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Reduction Intervention (reduction + intervention)
Kinds of Reduction Intervention Selected AbstractsThe cost-effectiveness of consistent and early intervention of harm reduction for injecting drug users in BangladeshADDICTION, Issue 2 2010Lorna Guinness ABSTRACT Aims To assess the cost-effectiveness of the CARE-SHAKTI harm reduction intervention for injecting drug users (IDUs) over a 3-year period, the impact on the cost-effectiveness of stopping after 3 years and how the cost-effectiveness might vary with baseline human immunodeficiency virus (HIV) prevalence. Design Economic cost data were collected from the study site and combined with impact estimates derived from a dynamic mathematical model. Setting Dhaka, Bangladesh, where the HIV prevalence has remained low despite high-risk sexual and injecting behaviours, and growing HIV epidemics in neighbouring countries. Findings The cost per HIV infection prevented over the first 3 years was US$110.4 (33.1,182.3). The incremental cost-effectiveness of continuing the intervention for a further year, relative to stopping at the end of year 3, is US$97 if behaviour returns to pre-intervention patterns. When baseline IDU HIV prevalence is increased to 40%, the number of HIV infections averted is halved for the 3-year period and the cost per HIV infection prevented doubles to US$228. Conclusions The analysis confirms that harm reduction activities are cost-effective. Early intervention is more cost-effective than delaying activities, although this should not preclude later intervention. Starting harm reduction activities when IDU HIV prevalence reaches as high as 40% is still cost-effective. Continuing harm reduction activities once a project has matured is vital to sustaining its impact and cost-effectiveness. [source] Interventions to reduce the incidence of falls in older adult patients in acute-care hospitals: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2009Cindy Stern BHS(Hons) Abstract Aim, Falls can cause serious physical and emotional injuries to patients leading to poor quality of life and increased length of hospital stay. The aim of this study was to present the best available evidence regarding the effectiveness of risk assessment or other interventions that aimed to minimise the number of falls. Methods, A systematic review of randomised controlled trials was undertaken to determine the effectiveness of interventions that were designed to reduce the incidence of falls in older acute-care patients. Only trials published between 1998 and 2008 were considered. Results, Only seven studies were included in the review, indicating the evidence on this topic is sparse. There is some evidence to suggest that implementing the following interventions in acute hospitals may be effective in reducing the amount of falls of older adult inpatients: ,,A multidisciplinary multifactorial intervention program consisting of falls risk alert card, an exercise program, an education program and the use of hip protectors after approximately 45 days ,,A one-on-one patient education package entailing information on risk factors and preventative strategies for falls as well as goal setting ,,A targeted fall risk factor reduction intervention that includes a fall risk factor screen, recommended interventions encompassing local advice and a summary of the evidence There is also some evidence to suggest that implementing a multidisciplinary multifactorial intervention that consists of systematic assessment and treatment of fall risk factors, as well as active management of postoperative complications, can reduce the amount of falls in patients following surgery for femoral neck fracture. Conclusion, There is some evidence to suggest that certain multifactorial interventions are more effective than others and that increasing patient education or targeting fall risk factors may be of benefit. Further high-quality research is needed in order to ascertain effective fall-prevention strategies in acute-care facilities. [source] Preliminary efficacy of a comprehensive HIV prevention intervention for abstinent adolescent girls: Pilot study findings,RESEARCH IN NURSING & HEALTH, Issue 6 2009Dianne Morrison-Beedy Abstract We developed and pilot-tested a comprehensive HIV prevention/sexual risk reduction intervention with 54 sexually abstinent girls and estimated the effect of the intervention on three antecedents of sexual risk behavior: information, motivation, and behavioral skills. Girls ages 14,18 were randomized into either (a) an AbsPlus intervention or (b) a structurally equivalent control group. Assessments were obtained at baseline and 3 months follow-up using audio computer assisted self-interview. The intervention resulted in a large effect for information (d,=,1.11); small to large effects for the motivational measures (d,=,.34,.88), and a moderate effect for a measure of behavioral skills (d,=,.67). The results indicate that antecedents of sexual risk behavior change were improved by a gender-specific theoretically guided intervention. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:569,581, 2009 [source] Group-based HIV risk reduction intervention for adolescent girls: Evidence of feasibility and efficacyRESEARCH IN NURSING & HEALTH, Issue 1 2005Dianne Morrison-Beedy Abstract The purposes of this pilot study were (a) to assess the feasibility of a community-based, small group HIV risk reduction intervention with adolescent girls, and (b) to obtain preliminary evidence of the efficacy of this theoretically-guided intervention using a controlled design. The feasibility of the intervention was demonstrated by successfully implementing it with 33 sexually-active, single girls. Preliminary evidence of the efficacy of the intervention was obtained using a randomized trial with 62 sexually-active, single girls. Data obtained at a 3-month follow-up assessment showed that girls who received the HIV-related intervention improved their HIV-related knowledge and enhanced their motivation for risk reduction compared to girls who received a control (health promotion) intervention. Effect sizes suggest that the HIV intervention also reduced several risk behaviors (e.g., vaginal sex without a condom, giving oral sex, and alcohol and drug use before sex). Challenges to implementation and suggestions for intervention enhancement are discussed. © 2004 Wiley Periodicals, Inc. Res Nurs Health 28:3,15, 2005 [source] Legal piperazine-containing party pills-a new trend in substance misuseDRUG AND ALCOHOL REVIEW, Issue 3 2007JANIE SHERIDAN In this Harm Reduction Digest Sheridan, Butler, Wilkins and Russell address the emergent phenomenon of so-called ,legal party pills' which have become a significant drug issue in New Zealand and elsewhere. Although banned in a number of countries, they are currently legally available in New Zealand where they are marketed as ,safe' alternatives' to ,illicit' drugs often used in the dance scene such as MDMA and amphetamines. The authors describe the availability and use of these substances in New Zealand, summarize what is known about their effects, and speculate on harm reduction interventions and mechanisms of control and their possible sequelae. The paper provides a timely account of an emerging drug issue of relevance to harm reduction internationally. [source] Evidence for the effectiveness of sterile injecting equipment provision in preventing hepatitis C and human immunodeficiency virus transmission among injecting drug users: a review of reviewsADDICTION, Issue 5 2010Norah Palmateer ABSTRACT Aims To review the evidence on the effectiveness of harm reduction interventions involving the provision of sterile injecting equipment in the prevention of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission among injecting drug users (IDUs). The interventions assessed were needle and syringe programmes (NSP), alternative modes of needle/syringe provision (pharmacies, vending machines and outreach) and the provision of injecting equipment other than needles/syringes. Methods Systematic searches of the English language literature to March 2007 were undertaken to identify systematic, narrative or meta-analytical reviews (also known as a review of reviews) of the impact of interventions on HCV transmission, HIV transmission or injecting risk behaviour (IRB). Critical appraisal criteria classified the reviews as either high quality (,core') or supplementary: a framework based on the quality of reviews, the reviewers' conclusions and the designs/findings of the primary studies was used to derive evidence statements. Results Three core and two supplementary reviews of injecting equipment interventions were identified. According to the proposed framework, this study found (a) insufficient evidence to conclude that any of the interventions are effective in preventing HCV transmission; (b) tentative evidence to support the effectiveness of NSP in preventing HIV transmission; (c) sufficient evidence to support the effectiveness of NSP (and tentative evidence of an additional impact of pharmacy NSP) in reducing self-reported IRB; and (d) little to no evidence on vending machines, outreach or providing other injecting equipment in relation to any of the outcomes. Conclusions The evidence is weaker than given credit for in the literature. The lack of evidence for effectiveness of NSP vis-à-vis biological outcomes (HCV and HIV incidence/prevalence) reflects the limitations of studies that have been undertaken to investigate these associations. Particularly for HCV, low levels of IRB may be insufficient to reduce high levels of transmission. New studies are required to identify the intervention coverage necessary to achieve sustained changes in blood-borne virus transmission. [source] Policy interventions to reduce the harm from smokingADDICTION, Issue 1s1 2000Peter Anderson The other papers in this series on reduced smoking discuss interventions focused on individuals. This paper illustrates possible smoking reduction interventions focused on policies rather than individuals. Target 12 of the new WHO Health For All Policy aims to significantly reduce the harm from addictive substances, including tobacco, in all member states by 2015, and the WHO Third Action Plan for Tobacco-Free Europe focuses on reducing the harm from tobacco. These documents recommend five key policy strategies: market regulation, product liability, smoke-free environments, support for smoking cessation and education, public information and public opinion. Interventions such as price increases, restricting availability, advertising bans and product control could all be used to achieve harm reduction. Research on reducing the harm of smoking needs to include policy as well as treatment research. [source] Relationship of Stigma to HIV Risk Among Women with Mental IllnessAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2008Pamela Y. Collins MD Urban women with severe mental illness (SMI) are vulnerable to stigma and discrimination related to mental illness and other stigmatized labels. Stigma experiences may increase their risk for negative health outcomes, such as HIV infection. This study tests the relationship between perceived stigma and HIV risk behaviors among women with SMI. The authors interviewed 92 women attending community mental health programs using the Stigma of Psychiatric Illness and Sexuality Among Women Questionnaire. There were significant relationships between personal experiences of mental illness and substance use accompanying sexual intercourse; perceived ethnic stigma and having a riskier partner type; and experiences of discrimination and having a casual or sex-exchange partner. Higher scores on relationship stigma were associated with a greater number of sexual risk behaviors. The findings underscore the importance of exploring how stigma attached to mental illness intersects with other stigmatized labels to produce unique configurations of HIV risk. HIV risk reduction interventions and prevention research should integrate attention to stigmatized identities in the lives of women with SMI. [source] Assessing violence risk in Tarasoff situations: a fact-based model of inquiry,BEHAVIORAL SCIENCES & THE LAW, Issue 3 2001Randy Borum Psy.D. Although significant advances in risk assessment research and practice have been made in recent years, there has not been any analysis in the professional literature regarding how and whether the emerging practice recommendations apply in Tarasoff -type situations. We suggest that, when faced with a Tarasoff -type situation, the appraisal of risk should be guided by a method that is primarily fact-based and deductive, rather than by the more inductive risk assessment approach for general violence recidivism, which is guided primarily by base rates and historical risk factors. We review the principles underlying a fact-based, or threat assessment, approach and outline six areas of inquiry that can guide the appraisal of risk: A,attitudes that support or facilitate violence, C,capacity, T,thresholds crossed, I,intent, O,other's reactions, and N,noncompliance with risk reduction interventions. Copyright © 2001 John Wiley & Sons, Ltd. [source] | |||||||||||||