Home About us Contact
|
Home About us Contact | ||
|
|
||
Intervention Efficacy (intervention + efficacy)
Selected AbstractsBrief alcohol intervention,where to from here?ADDICTION, Issue 6 2010Challenges remain for research, practice ABSTRACT Brief intervention (BI) is intended as an early intervention for non-treatment-seeking, non-alcohol-dependent, hazardous and harmful drinkers. This text provides a brief summary of key BI research findings from the last three decades and discusses a number of knowledge gaps that need to be addressed. Five areas are described: patient intervention efficacy and effectiveness; barriers to BI implementation by health professionals; individual-level factors that impact on BI implementation; organization-level factors that impact on BI implementation; and society-level factors that impact on BI implementation. BI research has focused largely upon the individual patient and health professional levels, with the main focus upon primary health care research, and studies are lacking in other settings. However, research must, to a larger degree, take into account the organizational and wider context in which BI occurs, as well as interaction between factors at different levels, in order to advance the understanding of how wider implementation of BI can be achieved in various settings and how different population groups can be reached. It is also important to expand BI research beyond its current parameters to investigate more ambitious long-term educational programmes and new organizational models. More widespread implementation of BI will require many different interventions (efforts, actions, initiatives, etc.) at different interlinked levels, from implementation interventions targeting individual health professionals' knowledge, skills, attitudes and behaviours concerning alcohol issues, BI and behaviour change counselling to efforts at the organizational and societal levels that influence the conditions for delivering BI as part of routine health care. [source] Moderators and mediators of two brief interventions for alcohol in the emergency departmentADDICTION, Issue 3 2010Nancy P. Barnett ABSTRACT Objective To evaluate moderators and mediators of brief alcohol interventions conducted in the emergency department. Methods Patients (18,24 years; n = 172) in an emergency department received a motivational interview with personalized feedback (MI) or feedback only (FO), with 1- and 3-month booster sessions and 6- and 12-month follow-ups. Gender, alcohol status/severity group [ALC+ only, Alcohol Use Disorders Identification Test (AUDIT+) only, ALC+/AUDIT+], attribution of alcohol in the medical event, aversiveness of the event, perceived seriousness of the event and baseline readiness to change alcohol use were evaluated as moderators of intervention efficacy. Readiness to change also was evaluated as a mediator of intervention efficacy, as were perceived risks/benefits of alcohol use, self-efficacy and alcohol treatment seeking. Results Alcohol status, attribution and readiness moderated intervention effects such that patients who had not been drinking prior to their medical event, those who had low or medium attribution for alcohol in the event and those who had low or medium readiness to change showed lower alcohol use 12 months after receiving MI compared to FO. In the AUDIT+ only group those who received MI showed lower rates of alcohol-related injury at follow-up than those who received FO. Patients who had been drinking prior to their precipitating event did not show different outcomes in the two interventions, regardless of AUDIT status. Gender did not moderate intervention efficacy and no significant mediation was found. Conclusions Findings may help practitioners target patients for whom brief interventions will be most effective. More research is needed to understand how brief interventions transmit their effects. [source] Using sensation seeking to target adolescents for substance use interventionsADDICTION, Issue 3 2010James D. Sargent ABSTRACT Aims This study examines the predictive validity of sensation seeking as a predictor of adolescent substance use, in order to optimize targeting for substance use prevention programs. Design Longitudinal study. Setting Random-digit dial telephone survey. Participants A total of 6522 US adolescents aged 10,14 years at baseline, resurveyed at 8-month intervals for three subsequent waves. Measurements Two outcomes were assessed,onset of binge drinking (more than five drinks in a short time) and established smoking (>100 cigarettes life-time). Sensation seeking level was assessed at baseline. Logistic regression was used to predict onset of substance use at any follow-up wave as a function of sensation seeking. The receiver operating characteristics curve was used to illustrate how well sensation seeking predicted substance use as a function of different cut-off points for defining high sensation seeking, and area under the receiver operating characteristics curve (AROC) was the metric of predictive validity. Findings Of 5834 participants with one or more follow-up assessments, 5634 reported no binge drinking and 5802 were not established smokers at baseline, of whom 717 (12.7% of 5634) reported binge drinking and 144 (2.5% of 5802) reported established smoking at one or more follow-up interviews. Sensation seeking predicted binge drinking moderately well [AROC = 0.71 (95% confidence interval 0.69, 0.73)] and was a significantly better predictor of established smoking onset [AROC = 0.80 (0.76, 0.83)]. For binge drinking, predictive validity was significantly lower in blacks; for established smoking it was significantly higher for Hispanics. Implications for two targeting interventions are discussed. Conclusions Sensation seeking works moderately well at identifying adolescents at risk for onset of binge drinking and established smoking. This study offers a guide for determining the appropriate targeting cut-off value, based on intervention efficacy, costs and risks. [source] Acceptability of Emergency Department-based Screening and Brief Intervention for Alcohol ProblemsACADEMIC EMERGENCY MEDICINE, Issue 12 2000Daniel W. Hungerford DrPH Abstract. Objectives: To adapt screening and brief intervention for alcohol problems (SBI) to a high-volume emergency department (ED) setting and evaluate its acceptability to patients. Methods: Patients at a large public-hospital ED were screened with the Alcohol Use Disorders Identification Test (AUDIT). Screen-positive drinkers (AUDIT score , 6) were provided brief, on-site counseling and referral as needed. Three months later, project staff blinded to baseline measures reassessed alcohol intake, alcohol-related harm, alcohol dependence symptoms, and readiness to change. Results: Of 1,034 patients approached, 78.3% (810) consented to participate (95% CI = 75.5% to 81.2%), and 21.2% (172) screened positive (95% CI = 18.4% to 24.0%). Of 88 patients with complete intervention data, 94.3% (83) accepted an intervention (95% CI = 89.5% to 99.2%), with acceptance rates ranging from 93% to 100% across four alcohol-problem-severity levels (p = 0.7). A majority (59.0%) set goals to decrease or stop drinking (95% CI = 48.4% to 69.6%). The group recontacted (n= 23) experienced statistically significant decreases in alcohol intake, alcohol-related harm, and dependence symptoms, with measures decreasing for 68%, 52%, and 61% of the patients. Readiness to change also showed statistically significant improvement, with scores increasing for 43% of the patients. Moreover, two-thirds of the patients (15/23) reported at follow-up that SBI was a helpful part of their ED visit. Conclusions: High rates of consent and acceptance of counseling for alcohol problems by patients across a wide range of problem severity indicate that this protocol was acceptable to at-risk patients in a public-hospital ED. Improvements in alcohol-related outcome measures at follow-up were strong enough to warrant controlled studies of intervention efficacy. [source] Assessment of the quality of reporting of randomized clinical trials in paediatric dentistry journalsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2009ABEER A. AL-NAMANKANY Introduction., Reporting of randomized controlled trials (RCTs) should be of high quality to support the conclusions reached by the authors. Poor-quality reporting has been associated with an overestimation in intervention efficacy. Within the field of paediatric dentistry, no study has assessed the quality of reporting. Objective., The aim of this study was to assess published RCTs in paediatric dental journals between 1985 and 2006 for: (i) whether quality of reporting allows readers to assess the validity of trials; and (ii) whether quality of reporting has improved since the introduction of the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Methods., Hand search of the main paediatric dentistry journals; inclusion criteria were: the trial was performed on children, and RCT. CONSORT guidelines were made into an operational checklist. Trials published between 1985 and 1997, and between 1998 and 2006 were compared to determine any improvement since the publication of the CONSORT guidelines. Results., One hundred and seventy-three of 5635 articles met the inclusion criteria. Reporting quality was poor overall and showed heterogeneity. It had improved slightly since the publication of CONSORT. Few trials were reported adequately. Conclusion., The quality of reporting of clinical trials is poor, and often not adequate to allow readers to assess trial validity. Overall quality of reporting has not substantially improved since the publication of CONSORT. [source] Age of Drinking Onset as a Moderator of the Efficacy of Parent-Based, Brief Motivational, and Combined Intervention Approaches to Reduce Drinking and Consequences Among College StudentsALCOHOLISM, Issue 7 2010Kimberly A. Mallett Background:, The current study tested age of onset as a moderator of intervention efficacy on drinking and consequence outcomes among a high-risk population of college students (i.e., former high school athletes). Methods:, Students were randomized to one of four conditions: assessment only control, combined parent-based intervention (PBI) and brief motivational intervention (BMI), PBI alone, and BMI alone. Participants (n = 1,275) completed web-administered measures at baseline (summer before starting college) and 10-month follow-up. Results:, Overall, the combined intervention demonstrated the strongest and most consistent reductions across all outcomes, particularly with the youngest initiators. Participants who initiated drinking at the youngest ages had significantly lower peak drinking, typical weekly drinking, and reported consequences at follow-up when they received the combined intervention when compared to the control group. The BMI and PBI groups, when examined independently, demonstrated significant effects across outcomes but were inconsistent across the different age groups. Conclusion:, Results suggest the combination of a PBI and a peer-delivered BMI is an appropriate and efficacious way to reduce drinking and related consequences among individuals who initiated drinking earlier in adolescence and are at an increased risk of experiencing alcohol problems. [source] Inter-rater and test,retest reliability of the Taiwanese rehabilitation functional scaleOCCUPATIONAL THERAPY INTERNATIONAL, Issue 3 2001Ay-Woan Pan Abstract The need of a standardized evaluation tool for clinical practice is acknowledged by occupational therapists worldwide. The purpose of this study was to examine the inter-rater and test,retest reliabilities of the Taiwanese Rehabilitation Functional Scale (TaRFS) developed in Taiwan. Seventy-five subjects with varying diagnoses were recruited to participate in the study. They came from an inpatient rehabilitation unit within a university-affiliated hospital. All participants were tested on a functional measure of their independence on activities of daily living and cognitive,social tasks, and of their sense of well-being. The Activity of Daily Living (ADL) and Cognitive-Social Skills (CSS) subscales of the TaRFS were found to be reliable across raters and times. But individual items on the Subjective Well Being subscale were not stable across time. The results indicated that the ADL subscale as well as most items in the CSS subscale of the TaRFS can be utilized reliably in clinical practice. The SWB subscale of the TaRFS may need further revision in order to be used stably across time. The development of the TaRFS and future revision of the scale can be beneficial for occupational therapists in Taiwan to provide evidence of their intervention efficacy. Copyright © 2001 Whurr Publishers Ltd. [source] Long-Term Outcomes of a Telephone Intervention After an ICDPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2005CYNTHIA M. DOUGHERTY Background: The purpose of this study was to determine the long-term benefits of participating in a structured, 8-week educational telephone intervention delivered by expert cardiovascular nurses post-ICD. The intervention was aimed to (1) increase physical functioning, (2) increase psychological adjustment, (3) improve self-efficacy in managing the challenges of ICD recovery, and (4) lower levels of health care utilization over usual care in the first 12 months post-ICD. This article reports on the 6- and 12-month outcomes of the nursing intervention trial. Methods and Results: A two-group (N = 168) randomized control group design was used to evaluate intervention efficacy with persons receiving an ICD for the secondary prevention of sudden cardiac arrest. Measures were obtained at baseline, 6 and 12 months post hospitalization. Outcomes included (1) physical functioning (Patient Concerns Assessment [PCA], Short Form Health Survey [SF-12], ICD shocks), (2) psychological adjustment (State-Trait Anxiety Inventory [STAI], Centers for Epidemiologic Studies,Depression [CES-D], fear of dying), (3) self-efficacy (Sudden Cardiac Arrest,Self-Efficacy [SCA-SE], Sudden Cardiac Arrest,Behavior [SCA-B], Sudden Cardiac Arrest,Knowledge [SCA-K]), and (4) health care utilization (emergency room [ER] visits, outpatient visits, hospitalizations). Using repeated measures ANOVA, the 6- and 12-month benefits of the intervention over usual care were in reductions in physical concerns (P = 0.006), anxiety (P = 0.04), and fear of dying (P = 0.01), with enhanced self-confidence (P = 0.04) and knowledge (P = 0.001) to manage ICD recovery. There were no statistically significant differences between the groups on total outpatient visits, hospitalizations, or ER visits over 12 months. Conclusion: A structured 8-week post-hospital telephone nursing intervention after an ICD had sustained 12-month improvements on patient concerns, anxiety, fear of dying, self-efficacy, and knowledge. Results may not apply to individuals with congestive heart failure who receive an ICD for primary prevention of sudden cardiac arrest. [source] A Drop in the Bucket: Randomized Controlled Trials Testing Reading and Math InterventionsLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 2 2005Pamela M. Seethaler The purpose of this study was to determine the proportion of empirical studies published in the last 5 years in a sample of special education peer-reviewed journals that (1) assessed the effects of reading and math interventions with group designs and (2) used random assignment to treatment conditions to test those interventions. A hand search of articles from the Journal of Special Education, Exceptional Children, Learning Disabilities Research & Practice, the Journal of Learning Disabilities, and School Psychology Review yielded 806 relevant articles, of which 5.46 percent tested a reading or math intervention using a group design and 4.22 percent used random assignment. These findings indicate that randomized experimental designs, which offer the highest level of evidence of an intervention's efficacy, are underrepresented in the literature, at least in the area of reading and math interventions. [source] | ||||||||||