Higher Tablet Use Is Associated With Better Sustained Attention Performance but Poorer Sleep Quality in School-Aged Children

There are growing concerns that increased screen device usage may have a detrimental impact on classroom behaviour and attentional focus. The consequences of screen use on child cognitive functioning have been relatively under-studied, and results remain largely inconsistent. Screen usage may displace the time usually spent asleep. The aim of this study was to examine associations between screen use, behavioural inattention and sustained attention control, and the potential modifying role of sleep. The relations between screen use, behavioural inattention, sustained attention and sleep were investigated in 162 6- to 8-year-old children, using parent-reported daily screen use, the SWAN ADHD behaviour rating scale, The sustained attention to response task and the children’s sleep habits questionnaire. Tablet use was associated with better sustained attention performance but was not associated with classroom behavioural inattention. Shorter sleep duration was associated with poorer behavioural inattention and sustained attention. Sleep quality and duration did not act as mediators between screen usage and behavioural inattention nor sustained attention control. These findings suggest that careful management of the amount of time spent on electronic screen devices could have a beneficial cognitive impact on young children. The results also highlight the critical role of sleep in enhancing both behavioural attention and sustained attention, which are essential for supporting cognitive development and learning.

Resourcefulness Intervention Efficacy for Parent Caregivers of Technology-Dependent Children: A Randomized Trial

Parent caregivers of children who require lifesaving technology (e.g., mechanical ventilation, feeding tubes) must maintain a high level of vigilance 24/7. A two-arm randomized controlled trial tested the efficacy of a resourcefulness intervention on parents’ mental/physical health and family functioning at four time points over six months. Participants ( n = 93) cared for their technology-dependent children <18 years at home. The intervention arm received teaching on social (help-seeking), personal (self-help) resourcefulness skills; access to the intervention video and skill application video-vignettes; four weeks of skills reinforcement using daily logs; four weekly phone contacts; and booster sessions at two- and four-month postenrollment. The attention control arm received phone contact at identical time points plus the current standard of care. Statistically significant improvement was noted; fewer depressive cognitions and improved physical health for the intervention participants than attention control participants over time after controlling for covariates. The findings support the resourcefulness intervention efficacy.

Impacts of A Web-Based Social-Norms Edutainment Program on Sexually Violent Behavior and Bystander Behavior among University Men in Vietnam: The GlobalConsent Randomized Controlled Trial (Preprint)

BACKGROUND Sexual violence against women occurs worldwide. Prevention programs that treat men as “allies” and integrate a bystander framework are emerging in lower-income settings but evidence of effectiveness is conflicting. OBJECTIVE We tested the impact of GlobalConsent on sexually violent behavior and prosocial bystander behavior among university men in Vietnam. METHODS We applied a double-blind, parallel intervention-versus-control-group design with 1:1 randomization in two universities. Consenting heterosexual or bisexual men 18-24 years and matriculating in September 2019 (n=793) were enrolled and assigned randomly to GlobalConsent or AHEAD. GlobalConsent is an adapted, theory-based, six-module web-based intervention with diverse behavioral-change techniques and a locally produced serial drama. AHEAD is a customized, six-module attention-control program on adolescent health. Both programs were delivered to computers and smartphones over 12 weeks. Sexually violent behaviors toward women in the prior six months and prosocial bystander behaviors in the prior year were measured at zero, six, and 12 months. RESULTS Over 91% of men in both study arms completed at least one program module, and over 88% completed all six modules. At baseline, notable percentages of men reported any sexually violent behavior (GlobalConsent: 31.06%, n=396, AHEAD: 25.94%, n=397) in the prior six months. At endline (posttests 1 and 2 combined) compared to baseline, men receiving GlobalConsent had 1.26 times the odds of reporting a high level (at least two acts) of sexually violent behavior, and 0.67 times the odds of reporting any bystander behavior. The corresponding odds ratios for the AHEAD peers were less favorable, 2.67 and 0.45. CONCLUSIONS Compared to a health attention-control condition, GlobalConsent has sustained favorable impacts on sexually violent behavior and prosocial bystander behavior among matriculating university men in Vietnam, who otherwise would face increasing risks of sexually violent behavior. GlobalConsent shows promise for national scale-up and regional adaptation. CLINICALTRIAL ClinicalTrials.gov NCT04147455

Guided self-determination intervention versus attention control for people with type 2 diabetes in outpatient clinics: a protocol for a randomised clinical trial

IntroductionIn the management of type 2 diabetes, autonomy-supporting interventions may be a prerequisite to achieving more long-term improvement. Preliminary evidence has shown that the guided self-determination (GSD) method might have an effect on haemoglobin A1c and diabetes distress in people with type 1 diabetes. Previous trials were at risk of uncertainty. Thus, the objective is to investigate the benefits and harms of a GSD intervention versus an attention control group intervention in adults with type 2 diabetes.Methods and analysisThis trial protocol is guided by the The Standard Protocol Items: Recommendations for International Trials Statement. We describe the protocol for a pragmatic randomised, dual-centre, parallel-group, superiority clinical trial testing a GSD intervention versus an attention control for people with type 2 diabetes in outpatient clinics. The participants (n=224) will be recruited from two diverse regions of Denmark. The experimental stepped-care intervention will consist of three to five GSD sessions lasting up to 1 hour with a trained GSD facilitator. The sessions will be conducted face to face, by video conference or over the telephone. The attention controls will receive three to five sessions lasting up to an hour with a communication-trained healthcare professional provided face to-face, by video conference, or over the telephone. Participants will be included if they have type 2 diabetes,>18 years old, are not pregnant. Participants will be assessed before randomisation, at 5-month, and 12-month follow-up, the latter being the primary. The primary outcome is diabetes distress. Secondary outcomes are quality of life, depressive symptoms and non-serious adverse events. Exploratory outcomes are haemoglobin A1c, motivation and serious adverse events. Data will be collected using REDCap and analysed using Stata V.16.Ethics and disseminationThe trial will be conducted in compliance with the protocol, the Helsinki Declaration in its latest form, International Harmonisation of Good Clinical Practice guidelines and the applicable regulatory requirement(s). The trial has been approved by the Danish Data Protection Agency (P-2020-864). The Ethics Committee of the Capital Region of Denmark reviewed the trial protocol, but exempted the trial protocol from full review (H-20003638). The results of the trial will be presented at the outpatient clinics treating people with type 2 diabetes, at national and international conferences as well as to associations for people with diabetes and their relatives.Trial registration numberClinicalTrials.gov identifier: NCT04601311.

Foundational Basis for the Development of MEDSReM

Discovering a composite of measures of executive function/working memory predicted everyday medication adherence among older adults, led to the development of a behavioral intervention, the Multifaceted Prospective Memory Intervention (MPMI) to improve hypertension medication adherence. The intervention resulted in a 35% improvement in adherence compared to an active education and attention control condition. However, adherence slowly declined over an additional five months of adherence monitoring without the presence of interventionists in the home. We proposed that the use of technology might help individuals maintain the prospective memory strategies, resulting in sustained adherence. An interdisciplinary team was formed to translate the behavioral intervention to technology, resulting in the first version of the MEDSReM system. In this presentation we describe the evolution of the project, from the components of the successful MPMI to the design and initial testing of MEDSReM. These efforts provide general insights about translating interventions into technology tools.

Correction to: Very preterm infants engage in an intervention to train their control of attention: results from the feasibility study of the attention control training (ACT) randomised trial

An amendment to this paper has been published and can be accessed via the original article.

SToRytelling to Improve Disease outcomes in Gout (STRIDE-GO): a multicenter, randomized controlled trial in African American veterans with gout

Background Urate-lowering therapy (ULT) adherence is low in gout, and few, if any, effective, low-cost, interventions are available. Our objective was to assess if a culturally appropriate gout-storytelling intervention is superior to an attention control for improving gout outcomes in African-Americans (AAs). Methods In a 1-year, multicenter, randomized controlled trial, AA veterans with gout were randomized to gout-storytelling intervention vs. a stress reduction video (attention control group; 1:1 ratio). The primary outcome was ULT adherence measured with MEMSCap™, an electronic monitoring system that objectively measured ULT medication adherence. Results The 306 male AA veterans with gout who met the eligibility criteria were randomized to the gout-storytelling intervention (n = 152) or stress reduction video (n = 154); 261/306 (85%) completed the 1-year study. The mean age was 64 years, body mass index was 33 kg/m2, and gout disease duration was 3 years. ULT adherence was similar in the intervention vs. control groups: 3 months, 73% versus 70%; 6 months, 69% versus 69%; 9 months, 66% versus 67%; and 12 months, 61% versus 64% (p > 0.05 each). Secondary outcomes (gout flares, serum urate and gout-specific health-related quality of life [HRQOL]) in the intervention versus control groups were similar at all time points except intervention group outcomes were better for the following: (1) number of gout flares at 9 months were fewer, 0.7 versus 1.3 in the previous month (p = 0.03); (2) lower/better scores on two gout specific HRQOL subscales: gout medication side effects at 3 months, 32.8 vs. 39.6 (p = 0.02); and unmet gout treatment need at 3 months, 30.9 vs. 38.2 (p = 0.003), and 6 months, 29.5 vs. 34.5 (p = 0.03), respectively. Conclusions A culturally appropriate gout-storytelling intervention was not superior to attention control for improving gout outcomes in AAs with gout. Trial registration Registered at ClinicalTrials.gov NCT02741700

Changes of Structural and Functional Attention Control Networks in Subclinical Hypothyroidism

Objective: This study aimed to explore the structural changes in patients with subclinical hypothyroidism (SCH) using voxel-based morphometry (VBM) and to investigate the altered attentional control networks using functional MRI (fMRI) during the performance of a modified Stroop task with Chinese characters.Methods: High-resolution three-dimensional (3D) T1-weighted images and an fMRI scan were taken from 18 patients with SCH and 18 matched control subjects. The Montreal Cognitive Assessment Chinese-revised (MoCA-CR) and the Stroop task were used to evaluate the cognitive and attention control of the participants.Results: Compared to controls, the VBM results showed decreased gray matter volumes (GMVs) in bilateral prefrontal cortices (PFCs, including middle, medial, and inferior frontal gyri), cingulate gyrus, precuneus, left middle temporal gyrus, and insula in patients with SCH. The fMRI results showed a distributed network of brain regions in both groups, consisting of PFCs (including superior and middle and inferior frontal cortices), anterior cingulate cortex (ACC), posterior cingulate cortex, and precuneus, as well as the insula and caudate nucleus. Compared to controls, the SCH group had lower activation of the above brain areas, especially during the color-naming task. In addition, the normalized GMV (nGMV) was negatively correlated with thyroid-stimulating hormone (TSH) level (r = −0.722, p &lt; 0.001).Conclusion: Results indicate that patients with SCH exhibit reduced GMVs, altered BOLD signals, and activation in regions associated with attention control, which further suggest that patients with SCH may have attentional control deficiency, and the weakened PFC–ACC–precuneus brain network might be one of the neural mechanisms. Negative correlations between nGMV and TSH suggest that TSH elevation may induce abnormalities in the cortex.