Investigating the Feasibility of Multisensory Environments to Improve the Assisted Bathing Experience for Veterans With Dementia: A Clinical Trial

2021 ◽  
pp. 193758672110538
Author(s):  
Lesa Lorusso ◽  
Sheila Bosch ◽  
Nam-Kyu Park ◽  
Ronald Shorr ◽  
Maureen Conroy ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Behavioral Intervention ◽  
Behavioral Interventions ◽  
Feasibility Studies ◽  
People With Dementia ◽  
Viable Solution ◽  
Study Team ◽  
Multisensory Environment ◽  
Dedicated Team ◽  
The Impact

Objectives: This evidence-based design clinical trial assessed the feasibility of a multisensory environment (MSE) using aromatherapy, color-changing lights, and music as a behavioral intervention to calm Veterans with dementia during assisted bathing to improve the patient experience. Background: The number of Veterans with dementia is growing rapidly, along with the associated debilitating behavior challenges. The severity of these distressed behaviors that predominantly occur at bath time often necessitates costly, dangerous sedatives. Feasibility studies of nonpharmacological behavioral interventions during bathing for people with dementia are urgently needed, and research supports MSE as a viable solution. Method: Using an A–B, multiple baselines across participants design, this study tracked operational behaviors of four Veterans with dementia during bathing without and with an MSE intervention. Sessions were provided and recorded by a dedicated team of five nurses, so the study team could analyze the Veterans’ operational behaviors to understand the impact of individualized MSE during both baseline and intervention phases. Results: The results support the feasibility of MSE as a helpful, nonpharmacological behavioral intervention for Veterans with dementia during bathing. All participants experienced an overall increase in duration of positive operational behaviors and an overall decrease in duration of negative operational behaviors. Conclusions: Healthcare environments are integral components in dementia care and the use of MSE within the bathing setting appears to improve not only operational behaviors but the overall bathing experience.

scholarly journals Functional Analytic Multisensory Environmental Therapy for People with Dementia

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Jason A. Staal
Keyword(s):  
Behavioral Interventions ◽  
Disease Process ◽  
Well Being ◽  
Theory And Practice ◽  
Behavioral Theory ◽  
Behavioral Disturbance ◽  
Positive Effects ◽  
Treatment Room ◽  
People With Dementia ◽  
Multisensory Environment

This paper introduces Functional Analytic Multisensory Environmental Therapy (FAMSET) for use with elders with dementia while using a multisensory environment/snoezelen room. The model introduces behavioral theory and practice to the multisensory environment treatment, addressing assessment, and, within session techniques, integrating behavioral interventions with emotion-oriented care. A modular approach is emphasized to delineate different treatment phases for multisensory environment therapy. The aim of the treatment is to provide a safe and effective framework for reducing the behavioral disturbance of the disease process, increasing elder well-being, and to promote transfer of positive effects to other environments outside of the multisensory treatment room.

scholarly journals Influence of Pilot and Small Trials in Meta-Analyses of Behavioral Interventions: A Meta-epidemiological Study

2020 ◽  
Author(s):  
Michael W. Beets ◽  
R. Glenn Weaver ◽  
John P.A. Ioannidis ◽  
Alexis Jones ◽  
Lauren von Klinggraeff ◽  
...  
Keyword(s):  
Sample Size ◽  
Behavioral Interventions ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Feasibility Studies ◽  
Small Sample ◽  
Effect Sizes ◽  
Absolute Difference ◽  
Meta Analyses ◽  
The Impact

Abstract Background: Pilot/feasibility or studies with small sample sizes may be associated with inflated effects. This study explores the vibration of effect sizes (VoE) in meta-analyses when considering different inclusion criteria based upon sample size or pilot/feasibility status. Methods: Searches were conducted for meta-analyses of behavioral interventions on topics related to the prevention/treatment of childhood obesity from 01-2016 to 10-2019. The computed summary effect sizes (ES) were extracted from each meta-analysis. Individual studies included in the meta-analyses were classified into one of the following four categories: self-identified pilot/feasibility studies or based upon sample size (N≤100, N>100, and N>370 the upper 75th of sample size). The VoE was defined as the absolute difference (ABS) between the re-estimations of summary ES restricted to study classifications compared to the originally reported summary ES. Concordance (kappa) of statistical significance between summary ES was assessed. Fixed and random effects models and meta-regressions were estimated. Three case studies are presented to illustrate the impact of including pilot/feasibility and N≤100 studies on the estimated summary ES.Results: A total of 1,602 effect sizes, representing 145 reported summary ES, were extracted from 48 meta-analyses containing 603 unique studies (avg. 22 avg. meta-analysis, range 2-108) and included 227,217 participants. Pilot/feasibility and N≤100 studies comprised 22% (0-58%) and 21% (0-83%) of studies. Meta-regression indicated the ABS between the re-estimated and original summary ES where summary ES were comprised of ≥40% of N≤100 studies was 0.29. The ABS ES was 0.46 when summary ES comprised of >80% of both pilot/feasibility and N≤100 studies. Where ≤40% of the studies comprising a summary ES had N>370, the ABS ES ranged from 0.20-0.30. Concordance was low when removing both pilot/feasibility and N≤100 studies (kappa=0.53) and restricting analyses only to the largest studies (N>370, kappa=0.35), with 20% and 26% of the originally reported statistically significant ES rendered non-significant. Reanalysis of the three case study meta-analyses resulted in the re-estimated ES rendered either non-significant or half of the originally reported ES. Conclusions: When meta-analyses of behavioral interventions include a substantial proportion of both pilot/feasibility and N≤100 studies, summary ES can be affected markedly and should be interpreted with caution.

scholarly journals Nudging Parents to Improve Preschool Attendance in Uruguay

2020 ◽  
Author(s):  
Mercedes Mateo Díaz ◽  
Laura Becerra Luna ◽  
Juan Manuel Hernández-Agramonte ◽  
Florencia López ◽  
Marcelo Pérez Alfaro ◽  
...  
Keyword(s):  
Preschool Children ◽  
Child Development ◽  
Behavioral Intervention ◽  
Behavioral Interventions ◽  
Mobile App ◽  
Average Treatment Effect ◽  
School Age Children ◽  
Preschool Attendance ◽  
Standard Deviations ◽  
The Impact

Uruguay has increased it preschool enrollment, reaching almost universal coverage among four- and five-year-olds. However, more than a third of children enrolled in preschool programs have insufficient attendance, with absenteeism higher in schools in lower socioeconomic areas and among younger preschool children. This paper presents the results of a behavioral intervention to increase preschool attendance nationwide. Most previous experiments using behavioral sciences have looked at the impact of nudging parents on attendance and learning for school-age children; this is the first experiment looking at both attendance and child development for preschool children. It is also the first behavioral intervention to use a government mobile app to send messages to parents of preschool children. The intervention had no average treatment effect on attendance, but results ranged widely across groups. Attendance by children in the 25th 75th percentiles of absenteeism rose by 0.320.68 days over the course of the 13-week intervention, and attendance among children in remote areas increased by 1.48 days. Among all children in the study, the intervention also increased language development by 0.10 standard deviations, an impact similar to that of very labor-intensive programs, such as home visits. The intervention had stronger effects on children in the remote provinces of Uruguay, increasing various domains of child development by about 0.33 to 0.37 standard deviations. Behavioral interventions seeking to reduce absenteeism and raise test scores usually nudge parents on both the importance of attendance and ways to improve child development. In this experiment, the nudges focused only on absenteeism but had an effect on both.

The Impact of Plant Bioactive Compounds on Aging and Fertility of Diverse Organisms: A Review

2020 ◽  
Vol 20 (13) ◽  
pp. 1287-1299
Author(s):  
Muhammad Akram Mohd Noordin ◽  
Mahanem Mat Noor ◽  
Wan Mohd Aizat
Keyword(s):  
Clinical Trial ◽  
Bioactive Compounds ◽  
Defense Mechanisms ◽  
Healthy Aging ◽  
Antioxidant Defense ◽  
Senior Citizens ◽  
Aging Population ◽  
Human Clinical Trial ◽  
Fertility Reduction ◽  
The Impact

It is expected that in 2050, there will be more than 20% of senior citizens aged over 60 years worldwide. Such alarming statistics require immediate attention to improve the health of the aging population. Since aging is closely related to the loss of antioxidant defense mechanisms, this situation eventually leads to numerous health problems, including fertility reduction. Furthermore, plant extracts have been used in traditional medicine as potent antioxidant sources. Although many experiments had reported the impact of various bioactive compounds on aging or fertility, there is a lack of review papers that combine both subjects. In this review, we have collected and discussed various bioactive compounds from 26 different plant species known to affect both longevity and fertility. These compounds, including phenolics and terpenes, are mostly involved in the antioxidant defense mechanisms of diverse organisms such as rats, mites, fruit flies, roundworms, and even roosters. A human clinical trial should be considered in the future to measure the effects of these bioactive compounds on human health and longevity. Ultimately, these plant-derived compounds could be developed into health supplements or potential medical drugs to ensure a healthy aging population.

scholarly journals Identifying and measuring the common elements of naturalistic developmental behavioral interventions for autism spectrum disorder: Development of the NDBI-Fi

Autism ◽  
2020 ◽  
Vol 24 (8) ◽  
pp. 2285-2297
Author(s):  
Kyle M Frost ◽  
Jessica Brian ◽  
Grace W Gengoux ◽  
Antonio Hardan ◽  
Sarah R Rieth ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Behavioral Intervention ◽  
Behavioral Interventions ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Common Elements ◽  
Intervention Science ◽  
Intervention Models ◽  
The Common ◽  
Naturalistic Developmental Behavioral Intervention

Naturalistic developmental behavioral interventions for young children with autism spectrum disorder share key elements. However, the extent of similarity and overlap in techniques among naturalistic developmental behavioral intervention models has not been quantified, and there is no standardized measure for assessing the implementation of their common elements. This article presents a multi-stage process which began with the development of a taxonomy of elements of naturalistic developmental behavioral interventions. Next, intervention experts identified the common elements of naturalistic developmental behavioral interventions using quantitative methods. An observational rating scheme of those common elements, the eight-item NDBI-Fi, was developed. Finally, preliminary analyses of the reliability and the validity of the NDBI-Fi were conducted using archival data from randomized controlled trials of caregiver-implemented naturalistic developmental behavioral interventions, including 87 post-intervention caregiver–child interaction videos from five sites, as well as 29 pre–post video pairs from two sites. Evaluation of the eight-item NDBI-Fi measure revealed promising psychometric properties, including evidence supporting adequate reliability, sensitivity to change, as well as concurrent, convergent, and discriminant validity. Results lend support to the utility of the NDBI-Fi as a measure of caregiver implementation of common elements across naturalistic developmental behavioral intervention models. With additional validation, this unique measure has the potential to advance intervention science in autism spectrum disorder by providing a tool which cuts across a class of evidence-based interventions. Lay abstract Naturalistic developmental behavioral interventions for young children with autism spectrum disorder share key elements. However, the extent of similarity between programs within this class of evidence-based interventions is unknown. There is also currently no tool that can be used to measure the implementation of their common elements. This article presents a multi-stage process which began with defining all intervention elements of naturalistic developmental behavioral interventions. Next, intervention experts identified the common elements of naturalistic developmental behavioral interventions using a survey. An observational rating scheme of those common elements, the eight-item NDBI-Fi, was developed. We evaluated the quality of the NDBI-Fi using videos from completed trials of caregiver-implemented naturalistic developmental behavioral interventions. Results showed that the NDBI-Fi measure has promise; it was sensitive to change, related to other similar measures, and demonstrated adequate agreement between raters. This unique measure has the potential to advance intervention science in autism spectrum disorder by providing a tool to measure the implementation of common elements across naturalistic developmental behavioral intervention models. Given that naturalistic developmental behavioral interventions have numerous shared strategies, this may ease clinicians’ uncertainty about choosing the “right” intervention package. It also suggests that there may not be a need for extensive training in more than one naturalistic developmental behavioral intervention. Future research should determine whether these common elements are part of other treatment approaches to better understand the quality of services children and families receive as part of usual care.

Understanding Motivating Operations and the Impact on the Function of Behavior

2020 ◽  
Vol 56 (2) ◽  
pp. 119-122
Author(s):  
Doris Adams Hill ◽  
Theoni Mantzoros ◽  
Jonté C. Taylor
Keyword(s):  
Behavioral Interventions ◽  
Special Educators ◽  
Motivating Operations ◽  
Behavior Intervention Plans ◽  
Education Professionals ◽  
Functional Behavior ◽  
Special Education Professionals ◽  
And Function ◽  
And Behavior ◽  
The Impact

Special educators are often considered the experts in their school when it comes to developing functional behavior assessments (FBA) and behavior intervention plans (BIP), yet rarely are they trained much beyond basic antecedents, behaviors, and consequences (ABC). This column discusses concepts that will expand special education professionals’ knowledge to make better decisions regarding interventions for the students they serve. Specifically, the focus is on motivating operations (MO) and function-based interventions and the implications of these on behavior. Knowledge of the concept of MOs can enhance a teacher’s ability to provide evidence-based interventions and more fully developed behavioral interventions for students in their purview.

scholarly journals An Effectiveness Trial of STEADI in an Outpatient, Primary Care Practice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-774
Author(s):  
David Rein ◽  
Madeleine Hackney ◽  
Michele Dougherty ◽  
Camille Vaughan ◽  
Laurie Imhof ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Review ◽  
Primary Care Practice ◽  
Controlled Trial ◽  
Care Practice ◽  
Strength Assessment ◽  
Randomized Controlled ◽  
Study Team ◽  
One Year ◽  
The Impact

Abstract The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.

scholarly journals Psychological and Behavioral Predictors of Vaccine Efficacy: Considerations for COVID-19

2021 ◽  
pp. 174569162198924
Author(s):  
Annelise A. Madison ◽  
M. Rosie Shrout ◽  
Megan E. Renna ◽  
Janice K. Kiecolt-Glaser
Keyword(s):  
Risk Factors ◽  
Side Effects ◽  
Vaccine Efficacy ◽  
Psychological Factors ◽  
Behavioral Interventions ◽  
Vulnerable Groups ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Vaccine Response ◽  
The Impact

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine candidates are being evaluated, with the goal of conferring immunity on the highest percentage of people who receive the vaccine as possible. It is noteworthy that vaccine efficacy depends not only on the vaccine but also on characteristics of the vaccinated. Over the past 30 years, a series of studies has documented the impact of psychological factors on the immune system’s vaccine response. Robust evidence has demonstrated that stress, depression, loneliness, and poor health behaviors can impair the immune system’s response to vaccines, and this effect may be greatest in vulnerable groups such as the elderly. Psychological factors are also implicated in the prevalence and severity of vaccine-related side effects. These findings have generalized across many vaccine types and therefore may be relevant to the SARS-CoV-2 vaccine. In this review, we discuss these psychological and behavioral risk factors for poor vaccine responses, their relevance to the COVID-19 pandemic, as well as targeted psychological and behavioral interventions to boost vaccine efficacy and reduce side effects. Recent data suggest these psychological and behavioral risk factors are highly prevalent during the COVID-19 pandemic, but intervention research suggests that psychological and behavioral interventions can increase vaccine efficacy.

scholarly journals Provider attitudes towards a brief behavioral intervention for sexual health in Moldova

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rob Stephenson ◽  
Galina Lesco ◽  
Viorel Babii ◽  
Andrei Luchian ◽  
Nataliia Bakunina ◽  
...  
Keyword(s):  
Sexual Health ◽  
Behavioral Intervention ◽  
Brief Intervention ◽  
Behavioral Interventions ◽  
Brief Interventions ◽  
Health Centers ◽  
Capital City ◽  
Vulnerable Groups ◽  
Provider Attitudes ◽  
Brief Behavioral Intervention

Abstract Background Brief behavioral interventions are seen as an efficient way to improve knowledge, change behavior, and reduce provider stigma regarding sexual health. When grounded in evidence-based behavioral change techniques and delivered using Brief Sexuality-related Communication (BSC) tools, brief behavioral interventions can address client-driven sexual health goals in a single session with their provider. Evidence for the efficacy of brief interventions for creating gains in sexual health comes largely from resource rich settings, and there is a lack of knowledge of how brief interventions can be implemented in the more resource constrained environments of low- and middle-income countries. As a first step in developing a brief intervention to address sexual health issues in Moldova, this paper reports on qualitative data collected from Moldovan providers to understand their attitudes, willingness and perceived barriers to the brief intervention and its implementation. Methods Thirty-nine in-depth interviews (IDI) were conducted between February and March 2020, with health providers recruited from three primary health care institutions, two Youth Friendly Health Centers and counselors from three NGOs who work with key populations in Moldova, including health centers selected from two cites - the capital city, Chisinau and from the Comrat Region. The IDI addressed four domains of provider attitudes: 1) attitudes towards the intervention; 2) willingness and motivation to implement the intervention; 3) logistics of providing the intervention and 4) ability to implement the intervention. A coding analysis approach was applied to all interview transcripts. Results Providers largely reported being willing to be trained in and implement the brief intervention. Willingness to implement the intervention stemmed from two perceptions: that it would improve the ability of providers to talk with their clients about sex, and that vulnerable groups would benefit from these conversations. However, while there were generally positive attitudes towards the intervention, providers consistently reported structural barriers to their perceived ability to implement the intervention. Conclusions While providers reported high levels of initial acceptance of a brief behavioral intervention, care is needed to ensure that brief interventions, and the training of providers on brief interventions, incorporate cultural attitudes and norms around sex, particularly in highly patriarchal settings, and provide opportunities for providers to practice the intervention in ways that address their assumptions and implicit biases.

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