Healthy Recovery: A Pilot Study of a Smoking and Other Health Behavior Change Intervention for People Attending Residential Alcohol and Other Substance Dependence Treatment

2019 ◽  
Vol 15 (3) ◽  
pp. 207-216
Author(s):  
Peter J. Kelly ◽  
Amanda L. Baker ◽  
Camilla J. Townsend ◽  
Frank P. Deane ◽  
Robin Callister ◽  
...  
2018 ◽  
Vol 53 (8) ◽  
pp. 756-768
Author(s):  
Rebecca Murray ◽  
Amanda Baker ◽  
Sean Halpin ◽  
Ben Britton ◽  
Kristen McCarter ◽  
...  

Abstract Background The relationship between a clinician and their client—the “therapeutic alliance” is a robust predictor of outcome in healthcare settings; yet, few interventions to improve alliance have been tested. Motivational interviewing is a client-centered approach that embodies many principles and strategies consistent with a strong therapeutic alliance. Purpose To examine whether alliance is enhanced by training dietitians to deliver a motivational interviewing informed health behavior change intervention (“Eating as Treatment”; EAT) as part of routine consultations with patients with head and neck cancer. The predictive ability of motivational interviewing techniques was also assessed. Methods A secondary analysis of the EAT stepped-wedge cluster-randomized controlled trial was conducted. Patients with head and neck cancer undergoing radiotherapy (n = 307) were treated by radiotherapy dietitians (n = 29) during the control (Treatment as Usual) or intervention (EAT) phase. Alliance was rated during the first and final weeks of radiotherapy, and again 4 and 12 weeks post-radiotherapy. Dietetic sessions were audiotaped. Week one sessions were objectively rated for dietitians’ use of motivational interviewing techniques. Results Generalized linear-mixed effects regressions found no effect of EAT on dietitian-rated alliance (p = .237). After excluding outliers, patient-rated alliance was 0.29 points lower after EAT training (p = .016). Post hoc analyses revealed lower patient ratings on perceived support and dietitian confidence. Hierarchical multiple regressions found that no specific motivational interviewing techniques predicted patient-rated alliance. Dietitian acknowledgment of patient challenges was related to dietitian-rated alliance (β =.15, p =.035). Conclusions Patient and dietitian ratings of alliance were high after EAT training, but not significantly improved. Further research is needed to better understand the differential impact of intervention training and delivery on patient and clinician ratings of therapeutic alliance. Clinical Trial information Trial registration number ACTRN12613000320752


2013 ◽  
Vol 4 (2) ◽  
pp. 160-169 ◽  
Author(s):  
Jennifer A Linde ◽  
Sarah M Sevcik ◽  
Christine A Petrich ◽  
Jolynn K Gardner ◽  
Melissa N Laska ◽  
...  

2014 ◽  
Vol 16 (2) ◽  
pp. e54 ◽  
Author(s):  
Erin O'Carroll Bantum ◽  
Cheryl L Albright ◽  
Kami K White ◽  
Jeffrey L Berenberg ◽  
Gabriela Layi ◽  
...  

2017 ◽  
Vol 3 (1) ◽  
pp. 8-14
Author(s):  
Abigail Remenapp ◽  
◽  
Brantlee Broome ◽  
Gail Maetozo ◽  
Heather Hausenblas ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Marcelo Trombka ◽  
Timothy B. Creedon ◽  
Marcelo Demarzo ◽  
Letícia T. Cuoco ◽  
Lydia Smith ◽  
...  

Background: Portuguese-speaking immigrants are a growing underserved population in the Unites States who experience high levels of psychological distress and increased vulnerability to mental health disorders such as depression and anxiety. Current evidence shows that mindfulness-based interventions (MBIs) are effective to promote physical and mental health among educated English speakers; nonetheless, the lack of diversity in the mindfulness literature is a considerable limitation. To our knowledge, the feasibility and acceptability of MBIs among Portuguese-speaking immigrants have not yet been investigated.Methods: This single-arm pilot study (N = 30) explored the feasibility, acceptability, and cultural aspects of Mindfulness Training for Primary Care (MTPC)-Portuguese among Portuguese-speaking immigrants in the Boston area. MTPC is an 8-week, primary care-adapted, referral-based, insurance-reimbursable, trauma-informed MBI that is fully integrated into a healthcare system. The study also examined intervention preliminary effectiveness on mental health outcomes (depression and anxiety symptoms) and self-regulation (emotional regulation, mindfulness, self-compassion, interoceptive awareness), and initiation of health behavior was explored.Results: Primary care providers referred 129 patients from 2018 to 2020. Main DSM-5 primary diagnoses were depression (76.3%) and anxiety disorders (6.7%). Participants (N = 30) attended a mean of 6.1 (SD 1.92) sessions and reported a mean of 213.7 (SD = 124.3) min of practice per week. All survey finishers would recommend the program to a friend, found the program helpful, and rated the overall program as “very good” or “excellent,” and 93% would participate again, with satisfaction mean scores between 4.6 and 5 (Likert scale 0–5). Participants and group leaders provided feedback to refine MTPC-Portuguese culturally responsiveness regarding materials language, settings, time, food, and community building. Patients exhibited reductions in depression (d = 0.67; p < 0.001) and anxiety (d = 0.48; p = 0.011) symptoms, as well as enhanced emotional regulation (d = 0.45; p = 0.009), and among survey finishers, 50% initiated health behavior change through action plan initiation.Conclusion: This pilot study suggests that MTPC-Portuguese is feasible, acceptable, and culturally appropriate among Portuguese-speaking patients in the Boston area. Furthermore, the intervention might potentially decrease depression and anxiety symptoms, facilitate health behavior change, and improve emotional regulation. MTPC-Portuguese investigation with larger samples in controlled studies is warranted to support its dissemination and implementation in the healthcare system.Clinical Trial Registration: Identifier: NCT04268355.


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