scholarly journals The Impact of Community Health Coalitions On Preventative Health Outcomes: A Systematic Review

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Emily Shockley ◽  
Aliya Amin ◽  
Dennis Savaiano
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Community Health ◽  
The United States ◽  
Randomized Control Trials ◽  
Preventative Care ◽  
Community Members ◽  
Preventative Health ◽  
Randomized Control

Background/Objective: Six out of ten deaths in the United States are caused by chronic diseases. There are multiple approaches to prevention and/or early detection of chronic diseases through screenings, nutrition, physical activity, and more. Unfortunately, a large portion of the US population have low rates of preventative care. Community health coalitions have the potential to improve preventative health outcomes by partnering with key members of communities to design programs that best fit community needs. In this systematic review, we examine evidence that community health coalitions can improve preventative health outcomes. Methods: PubMed, WebofScience, CINAHL, and PsycINFO were searched for (outcome OR health outcome) AND (prevention) AND (diabetes OR hypertension OR cancer OR prenatal) AND (community-based participatory research OR community coalition OR coalition OR health coalition). After screening 490 articles, 30 full-text, peer-reviewed, English articles meeting inclusion criteria of health coalition, prevention, health outcomes reported, and conducted in the United States were reviewed. Results: 27 of the 30 studies showed community health coalitions having a positive impact. Roughly half of the articles were randomized control trials. Community members and academia were represented in 80% and 77%, respectively, of the coalitions described, while other representations included faith-based organizations, health care, public health, industry, and education. Diabetes and cancer represented 74% of the targeted preventions addressed. 90% of the interventions focused on educating the community, and 33% focused on increasing health screening rates. 60% utilized trained community members to deliver interventions. 60% reported health measurements, 33% reported screening rates, and 30% reported knowledge and awareness. Conclusion, Impact, & Implications: While the evidence suggests community health coalitions are effective in improving preventative health outcomes, the quality of the studies remain low. There is a need for increased rigor of study design and assessment in order to determine the true efficacy of community health coalitions. The majority of the randomized-control trials in this review were rated as low-quality, highlighting the difficulty of designing a randomized, controlled study in a community. Inadequate funding, lack of rigorous design, or ethical challenges can limit the quality of the assessment. Further, although prenatal care was included as a search term, there were no coalitions found that addressed this type of preventative care. This points to a future need for the creation of or increased publications from prenatal health coalitions.  

scholarly journals Real-time fMRI neurofeedback training as a neurorehabilitation approach on depressive disorders: A systematic review of randomized control trials

2020 ◽  
Author(s):  
Pamela Gonzalez Mendez ◽  
Ranganatha Sitaram ◽  
Jeffrey A. Stanley ◽  
Julio Rodino Clement
Keyword(s):  
Systematic Review ◽  
Real Time ◽  
Depressive Disorders ◽  
Brain Mri ◽  
Neuropsychiatric Disorders ◽  
Randomized Control Trials ◽  
Neurofeedback Training ◽  
Randomized Control ◽  
Secondary Outcomes

ABSTRACT BACKGROUND: Depressive disorders are a group of neuropsychiatric disorders that cause significant distress and impairment in social, occupational, and other important areas of functioning. In the last decade, Brain-Computer Interfaces based-neurofeedback training appears as an innovative therapy for this condition and other neuropsychiatric disorders, allowing to volitionally self-regulate brain activity and behavior. Up to date, non-invasive neurofeedback training have been built on different techniques, including EEG, NIRS and fMRI. OBJECTIVES: This systematic review aims to evaluate the clinical application of fMRI neurofeedback training and its efficacy on treating depressive disorders. As a secondary objective, we intend to extract additional information on the neurofeedback training technique, in order to provide recommendations for future research. METHODS AND ANALYSIS: The systematic review complies with the PRISMA guidelines and it was submitted to PROSPERO registration. We will only include randomized control trials assessing participants with a depressive disorder. The intervention of interest is real-time fMRI neurofeedback training, the comparison of interest will be placebo neurofeedback, another active non-neurofeedback control or no treatment. The primary outcome will be effects on behavior (symptomatology/disease severity reduction). The secondary outcomes will assess quality of life, acceptability and adverse effects. Finally, we will evaluate other outcomes regarding brain MRI metrics (BOLD activation/connectivity), cognitive tasks performance, and physiology measures. At least two reviewers will independently select studies, extract data and assess the risk of bias. If methodologically possible, for primary and secondary outcomes, a meta-analysis will be performed and the data will be presented in summary tables of results using the GRADE approach. STRENGTH AND LIMITATIONS: As the number of studies on neurofeedback is increasing every year, and better quality of evidence is available, this systematic review, will include only randomized control trials. To our knowledge, this is the first systematic review assessing randomized control trials on fMRI neurofeedback training as a neurorehabilitation approach on depressive disorders. The main limitation of this systematic review might arise from the low number of extant RCTs.

scholarly journals Indiana Nonprofit Hospitals’ Community Health Needs Assessments Objectives and Evaluation

2020 ◽  
Vol 3 ◽  
Author(s):  
Kevin Walters ◽  
Dennis Savaiano
Keyword(s):  
Health Outcomes ◽  
Community Health ◽  
Population Health ◽  
The United States ◽  
Health Needs ◽  
High Quality ◽  
Nonprofit Hospitals ◽  
Community Benefit ◽  
Needs Assessments

Background/Objective:   Over half of the hospitals in the United States are not for profit and confer large tax advantages so long as they demonstrate community benefit. Since 2010 these hospitals have been required by law to conduct Community Health Needs Assessments (CHNAs) in order for community benefit to move from charity care to improved population health outcomes. For improved population health outcomes, we argue that effective community health programs must be put into place with high quality goals and evaluations to ensure effectiveness. We rated the objectives and evaluation plans of Indiana nonprofit hospitals’ CHNAs and then compared and correlated the quality of these plans with characteristics of the hospitals and health indicators of their community.      Methods:  CHNAs and Implementation Plans were obtained for 95 nonprofit hospitals in Indiana. The assessments and plans were independently scored by 2 assessors based on specific criteria for quality using a Likert scale which ranged from 0 to 5. We averaged the scores and then correlated and compared them to characteristics of the hospital, its local partnerships, and the health statistics of the communities in which they reside.    Results:  The average score for the objectives was 3.43 and for the evaluation 2.47 with large variations in the criteria met by each hospitals CHNA. Significant differences were found between the scores of system-based and independent hospitals for both evaluation and objectives (p=0.01, p<0.001).     Conclusion and Potential Impact:  Our data shows that the quality of CHNAs’ objectives and evaluation is universally poor and vary greatly from hospital to hospital. However, consistency and to a lesser degree quality of scores can be affected by system wide models. If the goal of these assessments is to create better population health outcomes through nonprofit hospitals, then the government needs to provide a high-quality model for hospitals to follow.  

How Does Mindfulness Affect Cognition? A Reflection on Confounding Issues Surrounding Mindfulness-based Intervention Research Targeting Cognitive Outcomes

2018 ◽  
Author(s):  
David R Vago ◽  
Resh Gupta ◽  
Sara Lazar
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Cognitive Functioning ◽  
Cognitive Processes ◽  
Methodological Quality ◽  
Cognitive Outcomes ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Existing Data

One potential pathway by which mindfulness-based meditation improves health outcomes is through changes in cognitive functioning. A systematic review of randomized controlled trials of mindfulness-based interventions (MBIs) was conducted with a focus on assessing the state of the evidence for effects on cognitive processes and associated assays. Here, we comment on confounding issues surrounding the reporting of these and related findings, including 1) criteria that appropriately define an MBI; 2) limitations of assays used to measure cognition; and 3) methodological quality of MBI trials and reporting of findings. Because these issues contribute to potentially distorted interpretations of existing data, we offer constructive means for interpretation and recommendations for moving the field of mindfulness research forward regarding the effects on cognition.

Site Selection Bias in Program Evaluation *

2015 ◽  
Vol 130 (3) ◽  
pp. 1117-1165 ◽  
Author(s):  
Hunt Allcott
Keyword(s):  
United States ◽  
Selection Bias ◽  
Site Selection ◽  
The United States ◽  
Randomized Control Trials ◽  
Program Evaluations ◽  
Out Of Sample ◽  
Target Treatment ◽  
Randomized Control ◽  
Selection For

Abstract “Site selection bias” can occur when the probability that a program is adopted or evaluated is correlated with its impacts. I test for site selection bias in the context of the Opower energy conservation programs, using 111 randomized control trials involving 8.6 million households across the United States. Predictions based on rich microdata from the first 10 replications substantially overstate efficacy in the next 101 sites. Several mechanisms caused this positive selection. For example, utilities in more environmentalist areas are more likely to adopt the program, and their customers are more responsive to the treatment. Also, because utilities initially target treatment at higher-usage consumer subpopulations, efficacy drops as the program is later expanded. The results illustrate how program evaluations can still give systematically biased out-of-sample predictions, even after many replications.

Trauma-Sensitive Yoga Interventions and Posttraumatic Stress and Depression Outcomes Among Women: A Systematic Review and Analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Ashleigh Kysar-Moon ◽  
Matthew Vasquez ◽  
Tierra Luppen
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress ◽  
Traumatic Event ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Randomized Control Trials ◽  
Methodological Rigor ◽  
History Of ◽  
Randomized Control ◽  
Analysis Models

Abstract Research shows that most people experience at least one traumatic event in their lifetimes, and between 6% and 8% of those with a history of trauma will develop posttraumatic stress disorder (PTSD) and/or related mental health conditions. Women face a greater threat of trauma exposure and have a higher risk of PTSD and depression than men. Trauma-Sensitive Yoga (TSY), a body-based adjunctive therapy, has shown potential in several studies as an effective method for reducing PTSD and depression symptoms. However, existing research and systematic reviews vary widely in their methodological rigor and comparison samples. Thus, in this systematic review we examined the effectiveness of TSY among women with a history of trauma and depression who had participated in randomized control trials with clear control and experimental groups. Findings in fixed- and mixed-effects meta-analysis models suggest marginally significant to no effects of TSY on PTSD and depression outcomes. Our systematic review highlights critical questions and significant gaps in the existing literature about the rationale and best practices of TSY intervention duration.

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