scholarly journals EXPRESS: Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach

2021 ◽  
pp. 174749302110176
Author(s):  
Brodie M Sakakibara ◽  
Scott A Lear ◽  
Susan I Barr ◽  
Charles Goldsmith ◽  
Amy Schneeberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Controlled Trial ◽  
Cognitive Status ◽  
Self Management ◽  
Community Living ◽  
Memory Training ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Lifestyle Behaviour ◽  
Mild Stroke

Background: Stroke Coach is a lifestyle coaching telehealth program to improve self-management of stroke risk factors. Aims: To examine the efficacy of Stroke Coach on lifestyle behaviour and risk factor control among community-living stroke survivors within one-year post stroke. Methods: Participants were randomized to Stroke Coach or an attention control Memory Training group. Lifestyle behaviour was measured using the Health Promoting Lifestyle Profile II. Secondary outcomes included specific behavioural and cardiometabolic risk factors, health-related quality of life (HRQoL), cognitive status, and depressive symptoms. Measurements were taken at baseline, post-intervention (6 months), and retention (12 month). Linear mixed-effects models were used to test the study hypotheses (p<0.05). All analyses were intention-to-treat. Results: The mean age of the Stroke Coach (n=64) and Memory Training (n=62) groups was 67.2 and 69.1 years, respectively. The majority of participants (n = 100) had mild stroke (modified Rankin Scale = 1 or 2), were active, with controlled blood pressure (mean = 129/79 mmHg) at baseline. At post-intervention, there were no significant differences in lifestyle (b = -2.87; 95%CI -8.03 to 2.29; p=0.28). Glucose control, as measured by HbA1c (b = 0.17; 95%CI 0.17 to 0.32; p=0.03), and HRQoL, measured using SF-36 Physical Component Summary (b = -3.05; 95%CI -5.88 to -0.21; p=0.04), were significantly improved in Stroke Coach compared to Memory Training, and the improvements were maintained at retention. Conclusion: Stroke Coach did not improve lifestyle behaviour, however, there were improvements to HbA1c and HRQoL among community-living stroke survivors with mild stroke-related disability. (ClinicalTrials.gov identifier: NCT02207023)

scholarly journals A telehealth intervention to promote healthy lifestyles after stroke: The Stroke Coach protocol

2017 ◽  
Vol 13 (2) ◽  
pp. 217-222 ◽  
Author(s):  
Brodie M Sakakibara ◽  
Scott A Lear ◽  
Susan I Barr ◽  
Oscar Benavente ◽  
Charlie H Goldsmith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Service Use ◽  
Primary Outcome ◽  
Recurrent Stroke ◽  
Controlled Trial ◽  
Cognitive Status ◽  
Self Management ◽  
Control Group ◽  
Stroke Survivors ◽  
Health Report

Rationale Recurrent stroke is prevalent and associated with high mortality rates, disability, and social and economic costs. Adequate management of risk factors may reduce recurrent stroke; however, many stroke survivors have poor control of risk factors. We have developed a theoretically sound and evidence-based lifestyle modification program called the Stroke Coach, a telephone-based self-management program to improve control of risk factors. Hypothesis Individuals who participate in Stroke Coach will achieve more lifestyle improvements than individuals in an attention controlled Memory Training Program. Design In this single blind randomized controlled trial, 126 community-living stroke survivors will be randomized to Stroke Coach or the attention control group. Participants randomized to the six-month Stroke Coach will receive seven telephone lifestyle coaching sessions, self-management education and practice, and a self-monitoring kit, comprised of a health report card, with blood pressure and activity monitors. Study Outcomes The primary outcome will be measured using the Health Promoting Lifestyle Profile II. Secondary outcomes include behavioral and physiological risk factors, quality of life, cognitive status, health and social service use. Measurements will be taken at baseline, immediately after the intervention and six-month post-intervention. Summary The results of this trial will add to our understanding of the use of self-management to improve control of risk factors, and may facilitate the development of a larger trial evaluating the effect of Stroke Coach on endpoints such as recurrent stroke or cardiac events as the primary outcome.

Improved Mood Boosts Memory Training Gains in Older Adults With Subjective Memory Complaints: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Shufei Yin ◽  
Xinyi Zhu ◽  
Rui Li ◽  
Lijuan Huo ◽  
Weicong Ren ◽  
...  
Keyword(s):  
Older Adults ◽  
Group Counseling ◽  
Controlled Trial ◽  
Memory Performance ◽  
Anxiety And Depression ◽  
Memory Training ◽  
Depression And Anxiety ◽  
Subjective Memory ◽  
Post Intervention ◽  
Symptoms Of Depression

Abstract Objective: Older adults with subjective memory complaints (SMC) have a higher risk of dementia and commonly demonstrate symptoms of depression and anxiety. The study aimed to examine the effect of a memory training program for individuals with SMC, and whether memory training combined with group counseling aimed at alleviating depression and anxiety would boost memory training gains.Design: A three-armed, double-blind, randomized controlled trial.Setting and Participants: Community-dwelling older adults with SMC, aged ≥ 60 years.Methods: Participants (n = 124) were randomly assigned to memory training (MT), group counseling (GC), or GC+MT intervention. The GT+MT group received 4-hour group counseling followed by a 4-week memory training, while the MT group attended reading and memory training, and the GC group received group counseling and health lectures. Cognitive function and symptoms of depression and anxiety were assessed at baseline, mid-, and post-intervention. The GC+MT group and GC group had resting-state functional magnetic resonance imaging at mid- and post-intervention.Results: After group counseling, the GC+MT and GC groups showed reduced symptoms of anxiety and depression, compared to the MT group. Memory training enhanced memory performance in both MT and GC+MT groups, but the GC+MT group demonstrated larger memory improvement (Cohen’s d = 0.96) than the MT group (Cohen’s d = 0.62). Amygdala-hippocampus connectivity was associated with improved mood and memory gains.Conclusion and Implications: Group counseling reduced symptoms of anxiety and depression, and memory training enhanced memory performance. Specifically, improved mood induced larger memory training effects. The results suggest that it may need to include treatment for depression and anxiety in memory intervention for older adults with SMC.Trial Registration: ChiCTR-IOR-15006165 in the Chinese Clinical Trial Registry.

scholarly journals Lending an Ear: iPeer2Peer plus Teens Taking Charge online self-management to empower adolescents with arthritis in Ireland: protocol for a pilot randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027952 ◽  
Author(s):  
Siobhan O'Higgins ◽  
Jennifer Stinson ◽  
Sara Ahola Kohut ◽  
Line Caes ◽  
Caroline Heary ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Peer Support ◽  
Qualitative Content Analysis ◽  
Controlled Trial ◽  
Self Management ◽  
Advisory Panel ◽  
Post Intervention ◽  
Pilot Randomised Controlled Trial ◽  
Taking Charge ◽  
Randomised Controlled

IntroductionJuvenile idiopathic arthritis (JIA) negatively affects adolescents’ everyday activities. To address the need for innovative, effective, convenient, low-cost psychosocial self-management programmes, we developed an Irish version of Canadian Teens Taking Charge (TTC) and integrated it with Skype-based peer support iPeer2Peer (iP2P).ObjectivesTo explore the feasibility and preliminary outcome impact (effectiveness) of an integrated iP2P and Irish TTC, via three-arm (treatment as usual, TTC and iP2P–TTC) pilot randomised controlled trial (RCT); and determine feasibility and sample size for a full RCT. To ensure active involvement of adolescents with JIA via a Young Person Advisory Panel and examine how participants experienced the study. Finally, to see if TTC and iP2P with TTC reduce costs for families.Methods and analysisRecruitment of 60 families will be ongoing until July 2019, via healthcare professionals and support groups. Analysis will consist of single-blinded (outcome assessment), three-arm pilot RCT, using online questionnaires, with assessments at baseline (T1), after intervention (T2) and 3 months post-intervention (T3). The primary outcomes on feasibility with comparisons of TTC and iP2P–TTC on fidelity, acceptability and satisfaction, engagement and degrees of tailoring. The secondary outcomes will be self-management and self-efficacy and a range of health-related quality-of-life factors, pain indicators and costs.Participants from the intervention groups will be invited to share their perspectives on the process in semistructured interviews. Quantitative data will be analysed using SPSS V.21 and the audio-taped and transcribed qualitative data will be analysed using qualitative content analysis.DisseminationVia journal articles, conference presentations, co-delivered by key stakeholders when possible, launch of accessible, effective and sustainable Internet self-management and peer support for Irish adolescents with JIA.Trial registration numberISRCTN13535901; Pre-results.

scholarly journals Reducing stroke burden through a targeted self-management intervention for reducing stroke risk factors in high-risk Ugandans: A protocol for a randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251662
Author(s):  
Mark Kaddumukasa ◽  
Josephine Najjuma ◽  
Scovia Nalugo Mbalinda ◽  
Martin N. Kaddumukasa ◽  
Jane Nakibuuka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Risk Reduction ◽  
Stroke Risk ◽  
Controlled Trial ◽  
Self Management ◽  
Primary Study ◽  
Management Intervention ◽  
Stroke Risk Factors ◽  
Randomized Controlled

Introduction Stroke burden is rapidly increasing globally. Modifiable risk factors offer an opportunity to intervene, and targeting hypertension is a key actionable target for stroke risk reduction in sub-Saharan Africa. This 3-site planned randomized controlled trial builds on promising preliminary data. Methods A total of 246 Ugandan adults will be recruited randomized to experimental intervention vs. enhanced treatment control. Intervention participants will receive six weekly group-format stroke risk reduction self-management training sessions, and the controls will receive information on cardiovascular risk. The primary study outcome is systolic B.P. measured at baseline, 13-week, 24 weeks (6 months). Secondary outcomes include other biological and behavioral stroke risk factors. Discussion The curriculum-guided self-management TargetEd MAnageMent Intervention (TEAM) program is anticipated to reduce the stroke burden in Uganda. Trial registration ClinicalTrials.gov identifier: NCT04685408, registered on 28 December 2020.

scholarly journals A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Shuanglan Lin ◽  
Lily Xiao ◽  
Diane Chamberlain
Keyword(s):  
Randomized Controlled Trial ◽  
Family Caregivers ◽  
Controlled Trial ◽  
Health Coaching ◽  
Self Management ◽  
Stroke Survivors ◽  
Randomized Controlled ◽  
Transition Care ◽  
Coaching Intervention ◽  
Hospital To Home

Abstract Background: Hospital to home transition care is a most stressful period for stroke survivors and their caregivers to learn self-management of stroke-related health conditions and to engage in rehabilitation. Health coaching has been identified as a strategy to enhance self-management of poststroke care at home. However, interventions in this field that are informed by a health coaching framework are scarce. This study will address a gap in research by testing the hypothesis that a nurse-led health coaching intervention can improve health outcomes for stroke survivors and their family caregivers in hospital to home transition care.Methods: This is a single-blind, two-arm parallel randomized controlled trial of a nurse-led health coaching program versus routine care situated in two tertiary hospitals in Chongqing, China. Stroke survivors and their primary family caregivers will be recruited together as “participant dyads”, and the estimated sample size is 140 (70 in each group). The intervention includes a 12-week nurse-led health coaching program in hospital to home transition care commencing at discharge from the hospital. The primary outcomes are changes in self-efficacy and quality of life of stroke survivors at 12 weeks from the baseline. The secondary outcomes are changes in stroke survivors’ functional ability, stroke-related knowledge, the number of adverse events, and unplanned hospital admissions, and caregivers’ self-efficacy and caregiver-related burden at 12 weeks from the baseline. The outcomes will be measured at 12 weeks and 24 weeks from the baseline.Discussion: This study will examine the effect of nurse-led health coaching on hospital to home transition care for stroke survivors and their caregivers. It is anticipated that findings from this trial will provide research evidence to inform policy, and resource and practice development to improve hospital to home transition care for stroke survivors and their caregivers.Trial registration: The Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000321145, registered on 1st March 2019.

scholarly journals Maori cultural adaptation of a brief mental health intervention in primary care

2012 ◽  
Vol 4 (3) ◽  
pp. 231 ◽  
Author(s):  
Fiona Mathieson ◽  
Kara Mihaere ◽  
Sunny Collings ◽  
Anthony Dowell ◽  
James Stanley
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Psychological Distress ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Self Management ◽  
Structured Interviews ◽  
Post Intervention ◽  
Mental Health Patient ◽  
Intervention Delivery

INTRODUCTION: There are no brief psychological mental health interventions designed specifically for Maori in a primary care setting. AIM: To adapt an existing cognitive behavioural therapy–based, guided self-management intervention for near-threshold mental health syndromes in primary care, for Maori, and to examine its acceptability and effectiveness. METHODS: Semi-structured interviews with primary care clinicians and Maori patients were conducted to inform adaptations to the intervention. Clinicians were then trained in intervention delivery. Patients were recruited if they self-identified as Maori, were aged 18–65 years, were experiencing stress or distress and scored =35 on the Kessler-10 (K10) measure of global psychological distress. Patient and clinician satisfaction was measured through a questionnaire and semi-structured interviews. Post-intervention, patients’ mental health status was measured at two weeks, six weeks and three months. RESULTS: Maori adaptations included increased emphasis on forming a relationship; spirituality; increased use of Maori language and changes to imagery in the self-management booklets. Nine of the 16 patients recruited into the study completed the intervention. Patients and clinicians rated the intervention favourably and provided positive feedback. Improvement was seen in patients’ K10 scores using intention-to-treat rated global psychological distress following intervention. DISCUSSION: This study found that it was not difficult to adapt an existing approach and resources, and they were well received by both providers and Maori patients. Further research is required with a larger sample utilising a randomised controlled trial, to establish whether this approach is effective. KEYWORDS: Primary health care; Maori mental health; patient satisfaction; brief intervention

scholarly journals Online prenatal trial in mindfulness sleep management (OPTIMISM): protocol for a pilot randomized controlled trial

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Ira Kantrowitz-Gordon ◽  
Susan M. McCurry ◽  
Carol A. Landis ◽  
Rachel Lee ◽  
Dahee Wi
Keyword(s):  
Randomized Controlled Trial ◽  
Sleep Quality ◽  
Pregnant Women ◽  
Outcome Measures ◽  
Mindfulness Meditation ◽  
Controlled Trial ◽  
Self Management ◽  
Secondary Outcome ◽  
Post Intervention ◽  
Randomized Controlled

Abstract Background Sleep deficiency affects a majority of pregnant women with significant impact on daily function, mood, and pregnancy and birth outcomes. This ongoing study combines two evidence-based strategies for improving sleep and mood, mindfulness meditation and cognitive-behavioral therapy for insomnia (CBT-I), in a unique online format to address the particular needs of pregnant women. The purpose of this study is to test the feasibility and estimate the efficacy of this novel 6-week online mindfulness meditation intervention to help pregnant women in remission from depression self-manage insomnia. Methods This is a two-arm, parallel group randomized controlled trial. A total of 50 pregnant women between 12 and 28 weeks gestation will be recruited from the community and randomly assigned to a mindfulness or education-only control group in a 1:1 ratio. During the study, all participants will complete six weekly online modules, daily sleep diaries, and optional participation in a treatment-specific online discussion forum. Feasibility outcome measures will include study recruitment, retention, intervention adherence (number of online modules completed, number of meditation days per week), and intervention acceptability (8-item questionnaire). The primary clinical outcome measure will be sleep quality measured with the Pittsburgh Sleep Quality Index. Secondary outcome measures will include sleep measured with actigraphy and diaries (sleep efficiency, total sleep time, total wake time), Patient-Reported Outcomes Measurement Information System (PROMIS) measures (fatigue, sleep-related impairment, sleep disturbance); mood (depression, anxiety, positive affect, quality of life); and self-management and behavior change (potential self-efficacy, self-regulation, sleep problem acceptance, and trait mindfulness). Assessments will occur at baseline and post-intervention; an additional acceptability survey will be completed 4 weeks postpartum. Analyses will examine within-group differences in outcome change scores from baseline to post-intervention. Open-ended feedback will be analyzed using qualitative content analysis. Discussion This research is innovative in addressing sleep in pregnancy using a self-management research design and methods that can be accessible and cost-effective for large numbers of pregnant women. The results from this study will inform intervention refinement and efficacy testing of the intervention in a larger randomized controlled trial. Trial registration ClinicalTrials.gov, NCT04016428. Registered on 11 July 2019. Updated version registered on 26 July 2019.

Feasibility and Acceptability of DemPower: A Couple Management App for Couples Where One Partner has a Dementia (Preprint)

2019 ◽  
Author(s):  
Reena Lasrado ◽  
Therese Bielsten ◽  
Mark Hann ◽  
James Schumm ◽  
Siobhan Reilly ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Self Management ◽  
Limited Attention ◽  
Post Intervention ◽  
Relational Networks ◽  
Health And Social Care ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
Randomised Controlled ◽  
Study Participants

BACKGROUND The increasing rate of dementia and high health and social care costs call for effective measures to improve public health and enhance the wellbeing of people living with dementia and their relational networks. Most post diagnostic services focus on the condition and the person with dementia with limited attention to the spouse or partner caregiver. The key focus of the study is to develop a self-management guide for couples where one partner has a diagnosis of dementia. This couple self-management guide is delivered in the form of an app, DemPower. The contents of the app were organized into four main themes, ‘Home and Neighbourhood’, ‘Activities and Relationship’, ‘Meeting, Sharing and Caring’ ‘Communication and Emotions’. Each of these themes included a series of videos and activities for couples to do together. OBJECTIVE The study aimed to investigate the feasibility and acceptability of DemPower. METHODS The study used a non-randomized feasibility design. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. We aimed to complete the app within three months and collected usage data from the devices at the end of the study. Outcome measures were obtained at baseline and post intervention. RESULTS 21 couples completed the study (48%). Of these, 18 (86%) completed all parts of the app and each couple spent an average of 8hrs on the app during the study period. Among the four themes, ‘Home and Neighbourhood’ averaged 250 visits, ‘Activities and Relationship’ average 174 visits, ‘Meeting, Sharing and Caring’ average 160 and ‘Communication and Emotions’ received average 122 visits. Over the course of the study, participants visited suggested activities pages more frequently (average 95) than the core contents pages displaying section specific introductory videos (average 71) or videos of couples (average 69), for example taking pictures, physical exercise, talking to each other, walking, music and home adaptation checklist. CONCLUSIONS The findings suggest that the DemPower app is a useful resource for couples where one partner has a dementia and that its implementation requires the support of memory clinics to reach couples at early diagnosis. CLINICALTRIAL International Standard Randomised Controlled Trial Number (ISRCTN): 10122979; http://www.isrctn.com/ISRCTN10122979 (Archived by WebCite at http://www.webcitation.org/70rB1iWYI)

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