Intervention Characteristics Research Articles

Nutritional Interventions in Older Persons with Type 2 Diabetes and Frailty: A Scoping Systematic Review.

In the elderly, the coexistence of type 2 diabetes mellitus (T2DM) and frailty is frequent. Much has been described about pharmacological management and glycemic control goals. However, there is a knowledge gap in terms of the objectives and characteristics of interventions, especially nutritional ones, for this population. A scoping review was performed to document the objectives, characteristics, and results of nutritional interventions in older people with T2DM and frailty. The five-stage framework of Arksey and O'Malley was used, as was the PRISMA extension for scoping reviews. The results stand out for three trends, as follows: (1) experimental studies with multicomponent intervention physical exercise programs and nutritional programs based on educational processes or behavioral intervention; (2) observational studies with an association of the kind of diet assessed by scales and their relation to stages of frailty; (3) a review that updates recommendations on pharmacological and non-pharmacological, diet, exercise, management, as well as glucose control goals for diabetes in frail older persons. Finally, the evidence shows that management of T2DM in older adults with frailty requires goals and interventions tailored to their functional capacity and health condition. The exercise, diet, and education programs reviewed have demonstrated their effectiveness in improving physical performance, reducing the risk of frailty or progression to more advanced stages, and achieving better glycemic control.

Supporting Co-Regulation and Development of Self-Regulation Skills in Students With Intellectual Disabilities: A Scoping Review

Abstract Young people with intellectual disability (ID) frequently have challenges with self-regulation that impact their success and participation in daily life. As they often require additional support with self-regulation, it is important to consider regulatory function and skill development within the context of co-regulatory interactions with caregivers. This scoping review aimed to identify factors associated with improved self-regulation and co-regulation in young people with ID. The review was conducted using Arksey and O’Malley’s (2005) framework, with 142 full-text records reviewed and critically appraised. The diverse factors that affect regulatory function in young people with ID fit within the five categories identified in the model of factors contributing to self-regulation enactment — biology, skills, motivation, caregiver support, and environmental context — highlighting the relevance of this model to regulatory function for this population. This review’s findings allow this model to be refined further for young people with ID, identifying the unique factors contributing to self-regulation enactment for this population and intervention characteristics that may support regulatory function for these individuals.

A PrEP decision aid for women survivors of intimate partner violence: Task-shifting implementation to domestic violence service settings.

Women exposed to intimate partner violence (IPV) experience multiple social and structural barriers to accessing HIV pre-exposure prophylaxis (PrEP), despite being at increased risk for HIV. In addition, few existing HIV prevention interventions address IPV. A recently developed PrEP decision aid for women has the potential to reach IPV survivors at risk for HIV if it could be integrated into existing domestic violence agencies that prioritize trust and rapport with female IPV survivors. Leveraging non-traditional service delivery mechanisms in the community could expand reach to women who are IPV survivors for PrEP. We conducted qualitative interviews and online qualitative surveys with 33 IPV survivors and 9 domestic violence agency staff at two agencies in Connecticut. We applied the Consolidated Framework for Implementation Research (CFIR) to understand barriers and facilitators to delivering a novel PrEP decision aid to IPV survivors in the context of domestic violence service agencies. Most IPV survivors and agency staff thought the PrEP decision aid intervention could be compatible with agencies' existing practices, especially if adapted to be trauma-responsive and delivered by trusted counselors and staff members. PrEP conversations could be packaged into already well-developed safety planning and wellness practices. Agency staff noted some concerns about prioritizing urgent safety needs over longer-term preventive health needs during crisis periods and expressed interest in receiving further training on PrEP to provide resources for their clients. IPV survivors and agency staff identified key intervention characteristics of a PrEP decision aid and inner setting factors of the service agencies that are compatible. Any HIV prevention intervention in this setting would need to be adapted to be trauma-responsive and staff would need to be equipped with proper training to be successful.

Remote patient monitoring in patients with COVID-19 at home: literature review.

During the pandemic healthcare providers implemented remote patient monitoring (RPM) for patients suffering from COVID-19. RPM is an interaction between healthcare professionals and patients who are in different locations, in which a certain number of patient's functioning parameters is assessed and followed up for a certain duration of time. By implementing RPM for these patients they obtained to reduce the strain on hospitals and primary care. With this literature review we aim at describing the characteristics of the RPM interventions, reporting on the patients with COVID-19 included in RPM, and providing an overview of outcome variables such as length of stay (LOS), hospital (re)admissions, and mortality. A combination of different searches in several database types (traditional databases, trial registers, daily (google) searches and daily Pubmed alerts) were run daily from March 2020 till December 2021. A search update for randomized clinical trials (RCT's) was done in April 2022. The initial search yielded more than 4448 articles (not including daily searches). After deduplication and assessment for eligibility, 241 articles were retained describing 164 telemonitoring studies from 160 centres. None of the 164 studies covering 248,431 included patients reported on the presence of a randomized control group. Studies described a 'prehosp' group (96 studies) with patients who had a suspected or confirmed COVID-19 diagnosis and for whom it was decided not to hospitalize them yet, but closely monitor them at home, or a 'posthosp' group (32 studies) with patients who were monitored at home after hospitalization for COVID-19; 34 studies described both groups, in 2 studies it was unclear. There is a large variety in number of emergency department (ED) visits (0-36% and 0-16%) and no convincing evidence that RPM leads to less or more ED-visits as well as hospital (re)admissions (0-30% and 0-22%) in prehosp and posthosp, respectively. Mortality was generally low, and there is weak to no evidence that RPM is associated with lower mortality. There is neither evidence that RPM shortens previous LOS. A literature update detected three small scale RCT's which could not demonstrate statistically significant differences in these outcomes. Most papers claim savings, however the scientific base for these claims is doubtful. The overall patient experiences with RPM were positive, as patients felt more reassured, although many patients declined RPM for several reasons (eg, technological embarrassment, digital literacy, etc.). Based on these results, there is no convincing evidence that RPM in COVID-19 patients could avoid ED-visits or hospital (re)admissions, could shorten LOS or reduce mortality, but neither is there evidence that RPM has adverse outcomes. Further research should focus on developing, implementing, and evaluating an RPM framework.

Court Navigators and Opportunities for Disseminating Overdose Prevention Strategies.

Objective. Describe how navigator programs from three New England states (Connecticut, Maine, and Massachusetts) function to connect individuals using court services to community-based treatment and services. Hypothesis. Implementation science frameworks can be used to analyze how multiple court programs function to inform replication and address gaps in the use of overdose prevention strategies. Method. The Template for Intervention Description and Replication (TIDieR) Implementation informed semi-structured interviews as part of an exploratory mixed-methods analysis of court navigator programs. Analysis of interviews based on the TIDieR and administrative data on client contacts (n = 436) were analyzed. A subsample of clients with additional background information (n = 249) was used to examine court navigator recommendations. Results. The TIDieR revealed court navigator programs shared basic intervention characteristics but varied dramatically by resources and organization contexts. Nearly half (46.5%) of clients were self-referred and more than two-thirds (69.1%) approved follow-up but varied by program. Of those allowing follow-up, more than one-third (35.7%) had previously experienced an overdose. Court navigators were significantly more likely to refer clients with a history of overdose to locations where they can receive naloxone (the opioid overdose antidote) though only one program had naloxone on hand. Conclusion. Navigators are employed by community organizations with access to courthouses to provide resources to those passing through. These efforts can be implemented to support linkages to treatment and services but there is a significant gap in the allocation of overdose prevention strategies in court settings and court navigator programs have the potential to address this unmet need.

Implementing palliative care in the intensive care unit: a systematic review and mapping of knowledge to the implementation research logic model.

The importance and effectiveness of palliative care (PC) in intensive care units (ICU)are known. Less is known about the implementation and integration of ICU-based PC interventions. This systematic review aims to use a modified implementation research logic model (IRLM) to identify, map, and synthesise evidence on implementation of ICU-PC (primary and/or specialist) interventions. This systematic review used an adapted Smith's IRLM to understand relationships between implementation factors-determinants (barriers and facilitators), strategies, and mechanisms-and report intervention characteristics and outcomes. Searches up to 2nd December 2023, of MEDLINE, Embase, Cochrane, CINAHL, and PsycINFO, combined PC, intensive care, and implementation terms. 84 studies (8 process evaluations, 76 effectiveness studies) were included. Published evidence on ICU-PC interventions issubstantial, but reporting on implementation factors is variable and often lacking, especially for patient and family-related determinants and for all aspects of mechanisms. Main facilitators forimplementation are adequate resources and collaborationbetween PC and ICU teams. Main barriers to implementation are lack of resources, negative perceptions of PC, and high ICU acuity.Implementation strategies include auditing resources, building stakeholder collaboratives, creating adaptable interventions, utilising champions, and supporting education. Mechanisms most commonly worked by facilitating collaborative working. This review provides recommendations for ICUs when designing (stakeholder involvement, ICU-PC collaboration, assessment of culture and resources); implementing (targeted and adapted strategies, champions, and education); and evaluating/reporting (collect effectiveness and implementation data, including mechanisms) ICU-PC interventions. Use of implementation structures and patient/family involvement are both needed and important to be included.

Is non-invasive neuromodulation a viable technique to improve neuroplasticity in individuals with acquired brain injury? A review.

This study aimed to explore and evaluate the efficacy of non-invasive brain stimulation (NIBS) as a standalone or coupled intervention and understand its mechanisms to produce positive alterations in neuroplasticity and behavioral outcomes after acquired brain injury (ABI). Cochrane Library, Web of Science, PubMed, and Google Scholar databases were searched from January 2013 to January 2024. Using the PICO framework, transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) randomized controlled trials (RCTs), retrospective, pilot, open-label, and observational large group and single-participant case studies were included. Two authors reviewed articles according to pre-established inclusion criteria. Data related to participant and intervention characteristics, mechanisms of change, methods, and outcomes were extracted by two authors. The two authors performed quality assessments using SORT. Twenty-two studies involving 657 participants diagnosed with ABIs were included. Two studies reported that NIBS was ineffective in producing positive alterations or behavioral outcomes. Twenty studies reported at least one, or a combination of, positively altered neuroplasticity and improved neuropsychological, neuropsychiatric, motor, or somatic symptoms. Twenty-eight current articles between 2020 and 2024 have been studied to elucidate potential mechanisms of change related to NIBS and other mediating or confounding variables. tDCS and TMS may be efficacious as standalone interventions or coupled with neurorehabilitation therapies to positively alter maladaptive brain physiology and improve behavioral symptomology resulting from ABI. Based on postintervention and follow-up results, evidence suggests NIBS may offer a direct or mediatory contribution to improving behavioral outcomes post-ABI. More research is needed to better understand the extent of rTMS and tDCS application in affecting changes in symptoms after ABI.

Constructs from the Consolidated Framework for Implementation Research associated with church enrollment and intervention adoption in a national implementation study of a faith-based organizational change intervention

BackgroundOrganizational adoption is a key but understudied step in translating evidence-based interventions into practice. The purpose of this study was to report recruitment strategies and factors associated with church enrollment and intervention adoption in a national implementation study of the Faith, Activity, and Nutrition (FAN) program.MethodsWe worked with partners using multiple strategies to disseminate intervention availability. Interested churches completed an online form. To enroll, the church coordinator (FAN coordinator) and pastor completed baseline surveys and then received intervention online training access. We compared enrolled vs. non-enrolled churches on how they heard about the study and church characteristics. We compared intervention-adopting vs. non-adopting churches on Consolidated Framework for Implementation Research (CFIR) constructs using Fisher’s exact tests, χ2, or independent sample t-tests and reported differences where p < 0.10, d≥|0.35|, or the difference in percentage points was ≥ 10.ResultsWe received 226 interest forms; 107 churches enrolled, and 85 churches adopted the intervention. Faith-based sources were the most, and paid media the least, effective in reaching churches, which were largely from the southeast with a Methodist or Baptist tradition (no differences by enrollment status). Enrolled churches were less likely to have 500 + worshipers and more likely to have attended a study information session than non-enrolled churches. Church (CFIR inner setting) and FAN coordinator characteristics, but not intervention characteristics, were related to intervention adoption.ConclusionPartnerships, relationships, and “face time” are important for enrolling churches in evidence-based interventions. Church and church coordinator characteristics are related to intervention adoption. Further work on adoption conceptualization and operationalization is needed.

The efficacy of cognitive behavioural therapy for depression and anxiety in multiple sclerosis: A systematic review and meta-analysis

Background: Adults with multiple sclerosis (MS) frequently experience symptoms of depression and anxiety, which pose significant challenges. However, psychological support for these symptoms remains a major unmet healthcare need.Objectives: To inform the evidence base for the psychological management of adults with MS, this study examined the efficacy of cognitive behavioural therapy (CBT) interventions for improving symptoms of depression and anxiety. CBT interventions teach skills for improving the relationships between an individual's thoughts, feelings, and/or behaviours. The study also examined the role of intervention and study characteristics as moderators of treatment effects.Methods: Medline, Embase, PsycINFO, and Cochrane Central Register of Controlled Trials were searched up to August 2024 for randomised control trials.Results: A meta-analysis of 15 clinical trials (1508 participants) was conducted, which found a medium significant treatment effect size for depression symptoms (g = 0.59, 95 % Confidence Interval [CI] [0.38, 0.80]) and a small significant treatment effect size for anxiety symptoms (g = 0.38 95 % CI [0.19, 0.57]). Moderator analyses revealed treatment effects for anxiety, but not depression, were significantly larger for studies conducted in non-Western countries compared to Western countries, and for those with smaller sample sizes.Conclusions: CBT-based interventions appear efficacious for the management of depression and anxiety symptoms in adults with MS. However, future clinical trials with larger samples and more rigorous methodology are warranted. Further examination of intervention characteristics, including ways in which CBT is tailored and how this relates to outcomes, may help to refine interventions for people with MS.

Predictors of follow-up of pediatric stone patients after surgical intervention

We investigated if socioeconomic and demographic factors predict post-surgical follow-up in pediatric stone patients. All patients having kidney stone surgery at a single academic pediatric hospital over a 5 year period (2016-2020) were identified through the use of CPT® codes specific to ureteroscopy, shock wave lithotripsy, and percutaneous nephrolithotomy. Electronic charts were reviewed for patient demographics, stone characteristics, and characteristics of intervention. Unique patients with a scheduled post-operative follow-up office visit following a first time stone surgery were included in the patient cohort (Figure 1). Primary outcome was attendance of a scheduled provider visit within 6 months after surgery. Secondary outcomes included completion of scheduled post-operative imaging and 24-h urine study. Univariable analysis was performed. 195 pediatric patients, a median age of 15.4 years (IQR: 11.34, 17.14) at surgery, were identified. The majority were non-Hispanic white (86.2%) and female (62.1%). Most had undergone ureteroscopy alone (85.6%). Of the 195 patients, 146 (74.9%) attended a post-operative office visit. Indicators of lower socioeconomic status, such as having public insurance and being from a single-parent home, were associated with not attending a scheduled follow-up visit (p<0.01 and p=0.02, respectively). Patients with a pre-operative urology clinic visit were more likely to follow-up with a clinic visit (p=0.02), while those with a larger total stone burden treated were more likely to undergo ordered imaging (p<0.01). We found that indicators of lower socioeconomic status, such as having public insurance status and being in a single-parent household, were associated with lower pediatric follow-up compliance after kidney stone surgery, while patients seen in the urology clinic preoperatively were more likely to attend follow-up. Identifying factors that may predict non-compliance could be used to help at-risk patient populations.

Behavioral Weight Management Interventions for Hispanic Men in the United States: A Systematic Review.

Hispanic men have the highest prevalence of obesity relative to other racial and ethnic subgroups; however, this population is consistently underrepresented in weight management interventions. This systematic review aims to provide an overview of behavioral weight management interventions adapted for Hispanic men and describe their tailoring strategies and efficacy. Six online databases were selected for their abundant collection of high-quality, peer-reviewed literature and searched for studies which evaluated and reported weight outcomes for a cohort of adult (>18 years) Hispanic men. Of 6,508 unique publications screened, 12 interventions met inclusion criteria, the majority of which were published in the past 10 years. Only one study regarding an intervention tailored for Hispanic men was a randomized controlled trial adequately powered to assess a weight-based outcome; the remaining assessed feasibility or utilized quasi-experimental methods. Intervention characteristics and tailoring strategies varied considerably, but content was most frequently based on the Diabetes Prevention Program. Tailoring strategies commonly focused on improving linguistic access and incorporating social or family support. Follow-up varied from 1 month to 30 months and mean change in weight, the most common outcome, ranged from 0.6 to -6.3 kg. Our findings reveal a need for more fully powered randomized controlled trials evaluating the efficacy of interventions systematically tailored specifically for Hispanic men. Although the majority were not fully powered, these interventions showed some efficacy among their small cohorts for short-term weight loss. Future directions include exploring how to tailor goals, concepts, and metaphors included in interventions and comparing individual to group delivery settings.

Nursing interventions for pediatric patients with CANCER and their families: A scoping review

BackgroundClinical nursing care is an essential element in pediatric oncology. The body of research interventions targeting pediatric oncology patients and their families has grown in recent years. However, no reviews are currently available on nursing interventions for pediatric oncology. AimThe aim was to develop a comprehensive overview of the available nursing interventions for pediatric oncology patients and their families, outline the characteristics of the interventions, and identify any knowledge gaps. MethodsThis review was conducted in accordance with the JBI guidelines for scoping reviews. Citations were retrieved from the following databases: Scopus, PubMed, CINAHL, PsyclNFO, and Embase. The following inclusion criteria were applied: peer-reviewed studies written in English, Danish, Norwegian, or Swedish from 2000 onwards, reporting on pediatric patients with cancer and/or family members of a pediatric patient with cancer who received non-pharmacological and non-procedural nursing interventions provided by a pediatric oncology hospital service. Eligible studies were screened by title and abstract, and in full text by two independent reviewers. Critical appraisal was achieved using the Mixed Methods Appraisal Tool. FindingsAmong 2762 references, 26 studies met the inclusions criteria, comprising 25 unique nursing interventions. 89 % had been published from 2013 onwards, reflecting the rapid changes occurring in pediatric oncology treatment. 36 % were qualitative, 58 % were quantitative and 8 % employed mixed methods. The studies were characterized by considerable diversity in terms of intervention content, components, timing of delivery, and delivery mode. 60 % of the interventions were targeted parents among whom mothers were highly overrepresented (75 %). 16 % adopted a family-centered focus. ConclusionThis review contributes to building a more comprehensive understanding of the evidence base within pediatric oncology nursing research. This field is evolving and holds the potential to support families with childhood cancer across various phases of their treatment trajectory. However, a clear need exists to develop and test interventions with a genuinely family-centered focus, targeting both patients and family members. A considerable gap exists in reporting of the intervention development process and intervention characteristics. Improving the reporting of intervention development is needed to enhance research quality and facilitate subsequent adaptation or upscaling of interventions for use in other populations and contexts. Tweetable abstractNursing interventions can support families with childhood cancer but future intervention studies need to enhance transparency in reporting @IJNSjournal.

Stress interventions for immigrant parents in the United States: a scoping review protocol.

This review will map stress interventions designed for and implemented among immigrant parents in the United States (US) according to intervention characteristics, participant characteristics, and reported outcomes and measurement tools. In addition to parenting stressors shared with their non-immigrant counterparts, immigrant parents also face immigration stressors. Although stress interventions can effectively manage, reduce, or prevent stress among non-immigrant populations, we know little about stress interventions designed for immigrant parents in the US. This study will be the first to explore stress interventions implemented among immigrant parents in the US. This scoping review will include published, peer-reviewed quantitative, qualitative, and mixed methods studies that evaluate stress interventions designed specifically for US immigrant parents with at least 1 child under the age of 18 years. Reported interventions must include stress as a primary or secondary outcome or be labeled as a stress intervention. Stress interventions are broadly defined, with no restrictions on the type of stress targeted (eg, job, general, parenting) or the intervention's nature (ie, prevention vs. management/reduction vs. treatment). A literature search will be conducted in ProQuest's APA PsycINFO and PsycARTICLES, CINAHL Plus (EBSCOhost), ERIC (ProQuest), Embase, MEDLINE (Ovid), International Bibliography of Social Sciences (ProQuest), and the Cochrane Library. Only English-language publications will be eligible, with no date restrictions. Retrieved titles and abstracts will be screened by at least 2 independent reviewers in duplicate. Data will be extracted using a self-developed data extraction tool. Findings will be presented in tabular or diagrammatic format, accompanied by a narrative summary. Open Science Framework osf.io/ec39j.

169 Strategies for recruitment of adolescent girls into physical activity programmes: a systematic review

Abstract Purpose Physical activity is essential for youth physical and mental health, yet just 15% of adolescent girls worldwide meet the World Health Organization guideline of 60 minutes of moderate-to-vigorous physical activity per day. A persistent challenge faced by physical activity providers, however, is recruiting adolescent girls into their programmes. This review aims to provide quantitative evidence-based recommendations for optimal recruitment practices for this cohort. Methods Five electronic databases were searched (Embase, Medline, CINAHL, Web of Science, and Cochrane Library – Central Trial Registry) including database-specific terms, truncations, and synonyms combining ‘adolescent females’, ‘recruitment’, and ‘physical activity’ to identify randomised controlled trials of physical activity interventions for adolescent girls worldwide. Hand searches of references were also conducted. Data was extracted regarding study, participant, and intervention characteristics, pre-determined recruitment goals, recruitment strategies employed, and the number of participants screened, eligible, approached, randomised, and retained. Outcomes included whether recruitment goals were met, recruitment rate, and any revised recruitment measures implemented mid-study. Results After removal of duplicates (n = 71), 5460 articles were screened by title and abstract independently by two reviewers. 70 full-text articles were screened by two reviewers, resulting in 26 included studies. Preliminary analysis showed that most physical activity programmes were school-based (76.4%), multicomponent (65.4%), and designed based on behaviour change theories (80.8%). All studies employed multiple recruitment strategies such as distributing information to eligible students in schools (14 studies), researchers presenting directly to eligible students at their school (10), teachers assisting with recruitment (6), providing small gifts, vouchers, or the ability to earn awards for participation (5 each), and posting flyers in schools (4). The mean recruitment rate for adolescent girls into physical activity randomised controlled trials was 60.4% (SD = 26.94), with high variability (23.6%-99.2%). Ongoing analysis will provide regression results regarding the effectiveness of recruitment strategies employed and their impact on recruitment outcomes. Conclusions Application of the findings of this review by physical activity programme providers may enhance their recruitment processes, potentially increasing teenage girls’ physical activity enrolment worldwide. Funding This research was funded by the Irish Research Council and the Dublin City Sport &amp; Wellbeing Partnership through the Enterprise Partnership Scheme.

221 - Preconception lifestyle interventions for women – a systematic review and meta-analysis of intervention characteristics and behaviour change techniques

221 - Preconception lifestyle interventions for women – a systematic review and meta-analysis of intervention characteristics and behaviour change techniques

Pre-implementation planning for a sepsis intervention in a large learning health system: a qualitative study

BackgroundSepsis survivors experience high morbidity and mortality. Though recommended best practices have been established to address the transition and early post hospital needs and promote recovery for sepsis survivors, few patients receive recommended post-sepsis care. Our team developed the Sepsis Transition and Recovery (STAR) program, a multicomponent transition intervention that leverages virtually-connected nurses to coordinate the application of evidence-based recommendations for post-sepsis care with additional clinical support from hospitalist and primary care physicians. In this paper, we present findings from a qualitative pre-implementation study, guided by the Consolidated Framework for Implementation Research (CFIR), of factors to inform successful STAR implementation at a large learning health system prior to effectiveness testing as part of a Type I Hybrid trial.MethodsWe conducted semi-structured qualitative interviews (n = 16) with 8 administrative leaders and 8 clinicians. Interviews were transcribed and analyzed in ATLAS.ti using a combination deductive/inductive strategy based on CFIR domains and constructs and the Constant Comparison Method.ResultsSix facilitators and five implementation barriers were identified spanning all five CFIR domains (Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals and Process). Facilitators of STAR included alignment with health system goals, fostering stakeholder engagement, sharing STAR outcomes data, good communication between STAR navigators and patient care teams/PCPs, clinician promotion of STAR with patients, and good rapport and effective communication between STAR navigators and patients, caregivers, and family members. Barriers of STAR included competing demands for staff time and resources, insufficient communication and education of STAR’s value and effectiveness, underlying informational and technology gaps among patients, lack of patient access to community resources, and patient distrust of the program and/or health care.ConclusionsCFIR proved to be a robust framework for examining facilitators and barriers for pre-implementation planning of post-sepsis care programs within diverse hospital and community settings in a large LHS. Conducting a structured pre-implementation evaluation helps researchers design with implementation in mind prior to effectiveness studies and should be considered a key component of Type I hybrid trials when feasible.Trial registrationClinicaltrials.gov, NCT04495946. Registered August 3, 2020.

A systematic review and meta-analysis of randomized controlled trials to reduce burden, stress, and strain in informal stroke caregivers

Objectives To understand the nature and effectiveness of interventions aimed at improving informal stroke caregiver burden, stress, and strain. Data sources In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of CENTRAL, CINAHL, MEDLINE, Embase, APA PsycInfo, and Web of Science was conducted in May 2022. Review methods Studies were eligible if they included an intervention designed for informal stroke caregivers, reported on caregiver burden, strain, or stress, were published in English, and used a randomized controlled trial design. An updated search was conducted in June 2024. The methodological quality of studies was appraised using the Cochrane risk-of-bias tool for randomized trials. The data were pooled, and a meta-analysis was completed for caregiver burden and strain outcomes. Results Nineteen studies met inclusion criteria and were meta-analyzed. Interventions ranged from 4 days to 12 months. Most studies incorporated educational and/or support components. Meta-analyses revealed nonsignificant effects on caregiver burden or strain. Significant between-group differences for caregiver strain and burden were, however, found in seven studies. Conclusion Limited studies, small sample sizes, and conflicting results made definitive conclusions on the most effective intervention characteristics for improving caregiver outcomes difficult. Of the 19 studies, seven found significant between-group differences for caregiver outcomes postintervention, and these tended to incorporate educational components and comprised between seven and nine sessions. Further high-quality research is required to identify optimal format, duration, and frequency for improving caregiver outcomes.

Interventions promoting resilience through climate smart agricultural practices for women farmers: A systematic review.

Climate change poses a significant threat to agricultural production worldwide, with developing countries being particularly vulnerable to its negative impacts. Agriculture, which is a crucial factor in ensuring food security and livelihoods, is particularly vulnerable to changes in climate patterns, such as increased temperatures, drought, and extreme weather events. One approach to addressing these challenges is by promoting the adoption of climate-smart agriculture (CSA) practices among farmers. CSA combines traditional agricultural practices with innovative techniques and technologies to adapt to and mitigate the impacts of climate change. infrastructure. By adopting CSA practices, farmers can enhance their resilience to climate variability and improve their productivity. This review examines the effectiveness of interventions promoting CSA to enhance farmers' knowledge of the benefits of CSA approaches, subsequent adoption of CSA, and disadoption of harmful agricultural practices in low- and middle-income countries (LMICs). We searched 39 academic and online databases, websites, and repositories and screened over 19,000 experimental and quasi-experimental publications to identify studies promoting CSA practices to women farmers. We conducted a citation tracking process on included studies and contacted experts to ensure a thorough search. The review focused on studies that included interventions promoting climate-smart agricultural approaches. Using EPPI Reviewer 4, two review authors independently screened the impact evaluation using a standardized screening tool. Information about participant characteristics, intervention characteristics, control conditions, research design, sample size, bias risk, outcomes, and results were gathered. Data collection and quantitative analysis were conducted using standard Campbell Collaboration methods. Eight impact evaluations were found (two randomized controlled trials) evaluating the effects of CSA practices on farmer's knowledge gains of the benefits of CSA practices and subsequent adoption. Knowledge dissemination approaches such as Farmer Field Schools and weather and climate information services were found to positively impact farmers' knowledge and adoption of specific CSA practices. However, the evidence supporting this claim is uncertain as a high risk of bias was assessed for five of the eight included studies. However, we found no effects on the disadoption of harmful practices such as pesticide overuse. The evidence base for studies promoting climate-smart agricultural approaches (CSA) to farmers in LMICs is small, and there is a lack of studies reporting sex-disaggregated data and studies explicitly targeting women farmers. The review suggests that knowledge dissemination techniques are significantly effective in improving CSA knowledge and adoption, including integrated pest management techniques and their benefits, adoption of climate-resilient rice seed varieties (STRVs), and use of botanical pesticides by farmers. More and better confidence studies are needed to inform policy and programming, including those that look at a wider range of interventions, including changing norms, values, and institutional arrangements.

Interprofessional education interventions for healthcare professionals to improve patient safety: a scoping review.

Patient safety incidents, such as adverse events and medical errors, are often caused by ineffective communication and collaboration. Interprofessional education is an effective method for promoting collaborative competencies and has attracted great attention in the context of patient safety. However, the effectiveness of interprofessional education interventions on patient safety remains unclear. This scoping review aimed to synthesize existing studies that focused on improving patient safety through interprofessional education interventions for healthcare professionals. Six databases, including Medline (via PubMed), Embase, Cochrane Library, CINAHL (via EBSCO), Scopus and Web of Science, were last searched on 20 December 2023. The search records were independently screened by two researchers. The Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental Studies was used for quality appraisal. The data were extracted by two researchers and cross-checked. Finally, a narrative synthesis was performed. The protocol for this scoping review was not registered. Thirteen quasi-experimental studies with moderate methodological quality were included. The results revealed that the characteristics of current interprofessional education interventions were diverse, with a strong interest in simulation-based learning strategies and face-to-face delivery methods. Several studies did not assess the reduction in patient safety incidents involving adverse events or medical errors, relying instead on the improvements in healthcare professionals' knowledge, attitude or practice related to patient safety issues. Less than half of the studies examined team performance, based primarily on the self-evaluation of healthcare professionals and observer-based evaluation. There is a gap in applying newer tools such as peer evaluation and team-based objective structured clinical evaluation. Additional evidence on interprofessional education interventions for improving patient safety is needed by further research, especially randomized controlled trials. Facilitating simulation-based interprofessional education, collecting more objective outcomes of patient safety and selecting suitable tools to evaluate teamwork performance may be the focus of future studies.

Interventions Used With Direct Support Workforce of Adults With Disabilities in Home and Community-Based Settings: A Scoping Review

Abstract This scoping review fills the gap on key characteristics of interventions and trainings for direct support workforce (DSW) of adults across disabilities and aging adults. We included quantitative and qualitative studies examining the impact of interventions in home and community-based settings in the United States or internationally and published in English since 1990. We initially identified 2,551 titles and completed final data extraction on 65 articles. Most of the studies were quantitative. The interventions reviewed were diverse, including Active support, Positive Behavior Support, and DSW stress reduction. We concluded that there is a need to conduct high-quality research focused on DSW well-being and their feeling of being valued to inform the field on how to best select and retain them.