scholarly journals Mediating Effects of Stigma and Depressive Symptoms in a Social Media–Based Intervention to Improve Long-term Quality of Life Among People Living With HIV: Secondary Analysis of a Randomized Controlled Trial

10.2196/27897 ◽  
2021 ◽  
Vol 23 (11) ◽  
pp. e27897
Author(s):  
Yiran Li ◽  
Yan Guo ◽  
Y Alicia Hong ◽  
Chengbo Zeng ◽  
Yu Zeng ◽  
...  
Keyword(s):  
Social Media ◽  
Depressive Symptoms ◽  
Intervention Group ◽  
Control Group ◽  
People Living With Hiv ◽  
Mediating Effects ◽  
Long Term Effects ◽  
Related Stigma ◽  
Living With Hiv

Background Mobile health (mHealth) interventions have been shown to effectively improve the quality of life (QOL) among people living with HIV. However, little is known about the long-term effects of mHealth interventions. Objective This study aims to explore the intervention mechanisms of a social media–based intervention, Run4Love, on the QOL of people with HIV over across a 9-month follow-up period. Methods We recruited people living with HIV who were concurrently experiencing elevated depressive symptoms from an HIV outpatient clinic in South China. A total of 300 eligible participants were randomized either to the intervention group or the control group in a 1:1 ratio after they provided informed consent and completed a baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines in addition to the usual care for HIV treatment. Neither participants nor the research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on participants’ QOL. Results About 91.3% (274/300), 88.3% (265/300), and 86.7% (260/300) of all participants completed follow-up surveys at 3, 6, and 9 months, respectively. Results showed that the intervention had significantly improved participants' QOL at 9 months, via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. Conclusions These findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effects on QOL improvements. We call for targeted mHealth interventions to improve QOL among people living with HIV, especially social media–based interventions that can address HIV-related stigma and alleviate depressive symptoms. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019

Mediating Effects of Stigma and Depressive Symptoms in a Social Media-based Intervention to Improve Long-term QOL among People Living with HIV: Secondary Analysis of a Randomized Controlled Trial Using Structural Equation Model. (Preprint)

2021 ◽  
Author(s):  
Yiran Li ◽  
Yan Guo ◽  
Y.Alicia Hong ◽  
Chengbo Zeng ◽  
Yu Zeng ◽  
...  
Keyword(s):  
Social Media ◽  
Depressive Symptoms ◽  
Structural Equation ◽  
Intervention Group ◽  
Equation Model ◽  
Control Group ◽  
People Living With Hiv ◽  
Mediating Effects ◽  
Related Stigma

BACKGROUND Mobile health (mHealth) interventions have been shown to effectively improve quality of life (QOL) among people living with HIV (PLWH). However, little is known about the mechanisms of how mHealth interventions take effects, especially in the long term. OBJECTIVE This study aimed to explore the intervention mechanisms of a social media-based intervention, Run4Love, on QOL over 9-month follow-up. METHODS We recruited PLWH who were concurrently experiencing elevated depressive symptoms from the HIV outpatient clinic in South China. A total of 300 eligible participants were randomized to the intervention group or control group in a 1:1 ratio after informed consent and baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines besides usual care for HIV treatment. Neither participants nor research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on QOL. RESULTS About 91.3%, 88.3%, and 86.7% participants completed follow-up surveys at 3, 6, and 9 months. Results showed that the intervention had significantly improved QOL at 9 months via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. CONCLUSIONS The findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effect on QOL improvements. We call for targeted mHealth interventions to improve QOL among PLWH, especially social media-based interventions that can address HIV-related stigma and alleviate depressive symptoms. CLINICALTRIAL The trail was registered in the Chinese Clinical Trial Registry (ChiCTR-IPR-17012606).

scholarly journals Effect of a WeChat-Based Intervention (Run4Love) on Depressive Symptoms Among People Living With HIV in China: A Randomized Controlled Trial

10.2196/16715 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e16715 ◽  
Author(s):  
Yan Guo ◽  
Y Alicia Hong ◽  
Weiping Cai ◽  
Linghua Li ◽  
Yuantao Hao ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Depressive Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
People Living With Hiv ◽  
Mhealth Intervention ◽  
Randomized Controlled ◽  
Hair Samples ◽  
Living With Hiv

Background People living with HIV (PLWH) have high rates of depressive symptoms. However, only a few effective mental health interventions exist for this vulnerable population. Objective The aim of this study was to assess the efficacy of a WeChat-based intervention, Run4Love, with a randomized controlled trial among 300 people living with HIV and depression (PLWHD) in China. Methods We recruited PLWH from the HIV outpatient clinic in South China. Participants were screened based on the Center for Epidemiologic Studies-Depression (CES-D) scale. Those who scored 16 or higher were eligible to participate. A total of 300 eligible patients were enrolled. After obtaining informed consent from the participants, completion of a baseline survey, and collection of participants’ hair samples for measuring cortisol, the participants were randomly assigned to an intervention or a control group in a 1:1 ratio. The intervention group received the Run4Love program, delivered via the popular social media app WeChat. Cognitive behavioral stress management courses and weekly reminders of exercise were delivered in a multimedia format. Participants’ progress was monitored with timely and tailored feedback. The control group received usual care and a brochure on nutrition for PLWH. Data were collected at 3, 6, and 9 months. The primary outcome was depression, which was measured by a validated instrument. Results Participants in the intervention and control groups were comparable at baseline; about 91.3% (139/150), 88.3% (132/150), and 86.7% (130/150) participants completed the 3-, 6-, and 9-month follow-ups, respectively. At the 3-month follow-up, a significant reduction in CES-D score was observed in the intervention group (from 23.9 to 17.7 vs from 24.3 to 23.8; mean difference=−5.77, 95% CI −7.82 to −3.71; P<.001; standard effect size d=0.66). The mean changes in CES-D score from baseline to the 6- and 9-month follow-ups between the two groups remained statistically significant. No adverse events were reported. Conclusions The WeChat-based mobile health (mHealth) intervention Run4Love significantly reduced depressive symptoms among PLWHD, and the effect was sustained. An app-based mHealth intervention could provide a feasible therapeutic option for many PLWHD in resource-limited settings. Further research is needed to assess generalizability and cost-effectiveness of this intervention. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showproj.aspx?proj=21019 (Archived by WebCite at https://www.webcitation.org/78Bw2vouF)

scholarly journals Effects of 1 y of free school fruit on intake of fruits, vegetables, and unhealthy snacks: 14 y later

2018 ◽  
Vol 108 (6) ◽  
pp. 1309-1315 ◽  
Author(s):  
Tonje Holte Stea ◽  
Ingrid Marie Hovdenak ◽  
Jannike Rønnestad ◽  
Kjersti Rennestraum ◽  
Frøydis Nordgård Vik ◽  
...  
Keyword(s):  
Fruits And Vegetables ◽  
Intervention Group ◽  
Baseline Survey ◽  
Control Group ◽  
Intervention Period ◽  
Long Term Effects ◽  
Intervention Effects ◽  
Sample Mean ◽  
Unhealthy Snacks

ABSTRACT Background There are not many studies evaluating the long-term effects of fruit and vegetable interventions. Objective We examined the effects of 1 y of free fruit in elementary school on long-term consumption of fruit, vegetables, and unhealthy snacks, according to sex and educational attainment, 14 y after the intervention period. Design In 2001, the baseline survey of the longitudinal cohort, Fruits and Vegetables Make the Marks (FVMM), included 1950 children (mean age: 11.8 y) attending 38 randomly drawn elementary schools from 2 counties in Norway. In the following 10 mo, 9 schools served as intervention schools by participating in the Norwegian School Fruit Program for free, whereas 29 schools served as control schools. A follow-up survey conducted in 2016 included 982 participants (50%) from the original study sample (mean age: 26.5 y). The consumption of fruit and vegetables was measured by a 24-h recall (portions per day), and the consumption of unhealthy snacks was measured by food-frequency questions (portions per week). Linear mixed models were performed to test possible intervention effects on the consumption of fruit, vegetables, and unhealthy snacks 14 y after the intervention period. Results No overall intervention effects after 14 y due to the free-fruit scheme on the consumption of fruit, vegetables, and unhealthy snacks were observed, but significant interactions showed a sustained higher frequency of fruit consumption among females in the intervention group compared with the control group [mean difference (MD): 0.38 portions/d; P = 0.023] and that this effect was only significant among less-educated females (MD: 0.73 portions/d; P = 0.043). No significant long-term intervention effects were observed in the consumption of fruit among highly educated females and males nor in the consumption of vegetables or unhealthy snacks. Conclusion Results from the present study indicate that receiving free fruit at school for 1 y may have positive long-term effects for females without higher education.

Effectiveness of Medical Nutrition Therapy to Improve Dietary Habits for Promoting Bone Health in People Living with Chronic HIV

2020 ◽  
Vol 76 (5) ◽  
pp. 313-321
Author(s):  
Alongkote Singhato ◽  
Somjet Khongkhon ◽  
Narisa Rueangsri ◽  
Uraiporn Booranasuksakul
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Dietary Habits ◽  
Intervention Group ◽  
Nutrition Therapy ◽  
Control Group ◽  
People Living With Hiv ◽  
Medical Nutrition Therapy ◽  
Living With Hiv ◽  
Medical Nutrition

<b><i>Introduction:</i></b> Previous studies have established the risk of bone loss among people living with HIV affected by antiretroviral therapy drug side effects and inadequate nutrient intake. Until recently, there have been limits on using the medical nutrition therapy (MNT) to improve dietary habits for promoting bone health among people living with HIV. This was a randomized controlled trial study aimed to investigate the effectiveness of MNT in improving the bone health in people living with HIV by promoting dietary habits. <b><i>Methods:</i></b> PLHIV at Queen Savang Vadhana Memorial Hospital were randomly grouped (by quota sampling) into the MNT group (intervention group) and the control group. One hundred and thirty PLHIV were recruited to participate in this study by convenient sampling. Sixty-five participants of the MNT group made a total of 6 appointments (for 12 weeks) to meet registered dietitians for receiving MNT to improve dietary habits for improving bone health, while 65 participants in the control group received only routine care at the hospital service center. <b><i>Results:</i></b> In general, participants in the MNT group had significant increase in the amounts of calcium, vitamin D, potassium, and phosphorus intakes and length of exercise after the final week compared with before intervention. Also, they had significantly higher amount of nutrient intakes (calcium, vitamin D, potassium, and phosphorus) and length of exercise than the control group after finishing the final week of the experiment. <b><i>Conclusion:</i></b> In conclusion, MNT is effective for improving food habits and physical activity to promote bone health among people living with HIV.

Impact of a New Parent Behavioral-Schema Training on Children with ADHD: A Pragmatic Control Trial

2020 ◽  
pp. 108705472095971
Author(s):  
Maly Solan ◽  
Anat Brunstein Klomek ◽  
Galia Ankori ◽  
Asheda Bloch ◽  
Alan Apter ◽  
...  
Keyword(s):  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Growth Curve Analysis ◽  
Long Term Effects ◽  
Hyperactivity Disorder ◽  
Behavioral Program ◽  
Symptom Relapse ◽  
Therapy Strategies

Objectives: To examine whether adding schema therapy strategies to the conventional parent behavioral program prevents symptom relapse in children with attention deficit hyperactivity disorder (ADHD). Method: The intervention was designed as an adaptive pragmatic control trial. The parent behavioral training and schema-enhanced parent behavior therapy (SPBT) protocols were delivered to the control group (40 parents of 23 children) and experimental group (97 parents of 54 children), respectively. Participants were assessed at baseline, mid-treatment, and termination. Parents and teachers indicated the severity of ADHD and comorbid symptoms through their responses to standardized questionnaires designed for this purpose. Results: A nested growth curve analysis demonstrated that participants in the schema-enhanced intervention group had a lower risk of symptom relapse than the control group. Conclusion: Participation in the SPBT program significantly reduced relapse rates by the end of the intervention. Future research may determine the long-term effects of the treatment.

scholarly journals Long-Term Effects of Financial Incentives for General Practitioners on Quality Indicators in the Treatment of Patients With Diabetes Mellitus in Primary Care—A Follow-Up Analysis of a Cluster Randomized Parallel Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Rahel Meier ◽  
Corinne Chmiel ◽  
Fabio Valeri ◽  
Leander Muheim ◽  
Oliver Senn ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Records ◽  
Financial Incentives ◽  
Controlled Trial ◽  
Intervention Group ◽  
Routine Data ◽  
Control Group ◽  
Long Term Effects ◽  
Patients With Diabetes

Background: The effect of financial incentives on the quality of primary care is of high interest, and so is its sustainability after financial incentives are withdrawn.Objective: To assess both long-term effects and sustainability of financial incentives for general practitioners (GPs) in the treatment of patients with diabetes mellitus based on quality indicators (QIs) calculated from routine data from electronic medical records.Design/Participants: Randomized controlled trial using routine data from electronic medical records of patients with diabetes mellitus of Swiss GPs.Intervention: During the study period of 24 months, all GPs received bimonthly feedback reports with information on their actual treatment as reflected in QIs. In the intervention group, the reports were combined with financial incentives for quality improvement. The incentive was stopped after 12 months.Measurements: Proportion of patients meeting the process QI of annual HbA1c measurements and the clinical QI of blood pressure levels below 140/85 mmHg.Results: A total of 71 GPs from 43 different practices were included along with 3,854 of their patients with diabetes mellitus. Throughout the study, the proportion of patients with annual HbA1c measurements was stable in the intervention group (78.8–78.9%) and decreased slightly in the control group (81.5–80.2%) [odds ratio (OR): 1.21; 95% CI: 1.04–1.42, p &lt; 0.05]. The proportion of patients achieving blood pressure levels below 140/85 mmHg decreased in the control group (51.2–47.2%) and increased in the intervention group (49.7–51.9%) (OR: 1.18; 95% CI: 1.04–1.35, p &lt; 0.05) where it peaked at 54.9% after 18 months and decreased steadily over the last 6 months.Conclusion: After the withdrawal of financial incentives for the GPs after 12 months, some QIs still improved, indicating that 1 year might be too short to observe the full effect of such interventions. The decrease in QI achievement rates after 18 months suggests that the positive effects of time-limited financial incentives eventually wane.

scholarly journals Mechanisms and Effects of a WeChat-Based Intervention on Suicide Among People Living With HIV and Depression: Path Model Analysis of a Randomized Controlled Trial

10.2196/14729 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e14729 ◽  
Author(s):  
Yiran Li ◽  
Yan Guo ◽  
Y Alicia Hong ◽  
Mengting Zhu ◽  
Chengbo Zeng ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Suicide Prevention ◽  
Perceived Stress ◽  
Mediating Effect ◽  
Path Model ◽  
Control Group ◽  
People Living With Hiv ◽  
Mhealth Intervention ◽  
Living With Hiv

Background People living with HIV and depression have high rates of suicide. Studies of mobile health (mHealth) interventions have shown feasibility, acceptability, and efficacy in improving mental health in people living with HIV and depression. However, few studies have examined the mechanisms and effects of mHealth interventions on suicide. Objective This study was designed to examine the mechanisms and effects of a WeChat-based intervention, Run4Love, on suicide among people living with HIV and depression in China, while considering perceived stress and depressive symptoms as mediators. Methods A sample of 300 People living with HIV and depression was recruited from the outpatient clinic of a large HIV or AIDS treatment hospital and was randomized to the Run4Love group or a control group. Data were collected at baseline, 3-, 6-, and 9-month follow-ups. Path analysis modeling, with longitudinal data, was used in data analyses. Results The Run4Love mHealth intervention had a direct effect on reducing suicide rate at the 6-month follow-up (beta=−.18, P=.02) and indirect effect through reducing perceived stress and depressive symptoms at the 3-month follow-up (beta=−.09, P=.001). A partial mediating effect between perceived stress and depressive symptoms accounted for 33% (–0.09/–0.27) of the total effect. Conclusions Through path analyses, we understood the mechanisms and effects of an mHealth intervention on suicide prevention. The findings underscored the importance of stress reduction and depression treatment in such a program. We call for more effective suicide prevention, especially mHealth interventions targeting the vulnerable population of people living with HIV and depression. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019

Effectiveness of a School-Based Intervention to Empower Children to Cope With Advertising

2020 ◽  
Vol 32 (3) ◽  
pp. 107-118 ◽  
Author(s):  
Esther Rozendaal ◽  
Bernd Figner
Keyword(s):  
Coping Strategies ◽  
Structural Equation ◽  
Coping Behavior ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Long Term Effects ◽  
Mixed Effect ◽  
School Based

Abstract. This study tested the effectiveness of a theory-driven, school-based advertising intervention entitled Ad Masters that aimed to stimulate children’s advertising coping behavior in the current media landscape. A cluster randomized controlled trial was completed among 704 children (7–12 years old) in schools. The schools were allocated to either the intervention group ( n = 399) or control group ( n = 305). Both short-term (directly after the intervention) and long-term effects (3 months after the end of the intervention) were measured. Bayesian mixed-effect analyses showed positive short- and long-term effects of the intervention on children’s understanding of advertising’s tactics. Structural equation analysis showed that the intervention-induced changes in children’s understanding of advertising’s tactics were not related to any changes in their use of advertising coping strategies or their advertising susceptibility. No other intervention effects were found. However, structural equation analyses showed that, regardless of the intervention, motivation and ability to use advertising coping strategies are both associated with children’s actual coping behavior. These findings indicate that motivation and ability to effectively use advertising coping strategies are important empowering factors that should be taken into account in future research on children’s advertising coping behavior and in advertising intervention development.

scholarly journals Mechanisms and Effects of a WeChat-Based Intervention on Suicide Among People Living With HIV and Depression: Path Model Analysis of a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Yiran Li ◽  
Yan Guo ◽  
Y Alicia Hong ◽  
Mengting Zhu ◽  
Chengbo Zeng ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Suicide Prevention ◽  
Perceived Stress ◽  
Mediating Effect ◽  
Path Model ◽  
Control Group ◽  
People Living With Hiv ◽  
Mhealth Intervention ◽  
Living With Hiv

BACKGROUND People living with HIV and depression have high rates of suicide. Studies of mobile health (mHealth) interventions have shown feasibility, acceptability, and efficacy in improving mental health in people living with HIV and depression. However, few studies have examined the mechanisms and effects of mHealth interventions on suicide. OBJECTIVE This study was designed to examine the mechanisms and effects of a WeChat-based intervention, <italic>Run4Love</italic>, on suicide among people living with HIV and depression in China, while considering perceived stress and depressive symptoms as mediators. METHODS A sample of 300 People living with HIV and depression was recruited from the outpatient clinic of a large HIV or AIDS treatment hospital and was randomized to the <italic>Run4Love</italic> group or a control group. Data were collected at baseline, 3-, 6-, and 9-month follow-ups. Path analysis modeling, with longitudinal data, was used in data analyses. RESULTS The <italic>Run4Love</italic> mHealth intervention had a direct effect on reducing suicide rate at the 6-month follow-up (beta=−.18, <italic>P</italic>=.02) and indirect effect through reducing perceived stress and depressive symptoms at the 3-month follow-up (beta=−.09, <italic>P</italic>=.001). A partial mediating effect between perceived stress and depressive symptoms accounted for 33% (–0.09/–0.27) of the total effect. CONCLUSIONS Through path analyses, we understood the mechanisms and effects of an mHealth intervention on suicide prevention. The findings underscored the importance of stress reduction and depression treatment in such a program. We call for more effective suicide prevention, especially mHealth interventions targeting the vulnerable population of people living with HIV and depression. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019

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