Delivering Anger Management Treatment through a Web-Based Intervention Supplemented with Brief Coaching: A Pilot Study (Preprint)

2019 ◽  
Author(s):  
Margaret-Anne Mackintosh ◽  
Carolyn J Greene ◽  
Lisa H Glassman ◽  
Emy A Willis ◽  
Kim M Schaper ◽  
...  

BACKGROUND Dysregulated anger as part of posttraumatic stress disorder (PTSD) can disrupt interpersonal functioning and negatively impact mental and physical health. However, many individuals are not able or willing to access clinic-based services. Self-management interventions, such as web-based programs, can reach those who need treatment but are not obtaining care from clinics. OBJECTIVE This paper describes a pilot study investigating a self-directed web-based anger management intervention, combined with brief clinician-level support, for veterans. METHODS The Anger and Irritability Management Skills (AIMS) course is an eight-session cognitive-behavioral program. This intervention was augmented with weekly phone-based coaching to enhance treatment engagement. Six males living on the Hawaiian Islands enrolled in the study. RESULTS Results broadly supported the feasibility, efficacy, and usability of the AIMS intervention with briefing coaching. Four of the six (67%) participants completed the study. Three of these four (75%) demonstrated statistically significant reductions in anger symptoms. AIMS received high usability ratings. Participants reported phone coaching to be helpful in completing the intervention and learning anger management skills. Individuals who terminated treatment early had higher anger and mental health scores at baseline compared to those who completed the intervention. CONCLUSIONS The AIMS intervention with brief clinician-level coaching performed well across several indicators, including feasibility, usability, treatment engagement, and initial efficacy. Results highlight the utility of self-management interventions along the continuum of care. CLINICALTRIAL pilot study

2020 ◽  
Author(s):  
Maggi Mackintosh

BACKGROUND Dysregulated anger as part of posttraumatic stress disorder (PTSD) can disrupt interpersonal functioning and negatively impact mental and physical health. However, many individuals are not able or willing to access clinic-based services. Self-management interventions, such as web-based programs, OBJECTIVE This paper describes a pilot study investigating a self-directed web-based anger management intervention, combined with brief clinician-level support, for veterans.can reach those who need treatment but are not obtaining care from clinics. METHODS The Anger and Irritability Management Skills (AIMS) course is an eight-session cognitive-behavioral program. This intervention was augmented with weekly phone-based coaching to enhance treatment engagement. Six males living on the Hawaiian Islands enrolled in the study. RESULTS Results broadly supported the feasibility, efficacy, and usability of the AIMS intervention with briefing coaching. Four of the six (67%) participants completed the study. Three of these four (75%) demonstrated statistically significant reductions in anger symptoms. AIMS received high usability ratings. Participants reported phone coaching to be helpful in completing the intervention and learning anger management skills. Individuals who terminated treatment early had higher anger and mental health scores at baseline compared to those who completed the intervention. CONCLUSIONS The AIMS intervention with brief clinician-level coaching performed well across several indicators, including feasibility, usability, treatment engagement, and initial efficacy. Results highlight the utility of self-management interventions along the continuum of care.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047921
Author(s):  
Anna Marcuzzi ◽  
Kerstin Bach ◽  
Anne Lovise Nordstoga ◽  
Gro Falkener Bertheussen ◽  
Ilya Ashikhmin ◽  
...  

IntroductionLow back pain (LBP) and neck pain (NP) are common and costly conditions. Self-management is a key element in the care of persistent LBP and NP. Artificial intelligence can be used to support and tailor self-management interventions, but their effectiveness needs to be ascertained. The aims of this trial are (1) to evaluate the effectiveness of an individually tailored app-based self-management intervention (selfBACK) adjunct to usual care in people with LBP and/or NP in secondary care compared with usual care only, and (2) to compare the effectiveness of selfBACK with a web-based self-management intervention without individual tailoring (e-Help).Methods and analysisThis is a randomised, assessor-blind clinical trial with three parallel arms: (1) selfBACK app adjunct to usual care; (2) e-Help website adjunct to usual care and (3) usual care only. Patients referred to St Olavs Hospital, Trondheim (Norway) with LBP and/or NP and accepted for assessment/treatment at the multidisciplinary outpatient clinic for back or neck rehabilitation are invited to the study. Eligible and consenting participants are randomised to one of the three arms with equal allocation ratio. We aim to include 279 participants (93 in each arm). Outcome variables are assessed at baseline (before randomisation) and at 6-week, 3-month and 6-month follow-up. The primary outcome is musculoskeletal health measured by the Musculoskeletal Health Questionnaire at 3 months. A mixed-methods process evaluation will document patients’ and clinicians’ experiences with the interventions. A health economic evaluation will estimate the cost-effectiveness of both interventions’ adjunct to usual care.Ethics and disseminationThe trial is approved by the Regional Committee for Medical and Health Research Ethics in Central Norway (Ref. 2019/64084). The results of the trial will be published in peer-review journals and presentations at national and international conferences relevant to this topic.Trial registration numberNCT04463043.


2021 ◽  
pp. 00158-2021
Author(s):  
Stephanie A. Robinson ◽  
J. Allen Cooper ◽  
Rebekah L. Goldstein ◽  
Madeline Polak ◽  
Paola N. Cruz Rivera ◽  
...  

Improving exercise capacity is a primary objective in chronic obstructive pulmonary disease (COPD). Declines in exercise capacity result in reduced physical activity (PA) and health-related quality of life (HRQL). Self-management interventions can teach patients skills and behaviours to manage their disease. Technology-mediated interventions have the potential to provide easily accessible support for disease self-management. We evaluated the effectiveness of a web-based self-management intervention, focused on PA promotion, on exercise capacity in COPD. This 6-month randomised controlled trial (NCT02099799) enrolled 153 persons with COPD at two U.S. sites (VABoston, n=108; VABirmingham, n=45). Participants were allocated (1:1) to the web-based self-management intervention (PA promotion through personalised, progressive step-count goals, feedback, online COPD-related education, and social support via an online community), or usual care. The primary outcome was exercise capacity (6-min walk test distance [6 MWD]). Secondary outcomes included PA (daily steps per day), HRQL (St. George's Respiratory Questionnaire Total Score), dyspnoea, COPD-related knowledge, and social support. Change in step-count goals reflected intervention engagement. Participants were 69±7 years old, mean FEV1% predicted 61±21%. Change in 6 MWD did not differ between groups. Intervention participants improved daily step counts by an average of 1312 more than usual care (p<0.001). Groups did not differ on other secondary outcomes. VABirmingham participants were significantly more engaged with the intervention, although site did not modify the effect of the intervention on 6 MWD or secondary outcomes. The intervention did not improve exercise capacity, but improved PA at 6 months. Additional intervention modifications are needed to optimise its COPD self-management capabilities.


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Yang ◽  
Z Hui ◽  
S Zhu ◽  
X Wang ◽  
G Tang ◽  
...  

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P &lt; 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.


2005 ◽  
Vol 11 (6) ◽  
pp. 297-302 ◽  
Author(s):  
Kristin J. Flynn ◽  
Lynda H. Powell ◽  
Carlos F. Mendes de Leon ◽  
Rocio Muñoz ◽  
Claudia B. Eaton ◽  
...  

10.2196/13579 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e13579 ◽  
Author(s):  
Yisselle Ilene Virella Pérez ◽  
Sharon Medlow ◽  
Jane Ho ◽  
Katharine Steinbeck

Background More adolescents with chronic physical illness are living into adulthood, and they require the development of proficient self-management skills to maintain optimal physical health as they transition into adult care services. It is often during this vulnerable transition period that deterioration in illness control is seen as a result of inadequate self-management skills and understanding of their chronic illness. Mobile technology has been proposed as an innovative opportunity to assist in improving the management of chronic conditions as young people transition to adult care services. Over the past 5 years, there has been a significant increase in research into the use of health-related apps. Objective This study aimed to evaluate the utility and effectiveness of mobile and Web-based health apps that support self-management and transition in young people with chronic physical health illnesses. Methods We conducted a comprehensive review of the literature in 5 bibliographic databases, using key search terms, considering only articles published from 2013, as we were extending the data from 2 previous systematic reviews. Abstracts were screened for possible inclusion by 2 reviewers. Data extraction and quality assessment tools were used for the evaluation of included studies. Results A total of 1737 records were identified from the combined electronic searches, and 854 records were removed as duplicates. A total of 68 full articles were further assessed for eligibility, and 6 articles met our review criteria: 3 pilot studies, 2 randomized controlled trials, and 1 prospective cohort study. Publication years ranged from 2015 to 2018. The apps reported were targeted at type 1 diabetes mellitus, epilepsy, asthma, beta thalassemia major, and sickle cell disease, with a combined sample size of 336. A total of 4 studies included in this review reported being effective in increasing knowledge of the targeted condition and increasing therapy adherence, including increased medication adherence. A total of 2 manuscripts only mentioned the word transition. Participant’s satisfaction was reported for all studies. Heterogeneity of the studies prevented meta-analysis. Conclusions There remain limited data on the effectiveness and use of mobile and Web-based apps, which might facilitate the transition of adolescents with chronic illnesses from pediatric to adult health care services. This systematic review provides an updated overview of available apps for adolescents with chronic illnesses. This systematic review has been unable to provide evidence for effectiveness of this approach, but it does provide insights into future study design, with reference to the development, evaluation, and efficacy of apps tailored for adolescents with chronic illnesses, including the involvement of adolescents in such designs. Trial Registration PROSPERO CRD42018104611; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=104611


2020 ◽  
Vol 1 (1) ◽  
pp. 49-57
Author(s):  
Iitáa Dáakuash ◽  
Alma McCormick ◽  
Shannen Keene ◽  
John Hallett ◽  
Suzanne Held

Chronic illness self-management best practices include goal-setting as an important tool for developing better self-management habits and are often included as elements of chronic disease self-management interventions. However, the goal theory that many of these tools employ relies on individualistic principles of self-efficacy that are not culturally consonant within many Indigenous communities. During the creation of the [blinded] program, a chronic illness management intervention, we developed a goal-setting tool specific to the [blinded] Nation. Emerging from an Indigenous paradigm and methodology, Counting Coup serves as a goal-setting tool that promotes the [blinded] culture, connects individuals with their ancestors, and focuses on achievement of goals within relationships. Future research and practice should be grounded in the historical and cultural contexts of their communities when designing and implementing goal-setting tools. Limitations to Counting Coup as a goal-setting tool include the need for program facilitators to have a relationship with participants due to Counting Coup’s foundation in relational accountability and that the environmental context may pose difficulties for participants in moving towards behavior change.


10.2196/33506 ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. e33506
Author(s):  
Anna Hatzioannou ◽  
Andreas Chatzittofis ◽  
Virginia Sunday Koutroubas ◽  
Evridiki Papastavrou ◽  
Maria Karanikola


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