scholarly journals Resources in vulnerable young adults: self-assessments during preventive consultation with their general practitioner in Denmark

2019 ◽  
Vol 35 (5) ◽  
pp. 1180-1189
Author(s):  
Kirsten Schierup Freund ◽  
Ann Dorrit Guassora ◽  
Trine Hegelund ◽  
Lotte Hvas ◽  
Jørgen Lous
Keyword(s):  
General Practitioner ◽  
Extrinsic Motivation ◽  
Controlled Trial ◽  
Well Being ◽  
Self Determination Theory ◽  
Old Patients ◽  
Vulnerable Patients ◽  
Inequality In Health ◽  
Health Related ◽  
Self Assessments

Abstract Inequality in health is increasing. People with many problems often lack energy to improve well-being and reduce their problems. This study analyses how psycho-socially challenged younger (20- to 44-year-old) patients described their own resources to reach lifestyle goals or alter life circumstances. Within the context of a randomized controlled trial, Danish participants had two structured preventive person-centred consultations with their general practitioner. Consultations focused on well-being, salutogenesis, resources, barriers and support of autonomy. Using the qualitative method: Systematic Text Condensation, we made thematic cross-analysis of patients’ goal-specific resource statements described at the first consultation. Of the 209 patients, 191 (91%) chose one or two goals for a better life next year; nearly all (179) could recall and describe which resources they would use to reach their goal. We categorized resource statements into (i) personal constitution as ‘willpower’ and ‘tenacity’; (ii) network, e.g. family; (iii) personal experience with identical or similar problems. Some patients needed to free up resources by handling psychological problems before being able to focus on lifestyle goals. The study demonstrates that patients with particular psycho-social problems could describe essential resources in a structured, salutogenic, preventive consultation with their general practitioner. Reflecting intrinsic and extrinsic motivation, these resources reflected dimensions of essential health theories like sense of coherence, self-efficacy and self-determination theory. Increased awareness of these resources seems essential for vulnerable patients by improving psychological well-being and optimism, thereby facilitating health-related changes. This may be an important step to reducing inequality in health.

Effects of Exercise on Health-Related Quality of Life and Fear of Falling in Home-Dwelling Older Women

2012 ◽  
Vol 20 (2) ◽  
pp. 198-214 ◽  
Author(s):  
Saija Karinkanta ◽  
Ritva Nupponen ◽  
Ari Heinonen ◽  
Matti Pasanen ◽  
Harri Sievänen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Women ◽  
Exercise Intervention ◽  
Fear Of Falling ◽  
Controlled Trial ◽  
Well Being ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

This randomized, controlled trial evaluated the effects of exercise on health-related quality of life (HRQoL) and fear of falling (FoF) among 149 home-dwelling older women. The 12-mo exercise program was intended to reduce the risk of falls and fractures. HRQoL was assessed by the RAND-36 Survey, and FoF, with a visual analog scale, at baseline, 12 mo, and 24 mo. On all RAND-36 scales, the scores indicated better health and well-being. The exercise had hardly any effect on HRQoL; only the general health score improved slightly compared with controls at 12 mo (p = .019), but this gain was lost at 24 mo. FoF decreased in both groups during the intervention with no between-groups difference at 12 or 24 mo. In conclusion, despite beneficial physiological changes, the exercise intervention showed rather limited effects on HRQoL and FoF among relatively high-functioning older women. This modest result may be partly because of insufficient responsiveness of the assessment instruments used.

A Researcher–Practitioner Collaboration to Enable Replication of an Evidence-Based Financial Education and Coaching Program That Improves Health in Low-Income Single Mothers

2021 ◽  
pp. 152483992110654
Author(s):  
Danielle Galvin ◽  
Julie Kalkowski
Keyword(s):  
Low Income ◽  
Controlled Trial ◽  
Financial Education ◽  
Well Being ◽  
Social Determinant ◽  
Theory Of Change ◽  
Financial Strain ◽  
Structured Interviews ◽  
Health Related ◽  
Core Components

Financial strain is a social determinant of health (SDOH). Although public financial education helps individuals improve financial well-being, specifics are lacking on how and why effective programs work, potentially limiting their successful replication in other practice settings. In this study, researchers and practitioners cocreated the core components and theory of change of a novel financial education and coaching program, which a randomized controlled trial found was effective in significantly improving participants’ financial and health-related behaviors. A Cocreating Knowledge Translation Framework within a case study design was used at a university-affiliated nonprofit in Omaha, Nebraska, from August to December 2020. Twelve practitioner and alumni participants were purposefully sampled. An administrative records review, semi-structured interviews (n =3), survey (n = 10), and facilitated backward mapping session (n = 5) were conducted. Transcripts were coded to identify themes. Thirty-one core components were identified within program principles, design, tools, activities, and expectations of participants and coaches. Ten theory of change outcomes described participants’ pathway to change. Interventions occurred at individual, relationship, and community levels from initial engagement, through behavioral changes, to improved health-related quality of life. Activities and indicators were mapped to each outcome. The program’s intersecting and reinforcing design was key to enabling participants’ outcomes. Its theory of change described how and why the model improved financial and health behaviors. Findings suggest that other SDOH-focused organizations may benefit from researcher–practitioner collaboration to investigate their interventions’ core components and theories of change. This may enable replication, promoting downstream health benefits in new community settings.

Impacts of oligodontia on oral health-related quality of life reported by affected children and their parents

2019 ◽  
Vol 42 (3) ◽  
pp. 250-256
Author(s):  
Leila Raziee ◽  
Peter Judd ◽  
Robert Carmichael ◽  
Shiyi Chen ◽  
Nicole Sidhu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Well Being ◽  
Permanent Teeth ◽  
Health Related Quality ◽  
Old Patients ◽  
Related Quality ◽  
Health Related ◽  
Child Perception

Summary Background Oligodontia (agenesis of six or more permanent teeth) affects functional, emotional, and social aspects of an individual’s life. Few published studies have evaluated oral health-related quality of life (OHRQoL) in children with oligodontia and very limited have compared the child and parental perceptions. Methods Thirty-five 8- to 18-year-old patients with oligodontia (10 M, 25 F; mean age: 12.4 ± 2.9 years; mean number of permanent teeth missing due to agenesis: 8.9 ± 3.2) recruited from The Hospital for Sick Children, Toronto, and Holland Bloorview Kids Rehabilitation Hospital, Toronto, and their parents completed the short format of Child Perception Questionnaire (CPQ11–14) and the Parent Child Perception Questionnaire, respectively. Results Children reported significantly worse overall CPQ score than their parents. Correlations between children’s and parents’ overall CPQ score, oral symptoms and functional limitations, and social well-being were not statistically significant. However, as children’s emotional well-being score increased, parents’ score also increased. There was no association between child CPQ score and age, gender, number, and location of permanent tooth agenesis in this sample. There was a significant correlation between overall CPQ score and Site-Specific Tooth Absences. Conclusion Children’s overall CPQ score and domain scores were significantly worse than their parents indicating that children with oligodontia had poorer OHRQoL compared to what was perceived by their parents.

scholarly journals Monitoring and Discussing Health-Related Quality of Life in Adolescents With Type 1 Diabetes Improve Psychosocial Well-Being: A randomized controlled trial

Diabetes Care ◽  
2008 ◽  
Vol 31 (8) ◽  
pp. 1521-1526 ◽  
Author(s):  
M. de Wit ◽  
H. A. Delemarre-van de Waal ◽  
J. A. Bokma ◽  
K. Haasnoot ◽  
M. C. Houdijk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Well Being ◽  
Health Related Quality ◽  
Randomized Controlled ◽  
Related Quality ◽  
Health Related

Paternalism, Public Health Ethics, and Equality

2015 ◽  
Vol 11 (2) ◽  
Author(s):  
Søren Flinch Midtgaard
Keyword(s):  
Well Being ◽  
The State ◽  
The Other ◽  
Inequalities In Health ◽  
Beneficial Effects ◽  
Health Choices ◽  
Inequality In Health ◽  
Health Related ◽  
Policy Measures ◽  
The Government

AbstractPeople’s lifestyles or their health choices importantly affect their general health. Furthermore, there is a social gradient in these choices such that people in relatively disadvantaged social positions tend to make worse choices with regard to their health than people in more advantaged positions. The consequence is deep inequalities in health. The state, to the extent it is part of its role to prevent harm and to reduce inequality, appears obliged to try to influence people’s health choices in the interest of their own health and general well-being. However, the state acting to prevent people from harming themselves is notoriously controversial, at least to liberals. It amounts to paternalism – something liberals have traditionally been loath to accept. Furthermore, the equality-generating credential of the available policy measures is in some cases doubtful. To assess the problem of paternalism in relation to government efforts to change lifestyles, partly with the aim of reducing inequalities in health, we need a clear notion of paternalism. The latter may, roughly, be seen as follows: A acts paternalistically in relation to B, if, and only if, (a) A restricts B’s liberty; (b) A does so against B’s will; (c) A does so in B’s interest; (d) A’s behavior cannot be justified without counting its beneficial effects to B in its favor. According to this conception, when the government informs citizens of the danger involved in certain types of health-related conduct, it is not acting paternalistically. However, campaigns may in fact increase rather than decrease inequality of health (because the worse off are less responsive to such measures than the better off). Nudging, on the other hand, stands a better chance of reducing inequality in health. However, nudging policies are less uncontroversial in terms of the problem of paternalism than their proponents are inclined to think. More familiar measures aiming to make the health-endangering behavior more expensive and/or difficult or outright prohibiting it stand a good chance of reducing inequalities, whilst not being more controversial than nudging policies (perhaps less) in terms of the paternalism they involve.

scholarly journals Can a teacher-led mindfulness intervention for new school entrants improve child outcomes? Protocol for a school cluster randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036523
Author(s):  
Jon L Quach ◽  
Ben Deery ◽  
Margaret Kern ◽  
Janet Clinton ◽  
Lisa Gold ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Well Being ◽  
Cluster Randomised ◽  
Health Related ◽  
Randomised Controlled ◽  
Post Randomisation

IntroductionThe first years of school are critical in establishing a foundation for positive long-term academic, social and well-being outcomes. Mindfulness-based interventions may help students transition well into school, but few robust studies have been conducted in this age group. We aim to determine whether compared with controls, children who receive a mindfulness intervention within the first years of primary school have better: (1) immediate attention/short-term memory at 18 months post-randomisation (primary outcome); (2) inhibition, working memory and cognitive flexibility at 18 months post-randomisation; (3) socio-emotional well-being, emotion-regulation and mental health-related behaviours at 6 and 18 months post-randomisation; (4) sustained changes in teacher practice and classroom interactions at 18 months post-randomisation. Furthermore, we aim to determine whether the implementation predicts the efficacy of the intervention, and the cost effectiveness relative to outcomes.Methods and analysisThis cluster randomised controlled trial will be conducted in 22 primary schools in disadvantaged areas of Melbourne, Australia. 826 students in the first year of primary school will be recruited to detect between groups differences of Cohen’s d=0.25 at the 18-month follow-up. Parent, teacher and child-assessment measures of child attention, emotion-regulation, executive functioning, socio-emotional well-being, mental health-related behaviour and learning, parent mental well-being, teacher well-being will be collected 6 and 18 months post-randomisation. Implementation factors will be measured throughout the study. Intention-to-treat analyses, accounting for clustering within schools and classes, will adopt a two-level random effects linear regression model to examine outcomes for the intervention versus control students. Unadjusted and analyses adjusted for baseline scores, baseline age, gender and family socioeconomic status will be conducted.Ethics and disseminationEthics approval has been received by the Human Research Ethics Committee at the University of Melbourne. Findings will be reported in peer-review publications, national and international conference presentations and research snapshots directly provided to participating schools and families.Pre-Results Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000326190).

scholarly journals A Low-Intensity Internet-Based Intervention Focused on the Promotion of Positive Affect for the Treatment of Depression in Spanish Primary Care: Secondary Analysis of a Randomized Controlled Trial

2020 ◽  
Vol 17 (21) ◽  
pp. 8094
Author(s):  
Mª Dolores Vara ◽  
Adriana Mira ◽  
Marta Miragall ◽  
Azucena García-Palacios ◽  
Cristina Botella ◽  
...  
Keyword(s):  
Primary Care ◽  
Positive Affect ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Well Being ◽  
Low Intensity ◽  
Treatment Of Depression ◽  
Education Levels ◽  
Related Quality ◽  
Health Related

Background: A large number of low-intensity Internet-based interventions (IBIs) for the treatment of depression have emerged in Primary Care; most of them focused on decreasing negative emotions. However, recent studies have highlighted the importance of addressing positive affect (PA) as well. This study is a secondary analysis of a randomized control trial. We examine the role of an IBI focused on promoting PA in patients with depression in Primary Care (PC). The specific objectives were to explore the profile of the patients who benefit the most and to analyze the change mechanisms that predict a significantly greater improvement in positive functioning measures. Methods: 56 patients were included. Measures of depression, affect, well-being, health-related quality of life, and health status were administered. Results: Participants who benefited the most were those who had lower incomes and education levels and worse mental health scores and well-being at baseline (7.9%–39.5% of explained variance). Improvements in depression severity and PA were significant predictors of long-term change in well-being, F (3,55) = 17.78, p < 0.001, R2 = 47.8%. Conclusions: This study highlights the importance of implementing IBIs in PC and the relevance of PA as a key target in Major Depressive Disorder treatment.

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