Identifying Key Elements to Inform the Development of an HIV Health Behavior Maintenance Intervention

2016 ◽  
Vol 32 (1) ◽  
pp. 48-58 ◽  
Author(s):  
Stephen J. Hile ◽  
Matthew B. Feldman ◽  
Amanda R. Raker ◽  
Mary K. Irvine
Keyword(s):  
New York ◽  
Low Income ◽  
Self Management ◽  
People Living With Hiv ◽  
Health Promoting Behaviors ◽  
Management Intervention ◽  
Management Interventions ◽  
Health Promoting ◽  
Maintenance Intervention ◽  
Behavior Maintenance

Purpose: To collect information that will inform the development of an intervention to support the maintenance of HIV-related health-promoting behaviors. Design: Focused, in-depth individual and group interviews. Setting: The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) and DOHMH-funded community-based organizations that primarily serve low-income people living with HIV within the five boroughs of NYC. Participants: A total of 42 individuals who had participated in The Positive Life Workshop—an HIV self-management intervention adapted and implemented by the NYC DOHMH. Method: Purposive sampling was used to recruit study participants. Five 60- to 90-minute focus groups (n = 38) and 4 individual interviews were conducted to assess motivations for and barriers to maintaining HIV-related health-promoting behaviors and to elicit feedback on the content and format for the proposed maintenance intervention. Thematic analysis was used to summarize the data. Results: Participants reported that relationships with family, a responsibility to protect others from HIV, and faith/spirituality supported the maintenance of health-promoting behaviors. Barriers to behavior maintenance included substance use and mental health issues. Meeting in small groups was also highlighted as a motivator to sustaining health behaviors, particularly in decreasing isolation and receiving affirmation from others. Conclusion: Participants identified several factors that could be incorporated into an intervention to support HIV-related health-promoting behavior maintenance that could supplement existing HIV self-management interventions.

scholarly journals The Effect of an HIV Self-Management Intervention on Neurocognitive Behavioral Processing

2019 ◽  
Vol 41 (7) ◽  
pp. 990-1008
Author(s):  
Allison R. Webel ◽  
Nathaniel Schreiner ◽  
Robert A. Salata ◽  
Jared Friedman ◽  
Anthony I. Jack ◽  
...  
Keyword(s):  
Self Management ◽  
People Living With Hiv ◽  
Management Intervention ◽  
Network Analyses ◽  
Mixed Effects Modeling ◽  
Management Interventions ◽  
Random Intercept ◽  
Trial Testing ◽  
Task Positive Network ◽  
Living With Hiv

People living with HIV (PLHIV) are increasingly diagnosed with comorbidities which require increasing self-management. We examined the effect of a self-management intervention on neurocognitive behavioral processing. Twenty-nine PLHIV completed a two-group, 3-month randomized clinical trial testing a self-management intervention to improve physical activity and dietary intake. At baseline and 3 months later, everyone completed validated assessments of physical, diet, and neurocognitive processing (functional magnetic resonance imaging [fMRI]–derived network analyses). We used linear mixed effects modeling with a random intercept to examine the effect of the intervention. The intervention improved healthy eating ( p = .08) but did not improve other self-management behaviors. There was a significant effect of the intervention on several aspects of neurocognitive processing including in the task positive network (TPN) differentiation ( p = .047) and an increase in the default mode network (DMN) differentiation ( p = .10). Self-management interventions may influence neurocognitive processing in PLHIV, but those changes were not associated with positive changes in self-management behavior.

Gender Differences and Their Influences on T2DM Self-Management Among Spanish-Speaking Latinx Immigrants

2021 ◽  
pp. 154041532110117
Author(s):  
Cheryl A. Smith-Miller ◽  
Diane C. Berry ◽  
Cass T. Miller
Keyword(s):  
Gender Differences ◽  
Health Literacy ◽  
English Language ◽  
Educational Achievement ◽  
Self Management ◽  
Structured Interviews ◽  
Health Promoting Behaviors ◽  
History Of ◽  
Health Promoting ◽  
Excessive Alcohol

Introduction: Evidence suggests that gender may influence many aspects of type 2 diabetes (T2DM) self-management (SM) and we posit that limited English language–proficient Latinx immigrants face additional challenges. Methods: Instruments and semi-structured interviews were used to examine gender differences on health literacy, diabetes knowledge, health-promoting behaviors, diabetes, eating and exercise self-efficacy (SE), and T2DM SM practices among a cohort of limited English language–proficient Latinx immigrants. Statistical and qualitative analysis procedures were performed comparing males and females. Results: Thirty persons participated. Males tended to be older, have higher educational achievement, and more financial security than females. Physiologic measures tended worse among female participants. Health literacy and exercise SE scores were similar, but females scored lower on Eating and Diabetes SE. Forty-seven percent ( n= 9) of the women reported a history of gestational diabetes mellitus and a majority of men ( n = 7) cited difficulty with excessive alcohol. Consumption: Males appeared to receive more SM support compared to females. Females more frequently noted how family obligations and a lack of support impeded their SM. Work environments negatively influenced SM practices. Conclusion: Men and women have unique SM challenges and as such require individualized strategies and support to improve T2DM management.

scholarly journals Self-management Interventions for Pain and Physical Symptoms Among People Living With HIV

2018 ◽  
Vol 79 (2) ◽  
pp. 206-225 ◽  
Author(s):  
Kennedy Nkhoma ◽  
Christine Norton ◽  
Caroline Sabin ◽  
Alan Winston ◽  
Jessica Merlin ◽  
...  
Keyword(s):  
Physical Symptoms ◽  
Self Management ◽  
People Living With Hiv ◽  
Management Interventions ◽  
Living With Hiv

scholarly journals Developing an Indigenous goal-setting tool: Counting Coup

2020 ◽  
Vol 1 (1) ◽  
pp. 49-57
Author(s):  
Iitáa Dáakuash ◽  
Alma McCormick ◽  
Shannen Keene ◽  
John Hallett ◽  
Suzanne Held
Keyword(s):  
Chronic Illness ◽  
Goal Setting ◽  
Indigenous Communities ◽  
Self Management ◽  
Future Research ◽  
Goal Theory ◽  
Management Intervention ◽  
Management Interventions ◽  
Indigenous Paradigm ◽  
Relational Accountability

Chronic illness self-management best practices include goal-setting as an important tool for developing better self-management habits and are often included as elements of chronic disease self-management interventions. However, the goal theory that many of these tools employ relies on individualistic principles of self-efficacy that are not culturally consonant within many Indigenous communities. During the creation of the [blinded] program, a chronic illness management intervention, we developed a goal-setting tool specific to the [blinded] Nation. Emerging from an Indigenous paradigm and methodology, Counting Coup serves as a goal-setting tool that promotes the [blinded] culture, connects individuals with their ancestors, and focuses on achievement of goals within relationships. Future research and practice should be grounded in the historical and cultural contexts of their communities when designing and implementing goal-setting tools. Limitations to Counting Coup as a goal-setting tool include the need for program facilitators to have a relationship with participants due to Counting Coup’s foundation in relational accountability and that the environmental context may pose difficulties for participants in moving towards behavior change.

scholarly journals Individually tailored self-management app-based intervention (selfBACK) versus a self-management web-based intervention (e-Help) or usual care in people with low back and neck pain referred to secondary care: protocol for a multiarm randomised clinical trial

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047921
Author(s):  
Anna Marcuzzi ◽  
Kerstin Bach ◽  
Anne Lovise Nordstoga ◽  
Gro Falkener Bertheussen ◽  
Ilya Ashikhmin ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Usual Care ◽  
Secondary Care ◽  
Self Management ◽  
Low Back ◽  
Musculoskeletal Health ◽  
Web Based ◽  
Management Intervention ◽  
Management Interventions

IntroductionLow back pain (LBP) and neck pain (NP) are common and costly conditions. Self-management is a key element in the care of persistent LBP and NP. Artificial intelligence can be used to support and tailor self-management interventions, but their effectiveness needs to be ascertained. The aims of this trial are (1) to evaluate the effectiveness of an individually tailored app-based self-management intervention (selfBACK) adjunct to usual care in people with LBP and/or NP in secondary care compared with usual care only, and (2) to compare the effectiveness of selfBACK with a web-based self-management intervention without individual tailoring (e-Help).Methods and analysisThis is a randomised, assessor-blind clinical trial with three parallel arms: (1) selfBACK app adjunct to usual care; (2) e-Help website adjunct to usual care and (3) usual care only. Patients referred to St Olavs Hospital, Trondheim (Norway) with LBP and/or NP and accepted for assessment/treatment at the multidisciplinary outpatient clinic for back or neck rehabilitation are invited to the study. Eligible and consenting participants are randomised to one of the three arms with equal allocation ratio. We aim to include 279 participants (93 in each arm). Outcome variables are assessed at baseline (before randomisation) and at 6-week, 3-month and 6-month follow-up. The primary outcome is musculoskeletal health measured by the Musculoskeletal Health Questionnaire at 3 months. A mixed-methods process evaluation will document patients’ and clinicians’ experiences with the interventions. A health economic evaluation will estimate the cost-effectiveness of both interventions’ adjunct to usual care.Ethics and disseminationThe trial is approved by the Regional Committee for Medical and Health Research Ethics in Central Norway (Ref. 2019/64084). The results of the trial will be published in peer-review journals and presentations at national and international conferences relevant to this topic.Trial registration numberNCT04463043.

scholarly journals Sometimes more is more: iterative participatory design of infographics for engagement of community members with varying levels of health literacy

2015 ◽  
Vol 23 (1) ◽  
pp. 174-183 ◽  
Author(s):  
Adriana Arcia ◽  
Niurka Suero-Tejeda ◽  
Michael E Bales ◽  
Jacqueline A Merrill ◽  
Sunmoo Yoon ◽  
...  
Keyword(s):  
Health Literacy ◽  
Participatory Design ◽  
Patient Reported Outcomes ◽  
Self Management ◽  
Community Members ◽  
Health Promoting Behaviors ◽  
Clinical Communication ◽  
Learning Health System ◽  
Patient Reported ◽  
Health Promoting

Abstract Objective To collaborate with community members to develop tailored infographics that support comprehension of health information, engage the viewer, and may have the potential to motivate health-promoting behaviors. Methods The authors conducted participatory design sessions with community members, who were purposively sampled and grouped by preferred language (English, Spanish), age group (18–30, 31–60, >60 years), and level of health literacy (adequate, marginal, inadequate). Research staff elicited perceived meaning of each infographic, preferences between infographics, suggestions for improvement, and whether or not the infographics would motivate health-promoting behavior. Analysis and infographic refinement were iterative and concurrent with data collection. Results Successful designs were information-rich, supported comparison, provided context, and/or employed familiar color and symbolic analogies. Infographics that employed repeated icons to represent multiple instances of a more general class of things (e.g., apple icons to represent fruit servings) were interpreted in a rigidly literal fashion and thus were unsuitable for this community. Preliminary findings suggest that infographics may motivate health-promoting behaviors. Discussion Infographics should be information-rich, contextualize the information for the viewer, and yield an accurate meaning even if interpreted literally. Conclusion Carefully designed infographics can be useful tools to support comprehension and thus help patients engage with their own health data. Infographics may contribute to patients’ ability to participate in the Learning Health System through participation in the development of a robust data utility, use of clinical communication tools for health self-management, and involvement in building knowledge through patient-reported outcomes.

An effectiveness-implementation hybrid trial for informatics-based cancer symptom management.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 236-236
Author(s):  
Justin D. Smith ◽  
Sofia F. Garcia ◽  
Frank J. Penedo ◽  
Denise M. Scholtens ◽  
Betina Yanez ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Cancer Patients ◽  
Symptom Management ◽  
Trial Design ◽  
Self Management ◽  
Management Intervention ◽  
Management Interventions ◽  
Implementation Trial ◽  
Hybrid Trial

236 Background: Oncology outpatients can facesignificant cancer- and treatment-related symptoms that compromise health related quality of life and quality health care. Although the burden of symptoms on patients’ lives are well-known, most health care systems are not ideally set up to relieve them. Patients are not typically drawn into meaningful engagement with the health care team in ways that enable symptom self-management. As a result, opportunities for early identification and treatment are lost, causing avoidable human suffering and cost. The Northwestern University IMPACT (NU IMPACT) project aims to evaluate the effectiveness and implementation of an informatics-driven symptom monitoring and web-based self-management intervention. The project uses PROMIS measures, integrated into the EHR, to trigger response and intervention. This presentation describes the effectiveness-implementation hybrid trial design and measurement of implementation. Methods: NU IMPACT will test the effectiveness and implementation of a system-wide symptom management intervention, across six adult hematology/oncology and gynecologic oncology outpatient clinics at Northwestern Memorial HealthCare, using a cluster randomized pragmatic roll-out implementation trial with an embedded individual-level randomized clinical trial. This unique design allows for a fully-powered randomized trial to establish the efficacy of the intervention, as well as a randomized test of implementation. We are enrolling approximately 6,000 patients in pre-implementation and 6,000 in post-implementation, with half of the latter group randomly assigned to enhanced symptom management, and the other half to usual care. Results: Implementation process is guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) model with evaluation following the RE-AIM framework. Particular focus is paid to adoption at the clinic and provider levels, the extent to which the intervention achieves meaningful reach to cancer patients, and the potential for sustainment. Additionally, we are testing and validating a newly developed method for tracking and reporting dynamic changes to implementation strategies. Conclusions: Achieving the aims of the NU IMPACT project is a critical step in the advancement of informatics-driven symptom management interventions for cancer patients. The innovative implementation trial design and measurement approach will aid in the rapid translation of findings to other healthcare systems. Clinical trial information: NCT03988543 .

scholarly journals Process evaluation of the Restore4stroke Self-Management intervention ‘Plan Ahead!’: a stroke-specific self-management intervention

2016 ◽  
Vol 30 (12) ◽  
pp. 1175-1185 ◽  
Author(s):  
Nienke S Tielemans ◽  
Vera PM Schepers ◽  
Johanna MA Visser-Meily ◽  
Jolanda CM van Haastregt ◽  
Wendy JM van Veen ◽  
...  
Keyword(s):  
Peer Support ◽  
Mixed Method ◽  
Qualitative Data ◽  
Action Planning ◽  
Self Management ◽  
Planning Tool ◽  
Stroke Patients ◽  
Management Intervention ◽  
Management Interventions ◽  
Intervention Plan

Objective: To investigate whether the self-management intervention was implemented as intended. Additionally, we studied involvement in and satisfaction with the intervention among patients, their partners and therapists. Design: Mixed method, prospective study. Setting: Outpatient facilities of hospitals/rehabilitation centres. Participants: Stroke patients, their partners and therapists from the experimental arm of the Restore4Stroke Self-Management study. Intervention: ‘Plan Ahead!’ is a 10-week self-management intervention for stroke patients and partners, consisting of seven two-hour group sessions. Proactive action planning, education and peer support are main elements of this intervention. Main measures: Session logs, questionnaires for therapists, patients and their partners, and focus groups. Data analysis: Qualitative data were analysed with thematic analysis supplemented by quasi-statistics. Quantitative data were reported as descriptive statistics. Results: The study sample consisted of 53 patients and 26 partners taking part in the intervention, and all therapists delivering the intervention ( N = 19). At least three-quarters of the intervention sessions were attended by 33 patients and 24 partners. On a scale from 1 to 10, patients, partners and therapists rated the intervention with mean scores of 7.5 (SD1.6), 7.8 (SD.7) and 7.4 (SD.7), respectively. Peer support was the most frequently appreciated element for participants and therapists. The proactive action planning tool was adequately applied in 76 of the 96 sessions. Conclusion: Although the target audience was reached and both participants and therapists were satisfied with the intervention, the proactive action planning tool that distinguishes the current intervention from existing stroke-specific self-management interventions was only partly implemented according to protocol.

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