scholarly journals Prevention of alcohol and other drug use using motivational interviewing among young adults in the Ukraine

2016 ◽  
Vol 1 (1) ◽  
pp. 010111 ◽  
Author(s):  
Svitlana Polshkova ◽  
Diana Voloshina ◽  
Rebecca Cunningham ◽  
Robert Zucker ◽  
Maureen Walton
Keyword(s):  
Alcohol Consumption ◽  
Drug Use ◽  
Emerging Adults ◽  
Brief Intervention ◽  
Intervention Group ◽  
Hospital Setting ◽  
World Health ◽  
Control Group ◽  
Risky Drinking ◽  
National Medical

Background World Health Organization data shows alarming rates of alcohol consumption among those ages 15 and older in the Ukraine. This study examined the feasibility and initial efficacy of a brief intervention to reduce risky drinking among emerging adults (ages 18-25) in the Ukraine. Methods Emerging adults presenting to two settings were screened for risky drinking (Railway Clinical Hospital and Kiev National Medical University), with those screening positive on the AUDIT-C (>5) enrolled in the study: 59 participants from the hospital setting (mean age = 22.6 (2.1), 55.9% male) and 61 participants from the university setting (mean age = 20.1(2.3), 55.7% male). After self-administering a computerized baseline assessment, participants were randomized to receive an in-person brief intervention with telephone booster or to a control condition; participants self-administered a computerized follow-up at 3 months. Results Regression analyses were conducted, separately for each setting, predicting alcohol outcomes (alcohol consumption and consequences); models controlled for baseline alcohol levels and condition assignment (brief intervention or control). In both settings, the brief intervention group showed significantly less alcohol consumption and consequences at 3-months as compared to the control group (p<.001); however, the groups did not significantly differ on other drug use (DAST-10 score). Conclusion Findings suggest that brief motivational interventions are promising for reducing risky drinking among emerging adults in the Ukraine in both inpatient hospital and university settings. Future studies are needed to replicate these findings and extend these effects to reduce other drug use among young people in the Ukraine.

scholarly journals Factors prolonging the period of sobriety in young patients with alcohol use

2020 ◽  
pp. 57-70
Author(s):  
Svitlana Polshkova ◽  
Oleg Chaban
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Emerging Adults ◽  
Brief Intervention ◽  
Intervention Group ◽  
Young Patients ◽  
Control Group ◽  
Risky Drinking ◽  
Quality Of Life Scale

Alcohol beverages became a regular part of the everyday life of society. This is particularly true for those in social environments when alcohol is using for socializing. Due to this fact, it is easy to fail to notice the health and social damage caused by alcohol drinking. In the pilot study we examined the feasibility and initial efficacy of a brief intervention on reducing risky drinking among emerging adults in Ukraine. Patients were evaluated in 3 months after the brief motivational intervention (BMI). We included patients who successfully completed the pilot study (all of them had an opportunity to visit our clinic after completing the study for free if necessary). We had 2 groups of participants: (1-st group - young patients of Railway Clinical Hospital, with risky drinking (AUDIT-C> 5); and, 2-nd group - students of the National Medical University OO Bogomolets, with risky drinking (AUDIT-C> 5). All participants were evaluated using set of tests (Structured Interview (personal data, substance use, substance use treatment history, medical history), AUDIT-C, RAPI, DMQ, Quality of Life Scale (O. Chaban, 2009), BSSS, PHQ-9, GAD-7, BPAQ-SF) in 4 years after taking part in a pilot study when they obtained BMI. We also evaluated many factors including the frequency of participants’ visits to our clinic after completing the pilot study. Participants from the university setting were significantly younger, and single (as opposed to married), with fewer children comparing to participants in the hospital setting. Regression analyses were conducted, separately for each setting, predicting alcohol outcomes (consumption and consequences). In both settings, the brief intervention group (BI group) showed significantly less alcohol consumption and consequences after 4 years period compare to the control group (p<0.001). However university group showed more cases of sobriety disruption during this period. Among the BMI sample showed lower level of depressive and anxiety symptoms according to PHQ-9 and GAD-7 scales, relative to the control group. Also, the brief intervention group showed a higher level of quality of life relative to the control group. Also the aggression level was different in BMI and control groups (control group showed higher level of aggression). However, there are some differences between patients and students samples with BMI in the results of quality of life scale. This result can be related to the quality of sobriety period in these groups and to the presence of higher level of aggression (including indirect aggression - guilty feelings, according to BPAQ-SF) in students sample. The data obtained indicate that BMI are promising for reducing risky drinking among emerging adults in the Ukraine in both settings (patient hospital and university).

scholarly journals Healthy eating and lifestyle in pregnancy (HELP): a cluster randomised trial to evaluate the effectiveness of a weight management intervention for pregnant women with obesity on weight at 12 months postpartum

2021 ◽  
Author(s):  
Sharon A. Simpson ◽  
Elinor Coulman ◽  
Dunla Gallagher ◽  
Karen Jewell ◽  
David Cohen ◽  
...  
Keyword(s):  
Weight Management ◽  
Healthy Eating ◽  
Primary Outcome ◽  
Intervention Group ◽  
Control Group ◽  
Risky Drinking ◽  
Management Intervention ◽  
Cluster Randomised ◽  
Secondary Outcomes ◽  
Weight Management Intervention

Abstract Objective To assess whether a weight management intervention for pregnant women with obesity was effective in reducing body mass index (BMI) 12 months after giving birth. Methods Pragmatic, cluster randomised controlled trial (RCT) with embedded cost-effectiveness analysis. 598 women with a BMI of ≥30 kg/m2 (between 12 and 20 weeks gestation) were recruited from 20 secondary care maternity units in England and Wales. BMI at 12 months postpartum was the primary outcome. A range of clinical and behavioural secondary outcomes were examined. Interventions Women attending maternity units randomised to intervention were invited to a weekly weight management group, which combined expertise from a commercial weight loss programme with clinical advice from midwives. Both intervention and control participants received usual care and leaflets on diet and physical activity in pregnancy. Results Mean (SD) BMI at 12 months postpartum was 36.0 kg/m2 (5.2) in the control group, and 37.5 kg/m2 (6.7) in the intervention group. After adjustment for baseline BMI, the intervention effect was −0.02 (95% CI −0.04 to 0.01). The intervention group had an improved healthy eating score (3.08, 95% CI 0.16 to 6.00, p < 0.04), improved fibre score (3.22, 1.07 to 5.37, p < 0.01) and lower levels of risky drinking at 12 months postpartum compared to the control group (OR 0.45, 0.27 to 0.74, p < 0.002). The net incremental monetary benefit was not statistically significantly different between arms, although the probability of the intervention being cost-effective was above 60%, at policy-relevant thresholds. Conclusions There was no significant difference between groups on the primary outcome of BMI at 12 months. Analyses of secondary outcomes indicated improved healthy eating and lower levels of risky drinking. Trial registration: Current Controlled Trials ISRCTN25260464.

A RANDOMIZED TRIAL TO MEASURE THE OPTIMAL ROLE OF THE PHARMACIST IN PROMOTING EVIDENCE-BASED ANTIBIOTIC USE IN ACUTE CARE HOSPITALS

2001 ◽  
Vol 17 (2) ◽  
pp. 171-180 ◽  
Author(s):  
George Dranitsaris ◽  
Diana Spizzirri ◽  
Monique Pitre ◽  
Allison McGeer
Keyword(s):  
Acute Care ◽  
Broad Spectrum ◽  
Randomized Clinical Trials ◽  
Intervention Group ◽  
Hospital Setting ◽  
Control Group ◽  
Evidence Based ◽  
Care Hospital ◽  
Broad Spectrum Antibiotics ◽  
The Impact

Background: There is a considerable gap between randomized clinical trials and implementing the results into practice. This is particularly relevant in the use of broad-spectrum antibiotics in hospitals. Hospital pharmacists can be effective vehicles for bridging this gap and promoting evidence-based medicine. To determine the most effective way of using the pharmacist in this role, a prospective cefotaxime intervention study was conducted with randomization incorporated into the design as well as patient-related therapeutic outcomes.Methods: A total of 323 patients who were prescribed cefotaxime were randomized into an intervention or nonintervention group where only the former was challenged by pharmacists for inappropriate cefotaxime usage relative to hospital guidelines. The primary outcome was the appropriateness of cefotaxime prescribing between groups. Logistic regression analysis was then used to identify factors that were associated with successful clinical response.Results: Overall, 94% of orders in the intervention group met cefotaxime dosage criteria compared with 86% in the control group (p = .018). However, there was no impact with respect to promoting cefotaxime use for an appropriate indication (81% vs. 80%; p = .67). There was a trend for improved clinical outcomes in patients who received cefotaxime within hospital guidelines (OR = 1.73; p = .31).Conclusions: The pharmacist as a vehicle for promoting the appropriate use of broad-spectrum antibiotics in the acute care hospital setting can improve the dosing of such agents. However, several barriers to optimizing the impact of the pharmacist were implied by the data. Removing these barriers could increase the pharmacists' utility as an agent for improved patient care.

Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Silvina Catuara-Solarz ◽  
Bartlomiej Skorulski ◽  
Inaki Estella ◽  
Claudia Avella-Garcia ◽  
Sarah Shepherd ◽  
...  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Intervention Group ◽  
Well Being ◽  
Self Report ◽  
World Health ◽  
Randomised Control Trial ◽  
Control Group ◽  
Mental Well Being ◽  
Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

scholarly journals The Effect of Health Literacy Counselling on Self-Care in Women after Mastectomy: a Randomized Clinical Trial

2020 ◽  
Vol 9 (1) ◽  
pp. 39-45
Author(s):  
Masoume Rastegar ◽  
Zohreh Mahmoodi ◽  
Sara Esmaelzadeh Saeieh ◽  
Nasibeh Sharifi ◽  
Kourosh Kabir
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Health Literacy ◽  
Intervention Group ◽  
Self Care ◽  
Essential Element ◽  
World Health ◽  
Control Group ◽  
Fars Province ◽  
The Mean

Introduction: Breast cancer has a high prevalence, constituting a major cause of mortality in women around the world. Health literacy has a vital role in the self-care of chronic diseases such as cancer and is an essential element in the ability of each person to engage with health promotion. The aim of this study was to determine effect of health literacy counselling on selfcare in women after mastectomy. Methods: This study is a randomized, controlled, clinical trial carried out on 72 women with breast cancer after mastectomy in Fars province. The eligible women entered the study using convenience sampling and were then divided into an intervention and a control group through randomized blocks of four. Health literacy questionnaire and self-care questionnaire were distributed among the participants before, immediately after and three weeks following the intervention. Data analysis was performed in SPSS ver.13. Results: The results showed no significant differences between the two groups in terms of their health literacy and self-care scores before the intervention (P=0.299 and 0.059). A comparison of the mean values showed a greater increase in the mean score of health literacy and score of selfcare immediately and three weeks after the intervention in the intervention group compared to the control group. Also, the mean score of the dimensions of self-care in chemotherapy increased over time in the intervention group. Conclusion: The findings of this study confirm the higher effectiveness of counseling with a health literacy approach on overall self-care in chemotherapy and all its dimensions.

Interprofessional Teamwork Innovation Model (ITIM) to promote communication and patient-centred, coordinated care

2018 ◽  
Vol 27 (9) ◽  
pp. 700-709 ◽  
Author(s):  
Jing Li ◽  
Preetham Talari ◽  
Andrew Kelly ◽  
Barbara Latham ◽  
Sherri Dotson ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Intervention Group ◽  
Hospital Setting ◽  
Control Group ◽  
Difference In Difference ◽  
Academic Medical Centre ◽  
Difference Analysis ◽  
Interprofessional Teamwork ◽  
Innovation Model ◽  
Ed Visits

BackgroundDespite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM).MethodsThis quality improvement (QI) study was conducted at an academic medical centre. We followed the system’s QI framework, FOCUS-PDSA, with Lean as guiding principles. Primary outcomes included 30-day all-cause same-hospital readmissions and 30-day emergency department (ED) visits. The intervention group consisted of patients receiving care on two hospitalist ITIM teams, and patients receiving care from other hospitalist teams were matched with a control group. Outcomes were assessed using difference-in-difference analysis.ResultsTeam members reported enhanced communication and overall time savings. In multivariate modelling, patients discharged from hospitalist teams using the ITIM approach were associated with reduced 30-day same-hospital readmissions with an estimated point OR of 0.56 (95% CI 0.34 to 0.92), but there was no impact on 30-day same-hospital ED visits. Difference-in-difference analysis showed that ITIM was not associated with changes in average total direct costs nor average cost per patient day, after adjusting for all other covariates in the models, despite the addition of staff resources in the ITIM model.ConclusionThe ITIM approach facilitates a collaborative environment in which patients and their family caregivers, physicians, nurses, pharmacists, case managers and others work and share in the process of care.

Abstract WP221: Very Brief Intervention Improves Stroke Response in a Randomized Trial: Stroke Ready Very Brief Intervention

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Lesli E Skolarus ◽  
Maria Cielito Robles ◽  
Springer Mellanie ◽  
Chun Chieh Lin ◽  
Casey Corches ◽  
...  
Keyword(s):  
Brief Intervention ◽  
Action Plan ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Average Score ◽  
Control Group ◽  
Symptom Recognition ◽  
Stroke Symptom ◽  
One To One

Introduction: Stroke pre-hospital delay has not improved over time. Hypothesis: Stroke Ready, a very brief (5 minute), theory based, peer-led, stroke preparedness intervention, will increase stroke response compared with a control intervention. Methods: We performed a randomized, single-blind controlled trial among adults in Flint, MI. The stroke preparedness intervention group received a Stroke Ready pamphlet and action plan, while the control group received stroke prevention materials - both delivered during a one-to-one interaction with a trained peer educator. Research staff, blinded to group intervention assignment, assessed baseline and immediate post-intervention outcomes. Primary outcome was change in stroke response (behavioral intent to call 911) using a community-modified stroke action test (range 0-12). Secondary outcome was change in stroke symptom recognition (range 0-8). We conducted descriptive analyses and used a linear regression model to evaluate the effect of the intervention on stroke response after adjustment for pre-intervention intent, age, education, race, marital status, history of stroke, stroke in someone they know and psychological constructs. Results: We enrolled 129 participants (74 intervention; 55 control). Mean age was 60 years (SD 14); 61% were women, 89% were African American and 19% were not high school graduates. Intervention participants had greater improvement in stroke response than control participants (figure 1), which remained after full adjustment (improvement in average score for stroke response was 1.7 higher in intervention participants than control participants, 95% CI 0.9-2.5, p<0.0001). There was no difference in stroke symptom recognition (figure 1). Conclusion: The Stroke Ready very brief intervention increased stroke response. This new approach using a very brief, one-to-one interaction with trained peer educators is a promising, scalable, intervention to increase stroke response.

scholarly journals Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Isabel Rodríguez-Gallego ◽  
Fatima Leon-Larios ◽  
Cecilia Ruiz-Ferrón ◽  
Maria-de-las-Mercedes Lomas-Campos
Keyword(s):  
Support Groups ◽  
Exclusive Breastfeeding ◽  
Intervention Group ◽  
World Health ◽  
Control Group ◽  
Breastfeeding Initiation ◽  
Primary Health ◽  
Breastfeeding Rate ◽  
Breastfeeding Rates ◽  
The Impact

Abstract Background In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn’s first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3–4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. Methods/design This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants’ breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn’s life. Discussion There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. Trial registration The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529). Date recorded: 17/06/2020.

scholarly journals PENGARUH SENAM HIPERTENSI TERHADAP PENURUNAN TEKANAN DARAH PADA PENDERITA HIPERTENSI

2019 ◽  
Vol 9 (02) ◽  
pp. 80-87
Author(s):  
Dewi Rury Arindari ◽  
Hendi Rifqi Alhafis
Keyword(s):  
Blood Pressure ◽  
Health Center ◽  
Blood Pressure Reduction ◽  
Intervention Group ◽  
World Health ◽  
Bivariate Analysis ◽  
Control Group ◽  
P Value ◽  
Average Value ◽  
Work Area

One in ten adults in the world has high blood pressure. World Health Organization (WHO) year (2016) called hypertension as "an epidemic that spreads beyond. Management of hypertension from it all can be prevented through nonpharmacological therapy that is by exercising regularly. According to data obtained from the Alang-Alang Lebar Public Health Center in Palembang it is known that the number of hypertensive sufferers in 2018 is 1,781 people. The purpose of this study was to determine the effect of hypertension exercise on blood pressure reduction in the Alang - Alang Lebar Puskesmas Work Area in 2019. This research method uses Quasy Experiment with a Non-Equivolent Control Group. The population of this study was all hypertension sufferers in the Work Area of Alang-Alang Lebar Health Center in Palembang in January - March 2019 as many as 84 people. The sample used in this study was a portion of the population, namely some patients with hypertension in the Alang-Alang Lebar Puskesmas Work Area in Palembang totaling 30 respondents. Data analysis uses univariate and bivariate analysis. The results showed an average value of blood pressure in the control group before hypertension was 160.56/100.56 mmHg and the intervention group averaged 159.4/96.6 mmHg. After hypertension gymnastics, the mean blood pressure in the control group was 160/99.44 mmHg and in the intervention group the average value was 136.11/93.89 mmHg. The results of the bivariate analysis revealed that there was an effect of hypertension exercise on the reduction of blood pressure in the Work Area of Palembang Alang-Alang Lebar Health Center in 2019 p value = 0,000. The results of this study can be used as one of the considerations in providing alternative non-pharmacological therapies in non-communicable disease (PTM) programs at the Alang-Alang Lebar Health Center in Palembang.

scholarly journals Results of a person-centered maternal health quality improvement intervention in Uttar Pradesh, India

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242909
Author(s):  
Dominic Montagu ◽  
Katie Giessler ◽  
Michelle Kao Nakphong ◽  
Kali Prasad Roy ◽  
Ananta Basudev Sahu ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Maternal Health ◽  
Intervention Group ◽  
Uttar Pradesh ◽  
World Health ◽  
Quality Improvement Intervention ◽  
Control Group ◽  
Process Of Care ◽  
Quality Improvement Process ◽  
Improvement Intervention

Background Poor patient experiences during delivery in Uttar Pradesh, India is a common problem. It delays presentation at facilities after the onset of labor and contributes to poor maternal health outcomes. Patient-centered maternity care (PCMC) is recognized by the World Health Organization as critical to overall quality. Changing PCMC requires changing the process of care, and is therefore especially challenging. Methods We used a matched case-control design to evaluate a quality improvement process directed at PCMC and based on widely established team-based methods used in many OECD countries. The intervention was introduced into three government facilities and teams supported to brainstorm and test improvements over 12 months. Progress was measured through pre-post interviews with new mothers, scored using a validated PCMC scale. Analysis included chi-squared and difference-in-difference tests. Findings On a scale to 100, the PCMC score of the intervention group increased 22.9 points compared to controls. Deliveries attended by midwives, dais, ASHAs or non-skilled providers resulted in significantly higher PCMC scores than those attended to by nurses or doctors. The intervention was associated with one additional visit from a doctor and over two additional visits from nurses per day, compared to the control group. Interpretation This study has demonstrated the effectiveness of a team-based quality improvement intervention to ameliorate women’s childbirth experiences. These improvements were locally designed and led, and offer a model for potential replication.

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