scholarly journals The Challenges of Engaging Users with Diabetes Apps: A Randomized Controlled Trial of two Commercially Available Diabetes Apps (Preprint)

2020 ◽  
Author(s):  
Alita Maharaj ◽  
David Lim ◽  
Rinki Murphy ◽  
Anna Serlachius
Keyword(s):  
Outcome Measures ◽  
Behaviour Change ◽  
Self Care ◽  
Secondary Outcome ◽  
Behaviour Change Techniques ◽  
User Engagement ◽  
Illness Beliefs ◽  
Glucose Testing ◽  
Management Interventions ◽  
Clinical Support

BACKGROUND Diabetes apps represent a promising addition to face-to-face self-management interventions, which can be time and resource intensive. However, few randomised controlled trials have evaluated the efficacy of diabetes apps, in particular as a stand-alone intervention without additional clinical support. OBJECTIVE We used a parallel group randomised trial design to investigate user engagement of two commercially available apps (free versions of Glucose Buddy and mySugr) over two weeks. We hypothesised higher user engagement would be associated with improved self-care behaviours and illness beliefs in adults with type 2 diabetes (T2D). METHODS Adults with T2D attending outpatient diabetes clinics in Auckland were recruited and randomised (1:1 without blinding) to use either the Glucose Buddy or mySugr diabetes apps. User engagement and self-care behaviours (primary outcome measures) and illness beliefs (secondary outcome) were measured two weeks after baseline. Spearman’s correlations, Mann-Whitney U tests and Wilcoxon-signed ranks tests were used to explore associations between the outcome measures, as well as to investigate changes between and within groups. Six participants were interviewed to further explore acceptability and usability. RESULTS Fifty-eight participants (29/group) completed the two-week follow-up, out of which only 38 reported using the apps (Glucose Buddy = 20; mySugr = 18). Both groups reported low engagement (days used Mdn=4 for Glucose Buddy and Mdn=6.5 for mySugr, P=.06; minutes used Mdn=10 for both groups). No changes were observed in self-care or illness beliefs in either group. Out of the self-care behaviours, only blood glucose testing was significantly associated with minutes of app use (P=.02). The interviews suggested that although both apps were deemed acceptable, they were generally viewed as time-consuming and complex to use. CONCLUSIONS Low engagement with both Glucose Buddy and mySugr reflect the challenges associated with engaging users with diabetes apps. The results highlight the need for more clinical support as well as involvement from end users and behaviour change specialists in order to incorporate evidence-based behaviour change techniques to motivate and provide value to users. CLINICALTRIAL Registered with Australia New Zealand Clinical Trials Registry on March 23rd 2018 (ACTRN12618000424202).

Applying the COM-B behaviour model to overcome barriers to heart failure self-care: A practical application of a conceptual framework for the development of complex interventions (ACHIEVE study)

2020 ◽  
pp. 147451512095729
Author(s):  
Amanda Whittal ◽  
Stefan Störk ◽  
Barbara Riegel ◽  
Oliver Rudolf Herber
Keyword(s):  
Heart Failure ◽  
Behaviour Change ◽  
Complex Interventions ◽  
Self Care ◽  
Intervention Development ◽  
Heart Association ◽  
Barriers And Facilitators ◽  
Behaviour Change Techniques ◽  
Anticipated Regret ◽  
Management Interventions

Background: Effective interventions to enhance adherence to self-care recommendations in patients with heart failure have immense potential to improve health and wellbeing. However, there is substantial inconsistency in the effectiveness of existing self-management interventions, partly because they lack theoretical models underpinning intervention development. Aim: To outline how the capability, opportunity and motivation behaviour model has been applied to guide the development of a theory-based intervention aiming to improve adherence to heart failure self-care recommendations. Methods: The application of the capability, opportunity and motivation behaviour model involved three steps: (a) identification of barriers and facilitators to heart failure self-care from two comprehensive meta-studies; (b) identification of appropriate behaviour change techniques to improve heart failure self-care; and (c) involvement of experts to reduce and refine potential behaviour change techniques further. Results: A total of 119 barriers and facilitators were identified. Fifty-six behaviour change techniques remained after applying three steps of the behaviour model for designing interventions. Expert involvement ( n=39, of which 31 were patients (67% men; 45% New York Heart Association II)) further reduced and refined potential behaviour change techniques. Experts disliked some behaviour change techniques such as ‘anticipated regret’ and ‘salience of consequences’. This process resulted in a final comprehensive list consisting of 28 barriers and 49 appropriate behaviour change techniques potentially enhancing self-care that was put forward for further use. Conclusion: The application of the capability, opportunity and motivation behaviour model facilitated identifying important factors influencing adherence to heart failure self-care recommendations. The model served as a comprehensive guide for the selection and design of interventions for improving heart failure self-care adherence. The capability, opportunity and motivation behaviour model enabled the connection of heart failure self-care barriers to particular behaviour change techniques to be used in practice.

scholarly journals Using the behaviour change technique taxonomy v1 (BCTTv1) to identify the active ingredients of pharmacist interventions to improve non-hospitalised patient health outcomes

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036500
Author(s):  
Claire Scott ◽  
Mícheál de Barra ◽  
Marie Johnston ◽  
Marijn de Bruin ◽  
Neil Scott ◽  
...  
Keyword(s):  
Social Support ◽  
Behaviour Change ◽  
Secondary Outcome ◽  
Behaviour Change Techniques ◽  
Secondary Outcome Measure ◽  
Control Groups ◽  
Data Set ◽  
Pharmacist Interventions ◽  
Hospitalised Patient ◽  
And Control

ObjectivesThe aim of this study was to identify which behaviour change techniques (BCTs) were present in intervention and control groups of randomised controlled trials (RCTs) included in a Cochrane systematic review.SettingThe RCTs included were conducted in community, primary and/or ambulatory-care settings.ParticipantsThe data set was derived from 86 RCTs from an interim update of the Cochrane review of the effectiveness of pharmacist services on non-hospitalised patient outcomes.Primary and secondary outcome measuresThe primary outcome was the identification of BCTs scheduled for delivery in intervention and control groups of the RCTs. The secondary outcome measure was to identify which BCTs are not being utilised in intervention and control groups of the RCTs.ResultsThe intervention and control groups included 31 and 12 BCTs, respectively. The number of identifiable BCTs/study ranged from 0 to 12 in the intervention groups (mean 3.01 (SD 2.4)) and 0 to 6 in the control groups (mean 0.38 (SD 0.84)). The most commonly identified BCTs in the intervention groups were: instruction on how to perform the behaviour (55%, n=47) (also the most common BCT in control groups); problem solving (29%, n=25); information about health consequences (24%, n=21); social support (practical) (24%, n=21); and social support (unspecified) (23%, n=20) (the second most common BCT in control groups). Thirteen trials had no identifiable BCTs in either group.ConclusionThe pharmacist interventions presented in this study did not use the full range of available BCTs. Furthermore, the reporting of BCTs was incomplete for both intervention and control groups, thereby limiting the utility and reproducibility of the interventions. Future interventions should be designed and reported using relevant taxonomies and checklists for example, BCT taxonomy and TIDieR (the template for intervention description and replication).

scholarly journals What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028231 ◽  
Author(s):  
Laura Birch ◽  
Rachel Perry ◽  
Linda P Hunt ◽  
Rhys Matson ◽  
Amanda Chong ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Outcome Measures ◽  
Body Mass ◽  
Body Fat ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Percentage Body Fat ◽  
Management Interventions ◽  
Meta Regression ◽  
Change In Mean

ObjectiveUsing meta-regression this paper sets out the minimum change in body mass index-SD score (BMI-SDS) required to improve adiposity as percentage body fat for children and adolescents with obesity.DesignMeta-regression.SettingStudies were identified as part of a large-scale systematic review of the following electronic databases: AMED, Embase, MEDLINE via OVID, Web of Science and CENTRAL via Cochrane library.ParticipantsIndividuals aged 4–19 years with a diagnosis of obesity according to defined BMI thresholds.InterventionsStudies of lifestyle treatment interventions that included dietary, physical activity and/or behavioural components with the objective of reducing obesity were included. Interventions of <2 weeks duration and those that involved surgical and/or pharmacological components (eg, bariatric surgery, drug therapy) were excluded.Primary and secondary outcome measuresTo be included in the review, studies had to report baseline and post-intervention BMI-SDS or change measurements (primary outcome measures) plus one or more of the following markers of metabolic health (secondary outcome measures): adiposity measures other than BMI; blood pressure; glucose; inflammation; insulin sensitivity/resistance; lipid profile; liver function. This paper focuses on adiposity measures only. Further papers in this series will report on other outcome measures.ResultsThis paper explores the potential impact of BMI-SDS reduction in terms of change in percentage body fat. Thirty-nine studies reporting change in mean percentage body fat were analysed. Meta-regression demonstrated that reduction of at least 0.6 in mean BMI-SDS ensured a mean reduction of percentage body fat mass, in the sense that the associated 95% prediction interval for change in mean percentage body fat was wholly negative.ConclusionsInterventions demonstrating reductions of 0.6 BMI-SDS might be termed successful in reducing adiposity, a key purpose of weight management interventions.Trial registration numberCRD42016025317.

scholarly journals Enhancing self-care adherence in patients with heart failure: a study protocol for developing a theory-based behaviour change intervention using the COM-B behaviour model (ACHIEVE study)

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e025907 ◽  
Author(s):  
Oliver Rudolf Herber ◽  
Louise Atkins ◽  
Stefan Störk ◽  
Stefan Wilm
Keyword(s):  
Heart Failure ◽  
Behaviour Change ◽  
Meta Analysis ◽  
Self Care ◽  
Normalisation Process Theory ◽  
Behaviour Change Techniques ◽  
Heinrich Heine ◽  
German Healthcare System ◽  
Registration Number ◽  
Underlying Mechanisms

IntroductionAlthough international guidelines recommend self-care as an integral part of routine heart failure management, and despite evidence supporting the positive outcomes related to self-care, patients are frequently unable to adhere. Self-care can be modified through behaviour change interventions (BCIs). However, previous self-care interventions have shown limited success in improving adherence to self-care, because they were neither theory-based nor well defined, which precludes the identification of underlying causal mechanisms as well as reproducibility of the intervention. Thus, our aim is to develop an intervention manual that contains theory-based BCIs that are well-defined using eight descriptors proposed to describe BCIs in a standardised way.Methods and analysisBCIs will be based on statements of findings derived through qualitative meta-summary techniques and a quantitative meta-analysis. These reviews will be used to extract factors (target behaviours) associated with self-care adherence/non-adherence. Extracted target behaviours will be mapped onto the ‘Capability, Opportunity, Motivation and Behaviour’ (COM-B) model to capture the underlying mechanisms involved. To develop approaches for change, the ‘Taxonomy of Behaviour Change Techniques’ will be used to allow effective mapping of the target behaviours onto established behaviour change techniques. Suggested BCIs will then be translated into locally relevant interventions using the Normalisation Process Theory to overcome the difficulties of implementing theoretically derived interventions into practice. Finally, a consensus development method will be employed to fine-tune the content and acceptability of the intervention manual to increase the likelihood of successfully piloting and implementing future BCIs into the German healthcare system.Ethics and disseminationThis study has been reviewed and approved by the Ethics Committee of the Medical Faculty of the Heinrich Heine University Düsseldorf, Germany (Ref #: 2018-30). The results will be disseminated via peer-reviewed journal publications, conference presentations and stakeholder engagement activities.Trial registration numberDRKS00014855; Pre-results.

scholarly journals Which behaviour change techniques are most effective in improving healthcare utilisation in COPD self-management programmes? A protocol for a systematic review

2019 ◽  
Vol 6 (1) ◽  
pp. e000369 ◽  
Author(s):  
Katelyn Rene Smalley ◽  
Lisa Aufegger ◽  
Kelsey Flott ◽  
Gracie Holt ◽  
Erik K Mayer ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Experimental Studies ◽  
Theoretical Domains Framework ◽  
Risk Of Bias ◽  
Self Management ◽  
Chronic Obstructive ◽  
Behaviour Change Techniques ◽  
Primary Analysis ◽  
Management Interventions

IntroductionSelf-management interventions are often presented as a way to improve the quality of care for patients with chronic illness. However, self-management is quite broadly defined and it remains unclear which types of interventions are most successful. This review will use the Theoretical Domains Framework (TDF) as a lens through which to categorise self-management interventions regarding which programmes are most likely to be effective and under which circumstances.The aim of this study is to (1) describe the types of self-management programmes that have been developed in chronic obstructive pulmonary disease (COPD) and identify the common elements between these to better classify self-management, and (2) evaluate the effect that self-management programmes have on the healthcare behaviour of patients with COPD by classifying those programmes by the behaviour change techniques used.Methods and analysisA systematic search of the literature will be performed in MEDLINE, EMBASE, HMIC and PsycINFO. This review will be limited to randomised controlled trials and quasi-experimental studies. The review will follow PRISMA-P guidelines, and will provide a PRISMA checklist and flowchart. Risk of bias in individual studies will be assessed using the Cochrane Risk of Bias criteria, and the quality of included studies will be evaluated using the GRADE criteria, and will be reported in a Summary of Findings table.The primary analysis will be a catalogue of the interventions based on the components of the TDF that were used in the intervention. A matrix comparing included behaviour change techniques to improvements in utilisation will summarise the primary outcomes.Ethics and disseminationNot applicable, as this is a secondary review of the literature.Prospero registration numberCRD42018104753.

scholarly journals Systematic Review of Behaviour Change Theories Implementation in Dietary Interventions for People Who Have Survived Cancer

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 612
Author(s):  
Jana Sremanakova ◽  
Anne Marie Sowerbutts ◽  
Chris Todd ◽  
Richard Cooke ◽  
Sorrel Burden
Keyword(s):  
Cancer Survivors ◽  
Behaviour Change ◽  
Cognitive Theory ◽  
Dietary Intervention ◽  
Cochrane Review ◽  
Change Theory ◽  
Behaviour Change Techniques ◽  
Limited Information ◽  
Dietary Interventions ◽  
Behaviour Change Theory

Background: An increasing number of dietary interventions for cancer survivors have been based on the behaviour change theory framework. The purpose of this study is to review the use and implementation of behaviour change theories in dietary interventions for people after cancer and assess their effects on the reported outcomes. Methods: The search strategy from a Cochrane review on dietary interventions for cancer survivors was expanded to incorporate an additional criterion on the use of behaviour change theory and updated to September 2020. Randomised controlled trials (RCT) testing a dietary intervention compared to the control were included. Standard Cochrane methodological procedures were used. Results: Nineteen RCTs, with 6261 participants (age range 44.6 to 73.1 years), were included in the review. The Social Cognitive Theory was the most frequently used theory (15 studies, 79%). Studies included between 4 to 17 behaviour change techniques. Due to limited information on the mediators of intervention and large heterogeneity between studies, no meta-analyses was conducted to assess which theoretical components of the interventions are effective. Conclusions: Whilst researchers have incorporated behaviour change theories into dietary interventions for cancer survivors, due to inconsistencies in design, evaluation and reporting, the effect of theories on survivors’ outcomes remains unclear.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

Three-Dimensional Printing in Cleft Care: A Systematic Review

2021 ◽  
pp. 105566562110131
Author(s):  
Farrukh R. Virani ◽  
Evan C. Chua ◽  
Mary Roz Timbang ◽  
Tsung-yen Hsieh ◽  
Craig W. Senders
Keyword(s):  
Systematic Review ◽  
3D Printing ◽  
Clinical Outcomes ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Secondary Outcome ◽  
Exclusion Criteria ◽  
3 Dimensional ◽  
Dimensional Printing

Objective: To determine the current applications of 3-dimensional (3D) printing in the care of patients with cleft lip and palate. We also reviewed 3D printing limitations, financial analysis, and future implications. Design: Retrospective systematic review. Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used by 3 independent reviewers. Articles were identified from Cochrane library, Ovid Medline, and Embase. Search terms included 3D printing, 3 dimensional printing, additive manufacturing, rapid prototyping, cleft lip, and cleft palate. Exclusion criteria included articles not in English, animal studies, reviews without original data, oral presentations, abstracts, opinion pieces, and articles without relevance to 3D printing or cleft lip and palate. Main Outcome Measures: Primary outcome measure was the purpose of 3D printing in the care of patients with cleft lip and palate. Secondary outcome measures were cost analysis and clinical outcomes. Results: Eight-four articles were identified, and 39 met inclusion/exclusion criteria. Eleven studies used 3D printing models for nasoalveolar molding. Patient-specific implants were developed via 3D printing in 6 articles. Surgical planning was conducted via 3D printing in 8 studies. Eight articles utilized 3D printing for anatomic models/educational purposes. 3-Dimensional printed models were used for surgical simulation/training in 6 articles. Bioprinting was utilized in 4 studies. Secondary outcome of cost was addressed in 8 articles. Conclusion: 3-Dimensional printing for the care of patients with cleft lip and palate has several applications. Potential advantages of utilizing this technology are demonstrated; however, literature is largely descriptive in nature with few clinical outcome measures. Future direction should be aimed at standardized reporting to include clinical outcomes, cost, material, printing method, and results.

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