Behavioural Advice Research Articles

The NEVERMIND e-health system in the treatment of depressive symptoms among patients with severe somatic conditions: A multicentre, pragmatic randomised controlled trial

SummaryBackgroundThis study assessed the effectiveness of the NEVERMIND e-health system, consisting of a smart shirt and a mobile application with lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy, in reducing depressive symptoms among patients diagnosed with severe somatic conditions. Our hypothesis was that the system would significantly decrease the level of depressive symptoms in the intervention group compared to the control group.MethodsThis pragmatic, randomised controlled trial included 425 patients diagnosed with myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants were recruited from hospitals in Turin and Pisa (Italy), and Lisbon (Portugal), and were randomly assigned to either the NEVERMIND intervention or to the control group. Clinical interviews and structured questionnaires were administered at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at 12 weeks measured by the Beck Depression Inventory II (BDI-II). Intention-to-treat analyses included 425 participants, while the per-protocol analyses included 333 participants. This trial is registered in the German Clinical Trials Register, DRKS00013391.FindingsPatients were recruited between Dec 4, 2017, and Dec 31, 2019, with 213 assigned to the intervention and 212 to the control group. The sample had a mean age of 59·41 years (SD=10·70), with 44·24% women. Those who used the NEVERMIND system had statistically significant lower depressive symptoms at the 12-week follow-up (mean difference=-3·03, p<0·001; 95% CI -4·45 to -1·62) compared with controls, with a clinically relevant effect size (Cohen's d=0·39).InterpretationThe results of this study show that the NEVERMIND system is superior to standard care in reducing and preventing depressive symptoms among patients with the studied somatic conditions.FundingThe NEVERMIND project received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 689691.

Advice on cat behavior in German veterinary practices:Expectations of cat owners and influencing factors on compliance

ABSTRACT Veterinarians play an important role in establishing and sharing the welfare of companion animals by carrying out regular health checks and informing owners about the specific needs of the animal’s environment and conditions of good husbandry. A survey among German cat owners revealed which role advice about cat behavior plays in daily practice and its influence on the cat owner’s compliance. Some owners (29.6%, n = 263/889) reported behavioral problems in their cat. Not all owners considered their veterinarian as their contact of choice for behavioral advice, although veterinarians who met owners’ expectations for advice on cat behavior are significantly more often described as feline-friendly (P < 0.000). Owners who expected an empathetic treatment of their cat will show a better compliance (P = 0.003). Owner compliance can be improved by providing accurate and effective veterinary advice about cat behavior and behavioral problems (P = 0.003). Thus, a sound foundation in cat behavior and knowledge of current treatment recommendations for feline behavioral problems can be worthwhile to ensure good husbandry for cats.

I Wish He'd Listen: Client Centred Interviewing Approaches Associate with Higher Behavioural Modification Advice Compliance in Pet Dog Owners

I Wish He'd Listen: Client Centred Interviewing Approaches Associate with Higher Behavioural Modification Advice Compliance in Pet Dog Owners

Optimising an intervention to support home-living older adults at risk of malnutrition: a qualitative study

BackgroundIn the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those at risk may help to reduce malnutrition risk, reduce the resulting need for healthcare use and improve quality of life. Interventions are needed to raise older adults’ risk awareness, offer relevant and meaningful strategies to address risk and support general practices to deliver treatment and support.MethodsUsing the Person-based Approach and input from Patient and Public Involvement representatives, we developed the ‘Eat well, feel well, stay well’ intervention. The intervention was optimised using qualitative data from think aloud and semi-structured process evaluation interviews with 23 and 18 older adults respectively. Positive and negative comments were extracted to inform rapid iterative modifications to support engagement with the intervention. Data were then analysed thematically and final adjustments made, to optimise the meaningfulness of the intervention for the target population.ResultsParticipants’ comments were generally positive. This paper focuses predominantly on participants’ negative reactions, to illustrate the changes needed to ensure that intervention materials were optimally relevant and meaningful to older adults. Key factors that undermined engagement included: resistance to the recommended nutritional intake among those with reduced appetite or eating difficulties, particularly frequent eating and high energy options; reluctance to gain weight; and a perception that advice did not align with participants’ specific personal preferences and eating difficulties. We addressed these issues by adjusting the communication of eating goals to be more closely aligned with older adults’ beliefs about good nutrition, and acceptable and feasible eating patterns. We also adjusted the suggested tips and strategies to fit better with older adults’ everyday activities, values and beliefs.ConclusionsUsing iterative qualitative methods facilitated the identification of key behavioural and contextual elements that supported engagement, and issues that undermined older adults’ engagement with intervention content. This informed crucial revisions to the intervention content that enabled us to maximise the meaningfulness, relevance and feasibility of the key messages and suggested strategies to address malnutrition risk, and therefore optimise engagement with the intervention and the behavioural advice it provided.

Encouraging evacuation: The role of behavioural message inputs in bushfire warnings

In catastrophic bushfires or wildfires, warnings are issued by emergency service organisations to inform communities about the hazard and provide guidance about protective actions. Long-form warnings are complemented by shorter social media warnings that preference content about hazard severity. Warnings that do not include clear behavioural guidance can challenge clarity and community uptake. However, there has been little research that examines and compares existing warnings with those constructed to encourage behavioural intentions. In this study, we follow the Protective Action Decision Model and first identify cues that predict evacuation intentions. Next, we compare existing long-form and social media warnings with those modified to include behavioural advice and instruction to examine their effect on clarity and ease of action and protective action intentions. Findings show how the inclusion of behavioural inputs into social media warnings enhances protective action intentions, offering evidence to specifically support changes to existing practice.

COVID-19 aftermath: Safe return to the office during the pandemic

Issue/problemCOVID-19 has affected almost all aspects of our human activity globally. Changing our working norm is one of them. This project explored strategies and control measures that could be adopted in different countries for preventing or limiting the transmission of the SARS-CoV-2 virus in indoor office workplaces, focusing on space and the well-being of workers.Description of the problemResearch took place in May-July 2020. Methods used comprised both systematic and narrative literature reviews as well as stakeholder consultations with executives involved in the office supply chain. Suggestions were split in: a) top-down suggestions, i.e. governmental and NGO guidance and b) bottom-up guidance, generated by industry. Surface contaminated? Protocols to reduce the psychological stress of employees returning to work, ventilation and virus transmission were indicative the questions along with a broader series of aspects involving employee wellbeing.ResultsResults were organised under four themes: a) advice on surface interactions and virus viability; b) behavioural advice focusing on the return-to-work effects on the psychological state of workers along with control measures; c) suggestions on preparing buildings to return-to-work during the pandemic and study of indoor environment parameters and their effect on office workers and d) advice on thermal and ventilation conditions and virus transmission.LessonsThe public health effect of COVID-19 on workspace is more relevant than ever globally as people return to work. This review demonstrated the complexity of decision making and the series of conflicting priorities that arose, especially infection control vs employee mental health or increased business costs for modifications during economic recession. The necessity of future studies focusing on interdisciplinary knowledge arose.Key messages Focusing not only on practical steps preparing office buildings but on the mental health of office workers and how this transition back to work in such a stressful period can be easier.Lessons learned from medical architecture and it’s applicability on office spaces.

Physically distant, virtually close: Adolescents’ sexting behaviors during a strict lockdown period of the COVID-19 pandemic

This study contextualizes Belgian adolescents' (12–18 years old) sexting behaviors between romantic and non-romantic partners during a strict lockdown period of the COVID-19 pandemic. An online survey among 543 Belgian respondents (Mage = 15.29, 68% girls) showed that 40.9% of the adolescents engaged in at least one type of sexting (i.e., type one = textual, type two = visual content with underwear/swimwear, type three = visual depiction of private parts, type four = visual depiction of sexual acts). Arousal needs were the most common reasons to sext (M = 3.33, SD = 1.89). Generalized ordered logit analyses show that higher arousal needs were linked to higher frequencies of the first three sexting types. Relational affirmation needs were related to the engagement in sexting type two, whereas partner pressure was related to sexting type three and four. Regarding the latter, a significant link was also found with stress regulation. Conditional relations emerged according to adolescents' sex, developmental status, and relationship status. The current study's findings not only help to inform practitioners in terms of behavioral advice for future pandemics or periods after social isolation, but can also offer explanations for (changes in) adolescents' sexting behaviors after the pandemic and the possible dual nature of its effects.

Reducing Dog Relinquishment to Rescue Centres Due to Behaviour Problems: Identifying Cases to Target with an Advice Intervention at the Point of Relinquishment Request.

Simple SummaryAnnually, thousands of dogs are relinquished to rescue centres globally. Dog owners report that a leading cause for relinquishment are their dogs’ behavioural problems. Efforts are needed to reduce dog relinquishment, by enabling dog owners to feel comfortable and confident with having them in their home. Free behavioural advice was offered to 1131 dog owners at the time of them calling to relinquish their dog to animal welfare charity. Behavioural advice was accepted by 24.4% of the dog owners calling to relinquish their dogs. The advice was accepted almost six times more often by owners with dogs with general management behaviour problems, compared to owners who had problems with aggression between dogs in their home. Offering free behavioural advice reduced the number of dog relinquishments. Consequently, the stress associated with maintaining a dog in sheltered conditions and rehoming them, and the trauma for the owner was eliminated in a quarter of cases. Moving forward, additional strategies are needed to enable more owners to keep their dogs in their homes and reduce relinquishment.Behaviour problems are a leading reason for dogs being relinquished to rescue centres across the world every year. The aim of this study was to investigate whether free behavioural advice would be accepted at the point of an owner requesting to relinquish their dog for behavioural reasons. The call records of 1131 relinquishment requests were reviewed and analysed to establish if the offer of free behaviour advice was accepted. The results showed that advice was accepted in 24.4% of relinquishment requests and behavioural problem was a significant predictor of whether advice was accepted (p < 0.001). The odds of advice being accepted were 5.755 times (95% CI: 2.835–11.681; p < 0.001) greater for a relinquishment request due to problems with general management behaviours compared to aggression between dogs in the home, representing 4.2% and 20.2% of overall relinquishment requests. These data suggest that owners are prepared to accept behaviour advice at the point of relinquishment request, so advice interventions could have potential to impact the levels of dog relinquishment to rescue centres. The impact of an intervention offering behaviour advice may be limited by overall levels of advice acceptance by owners and therefore complimentary proactive solutions to reduce behavioural relinquishments should also be considered.

Randomised controlled trial and economic evaluation of a targeted cancer awareness intervention for adults living in deprived areas of the UK

BackgroundCancer outcomes are poor in socioeconomically deprived communities, with low symptom awareness contributing to prolonged help-seeking and advanced disease. Targeted cancer awareness interventions require evaluation.MethodsThis is a randomised controlled trial involving adults aged 40+ years recruited in community and healthcare settings in deprived areas of South Yorkshire and South-East Wales. Intervention: personalised behavioural advice facilitated by a trained lay advisor. Control: usual care. Follow-up at two weeks and six months post-randomisation. Primary outcome: total cancer symptom recognition score two weeks post-randomisation.ResultsTwo hundred and thirty-four participants were randomised. The difference in total symptom recognition at two weeks [adjusted mean difference (AMD) 0.6, 95% CI: −0.03, 1.17, p = 0.06] was not statistically significant. Intervention participants reported increased symptom recognition (AMD 0.8, 95% CI: 0.18, 1.37, p = 0.01) and earlier intended presentation (AMD −2.0, 95% CI: −3.02, −0.91, p < 0.001) at six months. “Lesser known” symptom recognition was higher in the intervention arm (2 weeks AMD 0.5, 95% CI: 0.03, 0.97 and six months AMD 0.7, 95% CI: 0.16, 1.17). Implementation cost per participant was £91.34, with no significant between-group differences in healthcare resource use post-intervention.ConclusionsImproved symptom recognition and earlier anticipated presentation occurred at longer-term follow-up. The ABACus Health Check is a viable low-cost intervention to increase cancer awareness in socioeconomically deprived communities.Clinical trial registrationISRCTN16872545.

Impact of a self-guided, eHealth program targeting weight loss and depression in men: A randomized trial.

Objective: Obesity and depression are major, inter-related health concerns for men, yet many do not receive support to manage these conditions. This study investigated whether a self-guided, eHealth program (SHED-IT: Recharge) could reduce weight and depressive symptoms in men with overweight or obesity and low mood. Method: Overall, 125 men [Body Mass Index (BMI) 25-42 kg/m2] with depressive symptoms [Patient Health Questionnaire-9 (PHQ-9) score ≥5] were recruited for a 6-month RCT. Men were randomized to (a) the SHED-IT: Recharge group (n = 62) or (b) a wait-list control group (n = 63). The 3-month program included printed and online resources (e.g., website, interactive modules). It was adapted from an evidence-based weight loss program for men to include an additional focus on "mental fitness". The primary outcomes were weight (kg) and depressive symptoms (PHQ-9) at 3 months. Men were assessed at baseline, 3 months (post-intervention), and 6 months. Intention-to-treat linear mixed models examined program outcomes. Results: At 3 months, medium-sized treatment effects were detected for both weight, adjusted mean difference -3.1 kg, 95% CI [-4.3, -1.9], d = 0.9, and depressive symptoms, adjusted mean difference -2.4 units, 95% CI [-4.0, -0.9], d = 0.6. These effects were maintained at 6 months and supported by sustained improvements in other health outcomes. Conclusions: A self-guided, eHealth program that combined behavioral weight loss advice with mental health support decreased weight and depressive symptoms in men. Integrated interventions targeting physical and mental health may be an effective strategy to engage and support men with overweight or obesity and low mood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impact of pelvic floor muscle training (PFMT) on quality of life among women suffering from stress urinary incontinence after first childbirth: a feasibility study

Objective: To determine the feasibility of performing a randomized controlled trial comparing Pelvic Floor Muscle Training (PFMT) and behavioral advice only for postpartum SUI. Results: A feasibility study was performed with 207 women in 7-16 weeks postpartum at community postpartum clinics. Women reporting SUI were randomized to an intervention group (n=15), which followed an organized PFMT programme for six weeks and a control group (n=14). Control group was advised on routine postnatal care with behavioral advice. Both groups were assessed for QoL using a validated incontinence-quality of life (I-QOL) questionnaire at recruitment and in six weeks. There were 14% (29/207) of women suffering from SUI amongst the study sample. Before intervention there was no difference between I-QOL score in both groups. There was significant improvement (p&lt;0.001) of I-QOL score in the interventional group (PFMT) compared to the control group (routine care with behavioral advice) after six weeks. Studying QOL improvement with this intervention is feasible for an interventional study. If directly inquired by the healthcare provider, women were willing to report, discuss and seek treatment for SUI. Conclusion: SUI is a common postpartum problem in this urban cohort of Lankan women. These women can be effectively treated improving their QOL with PFMT intervention.

Infection Control Behavior at Home During the COVID-19 Pandemic: Observational Study of a Web-Based Behavioral Intervention (Germ Defence).

BackgroundTo control the COVID-19 pandemic, people should adopt protective behaviors at home (self-isolation, social distancing, putting shopping and packages aside, wearing face coverings, cleaning and disinfecting, and handwashing). There is currently limited support to help individuals conduct these behaviors.ObjectiveThis study aims to report current household infection control behaviors in the United Kingdom and examine how they might be improved.MethodsThis was a pragmatic cross-sectional observational study of anonymous participant data from Germ Defence between May 6-24, 2020. Germ Defence is an open-access fully automated website providing behavioral advice for infection control within households. A total of 28,285 users sought advice from four website pathways based on household status (advice to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk). Users reported current infection control behaviors within the home and intentions to change these behaviors.ResultsCurrent behaviors varied across all infection control measures but were between sometimes (face covering: mean 1.61, SD 1.19; social distancing: mean 2.40, SD 1.22; isolating: mean 2.78, SD 1.29; putting packages and shopping aside: mean 2.75, SD 1.55) and quite often (cleaning and disinfecting: mean 3.17, SD 1.18), except for handwashing (very often: mean 4.00, SD 1.03). Behaviors were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behavior across all website pathways and for all behaviors (overall average infection control score mean difference 0.30, 95% CI 0.29-0.31).ConclusionsSelf-reported infection control behaviors other than handwashing are lower than is optimal for infection prevention, although handwashing is much higher. Advice using behavior change techniques in Germ Defence led to intentions to improve these behaviors. Promoting Germ Defence within national and local public health and primary care guidance could reduce COVID-19 transmission.

Rheumatology in 2049: the age of all data

> If you think about the unthinkable long enough it becomes quite reasonable. > > Josephine Tey (1896–1952)British author Have you ever thought about what our life as specialists for...

The Resilience of Social Service Providers and Families of Children With Autism or Development Delays During the COVID-19 Pandemic-A Community Case Study in Hong Kong.

Background: Hong Kong is one of the earliest cities to have hampered by the COVID-19. When preventive public health measures are enforced, specific groups, who have already been facing inequality before the outbreak, are likely to become more overlooked and vulnerable.Aim: This community case study aims to describe the additional needs of families of children with autism spectrum disorder and other developmental issues, as well as unexpected difficulties and challenges social service professionals encountered when delivering service and their solutions toward these challenges.Methods: A focus group with 10 professionals providing the Caregiver Skills Training Program was conducted.Results: Poor families of vulnerable children were found to be challenged, more than average, in finding daily necessities during the initial stage of the outbreak. Most vulnerable children displayed additional problematic behaviors and emotional problems during the quarantine. The social service professionals addressed the family needs by providing tangible resources and offering online training, workshops, and programs to meet their needs. Several important lessons were learned. First, technology know-how on conducting online training, workshop, and program could be a challenge to some social service professionals and the parents. Second, the professionals reported that they made huge efforts to produce guidelines in protecting services users' privacy, to equip themselves with necessary skills in executing privacy-protection measures, and to keep exploring for safer alternatives. Third, providing tele-services in online mode represented a different interaction pattern between social service professionals and service users, especially in the recruitment processes and group dynamics.Conclusion: In comparison with other cities, Hong Kong has responded to the COVID-19 efficiently and effectively based on the citizen's strict adherence to behavioral advice and the innovative altruistic efforts from the multi-sectors in the community.

Smartphone-Based Virtual Agents to Help Individuals With Sleep Concerns During COVID-19 Confinement: Feasibility Study.

BackgroundThe COVID-19 crisis and consequent confinement restrictions have caused significant psychosocial stress and reports of sleep complaints, which require early management, have increased during recent months. To help individuals concerned about their sleep, we developed a smartphone-based app called KANOPEE that allows users to interact with a virtual agent dedicated to autonomous screening and delivering digital behavioral interventions.ObjectiveOur objective was to assess the feasibility of this app, in terms of inclusion rate, follow-up rate, perceived trust and acceptance of the virtual agent, and effects of the intervention program, in the context of COVID-19 confinement in France.MethodsThe virtual agent is an artificial intelligence program using decision tree architecture and interacting through natural body motion and natural voice. A total of 2069 users aged 18 years and above downloaded the free app during the study period (April 22 to May 5, 2020). These users first completed a screening interview based on the Insomnia Severity Index (ISI) conducted by the virtual agent. If the users were positive for insomnia complaints (ISI score >14), they were eligible to join the 2-stage intervention program: (1) complete an electronic sleep diary for 1 week and (2) follow personalized sleep recommendations for 10 days. We collected and analyzed the following measures: sociodemographic information, ISI scores and sleep/wake schedules, and acceptance and trust of the agent.ResultsApproximately 76% (1574/2069) of the app users completed the screening interview with the virtual agent. The virtual agent was well accepted by 27.4% (431/1574) of the users who answered the acceptance and trust questionnaires on its usability, satisfaction, benevolence, and credibility. Of the 773 screened users who reported sleep complaints (ISI score >14), 166 (21.5%) followed Step 1 of the intervention, and only 47 of those (28.3%) followed Step 2. Users who completed Step 1 found that their insomnia complaints (baseline mean ISI score 18.56, mean ISI score after Step 1 15.99; P<.001) and nocturnal sleep quality improved significantly after 1 week. Users who completed Step 2 also showed an improvement compared to the initial measures (baseline mean ISI score 18.87, mean ISI score after Step 2 14.68; P<.001). Users that were most severely affected (ISI score >21) did not respond to either intervention.ConclusionsThese preliminary results suggest that the KANOPEE app is a promising solution to screen populations for sleep complaints and that it provides acceptable and practical behavioral advice for individuals reporting moderately severe insomnia.

Smartphone-Based Virtual Agents Can Help the General Population Concerned by Sleep Complaints: A Proof-of-Concept Study&amp;nbsp;During COVID-19 Confinement

Background: The COVID-19 crisis induces psychosocial stress and sleep complaints that require early management. KANOPEE is a smartphone-based application, providing an interaction with a virtual agent dedicated to screen and deliver behavioral interventions to fight sleep disorders. This paper describes the feasibility study of this application, during the context of COVID-19 confinement in France.Method: 2,069 users of aged 18 years and over downloaded the app during the inclusion period (between 22 April and 5 May 2020). Users first answered a screening interview based on the insomnia severity index (ISI) that was conducted by the virtual agent. If participants were positive for insomniac complaints (ISI > 14), they could join a two-stage intervention program: a) complete an electronic sleep diary for one week, and b) follow personalized sleep recommendations for 10 days. Measures collected included socio-demographic information, ISI and sleep/wake schedules; and acceptance and trust of the agent. Findings: Of all participants, 80% (n=1,574) completed the screening interview with the virtual agent. The virtual agent was well accepted by users regarding its usability, satisfaction, benevolence, and credibility. Of the 773 screened subjects who reported sleep complaints (ISI>14), 214 of them followed the first step of the intervention (34%). Of these, 47 (31%) followed the second step. Users who completed step 1 found that their insomnia complaints (p > .001) and nocturnal sleep improved significantly after one week. Subjects who completed step 2 also showed an improvement compared to the initial measure (p 21) did not respond to either intervention.Interpretation: These preliminary results show that KANOPEE is a promising solution to screen populations for sleep complaints, and that it provides practical and effective behavioral advice for subjects reporting moderately severe insomnia.Funding: LABEX BRAIN, EQUIPEX PHENOVIRT, and Region Nouvelle-Aquitaine.Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: Following prior approval by the University and Hospital scientific committees, we obtained authorizations to be registered on the University Hospital register for GDPR approval by the French authorities (CNIL). Informed consent was obtained from all persons downloading the app according to the General Data Protection Regulation and CNIL regulations.

To trust or not to trust? Young people’s trust in climate change science and implications for climate change engagement

ABSTRACT This article discusses young people’s trust or distrust in climate change science. The aim is to show how the emotional dimension of trust in climate change science plays a role for an engagement at two levels: how young people relate to climate change at large, if they worry or deny climate change, and how young people deal with ambivalence regarding behavioral advice about, for example, climate-friendly food choices. The article ends by elaborating on the need for more research about what role trust/distrust in climate change science plays in young people’s everyday climate engagement, meaning-making, and identity development.

Practical Applications of How Much Is Behavioral Advice Worth?

Practical Applications Summary In How Much Is Behavioral Advice Worth? in the Fall 2019 edition of The Journal of Wealth Management, Michael Pompian of Sunpointe Investments, LLC, quantitatively analyzes behavioral mistakes by investors through a case study of an affluent family that commits two common ones: loss aversion and mental accounting. The author explains how such fundamentally irrational behavior, often driven by fear and the temptation to limit losses by selling during sudden market downturns, can be detrimental to overall long-term returns. Behavioral finance—the study of how psychology affects investors, analysts, and the overall market—has gained relatively widespread acceptance over the past 20 years. Yet many investors and advisers remain vulnerable to psychological pitfalls and may be uninformed about how wealth management strategies might incorporate behavioral advice. Pompian uses his case study to emphasize the importance of recognizing psychological biases and to illustrate how they can drive mistakes that reduce investment returns. He asserts that advisers who understand behavioral finance can help investors, especially wealthier ones with more complex investment needs, avoid needless risk. TOPICS:Wealth management, in wealth management

Effects of a patient-centered program including the cumulative-complexity model in women with chronic pelvic pain: a randomized controlled trial

ObjectivesTo evaluate the effects of a patient-centered intervention including the cumulative-complexity model on quality of life related to health, coping behaviors, pain, self-perceived occupational performance and activity levels. Study designRandomized controlled trial. Forty-four women with a clinical diagnosis of chronic pelvic pain were randomized into two groups. Patients in the experimental group (n = 22) were included in a patient-centered intervention that involved relevant activities proposed by participants. Patients in the control group (n = 22) received a leaflet with information about chronic pelvic pain, physical activity, fear of movement, false beliefs, active lifestyle and behavioral advice. Main outcome measuresThe primary outcome measures were health-related quality of life assessed with the EuroQol-5D and coping behavior using the Coping Strategies Questionnaires. Secondary outcomes included severity of pain using a Visual Analogue Scale, self-perception of occupational performance using the Canadian Occupational Performance Measure and physical activity levels assessed by the International Physical Activity Questionnaire. ResultsAn analysis of variance with repeated measures showed, in the experimental group compared with the control group, significantly greater improvement from baseline to post-intervention in health-related quality of life (EuroQol-5D Visual Analog Scale values of 70.06 ± 16.44 vs. 57.38 ± 16.40, p = 0.026) and coping behavior (adaptive coping 113.00 ± 31.89 vs. 83.24 ± 16.69, p = 0.002). Pain, self-perception of performance and physical activity levels also significantly improved. ConclusionsA patient-centered intervention considering the workload of patients and their capacity for performing health behaviors provides benefits regarding quality of life and coping behavior. Additionally, pain, self-perceived performance of relevant tasks and physical activity levels improved.

Personalised nutrition technologies: a new paradigm for dietetic practice and training in a digital transformation era

Personalised nutrition technologies: a new paradigm for dietetic practice and training in a digital transformation era