ACTS Program Research Articles

ACCEPTANCE AND COMMITMENT THERAPY INTERVENTION FOR PARENT CAREGIVERS: A STRENGTH-BASED APPROACH

Abstract ACT has emerged as a behavioral change approach that has been applied to address a wide range of challenges. Empirical research has shown that ACT can deliver positive long-term effects across various populations, including caregivers. Using six core principles of ACT, we have revised an acceptance and commitment therapy program (ACT) for custodial grandparents and their grandchildren. Our intervention program emphasized the importance of acceptance and promoting resilience among participants. This approach is particularly valuable for this population as the focus of the program is to strengthen their competencies, life skills and emotional resilience. The program consists of a web based ACT program with online coaching meetings across four sessions delivered for each age group. This program is unique in the sense that it utilizes both individual and group session techniques to facilitate the learning process. The main purpose of the program is to promote effective coping strategies, to reduce parenting stress among grandparents and to increase life skills (i.e., decision-making, proactivity) among children. Preliminary findings suggest that participating in ACT programs could help custodial, foster and biological parents improve self-efficacy, emotional well-being, higher self-confidence, social competence, lower depressive symptoms, and parenting distress, thereby leading to positive outcomes such as improved mental health and higher resilience.

Prevention of Child Maltreatment: Integrative Review of Findings From an Evidence-Based Parenting Program.

This integrative review of the ACT Raising Safe Kids (ACT)-child maltreatment prevention program for parents-focuses on the program's theoretical framework, examines the ACT studies about the effects on caregivers, and discusses the ACT's implications for the practice and public policy. A systematic search of the PubMed, Web of Science, PsycINFO, and Lilacs databases was performed, along with a search on the ACT Program website and contacting program researchers. Twenty-five studies evaluating the ACT Program were reviewed. The evaluation studies were conducted in the United States, Brazil, Portugal, and Peru. The program improved parenting practices in general and targeted populations such as incarcerated parents, mothers with a history of childhood violence, and mothers of preterm children. Additionally, the program was effective in decreasing child behavioral problems. Overall, the ACT Program effectively decreased hostile, aggressive, and coercive parenting and child behavior problems, which are key predictors of family violence.

The Effect of Assertive Commitment Therapy on Medication Adherence and Quality of Life of Pulmonary Tuberculosis (TB) Patients in the Buhit Health Center Area, Samosir Regency, Indonesia

Medication adherence is the extent to which a person's behavior in taking medication is in accordance with agreed recommendations from a health care provider. The long duration of TB treatment causes many sufferers to be disobedient because they feel they are healthy and feel bored and fed up. Assertive commitment therapy is a therapy that aims to improve flexible psychological aspects or the ability to better undergo current changes. This study aimed to determine the effect of assertive commitment therapy on medication adherence and quality of life of pulmonary TB patients in the Buhit Health Center area, Samosir Regency, in 2023. Type of quantitative research with research design quasi-experimental two group pre-test posttest design. Research in Buhit Health Center, Samosir Regency, in December 2022 – June 2023. The study population was 60 pulmonary TB patients, sampling technique used consecutive sampling. The sample was divided into 2 groups, namely 30 people in the intervention group and 30 people in the control group. Data collection using MMAS-8 and WHOQOL-BREF questionnaires. Data analysis with independent t-tests. The results of the study showed that the average value of medication adherence in the intervention group was higher after participating in the ACT program (Mean=20.54, SD=4.13) compared to the value before receiving treatment ((Mean=47.37, SD=3.68). These results indicate a difference between the mean value of medication adherence in the intervention group before and after treatment (t = -193, 09; p = 0.00). The mean value of quality of life in the intervention group was higher after participating in the ACT program (Mean=78.20, SD=11.17) compared to the value before receiving treatment (Mean=42.86, SD=7.61). These results show a difference between the mean value of quality of life in the intervention group before and after treatment (t = -55,42; p = 0,00).

ACT Program: Learning experiences of mothers about their parenting practices and child behavior

ACT Program: Learning experiences of mothers about their parenting practices and child behavior

Pharmacist-provider collaborative visits after hospital discharge in a comprehensive acute kidney injury survivor model

BackgroundPostdischarge follow-up in primary care is an opportunity for pharmacists to re-evaluate medication use in acute kidney injury (AKI) survivors. Of the emerging AKI survivor care models described in literature, only one involved a pharmacist with limited detail about the direct impact. ObjectiveThis study aimed to describe pharmacist contributions to a comprehensive postdischarge AKI survivorship program in primary care (the AKI in Care Transitions [ACT] program). MethodsThe ACT program was piloted from May to December of 2021 at Mayo Clinic as a bundled care strategy for patients who survived an episode of AKI and were discharged home without the need for hemodialysis. Patients received education and care coordination from nurses before discharge and later completed postdischarge laboratory assessment and clinician follow-up in primary care. During the follow-up encounter, patients completed a 30-minute comprehensive medication management visit with a pharmacist focusing on AKI survivorship considerations. Medication therapy recommendations were communicated to a collaborating primary care provider (PCP) before a separate 30-minute visit with the patient. PCPs had access to clinical decision support with evidence-based post-AKI care recommendations. Medication-related issues were summarized descriptively. ResultsPharmacists made 28 medication therapy recommendations (median 3 per patient, interquartile range 2-3) and identified 14 medication discrepancies for the 11 patients who completed the pilot program, and 86% of the medication therapy recommendations were acted on by the PCP within 7 days. Six recommendations were made to initiate renoprotective medications, and 5 were acted on (83%). ConclusionDuring the pilot phase of a multifaceted transitional care program for AKI survivors, pharmacists’ successfully identified and addressed multiple medication therapy problems, including for renally active drugs. These results demonstrate the potential for pharmacist-provider collaborative visits in primary care to improve safe and effective medication use in AKI survivors.

Reticular chemistry for the rational design of mechanically robust mesoporous merged-net metal-organic frameworks

Reticular chemistry for the rational design of mechanically robust mesoporous merged-net metal-organic frameworks

509 Pilot Projects as Catalysts for Research Initiatives

OBJECTIVES/GOALS: Pilot grants are small financial investments given out by CTSA hubs to facilitate new clinical and translational research projects. The New Jersey Alliance of Clinical and Translational Science (NJ ACTS) is one of 65 CTSA hubs. The goal of this project was to evaluate and improve the NJ ACTS program by learning from pilot programs across the consortium. METHODS/STUDY POPULATION: The initial research on pilot programs was conducted using the CTSA Search Solutions tool, a tool developed at NJ ACTS which provides links to individual pages by topic in all the hub websites. Using the tool, public information was accessed, including common award amounts, significant dates, and preferred categories of research. Then, a survey created in REDCap was distributed to colleagues at all CTSA hubs to gather additional information and thoughts on pilot programs. The data were compiled in an excel database to observe and analyze trends. These trends were graphically presented in figures developed from the data to see how NJ ACTS compares to other CTSA hubs in how they focus and operate their pilot programs. RESULTS/ANTICIPATED RESULTS: There are both similarities and differences between NJ ACTS and other hubs. NJ ACTS utilizes a REDCap form for its application, as do 14 other CTSA hubs. Surveys also show that NJ ACTS follows similar processes for: letter of intent and application due dates; having a standing review committee; and the categories of awards. Award categories for Clinical/Translational Innovation, Methodology/Infrastructure, and Partnership/Collaboration are shared with 47, 25, and 41 institutions, respectively. NJ ACTS requires collaboration between its multiple institutions, as do 28 other hubs. It does not, however, have a public notification of award date, and notifications tend to go out relatively late. NJ ACTS funded multiple proposals pertaining to COVID-19, something 11 other CTSA hubs did as well. DISCUSSION/SIGNIFICANCE: Although a new CTSA hub, NJ ACTSs Pilot Program operates comparably to more mature CTSA hubs. Using the survey data, NJ ACTS can implement modest changes, better serving its scientific community. CTSA Search Solutions has proven an excellent tool and can be used by any hub to understand how they compare and implement changes to improve their programs.

ACT Raising Safe Kids Program improves parenting practices, beliefs about physical punishment, management of anger, and mental health: Initial evidence from a study in Brazil

The exposure to child maltreatment has negative consequences for children’s health and development. These serious consequences demonstrate how important it is to develop and implement effective prevention strategies. The ACT Raising Safe Kids Program was developed to prevent child maltreatment and teach positive parenting skills to parents and caregivers. The aim of the present study was to evaluate initial evidence of effectiveness of the ACT Program in Porto Alegre, capital of the Brazilian state of Rio Grande do Sul. The study is based on an intervention with one-group pretest-protest design. The sample comprised 47 mothers and 5 fathers with a mean age of 38.73 years (SD = 6.81). Parenting meetings were implemented over nine weeks with groups, on average, composed of nine participants. Parenting practices, physical punishment beliefs, anger, and mental health outcomes were assessed through self-report measures before and after participation in the ACT Program. Measures included sociodemographic data, ACT Evaluation Questionnaire, Physical Punishment Beliefs Scale, State-Trait Anger Expression Inventory (STAXI-2), and Depression, Anxiety and Stress Scale (DASS-21). Within-group comparisons were analyzed through paired samples t-test. The results indicated that parenting practices (emotional and behavioral regulation, communication, and positive discipline), physical punishment beliefs, levels of anger (angry temperament, angry reaction, anger expression-out, and anger control-in), and mental health outcomes (depression and stress) improved significantly from pretest to posttest. The findings indicate the messages were enacted by parents. Further evaluation is required to determine the impact on parenting of the ACT Program in this context employing a randomized controlled design.

Process-informed Design of Tailor-made Sorbent Materials for Energy Efficient Carbon Capture (PrISMa)

The PrISMa (“Process-Informed designed of tailor-made sorbent materials for energy efficient carbon capture”) project is an international effort funded through the ACT programme (Accelerating CCS Technologies, Horizon2020 Project No 294766). It accelerates the transition of energy and industrial sectors to a low-carbon economy by developing a technology platform to tailormake cost-efficient carbon capture solutions for a range of different CO2 sources and CO2 use/destinations. This platform will guarantee an optimal separation in terms of an effective carbon price (ECP) that makes a particular process economically viable and environmentally beneficial. To achieve this aim, PrISMa integrates materials and process design, supported by computational materials genomic approaches, life cycle analysis, machine-learning, high-throughput material synthesis and characterization, device-performance testing, value chain analysis and systematic process design. In addition, PrISMa aims to initiate a systematic thinking about efficient solutions to mitigate CO2 emissions from different local CO2 sources that are optimal for a specific local setting. In such a setting the impact of PrISMa will be significant as the need for tailor-made solutions will be increasingly important if CO2 mitigation at the local level becomes the norm. The PrISMa platform allows for high-throughput screening of materials to maximise their impact, enables the design of efficient pilot-scale test facilities with improved processes under real conditions and, decreases the time to market of affordable, costcompetitive, low environmental impact, and resource-efficient advanced capture technologies. Through the integration of materials design, process design and environmental considerations, we change the paradigm on how novel materials are developed for carbon capture applications.

SLIGN-CCUS: The Results of an ACT Project on the Full CCUS Chain to Accelerate Implementation of Decarbonisation in Industrial Areas

ALIGN-CCUS (Accelerating Low CarboN Industrial Growth through Carbon Capture Utilisation and Storage) is a project supported by the ERA-NET Co-fund ACT program. In the first call of this program nine European countries, together with the European Horizon 2020 program have joined forces by making funds available for research and innovation actions related to carbon dioxide (CO2) Capture,Storage and Utilisation (CCUS). The participants of ALIGN-CCUS project represented the ERA-NET ACT countries of The Netherlands, Germany, Norway, Romania and the United Kingdom. The ALIGN-CCUS consortium involved 30 partners from industry, research and academia and has considerable involvement of industrial companies and enterprise organizations. The industrial partners not only supported the research but also committed to directly invest and participate in the R&D and demonstration activities in the project, boosting the credibility of the project’s potential for accelerating and maturing CCUS technologies. The project has ended in November 2020 and its results are already being used in various CCUS projects around the globe. More than 100 reports have been produced, of which 57 are public and available from our website www.alignccus.eu. Many detailed results will be presented at conferences and in other papers. In this paper a high-level overview is given of the research performed in ALIGN-CCUS and its immediate impact in the CCUS community.

Development and Implementation of a Complex Health System Intervention Targeting Transitions of Care from Hospital to Post-acute Care.

Failure of effective transitions of care following hospitalization can lead to excess days in the hospital, readmissions, and adverse events. Evidence identifies both patient and system factors that influence poor care transitions, yet health systems struggle to translate evidence into complex interventions that have a meaningful impact on care transitions. We report on our experience developing, pilot testing, and evaluating a complex intervention (Addressing Complex Transitions program, or ACT program) that aims to improve care transitions for complex patients. Following the Medical Research Council (MRC) framework, we engaged in iterative, stakeholder-driven work to develop a complex care intervention, assess feasibility and pilot methods, evaluate the intervention in practice, and facilitate ongoing implementation monitoring and dissemination. Patients receiving care from UW Medicine's health system including 4 hospitals and 20-site Post-Acute Care network. Literature review and prospective data collection activities informed ACT program design. ACT program components include a tailored risk calculator that provides real-time scoring of transitions of care risk factors, a multidisciplinary team with the capacity to address complex barriers to safe transitions, and enhanced discharge workflows to improve care transitions for complex patients. Program evaluation metrics included estimated hospital days saved and program acceptance by care team members. During the 6-month pilot, 565 patients were screened and 97 enrolled in the ACT program. An estimated 664 hospital days were saved for the index admission of ACT program participants. Analysis of pre/post-hospital utilization for ACT program participants showed an estimated 3227 fewer hospital days after ACT program enrollment. Health systems need to address increasingly difficult challenges in care delivery. The use of evidence-based frameworks, such as the MRC framework, can guide systems to design complex interventions that respond to their local context and stakeholder needs.

Parental attendance in two early-childhood training programmes to improve nurturing care: A randomized controlled trial.

Parent training programmes have significant potential to improve the quality of children's early environments and thereby their development and life-course outcomes. The aim of this study was to identify and explain the extent to which parents engaged in two group-based training programmes, offered to high-risk families enrolled in a randomized controlled trial study called PIÁ in Southern Brazil. The programmes were: (1) ACT: Raising Safe Kids, a 9-week programme aiming to reduce harsh parenting and maltreatment and improve positive parenting practices; (2) Dialogic book-sharing (DBS), an 8-week programme aiming to promote parental sensitivity and improve child cognitive development and social understanding. Of the 123 mothers randomly allocated to the ACT programme, 64.2% (n=79) completed the course, and of 124 mothers allocated to DBS, 76.6% (n=95) completed the course. After the interventions, mothers were very positive about the experience of both programmes but highlighted practical difficulties in attending. In adjusted regression analyses, only two variables significantly predicted ACT course completion (maternal age and distance between the intervention site and household); no significant predictor was found for DBS attendance. We conclude that although high completion rates are possible, there are important challenges to engaging parents of young children in training programmes, and practical difficulties occurring during training courses may be more important for attendance than baseline participant characteristics.

ACT 기반 집단프로그램이 초등학교 고학년 아동의 분노 감소에 미치는 영향

ACT 기반 집단프로그램이 초등학교 고학년 아동의 분노 감소에 미치는 영향

CO2 Capture and Utilization Editorial

S.G. would like to thank funding from the PrISMa and ALIGN-CCUS projects. The PrISMa Project (No 299659) is funded through the ACT programme (Accelerating CCS Technologies, Horizon 2020 Project No 294766). Financial contributions made from BEIS together with extra funding from NERC and EPSRC, UK; RCN, Norway; SFOE, Switzerland; and US-DOE, USA, are gratefully acknowledged. The ACT ALIGN-CCUS project (No 271501) has received funding from RVO (NL), FZJ/PtJ (DE), Gassnova (NO), UEFISCDI (RO), BEIS (UK) and is co-funded by the European Commission under the Horizon 2020 programme ACT, Grant Agreement No 691712; www.alignccus.eu. E.S.P. thanks funding from the Young Researchers R&D Project Ref.2177 financed by the Community of Madrid and the Rey Juan Carlos University.

Feasibility study of a preventive parenting program with mothers of children born preterm

Preterm infants constitute a high-risk population for presenting emotional and behavioral problems and developmental dysregulation. Parenting preventive interventions can support mothers to act as co-regulators and prevent child behavior problems. The ACT – Raising Safe Kids Program is recommended to strengthen positive parenting practices. The present study aimed to examine the feasibility of the ACT Program in a target sample of mothers of children born preterm, comparing parenting practices and child behavior problems at pre- and post-intervention. The sample consisted of 30 mothers of 1- to 7- year - old children born preterm. The mothers answered the ACT and Parenting and Family Adjustment scales, and the Strengthen and Difficulties Questionnaire, in the pre- and post-intervention. The within-group comparison was performed. The results showed that, after the intervention, there was a significant improvement in parenting practices dimensions of communication, emotional/behavioral regulation, monitoring of electronic media, positive encouragement, and parental consistency and adjustment. Also, the coercive practices decreased in the post-intervention. Furthermore, there was a decrease in child behavior problems and improvement in the pro-social behavior, from pre- to post-intervention. In conclusion, the ACT showed the feasibility to improve positive parenting practices, enabling mothers to act as a co-regulator of the behavior of children born preterm.

A Systematic Literature Review of the ACT Raising Safe Kids Parenting Program

The ACT Raising Safe Kids Program is a research-based parenting intervention developed by the American Psychological Association to teach caregivers positive parenting skills and prevent violence. It has been implemented and evaluated in several countries. This study conducted a systematic review of the literature evaluating the ACT Program to identify its current state of the art. Reporting follows PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. Searches were conducted from 2000 to October 2018 in the following databases: CAPES, PsycINFO, SciELO, Scopus and Web of Science. Thirteen empirical studies evaluating the program were found: 3 evaluated workshops for facilitators and 10 evaluated caregiver-training programs. All studies reported positive effects of the ACT program on knowledge held by both facilitators and caregivers, such as significant increase of positive parenting and decrease of corporal punishment. Overall 10 studies demonstrated the effectiveness of the program, 4 of these using quasi-experimental research designs and 6 studies through pre-experimental research designs. Three assessed the program’s efficacy by using experimental group designs with randomized controlled trials (RCT). Retention rates of the interventions are compared and research strategies to foster retention are listed. The authors of the studies identified the data collected exclusively on self-reports as one of the main limitations, and suggested the use of third-party information and/or observational measures to evaluate direct behavior changes. The ACT Program’s current state of the art is promising, and further RCT studies are needed to consolidate it as an evidence-based parenting program.

Preventive intervention for strengthening effective parenting practices: A randomized controlled trial

The present study evaluated the efficacy of the ACT Raising Safe Kids Parenting Program for improving parenting practices and reducing child behavior problems. Mothers of children aged 3 to 8 years were randomly allocated into the intervention (IG, n = 40) or wait list control (CG, n = 41) groups, and 67 caregivers were second informants on the children's behavior. Results showed that, after participation in the ACT program, the IG mothers reported improvements in their parenting practices, and the mothers and the other caregivers reported less child behavior problems. These positive improvements were maintained at the 3–4 month follow-up. During the waiting period the CG did not report changes in parents and child outcomes, however, after participating in the intervention, they also reported improvements in both outcomes. In conclusion, the ACT Program showed efficacy for improving the mothers' positive parenting practices and reducing the children's behavior problems.

Adoption for adaptation: A theory-based approach for monitoring a complex policy initiative

This paper explores some of the challenges involved in designing a monitoring framework for a complex policy initiative designed to support climate change adaptation in a highly varied and dynamic implementation environment. It looks specifically at the UK’s Department for International Development (DFID) initiative called Action on Climate Today, a five-year programme that aims to support the mainstreaming of climate change adaptation into policy systems in five countries and ten locations in South Asia.This paper presents a theory-based approach to designing a monitoring system for the ACT programme that seeks to account for the programme’s design and implementation complexities. It does so by providing an example for monitoring the causal processes and mechanisms that underpin the programme’s theory of change. The paper highlights a systematic approach to context monitoring through periodic context assessments and evaluative indicators; the use of categorical indicators to capture a diverse portfolio of support; and a flexible results framework structured around the adoption and implementation of programme outputs into the targeted policy systems.

Unique Practice, Unique Place: Exploring Two Assertive Community Treatment Teams in Maine

ABSTRACTAssertive Community Treatment (ACT) is a model of care that provides comprehensive community-based psychiatric care for persons with serious mental illness. This model has been widely documented and has shown to be an evidence-based model of care for reducing hospitalizations for this targeted population. Critical ingredients of the ACT model are the holistic nature of their services, a team based approach to treatment and nurses who assist with illness management, medication monitoring, and provider collaboration. Although the model remains strong there are clear differences between urban and rural teams. This article describes present day practice in two disparate ACT programs in urban and rural Maine. It offers a new perspective on the evolving and innovative program of services that treat those with serious mental illness along with a review of literature pertinent to the ACT model and future recommendations for nursing practice. The success and longevity of these two ACT programs are testament to the quality of care and commitment of staff that work with seriously mentally ill consumers. Integrative care models such as these community-based treatment teams and nursing driven interventions are prime elements of this successful model.

International child abuse prevention: insights from ACT Raising Safe Kids

Evidence-based practices are often viewed as lofty goals endorsed by wealthy academics in developed nations, but impossible to implement in other contexts. This article will provide evidence suggesting that, to the contrary, we can indeed scale up western-developed parenting interventions that can be both effective and warmly received by parents in diverse cultural and economic contexts. This paper gives a brief overview of the ACT Raising Safe Kids Program and summarizes the results of evaluation studies done with parents around the world. It discusses specific strategies facilitators use to modify the program as necessary to fit cultural contexts while also maintaining fidelity, implementing the manualized curriculum under varied, and complex circumstances. It is hoped that the lessons learned from our work will inspire practitioners to adapt ACT or other programs to diverse contexts, evaluate those programs, and thereby improve the mental health and life trajectories of children and families around the world.