Community-based Pilot Intervention Research Articles

Incentivizing Pregnant Women to Quit Smoking in the Real World-A Community-Based Pilot Intervention.

Smoking during pregnancy is a leading preventable cause of poor pregnancy outcomes. Financial incentives interventions yield quit rates of approximately 30% during pregnancy, versus approximately 4% in traditional smoking cessation programs. This pilot study assessed the feasibility of translating an efficacious University of Vermont research-based intervention into a rural community setting delivered by the Vermont Department of Health. Pregnant women using tobacco products were recruited from the Women, Infants and Children program and Rutland Women's Healthcare. Women were provided in-person tobacco cessation counseling during regularly scheduled meetings and received gift cards throughout pregnancy and 3 months postpartum contingent upon biochemically verified smoking abstinence. Cessation counseling and abstinence monitoring began with high frequency (three visits per week), tapering through postpartum to biweekly visits. Gift card values began at $15, increasing by $5 for consecutive negative samples, to $40 maximum. Participants completed three surveys (enrollment, 4-6 weeks postpartum, 6-12 months postpartum) assessing smoking habits, and barriers and facilitators of treatment engagement and success. From 2018 to 2020, we enrolled 20 pregnant women, of whom six self-reported quitting tobacco at some point during the intervention. At study completion, three reported sustained abstinence. Results suggest that it is feasible to translate a research-based smoking cessation program into a community setting. This article discusses the challenges faced and the lessons learned when implementing research in a rural community setting, recruiting and retaining participants, and adapting protocols during the Covid-19 pandemic.

Impact of a community-based pilot intervention to tackle childhood obesity: a \u2018whole-system approach\u2019 case study

BackgroundGo-Golborne was a three-year pilot programme to test an innovative, community-based ‘whole system’ approach to preventing overweight in children in Golborne ward, London. Whilst there is a growing interest in local whole systems approaches to obesity, understandings of what they look like in practice are newly emerging. Go-Golborne was designed, implemented and evaluated within this context.MethodsThe evaluation used a case-study design and theory of change approach to assess the effectiveness of the intervention. Height/weight measurements of children in the six participating primary schools were recorded annually for 4 years. For behavioural outcomes, children aged six-11 completed four annual on-line surveys (total 4331 responses). Parents were surveyed in year one and year four (177 responses). Three focus group discussions were held with children aged 10–11 (N = 21); interviews were conducted with parents (N = 11), and school representatives (N = 4). Stakeholders were surveyed twice (37 responses), and interviews were conducted with key stakeholders (N = 11). An extensive range of programme documents were reviewed and additional process data was collected from the programme team. The RE-AIM framework was used to synthesise findings and examine public health impact.ResultsGo-Golborne reached a diverse range of partners across Golborne. Events were attended by over 3360 local children and families and all six primary schools in the ward actively engaged in activities. The proportion of children in the above healthy weight categories remained stable over time. A number of changes in home, school and neighbourhood environments to support healthy behaviour change were evidenced. There was some qualitative evidence of positive changes in children’s behaviours, though significant or sustained changes were not evidenced by the quantitative data.ConclusionsGo-Golborne helped stakeholders and parents to develop a shared commitment to improving healthy weight in children, to identify barriers to a healthy lifestyle, and to start to make changes in their services/behaviours. The campaigns and changes made at micro-level appeared to be insufficient, in the face of counteracting forces and personal factors, to achieve significant behaviour change within 3 years. This highlights the need for local initiatives to be reinforced by supporting action at regional, national and global levels.

Effects of a Community-Based Pilot Intervention on Home Food Availability among U.S. Households.

The purpose of this study was to assess the effects of a pilot community-based behavioral intervention on the home food environment in U.S. households. Parents (21 females, 2 males; age = 36 ± 5.5 years; 78% Hispanic) of elementary school-aged children attended a 10-week dietary improvement behavioral intervention targeting an increase in fruit and vegetable consumption and a reduction in sugar intake. Home food availability of fruit, vegetables, and sugar-laden foods and beverages were assessed before and after the intervention using a modified version of the Home Food Inventory. Relative to baseline, the intervention resulted in significant increases in fruit availability (7.7 ± 3.2 items vs. 9.4 ± 3.1 items; p = 0.004) and low sugar cereal (2.3 ± 1.4 types vs. 2.7 ± 1.4 types; p = 0.033). There was a significant reduction in sugar-sweetened beverage availability (3.2 ± 1.9 types vs. 1.7 ± 1.3 types; p = 0.004). There was a significant increase in the number of households with accessible ready-to-eat vegetables and fruit, and a significant reduction in available prepared desserts, and candy (p < 0.01). There were no significant changes in the availability of vegetables and sugar-laden cereals. The current intervention resulted in positive changes in the home food environment. Further research to confirm these results in a randomized controlled trial is warranted.

Promoting posttraumatic growth among the refugee population in Spain: A community‐based pilot intervention

Various international organisations have identified the development of programmes that mitigate the negative impact that forced displacement has on refugees' mental health as a priority intervention area. From this perspective, this study seeks to lend empirical support to a community-based pilot intervention aimed at promoting posttraumatic growth (PTG) among refugee adults arrived to Seville, the capital of Andalucía (southern Spain). PTG constitutes a mental health indicator that refers to the positive personal transformations refugees undergo as a consequence of experiencing forced displacement. This concept does not negate the undeniable personal suffering forced displacement causes for refugees; rather, it focuses on the positive changes this event has the potential to bring about. Forty-seven individuals (age, M=33years; 20 women) from several countries in conflict participated in the intervention over 15weeks (March-June 2017). The implementation process comprised two phases: (a) training a group of settled refugees to become peer mentors; and (b) holding cultural peer-support group sessions made up of newly arrived refugees led by the mentors. Following quantitative and qualitative data collection (using the 'Posttraumatic Growth Inventory' (PTGI; Tedeschi & Calhoun, Journal of Traumatic Stress, 1996, 9, 455) and participants' written evaluations and comments, respectively), and adopting a pretest-posttest evaluation design, significant improvements were found in four of the five PTG factors: 'appreciation of life', 'personal strength', 'relating to others' and 'new possibilities'. However, no significant differences were observed for 'spiritual change'. We also documented implementation outcomes which revealed high intervention acceptability, appropriateness and feasibility. This study highlights how PTG shown by the refugee population can be actively improved through a community-based intervention, specifically by creating supportive community settings that adopt a mentorship and peer-based approach. The limitations and contributions of this research that address the current challenges behind promoting the mental health of refugees in places of settlement are discussed.

Community-based pilot intervention to tackle childhood obesity: a whole-system approach

ObjectivesGo-Golborne is a pilot intervention to prevent childhood obesity in the Royal Borough of Kensington and Chelsea between 2014 and 2018. It is a multistrategy approach targeting children aged 0–16 years and their families in all settings where children live, learn and play. This paper describes the methodology and the practical steps in the development of Go-Golborne. Study designThe programme uses a quasi-experimental design for the evaluation of changes in weight status using data from the extended National Child Measurement Programme across local schools. For specific behavioural change objectives, baseline self-reported lifestyle measures will be compared against annual follow-up data over the 3-year study period. Qualitative methods will be used to explore the perceptions of stakeholders and participants and organizational change. MethodsGo-Golborne aims to mobilize everyone in the community who has a role or interest in shaping the local environment, norms and behaviours across a range of sectors. A community network of local organizations has been established to codesign all programme activities. The Steering Group of Council officers support programme implementation and environmental changes. The programme has identified six specific behaviour change objectives representing the key areas of need in Golborne and all activities in the council and the community target these objectives during specific programme phases. Key components include community capacity building, community-wide social marketing, environment and policy change and evaluation. Results (Progress)The programme is currently at the beginning of its implementation phase with activities in the community and council targeting the first behaviour change objective. ConclusionsThe pilot aims to test the effectiveness of this approach to support behaviour change and prevent unhealthy weight gain in children using multiple strategies. This programme will inform the development of an intervention model that defines essential programme components, accountability of partner organizations delivering obesity prevention programmes and the effective use of existing assets.

A community intervention for behaviour modification: an experience to control cardiovascular diseases in Yogyakarta, Indonesia

BackgroundNon-communicable Disease (NCD) is increasingly burdening developing countries including Indonesia. However only a few intervention studies on NCD control in developing countries are reported. This study aims to report experiences from the development of a community-based pilot intervention to prevent cardiovascular disease (CVD), as initial part of a future extended PRORIVA program (Program to Reduce Cardiovascular Disease Risk Factors in Yogyakarta, Indonesia) in an urban area within Jogjakarta, Indonesia.MethodsThe study is quasi-experimental and based on a mixed design involving both quantitative and qualitative methods. Four communities were selected as intervention areas and one community was selected as a referent area. A community-empowerment approach was utilized to motivate community to develop health promotion activities. Data on knowledge and attitudes with regard to CVD risk factors, smoking, physical inactivity, and fruit and vegetable were collected using the WHO STEPwise questionnaire. 980 people in the intervention areas and 151 people in the referent area participated in the pre-test. In the post-test 883 respondents were re-measured from the intervention areas and 144 respondents from the referent area. The qualitative data were collected using written meeting records (80), facilitator reports (5), free-listing (112) and in-depth interviews (4). Those data were analysed to contribute a deeper understanding of how the population perceived the intervention.ResultsFrequency and participation rates of activities were higher in the low socioeconomic status (SES) communities than in the high SES communities (40 and 13 activities respectively). The proportion of having high knowledge increased significantly from 56% to 70% among men in the intervention communities. The qualitative study shows that respondents thought PRORIVA improved their awareness of CVD and encouraged them to experiment healthier behaviours. PRORIVA was perceived as a useful program and was expected for the continuation. Citizens of low SES communities thought PRORIVA was a “cheerful” program.ConclusionA community-empowerment approach can encourage community participation which in turn may improve the citizen’s knowledge of the danger impact of CVD. Thus, a bottom-up approach may improve citizens’ acceptance of a program, and be a feasible way to prevent and control CVD in urban communities within a low income country.

Abstract A21: Exercising our AABCs: A community-based pilot intervention in African American breast cancer survivors (AABCs).

Abstract African-American (AA) women have higher rates of breast cancer (BRCA) mortality than Caucasian women and, this disparity is even greater in certain local communities including Cuyahoga County, Ohio. Randomized control trials involving supervised aerobic and resistance training exercise have shown improved body composition and quality of life (QoL) in BRCA patients; however, most studies have focused on Caucasian women and many have been conducted in clinic-based settings. We aimed to evaluate the feasibility of conducting a 20-week, supervised, resistance training, group exercise intervention coupled with a support group program and home walking program utilizing facilities and personnel at a community cancer support center (The Gathering Place, Beachwood, Ohio) in 18 AA Stage I-III BRCA survivors who were within 12 months of completing treatment (surgery, chemotherapy, radiation). On average, the patients were 56.4 ± 10.8 years old and had a baseline BMI of 32.5 ± 6.3 kg/m2. Attendance rates were 70.0 ± 19.1% for the exercise sessions and 63.1 ± 13.8% for the support group. We found a post-treatment decrease in waist circumference (Baseline (B):93.7 ± 14.1 cm; End of Treatment (EOT): 92.0 ± 14.0 cm; p=0.02) and total body fat (B: 45.4 ± 7.1%; EOT: 44.1 ± 7.9%; p=0.01) and an increase in lean mass (B: 42.4 ± 4.4 kg; EOT: 43.2 ± 4.8 kg; p=0.02) among those who attended 70% or more of the sessions (n=12). We also found a clinically relevant improvement in overall QoL using the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale (B: 101.1 ± 21.5; EOT: 108.6 ± 19.8; p=0.05). Our preliminary results demonstrate that conducting lifestyle interventions in AA BRCA survivors in a community setting is feasible. Future interventions should include strategies to enhance adherence and include dietary and supervised aerobic exercise components to enable greater weight loss. Citation Format: Nora L. Nock, Cynthia Owusu, Emily S. Kullman, Kris Austin, Beth Roth, Carl Harmon, Stephen Cerne, Halle Moore, Paul Hergenroeder, Mary Vargo, Hermione Malone, Michael Rocco, Hillard M. Lazarus, John P. Kirwan, Ellen Heyman, Nathan A. Berger. Exercising our AABCs: A community-based pilot intervention in African American breast cancer survivors (AABCs). [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A21.