Development of a multimedia intervention to improve pneumoconiosis prevention in construction workers using RE-AIM framework

2021 ◽  
Author(s):  
Jieling Chen ◽  
Cho Lee Wong ◽  
Bernard Man Hin Law ◽  
Winnie Kwok Wei So ◽  
Doris Yin Ping Leung ◽  
...  
Keyword(s):  
South Asian ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Intervention Mapping ◽  
Intervention Development ◽  
Educational Interventions ◽  
Construction Workers ◽  
Post Intervention ◽  
Cohen’S D ◽  
Cohen's D

Summary Pneumoconiosis is a common occupational lung disease among construction workers. Educational interventions targeting specific ethnic groups of construction workers are of benefit for pneumoconiosis prevention. The aim of this study was to develop a multimedia educational intervention for pneumoconiosis prevention for South Asian construction workers, and to evaluate its feasibility, acceptability and effectiveness in increasing knowledge of pneumoconiosis, modifying beliefs about pneumoconiosis, and enhancing intention to implement measures for its prevention among the workers. This evaluation was performed using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. A one-group design was adopted and intervention mapping was used to guide the process of intervention development, while the Health Belief Model guided the development of intervention content. The intervention was delivered at construction sites, ethnic minority associations and South Asian community centres. Data were collected via surveys completed at pre-intervention, post-intervention and 3 months after the intervention. A total of 1002 South Asian construction workers participated in the intervention. The participants reported a moderate-to-large increase in knowledge, perceived susceptibility, perceived severity, perceived benefits, cues to action and self-efficacy (Cohen’s d: 0.37–0.89), a small reduction in perceived barriers (Cohen’s d = 0.12) and a moderate improvement in attitudes and intention to practice (Cohen’s d: 0.45, 0.51) at post-intervention. A follow-up survey of 121 participants found that the implementation of preventive measures appeared to increase. Overall, the findings demonstrate that the implementation of a culturally adapted multimedia educational intervention could be an effective approach to improving knowledge, self-efficacy and intention regarding pneumoconiosis prevention among South Asian construction workers.

Short-term outcomes of the Therapist-assisted Online Parenting Strategies intervention for parents of adolescents treated for anxiety and/or depression: A single-arm double-baseline trial

2021 ◽  
pp. 000486742110256
Author(s):  
Sarah Pheik Hoon Khor ◽  
Catherine Margaret Fulgoni ◽  
Deborah Lewis ◽  
Glenn A Melvin ◽  
Anthony F Jorm ◽  
...  
Keyword(s):  
Family Functioning ◽  
Self Efficacy ◽  
Trial Registration ◽  
Parenting Strategies ◽  
Post Intervention ◽  
Cohen’S D ◽  
Adolescent Attachment ◽  
Parent Distress ◽  
Cohen's D ◽  
Parenting Behaviours

Objective: This study aimed to evaluate whether the Therapist-assisted Online Parenting Strategies programme increased parenting behaviours known to be supportive of adolescents experiencing anxiety and/or depression. Secondary parenting outcomes of parental self-efficacy, parental accommodation, carer burden, parent–adolescent attachment, family functioning and parent distress were also examined, along with adolescent outcomes of anxiety and depression symptoms, suicidal ideation and sleep. Method: Seventy-one parents (94.4% females) and their adolescents (73.2% females) aged 12–18 years (Mean = 15.02, SD = 1.56) being treated for depression and/or anxiety in Australia were recruited into a single-arm double-baseline open-label trial. Parents received Therapist-assisted Online Parenting Strategies, which comprised up to nine web-based modules each supplemented with coaching sessions via videoconferencing. Outcomes were analysed using latent growth curve modelling to determine if changes to outcomes at post-intervention (4 month post-second baseline) exceeded changes between two baselines measured 1 month apart. Results: Sixty-five parents (91.6%) completed at least one module of the online parenting intervention and on average received nine coaching sessions (SD = 2). Parenting behaviours targeted by Therapist-assisted Online Parenting Strategies improved at post-intervention (Cohen’s d = 1.16, 95% confidence interval [0.78, 1.51]). Parent-reported parental self-efficacy and parent−adolescent attachment increased (Cohen’s d = 1.44 [1.05, 1.82] and 0.39 [0.05, 0.74], respectively), while impairments to family functioning and parent distress decreased (Cohen’s d = −0.51 [−0.86, −0.16] and −0.84 [−1.23, −0.44], respectively). Changes to adolescent anxiety, depression and sleep were not significant. Conclusion: The Therapist-assisted Online Parenting Strategies intervention improved self-reported parenting behaviours, parental self-efficacy, parent levels of distress, parent–adolescent attachment, and family functioning in parents with adolescents being treated for anxiety and/or depression. However, significant changes in adolescent mental health and sleep outcomes at post-intervention were not observed. The usefulness of a therapist-supported online parenting programme in addressing a service gap for parents seeking professional help is indicated. Trial Registration: Australian New Zealand Clinical Trials Registry Number (ACTRN) 12618000290291, prospectively registered on 26 February 2018; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368031

scholarly journals Preliminary Evaluation of the Engagement and Effectiveness of a Mental Health Chatbot

2020 ◽  
Author(s):  
Kate Daley
Keyword(s):  
Mental Health ◽  
Digital Health ◽  
Preliminary Evaluation ◽  
Real World Data ◽  
Post Intervention ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cohen’S D ◽  
Cohen's D ◽  
Human Support

Background: Mental health difficulties are highly prevalent yet access to support is impeded by barriers of stigma, cost and availability. These issues are even more prevalent in low- and middle-income countries, and use of digital technology is one way to overcome these barriers. Digital health interventions have been shown to be effective but often struggle with low engagement rates, particularly in the absence of any human support. Chatbots could offer a scalable solution, simulating human support at a lower cost. Objective: To complete a preliminary evaluation of engagement and effectiveness of Vitalk, a mental health chatbot, at reducing anxiety, depression and stress. Methods: Real world data was analysed from 3629 Vitalk users who had completed the first phase of a Vitalk program (‘less anxiety’, ‘less stress’ or ‘better mood’). Programs were delivered through written conversation with the chatbot. Engagement was calculated from the number of responses sent to the chatbot divided by days in the program. Results: Users sent an average of 8.17 responses / day. For all three programs, target outcome scores reduced between baseline and follow up with large effect sizes for anxiety (Cohen's d = -0.85), depression (Cohen's d = -0.91) and stress (Cohen's d =-0.81). Increased engagement resulted in improved post-intervention values for anxiety and depression. Conclusion: This study highlights the potential of a chatbot to reduce mental health symptoms in the general population within Brazil. Whilst findings show promise, further research is required.

scholarly journals Impact of Educational Weaning Knowledge and Practices of Parents and Guardians of Children under Two Years Old at the David Rose Health Centre

2019 ◽  
pp. 21-22
Author(s):  
Padmini Bissessar ◽  
Kenesha Adams ◽  
Gina Chin ◽  
Sheena Chin ◽  
Paul Garraway ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Repeated Measures ◽  
Health Centre ◽  
World Health Organisation ◽  
Educational Interventions ◽  
World Health ◽  
Post Intervention ◽  
Prospective Longitudinal Study ◽  
Repeated Measures Design ◽  
Prospective Longitudinal

Objectives: To assess the knowledge of weaning, of parents and guardians, of children under two-years-old, attending David Rose Health Centre. To assess whether there is an association between selected demographic variables, and the weaning knowledge. To educate the parents and guardians on the World Health Organisation recommended weaning practices. To assess the change in knowledge of weaning after the delivery of an educational intervention. Design and Methods: A prospective longitudinal study with repeated measures design obtained 120 participants using a convenient, non-probability sampling method. Data was collected using a pre-intervention and post-intervention questionnaire. The data was processed using the SPSS Version 24 Software Program and analysed with a scoring system developed by the researchers using the PAHO/WHO “Guiding Principles for Complementary Feeding of the Breastfed Child”. Results: Both educational interventions increased the participants knowledge from good to almost 100%. Conclusions: Most parents and guardians had good baseline knowledge. However, there were certain aspects where they lacked or had inaccurate knowledge. Overall, their knowledge improved regardless of the type of educational intervention they were exposed to. Recommendations: Future studies should be held in classroom settings, with more time allowed to assess change of knowledge.

scholarly journals 0636 Using AI To Predict Future CPAP Adherence and the Impact of Behavioral and Technical Interventions

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A243-A243
Author(s):  
W Hevener ◽  
B Beine ◽  
J Woodruff ◽  
D Munafo ◽  
C Fernandez ◽  
...  
Keyword(s):  
Effect Size ◽  
Statistical Significance ◽  
Post Intervention ◽  
Cpap Adherence ◽  
Cohen’S D ◽  
Usage Patterns ◽  
Patient Outreach ◽  
Cohen's D ◽  
The Impact ◽  
Usage Data

Abstract Introduction Clinical management of CPAP adherence remains an ongoing challenge. Behavioral and technical interventions such as patient outreach, coaching, troubleshooting, and resupply may be deployed to positively impact adherence. Previous authors have described adherence phenotypes that retrospectively categorize patients by discrete usage patterns. We design an AI model that predictively categorizes patients into previously studied adherence phenotypes and analyzes the statistical significance and effect size of several types of interventions on subsequent CPAP adherence. Methods We collected a cross-sectional cohort of subjects (N = 13,917) with 455 days of daily CPAP usage data acquired. Patient outreach notes and resupply data were temporally synchronized with daily CPAP usage. Each 30-days of usage was categorized into one of four adherence phenotypes as defined by Aloia et al. (2008) including Good Users, Variable Users, Occasional Attempters, and Non-Users. Cross-validation was used to train and evaluate a Recurrent Neural Network model for predicting future adherence phenotypes based on the dynamics of prior usage patterns. Two-sided 95% bootstrap confidence intervals and Cohen’s d statistic were used to analyze the significance and effect size of changes in usage behavior 30-days before and after administration of several resupply interventions. Results The AI model predicted the next 30-day adherence phenotype with an average of 90% sensitivity, 96% specificity, 95% accuracy, and 0.83 Cohen’s Kappa. The AI model predicted the number of days of CPAP non-use, use under 4-hours, and use over 4-hours for the next 30-days with OLS Regression R-squared values of 0.94, 0.88, and 0.95 compared to ground truth. Ten resupply interventions were associated with statistically significant increases in adherence, and ranked by adherence effect size using Cohen’s d. The most impactful were new cushions or masks, with a mean post-intervention CPAP adherence increase of 7-14% observed in Variable User, Occasional Attempter, and Non-User groups. Conclusion The AI model applied past CPAP usage data to predict future adherence phenotypes and usage with high sensitivity and specificity. We identified resupply interventions that were associated with significant increases in adherence for struggling patients. This work demonstrates a novel application for AI to aid clinicians in maintaining CPAP adherence. Support  

Formation of Breastfeeding Attitudes Among Nursing Students

2012 ◽  
Vol 3 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Darlene A. Showalter
Keyword(s):  
Nursing Students ◽  
Educational Intervention ◽  
Educational Interventions ◽  
Specific Information ◽  
Clinical Experiences ◽  
Post Intervention ◽  
Breastfeeding Practices ◽  
Initial Placement ◽  
Students Attitudes ◽  
Breastfeeding Attitudes

Nurses’ attitudes about breastfeeding may play a role in their ability to support and promote it. Orientation for labor and delivery (L&D) nurses includes the initial placement of neonate to breast. However, formation of nurses’ attitudes begins in their academic and clinical experiences. Educational interventions that target nursing students’ attitudes about breastfeeding provide an opportunity to not only teach lactation-specific information, but to also diffuse biases and misconceptions prior to delivering patient care as students and more importantly, registered nurses. Senior nursing students in a baccalaureate program were surveyed for attitudes about breastfeeding and perceived readiness to support breastfeeding practices. An educational intervention was implemented and a post-intervention survey was administered. Students’ attitudes toward breastfeeding and perceived readiness to support breastfeeding practices were positively impacted by the educational intervention. Nurses’ ability to promote and support breastfeeding may be dependent upon their attitude toward this healthy behavior.

scholarly journals Dancing With Health: Quality of Life and Physical Improvements From an EU Collaborative Dance Programme With Women Following Breast Cancer Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Vicky Karkou ◽  
Irene Dudley-Swarbrick ◽  
Jennifer Starkey ◽  
Ailsa Parsons ◽  
Supritha Aithal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Latin American ◽  
Radiation Treatment ◽  
Well Being ◽  
Post Intervention ◽  
Dance Movement ◽  
Cohen’S D ◽  
Cohen's D

Background: Women's health has received renewed attention in the last few years including health rehabilitation options for women affected by breast cancer. Dancing has often been regarded as one attractive option for supporting women's well-being and health, but research with women recovering from breast cancer is still in its infancy. Dancing with Health is multi-site pilot study that aimed to evaluate a dance programme for women in recovery from breast cancer across five European countries.Methods: A standardized 32 h dance protocol introduced a range of Latin American dances presented within a sports and exercise framework with influences from dance movement therapy. Fifty-four women (M age 53.51; SD 7.99) participated in the study who had a breast cancer diagnosis <3 years, chemotherapy >6 weeks, no indication of metastasis, or scheduled surgery/chemotherapy/radiation treatment for the duration of the intervention. Primary outcome data was collected for anthropometric and fitness measures next to cancer-related quality of life. T-tests and Wilcoxon signed ranked tests were used to establish differences pre and post intervention. Cohen's d was also calculated to determine the effect size of the intervention.Results: Statistically significant changes were found for: (i) weight, right and left forearm circumference and hip; (ii) 6 min walking, right and left handgrip, sit-to-stand and sit-and-reach; (iii) the EORTC-QLQ C30 summary score as well as the subscales of emotional and social functioning and symptoms. In all cases the direction of change was positive, while Cohen's d calculated showed that the effect of the intervention for these parameters ranged from intermediate to large.Conclusion: Changes on the above anthropometric, fitness and quality of life measures suggest that the intervention was of value to the participating women recovering from breast cancer. Results also advocate collaborative efforts across countries to further research.

scholarly journals Effectiveness of Blended Learning versus Lectures alone on ECG Analysis and Interpretation by Medical Students

2020 ◽  
Author(s):  
Charle Andre Viljoen ◽  
Rob Scott Millar ◽  
Kathryn Manning ◽  
Vanessa Celeste Burch
Keyword(s):  
Medical Students ◽  
Blended Learning ◽  
Web Application ◽  
Deliberate Practice ◽  
Clinical Clerkship ◽  
Post Intervention ◽  
Ecg Analysis ◽  
Cohen’S D ◽  
Conventional Teaching ◽  
Cohen's D

Abstract Background Most medical students lack confidence and are unable to accurately interpret ECGs. Better methods of ECG instruction are therefore being sought. Current literature indicates that the use of e-learning for ECG analysis and interpretation skills (ECG competence) is not superior to lecture-based teaching. We aimed to assess whether blended learning (lectures supplemented with the use of a web application) resulted in better acquisition and retention of ECG competence in medical students, than with conventional teaching (lectures alone). Methods Two cohorts of fourth-year medical students were studied prospectively. The conventional teaching cohort (n=67) attended four hours of interactive lectures, covering the basic principles of Electrocardiography, waveform abnormalities and arrhythmias. In addition to attending the same lectures, the blended learning cohort (n=64) used a web application that facilitated deliberate practice of ECG analysis and interpretation, with structured feedback. All participants completed three tests: pre-intervention (assessing baseline ECG competence at start of clinical clerkship), immediately post-intervention (assessing acquisition of ECG competence at end of six-week clinical clerkship) and delayed post-intervention (assessing retention of ECG competence six months after clinical clerkship, without any further ECG training). Diagnostic accuracy and uncertainty were assessed in each test. Results The pre-intervention test scores were similar for blended learning and conventional teaching cohorts (mean 31.02±13.19% versus 31.23±11.52% respectively, p=0.917). While all students demonstrated meaningful improvement in ECG competence after teaching, blended learning was associated with significantly better scores, compared to conventional teaching, in immediate (75.27±16.22% vs 50.27±17.1%, p<0.001; Cohen’s d =1.58), and delayed post-intervention tests (57.70±18.54% vs 37.63±16.35%, p<0.001; Cohen’s d =1.25). Although diagnostic uncertainty decreased after ECG training in both cohorts, blended learning was associated with better confidence in ECG analysis and interpretation. Conclusion Blended learning was superior in teaching ECG analysis and interpretation skills to medical students and achieved better levels of ECG competence and confidence than conventional lectures. Although medical students undergo a significant attrition of ECG competence without ongoing training, blended learning also resulted in better retention of ECG competence than conventional teaching. Web applications enabling deliberate practice with structured feedback may therefore be a useful adjunct to lectures for teaching Electrocardiography.

583 Treating Insomnia in Youth Depression: A Randomized Controlled Trial of CBT for Depression vs. CBT for Insomnia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A230-A230
Author(s):  
Shirley Xin Li ◽  
Ngan Yin chan ◽  
Siu Ping Lam ◽  
Tsz Ting Lui ◽  
Joey W Chan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Post Intervention ◽  
Meaningful Improvement ◽  
Treatment Groups ◽  
Comorbid Insomnia ◽  
Cohen’S D ◽  
Significant Difference ◽  
Cohen's D ◽  
Group Cbt

Abstract Introduction Insomnia is often comorbid with depression in youths and both may reciprocally exacerbate clinical outcomes and lead to a constellation of detrimental consequences. The present study aimed to test the efficacy of cognitive behavioral therapy (CBT) for insomnia (CBT-I) and CBT for depression (CBT-D), when compared with waitlist control, in youths with comorbid insomnia and depression. Methods 112 participants aged 12–24 years old (67.9% female) with insomnia and depression according to DSM-5 diagnostic criteria were randomised to one of the following conditions: 8-week group CBT-I (n=33), 8-week group CBT-D (n=39), or waiting-list control (n=40). Insomnia (Insomnia Severity Index, ISI) and depressive symptoms (Hamilton Rating Scale for Depression, HAMD) were assessed at baseline and post-intervention. The two active treatment groups were additionally followed up at post-treatment one-month. Results Linear mixed model showed that both treatment groups (CBT-D: Cohen’s d = -0.44, p&lt;.001; CBT-I: Cohen’s d =-0.56, p&lt;.001) had significantly lower ISI scores at post-intervention follow-up, as compared to the waitlist group. There was a significant difference in clinically meaningful improvement in insomnia (a reduction of ISI score ≥ 6 from baseline to post-intervention follow-up) between the groups (CBT-I: 73.1%; CBT-D: 40.0%; WL: 28.6%; p=.002). Moreover, there was a significant difference in remission of depression (HAMD≤7) at post-intervention follow-up (CBT-D: 75.9%; CBT-I: 81.5%; WL: 22.9%) (p &lt;.001). Both CBT-D and CBT-I resulted in comparable improvements in insomnia and depressive symptoms at one-month follow-up (p&gt;.05). Conclusion Preliminary evidence from this study supports the efficacy of CBT-I for improving both sleep and mood in youths with comorbid insomnia and depression. Support (if any) This work was supported by Early Career Scheme, Research Grants Council, Hong Kong SAR (Ref. 27613017).

Liberation from Ventilation: An Intervention Study in Public Adult Intensive Care Units in the Eastern Cape Province of South Africa

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Benedict Raphael Oamen ◽  
Portia Jordan ◽  
Wilma Ten Ham-Baloyi ◽  
Emmanuel Zamo Hlungwane
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Educational Intervention ◽  
Intervention Study ◽  
Intervention Group ◽  
Knowledge Score ◽  
Critical Care Nurses ◽  
Cohen’S D ◽  
Post Test ◽  
Cohen's D

Implementing evidence-based guidelines is one way of addressing the knowledge gap of critical care nurses regarding the ventilator liberation of critically ill adult patients in South Africa. A quasi-experimental intervention study using a pre-test/post-test design to measure critical care nurses’ knowledge on ventilator liberation of adult patients in intensive care units was conducted. The critical care nurses were purposively sampled into three groups and their knowledge was measured before an educational intervention, and three months after. Data was collected with pre/post-test questionnaires, n1=115 pre-test and n2=90 post-test, respectively. An educational intervention using a PowerPoint presentation, printed copies of the guidelines, posters as reminders, and informal monitoring visits (Intervention Group One) had an insignificant effect (p=0.371; Cohen’s d <0.20) on the improvement of the respondents’ knowledge score (62,93 versus 65,22). Handing out printed copies of guidelines alone (Intervention Group Two) had a small effect (p=0.033; Cohen’s d=0.49 small) but did not improve respondents’ knowledge score (60,34 versus 53,41). The absence of an educational intervention (Control Group) had an insignificant effect (p=0.884; Cohen’s d <0.20) on the improvement of respondents’ knowledge score (59,60 versus 60,33). Across the three groups, intensive care unit experience had a moderate effect (p=0,018; Cohen’s d=0.67 medium) on the way critical care nurses responded to the pre/post-test questionnaires. Respondents lacked knowledge of ventilator liberation practices in the study context, and this can be addressed using combined educational intervention methods. Sequel studies using different educational intervention methods are recommended that take into account the diversity within the study population.

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