scholarly journals Usage and weekly attrition from a smartphone based health behaviour intervention for adolescents: Pilot study (Preprint)

2020 ◽  
Author(s):  
Erlendur Egilsson ◽  
Ragnar Bjarnason ◽  
Urdur Njardvik
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Outcome Measures ◽  
Health Behaviour ◽  
Self Efficacy ◽  
Secondary Outcome ◽  
Specific Information ◽  
Attrition Rates ◽  
Mhealth Intervention ◽  
Time Specific

BACKGROUND Majority of adolescents own smartphones though only 8% of them use health apps. Attrition rates from adolescent mHealth interventions treating mental health problems, such as anxiety and depression, are an issue with high degree of variation and attrition rates. Attrition in mHealth interventions targeting adolescent populations is frequently presented in two-point fashion, from initiation of intervention to end of treatment, lacking more time-specific information on usage and times of attrition. Self-efficacy could provide avenue to lower attrition rates though a better understanding of the relationship between mental health factors and time specific attrition rates is needed. OBJECTIVE The study aimed at obtaining time-specific attrition rates among adolescents in an mHealth intervention and describe the intervention’s usage and feasibility in relation to adolescent self-efficacy levels, emotional- and physical health. METHODS A single-centre, randomized controlled elementary school pilot trial was undertaken with 41 adolescents. Outcome measures were assessed at baseline and after 6-weeks while in-app activity and attrition rates were continually assessed throughout intervention period. Primary outcome was attrition based on time and type of in-app health behaviour usage and feasibility of mHealth app. Secondary outcome measures were self-efficacy levels, depressive- and anxiety symptoms as well as BMI-SDS and sleep. Analyses of group mean variances with adjusted alpha levels through Bonferroni corrections were used to assess main outcome effects. RESULTS Attrition from initiation of intervention to 6-weeks follow-up was 35%. Attrition started in 3rd week of intervention and was related to daily time of app usage (Rt = 0.43, p <.05.). Average weekly in-app health exercises decreased significantly from 1st week of intervention (M = 55.25, SD = 10.96) to the next (M = 13.63, SD = 2.94). However, usage increased by 22% between week 2 and last week of intervention (M = 16.69, SD = 8.37). Usability measures revealed satisfactory scores or 78.09 (SD = 9.82) without gender differences (P=.85). Self-reported daily physical activity increased by 19.61% in intervention group while dropping by 26.21% among controls. Self-efficacy levels were increased by 8.23% in invention arm compared to 3.03% decrease in control group. CONCLUSIONS This pilot study demonstrated the feasibility and usability of a mHealth intervention among adolescent participants. Indications were towards beneficial effects on physical and mental health that warrant further research. Focus on time-specific attrition measures alongside daily times of usage and ways to increase participants’ self-efficacy levels appear to be a promising avenue for research on mHealth interventions for adolescent populations with the aim to ultimately lower attrition rates. CLINICALTRIAL

scholarly journals Usage and Weekly Attrition in a Smartphone-Based Health Behavior Intervention for Adolescents: Pilot Randomized Controlled Trial

10.2196/21432 ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. e21432
Author(s):  
Erlendur Egilsson ◽  
Ragnar Bjarnason ◽  
Urdur Njardvik
Keyword(s):  
Mental Health ◽  
Health Behavior ◽  
Outcome Measures ◽  
Self Efficacy ◽  
Secondary Outcome ◽  
Specific Information ◽  
Attrition Rates ◽  
Mhealth Intervention ◽  
Randomized Controlled ◽  
Time Specific

Background The majority of adolescents own smartphones, although only 8% of them use health apps. Attrition rates from adolescent mobile health (mHealth) interventions for treating mental health problems such as anxiety and depression are an issue with a high degree of variation. Attrition in mHealth interventions targeting adolescent populations is frequently presented in a two-point fashion, from initiation of the intervention to the end of treatment, lacking more time-specific information on usage and times of attrition. Self-efficacy could provide an avenue to lower attrition rates, although a better understanding of the relationship between mental health factors and time-specific attrition rates is needed. Objective The aims of this study were to obtain time-specific attrition rates among adolescents in an mHealth intervention, and to describe the intervention’s usage and feasibility in relation to adolescent self-efficacy levels, and emotional and physical health. Methods A single-center randomized controlled public school pilot trial was undertaken with 41 adolescents. Outcome measures were assessed at baseline and after 6 weeks, while in-app activity and attrition rates were continually assessed throughout the intervention period. The primary outcome was attrition based on time and type of in-app health behavior usage, and feasibility of the mHealth app. Secondary outcome measures were self-efficacy levels, depressive and anxiety symptoms, as well as standardized BMI and sleep. Analyses of group mean variances with adjusted α levels through Bonferroni corrections were used to assess main outcome effects. Results The attrition from initiation of the intervention to 6-week follow up was 35%. Attrition started in the third week of the intervention and was related to daily time of app usage (Rt=0.43, P<.001). The number of average weekly in-app health exercises completed decreased significantly from the first week of the intervention (mean 55.25, SD 10.96) to the next week (mean 13.63, SD 2.94). However, usage increased by 22% between week 2 and the last week of the intervention (mean 16.69, SD 8.37). Usability measures revealed satisfactory scores (mean 78.09, SD 9.82) without gender differences (P=.85). Self-reported daily physical activity increased by 19.61% in the intervention group but dropped by 26.21% among controls. Self-efficacy levels increased by 8.23% in the invention arm compared to a 3.03% decrease in the control group. Conclusions This pilot study demonstrated the feasibility and usability of an mHealth intervention among adolescent participants. Indications were toward beneficial effects on physical and mental health that warrant further research. Focus on time-specific attrition measures alongside daily times of usage and ways to increase participants’ self-efficacy levels appear to be a promising avenue for research on mHealth interventions for adolescent populations with the aim to ultimately lower attrition rates.

Synthesised Geriatric Assessment in the Emergency Department setting: is it NEAT?

2014 ◽  
Vol 38 (4) ◽  
pp. 370 ◽  
Author(s):  
Alan Nguyen ◽  
Lahn Straney ◽  
Peter Cameron ◽  
Judy Lowthian
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Outcome Measures ◽  
Geriatric Assessment ◽  
Patient Characteristics ◽  
Functional Independence ◽  
Secondary Outcome ◽  
Screening Instruments ◽  
Geriatric Screening ◽  
Time Critical

Objective To assess the time taken to complete a Synthesised Geriatric Assessment (SGA) in an Emergency Department (ED) and to determine what secondary patient characteristics affect results. Methods A convenience sample of 25 patients aged over 65 from an Australian single-centre ED was used for this pilot study. Primary outcome measures included the overall time taken as well as the times for individual screening instruments. Data regarding patient characteristics were taken as secondary outcome measures to assess impact on times. For each of the screening instruments, the mean, median, interquartile range and the 90th percentile for the test duration was calculated. Linear regression was used to evaluate univariate associations between times and patient characteristics. P-values < 0.05 were considered as statistically significant. Results Time required for completion of the SGA by 90% of the study population was 20 min and 40 s. This represents approximately 8.6% of new 4-h ED targets. Secondary characteristics that affected the time taken for screening included patients from non-English-speaking backgrounds (P < 0.05). Conclusions Use of the SGA for intra-ED geriatric risk stratification is feasible and practical in the time-critical National Emergency Access Target (NEAT) environment. The relatively short amount of time used for screening this vulnerable demographic has implications for interdisciplinary management and potentially represents an efficient intervention to reduce future re-presentations and overcrowding in Australian EDs. Future high-quality trials are required to assess the clinical benefit of the SGA. What is known about the topic? The newly introduced ED NEAT encourages patient discharge from ED within 4 h of arrival, placing increased pressure on ED protocols to be time efficient, while still maintaining safe quality care. The Comprehensive Geriatric Assessment in inpatient and ED settings has demonstrated improved outcomes in populations aged > 65, including parameters of ED re-presentations, functional independence and short-term mortality. Geriatric emergency patient guidelines have been recently adopted in the US and UK which incorporate intra-ED geriatric screening processes. Studies focusing on the feasibility of geriatric screening in Australian EDs are scarce. What does this paper add? Our pilot study focuses on the timing requirements of geriatric screening in time-critical ED environments. We analysed the time taken to conduct a SGA that was developed for a large research project, and the secondary patient characteristics that affected these times. Our paper provides valuable information for Australian EDs when considering the introduction of geriatric screening into EDs to optimise the care and outcomes of this patient group. Analysis of secondary patient characteristics and data patterns will further help EDs and future research into design of new protocols. What are the implications for practitioners? The results of our pilot study suggest that use of the SGA in Australian ED settings is feasible and practical. By using the results of our pilot study, EDs and clinician researchers can make informed decisions about implementation of new protocol to manage older patients. We suggest that implementation of intra-ED geriatric screening assessments will result in improved patient outcomes, including long-term functional independence and decreased rates of ED re-presentation. This in turn would help to unclog our currently overloaded EDs.

scholarly journals Douching With Water Works Device for Perceived Vaginal Odor With or Without Complaints of Discharge in Women With No Infectious Cause of Vaginitis: A Pilot Study

2006 ◽  
Vol 2006 ◽  
pp. 1-4 ◽  
Author(s):  
Ashwin J. Chatwani ◽  
Sarmina Hassan ◽  
Salma Rahimi ◽  
Stacey Jeronis ◽  
Vani Dandolu
Keyword(s):  
Pilot Study ◽  
Outcome Measures ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Open Label ◽  
Significant Change

Objective. To determine if douching with Water Works device for 1 month can (1) lower or eliminate perceived vaginal odor by subject; (2) have any effects on vaginal ecosystem.Methods. Ten women with perceived vaginal odor with or without discharge, douched every day for 4 weeks in an open-label, nonrandomized pilot study. Primary outcome measures included perceived vaginal odor by subject, lactobacilli score from Nugent slide, and acceptance of the Water Works douching system. Secondary outcome included the safety of using this douching device.Results. At week 4, there was improvement in vaginal odor (P=.0006) and there was no significant change in lactobacilli score.Conclusion. Douching with Water Works device is associated with reduction or elimination of vaginal odor without adversely affecting the vaginal ecosystem.

scholarly journals Screening for burn-out in Australian medical students undertaking a rural clinical placement

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029029 ◽  
Author(s):  
Vivian Isaac ◽  
Craig S McLachlan ◽  
Lucie Walters ◽  
Jennene Greenhill
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Social Isolation ◽  
Outcome Measures ◽  
Self Efficacy ◽  
Rural Practice ◽  
Clinical Placement ◽  
Secondary Outcome ◽  
Factors Associated ◽  
Burn Out

ObjectiveTo investigate Australian medical student burn-out during rural clinical placement. Second, to examine the association between perceived burn-out and rural career intent at the time of finishing their rural placement.Design, settings and participantsThe 2016 Federation of Rural Australian Medical Educators evaluation survey is a cross-sectional study of medical students from 17 Australian universities. Specifically, those medical students who completed a full academic year or more at a Rural Clinical School (RCS). Responses from 638 medical students from regional Australia were analysed in the study of all eligible 756 medical students (response rate 84.3%).Primary and secondary outcome measuresThe primary objective was to determine self-reported burn-out (emotional exhaustion) in rural placements for medical students. Secondary outcome measures were designed to explore interactions with rural practice self-efficacy and rural intentions. Logistic regression models explored factors associated with burn-out.Results26.5% of students reported experiencing burn-out during a rural placement. Factors associated with burn-out were female gender, rural origin, low preference for RCS, stress in the year prior to a rural clinical placement, perceived social isolation during rural placement and lower rural practice self-efficacy. Burn-out was not associated with rural career intentions. Social isolation and low rural self-efficacy were independently associated with burn-out during rural placement and together explained 10% of variance in burn-out (Model Nagelkerke R2=0.23).ConclusionBurn-out during rural placement may be a consequence of stress prior to a medical school placement. Social isolation and rural self-efficacy are amendable factors to mitigate medical student burn-out during rural placements.

scholarly journals Changes in self-efficacy in Japanese school-age children with and without high autistic traits after the Universal Unified Prevention Program: a single-group pilot study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Takuya Oka ◽  
Shin-ichi Ishikawa ◽  
Aya Saito ◽  
Kazushi Maruo ◽  
Andrew Stickley ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Skills ◽  
Pilot Study ◽  
Prevention Program ◽  
Self Efficacy ◽  
Mental Health Problems ◽  
Autistic Traits ◽  
General Mental Health ◽  
Universal Program ◽  
School Based

Abstract Background Research has shown the efficacy of school-based programs for mental health problems in children. However, few studies have focused on the strengths of children, such as resilience, which is essential in preventing mental health problems. Moreover, no research has investigated the effect of a universal school-based program on children with increased autistic traits in mainstream classes. We examined the changes in children's self-efficacy, social skills, and general mental health after the implementation of a newly developed universal program, the Universal Unified Prevention Program for Diverse Disorders (Up2-D2), and whether similar changes occurred in children with and without higher autistic traits. Methods To assess possible changes associated with the program, questionnaires were collected from 396 children (207 boys and 189 girls) aged 9–12 years old before (T1), immediately after (T2), and three months after (T3) the implementation of the program. Results Results from a linear mixed-effects model showed a significant increase in children's self-efficacy at T2 (adjusted difference 0.49, 95% CI 0.03–0.94; p < 0.05) and T3 (0.78, 95% CI 0.32–1.23; p < 0.001). There were also significant positive changes in social skills and general mental health. Similar changes were observed in children with high autistic traits. Autistic traits at T1 did not contribute to the degree of change in self-efficacy. Conclusions Our pilot study suggests that a universal program has the potential to promote positive attitudes and mental health in both at-risk and not-at-risk children.

Feasibility and Acceptability of Video narratives intervention to Promote Medication Understanding and Use Self-Efficacy: A Pilot Study on Post-Stroke Patients (Preprint)

2019 ◽  
Author(s):  
Jamuna Appalasamy ◽  
Siva Seeta Ramaiah ◽  
Joyce Pauline Joseph ◽  
Kia Fatt Quek ◽  
Anuar Zaini Md Zain ◽  
...  
Keyword(s):  
Pilot Study ◽  
Patient Education ◽  
Outcome Measures ◽  
Self Efficacy ◽  
Medical Information ◽  
Dropout Rate ◽  
Controlled Study ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Post Stroke

BACKGROUND A large number of the world’s post-stroke survivors suffers from moderate to severe disability. Long-term uncontrolled stroke risk factor led to unforeseen recurrent stroke and a growing number of stroke occurrence across ages in Malaysia. This situation has led to research works tapping into patient education, especially related to the self-efficacy of understanding and taking medication appropriately. Video narratives integrated with Health Belief Model (HBM) constructs have displayed potential impact as an aide to patient education efforts. OBJECTIVE This pilot study aimed to investigate the feasibility and acceptability of study procedures based on a trial protocol of video narratives intervention among post-stroke patients. In this paper, we report the preliminary efficacy of video narratives on medication understanding and use self-efficacy (MUSE). METHODS A parallel-group, randomized controlled study was conducted at the neurology outpatient clinic on post-stroke patients (N=54). Baseline data included patients’ socio-demographics, medical information, and all outcome measures. Post measurement of MUSE and blood parameters were done during 3 months follow-up. Feasibility of the study included recruitment and study completion rate with patients’ feedback on the burden of study procedures and outcome measures. Whereas, acceptability of study were analyzed qualitatively. Few statistical analyses were applied to ascertain preliminary results of the video narratives. RESULTS The recruitment rate was (60/157) 38%. Nevertheless, the dropout rate of (6/60) 10% was within the acceptable range. Patients were aged between 21 and 74 years. Over 85% of them had adequate health literacy and exposure to stroke education. Most patients (> 80%) were diagnosed with ischemic stroke whereby the majority were primarily hypertensive. The technicality of randomization and patient approach were carried out with minimal challenge and adequate patient satisfaction. However, the burden of outcome measures received some concerns. The video contents received good responses about its comprehension and simplicity. Moreover, an in-depth phone interview with 8 patients found the video narratives useful and inspiring. This findings also paralleled significant preliminary improvement in MUSE (P<0.05). CONCLUSIONS The queries and feedback noted from each study’s phase in the pilot study had been acknowledged, and thus, convincingly would be taken forward to the full trial. CLINICALTRIAL Universal Trial Number (UTN) U1111-1201-3955

An Efficient System for Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Pilot Study (Preprint)

2020 ◽  
Author(s):  
Nicolae Goga ◽  
Costin-Anton Boiangiu ◽  
Andrei Vasilateanu ◽  
Alexandru-Filip Popovici ◽  
Marius-Valentin Drăgoi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Outcome Measures ◽  
Effect Size ◽  
Traumatic Event ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Large Effect Size ◽  
Efficient System ◽  
Significant Difference ◽  
Post Test

BACKGROUND EMDR is a psychological therapy designed to treat emotional distress caused by a traumatic event from the past, most frequently in the PTSD treatment. We implemented a system based on video, tactile and audio sensors which includes an artificial intelligence chatbot that can replace the trained clinician in the EMDR procedure, thus making the system capable to act autonomously. OBJECTIVE This pilot study aims to develop an EMDR virtual assistant capable of assisting a user in performing an efficient therapy with a minimal intervention of a trained clinician. METHODS An EMDR virtual assistant was created that include audio, video and tactile sensors. A total of 31 participants were included in the pilot study, 14 males and 17 females, with ages between 19 and 33, (Mage = 26.2, SD = 4.21). Participants were invited to remember a traumatic event from their past that caused them discomfort, and they failed to overcome it. After accessing the traumatic memory, primary outcome measures (IES-R and STAI) and secondary outcome measures (VOC and SUD) instruments were applied in the pre-test condition. The designed intervention through application consisted of four phases of bilateral stimulation (visual, auditive, and sensorial). After the discussion with a specialist, and after the completion of the instruments on the pre-test assessment phase, the participants self-administered the intervention through the application and then completed again the instruments in the post-test phase. RESULTS The results showed that there was a significant difference in scores for the pre-test condition (M = 39.8, SD = 14.07) and post-test (M = 13.7, SD = 5.7) measured with IES-R scale; t(30) = 10.5, p < 0.001, and a large effect size (d = 1.89). Also, there are significant differences in scores for the pre-test condition (M = 56.7, SD = 8.3) and post-test (M = 33.8, SD = 4.6) regarding anxiety scores (STAI); t(30) = 11.7, p < 0.001, and a large effect size (d = 2,11) of intervention in reducing anxiety associated with the traumatic event. Related to the secondary outcome measure there was a significant pre- to post-intervention reduction in scores for both VOC; t(30) = 46.8, p < 0.00, and SUD; t(30) = 75.9, p < 0.001. It was shown that the higher scores decreased significantly at the end of the intervention. CONCLUSIONS Our results proved the efficiency of the virtual assistant system for EMDR in reducing anxiety, distress, and negative cognitions and emotions associated with traumatic memories. These findings are filling a gap in the existing literature regarding the efficiency and use of similar systems and could represent a starting point for developing applications and future controlled trials and protocols that can be used in similar cases.

scholarly journals Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) Program for Older Adults with Cognitive Concerns: Pilot Study Protocol

2021 ◽  
Vol 5 (1) ◽  
pp. 143-152
Author(s):  
Kerryn E. Pike ◽  
Carl I. Moller ◽  
Christina Bryant ◽  
Maree Farrow ◽  
Duy P. Dao ◽  
...  
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Outcome Measures ◽  
Memory Performance ◽  
Secondary Outcome ◽  
Access Barriers ◽  
Post Intervention ◽  
Cognitive Changes ◽  
Memory Strategies ◽  
Increased Risk

Memory interventions for older adults with cognitive concerns result in improved memory performance and maintenance of cognitive health. These programs are typically delivered face-to-face, which is resource intensive and creates access barriers, particularly for those with reduced mobility, limited transportation, and living in rural or remote areas. The COVID-19 pandemic has created an additional access barrier, given the increased risk this disease poses to older adults. Internet-based interventions seek to overcome these barriers. This paper describes the protocol of a pilot study that aims to evaluate the feasibility, acceptability, and efficacy of one such internet-based intervention: the Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) program. OPTIMiSE focuses on improving knowledge regarding memory and providing training in effective memory strategies for everyday life. The pilot study described in this protocol will be a single-arm pre-post study of 8 weeks duration, with a single maintenance session 3 months post-intervention. Participants will be Australian adults aged ≥60 years reporting cognitive changes compared with 10 years ago. Primary outcome measures will address feasibility, acceptability, and efficacy. Secondary outcome measures assessing sense of community and self-efficacy will be administered at the 8-week and 3-month timepoints. Data collection will conclude mid-2021, and results will be presented in a subsequent publication. Translation of memory interventions to internet-based delivery has the potential to remove many access barriers for older adults; however, the acceptability and feasibility of this modality needs investigation. OPTIMiSE is the initial step in what could be an important program enabling access to an evidence-based memory intervention for older adults worldwide. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12620000979954

Sign in / Sign up

Export Citation Format

Share Document