Using a Collaborative Process to Develop Goals and Self-Management Interventions to Support Young Adults With Disabilities at Work

2016 ◽  
Vol 30 (2) ◽  
pp. 110-128 ◽  
Author(s):  
Christine L. Nittrouer ◽  
Karrie A. Shogren ◽  
Julie L. Pickens
Keyword(s):  
Young Adults ◽  
Functional Assessment ◽  
Self Management ◽  
Task Completion ◽  
Single Subject ◽  
Collaborative Process ◽  
Adults With Disabilities ◽  
Job Roles ◽  
Management Interventions ◽  
The Impact

Purpose:This study examined the impact of using a collaborative process with person-centered teams and a functional assessment of problems in the workplace to design individualized goals and self-management interventions to support young adults with disabilities. These young adults had achieved employment through a customized employment process but were beginning to face challenges maintaining and advancing in their job roles.Method:A single subject, multiple baseline study was conducted with three individuals ages 22–29 years with autism and/or intellectual disability to determine the impact of the intervention on on-task behavior and job task completion.Results:The results suggest that the process can lead to meaningful change in the on-task and job completion behavior of young adults with disabilities in inclusive employment settings, although there were limitations.Conclusion:The findings, outcomes, and implications confirm and extend our understanding of the impact of person-centered teams, goal setting, functional assessment, and self-management after young adults with disabilities are employed in community-based settings.

A New Taxonomy for Technology-Enabled Diabetes Self-Management Interventions: Results of an Umbrella Review

2021 ◽  
pp. 193229682110364
Author(s):  
Deborah A. Greenwood ◽  
Michelle L. Litchman ◽  
Diana Isaacs ◽  
Julia E. Blanchette ◽  
Jane K. Dickinson ◽  
...  
Keyword(s):  
Feedback Loop ◽  
English Language ◽  
Controlled Trial ◽  
Self Management ◽  
Umbrella Review ◽  
Diabetes Outcomes ◽  
Management Interventions ◽  
Meta Analyses ◽  
The Impact ◽  
Technology Attributes

Background: A 2017 umbrella review defined the technology-enabled self-management (TES) feedback loop associated with a significant reduction in A1C. The purpose of this 2021 review was to develop a taxonomy of intervention attributes in technology-enabled interventions; review recent, high-quality systematic reviews and meta-analyses to determine if the TES framework was described and if elements contribute to improved diabetes outcomes; and to identify gaps in the literature. Methods: We identified key technology attributes needed to describe the active ingredients of TES interventions. We searched multiple databases for English language reviews published between April 2017 and April 2020, focused on PwD (population) receiving diabetes care and education (intervention) using technology-enabled self-management (comparator) in a randomized controlled trial, that impact glycemic, behavioral/psychosocial, and other diabetes self-management outcomes. AMSTAR-2 guidelines were used to assess 50 studies for methodological quality including risk of bias. Results: The TES Taxonomy was developed to standardize the description of technology-enabled interventions; and ensure research uses the taxonomy for replication and evaluation. Of the 26 included reviews, most evaluated smartphones, mobile applications, texting, internet, and telehealth. Twenty-one meta-analyses with the TES feedback loop significantly lowered A1C. Conclusions: Technology-enabled diabetes self-management interventions continue to be associated with improved clinical outcomes. The ongoing rapid adoption and engagement of technology makes it important to focus on uniform measures for behavioral/psychosocial outcomes to highlight healthy coping. Using the TES Taxonomy as a standard approach to describe technology-enabled interventions will support understanding of the impact technology has on diabetes outcomes.

Agent-based modeling for the self-management of chronic diseases: An exploratory study

SIMULATION ◽  
2017 ◽  
Vol 93 (9) ◽  
pp. 781-793 ◽  
Author(s):  
Sara Montagna ◽  
Andrea Omicini
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Chronic Diseases ◽  
Agent Based Modeling ◽  
Self Management ◽  
Agent Based ◽  
Management Interventions ◽  
The Impact

The impact of mobile technologies on healthcare is particularly evident in the case of self-management of chronic diseases, where they can decrease spending and improve life quality of patients. We propose the adoption of agent-based modeling and simulation techniques as built-in tools to dynamically monitor the state of patient health and provide recommendations for self-management. To demonstrate the feasibility of our proposal we focus on Type 1 diabetes mellitus as our case study, and provide simulation results where the dynamic evolution of signal parameters is shown in the case of healthy and Type 1 diabetes mellitus patients, focussing in particular on the beneficial effects that self-management interventions have on plasma glucose values.

scholarly journals Self-management interventions for Type 2 Diabetes: systematic review protocol focusing on patient workload and capacity support

2021 ◽  
Vol 6 ◽  
pp. 257
Author(s):  
Peter Hanlon ◽  
Iona Bryson ◽  
Holly Morrison ◽  
Qasim Rafiq ◽  
Kasey Boehmer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Hospital Admissions ◽  
Macrovascular Disease ◽  
Self Management ◽  
Management Support ◽  
Patient Capacity ◽  
Management Interventions ◽  
The Impact

Introduction: People living with type 2 diabetes undertake a range of tasks to manage their condition, collectively referred to as self-management. Interventions designed to support self-management vary in their content, and efficacy. This systematic review will analyse self-management interventions for type 2 diabetes drawing on theoretical models of patient workload and capacity. Methods and analysis: Five electronic databases (Medline, Embase, CENTRAL, CINAHL and PsycINFO) will be searched from inception to 27th April 2021, supplemented by citation searching and hand-searching of reference lists. Two reviewers will independently review titles, abstracts and full texts. Inclusion criteria include Population: Adults with type 2 diabetes mellitus; Intervention: Randomised controlled trials of self-management support interventions; Comparison: Usual care; Outcomes: HbA1c (primary outcome) health-related quality of life (QOL), medication adherence, self-efficacy, treatment burden, healthcare utilization (e.g. number of appointment, hospital admissions), complications of type 2 diabetes (e.g. nephropathy, retinopathy, neuropathy, macrovascular disease) and mortality; Setting: Community. Study quality will be assessed using the Effective Practice and Organisation of Care (EPOC) risk of bias tool. Interventions will be classified according to the EPOC taxonomy and the PRISMS self-management taxonomy and grouped into similar interventions for analysis. Clinical and methodological heterogeneity will be assessed within subgroups, and random effects meta-analyses performed if appropriate. Otherwise, a narrative synthesis will be performed. Interventions will be graded on their likely impact on patient workload and support for patient capacity. The impact of these theoretical constructs on study outcomes will be explored using meta-regression. Conclusion This review will provide a broad overview of self-management interventions, analysed within the cumulative complexity model theoretical framework. Analyses will explore how the workload associated with self-management, and support for patient capacity, impact on outcomes of self-management interventions. Registration number: PROSPERO CRD42021236980.

scholarly journals Treating Illness Distress in Chronic Illness

2019 ◽  
Vol 24 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Joanna L. Hudson ◽  
Rona Moss-Morris
Keyword(s):  
Mental Health ◽  
Mental Health Disorders ◽  
Cognitive Behavioral ◽  
Self Management ◽  
Depression And Anxiety ◽  
Long Term Conditions ◽  
Management Interventions ◽  
Health Disorders ◽  
Behavioral Mechanisms ◽  
The Impact

Abstract. Cognitive-behavioral therapy (CBT) is an evidence-based treatment for depression and anxiety recommended for those with and without physical long-term conditions (LTCs). However, the cognitive-behavioral mechanisms targeted in CBT protocols are based on empirical cognitive-behavioral models of depression and anxiety. In these models, emotions are conceptualized as primary mental health disorders rather than a reaction to the challenges of living with a LTC commonly referred to as illness distress. This raises important clinical questions with theoretical implications. These include: Is the experience of illness distress conceptually distinct from primary mental health diagnoses of anxiety and mood disorder? Are there unique cognitive-behavioral mechanisms related to illness self-management, which should be incorporated into CBT for illness distress? How can illness self-management interventions be embedded within existing CBT protocols for depression and anxiety? To address these questions, we distinguish between primary mental health disorders and illness distress conceptually and explore the impact of this on tailored treatment planning and engagement. Second, we review how health psychology theoretical models can help to inform modifications of existing cognitive-behavioral treatments for anxiety and depression to better support the needs of individuals experiencing illness distress. Third, we provide examples of how to embed processes important for illness self-management including, illness cognitions and adherence, alongside existing CBT techniques. The mechanisms and intervention techniques discussed may help to inform the development of integrated CBT treatments for illness distress for future hypothesis testing in comparative effectiveness trials.

scholarly journals Evidence generation for the clinical impact of myCOPD in patients with mild, moderate and newly diagnosed COPD: a randomised controlled trial

2020 ◽  
Vol 6 (4) ◽  
pp. 00460-2020
Author(s):  
Michael G. Crooks ◽  
Jack Elkes ◽  
William Storrar ◽  
Kay Roy ◽  
Mal North ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Small Sample Size ◽  
Controlled Trial ◽  
Small Sample ◽  
Self Management ◽  
Open Label ◽  
Management Interventions ◽  
Randomised Controlled ◽  
The Impact

Self-management interventions in COPD aim to improve patients' knowledge, skills and confidence to make correct decisions, thus improving health status and outcomes. myCOPD is a web-based self-management app known to improve inhaler use and exercise capacity in individuals with more severe COPD.We explored the impact of myCOPD in patients with mild–moderate or recently diagnosed COPD through a 12-week, open-label, parallel-group, randomised controlled trial of myCOPD compared with usual care. The co-primary outcomes were between-group differences in mean COPD assessment test (CAT) score at 90 days and critical inhaler errors. Key secondary outcomes were app usage and patient activation measurement (PAM) score.Sixty patients were randomised (29 myCOPD, 31 usual care). Groups were balanced for forced expiratory volume in 1 s (FEV1 % pred) but there was baseline imbalance between groups for exacerbation frequency and CAT score. There was no significant adjusted mean difference in CAT score at study completion, −1.27 (95% CI −4.47–1.92, p=0.44) lower in myCOPD. However, an increase in app use was associated with greater CAT score improvement. The odds of ≥1 critical inhaler error was lower in the myCOPD arm (adjusted OR 0.30 (95% CI 0.09–1.06, p=0.061)). The adjusted odds ratio for being in a higher PAM level at 90 days was 1.65 (95% CI 0.46–5.85) in favour of myCOPD.The small sample size and phenotypic difference between groups limited our ability to demonstrate statistically significant evidence of benefit beyond inhaler technique. However, our findings provide important insights into associations between increased app use and clinically meaningful benefit warranting further study in real world settings.

scholarly journals An Exploratory Study of the Impact of Gender on Health Behavior Among African American and Latino Men With Type 2 Diabetes

2016 ◽  
Vol 11 (2) ◽  
pp. 344-356 ◽  
Author(s):  
Jaclynn Hawkins ◽  
Daphne C. Watkins ◽  
Edith Kieffer ◽  
Michael Spencer ◽  
Gretchen Piatt ◽  
...  
Keyword(s):  
African American ◽  
Health Behavior ◽  
Health Behaviors ◽  
African American Men ◽  
Self Management ◽  
Future Research ◽  
Latino Men ◽  
Management Interventions ◽  
Values And Beliefs ◽  
The Impact

This study explores gender values and beliefs among Latino and African American men with diabetes and examines how these values and beliefs may influence their health behaviors. Participants were recruited from individuals who participated in one of three Racial and Ethnic Approaches to Community Health Detroit Partnership diabetes self-management interventions. One focus group was conducted with African American men ( n = 10) and two focus groups were conducted with Latino men ( n = 12) over a 3-month period. Sessions lasted 90 minutes, were audiotaped, and analyzed using thematic content analysis techniques. Two themes emerged that characterize gender identity and its relationship to health behavior in men: (a) men’s beliefs about being men (i.e., key aspects of being a man including having respect for themselves, authority figures, and peers; fulfilling the role as breadwinner; being responsible for serving as the leader of the family; and maintaining a sense of chivalry) and (b) influence of gender values and beliefs on health behavior (i.e., the need to maintain a strong image to the outside world, and the need to maintain control of themselves served as barriers to seeking out and engaging in diabetes self-management behaviors). Results suggest that gender values and beliefs may have implications for how health behaviors among men with diabetes. Future research should study the direct impact masculine identity has on health behaviors among men with diabetes.

scholarly journals Child and caregiver experiences and perceptions of asthma self-management

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Lauren Kelada ◽  
Charlotte J. Molloy ◽  
Peter Hibbert ◽  
Louise K. Wiles ◽  
Claire Gardner ◽  
...  
Keyword(s):  
Focus Groups ◽  
Asthma Management ◽  
Self Management ◽  
Emotional Wellbeing ◽  
Social And Emotional ◽  
Asthma Knowledge ◽  
School Aged Children ◽  
Management Interventions ◽  
Children With Asthma ◽  
The Impact

AbstractAsthma is the most common chronic condition of childhood. Self-management is integral to good asthma control. This qualitative paper explores how children with asthma and their parents perceive asthma, their experience with asthma, and how they manage symptoms, preventions and medications within and outside the home. We undertook 15 focus groups with 41 school-aged (6–11 years) children with asthma and 38 parents. Parents and their children attended the same focus groups. We used thematic analysis to analyse the transcripts. Our findings show the impact asthma can have on children’s social and emotional wellbeing and highlight how reliant school-aged children are on their parents to effectively manage their asthma. Parents reported being unsure when their child’s symptoms warranted visiting their doctor or hospital. Schools were identified as a source of difficulty regarding asthma management; families reported that children may be self-conscious about their asthma and using their inhaler at school. School policies and teachers’ lack of asthma knowledge were reported to exacerbate children’s reluctance to use their inhaler at school. Our results have implications for the design and implementation of children’s self-management interventions for their asthma, particularly when they are at school and away from their parents.

The impact of online self-management interventions on midlife adults with type 2 diabetes: a systematic review

2020 ◽  
Vol 29 (5) ◽  
pp. 266-272
Author(s):  
Aycan Celik ◽  
Rita Forde ◽  
Jackie Sturt
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Self Management ◽  
Diabetes Distress ◽  
Online Interventions ◽  
Management Interventions ◽  
Secondary Outcomes ◽  
Midlife Adults ◽  
The Impact

Background: Online self-management education programmes are now recommended for people with type 2 diabetes to improve self-management capacities. There is limited evidence to determine whether such programmes improve the health outcomes for midlife adults with diabetes. Aims: The purpose of this systematic review was to assess the impact of online self-management interventions with digital consulting on glycated haemoglobin (HbA1c), total cholesterol, blood pressure, diabetes distress, self-efficacy, and depression in midlife adults. Methods: A systematic review was undertaken searching Medline, Embase and CINAHL. Studies were appraised using the Cochrane Collaboration's tool. Results: Eight studies were included. Online interventions resulted in the improvement of HbA1c (pooled mean difference on HbA1c: -0.35%, 95% CI (-0.52, -0.18), P<0.001). A narrative synthesis was conducted for all secondary outcomes. No conclusions could be drawn on the impact of these outcomes. Conclusion: Online interventions improve HbA1c. Further research is needed for secondary outcomes.

scholarly journals Health Needs Above of Automation Fears: The Role of the Future of Work in Shaping Career Decisions and Appraisals of Employment Among Young Adults with Disabilities

2021 ◽  
Author(s):  
Arif Jetha ◽  
Ali Shamaee ◽  
Emile Tompa ◽  
Peter Smith ◽  
Ute Bultmann ◽  
...  
Keyword(s):  
Young Adults ◽  
Labor Market ◽  
Career Aspirations ◽  
Digital Technologies ◽  
Health Needs ◽  
Full Time ◽  
Adults With Disabilities ◽  
Future Of Work ◽  
The Future ◽  
The Impact

Abstract Objectives. Technological, sociopolitical and environmental forces are changing the working world and creating conditions that could be disadvantageous to young adults with disabilities. Our study aims to examine the thoughts and perceptions held by young adults with disabilities regarding the future of work.Methods. One-on-one semi-structured interviews with Canadian young adult (ages 18-35 years) with a disability were conducted. Participants were asked questions on their thoughts and perceptions regarding the impact the changing nature and availability of work on their labor market involvement and career aspirations. Themes that emerged from the data were inductively examined. Results. Twenty-two young adults were interviewed of which just over half were employed full-time. Career aspirations and work-related decisions were primarily shaped by a participant’s health needs. Aspects of the future of work were seen as a more proximal determinants to employment. Digital technologies were expected to impact working conditions for people with disabilities and create barriers and facilitators to employment. Participant who were securely employed held positive expectations regarding the impact of digital technology on their work. Conversely, participants working precariously held negative appraisals regarding the impact of digital technologies on employment opportunities.Conclusions. Initiatives that support labor market engagement of young adults with disabilities should consider changes in the future of work and emerging health needs while also accounting for the availability of secure work arrangements.

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