
- Washington University in St. Louis, Brown School, Health Communication Research Laboratory, United States of America; Washington University in St. Louis, School of Medicine, Department of Medicine, United States of America
| | - Rachel Garg
- Washington University in St. Louis, Brown School, Health Communication Research Laboratory, United States of America
| | - Tess Thompson
- Washington University in St. Louis, Brown School, Health Communication Research Laboratory, United States of America
| | - Qiang Fu
- Tufts University, Department of Community Health, United States of America
| | - Derek S Brown
- Washington University in St. Louis, Brown School, United States of America
| | - Michelle Kegler
- Emory University, Rollins School of Public Health, United States of America
| | | | - Matthew W Kreuter
- Washington University in St. Louis, Brown School, Health Communication Research Laboratory, United States of America
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