scholarly journals The long-term (24-month) effect on health and well-being of the Lifestyle Matters community-based intervention in people aged 65 years and over: a qualitative study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016711 ◽  
Author(s):  
Robin Chatters ◽  
Jennifer Roberts ◽  
Gail Mountain ◽  
Sarah Cook ◽  
Gill Windle ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Well Being ◽  
Lifestyle Choices ◽  
Randomised Controlled ◽  
The Uk ◽  
Occupational Therapy Intervention ◽  
Health And Well Being

ObjectivesTo assess the long-term effect on health and well-being of the Lifestyle Matters programme.DesignQualitative study of a subset of intervention arm participants who participated in the Lifestyle Matters randomised controlled trial (RCT).SettingThe intervention took place at community venues within two sites in the UK.ParticipantsA purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed at 24 months post randomisation. Interviews aimed to understand how participants had used their time in the preceding 2 years and whether the intervention had any impact on their lifestyle choices, participation in meaningful activities and well-being.InterventionLifestyle Matters is a 4-month occupational therapy intervention, consisting of group and individual sessions, designed to enable community living older people to make positive lifestyle choices and participate in new or neglected activities through increasing self-efficacy.ResultsInterviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants raised some form of benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, but there were significant and lasting benefits for 2 of 13 intervention participants interviewed.ConclusionThe majority of those who experienced the Lifestyle Matters intervention reported minor benefits and increases in self-efficacy, but they did not perceive that it significantly improved their health and well-being. The two participants who had experienced major benefits also reported having had life-changing events, suggesting that this intervention is most effective at the time when lifestyle has to be reconsidered if mental well-being is to be sustained.Trial registrationISRCTN,ISRCTN67209155, post results.

scholarly journals Study design, rationale and methods of the Revitalising Informal Settlements and their Environments (RISE) study: a cluster randomised controlled trial to evaluate environmental and human health impacts of a water-sensitive intervention in informal settlements in Indonesia and Fiji

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042850
Author(s):  
Karin Leder ◽  
John J Openshaw ◽  
Pascale Allotey ◽  
Ansariadi Ansariadi ◽  
S Fiona Barker ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Human Health ◽  
Controlled Trial ◽  
Informal Settlements ◽  
Cluster Randomised Controlled Trial ◽  
Well Being ◽  
Cluster Randomised ◽  
Abundance And Diversity ◽  
Randomised Controlled ◽  
Health And Well Being

IntroductionIncreasing urban populations have led to the growth of informal settlements, with contaminated environments linked to poor human health through a range of interlinked pathways. Here, we describe the design and methods for the Revitalising Informal Settlements and their Environments (RISE) study, a transdisciplinary randomised trial evaluating impacts of an intervention to upgrade urban informal settlements in two Asia-Pacific countries.Methods and analysisRISE is a cluster randomised controlled trial among 12 settlements in Makassar, Indonesia, and 12 in Suva, Fiji. Six settlements in each country have been randomised to receive the intervention at the outset; the remainder will serve as controls and be offered intervention delivery after trial completion. The intervention involves a water-sensitive approach, delivering site-specific, modular, decentralised infrastructure primarily aimed at improving health by decreasing exposure to environmental faecal contamination. Consenting households within each informal settlement site have been enrolled, with longitudinal assessment to involve health and well-being surveys, and human and environmental sampling. Primary outcomes will be evaluated in children under 5 years of age and include prevalence and diversity of gastrointestinal pathogens, abundance and diversity of antimicrobial resistance (AMR) genes in gastrointestinal microorganisms and markers of gastrointestinal inflammation. Diverse secondary outcomes include changes in microbial contamination; abundance and diversity of pathogens and AMR genes in environmental samples; impacts on ecological biodiversity and microclimates; mosquito vector abundance; anthropometric assessments, nutrition markers and systemic inflammation in children; caregiver-reported and self-reported health symptoms and healthcare utilisation; and measures of individual and community psychological, emotional and economic well-being. The study aims to provide proof-of-concept evidence to inform policies on upgrading of informal settlements to improve environments and human health and well-being.EthicsStudy protocols have been approved by ethics boards at Monash University, Fiji National University and Hasanuddin University.Trial registration numberACTRN12618000633280; Pre-results.

The Long-Term Effects of Solitary Confinement From the Perspective of Inmates

2021 ◽  
Vol 101 (6) ◽  
pp. 652-674
Author(s):  
Liat Tayer ◽  
Tomer Einat ◽  
Anat Yaron Antar
Keyword(s):  
Qualitative Study ◽  
Physical Exercise ◽  
Behavioral Disorders ◽  
Physical Aggression ◽  
Well Being ◽  
Solitary Confinement ◽  
Long Term Effects ◽  
Health And Well Being ◽  
Mental And Behavioral Disorders

This qualitative study analyzes the effects of solitary confinement on prisoners and the strategies used by them to cope with its difficulties. The findings indicate that solitary confinement is perceived as unfair and as intensifying hostile emotions and physical aggression, and that it is related to a range of long-term physiological, mental, and behavioral disorders. Three strategies are used to cope with the difficulties of solitary confinement: keeping to a ritualistic routine, a religious lifestyle, and physical exercise. We conclude that solitary confinement exacerbates the difficulties of detention and affects prisoners’ health and well-being for short and long terms.

scholarly journals Exploring psychiatrists’ perspectives of working with patients with dissociative seizures in the UK healthcare system as part of the CODES trial: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026493 ◽  
Author(s):  
Harriet Jordan ◽  
Sarah Feehan ◽  
Iain Perdue ◽  
Joanna Murray ◽  
Laura H Goldstein
Keyword(s):  
Qualitative Study ◽  
Patient Group ◽  
Controlled Trial ◽  
Improve Patient Care ◽  
Knowledge Gap ◽  
Link Type ◽  
Interpersonal Difficulties ◽  
Randomised Controlled ◽  
The Uk ◽  
Dissociative Seizures

ObjectiveThere is currently limited research exploring healthcare professionals’ (HCPs) experiences of working with patients with dissociative seizures (DS). Existing studies do not focus on the role of psychiatrists in treating this complex condition. The objective of this study was to gain an understanding of UK-based psychiatrists’ experiences of the DS patient group. Against the backdrop of a UK-wide randomised controlled trial (RCT), the focus was broadened to encompass issues arising in everyday practice with the DS patient group.Design, participants and methodsA qualitative study using semistructured interviews was undertaken with 10 psychiatrists currently working with DS patients within the context of a large RCT investigating treatments for DS. Thematic analysis was used to identify key themes and subthemes.SettingThe psychiatrists were working in Liaison or Neuropsychiatry services in England.ResultsThe key themes identified were other HCPs’ attitudes to DS and the challenges of the DS patient group. There is a clear knowledge gap regarding DS for many HCPs and other clinical services can be reluctant to take referrals for this patient group. Important challenges posed by this patient group included avoidance (of difficult emotions and help), alexithymia and interpersonal difficulties. Difficulties with alexithymia meant DS patients could struggle to identify triggers for their seizures and to express their emotions. Interpersonal difficulties raised included difficulties in attachment with both HCPs and family members.ConclusionsA knowledge gap for HCPs regarding DS has been identified and needs to be addressed to improve patient care. Given the complexity of the patient group and that clinicians from multiple disciplines will come into contact with DS patients, it is essential for any educational strategy to be implemented across the whole range of specialties, and to account for those already in practice as well as future trainees.Trial registration numberISRCTN05681227;NCT02325544; Pre-results.

scholarly journals Impact of a Family Economic Intervention (Bridges) on Health Functioning of Adolescents Orphaned by HIV/AIDS: A 5-Year (2012–2017) Cluster Randomized Controlled Trial in Uganda

2021 ◽  
Vol 111 (3) ◽  
pp. 504-513
Author(s):  
Fred M. Ssewamala ◽  
Julia Shu-Huah Wang ◽  
Rachel Brathwaite ◽  
Sicong Sun ◽  
Larissa Jennings Mayo-Wilson ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Primary Schools ◽  
Controlled Trial ◽  
Well Being ◽  
School Level ◽  
Self Concept ◽  
Sexual Risk Taking ◽  
Positive Health ◽  
Match Rate

Objectives. To investigate the long-term impacts of a family economic intervention on physical, mental, and sexual health of adolescents orphaned by AIDS in Uganda. Methods. Students in grades 5 and 6 from 48 primary schools in Uganda were randomly assigned at the school level (cluster randomization) to 1 of 3 conditions: (1) control (n = 487; 16 schools), (2) Bridges (1:1 savings match rate; n = 396; 16 schools), or (3) Bridges PLUS (2:1 savings match rate; n = 500; 16 schools). Results. At 24 months, compared with participants in the control condition, Bridges and Bridges PLUS participants reported higher physical health scores, lower depressive symptoms, and higher self-concept and self-efficacy. During the same period, Bridges participants reported lower sexual risk-taking intentions compared with the other 2 study conditions. At 48 months, Bridges and Bridges PLUS participants reported better self-rated health, higher savings, and lower food insecurity. During the same period, Bridges PLUS participants reported reduced hopelessness, and greater self-concept and self-efficacy. At 24 and 48 months, Bridges PLUS participants reported higher savings than Bridges participants. Conclusions. Economic interventions targeting families raising adolescents orphaned by AIDS can contribute to long-term positive health and overall well-being of these families. Trial Registration. ClinicalTrials.gov registration no. NCT01447615.

Conclusion

2017 ◽  
Author(s):  
Adrian Bonner
Keyword(s):  
Interdisciplinary Approach ◽  
Health Behaviours ◽  
Well Being ◽  
Community Resources ◽  
Successful Ageing ◽  
Lifestyle Choices ◽  
The Social ◽  
The Uk ◽  
Healthy Community ◽  
Health And Well Being

This book has examined the social determinants of health using an interdisciplinary approach, showing that relative poverty and social capital will provide the resilience for an individual to experience a sense of well-being and lead to successful ageing, while lifestyle choices and the support of a healthy community will reduce vulnerability to negative health behaviours. It has also explained how personal well-being is related to the availability of personal, family and community resources. This conclusion considers the austerity policies and other highly contentious policy intentions in the Conservative Party's manifesto and highlights their implications for health and well-being, particularly the policy on social care known as the ‘dementia tax’. It argues that these regressive policies are being reinforced by a major economic impact on the UK economy from policies related to Brexit and concludes by emphasising the importance of a wholistic approach to inequality and well-being.

scholarly journals Dance for people with chronic respiratory disease: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038719
Author(s):  
Keir Elmslie James Philip ◽  
Adam Lewis ◽  
Sian Williams ◽  
Sara Catherine Buttery ◽  
Michael I Polkey ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Respiratory Disease ◽  
Health Centre ◽  
Health Benefits ◽  
Well Being ◽  
Chronic Respiratory Disease ◽  
Convenience Sample ◽  
Community Dance ◽  
Health And Well Being

ObjectivesTo explore the experiences and perceived impact on health and well-being related to participation in a dance group for people with chronic respiratory disease (CRD).DesignAn exploratory qualitative study using thematic analysis of semistructured interviews.SettingA community dance group in a UK health centre.ParticipantsConvenience sample of long-term dance group participants.InterventionWeekly community dance sessions designed for people with breathlessness, lasting 75 min, led by a trained community dance leader.ResultsConvenience sample of eight participants, six females, aged 57–87 years (mean 75), with a median 2-year attendance at weekly dance sessions. Long-term attendance was driven by strongly held beliefs regarding the health and well-being benefits of participation. Four key themes were identified: dance as (1) a holistically beneficial activity, with physical and psychosocial health benefits including improved or maintained physical fitness and psychological well-being, and reduced need for healthcare; (2) an integral part of their life; (3) an enjoyable activity; and (4) a source of deep social cohesion.ConclusionsDance group participants perceived a broad range of health benefits of relevance to the biopsychosocial impacts of their respiratory disease. The themes identified are useful in the ongoing planning and evaluation of dance as a holistic complex intervention for people with CRD. Further research is required to assess the extent of health impacts identified, and how dance might be most effectively placed as an option in the management of CRD.Trial registration numberNCT04006015.

scholarly journals In the Eyes of Those Who Were Randomized: Perceptions of Disadvantaged Older Adults in a Tai Chi Trial

2018 ◽  
Vol 60 (4) ◽  
pp. 672-682 ◽  
Author(s):  
On-Yee Lo ◽  
Lisa A Conboy ◽  
Alexandra Rukhadze ◽  
Caroline Georgetti ◽  
Margaret M Gagnon ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Self Efficacy ◽  
Tai Chi ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Well Being ◽  
Subsidized Housing ◽  
Cluster Randomized ◽  
Supportive Program

Abstract Background and Objectives Older adults living in subsidized housing have typically been excluded from exercise intervention studies. We conducted a qualitative study to explore the perceived physical, psychological, social, and economic factors that influenced participation in and adherence to a year-long Tai Chi intervention within an ongoing cluster-randomized controlled trial (RCT) for older adults living within subsidized housing facilities. Research Design and Methods Focus groups were held with participants of the RCT who were allocated to the trial’s Tai Chi intervention. Individual phone interviews were conducted with those allocated to Tai Chi who had low adherence or who had withdrawn their participation from the study. Emergent themes were extracted using grounded-theory methods. Results In this qualitative study, we enrolled 41 participants who were allocated to the RCT’s Tai Chi intervention: 38 completed and 3 withdrew from the study. Average Tai Chi class attendance was 64.3%. Pragmatic factors that led to higher adherence and retention included: locating classes within each facility; providing programs at no cost; and deployment of a skilled research support team. In addition, the use of an accessible, simplified Tai Chi program improved confidence, social support, self-efficacy, and self-reported improvements in physical and psychological well-being. Discussion and Implications Perceived physical, psychological, social benefits, and self-efficacy likely enhance adherence and retention to research-based Tai Chi interventions for older adults. Delivering an on-site, no cost, and supportive program appears critical to overcoming financial and environmental barriers to participation for those living within subsidized housing.

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