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Intervention Delivery (intervention + delivery)

Distribution by Scientific Domains

Psychology	50%
Medical Sciences	50%

Selected Abstracts

Brief interventions: good in theory but weak in practice

DRUG AND ALCOHOL REVIEW, Issue 1 2004
Professor ANN M. ROCHE Director
Abstract A substantial body of research evidence has accumulated in support of the efficacy of brief interventions for a number of alcohol and drug-related problem areas, most notably alcohol and tobacco. This evidence has been used to exhort a range of professional groups such as general practitioners (GPs), and more recently emergency department hospital staff to engage in brief interventions. Internationally, however, these secondary prevention efforts have largely failed. Why have these proven interventions not been embraced by frontline workers? This is a little-asked question as efforts to press-gang unwilling professionals to take up the cudgel continue. This paper examines the characteristics of brief interventions and their principal delivery agents and explores reasons for the failure to move from efficacy to effectiveness. Given the prevention potential that rests with brief intervention, these are crucial questions to address. A key feature of brief intervention delivery also examined is the role of GPs versus the less well-explored option of the practice nurse. It will be proposed that perhaps we have the right vehicle but the wrong driver and that until closer scrutiny is made of this issue efforts in this key prevention area will continue to fail to achieve optimum results. [source]

Development of a structured generic drug intervention model for public health purposes: a brief application of motivational interviewing with young people

DRUG AND ALCOHOL REVIEW, Issue 4 2003
JIM MCCAMBRIDGE
Abstract Brief applications of Motivational Interviewing (MI) emerged around 15 years ago to target problematic alcohol and other drug use. Interventions which specifically target illicit drug use, young people, or which are delivered in settings other than health-care services have, however, been relatively slow to develop. The needs of young people for interventions distinct from those offered to adults are considered, as a precursor to an outline of the structure of a newly adapted intervention targeting drug use in general among young people. Based upon earlier topic-based approaches developed by Rollnick et al. this intervention is innovative in simultaneously targeting a range of drugs in pursuit of secondary prevention objectives, while also seeking to manifest the spirit of MI. The intervention consists of a single-session face-to-face conversation of up to 60 minutes duration. Data are presented which describe the development and conduct of this intervention during the course of an efficacy trial, with promising efficacy data themselves reported elsewhere. Observations are made on intervention delivery and consideration is given to implications for further novel targeting of young people and within the field of addiction interventions more generally. [source]

Enhancing Intervention Fidelity: A Means of Strengthening Study Impact

JOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2006
Sharon Horner
PURPOSE.,Intervention studies that address the goals of the Healthy People initiative are increasing, and many focus on health concerns of children and adolescents. The purpose of this paper is to present strategies and discuss the rationale for including intervention fidelity in study design. CONCLUSION.,Researchers need to verify that their interventions were delivered as designed (intervention fidelity), and that variations from the design can be assessed. Infidelity can result in non-significant findings that are not due to the study design but rather to elements that affected the intervention delivery. IMPLICATIONS.,Addressing intervention fidelity in study design supports the researcher's conclusion about associations between intervention and outcomes and helps reduce premature abandonment of potentially useful interventions. [source]

Development of a tool to assess fidelity to a psycho-educational intervention

JOURNAL OF ADVANCED NURSING, Issue 3 2010
Mi-Kyung Song
song m.-k., happ m.b. & sandelowski m. (2010) Development of a tool to assess fidelity to a psycho-educational intervention. Journal of Advanced Nursing66(3), 673,682. Abstract Aim., This paper is a description of a method to develop and conduct a customized psycho-educational intervention fidelity assessment as part of pilot work for an efficacy study. A tool designed to assess treatment fidelity to a psycho-education intervention for patients with end-stage renal disease and their surrogate decision makers, Sharing the Patient's Illness Representations to Increase Trust, is presented as an illustration. Background., Despite the specificity and idiosyncrasy of individual interventions and the call to systematically evaluate treatment fidelity, how to accomplish this goal has not been clarified. Tools to adequately measure treatment fidelity are lacking. Methods., We developed the Sharing the Patient's Illness Representations to Increase Trust Treatment Fidelity Assessment tool by identifying elements that were idiosyncratic to the intervention and those that could be adapted from existing tools. The tool has four components: overall adherence to the intervention content elements; pacing of the intervention delivery; overall dyad responsiveness; and, overall quality index of intervention delivery. The study was undertaken between 2006 and 2008. Results., Inter-rater reliability ranged from 0·80 to 0·87 for the four components. The tool showed utility in training and monitoring, such as detecting unplanned content elements delivered and the use of proscribed communication behaviours. Conclusion., Psycho-educational interventions are one of the most common types of nursing interventions worldwide. Use of fidelity assessment tools customized to the individual interventions may enhance systematic evaluation of training and monitoring treatment fidelity. [source]

Cost-effectiveness of Weight Watchers and the Lighten Up to a Healthy Lifestyle program

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010
Linda Cobiac
Abstract Objective: Intensive weight loss programs that incorporate dietary counselling and exercise advice are popular and are supported by evidence of immediate weight loss benefits. We evaluate the cost-effectiveness of two weight loss programs, Lighten Up to a Healthy Lifestyle and Weight Watchers. Methods: Health gains from prevention of chronic disease are modelled over the lifetime of the Australian population. These results are combined with estimates of intervention costs and cost offsets (due to reduced rates of lifestyle-related diseases) to determine the dollars per disability-adjusted life year (DALY) averted by each intervention program, from an Australian health sector perspective. Results: Both weight loss programs produced small improvements in population health compared to current practice. The time and travel associated with attending group-counselling sessions, however, was costly for patients, and overall the cost-effectiveness ratios for Lighten Up ($130,000/DALY) and Weight Watchers ($140,000/DALY) were high. Conclusion: Based on current evidence, these intensive behavioural counselling interventions are not very cost-effective strategies for reducing obesity, and the potential benefits for population health are small. Implications: It will be critical to consider other strategies (e.g. changing the ,obesogenic' environment) or explore alternative methods of intervention delivery (e.g. Internet) to see if they offer a more cost-effective approach by effectively reaching a high number of people at a low cost. [source]

Adherence and Flexibility: They Can (and Do) Coexist!

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 3 2010
Rex Forehand
[Clin Psychol Sci Prac 17: 258,264, 2010] Using their experiences disseminating the Triple P parenting program, Mazzucchelli and Sanders (2010) make a strong case for how flexibility enhances provider satisfaction, critical thinking about intervention delivery, and most importantly, adherence and fidelity. Their article makes an outstanding and innovative contribution to the literature on implementation research, advancing the field to a view of flexibility as a feature that may facilitate adherence. In this commentary, we place Mazzucchelli and Sanders's work within the context of ongoing implementation research. We also call for embedding questions about implementation science into effectiveness trials to better inform dissemination efforts aimed at facilitating provider adoption and adherence to empirically supported treatments. [source]