Evaluating the Home-based Intervention Strategy (HIS-UK) to reduce new chlamydia infection among young men aged 16-25 years by promoting correct and consistent condom use: What is the cost effectiveness of two different delivery models (face-to-face and digital delivery)? Protocol for a randomised controlled trial. (Preprint)

BACKGROUND The health, social, and economic costs of sexually transmitted infections (STIs) represent a major public health concern. Young people are considered one of the groups most at risk for acquiring and transmitting STIs. Correct and consistent condom use has been shown to be the most effective method for reducing STIs; however, condoms are often not used properly. Evidence has shown that brief behavioural change interventions that focus on skills, communication, and motivation to acquire safe sex practices, should be adopted into routine care to reduce STIs. Funding for sexual health services (SHS) in England has declined dramatically, so novel ways of reducing clinic attendance are being sought. The Home-based Intervention Strategy (HIS-UK) to promote condom use among young men has shown promise in feasibility and pilot studies by demonstrating high acceptability of the intervention in participant and health professional feedback, including aiding men to find condoms that they like and to feel more confident when using condoms. OBJECTIVE To determine the effectiveness and cost-effectiveness of HIS-UK when compared to usual condom distribution care in young men. The three trial arms consisting of ‘eHIS’ (HIS-UK delivered digitally), ‘proHIS’ (HIS-UK delivered face-to-face) and control condition (usual NHS care) will be compared against three primary outcomes: the extent to which they increase correct and consistent condom use, improve condom use experiences (pleasure, fit-and-feel), and reduce chlamydia test positivity. METHODS The study aims to address skills acquisition and motivation to use condoms. Eligibility criteria include men aged 16-25 years at risk of STIs through reporting of condom use errors (i.e. breakage/slippage) or condomless penile-vaginal or penile-anal intercourse with casual/non-regular or new sexual partners during the previous three months. Prospective participants will be recruited through targeted advertisements and an opportunistic direct approach at selected sexual health and genitourinary medicine services and University-associated health centres and GP practices. Community and educational establishments will be used to further advertise the study and signpost men to recruitment sites. Participants will be randomly allocated to one of three trial arms. A repeated measures design will assess the three parallel arms with baseline and 12 monthly follow-up questionnaires post intervention and three chlamydia screening points (baseline, 6 and 12 months). RESULTS Recruitment commenced in March 2020. Due to the COVID-19 pandemic the study was halted and has since reopened for recruitment in Summer 2021. CONCLUSIONS If effective and cost-effective, HIS-UK can be scaled up into routine NHS usual care to reduce both STI transmission in young people and pressure on NHS resources. This intervention may further encourage SHSs to adopt further digital technologies, allowing for such services to become more widely available to young people whilst also decreasing health inequalities and fear of stigmatisation. CLINICALTRIAL ISRCTN: 11400820, October 2019

A Multicomponent Home-Based Intervention for Neuropsychiatric Symptoms in People With Dementia and Caregivers’ Burden and Depression: A 6-Month Longitudinal Study

Objectives: Many people with dementia live in their home and require ongoing care, which is often provided by informal family caregivers. Thus, we examined the effectiveness of a multicomponent home-based intervention by evaluating its impact on a) neuropsychiatric symptoms of people with dementia and b) burden and depression of their caregivers. Methods: During the first 6 months of this prospective single-center study, we applied a home-based multicomponent intervention in 205 dyads of care-recipients and caregivers. In further analyzes, we included only dyads of caregivers and care-recipients with available data both at baseline and 6-month follow-up (N = 144). All assessments were conducted at home and included sociodemographic features, care-recipients’ clinical data, cognitive status (Mini-Mental State Examination), activities of daily living (Instrumental Activities of Daily Living; Katz Index of Independence in Activities of Daily Living), neuropsychiatric symptoms (Neuropsychiatric Inventory), and caregivers’ burden (Zarit Burden Inventory) and depression (Center for Epidemiological Studies-Depression). Results: We found significant decreases in the severity (pFDR = 0.002) and associated distress (pFDR = 0.001) of neuropsychiatric symptoms, as well as caregivers’ burden (pFDR = 0.004) and depressive symptoms (pFDR = 0.001). As expected, there was significant deterioration in care-recipients’ cognitive status (pFDR = 0.005) and measures of activities of daily living (pFDR < 0.005). Conclusion: Despite the progressive course of dementia, the home-based multicomponent intervention was effective in decreasing caregivers’ burden and depression and minimizing care-recipients’ neuropsychiatric symptoms’ severity and associated distress after 6 months. Our study highlights the establishment of home-based care units as an advantageous solution, specifically for family members seen to have a “taken-for-granted” role in dementia caring.

Adherence Is More Than Just Being Present: Example of a Lay-Led Home-Based Programme with Physical Exercise, Nutritional Improvement and Social Support, in Prefrail and Frail Community-Dwelling Older Adults

Background: Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. Methods: Eighty prefrail and frail persons (≥65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. Results: Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1–12/13–24. Out of those, 59% carried out ≥75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. Conclusion: Adherence is much more than “being there”. Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.

Home Based Intervention Sebagai Upaya Meningkatkan Preferensi Konsumsi Sayur dan Buah Anak Usia Sekolah Dasar

Masa usia sekolah dasar menjadi periode tumbuh kembang anak, dimana kecukupan zat gizi makro dan mikro harus terpenuhi. Namun demikian orang tua kerap menghadapi tantangan untuk bisa membiasakan anak mengonsumsi buah dan sayur yang kaya akan zat gizi mikro. Kegiatan ini bertujuan untuk mengupayakan peningkatan pengetahuan dan preferensi konsumsi buah dan sayur pada anak usia sekolah dasar melaui kegiatan Home Based Intervention. Pelaksanaan kegiatan dilakukan secara daring (online) menggunakan zoom meeting dengan melakukan storytelling untuk anak oleh pendongeng dan sosialisasi untuk orangtua oleh ahli gizi. Pada kegiatan ini, pengetahuan dan preferensi anak dilihat dari pengisian kuesioner pre-test dan post-test. Sebanyak 21 orang tua dan 11 anak mengikuti pre-test kegiatan ini. Hasil post-test menunjukan terdapat kenaikan skor pengetahuan orang tua sebanyak 3 sampai 4 poin dan skor pengetahuan anak sebanyak 1-2 poin. Skor preferensi konsumsi sayur dan buah pada anak pun mengalami kenaikan sebesar 1 dan 5 poin. Kegiatan Home Based Intervention melalui storytelling pada anak dan sosialisasi pada orang tua pada dasarnya memberi efek positif terhadap preferensi serta pengetahuan anak dan pengetahuan orang tua, namun demikian perlu adanya sosialisasi secara frekuentif guna memberi efek yang lebih nyata pada perilaku konsumsi buah dan sayur pada anak.Kata Kunci: Home based intervention, Pengetahuan, Buah, Sayur, Anak Usia Sekolah.

A home-based intervention towards preschoolers’ EFL sentence development

Research has shown that the initial few years of children’s lives are the best times for language to develop at a rapid pace, the first language (L1) or a foreign language (FL) may be acquired these times. Researches on preschoolers FL acquisition with home-based intervention (HBI) have not been studied extensively under the L1 environment. This study aims to examine the results of HBI on the development of the acquisition of Indonesian preschoolers’ English as a Foreign Language (EFL) sentences. This research is a case study with naturalistic observation design, where data were obtained from logbooks and interview. The research subjects were 2 preschoolers about 36 months. The study’s duration was 24 months from the 13th until the 36th month with HBI, namely parents-based and authentic/semi authentic-media intervention. The data were the children’s English sentences taken at 24th to 36th months at their own homes. The Owens’ acquisition of sentence forms measured the English sentences’ development of in the respondents’ conversation and self-narration. This research found that at about 36th month, these Indonesian preschoolers were able to communicate in English in various sentences such as declarative, negative, interrogative, imperative, embedded and conjoining. HIGHLIGHTS: Simultaneous foreign language learning and first language acquisition for children is tangible advantage. Authentic input and active interaction act as the language environment substitute in foreign language learning. Intensive learning makes preschoolers speak a foreign language earlier.

Effects of High-Intensity Interval Training and Moderate-Intensity Training on Stress, Depression, Anxiety, and Resilience in Healthy Adults During Coronavirus Disease 2019 Confinement: A Randomized Controlled Trial

Objective: This study aimed to compare the effects of two intervention programs, (1) high-intensity interval training (HIIT) and (2) moderate-intensity training (MIT), on anxiety, depression, stress, and resilience during the confinement caused by the coronavirus disease 2019 (COVID-19) in healthy adults.Methods: A total of 67 adults who participated were randomly assigned to two groups: HIIT and MIT groups. The MIT group had to perform a home-based intervention based on aerobic exercises, whereas the HIIT group had to perform a home-based intervention based on HIIT exercises. The two groups (HIIT and MIT) had to complete the same physical exercise volume, 40 min per session (6 days per week) during the confinement period (6 weeks). Depression, anxiety, stress, and resilience were assessed before and after the intervention.Results: Results showed that HIIT and MIT significantly reduced the stress, anxiety, and depression as well as increase the resilience (p &lt; 0.05). Moreover, the improvements obtained in the HIIT group seem to be greater than those of the MIT group in depression (p &lt; 0.05).Conclusions: HIIT and MIT decreased anxiety, stress, and depression as well as increased resilience during the COVID-19 confinement. In addition, the HIIT intervention seemed to be more beneficial to reduce depression than the MIT intervention.

Effect of individualized home-based intervention program in preterm infants at 35-36 weeks gestational age using prechtl’s general movement assessment: a pre-post experimental study

Background: Preterm birth associated with various abnormalities can have a detrimental impact on an infant’s developmental outcome which marks the need of a landmark tool to detect an abnormality at an early age and incorporate specific intervention strategies. Positive effects of intervention on developmental outcomes have been noted, however tailored home-based intervention programs on developmental enhancements are essential. Purpose: To evaluate the impact of Individualized Home Based Developmental Program on the neurodevelopmental outcome of preterm infants using Prechtl’s General Movement Assessment. Methodology: Ninety preterm infants admitted to the NICU (Neonatal Intensive Care Unit)of a tertiary care hospital in Tertiary care hospital at Belagavi, Karnataka, India. The study was carried out for a duration of 12 months. Participants were conveniently selected from a population-based sample from May 2018 to March 2019. Based on the inclusion criteria of the study, these infants were screened for the movement trajectories on Prechtl’s GMA at 3-36- and 38-40-weeksGA(Gestational Age) respectively. Out of the 90 infants, 19 infants showing abnormal movement trajectories were recruited for individualized home-based developmental program for a duration of 12 weeks followed by re-evaluation at 3 months post term age. Results: The results were statistically significant (p<0.001) with 14 out of 19 infants exhibiting 70% improvement with normal Fidgety movements at 3 months post term age. Conclusion: IHBP delivered for 12 weeks was found to be effective in promoting developmental outcome in preterm infants. KEY WORDS: Preterm infants, Prechtl’s General Movement Assessment, home-based early intervention.

Improvements of Disability Outcomes in CAPABLE Older Adults Differ by Financial Strain Status

The Community Aging in Place–Advancing Better Living for Elders (CAPABLE) program reduces disability in low-income older adults. In this study, we used CAPABLE baseline and 5-month data to examine whether its effects in reducing activities of daily living (ADLs) and instrumental ADLs (IADLs) difficulties differed by participants’ financial strain status. At baseline, participants with financial strain were more likely to report higher scores on depression ( p < .001), have low energy ( p < .001), and usually feel tired ( p = .004) compared with participants without financial strain, but did not differ in ADL/IADL scores. Participants with financial strain benefited from the program in reducing ADL (relative risk [RR]: 0.61, 95% confidence interval [CI]: 0.43, 0.86) and IADL disabilities (RR: 0.69, 95% CI: 0.54, 0.87), compared with those with financial strain receiving attention control. Individuals with financial strain benefited more from a home-based intervention on measures of disability than those without financial strain. Interventions that improve disability may be beneficial for financially strained older adults.