Evaluating the Impact of Alcohol Control Interventions on Suicide Mortality Rates

Introduction & Objective: Given that the impact of regulatory and public policy initiatives cannot usually be tested through traditional randomized controlled trial designs, well-selected, -designed, and -analyzed natural experiments are the method of choice when examining the effects of such enactments on a variety of outcomes. The classic methodology for such evaluations is interrupted time-series (ITS) analysis, which is considered as one of the quasi-experimental designs that use both pre- and post-policy data without randomization. This study tests the impact of alcohol control interventions implemented in different period of times on suicide mortality rates among people 25-74 years of age using ITS. Methods: We mainly use the generalized additive mixed model (GAMM) to capture trend and seasonality in suicide mortality rates while controlling for unemployment rates, financial crisis during 2007-2008, and legal alcohol consumption records. Given the notable differences in alcohol consumption and suicide mortality between males and females, all analyses are conducted gender-specifically. Results: The ITS shows that the intervention introduced in 2017 has a significant effect on reducing suicide mortality rates for males between 25 and 74. Following the implementation of the intervention, suicide mortality rates decreased by 23.8% (95% CI: 10.2% - 35.4%) on average. Conclusion: The alcohol control intervention that strictly increased the excise tax on alcohol products has been shown to have a strong impact on reducing suicide mortality rates among male adults 25-74 years of age. ITS analyses are one of the strongest evaluative designs and allow a more detailed assessment of the longitudinal impact of an intervention than may be possible with a randomized control trial.

Download Full-text

Investigating the Impact of Cognitive Training for Individuals With Bothersome Tinnitus: A Randomized Controlled Trial

Otolaryngology ◽

10.1177/0194599821994742 ◽

2021 ◽

pp. 019459982199474

Author(s):

Maggie Xing ◽

Dorina Kallogjeri ◽

Jay F. Piccirillo

Keyword(s):

Randomized Controlled Trial ◽

Cognitive Training ◽

Mixed Model ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Functional Index ◽

Open Label ◽

Randomized Controlled ◽

The Impact

Objective To evaluate the effectiveness of cognitive training in improving tinnitus bother and to identify predictors of patient response. Study Design Prospective open-label randomized controlled trial. Setting Online. Methods Participants were adults with subjective idiopathic nonpulsatile tinnitus causing significant tinnitus-related distress. The intervention group trained by using auditory-intensive exercises for 20 minutes per day, 5 days per week, for 8 weeks. The active control group trained on the same schedule with non–auditory intensive games. Surveys were completed at baseline, 8 weeks, and 12 weeks. Results A total of 64 participants completed the study. The median age was 63 years (range, 25-69) in the intervention group and 61 years (34-68) in the control group. Mixed model analysis revealed that within-subject change in Tinnitus Functional Index in the intervention group was not different than the control group, with marginal mean differences (95% CI): 0.24 (–11.20 to 10.7) and 2.17 (–8.50 to 12.83) at 8 weeks and 2.33 (–8.6 to 13.3) and 3.36 (–7.91 to 14.6) at 12 weeks, respectively. When the 2 study groups were compared, the control group had higher Tinnitus Functional Index scores than the intervention group by 10.5 points at baseline (95% CI, –0.92 to 29.89), 8.1 at 8 weeks (95% CI, –3.27 to 19.42), and 9.4 at 12 weeks (95% CI, –2.45 to 21.34). Conclusion Auditory-intensive cognitive training was not associated with changes in self-reported tinnitus bother. Given the potential for neuroplasticity to affect tinnitus, we believe that future studies on cognitive training for tinnitus remain relevant.

Download Full-text

The Use of Telehealth Technology in Assessing the Accuracy of Self-Reported Weight and the Impact of a Daily Immediate-Feedback Intervention among Obese Employees

International Journal of Telemedicine and Applications ◽

10.1155/2011/909248 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Nicolaas P. Pronk ◽

A. Lauren Crain ◽

Jeffrey J. VanWormer ◽

Brian C. Martinson ◽

Jackie L. Boucher ◽

...

Keyword(s):

Body Weight ◽

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Intervention Group ◽

Study Groups ◽

Outcome Variable ◽

Control Group ◽

Immediate Feedback ◽

The Impact

Objective.To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees.Methods.As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time.Results.At baseline, study participants underreported their weight by an average of 2.06 (se=0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group.Conclusions.The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight.

Download Full-text

Alcohol Use Disorder and Comorbid Depression: A Randomized Controlled Trial Investigating the Effectiveness of Supportive Text Messages in Aiding Recovery

Alcohol and Alcoholism ◽

10.1093/alcalc/agz060 ◽

2019 ◽

Vol 54 (5) ◽

pp. 551-558 ◽

Cited By ~ 3

Author(s):

Helen O’Reilly ◽

Aisling Hagerty ◽

Seamus O’Donnell ◽

Aoife Farrell ◽

Dan Hartnett ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Controlled Trial ◽

Text Messages ◽

Comorbid Depression ◽

Randomized Controlled ◽

Lower Alcohol ◽

The Impact

This randomized controlled trial examined the impact of daily supportive text messages over a six-month treatment period on mood and alcohol consumption in individuals with a dual diagnosis of alcohol use disorder (AUD) and depression. Results highlighted mood benefits at 3-month and lower alcohol consumption at 6-month treatment points.

Download Full-text

Evaluating the impact of a coach development intervention for improving coaching practices and player outcomes in netball: The MASTER coaching randomized control trial

International Journal of Sports Science & Coaching ◽

10.1177/1747954120976966 ◽

2020 ◽

pp. 174795412097696

Author(s):

Narelle Eather ◽

Andrew Miller ◽

Brad Jones ◽

Philip J Morgan

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Assessment Tool ◽

Controlled Trial ◽

Assessment Instrument ◽

Master Program ◽

Development Intervention ◽

Self Perceptions ◽

Coach Development ◽

The Impact

The aim of this randomized controlled trial was to evaluate the impact of a novel 8-week coach development intervention (MASTER) on game-based coaching practices of netball coaches from one netball club (n = 16; 8 intervention, 8 active-control; NSW Australia), and player outcomes for the junior athletes being coached. The multi-component MASTER intervention aimed to educate coaches on how to design and implement high quality game-based coaching sessions. The core pillar of MASTER is ‘positive coaching,’ delivered through games-based coaching practices. At baseline and 10-weeks, two coaching sessions per coach were filmed and assessed using the MASTER assessment tool. Players (8-16yrs; n = 85) were videoed during structured gameplay, with three aspects of game play assessed using Game Performance Assessment Instrument. Coaches and players (n = 75; 12-16yrs) completed a perceptions questionnaire. Using linear mixed model ITT analysis, significant interventions effects were observed for the primary outcome: percentage of time spent performing playing-form activities [25.7% (95% CI (7.79-43.65), P = 0.008, d = 1.52]. Significant interventions effects were also observed for coach perceptions, player game skills, and player self-perceptions (P < 0.05). No significant changes were observed for player enjoyment, motivation, or wellbeing. The MASTER program was effective in improving coach and player self-perceptions, and coaching practices of netball coaches during training sessions.

Download Full-text

Evaluation of a prescription support-tool for chronic management of oral antithrombotic combinations in adults using clinical vignettes: protocol of a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2018-025544 ◽

2019 ◽

Vol 9 (6) ◽

pp. e025544 ◽

Cited By ~ 1

Author(s):

Lorene Zerah ◽

Dominique Bonnet-Zamponi ◽

Paul Frappé ◽

Marie Hauguel-Moreau ◽

Yann De Rycke ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Online Survey ◽

Mixed Model ◽

Controlled Trial ◽

Real Life ◽

Bleeding Events ◽

Support Tool ◽

Clinical Vignettes ◽

Randomised Controlled ◽

The Impact

IntroductionImproving the appropriateness of prescriptions of oral antithrombotic (AT) drugs, especially AT combinations, is crucial because these drugs are implicated in bleeding events. We developed a prescription support-tool synthesising guidelines on chronic management of oral AT combinations. Our main objective is to assess the impact of this tool on improving the prescription of oral ATs to comply with guidelines.Methods and analysisA randomised controlled trial will be conducted among French general practitioners and cardiologists involved in outpatient settings. Physicians will be invited to participate to an online survey by email via physician associations, social networks or word of mouth. They will be randomised to two arms: the experimental arm (access to the prescription support-tool) or the control arm (no prescription support-tool). Then, all participants will be presented three different clinical vignettes illustrating outpatient clinical situations and will be asked to propose prescriptions for each vignette (number of ATs, type, dosage and duration). A computer-generated randomisation scheme implemented in the online survey will be used to allocate physicians to the experimental or control arm and then stratified by medical specialty. The primary outcome will be fully appropriate prescription of oral ATs ie, that comply with the guidelines in terms of number of drugs, drug class, dosage and duration. To demonstrate a 5% increase in this proportion, we will need to include a minimum of 230 physicians per arm. A logistic mixed model with a clinical vignette-effect and a physician-effect nested in the arm of the study will be used.Ethics and disseminationTheInstitutional Review Boardof Inserm (IRB00003888) approved our research project (no. 18–492). If the prescription support-tool improves the prescription of oral ATs, we will create an interactive web tool and will assess its impact in terms of clinical outcomes in real-life.Trial registration numberNCT03630874; Pre-results.

Download Full-text

Regional Variation and Socio-Economic Determinants of Suicide Mortality in Greece before and during Economic Crisis

Applied Sciences ◽

10.3390/app10176117 ◽

2020 ◽

Vol 10 (17) ◽

pp. 6117

Author(s):

Christos Zilidis ◽

Dimitrios Papagiannis ◽

Georgios Rachiotis

Keyword(s):

Mental Health ◽

Economic Crisis ◽

Regional Variation ◽

Correlation Coefficients ◽

Mortality Rates ◽

Suicide Mortality ◽

Related Factors ◽

Before And After ◽

Health Related ◽

The Impact

Background. Suicide mortality increased in Greece after the 2008 financial crisis. This study aimed to explore the regional variation of suicide mortality before and after the economic crisis, and its correlation with socio-economic and mental health-related variables factors. Methods. This is a quasi-experimental ecological study. Data from the national mortality statistics were analyzed, and standardized death rates and age-specific mortality rates were calculated. The effect of economic crisis was explored by comparing mortality rates before and after crisis onset. Pearson’s and Spearman’s correlation coefficients and multiple linear regression were used to assess the impact of socioeconomic and mental health-related factors on suicide mortality. Results. Trends of suicide mortality showed a rise during 2011–2014, followed by a decline during 2015–2016. Significant differences were observed between regions, ranging from 27.6% lower to 54% higher than the national average. Unemployment, income, and change of gross domestic product were significantly correlated with regional variation. No association was found with mental disorder mortality rates and psychotropic drug consumption. Conclusions. Socio-economic factors explained only a part of the suicide mortality variation. Mental health-related factors were not significantly correlated with suicide mortality. More research is needed to investigate other possible determinants of suicides.

Download Full-text

Cluster-randomised controlled trial of Stroke 1-2-0 education programme to reduce stroke prehospital delay in China: a study protocol

BMJ Open ◽

10.1136/bmjopen-2020-048064 ◽

2021 ◽

Vol 11 (5) ◽

pp. e048064

Author(s):

Yong Wang ◽

Yang Liu ◽

Renyu Liu ◽

Jing Zhao

Keyword(s):

Usual Care ◽

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Education Programme ◽

Primary Objective ◽

Prehospital Delay ◽

Cluster Randomised ◽

Randomised Controlled ◽

The Impact

IntroductionStroke is the leading cause of death and disability in China. The median time of stroke pre-hospital delay is more than 15 hours, mainly due to the lack of awareness on stroke symptoms and calling emergency services. We developed Stroke 1-2-0 recognition tool in China, by adapting Face, Arm, Speech and Time. Our preliminary findings suggested that Stroke 1-2-0 can improve public’s knowledge of the stroke symptoms, but its impact on the prehospital delay is still unclear. Furthermore, these findings were mainly obtained from Shanghai, one of the largest metropolises in China. However, more than half of population in China lives in the rural area. Given the striking disparities in socioeconomic status and quality of stroke care across the nation, a multicentre trial is warranted.Methods and analysisStroke 1-2-0 education programme will adopt a multicentre, cluster-randomised controlled design. We aimed to recruit 32 communities from 16 counties across China. Each county includes two communities having more than 100 000 residents. The two communities sampled in the same county will be randomly assigned to receive either Stroke 1-2-0 education programme or usual care. The primary objective of this study is to evaluate the impact of Stroke 1-2-0 public education programme in reducing stroke prehospital delay among adults residing in the community, compared with the usual care. The intervention will be implemented for 1 year. The primary outcomes are the symptom onset to hospital arrival time (‘onset-to-door time’, ODT) and 3-hour hospital arriving rate. We will use an intention-to-treat approach. A linear mixed model will be used to control for potential cluster effects.Ethics and disseminationThis study is approved by the Shanghai Minhang District Central Hospital Institutional Review Board (Shanghai, China). The findings will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberChiCTR2000040782.

Download Full-text

The impact of FFP3 respirators on the blood saturation of intensive care unit medical staff.

10.21203/rs.3.rs-812029/v1 ◽

2021 ◽

Author(s):

Izabela Wojtasz ◽

Krystyna Jaracz ◽

Pawel Sobczynski ◽

Artur Druzdz ◽

Danuta Dyk ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Mixed Model ◽

Controlled Trial ◽

Well Being ◽

Normal Ranges ◽

Care Workers ◽

Reliable Solution ◽

And Control ◽

The Impact

Abstract BackgroundRecent studies support the effectiveness of filtering facepiece class 3 respirators (FFP3) during the COVID-19 pandemic in terms of protecting both health care workers (HCWs) and patients. However, wearing FFP3 respirators together with personal protective equipment (FFP3/PPE) could increase the feeling of discomfort or could even cause hypoxia. This study aims to investigate whether wearing an FPP3/PPE during work in the intensive care unit (ICU) affects the blood saturation (SpO2), the heart rate (HR), and the well-being of HCWs, as depicted by a score scale.MethodsThe study included a group of 21 volunteers, staff nurses, students and consultants (including 16 females (76%), with a median age of 23 years (interquartile range 21-27), range 20-59 years).We applied a counterbalanced crossover design—a self-controlled trial. Each subject served as his own control and performed the test two times: they wore the FFP3/PPE for a three-hour shift in the ICU and then did not wear the FFP3/PPE for 3 hours. To record the SpO2 and HR in real time, we used a Nellcor PM10N (Coviden, USA) portable monitoring system. Additionally, every 30 minutes during the shift and control run, each subject completed a questionnaire concerning their well-being, with a score scale to evaluate for headaches, shortness of breath, perspiration, fatigue, and thirst.ResultsThe mixed model demonstrated that working with an FFP3/PPE compared to not working with an FFP3/PPE caused a significant, but still within normal ranges, influence on the level of SpO2, with a mean decrease of -1.43%. The highest reduction in the SpO2 was 2.29%, and occurred after 150 minutes of work. We also found a significant increase in the HR at 60, 90, and 120 minutes after starting work. All of the score scales of the well-being markers increased consecutively but were moderate during the shift while wearing the FFP3/PPE; the side effects were mainly fatigue, thirst, and sweating.ConclusionWe assume that a 3 hour shift rhythm –, i.e., three hours of working in the FFP3/PPE in the ICU, followed by rest or working without an FFP3/PPE is a safe and reliable solution.

Download Full-text

“Moving Forward with Life”: Acceptability of a Brief Alcohol Reduction Intervention for People Receiving Antiretroviral Therapy in South Africa

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165706 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5706

Author(s):

Bronwyn Myers ◽

Charles D. H. Parry ◽

Neo K. Morojele ◽

Sebenzile Nkosi ◽

Paul A. Shuper ◽

...

Keyword(s):

South Africa ◽

Antiretroviral Therapy ◽

Problem Solving ◽

Alcohol Consumption ◽

Controlled Trial ◽

Hiv Treatment ◽

People Living With Hiv ◽

Problem Solving Therapy ◽

The Impact ◽

Alcohol Reduction

Background: In South Africa, interventions are needed to address the impact of hazardous drinking on antiretroviral therapy among people living with HIV (PLWH). Participant feedback about these interventions can identify ways to enhance their acceptability. We interviewed participants in a randomized controlled trial of a brief motivational interviewing and problem-solving therapy (MI-PST) intervention about their perceptions of this alcohol-reduction intervention. Methods: The trial was conducted in HIV treatment clinics operating from six hospitals in the Tshwane region of South Africa. We conducted qualitative in-depth interviews with a random selection of participants. Twenty-four participants were interviewed after the final intervention session and 25 at the six-month follow up. Results: Participants believed that it was acceptable to offer PLWH, an alcohol reduction intervention during HIV treatment. They described how the MI-PST intervention had helped them reduce their alcohol consumption. Intervention components providing information on the health benefits of reduced consumption and building problem-solving and coping skills were perceived as most beneficial. Despite these perceived benefits, participants suggested minor modifications to the dosage, content, and delivery of the intervention for greater acceptability and impact. Conclusions: Findings highlight the acceptability and usefulness of this MI-PST intervention for facilitating reductions in alcohol consumption among PLWH.

Download Full-text

What happens when the party moves home? The effect of the COVID-19 pandemic on U.S. college student alcohol consumption as a function of legal drinking status using longitudinal data

Translational Behavioral Medicine ◽

10.1093/tbm/ibab006 ◽

2021 ◽

Vol 11 (3) ◽

pp. 772-774

Author(s):

Nicole C Ryerson ◽

Oliver W A Wilson ◽

Alejandra Pena ◽

Michele Duffy ◽

Melissa Bopp

Keyword(s):

College Student ◽

Alcohol Consumption ◽

Online Survey ◽

Mixed Model ◽

The United States ◽

Consumption Patterns ◽

Future Research ◽

Living Situation ◽

Drinking Age ◽

The Impact

Abstract Many young adults in the United States (U.S.) moved from college accommodations to live with their parents/family during the Spring 2020 semester due to the COVID-19 pandemic. While alcohol consumption fluctuates during a typical semester among students, the impact of the sudden changes stemming from the pandemic on students’ alcohol consumption patterns is unclear. To examine the impact of the COVID-19 pandemic on college student alcohol consumption while accounting for legal drinking age and living situation. Data were collected from students (n = 302) at a large, northeastern U.S. university at the beginning and end of the of the 2019 and 2020 Spring semesters via an online survey that assessed socio-demographic characteristics (age, gender, race/ethnicity, living situation) and alcohol consumption using the daily drinking questionnaire. Data were analyzed using a 2 (cohort group: COVID-19 vs. normal) × 2 (age group: above 21 vs. under 21) × 2 (time: beginning vs. end of the semester) mixed model ANOVA. There was a significant three-way interaction. Students over the legal drinking age impacted by the pandemic demonstrated a drastic decrease in alcohol consumption by the end of the semester compared to those under normal circumstances. Change in living situation as a result of the pandemic drastically impacted the alcohol consumption patterns of students over the legal drinking age. Suggestions for future research on the continuing effects of the pandemic on students are discussed.

Download Full-text