Feasibility of SMS Booster for Alcohol Reduction in Injury Patients in Tanzania

2021 ◽  
Author(s):  
Catherine A. Staton ◽  
Mary Catherine Minnig ◽  
Ashley J. Phillips ◽  
Arthi S. Kozhumam ◽  
Msafiri Pesambili ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Positive Impact ◽  
Traumatic Injury ◽  
Text Messages ◽  
Feasibility Trial ◽  
Middle Income ◽  
Harmful Alcohol ◽  
Message Service ◽  
The Impact

BackgroundAlcohol use is associated with 3 million annual deaths globally. Harmful alcohol use, which is particularly prevalent in low- and middle-income countries (LMICs), often increases the probability of traumatic injury. Treatments for harmful alcohol use in LMICs, such as Tanzania, lack trained personnel and adequate infrastructure. The aim of this study was to assess the feasibility of using SMS boosters to augment a hospital based brief intervention (BNI) in this low resourced setting.Methods:We conducted a three stage, four arm feasibility trial of a culturally adapted BNI for injury patients with harmful and hazardous drinking admitted to Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. Post hospital discharge, two of the four arms included patients receiving either a standard or personalized short message service (SMS) booster to enhance and or perpetuate the effect of the in-hospital BNI. Text messages were sent weekly throughout a 3-month follow-up period. SMS feasibility was assessed according to the TIDier checklist evaluating what, when, how much, tailoring processes, modifications and how well (intervention fidelity). Data was collected with SMS logs and short answer surveys to participants. Results:While 42 study participants were intended to each receive 12 SMS over a three-month period, 38 received messages correctly, 6 did not receive messages but were supposed to, and 1 received a message who was not supposed to. Of the 258 attempted texts, 73% were successfully sent through the messaging system. Of the messages that failed delivery, the majority were not able to be sent due to participants travelling out of cellular service range or turning off their phones. Participants in both booster arms reported that messages were appropriate, and that they would appreciate the continuation of such reminders. At 6-month follow-up, 100% (n=11) of participants believed that the boosters had a positive impact on their behavior, with 90% reporting a large impact.ConclusionThis study demonstrated feasibility and acceptability of the integration of SMS mobile health technology to supplement this type of nurse-led BNI. SMS booster is a practical tool that can potentially prolong the impact of a brief hospital based intervention to enact behavioral change in injury patients with AUD.

scholarly journals Does parental permissiveness toward cigarette smoking and alcohol use influence illicit drug use among adolescents? A longitudinal study in seven European countries

2021 ◽  
Author(s):  
Emina Mehanović ◽  
Federica Vigna-Taglianti ◽  
Fabrizio Faggiano ◽  
Maria Rosaria Galanti ◽  
Barbara Zunino ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Drug Use ◽  
Cigarette Smoking ◽  
Longitudinal Data ◽  
Illicit Drug ◽  
Large Population ◽  
Illicit Drug Use ◽  
European Countries ◽  
The Impact

Abstract Purpose Adolescents’ perceptions of parental norms may influence their substance use. The relationship between parental norms toward cigarette and alcohol use, and the use of illicit substances among their adolescent children is not sufficiently investigated. The purpose of this study was to analyze this relationship, including gender differences, using longitudinal data from a large population-based study. Methods The present study analyzed longitudinal data from 3171 12- to 14-year-old students in 7 European countries allocated to the control arm of the European Drug Addiction Prevention trial. The impact of parental permissiveness toward cigarettes and alcohol use reported by the students at baseline on illicit drug use at 6-month follow-up was analyzed through multilevel logistic regression models, stratified by gender. Whether adolescents’ own use of cigarette and alcohol mediated the association between parental norms and illicit drug use was tested through mediation models. Results Parental permissive norms toward cigarette smoking and alcohol use at baseline predicted adolescents’ illicit drug use at follow-up. The association was stronger among boys than among girls and was mediated by adolescents’ own cigarette and alcohol use. Conclusion Perceived parental permissiveness toward the use of legal drugs predicted adolescents’ use of illicit drugs, especially among boys. Parents should be made aware of the importance of norm setting, and supported in conveying clear messages of disapproval of all substances.

scholarly journals Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041599 ◽  
Author(s):  
Mary McCauley ◽  
Joanna Raven ◽  
Nynke van den Broek
Keyword(s):  
Low Income ◽  
Online Survey ◽  
Positive Impact ◽  
Healthcare Providers ◽  
International Medical ◽  
Middle Income ◽  
Use Of Resources ◽  
The Uk ◽  
Medical Volunteers ◽  
The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

scholarly journals Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes

10.2196/15927 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15927
Author(s):  
Scott Sittig ◽  
Jing Wang ◽  
Sriram Iyengar ◽  
Sahiti Myneni ◽  
Amy Franklin
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Text Messages ◽  
Feasibility Trial ◽  
Significant Difference ◽  
Within Subjects ◽  
The Impact

Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

scholarly journals Evaluation of an anti-stigma intervention for Mexican psychiatric trainees

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Emmeline Lagunes-Cordoba ◽  
Ruth Alcala-Lozano ◽  
Roberto Lagunes-Cordoba ◽  
Ana Fresan-Orellana ◽  
Manuela Jarrett ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Negative Attitudes ◽  
Middle Income ◽  
Self Reflection ◽  
Middle Income Countries ◽  
People With Mental Illness ◽  
Related Stigma ◽  
Health Related ◽  
The Impact

Abstract Background There is research evidence regarding the presence of stigmatising attitudes in psychiatrists towards people with mental illness, but a lack of studies and interventions focused on this issue in low and middle-income countries. Aims To assess the feasibility of implementing an anti-stigma intervention for Mexican psychiatric trainees, and its potential effects. Methods This study comprised a pre-post design with outcome measures compared between baseline and 3-month follow-up. Quantitative outcome measures were used to evaluate the potential effects of the intervention, whilst the process evaluation required the collection and analysis of both quantitative and qualitative data. Results Twenty-nine trainees (25% of those invited) participated in the intervention, of whom 18 also participated in the follow-up assessment. Outcome measures showed the intervention had moderately large effects on reducing stereotypes and the influence of other co-workers on trainees’ own attitudes. The main mechanisms of impact identified were recognition of negative attitudes in oneself and colleagues, self-reflection about the impact of stigma, one’s own negative attitudes and recognition of one’s ability to make change. Participants accepted and were satisfied with the intervention, which many considered should be part of their routine training. However, trainees’ work overload and lack of support from the host organisation were identified as barriers to implement the intervention. Conclusions A brief anti-stigma intervention for Mexican psychiatric trainees is feasible, potentially effective, well accepted and was considered necessary by participants. This study also suggests mechanisms of impact and mediators should be considered for developing further interventions, contributing to reducing the damaging effects that mental health-related stigma has on people’s lives.

scholarly journals Socioeconomic inequalities in lifestyle risk factors across low- and middle-income countries

2021 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer
Keyword(s):  
Risk Factors ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Socioeconomic Inequalities ◽  
Middle Income ◽  
Lifestyle Risk Factors ◽  
Middle Income Countries ◽  
The Poor ◽  
Harmful Alcohol ◽  
Lifestyle Risk

Abstract Background The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce their underlying risk factors, which are often linked to lifestyles. To effectively supplement nationwide policies with targeted interventions, it is important to know how these risk factors are distributed across socioeconomic segments of populations in LMICs. This study quantifies the prevalence and socioeconomic inequalities in lifestyle risk factors in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030. Methods Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with the different lifestyle risk factors. Results The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively − 0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off. The associations between the share of GDP spent on health and the socioeconomical distribution of lifestyle factors are multidirectional. Conclusions This study emphasizes the importance of lifestyle risk factors in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in lifestyle risk factors - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted to supplement nationwide policies.

scholarly journals A novel brief treatment for methamphetamine use disorders in South Africa: a randomised feasibility trial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
K. Sorsdahl ◽  
D. J. Stein ◽  
S. Pasche ◽  
Y. Jacobs ◽  
R. Kader ◽  
...  
Keyword(s):  
South Africa ◽  
Controlled Trial ◽  
Adverse Outcomes ◽  
Feasibility Trial ◽  
Control Group ◽  
Brief Treatment ◽  
Middle Income ◽  
Methamphetamine Use ◽  
Intention To Treat

Abstract Background Effective brief treatments for methamphetamine use disorders (MAUD) are urgently needed to complement longer more intensive treatments in low and middle income countries, including South Africa. To address this gap, the purpose of this randomised feasibility trial was to determine the feasibility of delivering a six-session blended imaginal desensitisation, plus motivational interviewing (IDMI) intervention for adults with a MAUD. Methods We enrolled 60 adults with a MAUD and randomly assigned them 1:1 to the IDMI intervention delivered by clinical psychologists and a control group who we referred to usual care. Feasibility measures, such as rates of recruitment, consent to participate in the trial and retention, were calculated. Follow-up interviews were conducted at 6 weeks and 3 months post-enrollment. Results Over 9 months, 278 potential particiants initiated contact. Following initial screening 78 (28%) met inclusion criteria, and 60 (77%) were randomised. Thirteen of the 30 participants assigned to the treatment group completed the intervention. Both psychologists were highly adherent to the intervention, obtaining a fidelity rating of 91%. In total, 39 (65%) participants completed the 6-week follow-up and 40 (67%) completed the 3-month follow-up. The intervention shows potential effectiveness in the intention-to-treat analysis where frequency of methamphetamine use was significantly lower in the treatment than in the control group at both the 6 week and 3-month endpoints. No adverse outcomes were reported. Conclusions This feasibility trial suggests that the locally adapted IDMI intervention is an acceptable and safe intervention as a brief treatment for MAUD in South Africa. Modifications to the study design should be considered in a fully powered, definitive controlled trial to assess this potentially effective intervention. Trial registration The trial is registered with the Pan African Clinical Trials Registry (Trial ID: PACTR201310000589295)

scholarly journals An Interactive Parent-Targeted Text Messaging Intervention to Improve Oral Health in Children Attending Urban Pediatric Clinics: Feasibility Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Belinda Borrelli ◽  
Michelle Henshaw ◽  
Romano Endrighi ◽  
William G Adams ◽  
Timothy Heeren ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Behaviors ◽  
Self Efficacy ◽  
Text Messaging ◽  
Text Messages ◽  
Feasibility Trial ◽  
Randomized Controlled ◽  
Oral Health Behaviors ◽  
Scale Range

BACKGROUND Effective preventive treatments for dental decay exist, but caries experience among preschoolers has not changed, with marked disparities in untreated decay. Despite near-universal use of SMS text messaging, there are no studies using text messages to improve the oral health of vulnerable children. OBJECTIVE This randomized controlled feasibility trial aimed to test the effects of oral health text messages (OHT) versus a control (child wellness text messages or CWT). OHT was hypothesized to outperform CWT on improving pediatric oral health behaviors and parent attitudes. METHODS Parents with a child aged &lt;7 years were recruited at urban clinics during pediatric appointments (79% [41/52] below poverty line; 66% [36/55] black) and randomized to OHT (text messages on brushing, dental visits, bottle and sippy cups, healthy eating and sugary beverages, and fluoride) or CWT (text messages on reading, safety, physical activity and development, secondhand smoke, and stress) groups. Automated text messages based on Social Cognitive Theory were sent twice each day for 8-weeks. Groups were equivalent on the basis of the number of text messages sent, personalization, interactivity, and opportunity to earn electronic badges and unlock animated characters. Assessments were conducted at baseline and 8 weeks later. Data were analyzed with linear mixed–effects models. RESULTS A total of 55 participants were randomized (28 OHT and 27 CWT). Only one participant dropped out during the text message program and 47 (24 OHT and 23 CWT) completed follow up surveys. Response rates exceeded 68.78% (1040/1512) and overall program satisfaction was high (OHT mean 6.3; CWT mean 6.2; 1-7 scale range). Of the OHT group participants, 84% (21/25) would recommend the program to others. Overall program likeability scores were high (OHT mean 5.90; CWT mean 6.0; 1-7 scale range). Participants reported high perceived impact of the OHT program on brushing their child’s teeth, motivation to address their child's oral health, and knowledge of their child's oral health needs (mean 4.7, 4.6, and 4.6, respectively; 1-5 scale range). At follow up, compared with CWT, OHT group participants were more likely to brush their children’s teeth twice per day (odds ratio [OR] 1.37, 95% CI 0.28-6.50) and demonstrated improved attitudes regarding the use of fluoride (OR 3.82, 95% CI 0.9-16.8) and toward getting regular dental checkups for their child (OR 4.68, 95% CI 0.24-91.4). There were modest, but not significant, changes in motivation (F1,53=0.60; <italic>P</italic>=.45) and self–efficacy (F1,53=0.24; <italic>P</italic>=.63) to engage in oral health behaviors, favoring OHT (<italic>d</italic>=0.28 and <italic>d</italic>=0.16 for motivation and self–efficacy, respectively). CONCLUSIONS The OHT program demonstrated feasibility was well utilized and appealing to the target population and showed promise for efficacy.

scholarly journals Volunteering via Smart-Phone for People With Psychosis—Protocol of a Feasibility Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Mariana Pinto da Costa ◽  
Phone Pal Advisory Groups
Keyword(s):  
Smart Phone ◽  
Outcome Data ◽  
Text Messages ◽  
Feasibility Trial ◽  
Second Phase ◽  
Retention Data ◽  
The United Kingdom ◽  
Two Phases ◽  
Communication Methods

The literature suggests that volunteering can be used to address social isolation and support patients with psychosis in the community. However, many expect in person meetings, requiring a greater effort of availability and commitment. There is therefore a need for more flexible, easily accessible support. Volunteering via smart-phone could be a useful intervention for people with psychosis. One patient and one volunteer have been matched for a duration of 12 weeks, and participants have been encouraged to communicate through a variety of communication methods (audio calls, video calls, text messages, WhatsApp messages and e-mails). The Phone Pal study aimed to investigate the feasibility of recruitment, participant retention, data collection procedures, intervention usage of the methods of communication and changes in outcome data. At baseline and follow-up outcome measures collected from patients and volunteers included their quality of life, physical activity, self-esteem and social comparison. Additional outcomes assessed patients' attachment, social contacts and symptoms; for volunteers, their social distance was evaluated. At follow-up both patients and volunteers rank their perception of their relationship with each other. This mixed method feasibility study has been conducted in two phases, the first stage evaluating a smaller sample of patients and volunteers recruited in London, and then a second phase with a larger sample of volunteers recruited from across the United Kingdom.Trial registration: ISRCTN17586238.

Socioeconomic inequalities in unhealthy lifestyles in low- and middle-income countries

2020 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Socioeconomic Inequalities ◽  
Individual Characteristics ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
The Poor ◽  
Harmful Alcohol ◽  
Low And Middle Income

Abstract Background: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce unhealthy lifestyles. To effectively target these interventions, it is important to know how unhealthy lifestyles vary with socioeconomic characteristics. This study quantifies prevalence and socioeconomic inequalities in unhealthy lifestyles in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030.Methods: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with different unhealthy lifestyles.Results: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively -0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off.Conclusions: This study emphasizes the importance of unhealthy lifestyles in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in unhealthy lifestyles - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted.

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