Behavioral Techniques Research Articles

3 Implementation of Family-based Treatment Principles in the Primary Care Management of Paediatric Anorexia Nervosa

Abstract Background Anorexia nervosa (AN) is a complex illness frequently beginning in adolescence and often associated with significant medical complications. In Canada, youth with AN typically first present to a primary care provider. Currently, the standard of care for paediatric restrictive eating disorders is Family Based Treatment (FBT). However, access to this modality remains limited. Numerous principles of FBT, including behavioural approaches to treatment, could be applied in a community setting. However, little is known regarding the awareness and uptake of FBT principles by primary care providers. Objectives To identify the extent to which FBT principles are understood and implemented by community providers (family physicians and community paediatricians) in treating paediatric patients with anorexia nervosa. Design/Methods We undertook a cross-sectional survey among family physicians and community paediatricians from 5 paediatric, urban, community clinics in Montreal, Quebec. Participants completed a standardized, self-administered electronic questionnaire to characterize their knowledge and degree of implementation of FBT principles in the treatment of adolescent AN. All practicing physicians who evaluated paediatric patients (age 5-18 years) were recruited to participate. Physicians were excluded if they self-reported spending less than 50% of their clinical practice in community care or were not involved in the assessment of eating disorder patients. Chi-square testing was used to compare frequency data between family physicians and community paediatricians. Results Survey response rate was 65% (n=36/55; 16/20 family physicians and 16/32 paediatricians, 4/55 other). Half of respondents had been in practice for over 10 years. Overall, 56% of respondents reported referring all their paediatric AN patients to tertiary services. Less than half of respondents (31.3%) reported following these patients weekly or biweekly once a referral was sent. Frequency of follow up did not vary for paediatricians and family physicians (37.5% vs. 25% p=0.45). Across both groups, 50% reported good knowledge of FBT principles, yet 47% reported using or expecting a nutritionist to use strict meal plans during treatment. There was no significant difference between family physicians and paediatricians in their reported awareness of FBT principles (43.8% vs. 56.3% p=0.48), and knowledge of behavioural management techniques in the treatment of paediatric AN (31.3% vs. 37.5% p=0.71). Overall, only a small percentage felt comfortable in applying FBT principles in the community (12.5% of family physicians vs. 6.3% of paediatricians, p=0.54) and 63% felt unaware of existing resources to assist physicians in implementing the tenets of FBT in a community practice. Conclusion Survey results suggest poor awareness and implementation of FBT principles in the community medical management of adolescent AN. FBT-specific education likely represents an important intervention to optimize physician comfort and improve the early delivery of appropriate care for adolescents with eating disorders.

An overview of corrosion behavior and contemporary management techniques of thermomechanically treated rebars in concrete structures

ABSTRACT The corrosion of reinforcement possesses a huge problem for our present infrastructure both in terms of human lives and monetary ground. Understanding the corrosion of thermomechanically treated (TMT) rebar in concrete structures is essential as it represents a large segment of reinforcement materials. In this review, we have tried to scrutinize this issue from different directions. The established corrosion model for rebar, especially for TMT rebar, has been examined. The main contributing factor for rebar corrosion is how passivation occurs and its disintegration in contact with aggressive ions. The effects of composition, microstructure, concrete-rebar interface, concrete type, and corrosion media on this phenomenon have been analyzed. We have realized that the exact time of chloride ion attack determines the effectiveness of the passive layer in inhabiting the corrosion initiation. A combination of suitable alloying and controlled thermomechanical treatment ensures corrosion resistant rebar. Concrete also plays an important role in corrosion prevention as it helps passivation step and stops aggressive ions from reaching the rebars. Finally, we have discussed some recent trends in corrosion management technologies and their effectiveness.

Compliance with oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease among head and neck cancer patients – a qualitative study

ObjectivesTo elicit head and neck cancer (HANC) patients’ views about their oral health and to identify potential issues regarding compliance with clinical oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease. MethodsA purposive sample of twelve HANC patients between 6- and 12-months post-radiotherapy were recruited to undergo a semi-structured interview with a qualitative researcher. A pre-piloted topic guide was used to frame each interview. Qualitative data were analysed via thematic analysis. ResultsData were categorised into four main themes – ‘How HANC patients perceive oral health’, ‘Cancer diagnosis and cancer care pathway’, ‘Impact of oncology treatment (radiotherapy, surgery, and chemotherapy)’, and ‘Post-oncology treatment recovery’, with 14 subthemes. Oral health was viewed as an important component of HANC patients’ overall physical and mental health post-treatment. Patients’ non-compliance with adequate oral hygiene practice was related to oral mucositis, a “burning” sensation associated with high fluoride toothpaste, forgotten or inconsistent clinical advice, and an inadequate supply of preventive oral hygiene products. The potentially highly cariogenic nature of prescribed nutritional supplements for patients at risk of malnutrition did not tend to be communicated to patients in advance of their prescription. ConclusionsAdequate oral health is essential for the overall physical and mental well-being of post-treatment HANC patients. Non-compliance with preventive clinical advice increases the risk of post-treatment oral health deterioration and was related to miscommunication, inadequate supplies of oral hygiene products, and treatment-related oral discomfort. Clinical significancePost-treatment HANC patients are at increased risk of dental disease. Educational and behavioural techniques should be employed to enhance patients’ compliance with clinical oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease. Patients should be informed about the potentially highly cariogenic nature of nutritional supplements, and these patients should undergo frequent dental recall. Clinical advice regarding oral hygiene and dietary practices needs to be given consistently to HANC patients by different specialists of the HANC multidisciplinary team.

Konseling Kelompok dengan Teknik Behavioral untuk Meningkatkan Minat Belajar pada Siswa Slow Learner di Sekolah Dasar

The problem in this research is that it is limited to the group counseling model to increase interest in learning in slow learner students, while the aim is to describe the description of interest in learning and the effectiveness of the group counseling model with behavioral techniques to increase student interest in learning. The method used in this research is qualitative descriptive research, data is obtained from interviews and observations as well as documentation to be described to describe the reality in the field. The research results show that students have done their schoolwork, focused on studying, can control their emotions, are responsible for the tasks given by the teacher and can socialize with their peers. The feasibility test results show that the designed model is suitable for implementation in the field. It can be concluded that the group counseling model using behavioral techniques can effectively increase interest in learning among slow learner students in all indicators which include: being responsible for the tasks given by the teacher, being disciplined in going to school, being active in learning activities in class and diligently doing homework.

Obesity and psychiatric disorders

Obesity and mental disorders belong to the most alarming health concerns in the modern era, and when they co-occur, they can pose a significant threat to patients' overall health and well-being. It has been shown that obesity increases the risk of developing psychiatric conditions, and individuals with mental illness are more likely to become obese. The relationship between psychiatric illness and weight is complex and involves multiple factors, including neurobiological, psycking it challenging for individuals to follow a healthy lifestyle. Another undisputable association between obesity and mental illness is the iatrogenic weight gain caused by psychopharmacological treatment. Managing weight in individuals with mental illness and obesity should involve prescribing weight-neutral medications for managing psychiatric symptoms, evaluation of associated comorbidities and metabolic risk factors, utilization of behavioral weight management techniques, and potentially adding weight loss pharmacotherapy if needed.

Refocusing of Attention on Positive Events Using Monitoring-Based Feedback and Microinterventions for Patients With Chronic Musculoskeletal Pain in the PerPAIN Randomized Controlled Trial: Protocol for a Microrandomized Trial.

Chronic musculoskeletal pain (CMSP) affects between 13% and 47% of the population, with a global growth rate of 20.3% within the last 15 years, suggesting that there is a high need for effective treatments. Pain diaries have long been a common tool in nonpharmacological pain treatment for monitoring and providing feedback on patients' symptoms in daily life. More recently, positive refocusing techniques have come to be used, promoting pain-free episodes and positive outcomes rather than focusing on managing the pain. This study aims to evaluate the feasibility (ie, acceptability, intervention adherence, and fidelity) and initial signals of efficacy of the PerPAIN app, an ecological momentary intervention for patients with CMSP. The app comprises digitalized monitoring using the experience sampling method (ESM) and feedback. In addition, the patients receive 3 microinterventions targeted at refocusing of attention on positive events. In a microrandomized trial, we will recruit 35 patients with CMSP who will be offered the app for 12 weeks. Participants will be prompted to fill out 4 ESM monitoring questionnaires a day assessing information on their current context and the proximal outcome variables: absence of pain, positive mood, and subjective activity. Participants will be randomized daily and weekly to receive no feedback, verbal feedback, or visual feedback on proximal outcomes assessed by the ESM. In addition, the app will encourage participants to complete 3 microinterventions based on positive psychology and cognitive behavioral therapy techniques. These microinterventions are prompts to report joyful moments and everyday successes or to plan pleasant activities. After familiarizing themselves with each microintervention individually, participants will be randomized daily to receive 1 of the 3 exercises or none. We will assess whether the 2 feedback types and the 3 microinterventions increase proximal outcomes at the following time point. The microrandomized trial is part of the PerPAIN randomized controlled trial (German Clinical Trials Register DRKS00022792) investigating a personalized treatment approach to enhance treatment outcomes in CMSP. Approval was granted by the Ethics Committee II of the University of Heidelberg on August 4, 2020. Recruitment for the microrandomized trial began in May 2021 and is ongoing at the time of submission. By October 10, 2022, a total of 24 participants had been enrolled in the microrandomized trial. This trial will provide evidence on the feasibility of the PerPAIN app and the initial signals of efficacy of the different intervention components. In the next step, the intervention would need to be further refined and investigated in a definitive trial. This ecological momentary intervention presents a potential method for offering low-level accessible treatment to a wide range of people, which could have substantial implications for public health by reducing disease burden of chronic pain in the population. DERR1-10.2196/43376.

Exposure to beer prior to extinction reduces spontaneous recovery of beer seeking in rats

In one experiment with rats, we investigated the impact of a retrieval-extinction procedure on spontaneous recovery of operant responses. Four groups of rats were trained to press a lever for beer during the first phase of the experiment. In the second phase, lever pressing underwent extinction. Each extinction session was preceded by brief exposure to the beer in two of the groups, either 15 or 120 min before each session. Then, the four groups were tested twice to measure spontaneous recovery. The first test was carried out immediately after the last extinction session for all rats. The second test took place after 60 min for one group, while for the remaining groups it was conducted after 5 days. We found spontaneous recovery in the three groups that experienced a delay of 5 days between the first and second test. However, the spontaneous recovery effect was attenuated in the group for which the reinforcer had been presented 15 min before each extinction session. Our data indicates that the retrieval-extinction paradigm may be a suitable behavioral technique for reducing the reappearance of beer-seeking behavior.

Mechanisms and molecular targets surrounding the potential therapeutic effects of psychedelics.

Psychedelics, also known as classical hallucinogens, have been investigated for decades due to their potential therapeutic effects in the treatment of neuropsychiatric and substance use disorders. The results from clinical trials have shown promise for the use of psychedelics to alleviate symptoms of depression and anxiety, as well as to promote substantial decreases in the use of nicotine and alcohol. While these studies provide compelling evidence for the powerful subjective experience and prolonged therapeutic adaptations, the underlying molecular reasons for these robust and clinically meaningful improvements are still poorly understood. Preclinical studies assessing the targets and circuitry of the post-acute effects of classical psychedelics are ongoing. Current literature is split between a serotonin 5-HT2A receptor (5-HT2AR)-dependent or -independent signaling pathway, as researchers are attempting to harness the mechanisms behind the sustained post-acute therapeutically relevant effects. A combination of molecular, behavioral, and genetic techniques in neuropharmacology has begun to show promise for elucidating these mechanisms. As the field progresses, increasing evidence points towards the importance of the subjective experience induced by psychedelic-assisted therapy, but without further cross validation between clinical and preclinical research, the why behind the experience and its translational validity may be lost.

Nitrous oxide and hypnotherapy in paediatric dentistry.

Patient compliance is of paramount importance for proper dental treatment, which can be difficult to achieve in children due to anxiety and fear, hindering the therapeutic procedure. In addition to well-known sedation methods (pharmacological and nitrous oxide), further methods of approach are being tested, such as hypnotherapy. The sample consisted of 150 children (90 males, 60 females). Paper questionnaires, frequency meter, nitrous oxide dispenser in association with the use of the television were exploited. At the end of treatment, subjective pain was assessed using the VAS scale, while objective pain was assessed using the FLACC scale and heart rate. This made it possible to compare two experimental groups, one treated with nitrous oxide, and the other with hypnotherapy. The control group was treated with classic behavioural approach techniques. The results obtained were analysed by SPSS Software (Statistical Package for Social Science, version 27) and the inferences between the results were calculated for confirmation. Hypnotherapy can be a valid substitute for nitrous oxide in paediatric dentistry.

Digital traces of offline mobilization.

Since 2009, there has been an increase in global protests and related online activity. Yet, it is unclear how and why online activity is related to the mobilization of offline collective action. One proposition is that online polarization (or a relative change in intensity of posting mobilizing content around a salient grievance) can mobilize people offline. The identity-norm nexus and normative alignment models of collective action further argue that to be mobilizing, these posts need to be socially validated. To test these propositions, across two analyses, we used digital traces of online behavior and data science techniques to model people's online and offline behavior around a mass protest. In Study 1a, we used Twitter behavior posted on the day of the protest by attendees or nonattendees (759 users; 7,592 tweets) to train and test a classifier that predicted, with 80% accuracy, who participated in offline collective action. Attendees used their mobile devices to plan logistics and broadcast their presence at the protest. In Study 1b, using the longitudinal Twitter data and metadata of a subset of users from Study 1a (209 users; 277,556 tweets), we found that participation in the protest was not associated with an individual's online polarization over the year prior to the protest, but it was positively associated with the validation ("likes") they received on their relevant posts. These two studies demonstrate that rather than being low cost or trivial, socially validated online interactions about a grievance are actually key to the mobilization and enactment of collective action. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A short review on behavioural assessment methods in rodents.

The rodent behavioural examination techniques are used to assess various psychological, neurological models and neurotoxicity studies. Therefore, it is of interest to document the various behavioural assessment methods used in rodent model to study the motor, sensory, cognitive functions and emotional behaviour.

A Spectrum of Solutions: Unveiling Non-Pharmacological Approaches to Manage Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a developmental disorder that causes difficulty while socializing and communicating and the performance of stereotyped behavior. ASD is thought to have a variety of causes when accompanied by genetic disorders and environmental variables together, resulting in abnormalities in the brain. A steep rise in ASD has been seen regardless of the numerous behavioral and pharmaceutical therapeutic techniques. Therefore, using complementary and alternative therapies to treat autism could be very significant. Thus, this review is completely focused on non-pharmacological therapeutic interventions which include different diets, supplements, antioxidants, hormones, vitamins and minerals to manage ASD. Additionally, we also focus on complementary and alternative medicine (CAM) therapies, herbal remedies, camel milk and cannabiodiol. Additionally, we concentrate on how palatable phytonutrients provide a fresh glimmer of hope in this situation. Moreover, in addition to phytochemicals/nutraceuticals, it also focuses on various microbiomes, i.e., gut, oral, and vaginal. Therefore, the current comprehensive review opens a new avenue for managing autistic patients through non-pharmacological intervention.

An Update in Non-Nutritive Sucking Habit Cessation

Statement of the problem Non-nutritive sucking habits (NNSH) encompass a variety of comforting behaviours in children. While considered normal in early childhood, the persistence of these habits has the potential to cause adverse effects on dental and skeletal relationships in the permanent dentition. Several interceptive techniques to promote habit cessation have been recommended. Purpose of the review To update the dental practitioner on techniques recommended for cessation of NNSH in children and evidence of their efficacy. Discussion There are various interventions for NNSH cessation, including pacifier substitution, behavioural modification, orthodontic appliances, or aversive therapy. Psychological interventions were more likely to stop NNSH versus no treatment in the short and long term. Appliances were shown to be effective in stopping NNSH and demonstrated favourable effects on occlusion. There was no difference between alternative behavioural techniques. While there is insufficient evidence in support of a single intervention, these techniques demonstrate success when used alone or in combination to promote the cessation of NNSH. Conclusions Creating awareness of the treatment options available for managing NNSH may allow practitioners to work with families to establish early habit intervention, with options individualised to the patient. Further high-quality studies are needed to strengthen the evidence base surrounding techniques available for NNSH cessation in general practice.

ANALYSIS OF NURSING CARE IN PATIENTS WITH SENSORY PERCEPTION DISORDERS THROUGH APPLICATION OF THERAPY THOUGHT STOPPING

Schizophrenia is a serious mental disorder that can affect individual thoughts, feelings and behavior. Schizophrenia is part of a psychotic disorder which is primarily characterized by loss of understanding of reality and loss of self-view. Thought stopping is one of a cognitive behavioral psychotherapy technique that can be used to help clients change their thought processes. Sources of data obtained using primary and secondary data, primary data obtained by means of interviews with respondents, while secondary data related to case studies obtained from medical records.The subjects of this case study were schizophrenic patients with sensory perception disorders at Prof Dr Soerojo Psychiatric Hospital, with the number of case study subjects 3 patients who experience sensory perception disorders. The instrument is a measuring tool to measure what will be measured. The instrument for this case study method uses the PYSRAT (Psychotic Symptom Rating Scale). The nursing actions applied to three schizophrenic clients with sensory perception disorders in this case study focused on the application of thought stopping. The intervention was carried out 3 times with a duration of 10-15 minutes at each visit. Based on the application that has been done on clients, it is known that thought stopping can help reduce signs and symptoms and control sensory perceptual disorders. The results of sensory perception getting better.
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The Impact of a Digital Weight Loss Intervention on Health Care Resource Utilization and Costs Compared Between Users and Nonusers With Overweight and Obesity: Retrospective Analysis Study.

The Noom Weight program is a smartphone-based weight management program that uses cognitive behavioral therapy techniques to motivate users to achieve weight loss through a comprehensive lifestyle intervention. This retrospective database analysis aimed to evaluate the impact of Noom Weight use on health care resource utilization (HRU) and health care costs among individuals with overweight and obesity. Electronic health record data, insurance claims data, and Noom Weight program data were used to conduct the analysis. The study included 43,047 Noom Weight users and 14,555 non-Noom Weight users aged between 18 and 80 years with a BMI of ≥25 kg/m² and residing in the United States. The index date was defined as the first day of a 3-month treatment window during which Noom Weight was used at least once per week on average. Inverse probability treatment weighting was used to balance sociodemographic covariates between the 2 cohorts. HRU and costs for inpatient visits, outpatient visits, telehealth visits, surgeries, and prescriptions were analyzed. Within 12 months after the index date, Noom Weight users had less inpatient costs (mean difference [MD] -US $20.10, 95% CI -US $30.08 to -US $10.12), less outpatient costs (MD -US $124.33, 95% CI -US $159.76 to -US $88.89), less overall prescription costs (MD -US $313.82, 95% CI -US $565.42 to -US $62.21), and less overall health care costs (MD -US $450.39, 95% CI -US $706.28 to -US $194.50) per user than non-Noom Weight users. In terms of HRU, Noom Weight users had fewer inpatient visits (MD -0.03, 95% CI -0.04 to -0.03), fewer outpatient visits (MD -0.78, 95% CI -0.93 to -0.62), fewer surgeries (MD -0.01, 95% CI -0.01 to 0.00), and fewer prescriptions (MD -1.39, 95% CI -1.76 to -1.03) per user than non-Noom Weight users. Among a subset of individuals with 24-month follow-up data, Noom Weight users incurred lower overall prescription costs (MD -US $1139.52, 95% CI -US $1972.21 to -US $306.83) and lower overall health care costs (MD -US $1219.06, 95% CI -US $2061.56 to -US $376.55) per user than non-Noom Weight users. The key differences were associated with reduced prescription use. Noom Weight use is associated with lower HRU and costs than non-Noom Weight use, with potential cost savings of up to US $1219.06 per user at 24 months after the index date. These findings suggest that Noom Weight could be a cost-effective weight management program for individuals with overweight and obesity. This study provides valuable evidence for health care providers and payers in evaluating the potential benefits of digital weight loss interventions such as Noom Weight.

SuperKid makes it easier: Effect of an intervention prepared with cognitive behavioral technique on reducing fear and pain of children during intravenous insertion

PurposeThe aim of this randomized controlled trial was to evaluate the effectiveness of a cognitive-behavioral SuperKid intervention, in reducing fear and pain among children undergoing intravenous insertion in outpatient services. Design and methodsThis study was designed as a randomized controlled trial, with 96 children aged 5–7 years. SuperKid intervention employed cognitive-behavioral techniques, implemented through a set of prepared cards. Fear was assessed using the Child Fear Scale, while pain status was measured using the Wong Baker Face Pain Scale. Scoring was performed by the mother, child, and researcher. Time series tests were conducted using the Wilks Lambda test. ResultsMost children in both the experimental and control groups reported fear regarding hospital procedures, particularly those involving pain and separation from their mothers. However, children in the experimental group who underwent the SuperKid intervention during and after IV insertion procedure experienced significantly less fear and pain than those in the control group. ConclusionsSuperKid intervention was found to be effective in reducing the procedural fear and pain of children undergoing intravenous insertion in outpatient services. The utilization of cognitive-behavioral techniques through a set of prepared cards provides an accessible and engaging means of alleviating negative emotional experiences among children undergoing medical/nursing procedures. Practice implicationsSuperKid intervention can potentially improve children's attitudes toward medical care and make future procedures easier for them. Healthcare providers could consider incorporating cognitive-behavioral interventions, such as the SuperKid intervention, into their clinical practice to reduce the fear and pain experienced by children during medical/nursing procedures.

Age Weakens the Other-Race Effect among Han Subjects in Recognizing Own- and Other-Ethnicity Faces.

The development and change in the other-race effect (ORE) in different age groups have always been a focus of researchers. Previous studies have mainly focused on the influence of maturity of life (from infancy to early adulthood) on the ORE, while few researchers have explored the ORE in older people. Therefore, this study used behavioral and eye movement techniques to explore the influence of age on the ORE and the visual scanning pattern of Han subjects recognizing own- and other-ethnicity faces. All participants were asked to complete a study-recognition task for faces, and the behavioral results showed that the ORE of elderly Han subjects was significantly lower than that of young Han subjects. The results of eye movement showed that there were significant differences in the visual scanning pattern of young subjects in recognizing the faces of individuals of their own ethnicity and other ethnicities, which were mainly reflected in the differences in looking at the nose and mouth, while the differences were reduced in the elderly subjects. The elderly subjects used similar scanning patterns to recognize the own- and other-ethnicity faces. This indicates that as age increases, the ORE of older people in recognizing faces of those from different ethnic groups becomes weaker, and elderly subjects have more similar visual scanning patterns in recognizing faces of their own and other ethnicities.

Toward Artificial Cell-Mediated Tissue Engineering: A New Perspective.

The fast-growing pace of regenerative medicine research has allowed the development of a range of novel approaches to tissue engineering applications. Until recently, the main points of interest in the majority of studies have been to combine different materials to control cellular behavior and use different techniques to optimize tissue formation, from 3-D bioprinting to in situ regeneration. However, with the increase of the understanding of the fundamentals of cellular organization, tissue development, and regeneration, has also come the realization that for the next step in tissue engineering, a higher level of spatiotemporal control on cell-matrix interactions is required. It is proposed that the combination of artificial cell research with tissue engineering could provide a route toward control over complex tissue development. By equipping artificial cells with the underlying mechanisms of cellular functions, such as communication mechanisms, migration behavior, or the coherent behavior of cells depending on the surrounding matrix properties, they can be applied in instructing native cells into desired differentiation behavior at a resolution not to be attained with traditional matrix materials.

Short Research Article: RESEED - the perceived impact of an enhanced usual care model of a novel, teacher-led, task-shifting initiative for child mental health.

Task-shifted, teacher-led care may begin to bridge the child mental health care gap in low- and middle-income countries by improving mental health literacy. We explore the perceived impact of RESEED (Responding to Students' Emotions through Education), an abbreviated version of Tealeaf (Teachers Leading the Frontlines). After classroom implementation of tools from a 3-day training on child mental health and cognitive behavioral techniques in Darjeeling, India, 29 teachers participated in focus group discussions (FGDs). Inductive content analyses of FGDs demonstrated RESEED's acceptability, positive overall impact, and barriers. Stepped levels of teacher-led care may support child mental health in resource-limited settings through mental reframing.

Oral appliance therapy for the management of obstructive sleep apnea in adults: an umbrella review protocol.

The objective of this review is to summarize the evidence on the effectiveness of oral appliance therapy compared with other therapeutic approaches (continuous positive airway pressure, maxillomandibular and upper airway surgeries, behavioral techniques) for the management of obstructive sleep apnea in adults. For primary snoring, mild to moderate obstructive sleep apnea, and patients with a severe condition who are intolerant of continuous positive airway pressure therapy, an oral appliance is the treatment of choice among conservative procedures. The effectiveness of these appliances is largely determined by a variety of parameters, including the severity of sleep apnea (mild, moderate, severe), materials and methods used to fabricate the appliance, and the degree of mandibular protrusion. Thus, it is important to evaluate the effectiveness of oral appliances in the reduction of sleep apnea. This review will include systematic reviews of quantitative studies reporting on the effectiveness of oral appliances for the treatment of obstructive sleep apnea of any severity, confirmed using polysomnography. The primary outcome will be measured by reduction in the apnea-hypopnea index. A search will be conducted of MEDLINE, Cochrane Database of Systematic Reviews, Scopus, Web of Science, CINAHL, Epistemonikos, Embase, ProQuest Dissertations and Theses, and Shodhganga Dissertations and Theses from database inception until the present, with no language restrictions. Google Scholar will be searched manually. Two independent reviewers will screen titles, abstracts, and full-text articles and perform data extraction. Quality assessment will be conducted using the standard JBI critical appraisal tool. Data will be extracted from systematic reviews and a synthesis of the findings will be presented. The certainty will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). PROSPERO CRD42021258515.