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Intervention Programme (intervention + programme)
Kinds of Intervention Programme Selected AbstractsEvaluation of a community mental health carepath for early psychosisJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2006Laura A. Hanson PhD RPsych Abstract Purpose, To implement a carepath for early psychosis across all community mental health centres through the Early Psychosis Intervention Programme in the Fraser South Area of British Columbia, Canada. Methods, Prior to developing the carepath, chart reviews and interviews were performed to assess for adherence to published guidelines for early psychosis intervention. This assessment revealed the inadequacies of narrative recording and that core psychosocial interventions were inconsistently provided. The carepath developed included prompts for interventions and standardized assessments and ultimately replaced the charting system used in the mental health centres for early psychosis clients. Results and conclusions One-year evaluation revealed some improvements in clinical practice but also identified other areas that require further improvement. This project demonstrated that it is possible to successfully implement a carepath in community mental health and that doing so provides a standardized method for ongoing improvements in care. [source] Early home-based intervention in the Netherlands for children at familial risk of dyslexiaDYSLEXIA, Issue 3 2009Sandra G. van Otterloo Abstract Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and letter knowledge. A control group (n=25) received a non-specific training in morphology, syntax, and vocabulary. Both interventions were designed to take 10,min a day, 5 days a week for 10 weeks. Most parents were sufficiently able to work with the programme properly. At post-test the experimental group had gained more on phoneme awareness than the control group. The control group gained more on one of the morphology measures. On average, these specific training results did not lead to significant group differences in first-grade reading and spelling measures. However, fewer experimental children scored below 10th percentile on word recognition. Copyright © 2008 John Wiley & Sons, Ltd. [source] A course of treatment of binge eating disorder: a time series approachEUROPEAN EATING DISORDERS REVIEW, Issue 2 2006Beate Wild Abstract Objective The aim of the study was an analysis of the therapeutic course of treatment of a patient with binge eating disorder (BED), who participated in the multi-modal intervention programme at the Medical University Hospital of Heidelberg. Method Throughout the course of the treatment period, the patient answered questions daily on a handheld computer about her eating behaviour as well as her psychological and physical state. Diary data was analysed with a time series analysis method. Results Multiple regression analysis revealed that both depression and distress were same-day predictors for eating behaviour. Delayed predictors were both the eating behaviour and the anxiety of the previous day, as well as the activity 2 days earlier. The model accounts for 55% of the total variance. Discussion The findings of this study expand upon the evidence of previous cross-sectional studies, suggesting that the development process of the eating behaviour during treatment is strongly associated with affective variables. The study demonstrates that changes that occur during the treatment occur simultaneously on multiple levels. The causal interpretation of the delayed predictors shows that for this patient anxiety is a trigger of binge eating episodes. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Results of a multi-componential psychosocial intervention programme for women with early-stage breast cancer in Spain: quality of life and mental adjustmentEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2009D. MANOS phd, psychologist-psychotherapist The effectiveness of a structured psychosocial intervention for women with breast cancer was studied in relation to a control group. The study was conducted in a hospital setting in Spain, and the aim of the intervention programme was to foster a higher quality of life and a more positive mental adjustment to the cancer. Three measures were used: baseline, post-treatment and 6-month follow-up for both groups. The dependent variables examined were quality of life and mental adjustment. The independent variable was the psychosocial intervention programme. Subjects were 188 women who had been operated for breast cancer and who satisfied a series of medical criteria, had no history of psychological problems and were between 25 and 65 years old. The results have shown that the psychosocial intervention programme was highly effective in improving the patients' quality of life, as compared with baseline measures, as well as compared with the control group. Additionally, the intervention increased the patients' fighting spirit and hopefulness/optimism, and reduced their anxious preoccupation as coping styles. These changes persevered at the 6-month follow-up. [source] Promoting breast health: older women's perceptions of an innovative intervention to enhance screeningINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 2 2006Robin Y. Wood EdD Aims and objectives., This study is a continuation of prior funded research in which we tested the use of age and ethnically sensitive video breast health kits to increase knowledge about breast cancer and enhance the screening practices of breast self-examination and mammography among older Caucasian and African-American women. Background., Breast cancer is the most frequent cancer in women worldwide and accounts for 23% of all cancers. Mammography is currently the best procedure available for mass screening of breast cancer. However, underutilization of mammography is a problem among older women in the United States. Elders are at the greatest risk for developing and dying from breast cancer but they are the least likely group to be screened routinely with mammograms or to practice breast self-examination, particularly if they are African-American. Design., Participatory qualitative evaluation focus groups were used to assess the overall impact of the video kit intervention programme and to elucidate the quantitative findings of the original study. Methods., Four focus groups were conducted in two diverse settings with a purposive sample of 23 participants (N = 23). The overall sample was predominantly African-American (87%) with mean age of 71 ± 7.9 years and mean education completed of 12 ± 3.4 years. Results., Five major themes emerged from group discussions: usability and appeal of the intervention, fear and empowerment, personal relevance and intergenerational sharing, impact on screening behaviours, and story telling. Conclusions., Analyses suggest that customized media materials constructed especially for older African-American women empowered participants in this sample to action regarding their own breast health. Relevance to clinical practice., These findings may translate to global populations where risk is increasing but screening programmes are not widely available. Given that older women are historically difficult to access and impact, further design and evaluation of innovative and sensitive educational programmes such as the one described here are recommended. [source] Evaluation of patient opinions in a pharmacy-level intervention studyINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2003M. C. M. Pronk PhD researcher ABSTRACT Objective To explore patients' satisfaction with their community pharmacy's services and to evaluate the effects of an intervention programme in which a trained technician organised patient education activities in the pharmacy. Method We surveyed patients visiting the participating pharmacies at three stages: at the start of the intervention period (0 months, T0), at the end (after 12 months, T1), and 12 months after the intervention had been completed (24 months from baseline, T2). At each stage, 500 questionnaires were distributed by each pharmacy. Setting 28 Dutch community pharmacies: 14 intervention and 14 controls. Key findings The response rates were 54%, 44% and 43% at T0, T1 and T2, respectively. Baseline data showed that patients reported satisfaction with helpfulness, waiting time, ease of asking questions, answers to questions, and patient leaflets provided. Around two thirds (59.5%) of the patients said they would ask a pharmacy employee questions if they were concerned about side effects of their medication. Asking questions was not reported to be difficult for most patients (88.9%). The reasons most often given for experiencing difficulties with asking questions were related to lack of privacy (16.9% of all patients), waiting time of other patients (8.8%) and busy pharmacy employees (6.7%). The most frequently reported reason for being less satisfied with the answers to questions was receiving too little information (7.5%). Our analyses showed a significant improvement only on the outcome variable "helpfulness" experienced by patients between 0 (T0) and 12 months (T1), and this was found to be sustained one year later (T2). Conclusion The overall findings on patient satisfaction showed that almost two-thirds of the respondents saw the pharmacy as a source of information about medication. Community pharmacies clearly have an important role in providing such information. Lack of privacy was the most common reason for patients reporting difficulties in asking questions about medicines and this needs pharmacists' attention. Our analysis showed that the intervention had an effect on "helpfulness" experienced by patients, which slightly increased in the intervention period (T0-T1 differences) and appeared to have remained at the higher level one year later (T2). [source] Doctors' assistants' views of case management to improve chronic heart failure care in general practice: a qualitative studyJOURNAL OF ADVANCED NURSING, Issue 4 2009Rebecca Olbort Abstract Title.,Doctors' assistants' views of case management to improve chronic heart failure care in general practice: a qualitative study. Aim., This paper is a report of a study to explore the views, concerns and experiences of doctors' assistants of case management for patients with chronic heart failure, while experiencing the new role of being a case manager within the Heidelberg Integrated Case Management trial. Background., Case management is being investigated as part of a randomised controlled trial aiming to improve care for patients with chronic systolic heart failure. In a complex, multifaceted intervention, trained doctors' assistants (equivalent to a nursing role) adopted new tasks using standardised case management involving telephone monitoring, home visits and diagnostic screening. Method., In April 2007, 3 months after implementation of the intervention programme, 27 doctors' assistants participated in four focus group interviews discussing their views on, and experiences of, case management. Thematic analysis of the data was undertaken. Findings., Participants believed that the most positive factors in case management were about interaction with patients, including opportunities for identifying disease and psychosocial problems. However, barriers included lack of time allocated to perform case management in addition to their normal role and poor cooperation within the practice team. According to the doctors' assistants, the routine implementation of case management was acceptable, feasible and effective in improving the management of patients with chronic systolic heart failure. Conclusion., Case management enhanced the role of doctors' assistants, leading to increased awareness of the perspective of patients with chronic disease. In the wider international primary care practice nursing context, the orchestrated delegation of tasks using specific case management may be a promising strategy for improving the quality of care of chronically ill patients and enabling patient self-management. [source] Researchers' experience of co-operative inquiry in acute mental health careJOURNAL OF ADVANCED NURSING, Issue 2 2005Jan Kåre Hummelvoll BA DrPH RPN RNT Aim., The aim of this article is to reflect upon our experiences of using co-operative inquiry in an acute mental health care setting, with a focus on the methodology used in a 4-year intervention programme developed in Norway between 1999 and 2003. Background., Action research plays a crucial role in assisting nurses to integrate theory and research with nursing practice. The central characteristic of this approach is the grounding of research in practice in collaboration with clinical practitioners. Methods., The research was a co-operative inquiry based on a hermeneutic-phenomenological approach. The research methods used were ethnographic, including participant observation and face-to-face interviews, questionnaires, focus group interviews, and our process notes. Findings., The different methods used in the co-operative inquiry design of the Project Teaching Ward (PTW) had both benefits and drawbacks. In particular, the focus group method proved useful due to its ability to stimulate participants' research interest, and thus motivating them to be actively involved in the development of knowledge. The particular knowledge development process used has been described as a local knowledge dialogue. This dialogue must incorporate critical subjectivity on the part of participants in order to ensure that the research has a reflective resistance, which is decisive for its validity and quality. The findings also highlight the importance of the different roles of project leader in lengthy action research collaboration. Conclusions., The PTW has illustrated that co-operative inquiry was well suited for developing knowledge relevant to practice, thus contributing to bridging the gap between practice and theory. In order for this to happen, the research collaboration should be characterized by patience, realism and engagement. [source] Development and implementation of a noise reduction intervention programme: a pre- and postaudit of three hospital wardsJOURNAL OF CLINICAL NURSING, Issue 23 2009Annette Richardson Aims., By developing, implementing and delivering a noise reduction intervention programme, we aimed to attempt to reduce the high noise levels on inpatient wards. Background., Sleep is essential for human survival and sleep deprivation is detrimental to health and well being. Exposure to noise has been found to disrupt sleep in hospitalised patients which is to be expected as noise levels have been measured and reported as high. Design., A primarily nursing focused, multi-method approach, involving development of clinical guidelines, ward environment review and a staff noise awareness and education programme, was used to target mainly nursing staff plus other healthcare staff on three wards within one hospital. Methods., This practice development initiative was carried out in three key phases (1) Preaudit of ward noise levels, (2) The development, implementation and delivery of a noise reduction intervention programme, (3) Postaudit of ward noise levels. Results., Preintervention average peak decibel levels over 24 hours were found to be 96·48 dB(A) and postintervention average peak decibel levels were measured at 77·52 dB(A), representing an overall significant reduction in noise levels (p < 0·001). Conclusions., This study describes one way to reduce peak noise levels on inpatient hospital wards. Relevance to clinical practice., Sleep deprivation is detrimental to patients with acute illness, so any developments to improve patients' sleep are important. Nurses have a key role in leading, developing and implementing changes to reduce peak noise levels on inpatient wards in hospitals. This nurse-led practice development programme has demonstrated how improvements can be achieved by significantly reducing peak noise levels using simple multi-method change strategies. [source] Effect of an interactive computerized psycho-education system on patients suffering from depressionJOURNAL OF CLINICAL NURSING, Issue 5 2008MPsychN, Mei-Feng Lin PhD Aims., The aim of this study was to examine the effect of an Interactive Computerized Psycho-Education System on patients suffering from depression and to compare the use of an Interactive Computerized Psycho-Education System vs. traditional pamphlet education approach. Background., Depression management depends on pharmacological treatment and psychotherapy and on appropriate and timely patient education. Whilst multimedia learning concepts have been applied in areas such as education, this approach has not been widely used in psychiatric outpatient departments. Design and method., A preliminary pre and post quasi-experimental design with patients with depression was employed at an hospital. Participants in the experimental group (n = 19) received an Interactive Computerized Psycho-Education System intervention programme (Interactive Computerized Psycho-Education System and the educational manual). Participants in the control group (n = 13) were exposed only to the traditional pamphlet education approach (consultation from psychiatrists and information sheets). Primary outcome was depression knowledge scores. Secondary outcomes were scores on the Compliance Behaviour Assessment Scale. Results., In the experimental group (n = 19), the time spent working on the Interactive Computerized Psycho-Education System was about 30,180 minutes per session, with an average of 67 minutes. Participants in the experimental group had a considerably decreased incidence of medication non-compliance compared with participants in the control group. Knowledge scores of the experimental group ranged from 30,100, with an average score of 74.7. Conclusion., The Interactive Computerized Psycho-Education System is acceptable and may be as more effective than a traditional education approach to achieve adherence to medications for depression. Relevance to clinical practice., Compared with a traditional approach, the combination of the Interactive Computerized Psycho-Education System and a nursing-consulting clinic may assist patients with depression to achieve and maintain better medication compliance in addition to improving their knowledge of depression. [source] Commentary on the ,Healthy Foods North' intervention programmeJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2010J. K. Cruickshank No abstract is available for this article. [source] A new evidence-based model for weight management in primary care: the Counterweight ProgrammeJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2004The Counterweight Project Team Abstract Background/Aims Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care. Methods The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18,75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit. Results By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m2 (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months. Conclusion The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care. [source] The development and pilot evaluation of a nutrition education intervention programme for pregnant teenage women (food for life)JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 2 2003W. L. Wrieden Abstract Background A healthy diet in pregnancy is important for both maternal and infant health but this may be difficult to achieve particularly for groups such as teenage pregnant women, many of whom are from disadvantaged backgrounds. To our knowledge this is the first report of a practical nutrition education programme for this group in the UK. Method An intervention was designed incorporating seven informal food preparation sessions, which allowed opportunities for discussion of nutritional, and other topics (e.g. food safety and well-being in pregnancy). Midwives in a community centre setting led the sessions. The acceptability of the package to participants and midwives was recorded and pre- and post-intervention data collected on sociodemographic details, dietary intake (using an eating-habits questionnaire and a 24-h dietary recall) and cooking skills. Results The midwives found the package easy to follow and use. The 16 (of the 120 invited) women who attended found the courses helpful but objective evaluation of dietary intake was not possible because of poor compliance. Conclusions The nutrition education programme was favourably received by midwives and the women who participated. However recruitment was problematic and alternative methods of delivering and evaluating such a package should be investigated. [source] Perspectives of fathers and mothers of children in early intervention programmes in assessing family quality of lifeJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 12 2006M. Wang Abstract Background Family quality of life (FQOL), as a family outcome measure of early intervention and other services, has increasingly drawn attention of researchers, policymakers and service providers. Developing an index of family QOL requires a measure suitable for use with multiple family members. The purpose of this study was to test whether mothers and fathers similarly view the conceptual model of FQOL embodied in one measure. Method This study involved fathers and mothers of 107 families who have a young child (birth to five) with a disability enrolled in an early intervention programme. Data from couples completing the Beach Center FQOL measure were analysed using structural equation modelling (SEM) to determine similarities or differences between fathers and mothers with respect to their assessment of FQOL. Results The analysis of measurement invariance of the FQOL construct across the father and mother groups indicates that the Beach Center FQOL Scale measures equally the underlying FQOL construct across fathers and mothers in this sample. Fathers do not differ from mothers in perceived importance of factors related to FQOL items, nor did they differ in their overall satisfaction with FQOL. Conclusion These results suggest that fathers and mothers respond similarly to the latent constructs within the Beach Center FQOL Scale; therefore, it holds promise for use with both fathers and mothers in assessing FQOL across multiple family members. Further implications for research and practice are discussed. [source] Effect of an early intervention programme on low birthweight infants with cerebral injuriesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2004S Ohgi Objective: To determine the effect of an early intervention programme (EIP) on low birthweight infants with cerebral injuries. Methods: Subjects were 23 high-risk low birthweight infants (periventricular leukomalacia 15, intraventricular haemorrhage 5, both 3) receiving care in the neonatal intensive care unit (NICU) at Nagasaki University Hospital. Subjects were randomly assigned to the EIP group (n = 12) or the control group (n = 11). Participants in the EIP group received a Neonatal Behavioral Assessment scale (NBAS)-based intervention combined with developmental support designed to enhance the infants' development and the quality of the parent,infant relationship. The control group received routine medical nursing care without the EIP. The EIP began prior to discharge from the NICU and lasted until 6 months of corrected age. All children were examined on the NBAS preintervention and again at 44 weeks postconceptional age. Maternal anxiety status (STAI) and maternal feelings of confidence in dealing with her baby (LCC) were measured pre and postintervention. Mental and motor development was assessed postintervention using the Bayley Scale of Infant Development. Results: Orientation and State Regulation of infant behavioural profiles, the STAI and LCC scores significantly improved in the EIP group (mean difference (95% CI): Orientation 0.7 (0.4, 1.1), State Regulation 0.9 (0.3, 1.5), STAI ,5.5 (, 9.1, ,1.9, LCC 5.3 (4.2, 6.5)), but not in the control group. Bayley mental developmental index (MDI) score in the EIP group was higher than in the control group, but there was no significant difference between the two groups (mean difference (95% CI): MDI 8.5 (, 0.8, 17.8), PDI 6.7 (, 1.9, 15.4)). Conclusion: The EIP has beneficial effects on neonatal neurobehavioural development and maternal mental health of low birthweight infants with cerebral injuries. This evidence suggests that short-term changes in maternal mental health and infant neurobehaviour promoted by an EIP may serve to initiate a positive interaction between parents and infants. [source] The effect of psychological and educational counselling in reducing anxiety in nursing studentsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2004F. SHARIF rn msc phd A quasi-experimental pre-, post-test, follow-up and control group design was used to investigate the effect of psychological and educational counselling in reducing anxiety in nursing students. The research study used methodological triangulation, involving the use of structured data collection techniques such as standardized questionnaires and semi-structured focus groups. Focus groups were used to provide greater insight regarding the student's opinions. The sample consisted of 100 second- and fourth-year baccalaureate nursing students from the Faculty of Nursing at Shiraz University of Medical Sciences, Iran. They were randomly assigned to either an experimental group (n = 50) or a control group (n = 50). The experimental group received a 12-week intervention programme. Quantitative analysis of data was undertaken using t -test and analysis of variance for repeated measures to test differences between and within groups. The results indicated that from pre- to post-test there was no statistically significant reduction in anxiety between groups, but there was a statistically significant reduction in anxiety after one semester (in the follow-up). Student self-esteem was increased significantly from pre- to post-test. This increase was statistically significant and remained the same in follow-up. A statistically significant difference was seen in the student grade point average from pre-test to follow-up in the experimental group but not for the control group. The implementation of an intervention programme reduced their anxiety, increased their self-esteem and improved their grade point average over time. [source] The effects of a comprehensive reading intervention programme for Grade 3 childrenJOURNAL OF RESEARCH IN READING, Issue 3 2007Jørgen Frost A group of 37 8-year-old children who had scored below the 20th percentile on a national reading test were offered intensive reading instruction in groups of four during Grade 3 in two periods (10 and 5 weeks). The intervention was delivered by six teachers who received training in a comprehensive reading intervention programme called Epi-Meta-Mastery-Approach, designed on the basis of the theory of metalinguistic development (Gombert, 1992). A control group of 36 children received increased instructional intensity during the same periods. The intervention group showed gains in comparison with the control group on measures of word and non-word reading and spelling. [source] A Bayesian model for longitudinal count data with non-ignorable dropoutJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES C (APPLIED STATISTICS), Issue 5 2008Niko A. Kaciroti Summary., Asthma is an important chronic disease of childhood. An intervention programme for managing asthma was designed on principles of self-regulation and was evaluated by a randomized longitudinal study. The study focused on several outcomes, and, typically, missing data remained a pervasive problem. We develop a pattern,mixture model to evaluate the outcome of intervention on the number of hospitalizations with non-ignorable dropouts. Pattern,mixture models are not generally identifiable as no data may be available to estimate a number of model parameters. Sensitivity analyses are performed by imposing structures on the unidentified parameters. We propose a parameterization which permits sensitivity analyses on clustered longitudinal count data that have missing values due to non-ignorable missing data mechanisms. This parameterization is expressed as ratios between event rates across missing data patterns and the observed data pattern and thus measures departures from an ignorable missing data mechanism. Sensitivity analyses are performed within a Bayesian framework by averaging over different prior distributions on the event ratios. This model has the advantage of providing an intuitive and flexible framework for incorporating the uncertainty of the missing data mechanism in the final analysis. [source] Intervention Effects on Cognitive Antecedents of Physical Exercise: A 1-Year Follow-Up StudyAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 2 2009Wiebke Göhner We developed and evaluated a theory-based intervention programme (MoVo-LISA) that encompasses motivational and volitional strategies aiming to prepare orthopaedic rehabilitation patients to perform physical exercise on a regular basis after discharge. The intervention consists of six units: two group sessions, one one-to-one interview, and three after-care contacts. Two hundred and twenty inactive patients were subsequently assigned to an intervention group (standard care plus MoVo-LISA) and a control group (standard care). Participants filled out questionnaires assessing cognitive antecedents of physical exercise. Measurement took place before and after rehabilitation, 6 weeks and 6 months after discharge, and 1 year after discharge. A 2 × 5 repeated measurement design was applied. Results revealed significant main and interaction effects with regard to cognitive variables; the intervention group reported enhanced self-efficacy and more positive balance of outcome expectations at 6 months as well as stronger goal intentions, more elaborated implementation intentions, and optimised strategies of intention shielding at 12 months after discharge compared to patients of the control group. Our findings demonstrate that a short and inexpensive cognitive-behavioural training programme is an effective tool to enable rehabilitation patients to follow treatment recommendations after discharge. The standardised intervention can be conducted by personnel other than psychologists. [source] The experiences of staff concerning the introduction and impact of a fall prevention intervention in aged care facilities: a qualitative studyAUSTRALASIAN JOURNAL ON AGEING, Issue 4 2003Meg Butler Objective: Falls in aged care facilities are a major public health concern. A pilot study tested the acceptability of a falls risk management intervention. Method: Focus group discussions with care giving staff and falls coordinators and individual interviews with principal nurse managers were taped and transcribed and thematic analysis identified main issues for staff in utilising the intervention. Results: Acceptance of the intervention was high for principal nurse managers and falls coordinators, although the paper work was found to be time consuming. While most caregivers found undertaking fall prevention strategies worthwhile, others found such strategies were irrelevant to them as they "knew" their residents. Conclusions: Among all levels of staff, falls among residents were regarded as stressful events. While the general acceptunce of the intervention programme was high, resistance to changing practices of care by some staff could limit the wider implementation of such a programme. Further research is needed to examine appropriate delivery of educational messages for caregivers, which include multiple cultural understandings. [source] Positive Connections: a programme for children who have a parent with a mental illnessCHILD & FAMILY SOCIAL WORK, Issue 2 2003Nancy A. Orel ABSTRACT Mental health professionals working with parents who suffer from a mental illness often overlook the children within the family. Children whose parents are mentally ill face numerous obstacles to their own emotional development and these children are at higher risk for developing mental illnesses than other children. These risks can be decreased if protective or positive interventions are available for the children. This article will describe the development and implementation of Positive Connections, an effective intervention programme specifically designed for children whose parents have been diagnosed with a mental disorder. The effectiveness of this programme has been evaluated using both qualitative and quantitative research strategies, and the results are presented. [source] Long-term process evaluation of a school-based programme for overweight preventionCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2009R. Muckelbauer Abstract Background The epidemic increase in childhood overweight demands effective and also feasible prevention programmes. A school-based environmental and educational intervention focusing on the promotion of water consumption was found to be effective for overweight prevention in children. Process evaluation and long-term surveillance are necessary to evaluate the feasibility and sustainability of the intervention programme in a school setting. Methods Process evaluation was conducted during the intervention period (one school year) and a 19-month follow-up after the intervention trial on the prevention of overweight in 17 elementary schools. Data were collected through measuring the water flow of water fountains installed in schools, and questionnaires and interviews were administered to teachers and headmasters of intervention schools. Main outcomes were implementation of the intervention components, behavioural modification of the children concerning water consumption, and teacher and headmaster attitudes towards the intervention. Results Eleven out of 17 intervention schools maintained the water fountains until 19-month follow-up. The mean water flow of the fountains decreased initially, but remained stable after the during the follow-up period. The implementation rate of the educational units by teachers varied between the units from 13% to 84%. Teachers graded the overall concept of the intervention as good, continuously during the intervention and follow-up period. The majority of teachers organized the water supply of the fountains on the class level during the intervention period but not during the follow-up. Conclusions The long-term process evaluation showed that the combined educational and environmental intervention has potential for sustained modifications in the beverage consumption habits of children. It also identified barriers and promoting factors of a sustainable and feasible implementation of the preventive programme in a school setting. [source] The implications of US experiences with early childhood interventions for the UK Sure Start ProgrammeCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2007R. Gray Abstract Background, The UK Government introduced a large-scale early childhood intervention programme, Sure Start, in 1999. Sure Start is to be further expanded, to achieve national coverage. US experience is highly relevant for anticipating challenges that this expansion will raise. Methods, This is a focused, narrative review. We examine the impact, funding, quality-improvement and programme objectives of Head Start and Early Head Start programmes. Results, (1) Early childhood interventions can make a significant difference to children's life chances; (2) expansion without adequate funding threatens quality; (3) narrower objectives, which are easier to measure, can crowd out broader objectives, which are difficult to measure; (4) programmes must balance fidelity to the model and flexibility to local conditions; (5) multiple objectives may conflict; and (6) programmes may have differential impacts. We consider the implications of these findings for Sure Start, focusing on funding, quality control and parental involvement. We also consider that the potential Sure Start should offer for tackling health inequalities in early childhood and suggest ways in which this aspect of the Programme could be enhanced. Conclusion, Head Start has been dogged by concerns about quality and effectiveness. Many of these problems stemmed from an over-hasty expansion, which locked the Programme into inadequate funding and uneven project- and staff-quality. These issues have been addressed through large funding increases and more rigorous performance measures. Nevertheless, concerns about the aims of the Programme and the extent of parental involvement in management remain. Current funding for Sure Start appears to be adequate, while systematic evaluation procedures have been built in from its inception. Concerns have been raised about the implications of expansion for funding, quality and for parental involvement in management of local programmes. US experience shows that these are centrally important issues and that, if they are not addressed early on, they can take many years to rectify. [source] Do community-based support services benefit bereaved children?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2001A review of empirical evidence Abstract Aims To consider the evidence of effect from English language, empirically based quantitative evaluations of community-based interventions for bereaved children; community-based interventions being understood as those taking place outside a clinical setting. Methods MedLine, PsychInfo, Applied Social Sciences Index and Sociological Abstracts were searched for documents containing the words ,child', ,bereavement' and ,program', ,group', ,intervention', ,support' or ,evaluation'. The criterion for inclusion was that studies use a control group or pre- and post-test measurements using a standardized instrument. Results Nine relevant studies were identified. However, empirical evidence of positive outcomes for children was limited and compromised by methodological weaknesses in the design of the studies. Small sample sizes, irregular attendance, high levels of attrition, short time scales between pre- and post-testing and difficulty in developing appropriate instrumentation, including assessment of adherence to the agreed intervention programme, all created problems. Conclusions The case for universal inclusion of this group of children in such support programmes remains unproven, and further exploration of the outcomes of a range of different community interventions is required, with a specific focus on long-term and/or unwanted effects and evaluation of the basis for referral. [source] Dietary intervention increases n-3 long-chain polyunsaturated fatty acids in skeletal muscle membrane phospholipids of obese subjects.CLINICAL ENDOCRINOLOGY, Issue 2 2006Implications for insulin sensitivity Summary Objective, Cross-sectional studies suggest that the fatty acid (FA) composition of phospholipids in skeletal muscle cell membrane may modulate insulin sensitivity in humans. We examined the impact of a hypocaloric low-fat dietary intervention on membrane FA composition and insulin sensitivity. Design, Muscle membrane FA profiles were determined in muscle (vastus lateralis) biopsies from 21 obese subjects before and after 6 months of dietary restriction. Diet instructions emphasized low intake of FA of marine origin by recommending lean fish and prohibiting fatty fish and fish oil supplements. Insulin resistance was estimated by the homeostasis model assessment (HOMA-IR). Results, The mean weight loss was 5·1 kg (range ,15·3 to +1·3 kg). BMI decreased from 36·5 to 34·9 kg/m2 (P = 0·003). Saturated FA (SFA) decreased 11% (P = 0·0001). Polyunsaturated FA (PUFA)n-6 increased 4% (P = 0·003). Long-chain PUFAn-3 increased 51% (P = 0·0001), mainly due to a 75% increase (P < 0·0001) in docosahexaenoic acid. Changes in HOMA-IR correlated significantly with changes in long-chain PUFAn-3 (R = ,0·57, P < 0·01), SFA (R = 0·58, P < 0·01) and waist circumference (R = 0·46, P < 0·05). A multivariate linear regression analysis that included changes in weight, fat mass, waist circumference, plasma lipids, PUFA, SFA and long-chain PUFAn-3 indicated that SFA and long-chain PUFAn-3 were independent predictors of HOMA-IR (R2 = 0·33, P < 0·01). Conclusions, A hypocaloric low-fat dietary intervention programme increased incorporation of long-chain PUFAn-3 and reduced SFA in skeletal muscle membrane phospholipids of obese subjects, a setting that may impact on insulin action. [source] Isoresistive dynamometer measurement of trunk muscle velocity at different angular phases of flexion and extensionCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 4 2001J. Surakka Isoresistive trunk muscle dynamometer is a potentially useful piece of equipment in evaluation of trunk muscle velocity, but to date, studies analysing the possibilities and limitations of such measurements are scarce. The aim of this study was to analyse the trunk muscle velocity in repetitive flexion and extension movements at three different angular phases, using an isoresistive trunk muscle dynamometer, and to assess the reliability of the measurements. The study population consisted of 120 healthy, sedentary men and women who volunteered for the study. The measurements were carried out before and after a 22-week training intervention programme. The results show that the peak velocities of the phases between 15 and 35° in flexion and 20,0° in extension (i.e. the second phases) correlated highly (r=0·99 in flexion and in extension) with the peak velocity of the whole movement ranging from ,5 to 55° in flexion and 40 to ,20° in extension. Correlations were high, both before and after the intervention. The LISREL model analysis showed high reliability of measurement for the second angular phases (in flexion and extension). According to the model, the correlation between the first and second measurement (with a 22-week training intervention in between) was 0·78 in flexion and 0·81 in extension. In conclusion, the angular phases from 15 to 35° in flexion and from 20 to 0° in extension represent the peak velocity of the whole movement. Negative residual correlations between the first and last angular phases in the LISREL model reflect the way of performing the movement: the faster the start the slower the end, and vice versa. [source] What is problem solving?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2001A review of theory, applications, research Introduction Structured training or therapy programmes designed to develop cognitive problem-solving skills are now widely used in criminal justice and mental health settings. Method This paper describes the conceptual origins and theoretical models on which such programmes are based, and provides a historical overview of their development. Theoretical formulations of problem-solving deficits have also been used to inform the design of intervention programmes, and a number of studies and evaluations of such interventions are reviewed, with particular reference to criminal and other antisocial behaviour. Discussion In recent years there has been steadily growing supportive evidence for the benefits of this approach. However, there are also several aspects of its application that require further investigation, and some of the remaining questions are identified. Copyright © 2001 Whurr Publishers Ltd. [source] The validity of an Australian modification of the AUDIT questionnaireDRUG AND ALCOHOL REVIEW, Issue 2 2001LOUISA J. DEGENHARDT Abstract The Alcohol Use Disorders Identification Test (AUDIT) has been used widely and is reported to be superior to conventional questionnaires in detection of current hazardous and harmful alcohol use. We assessed the validity of an Australian modification of the AUDIT (the AusAUDIT), which has been employed widely in Australian and New Zealand early intervention programmes. We used a cross-sectional study of 370 subjects from the follow-up phase of a randomized controlled trial of early intervention to reduce hazardous alcohol consumption. Scores on the AusAUDIT were compared against 12-month ICD-10 diagnoses of harmful alcohol use and dependence, as determined by the Composite International Diagnostic Interview, and against self-report of alcohol consumption exceeding Australian National Health and Medical Research Council (NH&MRC) recommended limits. AusAUDIT had good internal consistency and discriminated significantly between persons meeting criteria for ICD-10 alcohol use disorders, and drinkers who did not. At currently recommended cut-off scores, AusAUDIT detected more than 85% of people meeting criteria for ICD-10 alcohol use disorders, or drinking over NH&MRC recommended limits, but its specificity was limited (29% in men, and 58% in women for drinking over NH&MRC limits). No subset of questions performed as well as the full AusAUDIT in detection of drinking problems, but the alcohol consumption items provided a reasonable screen for drinking over NH&MRC limits. We conclude that AusAUDIT is effective in detecting problematic drinking, but positive cases should be confirmed by clinical assessment. The findings illustrate the need for validation of questionnaire modifications, and the difficulty in increasing test sensitivity without reducing specificity. [source] The First-Episode Psychosis Outcome Study: premorbid and baseline characteristics of an epidemiological cohort of 661 first-episode psychosis patientsEARLY INTERVENTION IN PSYCHIATRY, Issue 2 2007Philippe Conus Abstract Aims:, Studies conducted in first-episode psychosis (FEP) samples avoid many biases. However, very few studies are based on epidemiological cohorts treated in specialized FEP services. The aim of this file audit study was to examine premorbid and baseline characteristics of a large epidemiological sample of FEP. Methods:, File audit study of all patients admitted to the Early Psychosis Prevention and Intervention Centre between 1998 and 2000 using a specialized questionnaire. Results:, There were 661 patient files included in the study. Premorbid evaluation revealed high rates of substance use disorder (74.1%), history of psychiatric disorder (47.5%), past traumatic events (82.7%) suicide attempts (14.3%) and family history of psychiatric illness (55.6%). Baseline characteristics revealed high intensity of illness (mean CGI 5.5), high prevalence of lack of insight (62%) and high rate of comorbidity (70%). Conclusion:, High rates of traumatic events or episodes of mental illness before treatment for FEP must be considered when designing treatment approaches because a too narrow focus on positive psychotic symptoms will inevitably lead to incomplete treatment. Additionally, early intervention programmes need sufficient range of resources to address the multiple challenges presented by FEP patients such as high severity of illness, comorbidities and functional impairment. Finally, observation of an important degree of functional impairment despite short duration of untreated psychosis suggests that while early detection of FEP is a necessary step in early intervention, it may not be sufficient to improve functional recovery in psychosis and that efforts aimed at identifying people during the prodromal phase of psychotic disorders should be pursued. [source] Do smoking attitudes predict behaviour?ADDICTION, Issue 10 2008A longitudinal study on the bi-directional relations between adolescents' smoking attitudes, behaviours ABSTRACT Aims Prevention and intervention programmes focus frequently upon retaining or creating negative attitudes towards smoking in an effort to prevent adolescents from smoking. As the focus upon attitudes is central in these programmes it is essential to know whether smoking attitudes actually precede smoking behaviour or, conversely, are affected by it. Therefore, in the present study we examined to what extent bi-directional relations existed between smoking attitudes and behaviour. Design Data were used from the three annual waves of the ,Family and Health' project. Setting Participants were asked to complete questionnaires individually at their homes. Participants Addresses of families consisting of two parents and two adolescents were obtained from the records of 22 municipalities in the Netherlands. At baseline, 428 families participated with a response rate of 94% at the third measurement. Measurements Self-reports were used to assess adolescents' smoking attitudes and behaviour. Associations between smoking attitudes and behaviour were tested using structural equation modelling. Findings Findings revealed that smoking attitudes did not predict smoking consistently over time. However, past smoking affected subsequent attitudes moderately, suggesting that adolescents who started to smoke developed less negative attitudes towards smoking. Conclusions The current findings imply that smoking behaviour predominantly shapes smoking-related attitudes, rather than vice versa. Focusing merely on smoking attitudes is probably not enough to prevent adolescents from smoking. [source] | |||||||||||||||||||||||||||||||||||||