Effectiveness of a Theory-Driven mHealth Intervention on Patients’ Post-Surgery Rehabilitation Adherence: A Randomized Clinical Trial (Preprint)

2020 ◽  
Author(s):  
Alfred Sing Yeung Lee ◽  
Patrick Shu-Hang Yung ◽  
Michael Tim-Yun Ong ◽  
Chris Lonsdale ◽  
Martin Hagger ◽  
...  

BACKGROUND Low adherence to post-surgery rehabilitation programs among anterior cruciate ligament (ACL) reconstruction patients is frequently reported. It is important to develop effective interventions that promote adherence to treatment and rehabilitation in ACL ruptured patients. OBJECTIVE This study aimed to assess effects of a theory-based smartphone-delivered intervention on ACL ruptured patients’ psychological, behavioral, and clinical outcomes during post-surgery rehabilitation period. METHODS We recruited 96 eligible participants (Mage = 27.824, SD = 8.732, range = 18 to 53; female = 38.947%) who underwent ACL reconstruction surgery. Participants were randomly assigned to a treatment group (n=41), which received standard post-surgical treatment and smartphone application (“ACL-Well”) delivering the intervention, or a control group (n=55), which received standard post-surgical treatment only. The primary outcomes were the recovery outcomes from ACL surgery, measured by knee muscle strength and laxity, and subjective knee evaluation completed 4-month post-intervention. Secondary outcomes were the psychological and behavioral outcomes measured at baseline within 2 weeks of surgery, and at 2- and 4-month post-intervention follow-up. RESULTS ANCOVA suggested no significant difference between the intervention and the control group in the recovery outcomes. Growth mixture modelling revealed self-determined treatment motivation declined significantly over the intervention period in the control group, but not in the intervention group. Intention and rehabilitation adherence also revealed similar patterns among patients who had lower levels of motivational or behavioral factors of rehabilitation at baseline. CONCLUSIONS The smartphone application developed in this project shows promise as a means to promote orthopedic outpatients’ motivation and adherence to treatment, but fell short in promoting recovery. Research on long-term effects of interventions are needed. CLINICALTRIAL HKUCTR-2761

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Mohammad Farhan Rusli ◽  
Nor Afiah Mohd Zulkefli ◽  
Muhammad Hanafiah Juni

Introduction: Knowledge on under-five childhood immunization has been identified as a key factor in determining understanding and compliance to the schedule. Understanding the current levels of knowledge and introducing a health intervention to improve the level will benefit the population to be healthier and reduce morbidity. Materials and Method: A quasi-experimental study was conducted in nurseries in Putrajaya and Cyberjaya, Malaysia from January 2016 to January 2018. 98 respondents from Putrajaya were given the technology based intervention and 98 from Cyberjaya were the wait-listed control group. Respondents answered a validated, self-administered questionnaire at baseline, immediate post-intervention and 3 months post-intervention that were specifically targeted to examine their levels of knowledge on under five childhood intervention. Results: Data was analysed using Statistical Package for Social Science (SPSS) Version 23. The level of knowledge at baseline was 58.9% for the intervention group and 61.7% for the control group with no significant difference between both groups (p=0.651). Immediate post intervention showed a significant difference (p<0.001) between the intervention group (97.7%) and control group (54.9%). As for 3 months post-intervention the intervention group was 95.5% and the control was at 85.1% (p<0.001). Conclusion: The level of knowledge improved after receiving the health intervention module and was effective in the increasing of knowledge among the respondents. However, there are still gaps in research that must be addressed in future studies to help further improve knowledge on under-five childhood immunization schedule.


Author(s):  
Mohammed DG ◽  
Habsah H ◽  
Naing NN ◽  
Rafie MA ◽  
Nadiah WA ◽  
...  

Objectives: We aimed to develop and evaluate the efficacy of a health education program for increasing knowledge, changing attitudes and promoting preventive practices to reduce the incidence of RTIs among Malaysian Hajj pilgrims.Methods: A quasi-experimental study was conducted among 132 Hajj pilgrims attending Hajj orientation programme organized by a private Hajj companies. Hajj pilgrims were sequentia lly enrolled and assigned to receive smartphone health education application in the intervent ion group (n = 66) and another different smartphone application on general Hajj process in the control group (n = 66). Data were collected from August 2018 to April 2019 at baseline prior to departure and post-intervention, immediately after return from Saudi Arabia using a validated questionnaire.Results: There was no significant difference with respect to socio-demographic characterist ics, KAP of the respondents in the intervention and control group at baseline. However, there was significant improvement in knowledge in the intervention group compared to the control group, based on time (p = 0.005, ἠ2 = 0.075) and group and time interaction (p = 0.031, ἠ2 = 0.046). Likewise, there was significant improvement in attitude based on time (p = 0.035, ἠ2 = 0.044). Similarly, there was significant main effect in practice based on time (p = <0.001, ἠ2 = 0.155) and interaction of group with time (p = 0.042, ἠ2 = 0.041).International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 30


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Younes Lotfi ◽  
Mahdieh Hasanalifard ◽  
Abdollah Moossavi ◽  
Enayatollah Bakhshi ◽  
Mohammad Ajalloueyan

Abstract Background The objective of this study was to evaluate the effect of “Spatially separated speech in noise” auditory training on the ability of speech perception in noise among bimodal fitting users. The assumption was that the rehabilitation can enhance spatial hearing and hence speech in noise perception. This study was an interventional study, with a pre/post-design. Speech recognition ability was assessed with the specific tests. After performing the rehabilitation stages in the intervention group, the speech tests were again implemented, and by comparing the pre- and post-intervention data, the effect of auditory training on the speech abilities was assessed. Twenty-four children of 8–12 years who had undergone cochlear implantation and continuously used bimodal fitting were investigated in two groups of control and intervention. Results The results showed a significant difference between the groups in different speech tests after the intervention, which indicated that the intervention group have improved more than the control group. Conclusion It can be concluded that “Spatially separated speech in noise” auditory training can improve the speech perception in noise in bimodal fitting users. In general, this rehabilitation method is useful for enhancing the speech in noise perception ability.


Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 83
Author(s):  
Alessandro Ghelardi ◽  
Roberto Marrai ◽  
Giorgio Bogani ◽  
Francesco Sopracordevole ◽  
Paola Bay ◽  
...  

Data suggest that adjuvant human papillomavirus (HPV)-vaccination in women treated for cervical HPV diseases reduces recurrent disease. This study investigates adjuvant HPV-vaccination and the rate of recurrence in women undergoing surgery for vulvar high-grade squamous intraepithelial lesions (HSIL). From January 2013 to April 2020, we enrolled 149 women in a prospective case-control study. The control group (NV-group) was treated by standard surgery alone, while the study group received adjuvant vaccination soon after surgery (V-group). A follow-up was performed by vulvoscopy and HPV test. Statistical analysis was performed by Fisher’s exact test. HSIL recurrence was observed in 24/76 (32%) patients in NV-group and in 8/42 patients (19%) of the vaccinated group. By analysing the recurrence rate related to the incident and reactivated latent HPV infection, we found a significant difference between (17/76) 22.3% in NV-group and (2/42) 4.8% in V-group (p = 0.01). A reduction of 78.5% in incident/reactivated HPV infections was demonstrated. Data results add to the current knowledge about the mechanism of post-surgical adjuvant HPV vaccination. Our prospective study is the first to document the vaccine clinical effectiveness in preventing “reactivation” of latent HPV infections. Quadrivalent HPV vaccine administered after the surgical treatment for vulvar HSIL appears to be useful in preventing recurrent disease.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
D. Santa Maria ◽  
C. Markham ◽  
S. M. Misra ◽  
D. C. Coleman ◽  
M. Lyons ◽  
...  

Abstract Background Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement. Methods Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11–14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level. Results Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period. Conclusion A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates. Trial registration ClinicalTrials.gov Identifier: NCT02600884. Prospectively registered September 1, 2015.


Author(s):  
Byamukama Topher ◽  
Keraka M. Margaret ◽  
Gitonga Eliphas

Background: Immunization is one of the most cost-effective public health interventions to reduce child mortality and morbidity associated with infectious diseases. The objective of this study was to determine the perceptions of caregivers on immunization in Ntungamo district.Methods: Quasi-experimental study was used with health centres assigned to intervention and control groups. Purposive sampling was used to select the two counties where the study was done. Proportional sampling was done to get study samples from each health facility, while systematic sampling was done to get study participants. A total of 787 children from twelve health facilities provided the study sample. A post intervention evaluation was conducted to determine the effect of these interventions. Association of variables was tested using Mann Whitney U-test and Chi-square.Results: On benefits, most caregivers in the intervention group (85.3%) and in the control group (54.3%) regarded immunization as very highly and moderately beneficial to their children respectively. On risks, most caregivers in the intervention group (85.5%) and control group (43.1%) regarded the risk factor associated with immunization as very low and moderate respectively. From hypothesis testing, there was a significant difference on the perceived benefits and risks of immunization between the intervention and control group.Conclusions: Most caregivers in the intervention and control group regarded immunization as very highly beneficial and moderately to their children respectively. Most of the caregivers in the intervention and control group regarded the risk factor associated with immunization as very low and moderate respectively. 


2018 ◽  
Vol 46 (5) ◽  
pp. 1143-1149 ◽  
Author(s):  
Shaohua Liu ◽  
Hong Li ◽  
Hongyue Tao ◽  
Yaying Sun ◽  
Shiyi Chen ◽  
...  

Background: The hamstring tendons are commonly harvested for anterior cruciate ligament (ACL) reconstruction with detachment of the tibial insertion. Retaining the insertion may help to preserve vascularity and viability of the graft and bypass the stages of avascular necrosis and revascularization, which might be beneficial to graft maturity. Purpose: To investigate and compare graft maturity by magnetic resonance imaging (MRI) after ACL reconstruction with preservation or detachment of hamstring tendon tibial insertion at up to 2 years. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Forty-five patients (age range, 18-45 years) undergoing isolated ACL reconstruction with hamstring tendon were enrolled and randomized to 2 groups. The tibial insertion of the hamstring tendon was preserved in the study group (n = 21) and detached in the control group (n = 24). Patients had follow-up at 3, 6, 12, and 24 months, which consisted of the following: (1) clinical examination and (2) MRI evaluation of graft signal intensity based on signal/noise quotient (SNQ) values. Finally, 18 patients in the study group and 19 in the control group received full follow-up evaluation (ie, at all 4 time points). Results: All knees acquired full range of motion at 24 months without significant laxity. At each time point, the KT-1000 arthrometer revealed no significant difference between groups; the clinical scores significantly improved in both groups, although the difference between groups was not significant. In the control group, the SNQ value increased from 3 months, peaked at 6 months, and then decreased (3 months, 21.4 ± 12.7; 6 months, 25.6 ± 12; 12 months, 18.3 ± 7.7; 24 months, 15.3 ± 6.3). However, the insertion-preserved graft in the study group maintained relatively lower and unchanged signal intensity throughout all time points (3 months, 15.0 ± 11.2; 6 months, 14.9 ± 6.3; 12 months, 12.6 ± 7.0; 24 months, 14.6 ± 7.0). Between groups, there was no significant difference at 3 or 24 months ( P = .11 and .75, respectively), while the SNQ values were significantly lower in the study group versus the control group at 6 and 12 months ( P = .002 and .02, respectively). Conclusion: The insertion-detached hamstring tendon grafts underwent a significantly increasing change in signal intensity during the first 2 years after ACL reconstruction, while the insertion-preserved grafts kept a relatively lower and unchanged signal intensity. The difference was most significant at 6 and 12 months postoperatively.


2020 ◽  
Vol 31 (3) ◽  
Author(s):  
Kristen Clatos ◽  
Matthew Asare

The purpose of the study is to evaluate pilot sexuality education intervention for parents of children with disabilities between ages between 6 and 25 years old. A within subjects design was utilized and 15 parents of children with disabilities were recruited to receive a two-week sexuality education without a control group. A paired-samples t-test results showed that there was a significant difference between the participants’ pre-test and post intervention scores in their attitude and beliefs, sexual communication, knowledge, and self-efficacy of sexuality education among children with disabilities (all p<.001). The intervention change the participants sexual communication behavior and increased knowledge about sexuality education among parents of children with disabilities.


2021 ◽  
Vol 11 (6) ◽  
pp. 342-348
Author(s):  
Nishat Tabassum ◽  
Sanghamitra Jena

Study Objective: To know about the effects of cryotherapy and active stretching together and active stretching alone for improving hamstring flexibility in asymptomatic individuals. Method: 22 subjects were participated in study of the age 18 to 40. Subjects were randomly and equally assigned to static stretching and cryotherapy (group 1) and only active stretching (group 2). Subjects in each group were given stretching and cryotherapy for three weeks. Pre and post assessment of ROM was measured by the KEA, SLR and Sit and reach test. Results: After three weeks of intervention there was a significant difference between pre intervention and post intervention score in both the group but in group 1 showed significant difference between KEA, SLR and SRT variables. Conclusion: Subject who received active stretching and cryotherapy showed better improvement than the control group who received only active stretching. Hence it can be concluded that active stretching along with cryotherapy can improve hamstring flexibility than the active stretching only. Key words: Cryotherapy, flexibility, ROM, active stretching.


2020 ◽  
Author(s):  
Saeideh Shahsavari ◽  
Sakineh dadipoor ◽  
Mohtasham Ghaffari ◽  
Ali Safari-Moradabadi

Abstract Background: The aim of the present study was to assess readiness to become or stay physically active according to the Stages of Change Model.Methods: The present quasi-experimental study was conducted on 100 women working in the healthcare centres of Bandar Abbas, Iran. The sampling method is clustering in type. The subjects were assigned into two groups of intervention and control. The collected data were analysed by SPSS-16 software using descriptive and inferential statistics, including independent-sample t-test, paired-sample t-test and Chi-square test.Results: Before the educational intervention, 19 subjects (0.38%) from the intervention group showed to have regular physical activity (4-5 stages). This number changed to 29 (0.58%) and 25 (0.50%) after three months and six months of intervention. A statistically significant difference was found before the intervention and 3 and 6 months afterwards (P˂.001). In the control group, no statistically significant difference was found between the pre-intervention and post-intervention (three months (P=.351) and six months (P=.687).Conclusion: The educational intervention based on the stages of behaviour change model showed to be effective in promoting the physical activity of employed women. These findings may benefit health education researchers and practitioners who tend to develop innovative theory-based interventions and strategies to increase the level of physical activity in women.


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