Predicting Response to Treatment in a Tier 2 Supplemental Vocabulary Intervention

2018 ◽  
Vol 61 (1) ◽  
pp. 94-103 ◽  
Author(s):  
Elizabeth Kelley ◽  
Emily Leary ◽  
Howard Goldstein
Keyword(s):  
Response To Intervention ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Response To Treatment ◽  
Poor Responders ◽  
Specific Information ◽  
Tier 2 ◽  
Vocabulary Intervention ◽  
Effective Interventions ◽  
Cluster Randomized

PurposeTo effectively implement a response to intervention approach, there is a need for timely and specific information about student learning in response to treatment to ensure that treatment decisions are appropriate. This exploratory study examined responsivity to a supplemental, Tier 2 vocabulary intervention delivered to preschool children with limited language abilities.MethodA secondary analysis of a cluster-randomized trial of a supplemental vocabulary intervention was conducted. Responsivity (e.g., adequate learning) to the intervention was examined, and learning in the 1st few weeks of intervention was evaluated as a possible predictor of response to intervention.ResultsUsing a criterion of learning of 20% of target vocabulary, nearly one third of participants were identified as poor responders. A 1st unit benchmark was identified that maximized the sensitivity to identification of children who were likely to respond to the intervention.ConclusionsEven for generally effective interventions, there is likely to be a substantial proportion of children who are not responsive. Learning in the 1st few weeks of intervention may be a useful indicator of appropriate response to treatment and could inform instructional decisions.

scholarly journals Does #Tamojunto alter the dynamic between drug use and school violence among youth? Secondary analysis from a large cluster-randomized trial

2021 ◽  
Author(s):  
Hugo Cogo-Moreira ◽  
Julia D. Gusmões ◽  
Juliana Y. Valente ◽  
Michael Eid ◽  
Zila M. Sanchez
Keyword(s):  
Drug Use ◽  
School Violence ◽  
Causal Effect ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Random Intercept ◽  
Carry Over ◽  
Cluster Randomized ◽  
Use Behavior

AbstractThe present study investigated how intervention might alter the relationship between perpetrating violence and later drug use. A cluster-randomized controlled trial design involving 72 schools (38 intervention, 34 control) and 6390 students attending grades 7 and 8 was employed in Brazil. Drug use and violence were assessed at three points. A random-intercept cross-lagged panel model examined the reciprocal association between drug use and school violence domains across the three data collection waves. For both groups, we found that the cross-lagged effect of perpetration on further drug use in adolescents was stronger than the reverse, but the interrelationship was not statistically significant between #Tamojunto and control schools. The carry-over effects of drug use and violence were also not significantly different between groups. There is a lack of evidence showing that #Tamojunto can modify the dynamics between drug use and school violence across the 21-month period. The direction of the causal effect (i.e., the more perpetration behavior, the more subsequent drug use behavior) is present, but weak in both groups. The trial registration protocol at the national Brazilian Register of Clinical Trials (REBEC) is #RBR-4mnv5g.

scholarly journals Vital sign monitoring following stroke associated with 90-day independence: A secondary analysis of the QASC cluster randomized trial

2019 ◽  
Vol 89 ◽  
pp. 72-79
Author(s):  
Sandy Middleton ◽  
Patrick McElduff ◽  
Peta Drury ◽  
Catherine D’Este ◽  
Dominique A. Cadilhac ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Vital Sign ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Cluster Randomized

scholarly journals Children Immunization App (CImA) Among Syrian Refugees in Zaatari Camp, Jordan: Protocol for a Cluster Randomized Controlled Pilot Trial Intervention Study

10.2196/13557 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e13557 ◽  
Author(s):  
Yousef S Khader ◽  
Lucie Laflamme ◽  
Daniela Schmid ◽  
Soha El-Halabi ◽  
Mohammad Abu Khdair ◽  
...  
Keyword(s):  
Demographic Data ◽  
Pilot Trial ◽  
Cluster Randomized Trial ◽  
Childhood Vaccination ◽  
Secondary Outcome ◽  
Local Resident ◽  
Vaccination Rates ◽  
Effective Interventions ◽  
Cluster Randomized

Background There are up to 19.4 million children who are still unvaccinated and face unnecessary deaths, especially among refugees. However, growing access to smartphones, among refugees, can be a leading factor to improve vaccination rates. Objective This study aims to determine whether a smartphone app can improve the vaccination uptake among refugees and determine the app’s effectiveness in improving the documentation of vaccination records. Methods We developed and planned to test an app through a cluster randomized trial that will be carried out at the Zaatari refugee camp in Jordan. The study will be open to all parents who carry Android smartphones, have at least one child, and agree to participate in the study. The parents will be recruited to the study by trained volunteers at the vaccination sites around the Zaatari camp. Inclusion criteria will be the following: having at least one child of 0 to 5 years, being a local resident of the camp, and having an Android smartphone. Results The intervention includes an app that will allow storing Jordanian vaccination records, per child, on the parents’ smartphones in Arabic and English (in an interchangeable fashion). Every record will have a set of automated reminders before the appointment of each child. The app will summarize immunization records in form of due, taken, or overdue appointments, labeled in orange, green, and red, respectively. Baseline will include the collection of our primary and secondary outcomes that are needed for the pre and postdata measurements. This includes social demographic data, any previous vaccination history, and electronic health literacy. Participants, in both study arms, will be monitored for their follow-up visits to the clinic for vaccination doses. For the study outcome measures, we will measure any differences in the uptake of vaccinations. The secondary outcome is to analyze the effect of the children immunization app on visits for follow-up doses. Conclusions Owing to the limited evidence of effective interventions for childhood vaccination among refugees, research in this area is greatly needed. The project will have a significant impact on the health of refugees and the public health system. In Jordan and the Middle East, the vaccination level is low. Given the influx of refugees from the area, it is crucial to ensure a high vaccination level among the children. International Registered Report Identifier (IRRID) PRR1-10.2196/13557

scholarly journals Acquisition of Antibiotic-Resistant Gram-negative Bacteria in the Benefits of Universal Glove and Gown (BUGG) Cluster Randomized Trial

2020 ◽  
Author(s):  
Anthony D Harris ◽  
Daniel J Morgan ◽  
Lisa Pineles ◽  
Larry Magder ◽  
Lyndsay M O’Hara ◽  
...  
Keyword(s):  
Intensive Care ◽  
Randomized Trial ◽  
Primary Outcome ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Gram Negative Bacteria ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Cluster Randomized

Abstract Background The Benefits of Universal Glove and Gown (BUGG) cluster randomized trial found varying effects on methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus and no increase in adverse events. The aim of this study was to assess whether the intervention decreases the acquisition of antibiotic-resistant gram-negative bacteria. Methods This was a secondary analysis of a randomized trial in 20 hospital intensive care units. The intervention consisted of healthcare workers wearing gloves and gowns when entering any patient room compared to standard care. The primary composite outcome was acquisition of any antibiotic-resistant gram-negative bacteria based on surveillance cultures. Results A total of 40 492 admission and discharge perianal swabs from 20 246 individual patient admissions were included in the primary outcome. For the primary outcome of acquisition of any antibiotic-resistant gram-negative bacteria, the intervention had a rate ratio (RR) of 0.90 (95% confidence interval [CI], .71–1.12; P = .34). Effects on the secondary outcomes of individual bacteria acquisition were as follows: carbapenem-resistant Enterobacteriaceae (RR, 0.86 [95% CI, .60–1.24; P = .43), carbapenem-resistant Acinetobacter (RR, 0.81 [95% CI, .52–1.27; P = .36), carbapenem-resistant Pseudomonas (RR, 0.88 [95% CI, .55–1.42]; P = .62), and extended-spectrum β-lactamase–producing bacteria (RR, 0.94 [95% CI, .71–1.24]; P = .67). Conclusions Universal glove and gown use in the intensive care unit was associated with a non–statistically significant decrease in acquisition of antibiotic-resistant gram-negative bacteria. Individual hospitals should consider the intervention based on the importance of these organisms at their hospital, effect sizes, CIs, and cost of instituting the intervention. Clinical Trials Registration NCT01318213.

scholarly journals Computerized Clinical Decision Support System for Prompting Brief Alcohol Interventions with Treatment Seeking Smokers: A Sex-Based Secondary Analysis of a Cluster Randomized Trial

2020 ◽  
Vol 17 (3) ◽  
pp. 1024 ◽  
Author(s):  
Nadia Minian ◽  
Anna Ivanova ◽  
Sabrina Voci ◽  
Scott Veldhuizen ◽  
Laurie Zawertailo ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Clinical Decision ◽  
Alcohol Intervention ◽  
Brief Alcohol Intervention ◽  
Cluster Randomized

Although brief alcohol intervention can reduce alcohol use for both men and women, health care providers (HCPs) are less likely to discuss alcohol use or deliver brief intervention to women compared to men. This secondary analysis examined whether previously reported outcomes from a cluster randomized trial of a clinical decision support system (CDSS)—prompting delivery of a brief alcohol intervention (an educational alcohol resource) for patients drinking above cancer guidelines—were moderated by patients’ sex. Patients (n = 5702) enrolled in a smoking cessation program at primary care sites across Ontario, Canada, were randomized to either the intervention (CDSS) or control arm (no CDSS). Logistic generalized estimating equations models were fit for the primary and secondary outcome (HCP offer of resource and patient acceptance of resource, respectively). Previously reported results showed no difference between treatment arms in HCP offers of an educational alcohol resource to eligible patients, but there was increased acceptance of the alcohol resource among patients in the intervention arm. The results of this study showed that these CDSS intervention effects were not moderated by sex, and this can help inform the development of a scalable strategy to overcome gender disparities in alcohol intervention seen in other studies.

scholarly journals Time to move? Factors associated with burden of care among informal caregivers of cognitively impaired older people facing housing decisions: secondary analysis of a cluster randomized trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexandrine Boucher ◽  
Julie Haesebaert ◽  
Adriana Freitas ◽  
Rhéda Adekpedjou ◽  
Marjolaine Landry ◽  
...  
Keyword(s):  
Social Support ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Cognitively Impaired ◽  
Burden Of Care ◽  
Older Person ◽  
Factors Associated ◽  
Support Resources ◽  
Cluster Randomized ◽  
Social Support Resources

Abstract Background Making health-related decisions about loved ones with cognitive impairment may contribute to caregiver burden of care. We sought to explore factors associated with burden of care among informal caregivers who had made housing decisions on behalf of a cognitively impaired older person. Methods We conducted a secondary analysis within a cluster randomized trial (cRT) conducted in 16 publicly-funded home care service points across the Province of Quebec. The cRT assessed the impact of training home care teams in interprofessional shared decision making (IP-SDM). We assessed burden of care with the Zarit Burden Interview (ZBI) scale. We adapted Pallett’s framework to inform our data analysis. This framework posits that factors influencing burden of care among caregivers fall within four domains: (a) characteristics of the caregiver, (b) characteristics of the cognitively impaired older person, (c) characteristics of the relationship between the caregiver and the cognitively impaired older person, and (d) the caregiver’s perception of their social support resources. We computed the ZBI score and performed multilevel linear regression modelling. Results Among 296 caregivers included in the dataset, the mean ZBI score was 29.8 (SD = 17.5) out of 88. The typical participant was 62.6 years old (SD = 11.7), female (74.7%), and caring for a mother or father (61.2%). Using multivariate analysis, factors significantly associated with caregiver burden mapped onto: caregiver characteristics (caregivers with higher burden were female, experienced higher decision regret and decisional conflict, preferred that their loved one move into the caregiver’s home, into a private nursing home or a mixed private-public nursing home, and had made the decision more recently); relationship characteristics (spouses and children experienced higher burden); and caregiver’s perception of social support resources (caregivers who perceived that a joint decision making process had occurred had higher burden). Conclusion In line with the proposed framework used, we found that caregiver characteristics, relationship characteristics and caregiver’s perception of social support resources were associated with burden of care. Our results will help design interventions to prevent and/or reduce caregivers’ burden of care. Trial registration NCT02244359. Date of registration: September 18, 2014.

scholarly journals Characteristics Associated with Choosing Long-Acting Reversible Contraception in Rural Guatemala: A Secondary Analysis of a Cluster-Randomized Trial

2021 ◽  
Vol 04 (02) ◽  
Author(s):  
Margo S Harrison ◽  
Saskia Bunge-Montes ◽  
Claudia Rivera ◽  
Andrea Jimenez-Zambrano ◽  
Gretchen Heinrichs ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Cluster Randomized ◽  
Long Acting

Feasible Implementation Strategies for Improving Vocabulary Knowledge of High-Risk Preschoolers: Results From a Cluster-Randomized Trial

2020 ◽  
Vol 63 (12) ◽  
pp. 4000-4017
Author(s):  
Elizabeth Spencer Kelley ◽  
R. Michael Barker ◽  
Lindsey Peters-Sanders ◽  
Keri Madsen ◽  
Yagmur Seven ◽  
...  
Keyword(s):  
Early Childhood ◽  
Treatment Group ◽  
High Risk ◽  
Intervention Program ◽  
Implementation Strategies ◽  
Cluster Randomized Trial ◽  
Vocabulary Knowledge ◽  
Vocabulary Intervention ◽  
Early Childhood Classrooms ◽  
Cluster Randomized

Purpose Many children begin school with limited vocabularies, placing them at a high risk of academic difficulties. The goal of this study was to examine the effects of a vocabulary intervention program, Story Friends , designed to improve vocabulary knowledge of at-risk preschool children. Method Twenty-four early-childhood classrooms were enrolled in a cluster-randomized design to evaluate the effects of a revised Story Friends curriculum. In each classroom, three to four preschoolers were identified as having poor language abilities, for a total of 84 participants. In treatment classrooms, explicit vocabulary instruction was embedded in prerecorded storybooks and opportunities for review and practice of target vocabulary were integrated into classroom and home practice activities. In comparison classrooms, prerecorded storybooks included target vocabulary, but without explicit instruction, and classroom and home strategies focused on general language enrichment strategies without specifying vocabulary targets to teach. Intervention activities took place over 13 weeks, and 36 challenging, academically relevant vocabulary words were targeted. Results Children in the treatment classrooms learned significantly more words than children in the comparison classrooms, who learned few target words based on exposure. Large effect sizes (mean d = 1.83) were evident as the treatment group averaged 42% vocabulary knowledge versus 11% in the comparison group, despite a gradual decline in vocabulary learning by the treatment group over the school year. Conclusions Findings indicate that a carefully designed vocabulary intervention can produce substantial gains in children's vocabulary knowledge. The Story Friends program is feasible for delivery in early childhood classrooms and effective in teaching challenging vocabulary to high-risk preschoolers. Supplemental Material https://doi.org/10.23641/asha.13158185

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