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Low NJH, Leow DGW, Klainin-Yobas P. Effectiveness of Technology-Based Psychosocial Interventions on Psychological Outcomes Among Adult Cancer Patients and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2024; 40:151533. [PMID: 37977974 DOI: 10.1016/j.soncn.2023.151533] [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: 05/11/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Technology-based psychosocial interventions (TBPIs) have increasingly gained intention. However, the effectiveness of TBPIs on psychological outcomes remains inconclusive. This review aimed to evaluate the effectiveness of TBPIs on health-related quality of life (HRQOL), coping, self-efficacy, and depression among adult cancer patients and caregivers. DATA SOURCES Randomised controlled trials (RCTs) evaluating the effectiveness of TBPIs targeting adult cancer patients, caregivers, or patient-caregiver dyads were included. English articles dated from 2012 to 2022 were retrieved from eight electronic databases, three clinical trial registries, and six grey literature databases. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias assessment tool and GRADE were used to appraise the methodological quality of included studies. Meta-analyses and subgroup analyses were undertaken with statistical pooling of standardized mean differences based on the random-effects model. CONCLUSION Totally, 37 RCTs were included in the review, with 35 trials for meta-analysis. Results demonstrated improvements in HRQOL, self-efficacy, and depression among cancer patients and caregivers with varying pooled effect sizes. Subgroup analyses suggested that dyadic TBPIs were more effective in improving HRQOL among cancer patients and caregivers, compared with those solely targeted at cancer patients or caregivers. IMPLICATION FOR NURSING PRACTICE Findings value-added to the existing evidence base on TBPIs. An interactive patient-caregiver dyadic program integrating TBPIs into routine oncology care is recommended to improve health outcomes for cancer patients and caregivers. Well-designed future RCTs are required to further evaluate the effectiveness of dyadic TBPIs, with emphasis on coping and self-efficacy outcomes among cancer patients and caregivers.
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Affiliation(s)
| | - Darryl Ge Wei Leow
- Staff Nurse, Woodlands Health Campus, Yishun Community Hospital, Singapore
| | - Piyanee Klainin-Yobas
- Associate Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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Ganna S, Rahimi S, Lu A, Laborde K, Trivedi M. Interventions to improve oral endocrine therapy adherence in breast cancer patients. J Cancer Surviv 2024:10.1007/s11764-023-01513-y. [PMID: 38233637 DOI: 10.1007/s11764-023-01513-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE Oral endocrine therapy (OET) is recommended in prevention and treatment of hormone receptor-positive breast cancer (HR+ BC). Despite the reduced incidence, recurrence, and mortality, OET adherence is poor in this patient population. The aim of this study was to review the latest literature to identify effective interventions to improve medication adherence in patients taking OET for prevention or treatment of HR+ BC. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework was used to perform this review. We utilized PubMed, SCOPUS, EMBASE, Cochrane, and Web of Science to acquire articles using search terms including breast cancer, adherence, persistence, and acceptability. Inclusion criteria included publication in peer-reviewed journal, primary data source, longitudinal, patients on OET such as aromatase inhibitors (AIs) or selective estrogen receptor modulators (SERMs), measuring adherence, persistence, or acceptability. RESULTS Out of 895 articles identified, 10 articles were included. Majority of patients had early-stage HR+ BC. Two out of two studies incorporating technological intervention, two out of three studies with text communication-based intervention, and three out of five studies with verbal communication-based intervention reported significant improvement in OET adherence and/or persistence. CONCLUSIONS While the interventions tested so far have shown to improve OET adherence in HR+ BC patients in some studies, there is a need to design combination interventions addressing multiple barriers in this population. IMPLICATIONS FOR CANCER SURVIVORS This study showcases effectiveness of novel interventions to improve OET adherence and the need to further develop patient-centered strategies to benefit all patients with HR+ BC.
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Affiliation(s)
- Sourab Ganna
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, TX, 77204, USA
| | - Sama Rahimi
- West Penn Hospital, Pittsburg, PA, 15224, USA
| | - Anh Lu
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Health 2, 4349 Martin Luther King Blvd, Houston, TX, 77204-5000, USA
| | - Krista Laborde
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Health 2, 4349 Martin Luther King Blvd, Houston, TX, 77204-5000, USA
| | - Meghana Trivedi
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Health 2, 4349 Martin Luther King Blvd, Houston, TX, 77204-5000, USA.
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Hendryckx C, Nalder E, Drake E, Leclaire É, Pituch E, Gouin-Vallerand C, Wang RH, Poulin V, Paquet V, Bottari C. Managing challenging behaviours in adults with traumatic brain injury: A scoping review of technology-based interventions. J Rehabil Assist Technol Eng 2023; 10:20556683231191975. [PMID: 37614442 PMCID: PMC10443634 DOI: 10.1177/20556683231191975] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Challenging behaviours are one of the most serious sequelae after a traumatic brain injury (TBI). These chronic behaviours must be managed to reduce the associated burden for caregivers, and people with TBI. Though technology-based interventions have shown potential for managing challenging behaviours, no review has synthesised evidence of technology aided behaviour management in the TBI population. The objective of this scoping review was to explore what technology-based interventions are being used to manage challenging behaviours in people with TBI. Two independent reviewers analysed 3505 studies conducted between 2000 and 2023. Studies were selected from five databases using search strategies developed in collaboration with a university librarian. Sixteen studies were selected. Most studies used biofeedback and mobile applications, primarily targeting emotional dysregulation. These technologies were tested in a variety of settings. Two interventions involved both people with TBI and their family caregivers. This review found that technology-based interventions have the potential to support behavioural management, though research and technology development is at an early stage. Future research is needed to further develop technology-based interventions that target diverse challenging behaviours, and to document their effectiveness and acceptability for use by people with TBI and their families.
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Affiliation(s)
- Charlotte Hendryckx
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la Réadaptation en déficience Physique de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Research Center from CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, QC, Canada
- Department Of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Emma Drake
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Éliane Leclaire
- Department Of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Evelina Pituch
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Charles Gouin-Vallerand
- Centre de Recherche Createch sur les Organisations Intelligentes, Université de Sherbrooke, Sherbrooke, QC, Canada
- DOMUS Laboratory, Université de Sherbrooke, Sherbrooke, QC, Canada
- University of Sherbrooke, Sherbrooke, QC, Canada
| | - Rosalie H Wang
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Valérie Poulin
- Department Of Occupational therapy, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, QC, Canada
| | - Virginie Paquet
- Bibliothèque Marguerite-D’Youville, Université de Montréal, Montréal, QC, Canada
| | - Carolina Bottari
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la Réadaptation en déficience Physique de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
- Occupational Therapy Program, School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
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Su Z, Cheshmehzangi A, Bentley BL, McDonnell D, Šegalo S, Ahmad J, Chen H, Terjesen LA, Lopez E, Wagers S, Shi F, Abbas J, Wang C, Cai Y, Xiang YT, da Veiga CP. Technology-based interventions for health challenges older women face amid COVID-19: a systematic review protocol. Syst Rev 2022; 11:271. [PMID: 36514147 PMCID: PMC9746565 DOI: 10.1186/s13643-022-02150-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Pandemics, such as COVID-19, are dangerous and socially disruptive. Though no one is immune to COVID-19, older persons often bear the brunt of its consequences. This is particularly true for older women, as they often face more pronounced health challenges relative to other segments in society, including complex care needs, insufficient care provisions, mental illness, neglect, and increased domestic abuse. To further compound the situation, because protective measures like lockdowns can result in unintended consequences, many health services older women depend on can become disrupted or discontinued amid pandemics. While technology-based interventions have the potential to provide near-time, location-free, and virtually accessible care, there is a dearth of systematic insights into this mode of care in the literature. To bridge the research gaps, this investigation aims to examine the characteristics and effectiveness of technology-based interventions that could address health challenges older women face amid COVID-19. METHODS A systematic review of randomized trials reporting on technology-based interventions for older women (≥65 years) during COVID-19 will be conducted. The databases of Web of Science, ScienceDirect, PubMed/MEDLINE, PsycINFO, CINAHL, and Scopus will be searched. Retrieved citations will be screened independently by at least two reviewers against the eligibility criteria. Included studies will be assessed using the Cochrane ROB-2 tool. Data will be extracted independently by the reviewers. Where possible, meta-analyses will be performed on relevant study outcomes and analysed via odds ratios on the dichotomized outcomes. Where applicable, heterogeneity will be measured using the Cochrane Q test, and publication bias will be assessed via funnel plots and Egger's regression test. DISCUSSION Technology has the potential to transform healthcare for the better. To help society better safeguard vulnerable populations' health and quality of life, this investigation sets out to gauge the state-of-the-art development of technology-based interventions tailored to the health challenges older women face amid COVID-19. In light of the growing prevalence of population ageing and the inevitability of infectious disease outbreaks, greater research efforts are needed to ensure the timely inception and effective implementation of technology-based health solutions for vulnerable populations like older women, amid public health crises like COVID-19 and beyond. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020194003.
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Affiliation(s)
- Zhaohui Su
- School of Public Health, Institute for Human Rights, Southeast University, Nanjing, 210009, China.
| | - Ali Cheshmehzangi
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, Zhejiang, 315100, China.,Network for Education and Research on Peace and Sustainability (NERPS), Hiroshima University, Hiroshima, 739-8530, Japan
| | - Barry L Bentley
- Cardiff School of Technologies, Cardiff Metropolitan University, Cardiff, UK.,Collaboration for the Advancement of Sustainable Medical Innovation, University College London, London, UK
| | - Dean McDonnell
- Department of Humanities, South East Technological University, Carlow, R93 V960, Ireland
| | - Sabina Šegalo
- Faculty of Health Studies, University of Sarajevo, 71000, Sarajevo, Bosnia and Herzegovina
| | | | - Hengcai Chen
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, 315100, China
| | | | | | - Shelly Wagers
- Department of Criminology, University of South Florida St. Petersburg, St. Petersburg, USA
| | - Feng Shi
- Department of Research and Development, Shanghai United Imaging Intelligence, Shanghai, China
| | - Jaffar Abbas
- Antai College of Economics and Management, and School of Media and Communication, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Caifeng Wang
- Department of Environmental Health, School of Public Health, School of Nursing, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China
| | - Yuyang Cai
- School of Public Health, China Institute for Urban Governance, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, Centre for Cognitive and Brain Sciences, Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
| | - Claudimar Pereira da Veiga
- Fundação Dom Cabral - FDC, Av. Princesa Diana, 760 Alphaville, Lagoa dos Ingleses, Nova Lima, MG, 34018-006, Brazil.
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5
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Wright A, Lee D, Marshall A, Booshehri LG, Dugan JA. Examining the effects of social and cash transfer programs for homeless adults: Evidence from the Samaritan pilot. Public Health Pract (Oxf) 2022; 4:100331. [PMID: 36324635 DOI: 10.1016/j.puhip.2022.100331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/21/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To conduct a program evaluation of a technology-based intervention for a housing insecure population. Study design We conduct a quantitative analysis of Samaritan pilot administrative records. Methods Samaritan conducted an initial single-arm pilot of their technology platform among a housing insecure population (N = 500). Administrative records containing basic demographics and social determinants of health were analyzed as part of this evaluation. Results Our analysis revealed that among the participants, roughly 60% reported one or more improvements in unmet social determinants of health, showing the greatest improvements in the areas of utilities and nutrition. A gender subgroup analysis also revealed a differential pattern of platform use to address social determinant needs, with women more likely to report improvements in housing and nutrition while men report improvements in income and hope categories. Conclusion Samaritan, a technology-based intervention targeted at housing insecure individuals, aims to connect users to the financial and social capital necessary to improve their current situations. The results of the pilot demonstrate the potential role the Samaritan platform could play in addressing social determinant needs and insights on potentially useful technology-based intervention features for housing insecure populations.
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Gorowska M, Tokarska K, Zhou X, Gola MK, Li Y. Novel approaches for treating Internet Gaming Disorder: A review of technology-based interventions. Compr Psychiatry 2022; 115:152312. [PMID: 35405548 DOI: 10.1016/j.comppsych.2022.152312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/21/2022] [Accepted: 03/27/2022] [Indexed: 11/28/2022] Open
Abstract
Internet Gaming Disorder (IGD) has become a significant issue in mental healthcare over the past decades as the number of people engaging in excessive and unhealthy gaming increases with each year. Despite its inclusion in the 5th Edition of Diagnostic Statistical Manual and the development of a number of treatment methods that have been designed and tested for IGD, treatment remains a challenge. This review attempts to give an overview of the current state of IGD and its treatment with a specific focus on the potential of technology-based solutions, such as web-based programs, mobile applications, and virtual reality. The review also highlights the need for additional work in the area of treatment development for IGD and the preliminary evidence for the usefulness and importance of technology-based treatment methods which offer unique advantages, such as accessibility, scalability, and cost-effectiveness, over other existing treatment options.
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Affiliation(s)
- Monika Gorowska
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Klaudia Tokarska
- Aarhus University, Aarhus, Denmark; Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
| | - XinYu Zhou
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
| | - Mateusz Kazimierz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA; Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Yonghui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Dougherty EC, Burse N, Butzner M, Wu H, Stuckey HL, Allison JJ, Cuffee YL. Examining medication adherence and preferences for a lifestyle intervention among Black and Latinx adults with hypertension: a feasibility study. Pilot Feasibility Stud 2021; 7:209. [PMID: 34809710 PMCID: PMC8607626 DOI: 10.1186/s40814-021-00930-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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Approximately 116.4 million adults in the USA have hypertension, and the rates of uncontrolled hypertension remain higher among racial and ethnic minorities. There is a need for effective interventions that promote healthy behaviors and long-term behavioral change in the management of hypertension. The primary objective of this study was to determine the feasibility of developing a lifestyle intervention that would assess hypertension management and the use of technology among Blacks and Latinx with hypertension. The secondary objective is to explore perceptions of community-based resources for hypertension and preferences for a lifestyle intervention for hypertension among Blacks and Latinx with hypertension. Methods In this explanatory mixed-methods study, quantitative data were collected using surveys, participants reported their use of technology and adherence to antihypertensive medication. Participants were Black and Latinx adults with hypertension living in Central Pennsylvania, USA. Qualitative data were obtained from semi-structured interviews and focus groups, and participants were asked about managing hypertension, local resources, and preferences for a behavioral intervention. Data were examined using summary statistics for quantitative data and thematic analysis for qualitative data. Results Black and Latinx participants (n=30) completed surveys for the quantitative study. The majority (75%) of participants self-reported being confident in managing their medication without help and remembering to take their medication as prescribed. Fewer participants (54.2%) reported using technology to help manage medication. There were 12 participants in the qualitative phase of the study. The qualitative findings indicated that participants felt confident in their ability to manage hypertension and were interested in participating in a lifestyle intervention or program based online. Some participants reported a lack of resources in their community, while others highlighted local and national resources that were helpful in managing high blood pressure. Conclusion This study provides important insights on barriers and facilitators for managing hypertension, current use of technology and interest in using technology to manage hypertension, and preferences for future lifestyle interventions among racial and ethnic minorities. This study also provides insights to the health needs and resources available in this community and how future behavioral interventions could be tailored to meet the needs of this community. The findings of this study will be used to inform the tailoring of future lifestyle interventions; specifically, we will include text messaging reminders for medication and to disseminate educational materials related to hypertension and provide resources to connect study participants with local and national resources.
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Affiliation(s)
- Emily C Dougherty
- General Academic Pediatrics, University of Pittsburgh, 3414 Fifth Avenue, Pittsburgh, PA, 15213, USA
| | - Natasha Burse
- Department of Public Health Sciences, Penn State College of Medicine, 90 Hope Drive, Academic Support Building, Hershey, PA, 17033, USA
| | - Michael Butzner
- Department of Public Health Sciences, Penn State College of Medicine, 90 Hope Drive, Academic Support Building, Hershey, PA, 17033, USA
| | - Hongke Wu
- Department of Public Health Sciences, Penn State College of Medicine, 90 Hope Drive, Academic Support Building, Hershey, PA, 17033, USA
| | - Heather L Stuckey
- Department of Public Health Sciences, Penn State College of Medicine, 90 Hope Drive, Academic Support Building, Hershey, PA, 17033, USA
| | - Jeroan J Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655, USA
| | - Yendelela L Cuffee
- Epidemiology Program, College of Health Sciences, University of Delaware, Newark, DE, USA.
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Ibitoye M, Lappen H, Freeman R, Jordan AE, Aronson ID. Technology-Based Interventions to Increase Point-of-Care HIV Testing and Linkage to Care Among Youth in the US: A Systematic Review. AIDS Behav 2021; 25:1829-38. [PMID: 33231846 DOI: 10.1007/s10461-020-03112-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2020] [Indexed: 12/28/2022]
Abstract
HIV testing rates remain low among youth ages 13–24 in the US, with only 55% of HIV-positive youth aware of their serostatus. We conducted a systematic review to assess the utility of technology-based interventions to increase point-of-care youth HIV testing and linkage to care. We searched PubMed, Embase, CINAHL, and Cochrane CENTRAL for randomized controlled trials of technology-based interventions aimed at increasing point-of-care youth HIV testing, published between 2008 and 2020. All identified citations were independently screened for inclusion by two authors, and the Cochrane Risk of Bias Tool for Randomized Controlled Trials was used to assess the quality of included studies. Three studies met all inclusion criteria. Two interventions were effective in increasing HIV testing, while one was effective at linkage to care. Technology-based interventions have the potential to increase youth HIV testing in clinical settings and facilitate linkage to care, possibly reducing undiagnosed HIV among adolescents and emerging adults.
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Su Z, McDonnell D, Liang B, Kue J, Li X, Šegalo S, Advani S, Flores BE, Wang J. Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol. Syst Rev 2021; 10:43. [PMID: 33526095 PMCID: PMC7849615 DOI: 10.1186/s13643-021-01592-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. METHODS A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. CONCLUSIONS COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020196301.
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Affiliation(s)
- Zhaohui Su
- School of Nursing, Center on Smart and Connected Health Technologies, Mays Cancer Center, UT Health San Antonio, San Antonio, TX 78229 USA
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, R93 V960, Ireland
| | - Bin Liang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10010 China
| | - Jennifer Kue
- School of Nursing, Ohio State University, Columbus, USA
| | - Xiaoshan Li
- Program of Public Relations and Advertising, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Sabina Šegalo
- Department of Microbiology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Shailesh Advani
- Terasaki Institute of Biomedical Innovation, Los Angeles, CA 21100 USA
| | - Bertha E. Flores
- School of Nursing, UT Health San Antonio, San Antonio, TX 78229 USA
| | - Jing Wang
- School of Nursing, Center on Smart and Connected Health Technologies, Mays Cancer Center, UT Health San Antonio, San Antonio, TX 78229 USA
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Patel SR, Comer J, Simpson HB. Innovations in the Delivery of Exposure and Response Prevention for Obsessive-Compulsive Disorder. Curr Top Behav Neurosci 2021; 49:301-29. [PMID: 33590457 DOI: 10.1007/7854_2020_202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Obsessive-Compulsive Disorder is an important cause of global health-related disability. In the last several decades, exposure and response prevention (EX/RP) has emerged as one of the most evidence-based treatments for adult and pediatric OCD. Recommended as a first-line treatment in practice guidelines for OCD, EX/RP, when expertly delivered, can be superior to serotonin reuptake inhibitor (SRI) medications alone and superior to adding antipsychotic medication to augment SRI treatment response. Despite a robust evidence base, EX/RP is not widely available. Moreover, although effective, only about half of patients who receive a standard course of EX/RP will achieve remission.This chapter will review innovations in delivering EX/RP, focusing on technology-based methods designed to increase access to EX/RP and translational neuroscience approaches to personalizing and optimizing EX/RP. Technology-based innovations to deliver EX/RP include video conferencing, internet-based treatment, and smartphone apps. Of these, internet-based, clinician-supported treatment has the most evidence base to date. Relevant to all technology-based innovations are the need for advances in the ethical, regulatory and financial aspects of understanding how access to EX/RP may be delivered to individuals of diverse socioeconomic backgrounds in accordance with professional standards and regulations and covered by healthcare.Advances in our understanding of the neural processes underlying learning and memory have led to new ways to combine EX/RP with medications, behavioral interventions, or neuromodulatory methods, with the goal of enhancing the functioning of brain circuits that subserve fear processing and cognitive control. Among the pharmacological approaches to enhancing EX/RP outcome, both ketamine and cannabinoids show promise in small open trials but are in need of further study. Studies to train cognitive control are at an early stage of development yet provide preliminary evidence that training neural processes may be a new path to personalize treatment. How best to combine EX/RP with different types of neuromodulation is being actively studied.Together these innovations in the delivery of EX/RP for OCD hold great promise for improving outcomes of care for individuals with OCD by increasing the availability and the individual treatment effects of this already effective treatment.
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Frías Á, Solves L, Navarro S, Palma C, Farriols N, Aliaga F, Hernández M, Antón M, Riera A. Technology-Based Psychosocial Interventions for People with Borderline Personality Disorder: A Scoping Review of the Literature. Psychopathology 2020; 53:254-263. [PMID: 33166964 DOI: 10.1159/000511349] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/02/2020] [Indexed: 11/19/2022]
Abstract
Evidence-based psychosocial interventions for borderline personality disorder (BPD) still face multiple challenges regarding treatment accessibility, adherence, duration, and economic costs. Over the last decade, technology has addressed these concerns from different disciplines. The current scoping review aimed to delineate novel and ongoing clinical research on technology-based psychosocial interventions for patients with BPD. Online databases (PubMed, Cochrane Library, EMBASE, Web of Science, PsycInfo, and Google Scholar) were searched up to June 2020. Technology-based psychosocial treatments included innovative communication (eHealth) and computational (e.g., artificial intelligence), computing (e.g., computer-based), or medical (e.g., functional magnetic resonance imaging [fMRI]) software. Clinical research encompassed any testing stage (e.g., feasibility, efficacy). Fifteen studies met the inclusion criteria. The main findings were the following: almost two-thirds of the studies (9/15) tested software explicitly conceived as adjunctive interventions to conventional therapy; nearly half of the studies (7/15) were referred to as dialectical behavior therapy-based software; most studies (13/15) were focused on the initial stage of the clinical research cycle (feasibility/acceptance/usability testing), reporting good results at this point; more than one-third of the studies (6/15) tested mobile apps; there is emerging evidence for Internet-based interventions and real-time fMRI biofeedback but only little evidence for mHealth interventions, virtual and augmented reality, and computer-based interventions; there was no computational technology-based clinical research; and there was no satisfaction/preference, security/safety, or efficiency testing for any software. Taken together, the results suggest that there is a growing but still incipient amount of technology-based psychosocial interventions for BPD supported by some kind of clinical evidence. The limitations and directions for future research are discussed.
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Affiliation(s)
- Álvaro Frías
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, University of Ramon-Llull, Barcelona, Spain, .,Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain,
| | - Laia Solves
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, University of Ramon-Llull, Barcelona, Spain.,Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
| | - Sara Navarro
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, University of Ramon-Llull, Barcelona, Spain.,Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
| | - Carol Palma
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, University of Ramon-Llull, Barcelona, Spain.,Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
| | - Núria Farriols
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, University of Ramon-Llull, Barcelona, Spain.,Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
| | - Ferrán Aliaga
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, University of Ramon-Llull, Barcelona, Spain.,Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
| | - Mònica Hernández
- Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
| | - Meritxell Antón
- Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
| | - Aloma Riera
- Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain
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12
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Hecht J, Rigotti NA, Minami H, Kjome KL, Bloom EL, Kahler CW, Price LH, Levy DE, Carpenter KM, Brown RA. Adaptation of a sustained care cessation intervention for smokers hospitalized for psychiatric disorders: Study protocol for a randomized controlled trial. Contemp Clin Trials 2019; 83:18-26. [PMID: 31212100 DOI: 10.1016/j.cct.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/30/2019] [Accepted: 06/11/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Individuals with serious mental illness (SMI) smoke at disproportionately higher rates than those without SMI, have lifespans 25-32 years shorter, and thus bear an especially large burden of tobacco-related morbidity and mortality. Several recent studies demonstrate that smokers with SMI can successfully quit smoking with adequate support. Further evidence shows that using technology to deliver sustained care interventions to hospitalized smokers can lead to smoking cessation up to 6 months after discharge. The current comparative effectiveness trial adapts a technology-assisted sustained care intervention designed for smokers admitted to a general hospital and tests whether this approach can produce higher cessation rates compared to usual care for smokers admitted to a psychiatric inpatient unit. METHODS A total of 353 eligible patients hospitalized for psychiatric illness are randomized by cohort into one of two conditions, Sustained Care (SusC) or Usual Care (UC), and are followed for six months after discharge. Participants assigned to UC receive brief tobacco education delivered by a hospital nurse during or soon after admission. Those assigned to SusC receive a 40-min, in-hospital motivational counseling intervention. Upon discharge, they also receive up to 8 weeks of free nicotine patches, automated interactive voice response (IVR) telephone and text messaging, and access to cessation counseling resources lasting 3 months post discharge. Smoking cessation outcomes are measured at 1-, 3- and 6-months post hospital discharge. CONCLUSION Results from this comparative effectiveness trial will add to our understanding of acceptable and effective smoking cessation approaches for patients hospitalized with SMI.
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Travers BG, Mason AH, Mrotek LA, Ellertson A, Dean DC, Engel C, Gomez A, Dadalko OI, McLaughlin K. Biofeedback-Based, Videogame Balance Training in Autism. J Autism Dev Disord 2019; 48:163-175. [PMID: 28921103 DOI: 10.1007/s10803-017-3310-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The present study examined the effects of a visual-based biofeedback training on improving balance challenges in autism spectrum disorder (ASD). Twenty-nine youth with ASD (7-17 years) completed an intensive 6-week biofeedback-based videogame balance training. Participants exhibited training-related balance improvements that significantly accounted for postural-sway improvements outside of training. Participants perceived the training as beneficial and enjoyable. Significant moderators of training included milder stereotyped and ritualistic behaviors and better starting balance. Neither IQ nor BMI moderated training. These results suggest that biofeedback-based balance training is associated with balance improvements in youth with ASD, most robustly in those with less severe repetitive behaviors and better starting balance. The training was perceived as motivating, further suggesting its efficacy and likelihood of use.
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Affiliation(s)
- Brittany G Travers
- Occupational Therapy Program, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA. .,Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA. .,Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA.
| | - Andrea H Mason
- Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA
| | - Leigh Ann Mrotek
- Kinesiology Department, University of Wisconsin-Oshkosh, 800 Algoma Boulevard, Oshkosh, WI, 54901-8630, USA.,Biomedical Engineering Department, Marquette University, 1515 West Wisconsin Avenuue, Milwaukee, WI, 53233, USA
| | - Anthony Ellertson
- Department of Computer Science, Boise State University, 1910 University Dr., Boise, ID, 83725, USA
| | - Douglas C Dean
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Courtney Engel
- Occupational Therapy Program, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA.,Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA.,Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Andres Gomez
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Olga I Dadalko
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Kristine McLaughlin
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
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Widman L, Nesi J, Kamke K, Choukas-Bradley S, Stewart JL. Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth. J Adolesc Health 2018; 62:651-660. [PMID: 29784112 PMCID: PMC5966833 DOI: 10.1016/j.jadohealth.2018.02.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [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: 11/10/2017] [Revised: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE Technology-based interventions to promote sexual health have proliferated in recent years, yet their efficacy among youth has not been meta-analyzed. This study synthesizes the literature on technology-based sexual health interventions among youth. METHODS Studies were included if they (1) sampled youth ages 13-24; (2) utilized technology-based platforms; (3) measured condom use or abstinence as outcomes; (4) evaluated program effects with experimental or quasi-experimental designs; and (5) were published in English. RESULTS Sixteen studies with 11,525 youth were synthesized. There was a significant weighted mean effect of technology-based interventions on condom use (d = .23, 95% confidence interval [CI] [.12, .34], p < .001) and abstinence (d = .21, 95% CI [.02, .40], p = .027). Effects did not differ by age, gender, country, intervention dose, interactivity, or program tailoring. However, effects were stronger when assessed with short-term (1-5 months) than with longer term (greater than 6 months) follow-ups. Compared with control programs, technology-based interventions were also more effective in increasing sexual health knowledge (d = .40, p < .001) and safer sex norms (d = .15, p = .022) and attitudes (d = .12, p= .016). CONCLUSIONS After 15 years of research on youth-focused technology-based interventions, this meta-analysis demonstrates their promise to improve safer sex behavior and cognitions. Future work should adapt interventions to extend their protective effects over time.
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Affiliation(s)
- Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, North Carolina.
| | - Jacqueline Nesi
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristyn Kamke
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | | | - J L Stewart
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
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15
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Quaglio G, Schellekens A, Blankers M, Hoch E, Karapiperis T, Esposito G, Brand H, Nutt D, Kiefer F. A Brief Outline of the Use of New Technologies for Treating Substance Use Disorders in the European Union. Eur Addict Res 2017; 23:177-181. [PMID: 28803249 DOI: 10.1159/000478904] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/22/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Clinicians in the field of drug addiction have started to exploit the growth of Technology-Based Interventions (TBIs). However, there is little information on how health personnel evaluate them. METHODS Semi-structured interviews were conducted among 20 European experts. RESULTS All of the interviewees recognised TBIs as a valuable tool to improve the management of substance-use disorders (SUDs). Most interviewees indicated that combining both traditional face-to-face therapist-patient clinic appointment with TBIs is probably the most effective method. Most interviewees agree that TBIs are valuable tools to overcome both physical and social barriers, and hence significantly facilitate the access to treatment. Poor infrastructure and lack of digital literacy are recognised as major barriers to the diffusion of these tools. CONCLUSIONS The application of various forms of technology in SUD treatment is an interesting development for the European Union. Technical and non-technical barriers exist and impede their full exploitation.
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Affiliation(s)
- GianLuca Quaglio
- Scientific Foresight Unit (Science and Technology Options Assessment [STOA]), Directorate-General for Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
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Linke SE, Larsen BA, Marquez B, Mendoza-Vasconez A, Marcus BH. Adapting Technological Interventions to Meet the Needs of Priority Populations. Prog Cardiovasc Dis 2016; 58:630-8. [PMID: 26957186 DOI: 10.1016/j.pcad.2016.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 02/02/2023]
Abstract
Cardiovascular diseases (CVD) comprise the leading cause of mortality worldwide, accounting for 3 in 10 deaths. Individuals with certain risk factors, including tobacco use, obesity, low levels of physical activity, type 2 diabetes mellitus, racial/ethnic minority status and low socioeconomic status, experience higher rates of CVD and are, therefore, considered priority populations. Technological devices such as computers and smartphones are now routinely utilized in research studies aiming to prevent CVD and its risk factors, and they are also rampant in the public and private health sectors. Traditional health behavior interventions targeting these risk factors have been adapted for technology-based approaches. This review provides an overview of technology-based interventions conducted in these priority populations as well as the challenges and gaps to be addressed in future research. Researchers currently possess tremendous opportunities to engage in technology-based implementation and dissemination science to help spread evidence-based programs focusing on CVD risk factors in these and other priority populations.
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Affiliation(s)
- Sarah E Linke
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA.
| | - Britta A Larsen
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA
| | - Becky Marquez
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA
| | - Andrea Mendoza-Vasconez
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA
| | - Bess H Marcus
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA
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Hamm J, Money AG, Atwal A, Paraskevopoulos I. Fall prevention intervention technologies: A conceptual framework and survey of the state of the art. J Biomed Inform 2016; 59:319-45. [PMID: 26773345 DOI: 10.1016/j.jbi.2015.12.013] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/14/2015] [Accepted: 12/20/2015] [Indexed: 11/28/2022]
Abstract
In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.
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Affiliation(s)
- Julian Hamm
- Department of Computer Science, Brunel University London, UK.
| | - Arthur G Money
- Department of Computer Science, Brunel University London, UK.
| | - Anita Atwal
- Department of Clinical Sciences, Brunel University London, UK.
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18
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Kiluk BD, Serafini K, Frankforter T, Nich C, Carroll KM. Only connect: The working alliance in computer-based cognitive behavioral therapy. Behav Res Ther 2014; 63:139-46. [PMID: 25461789 DOI: 10.1016/j.brat.2014.10.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 07/23/2014] [Accepted: 10/14/2014] [Indexed: 01/08/2023]
Abstract
The limited role of therapists in some technology-based interventions raises questions as to whether clients may develop a 'working alliance' with the program, and the impact on relationships with a therapist and/or treatment outcomes. In this study, the Working Alliance Inventory (WAI), and an adapted version for technology-based interventions (WAI-Tech), were administered within a subsample (n = 66) of cocaine-dependent individuals participating in a randomized trial evaluating the efficacy of Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT) as an adjunct to treatment as usual (TAU). Results suggest the WAI-Tech has relatively similar psychometric characteristics as the standard WAI; however the 'bond' subscale scores were lower on the WAI-Tech [F(1,52) = 5.78, p < .05]. Scores on the WAI-Tech were not associated with cocaine use outcomes, whereas total scores on the WAI for those assigned to TAU were associated with the percentage of days abstinent from cocaine (r = .43, p < .05). There was little evidence that adding a technology-based intervention adversely affected the working alliance with a therapist in this sample. These preliminary findings suggest some concepts of working alliance may apply to computer-based CBT, yet the function of the alliance may be different in technology-based interventions than in face-to-face psychotherapies.
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Affiliation(s)
- Brian D Kiluk
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA.
| | - Kelly Serafini
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Tami Frankforter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Charla Nich
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Kathleen M Carroll
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
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