6-month Postintervention Research Articles

Evaluating the effectiveness of patient-tailored treatment for patients with non-specific (sub)acute neck pain

BackgroundAn important issue in the debate about best practice management of non-specific neck pain (NSNP) is the effectiveness of tailored versus generalized interventions. MethodsParticipants with (sub)acute NSNP were randomly allocated to a patient-tailored treatment (PTT), non-patient-tailored treatment (NPTT) or control group (no intervention). The outcome measures were pain (NPRS), disability (NDI), global perceived effect and satisfaction (GPES), productivity costs, and medical consumption. Patients were assessed at baseline, post-intervention, and at 3-, 6-, and 12-months post-intervention. Evolution of the complaints, treatment adherence, and medication intake was registered during the intervention period. Linear mixed models were used to examine interaction effects as well as between- and within-group differences. ResultsSixty-one participants were included. There was no “Group x Time”-interaction effect for all outcome measures. Nevertheless, all groups showed significant and clinically relevant within-group differences at all time points for pain and disability (p < 0.001). At 6 months follow-up, NPTT was superior to PTT for reductions in pain but not for disability. At 1 year, the number of responders in the NPTT group remained higher (75%) compared to the PTT group (40%). ConclusionThis study found a significant and clinically relevant reduction of pain and disability within all groups. Patient-tailored treatment as well as NPTT can be considered an effective method when aiming for a reduction in pain and disability at short-term (12 weeks). However, NPTT seemed to be more effective at 1-year follow-up and therapists should consider spontaneous recovery. The results should be interpreted with caution and further research is warranted.

Hope Connection® 2.0: The effectiveness of a post-adoption family camp intervention for promoting emotional and behavioral health among adopted children

Decades of research demonstrates that experiencing pre-adoption risk and trauma can lead to long-term effects on emotional, behavioral, and sensory processing challenges. Post-adoption services that equip parents with tools to address adopted children’s needs are critical to support healthy development. More specifically, interventions are needed that focus on the adopted child within the family context and incorporate trauma-informed approaches. The current study examines the effectiveness of Hope Connection® 2.0, a therapeutic family post-adoption intervention to improve trauma-related emotional and behavioral issues in adopted children ages 6–12. The camp context included programming for siblings, training and support for parents in Trust-based Relational Intervention® (TBRI®), and was conducted in two segments to allow parents time to practice TBRI at home between sessions. A within-subjects waitlist control design involving 32 adopted children from 18 families was used to examine change prior to and following the intervention. Analysis of variance revealed significant change at 6-months post-intervention. Parents reported decreases in conduct problems and post-traumatic stress (arousal) over time, some reductions in hyperactivity and anger, and decreased sensory processing challenges (i.e., seeking and avoiding behaviors). Findings suggest that Hope Connection 2.0′s emphasis on the entire family shows promise as an effective intervention for reducing emotional and behavioral challenges in adoptive children and provides further evidence for the utility of TBRI in improving outcomes for adopted children.

AHP SO08 - Weekend physiotherapy pilot for patients on hepatobiliary enhanced recovery pathways: Examining the impact of a 7-day service

Abstract Background Enhanced recovery after surgery (ERAS) is a safe, multi-disciplinary, evidenced-based approach to optimise the perioperative management and outcomes after hepatobiliary (HPB) surgery. Despite the adoption of the ERAS mobilisation protocols to improve recovery time, one limitation is a traditional 5-day service model (Monday-Friday). This can result in an inequality of service provision for those patients operated Thursday or Friday and lead to increased length of stay (LOS) in hospital. Mobilisation across 7 days can ensure improved compliance with ERAS mobilisation protocols, better continuity of care, facilitate improved outcomes and timely discharge from hospital. Method Data was collected pre-introduction of the 7-day physiotherapy service from May-October 2022. During November 2022 – April 2023 a 7-day physiotherapy service was piloted. This service included 1 qualified physiotherapist and 1 non-qualified physiotherapist on Saturday and Sunday. This 7-day service provided continuity of care for patients from intensive care or post-anaesthesia care unit to the ward, facilitating discharges and accelerating return to independence. Data was collected during the 7-day service as well as 6 months post intervention (May 2023-October 2023). Acceptability of the intervention was assessed among the HPB multi-disciplinary team (MDT) using a survey consisting of 5 qualitative questions. Results The table illustrates that a reduction in mean LOS was seen in all 4 HPB surgeries that follow ERAS protocols during the 7-day physiotherapy service. It was also shown that 6-months post intervention (returning to a 5-day service) all 4 HPB ERAS surgeries mean LOS increased. To determine the acceptability of the 7-day physiotherapy service, 22 members of the MDT responded to a survey (5 consultants, 4 physiotherapy staff, 4 sisters, 5 staff nurses, 1 nursing assistant, 2 healthcare assistants). All 22 members of the MDT agreed that a 7-day physiotherapy service was acceptable and improves recovery. Conclusion A 7-day physiotherapy service has shown to reduce mean LOS in comparison to a 5-day physiotherapy service within HPB ERAS pathways. From an MDT perspective the 7-day physiotherapy service was also deemed to be beneficial and improves patient recovery.

Protocol for the development and piloting of a cluster randomised controlled trial for stress prevention, management, and coping mechanism among police officers in Nigeria

BackgroundPolicing is a stressful occupation. Police officers are exposed to stressors that are inherent in the organization and operations of law enforcement. Similar to their counterparts around the world, many Nigeria police officers are exposed to high levels of stress, making them vulnerable to stress-related mental health conditions and other noncommunicable diseases. Despite these risks and their consequences to the health and safety of police officers and the larger society, interventions are currently not available to address this challenge in Nigeria. This pilot study aims to assess the burden of stress from a national sample of police officers and test the feasibility of an intervention for stress prevention, management, and coping mechanisms among police officers in Nigeria.MethodsThis is a three-phase study: (1) a needs assessment and situational analysis using a convergent parallel, mixed-methods approach to determine the prevalence of stress and mental health burden among 1200 police officers in four randomly selected states in four geopolitical zones of the country, (2) the development of a peer-led intervention for stress prevention, management, and coping mechanism which will be tested using a cluster randomized trial among 200 police officers, and (3) the preliminary evaluation of the intervention based on knowledge about stress management and mental disorders and psychological distress and reduction in stress levels. These measures will be obtained at baseline (T0), immediate (T1), and 6-month post-intervention (T2). Feasibility will be determined based on enrollment rate, attendance, and completion of the group sessions. Multivariable linear regression models taking into account clustering effects will be used to estimate between-group differences in outcome measures.DiscussionFindings from the study will inform policy review and the development of a pragmatic intervention on stress prevention and management among police officers. This will enhance the policing role of officers, thus contributing to the safety of the communities they serve.Trial registrationPACTR Registry: PACTR202310474721238. Registered on 6 October, 2023.https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25663.Protocol version number 1.0 (date: 6 October, 2023).

Effectiveness of digital screening and brief intervention for alcohol misuse among college students: A state-wide cluster randomized trial from India.

Alcohol misuse is prevalent among college students globally, including in India. Digital screening and brief interventions (DSBI) promise to address this issue. This study assesses DSBI's effectiveness in a state-wide cluster randomized trial among college students in India. We recruited 548 participants (274 in each DSBI and digital screening and brief advice-DSBA) from 40 colleges across 10 districts of Punjab, India. Colleges were selected via two-stage cluster random sampling and were allocated to groups using permuted block randomization. Participants with Alcohol Use Disorder Identification Test (AUDIT) scores between 8 and 19 were included. The digital platform directed eligible participants to their respective groups. DSBI participants received information on alcohol harms, normative and personalized feedback, a decisional balance checklist, and a menu of options. DSBA participants received screening and alcohol harm information. Follow-ups were conducted at 3- and 6-month post-intervention. reduction in AUDIT scores; secondary outcomes: frequency of drinking, drinks per drinking day, and frequency of heavy episodic drinking (HED). Baseline demographics and clinical variables did not significantly differ between groups, except for participants' age. 37.6% were women. Follow-up rates were 513/548 at 3 months and 483/548 at 6 months, with no group differences in attrition. AUDIT scores significantly decreased in both groups at 3 and 6 months (Time F = 1870.11, p < 0.001, partial η2 = 0.77), with no Group × Time effects (F = 0.160, p = 0.85). Drinking frequency, HED frequency, and drinks per drinking day decreased significantly in both groups without between-group differences. The study highlights the potential policy implications of integrating brief digital interventions for alcohol misuse into educational health initiatives.

Behavioral activation program for reducing depressive symptoms among the bereaved of cancer patients: A feasibility and preliminary effectiveness study in Japan.

This study aimed to examine the feasibility and preliminary effectiveness of a behavioral activation (BA) program for the bereaved of cancer patients toward reducing depressive symptoms. The BA program for the bereaved was a partially modified version for cancer patients. This program encompassed a preinterview and seven 50-minute sessions every 1-2 weeks, using worksheets, with homework assignments each day. To examine feasibility, the completion rates of intervention and 3 months of follow-up were examined. To examine the preliminary effectiveness, psychological symptoms were assessed with the Patient Health Questionnaire (PHQ-9; primary outcome) and Beck Depression Inventory-II (BDI-II) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. These were evaluated 3 times: before, immediately after, and 3-month post-intervention. Non-parametric tests were used for comparison of scores at 3 time points and calculation of effect size. Of the 42 bereaved who were contacted, 21 were eligible and 20 were participated, while 19 and 18 were in the completed intervention and completed 3-month post-intervention categories (intervention completion rate was 95% and follow-up completion rate was 90%). PHQ-9, BDI-II, and GAD-7 showed significant reductions immediately and 3 months after the intervention compared to pre-intervention, and the effect sizes were all large after 3 months, although they were less than immediately after (PHQ-9: 0.89, 0.71; BDI-II: 0.88, 0.67; GAD-7: 0.57, 0.53). This study indicated that the BA program for the bereaved of cancer patients was feasible and effective vis-à-vis reducing depressive symptoms.

Effect of weighted blankets on sleep quality among adults with insomnia: a pilot randomized controlled trial.

Weighted blanket is an emerging non-pharmacotherapy for sleep disorders, but its effect on sleep among relatively healthy adults with insomnia remains uncertain. This study aimed to evaluate whether weighted blankets could better improve sleep quality and sleep-related symptoms among adults with insomnia. In a prospective, pilot randomized controlled trial conducted in three tertiary hospitals in China, participants with clinical insomnia were randomized (1:1) to receive weighted blanket intervention or normal blanket intervention for 1 month by random-number tables. The primary outcomes were sleep quality assessed with Pittsburgh Sleep Quality Index (PSQI) and insomnia severity assessed with Insomnia Severity Index. Subjective outcomes were measured at baseline, 1 week, and 1-month post-intervention. Sleep was also objectively monitored by actigraphy. We did analysis by intention to treat. A total of 102 participants were randomly assigned to receive weighted blanket intervention (n = 52) or normal blanket intervention (n = 50). 95 (93.1%) participants completed the follow-up, and 7 (6.9%) participants dropped out of the study. The weighted blanket group had significant improvements in sleep quality compared to the normal blanket group after 1 month of intervention (changes in the mean [SD] of PSQI score: -4.1 [4.1] vs. -2.0 [3.2], P = 0.006). Similar results were observed for daytime sleepiness, stress, anxiety, fatigue, and bodily pain (all P < 0.05). Recordings from actigraphy showed a decrease in the mean (SD) of the number of awakenings in weighted blanket group (-1.4 [9.5]) and an increase in normal blanket group (+ 1.0 [7.9]) (P = 0.280). No severe adverse events occurred. Weighted blanket might be an effective, safe and promising non-pharmacotherapy tool for improving sleep-related symptoms among adults with insomnia, although validation with a larger sample size is needed. Chinese Clinical Trial Registry: ChiCTR2300078011, date of registration: 11/27/2023, retrospectively registered.

Effects of smartphone-based chatbot intervention to increase influenza and COVID-19 vaccine uptake among South Asian ethnic minorities in Hong Kong: protocol for a randomised waitlist-controlled trial

IntroductionProtecting non-native ethnic minority groups against cocirculation of influenza and COVID-19 is crucial, and vaccination could be a viable option. Smartphone-based chatbots offer promising opportunities for improving vaccine knowledge and...

Telehealth-delivered depression prevention: Short-term outcomes from a school-based randomized controlled trial.

To examine short-term (i.e., postintervention) outcomes from a randomized controlled trial comparing a school-based telehealth-delivered depression prevention program, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), to services as usual (SAU). We expected IPT-AST would be acceptable and feasible and that IPT-AST adolescents would experience greater reductions in depression symptoms, anxiety symptoms, and impairment compared with SAU. Adolescents (N = 242; Mage = 14.80 years, SD = 0.70; 65% female; 21% Black; 13% Hispanic/Latinx) with elevated scores on the Center for Epidemiologic Studies Depression Scale (Radloff, 1977) at screening provided data at baseline, 2-month (midpoint of IPT-AST), and 3-month (postintervention) assessments. They reported depression symptoms on the Center for Epidemiologic Studies Depression Scale, anxiety symptoms on the Screen for Child Anxiety Related Emotional Disorders (Birmaher et al., 1997), and impairment on the Columbia Impairment Scale (Bird et al., 1993). Baseline depression diagnosis was examined as a moderator. Hierarchical linear models showed that adolescents reported significant reductions in depression symptoms and impairment across conditions. IPT-AST adolescents reported significantly greater reductions in anxiety symptoms than SAU adolescents, d = .39, 95% CI [.05, .72], p = .003. Depression diagnosis moderated outcomes (ds = .33-.34, ps ≤ .05), such that IPT-AST adolescents without a diagnosis at baseline showed greater improvements in depression and anxiety symptoms than SAU adolescents. Adolescents in SAU with a depression diagnosis at baseline showed greater improvements in impairment compared with IPT-AST. Attendance and satisfaction data demonstrated the feasibility and acceptability of telehealth-delivered IPT-AST. Results support telehealth-delivered IPT-AST as a promising intervention for improving short-term outcomes among adolescents with depression symptoms but without a depression diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Young adult Latino testicular cancer survivors: a pilot study of Goal-focused Emotion regulation Therapy (GET)

PurposeYoung adult Latino testicular cancer survivors experience adverse impacts after treatment. We developed Goal-focused Emotion regulation Therapy (GET) to improve distress symptoms, goal navigation skills, and emotion regulation. This open pilot trial extended GET to Latino young adult survivors of testicular cancer and assessed feasibility and tolerability as well as changes in anxiety and depressive symptoms. Secondary outcomes included goal navigation, emotion regulation, and components of hope-related goal processes (i.e., agency and pathway mapping). To assess the extent to which GET is culturally congruent or in need of adaptation, the influence of simpatía and acculturative stress were also examined.MethodsThirty-five eligible young adult (age 18–39) survivors treated with chemotherapy were enrolled and assessed at baseline. Study acceptability, tolerability, and therapeutic alliance were examined. Preliminary efficacy was evaluated for changes in anxiety and depressive symptoms as well as psychological processes (goal navigation, agency, goal pathway skill, and emotion regulation) from baseline to immediate post- and 3-month post-intervention.ResultsAmong the 35 men assessed at baseline, 54% initiated intervention sessions. Among these, 94.7% completed all study procedures. Helpfulness ratings of intervention components and therapeutic alliance scores were strong. Repeated measures ANOVA revealed significant reductions in anxiety and depressive symptoms from pre- to post-intervention with sustained change at the 3-month follow-up. Favorable patterns of change were also observed in GET-related psychological processes. Simpatía was associated with less depressive symptoms at post-intervention, but not change in anxiety. Acculturative stress was associated with increased anxiety and depressive symptoms over time.ConclusionGET is a feasible and acceptable intervention for reducing adverse outcomes after testicular cancer for young adult Latino men. Results should be considered preliminary but suggest meaningful changes in emotional and psychological outcomes.

Phenotypes of sleep health among adults with chronic heart failure in a randomized controlled trial of cognitive behavioral therapy for insomnia

BackgroundPoor sleep contributes to adverse health in heart failure. However, studies are limited to isolated sleep characteristics. PurposesTo evaluate changes in sleep health phenotypes after cognitive behavioral therapy for insomnia or attention control and associations between sleep health phenotypes, symptoms, stress, functional performance, and emergency department visits and hospitalizations. MethodsSecondary analysis of a randomized controlled trial of cognitive behavioral therapy for insomnia among adults with heart failure. We measured sleep (rest-activity rhythms, sleep duration, quality, and efficiency, insomnia severity, daytime sleepiness), symptoms, cognitive ability, vigilance, and 6-minute walk distance at baseline and 3-, 6-, and 12-month postintervention and collected hospitalizations and emergency department visits. We used K-means cluster analysis and generalized linear mixed models, generalized estimating equations, and Cox proportional hazard models. ResultsAmong 166 participants (M age=63.2 (SD=12.6) years; 57% male; 23% New York Heart Association Class III/IV), there were four sleep health phenotypes (“Unstable Sleep” (15%); “Short Sleep” (39%); “Low Sleep Efficiency” (25%); and “Good Sleep” (21%)) at baseline. The healthiest phenotype was associated with the lowest fatigue. The proportions of participants in the healthiest sleep group increased from pre- to post-treatment. Low sleepiness (p = .0188) and a robust circadian quotient (p = .007) predicted transition to the healthiest phenotype. The poorest sleep phenotype at baseline predicted time to hospitalizations and emergency department visits (hazard ratios 0.35-0.60) after adjusting for covariates. ConclusionSleep phenotypes predict heart failure outcomes. Tailored interventions targeting phenotypes may be more effective than approaches that focus on single sleep characteristics.

Does working memory training in children need to be adaptive? A randomized controlled trial.

Most cognitive training programs are adaptive, despite limited direct evidence that this maximizes children's outcomes. This randomized controlled trial evaluated working memory training with difficulty of activities presented using adaptive, self-select, or stepwise compared with an active control. At baseline, immediately, and 6-months post-intervention, 201 Australian primary school children (101 males, 7-11 years) completed working memory tests (near and intermediate transfer) and the Raven's Standard Progressive Matrices, and caregivers completed the attention-deficit/hyperactivity disorder-Rating Scale-5 (far transfer). The intervention comprised ten 20-min sessions delivered in class. For each training condition, compared with the active control, there was no evidence of transfer immediately or 6-months post-intervention (negligible to small effects). This trial provides no evidence that adaptive working memory training maximizes children's outcomes.

WAT’s up? Exploring the Impact of Wearable Activity Trackers on Physical Activity and Wellbeing: A Systematic Research Review

AbstractWearable activity trackers (WATs) can facilitate engagement in physical activity. Yet, there may be an additional psychological impact, which can influence their effectiveness. Therefore, the aim of this systematic review was to assess the impact of wrist-based WATs on physical activity and subsequent psychological wellbeing in healthy adults. The review was carried out using PRISMA guidelines and registered on the Open Science Framework (OSF). An initial search was conducted in December 2022 with a follow-up in October 2023. Databases included PsychInfo, PsycArticles, ScienceDirect, Web of Science and SPORTDiscus. Nine studies were selected for inclusion and reviewed. Most studies comprised white adults with an average age of 21.5 to 49 years. Participants were employed or students with a mostly normal BMI. Changes in self-efficacy for exercise, depressive symptoms, mental health and general wellbeing, quality of life and burnout were evaluated. Half the studies reported a WAT-related increase in physical activity engagement. Four studies assessed self-efficacy for exercise, with half observing an improvement post-intervention. Three studies assessed mental health and depressive symptoms with one observing improvement and two observing no change. The remaining studies included measures of burnout and quality of life, where only burnout scores improved 1-month post-intervention. Although the quality of the studies reviewed was acceptable, only 4 included a suitable control/comparison group. Further, the measurement of psychological wellbeing varied considerably. In sum, the results indicate that the effect of WATs on physical activity and subsequent psychological wellbeing is understudied. Further research is required to fully elucidate these relationships.

Exploring the efficacy of memory specificity training on depression among Iranian adolescents: a comparative analysis of online vs. in-person delivery

Depression in adolescence is common worldwide, with the burden being highest in low- and middle-income countries. This study assessed the efficacy of in-person Memory Specificity Training (MeST) and computerized MeST (c-MeST) as cognitive training programs aimed at addressing depression among Iranian adolescents. A secondary aim was to evaluate the efficacy of MeST and c-MeST on autobiographical memory specificity, emotion regulation and cognitive control. Ninety Iranian male adolescents (aged 13–18 years) with depression were randomly assigned to three groups; MeST group (n = 30), c-MeST group (n = 30) and the non-active control group (n = 30). Participants completed the Beck Depression Inventory-II, Autobiographical Memory Test, Cognitive Emotion Regulation Questionnaire, Wisconsin Card Sorting Test and Stroop Color and Word Test. The groups underwent either MeST and c-MeST. All the assessments were re-conducted after the intervention (post-intervention) and at 1-month post-intervention (follow-up). The in-person MeST group exhibited significantly higher autobiographical memory specificity at post-intervention and follow-up compared to the c-MeST group. Both groups demonstrated significantly lower levels of depression at post-intervention and follow-up. Both groups showed improvements in emotion regulation and cognitive control, which were found to mediate improvements in depression symptomatology. c-MeST and MeST appear promising brief interventions for the treatment of depression among adolescents in Iran.

NeuroCARE: A Randomized Controlled Trial of a Psychological Intervention for Caregivers of Patients With Primary Malignant Brain Tumors.

Caregivers of patients with primary malignant brain tumors (PMBT) experience significant psychological distress. We assessed the effect of a psychological intervention (NeuroCARE) on anxiety symptoms among PMBT caregivers. We conducted a randomized trial of NeuroCARE versus usual care in PMBT caregivers with elevated anxiety (Generalized Anxiety Disorder-7 score ≥5) within 6 months of the patient's diagnosis. NeuroCARE was developed for PMBT caregivers and consists of six telehealth sessions with a behavioral health specialist. Participants completed surveys at baseline, 11-week (postintervention), and 16-week (1-month postintervention) time points. The primary outcome was 11-week anxiety symptoms (Hospital Anxiety and Depression Scale [HADS]-Anxiety Subscale). We also measured depression symptoms (HADS-Depression Subscale), quality of life (QOL; Caregiver QOL survey), caregiver burden (Caregiver Reaction Assessment), self-efficacy (Lewis Cancer Self-Efficacy Scale), coping (Measure of Current Status), and post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for DSM-5). We conducted analysis of covariance and linear mixed-effects regression analyses to examine intervention effects on study outcomes. We enrolled 120 caregivers (60/group) between October 2019 and June 2022; 105 were evaluable for the primary outcome. At 11 weeks, NeuroCARE participants reported significantly lower anxiety symptoms than usual care participants (M, 8.87 v 10.69; P = .008). NeuroCARE caregivers also reported significantly lower depression symptoms (M, 6.08 v 7.77; P = .004), and better self-efficacy (M, 128.81 v 111.17; P < .001) and coping (M, 32.25 v 25.65; P < .001) at 11 weeks. Study groups did not differ significantly in 11-week QOL, caregiver burden, or PTSD symptoms. In longitudinal analyses, intervention effects on depression symptoms, self-efficacy, and coping were sustained. A novel, population-specific psychological intervention led to improved anxiety and depression symptoms, self-efficacy, and coping among PMBT caregivers.

Mothers and Babies Virtual Group (MBVG) for perinatal Latina women: study protocol for a hybrid type-1 effectiveness-implementation randomized controlled trial

BackgroundImmigrant Latinas (who are foreign-born but now reside in the USA) are at greater risk for developing postpartum depression than the general perinatal population, but many face barriers to treatment. To address these barriers, we adapted the Mothers and Babies Course—an evidence-based intervention for postpartum depression prevention—to a virtual group format. Additional adaptations are inclusion of tailored supplemental child health content and nutrition benefit assistance. We are partnering with Early Learning Centers (ELC) across the state of Maryland to deliver and test the adapted intervention.MethodsThe design is a Hybrid Type I Effectiveness-Implementation Trial. A total of 300 participants will be individually randomized to immediate (N = 150) versus delayed (N = 150) receipt of the intervention, Mothers and Babies Virtual Group (MB-VG). The intervention will be delivered by trained Early Learning Center staff. The primary outcomes are depressive symptoms (measured via the Center for Epidemiologic Studies-Depression Scale), parenting self-efficacy (measured via the Parental Cognition and Conduct Towards the Infant Scale (PACOTIS) Parenting Self-Efficacy subscale), and parenting responsiveness (measured via the Maternal Infant Responsiveness Instrument) at 1-week, 3-month, and 6-month post-intervention. Depressive episodes (Structured Clinical Interview for DSM-V- Disorders Research Version) at 3-month and 6-month post-intervention will also be assessed. Secondary outcomes include social support, mood management, anxiety symptoms, perceived stress, food insecurity, and mental health stigma at 1-week, 3-month, and 6-month post-intervention. Exploratory child outcomes are dysregulation and school readiness at 6-month post-intervention. Intervention fidelity, feasibility, acceptability, and appropriateness will also be assessed guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.DiscussionThis study will be one of the first to test the efficacy of a group-based virtual perinatal depression intervention with Latina immigrants, for whom stark disparities exist in access to health services. The hybrid effectiveness-implementation design will allow rigorous examination of barriers and facilitators to delivery of the intervention package (including supplemental components) which will provide important information on factors influencing intervention effectiveness and the scalability of intervention components in Early Learning Centers and other child-serving settings.Registration.ClinicalTrials.gov NCT05873569.

SP5.2 - Reducing Elective Colorectal Surgical Site Infections with Change of Gloves and Instruments Prior to Abdominal Closure; A Multicycle Audit

Abstract Aims Surgical site infections (SSI) carry a significant impact on patient morbidity, length of stay and antibiotic resistance. Our local colorectal unit has made several interventions over many years with no significant nor sustained improvement in the rate of SSI. The ChEETAh trial (Lancet, 2022) demonstrated a reduction in the rate of 30-day SSI by 13% with routine change of gloves and instruments (COGI) prior to abdominal closure. We aim to reduce our rate of SSI through implementation of COGI prior to abdominal closure; involving whole scrub team change of gloves and use of sterile instruments. Methods Adults undergoing elective colorectal surgery with an abdominal wound greater than 5cm were eligible for this study. Diagnosis of SSI was made based on at least one clinical indicator of infection or at least one symptom of SSI with data collection over 3 cycles spanning 11 months using clinical notes, imaging and microbiology results. The primary outcome was the diagnosis of a SSI involving the skin, subcutaneous, muscle or fascial layer up to 30 days post-operatively. Results The baseline SSI rate prior to intervention was audited at 29%. After implementation of COGI the rate fell to 23%. Further reinforcement of COGI and team education has demonstrated a further decrease in SSI to 15%. This has been sustained across a 6-month period post intervention. Conclusions Change of gloves and instruments is an effective, reliable and sustainable method to reduce the rate of surgical site infection in elective colorectal abdominal surgery.

A Transdiagnostic Video-Based Internet Intervention (Uni Virtual Clinic-Lite) to Improve the Mental Health of University Students: Randomized Controlled Trial.

Numerous studies have demonstrated the effectiveness of digital interventions for improving the mental health of university students. However, low rates of engagement with these interventions are an ongoing challenge and can compromise effectiveness. Brief, transdiagnostic, web-based video interventions are capable of targeting key mental health and related issues affecting university students and may be more engaging and accessible for this population. This study used a 2-arm randomized controlled trial to evaluate the effectiveness of Uni Virtual Clinic-Lite (UVC-Lite), a fully automated, transdiagnostic, web-based video intervention, relative to an attention-control condition. The primary outcomes were symptoms of depression and generalized anxiety disorder. The secondary outcomes included psychological distress, social anxiety symptoms, body appreciation, quality of life, well-being, functioning, general self-efficacy, academic self-efficacy, and help seeking. Program use (intervention uptake and engagement) and satisfaction were also assessed. University students (n=487) with mild to moderate symptoms of distress were recruited from universities across Australia and randomly allocated to receive access to the UVC-Lite intervention or an attention-control condition targeting general health for a period of 6 weeks. UVC-Lite includes 12 modules, each comprising a brief animated video and an accompanying exercise. Of the 12 modules, 7 also included a brief symptom screening quiz. Outcomes were assessed at baseline, postintervention, and 3- and 6-months postintervention. The primary and secondary outcomes were analyzed on an intention-to-treat basis using mixed models repeated measures ANOVA. The intervention was not found to be effective relative to the control condition on any of the primary or secondary outcomes. While 67.9% (114/168) of participants accessed at least 1 module of the intervention, module completion was extremely low. Subgroup analyses among those who engaged with the program (completed at least 1 video) and those with higher baseline distress (Distress Questionnaire-5 score ≥15) did not reveal any differences between the conditions over time. However, uptake (accessing at least 1 video) and engagement (completing at least 1 video) were higher among those with higher baseline symptoms. Satisfaction with the intervention was high. The UVC-Lite intervention was not effective relative to a control program, although it was associated with high satisfaction among students and was not associated with symptom deterioration. Given the challenges faced by universities in meeting demand for mental health services, flexible and accessible interventions such as UVC-Lite have the potential to assist students to manage symptoms of mental health problems. However, low uptake and engagement (particularly among students with lower levels of symptomatology) are significant challenges that require further attention. Future studies should examine the effectiveness of the intervention in a more highly symptomatic sample, as well as implementation pathways to optimize effective engagement with the intervention. Australian New Zealand Clinical Trials Registry ACTRN12621000375853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380146.

An Intervention to Improve Evidence-Based Nicotine Prescribing by Primary Care Physicians

Objectives Nearly 70% of people who use tobacco want to quit. Combination nicotine replacement therapy (cNRT), a long-acting controller plus short-acting reliever, is the most effective way to prescribe nicotine but is infrequently prescribed by primary care physicians (PCPs). We tested the feasibility and effectiveness of a brief, educational intervention to increase cNRT prescribing by PCPs in a large integrated health system. Methods We conducted a pre-post study from 2022–2023 at a large integrated health system in California where specific NRT products are covered with a prescription. PCPs were offered a 30-minute virtual training about cNRT during a required monthly meeting (n = 267; 202 attended). The training was interactive, included simple “asks” and a 6-week follow-up communication. Chi-square analysis was used to test for changes in cNRT prescribing behaviors in the 6 months before and after training. Results Among physicians who completed a posttraining questionnaire (180/202), 93% reported increased confidence, 91% reported favorable attitudes, and 88% reported intention to prescribe cNRT. According to data obtained from the integrated pharmacy database, the total number of patients who received a cNRT prescription increased from the 6-month pre- to 6-month postintervention from 135 (9%) to 380 (23%), P &lt; 0.001. The total number of physicians who prescribed cNRT increased pre- to posttraining from 78 (23%) to 124 (37%), P &lt; 0.001. Conclusion cNRT is an underutilized form of tobacco cessation therapy by PCPs. This may reflect a gap in prescriber knowledge. A brief, virtual training delivered to PCPs was associated with increased cNRT prescribing.

Efficacy of a mountain craft training in improving resilience and psychological well-being and reducing fatigue in childhood cancer survivors.

TPS167 Background: This pilot study aims to determine the feasibility, acceptability, and preliminary efficacy of mountain craft training in improving resilience and quality of life and reducing fatigue and depressive symptoms in childhood cancer survivors (CCS). Methods: A randomised controlled trial. A sample of 40 CCS, aged 10 to 16, will be invited to participate in this study. Resilience scale, Center for epidemiologic studies depression scale; Paediatric Quality of Life Inventory; and Fatigue Scale – Child will be used to assess resilience, depressive symptoms, health-related quality of life and levels of fatigue, respectively. Participants in the intervention group will receive two 30-45 mins lectures on resilience, physical exercise, knowledge and skills in mountain craft; and a 4-day hiking programme on weekends over a 3-month period. Participants in the control group will participate in 4 day of leisure activities on weekends over a 3-month period. The main outcome measure: The participants’ level of resilience at 6-month post intervention The Statistical Package for Social Sciences (SPSS) software (version 26.0) will be used to analyse the quantitative data. Pearson chi-square test or Fisher’s exact test for categorical variables, and the independent sample t-test for continuous variables. The Generalised Estimating Equation (GEE) will be employed to determine the changes between the intervention and placebo control groups, the within-group (time) effects, and the interaction effects.