Description Of Intervention Research Articles

Co-designing the FOotpaths foR Adolescent MAternal Mental HeAlth (FOR MAMA) intervention for pregnant teens in Malawi.

This study aimed to gain insights into stakeholders' priorities and preferences for a scalable intervention for common mental problems among perinatal adolescents in Malawi. Participatory stakeholder workshops (n=9) were conducted iteratively according to the principles of the Person-Based Approach. Three stakeholder groups were recruited from one urban and one rural primary health centre in Zomba district, Malawi: perinatal adolescents (n=10), their family members (n=8) and healthcare workers (n=10). Framework analysis was conducted using intervention descriptors from the Template for Intervention Description and Replication checklist. Participants emphasized the need for information on causes and symptoms of common mental problems and for developing coping strategies: a) those focused on external stressors-problem-solving, financial literacy and interpersonal skills-and b) emotion-focused approach behaviours-behavioural activation, relaxation and anger management. There was a strong preference for healthcare workers as intervention providers. Participants agreed on a brief antenatal intervention delivered weekly using both group and individual formats. There were positive views on both self-help and guided formats. All stakeholder groups felt there was a need for follow-up to ensure that adolescents correctly engaged with the intervention material. Findings informed the design of a brief multicomponent guided intervention for adolescents in the antenatal period.

Opening the black box of health systems performance management using the behaviour change techniques taxonomy: implications for health research and practice

BackgroundPerformance management (PM) systems in healthcare consist of many interacting interventions, such as contracts, scorecards and incentives. The diversity, complexity and poor description of PM interventions hampers replication in research, standardized comparative analysis and accumulation of evidence. Specifying PM systems and interventions in terms of their behaviour change techniques (BCTs) using standardized language can address these challenges and clarify the mechanisms linking system-level PM with individual behaviours.MethodsWe conducted an analysis of BCTs in a PM system in Ontario, Canada using a modified behaviour change technique taxonomy (BCTT). We reviewed 64 documents, observed 15 meetings and conducted 4 semi-structured interviews with key informants to map the PM interventions on to the taxonomy.ResultsWe identified 54 BCTs spanning 13 taxonomy domains in the PM system. BCTs were concentrated in four domains: (1) goals and planning, (2) reward and threat, (3) feedback and monitoring and (4) identity. The BCTs coded most often included: (1) discrepancy between current behaviour and goal, (2) feedback on outcome(s) of behaviour, (3) social comparison and (4) social incentive/reward. These BCTs suggest that this PM system seeks to change behaviour primarily by directing programme attention to their current performance in relation to the target and in relation to other programs across the province, and by acknowledging good performance with praise or recognition. A total of five PM interventions accounted for 58% of identified BCTs – the scorecard, quarterly performance review reports, quarterly performance review meetings, escalation letter for poor or declining performance and the improvement action plan.ConclusionsThe results provide a unique analytical and evaluative characterization of the PM system, revealing how a behaviour-change lens on health systems PM can support the (re)design, standardized comparison, and evaluation of PM systems in research and in practice.

Improving reporting standards in quantitative educational intervention research: introducing the CLOSER and CIDER checklists

In educational research, the complexity of interventions and the diversity of contexts challenge the adequacy of existing reporting standards, primarily tailored for health interventions and randomised controlled trials. Recognising the critical need for appropriate tools to support education research, we developed two checklists: the CheckList Of Standards of reporting in Education Research (CLOSER) and the Checklist for Intervention Description of Education Research (CIDER). CLOSER was designed to guide the comprehensive reporting of quantitative educational intervention research from the abstract to the discussion for multiple study designs. Concurrently, CIDER details the precise features of educational interventions. The final refinements of CLOSER and CIDER comprise of 34 and 17 items, respectively, developed through a five-stage process, including tool adaptation, expert feedback, a 2-round modified Delphi consensus survey, and final refinements. These checklists aim to enhance the clarity of educational intervention research findings, facilitating their replicability and subsequent meaningful translation into practice and policy. This addresses the gap in educational research reporting standards and sets the stage for a more robust, evidence-informed approach to educational intervention development and evaluation.

Personalized interventions for behaviour change: A scoping review of just-in-time adaptive interventions.

Examine the development, implementation and evaluation of just-in-time adaptive interventions (JITAIs) in behaviour change and evaluate the quality of intervention reporting. A scoping review of JITAIs incorporating mobile health (mHealth) technologies to improve health-related behaviours in adults. We searched MEDLINE, Embase and PsycINFO using terms related to JITAIs, mHealth, behaviour change and intervention methodology. Narrative analysis assessed theoretical foundations, real-time data capturing and processing methods, outcome evaluation and summarized JITAI efficacy. Quality of intervention reporting was assessed using the template for intervention description and replication (TIDieR) checklist. Sixty-two JITAIs across physical activity, sedentary behaviour, dietary behaviour, substance use, sexual behaviour, fluid intake, treatment adherence, social skills, gambling behaviour and self-management skills were included. The majority (71%) aimed to evaluate feasibility, acceptability and/or usability. Supporting evidence for JITAI development was identified in 46 studies, with 67% applying this to develop tailored intervention content. Over half (55%) relied solely on self-reported data for tailoring, and 13 studies used only passive monitoring data. While data processing methods were commonly reported, 44% did not specify their techniques. 89% of JITAI designs achieved full marks on the TIDieR checklist and provided sufficient details on JITAI components. Overall, JITAIs proved to be feasible, acceptable and user-friendly across behaviours and settings. Randomized trials showed tailored interventions were efficacious, though outcomes varied by behaviour. JITAIs offer a promising approach to developing personalized interventions, with their potential effects continuously growing. The recommended checklist emphasizes the importance of reporting transparency in establishing robust intervention designs.

Effectiveness of rehabilitation programmes targeting quality of life, psychological wellbeing, and functional capacity in pulmonary embolism survivors; a systematic review and best evidence synthesis.

Half of people post pulmonary embolism (PE) experience ongoing symptoms such as dyspnoea, anxiety and depression, exercise limitation and fatigue. These symptoms can reduce their quality of life (QoL), psychological wellbeing, and functional capacity. The efficacy of rehabilitation interventions to prevent and manage these symptoms has not been established. The objectives of this review were to synthesise the evidence on interventions targeting QoL, psychological wellbeing, and functional capacity post PE, and to identify intervention characteristics and behaviour change techniques (BCTs) that contribute to successful rehabilitation programmes. The PRISMA reporting guidelines were followed. Five electronic databases were searched; PubMED, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. Searching began in November 2023, with the final search run in December 2023. Studies using experimental designs, in adult populations, employing rehabilitation programmes to target patient outcomes post PE were included. The Template of Intervention Description and Replication (TIDieR) 12 item checklist was used to score the description and replicability of the intervention and control conditions and the BCT taxonomy V1 was used to identify BCTs across the included interventions. Data was extracted and a best evidence synthesis was conducted. Of 7321 studies identified, 12 studies (n=648 participants) met the inclusion criteria; four randomised controlled trials (RCTs), one pilot RCT study and seven prospective cohort studies, all conducted at different timepoints in the disease course, using different selection criteria and with different interventions. Eight of the 12 included studies were evaluated as being of low quality based on the Effective Public Health Practice Project (EPHPP) tool. The mean TIDieR score was six out of 24 for intervention completeness and reporting. Twenty five BCTs were identified across the included studies, three of which were identified in all studies ("Instruction on how to perform the behaviour", "demonstration of the behaviour" and "behaviour practice/ rehearsal"). Overall the best evidence synthesis provided a mixed level of evidence for the effectiveness of rehabilitation interventions post PE. There is a limited level of evidence that rehabilitation has a positive effect on patient perceived QoL and inconsistent evidence that rehabilitation has any effect on psychological wellbeing. There is however, a moderate level of evidence to support the effectiveness of rehabilitation when it comes to improving functional capacity. This review highlights heterogeneity across available studies and provides some evidence supporting rehabilitation programmes to improve functional capacity in people living post PE. However, further research is required to establish their effectiveness for improving QoL and psychological wellbeing. Although a number of BCTs were identified, few of those identified were linked to behaviour change theory. This, combined with limited reporting of components of the rehabilitation interventions, restricted evaluation of their effectiveness. PROSPERO 2020 CRD42023459411 Available from: https://www.crd.york.ac.uk/prospero/#recordDetails.

Systematic Review: Integrated Models of Care for Managing Irritable Bowel Syndrome.

Multidisciplinary integrated models of care show promise for improving symptoms and quality of life (QoL) in adults with irritable bowel syndrome (IBS). To describe and evaluate the characteristics of integrated models of care for IBS and identify how digital health is being used in these models of care. Four databases were searched to March 2024 for studies that included adults with IBS who participated in multidisciplinary integrated models of care that delivered non-pharmacological therapies. The template for intervention description and replication (TIDieR) checklist was used to appraise study quality and extract model of care characteristics, which were mapped against the Project INTEGRATE framework to establish topics. Sixteen studies (6 randomized controlled trials, 2 quasi-experimental, 8 cohort studies) reported 14 integrated models of care including 2165 patients of which 918 were IBS patients. Integrated models of care led to improved IBS symptoms (n = 11/13 models of care) and QoL (n = 6/9 models of care). Studies showed moderate compliance with the TIDieR checklist. Five topics were established: clinicians involved, therapies provided, location and mode of delivery, coordinating clinical partnerships, and sharing visions and values of integrated care. Most commonly, a gastroenterologist coordinated care with a psychologist, dietitian, and/or nurse in tertiary care. Psychological, dietary, and physical therapies were provided by n = 11, n = 8, and n = 3 integrated models of care, respectively. Six models of care provided joint consultations or group sessions. Four models of care used digital health such as telephone coaching or online modules. Integrated models of care for IBS exhibited diverse characteristics including the clinicians involved, the therapies provided and the mode of delivery of each therapy. There is a need to evaluate the use of digital health and the delivery of integrated models of care in primary care settings.

Return on investment of pharmacists' services among non-hospitalized patients: A scoping review.

As pharmacists' role has evolved to encompass medication management services, there has been limited expansion of insurance coverage of these services. Investment in services by employers and insurance plans may be limited due to concerns regarding financial viability and an unclear return on investment (ROI). This scoping review described reported ROI of studies evaluating pharmacist driven medication management services among non-hospitalized patients. A secondary objective was to describe key details of included studies that could impact the ROI analysis. Reporting for this scoping review was conducted in consultation with the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR). Search was conducted in PubMed, Embase, and Web of Science from inception up to the search date. Two-stage process in the Covidence web platform was utilized to screen and identify studies. For studies to be included, the study (1) needed to be a pharmacy service provided to a non-hospitalized patient, (2) needed to have evaluated the effect of the intervention on medical costs or medical and prescription costs, and (3) needed to report ROI as an outcome. Extracted data included year of publication, study design, follow-up, or observation period, setting, sample size, perspective of analysis, inclusion and exclusion criteria, type and description of intervention, and details and outcomes of economic analysis. There were 28 studies included. ROI ranged from -3% to 504% among the nine studies that reported ROI as percentages. ROI ranged from $1.29 to $18.5 per dollar spent on the pharmacy service among the 19 studies that reported ROI as a ratio. Only one study reported a negative ROI. A total of five studies did not report how ROI was calculated. There was a largely positive return on investment of pharmacists' services provided in outpatient settings from the perspective of payers and employers. However, a lack of consistency and clarity in the reporting of study characteristics and economic outcomes was noted, which may partly limit the generalizability and utility of economic analyses to support the implementation of new pharmacists' services in other settings.

Describing the landscape of nutrition- and diet-related randomized controlled trials: metaresearch study of protocols published between 2012 and 2022.

Publishing protocols promotes transparency and reproducibility. The scope and methods of protocols for nutrition- and diet-related randomized controlled trials (RCTs) have not been investigated yet. This study aims to map the landscape of nutrition- and diet-related interventions research. We conducted a metaresearch of nutrition-and diet-related RCT protocols published between January 2012 and March 2022, in any language, targeting human participants, evaluating nutrition interventions isolated or combined. A systematic search of the literature was conducted in 6 online databases. Bibliometric information, study characteristics, and research transparency practices data were collected from the included publications. The instructions for authors of journals with publications in our sample were checked for endorsement of reporting guidelines. Mentions to reporting guidelines in the included protocols were also checked. Among the 62,319 records retrieved, 1068 were eligible. The number of published protocols increased annually, with a mean of 103 (range: 32-163) publications/y. Protocols were published in 148 journals, 50 of them (33.8%) endorsed Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT), 111 (75.3%) Consolidated Standards of Reporting Trials (CONSORT), and 4 (2.7%) Template for Intervention Description and Replication (TIDieR), whereas 343 (32.1%) protocols mentioned SPIRIT, 297 (27.8%) CONSORT, and 20 (1.9%) TIDieR. Most protocols reported the RCT registration number (n = 1006; 94.2%) and included statements about conflicts of interest (n = 952; 89.1%) and funding (n = 994; 93.2%). About one-third of protocols focused on adults or elderly participants (n = 677; 63.4%). Most protocols described 1 isolated nutrition- or diet-related intervention (n = 724; 67.8%), which were most frequently "supplementation, supplements or fortification" (n = 405; 37.9%) or "nutrition education, counseling or coordination of care" (n = 354; 33.1%). The most frequent primary outcomes reported were related to clinical status (n = 308; 28.8%). The number of protocols for nutrition- or diet-related RCTs published is increasing, supporting the raising awareness and the importance of promoting these publications. The support and mention of relevant reporting guidelines by journals and researchers, respectively, remain far from ideal.

Behavior change techniques in low-calorie and very low-calorie diet interventions for weight loss: A systematic review with meta-analysis.

There is limited evidence and clinical guidelines on the behavior change support required for low-calorie diet programs. This systematic review aimed to establish the behavior change technique(s) (BCT) implemented in weight loss interventions (≤1200 kcal/d) and how these contribute to effectiveness. Databases were searched from inception to April 2022. Screening, data extraction, BCT coding, and quality appraisal were conducted in duplicate using the Template for Intervention Description and Replication framework, Behavior Change Technique Taxonomy, and Cochrane Risk of Bias 2 tool. Data were analyzed via narrative synthesis and random effects multi-level meta-analyses. Thirty-two papers reporting on 27 studies were included. Twenty-four BCTs were identified across studies. Eight BCTs were significantly associated with a larger reduction in weight at the end-of-diet time-point; one BCT was statistically significant at the end of weight maintenance. Physical activity, Type 2 Diabetes, and BMI category moderated intervention effects. This is the first meta-analysis to examine how specific BCTs contribute to the effectiveness of low-calorie diets. It is recommended that a) these findings are used to develop clinical guidelines specific to behavioral support in low-calorie diet programs, and b) program commissioners stipulate the use of these BCTs in their service specifications.

Digital health technologies and self-efficacy in Parkinson’s: a scoping review

ObjectivePrior research has identified that people with Parkinson’s reporting lower levels of self-efficacy exhibit worsening motor and non-motor symptomology, reduced quality of life, and self-management. Our key objective was to...

Characteristics of Effective Elementary Mathematics Instruction: A Scoping Review of Experimental Studies

Considering that the teaching of mathematics in elementary school is an important prerequisite for the development of mathematically literate citizens, it is essential to identify what makes it effective. The aim of this study is to determine the characteristics of effective interventions in elementary school mathematics education. To this end, a scoping review was conducted that included 44 experimental studies published between 2014 and 2023. Through a qualitative analysis of the intervention descriptions, we identified 27 characteristics, which were categorized into nine thematic units. We found that, on average, seven characteristics were used per intervention. The results of this study suggest that effective elementary school mathematics instruction should foster students’ conceptual understanding and procedural fluency through problem-solving, active learning, and mathematical games. This can be achieved through a dynamic alternation of whole-class instruction and cooperative and individual learning with the use of manipulatives and visualizations to reach the level of abstraction. Considering that the analyzed interventions rarely addressed students’ common errors and critical thinking, future research could focus on these aspects in elementary school mathematics education.

Evaluating Intervention Reporting in Nursing Journal RCTs Using the TIDieR Checklist: A Cross-Sectional Study.

To assess the completeness of intervention reporting in randomised controlled trials (RCTs) published in nursing journals based on the Template for Intervention Description and Replication (TIDieR) checklist. A cross-sectional study. RCTs published in English in nursing journals between January 2022 and December 2022 were identified through PubMed. Title- and abstract-screening were undertaken independently by two reviewers to select eligible trials, from which data were extracted. Reports of interventions were likewise independently evaluated based on the TIDieR checklist. Binary logistic regression analysis was performed to investigate potential predictors for the compliance of TIDieR. Our analysis included 303 eligible trials, which generally adhered to most items on the TIDieR checklist, though adherence varied across the trials. Slightly fewer than half of the trials demonstrated good reporting quality. Poor reporting was associated in areas such as modifications, tailoring, and the type of locations where the intervention occurred. Additionally, suboptimal reporting on intervention adherence was noted. Compliance with TIDieR was found to be influenced by factors such as funding availability and the journal's ranking. Our study revealed suboptimal reporting of the TIDieR items in RCTs published in nursing journals. More rigorous adherence to the TIDieR checklist is needed to improve the quality of intervention reporting. Additionally, comparing adherence before and after the implementation of TIDieR may be considered in future investigations. This paper represents the first study to appraise the reporting quality of RCTs in nursing journals based on the TIDieR checklist. Evidence of suboptimal compliance of RCTs to the TIDieR checklist items is presented. No patient or public contribution applied.

THE MATURE CRISIS IN CONTEMPORARY TIME: Critical psychosocial analysis in Winnicott

This study addresses the crisis of maturity in contemporary times, exploring its possible causes and illnesses, in addition to presenting interventions based on the Winnicottian approach. The methodology used consists of a bibliographical review focused on Winnicott's studies on the coming-of-age crisis, using periodicals, dissertations, theses and relevant books. The qualitative approach is adopted to provide a comprehensive understanding of reality, especially with regard to the profile of the contemporary generation. The Literature Review offers a wide range of materials for the critical analysis of theoretical data. The specific objectives include the analysis of differences between generations, the identification of possible causes and illnesses arising from the maturational crisis, and the description of possible interventions based on the Winnicottian approach. This study seeks to contribute to the understanding of the phenomenon of the coming-of-age crisis in contemporary times and provide relevant insights for effective therapeutic approaches. The research addressed the crisis of contemporary maturity, highlighting the importance of psychological and emotional maturity, creativity and cultural impact, especially related to the use of technology in young people's mental health. Limitations were identified, such as the lack of empirical data and the temporal delimitation of the studies reviewed. Future research with mixed methodologies is recommended, considering cultural and contextual aspects to support young people in the transition to adulthood.

Emotional Eating Interventions for Adults Living With Overweight and Obesity: A Systematic Review and Meta-Analysis of Behaviour Change Techniques.

Emotional eating (EE) is a barrier to the long-term success of weight loss interventions. Psychological interventions targeting EE have been shown to reduce EE scores and weight (kg), though the mechanisms remain unclear. This review and meta-analysis aimed to identify the specific behaviour change techniques (BCTs) associated with improved outcomes. This is a review update and extension, with new studies extracted from searches of CINAHL, PsycINFO, MEDLINE and EMBASE 1 January 2022 to 31 April 2023. EE interventions for adults with BMI > 25 kg/m2 were considered for inclusion. Paper screening, extraction, BCT-coding and risk of bias were completed using the Template for Intervention Description and Replication (TIDieR) checklist, Behaviour Change Taxonomy v1 (BCTTv1) and Risk of Bias2 (RoB2)/Risk of Bias In Non-randomised Studies (ROBINS-I) tool. Narrative syntheses and random effects multi-level meta-analyses were conducted. In total, 6729 participants were included across 47 studies (13 identified in the update). Forty-two studies contributed to the pooled estimate for the impact of interventions on EE (SMD = -0.99 [95% CI: -0.73 to -1.25], p < 0.001). Thirty-two studies contributed to the pooled estimate for the impact of interventions on weight (-4.09 kg [95% CI: -2.76 to -5.43 kg], p < 0.001). Five BCTs related to identity, values and self-regulation were associated with notable improvements to both weight and EE ('incompatible beliefs', 'goal setting outcome'. 'review outcome goals', 'feedback on behaviour' and 'pros/cons'). Implementation and evaluation of the highlighted BCTs are required. Weight management services should consider screening patients for EE to tailor interventions to individual needs.

Surveying the Literature on Implementation Determinants and Strategies for HIV Structural Interventions: A Systematic Review Protocol.

Despite improvements in HIV prevention, treatment, and surveillance, vast disparities remain in access, uptake, and adherence of evidence-based interventions. These disparities are most pronounced among racially, sexually, and gender minoritized populations, as well as among those living in poverty and/or who use injectable drugs. Structural interventions, or interventions that target social and structural determinants of health like housing, transportation, or income, are needed to increase access to, use of, and adherence to HIV EBIs to advance the aims of the national Ending the HIV Epidemic initiative. However, it is unclear to what extent barriers and facilitators of structural interventions have been identified in the U.S. and what implementation strategies and adjunctive interventions have been developed to enhance their delivery. To identify what implementation determinants, implementation strategies, and adjunctive interventions have been identified for HIV structural interventions, we carried out a broad database search between May and July 2024, identifying a total of 8,098 articles. We will use a multi-step process to identify articles to include in the systematic review. We will use natural language processing to identify articles for exclusion, followed by manual text review and extraction using COVIDENCE software. Literature on determinants will be coded according to the Consolidated Framework for Implementation Research. Implementation strategies and adjunctive interventions will be coded according to the Expert Recommendations for Implementing Change, the Theoretical Domains Framework, and COM-B. We will descriptively analyze determinants, implementation strategies, and adjunctive interventions, use natural language processing for thematic analysis of determinants, implementation strategies, and adjunctive interventions, and provide narrative description of implementation strategies and adjunctive interventions. This systematic review will identify key barriers and facilitators for HIV structural intervention implementation strategies, including multi-level approaches to address disparities among marginalized populations. Findings will provide insights for advancing equitable, scalable interventions to support the goals of the Ending the HIV Epidemic initiative. CRD42024554315.

Public acceptance of microbiome management strategy in dairy calves: A European survey on colostrum, probiotic provision and prolonged cow-calf contact

The microbiome plays a crucial role in the calves’ early stage of life. Several management practices can be considered to enhance the development and composition of the microbiome in calves. However, their social acceptance is largely unknown. The aim of this study was to investigate the public acceptance of innovative microbiome management practices aimed at improving the health and welfare of calves and to assess the factors influencing these levels of acceptance. Data used in the analysis were obtained from an online survey conducted in July 2023. The final sample consists of 3 220 citizens from four EU countries (Finland=813, France=803, Ireland=801 and Poland=803). Participants were asked to assess four management practices designed to improve calves’ health and welfare: (1) using colostrum, (2) providing mix probiotics powder, (3) providing probiotics as yogurt or kefir and (4) prolonged cow-calf contact. Participants were provided with different levels of information: one group received only a short description of the intervention, while the other group received both the intervention description and information on aspects such as potential costs and environmental impact of the intervention. Participants were asked to rate the acceptance on a standardised scale ranging from 1 to 5, with 1 indicating “strongly agree” and 5 indicating “strongly disagree”. Additionally, the participants were questioned about their socio-demographic background (e.g. age, education). They were also asked to provide their perspectives on various dimensions concerning familiarity with farming and microbiome, food safety, environmental awareness, cost consideration, cultural perspective of consuming dairy products. Obtained data was analysed using ordinary least squares regression model. The findings reveal that prolonged cow-calf contact was the most acceptable measure among tested interventions in all countries (79% of responders agreed or strongly agreed). Attitudinal and socio-economic variables were found to have a differential effect across the studied management strategies. For instance, individuals with greater familiarity with farming systems and microbiomes were more inclined to accept all four interventions, while women, compared to men, showed higher acceptance of prolonged cow-calf contact. Results also indicate that the provision of additional information to the participants was associated with a decrease in the acceptance of the measures. In conclusion, the public’s perceptions regarding microbiome management strategies in dairy calves are shaped by complex factors. Also, our discussion emphasizes the importance of clarity and transparency of messages, ethical dissemination of scientific knowledge, and the necessity for balanced and coherent communication.

Effectiveness of oral health promotion in children and adolescents through behaviour change interventions: A scoping review.

To explore the interventions for change in oral health behaviour that are effective in improving oral health behaviours in 8 to 18-year-old children during oral health promotion. The Joanna Briggs Institute framework of evidence synthesis for conducting a scoping review was implemented for the methodology. Included studies related to the objective, measured clinical or non-clinical outcomes, were in English, 2011-2023, and were experimental, observational or reviews. PUBMED, Science-Direct, Scopus and Sabinet were systematically searched with predetermined search strings. Studies were selected by appraisal of the title, abstract and full text. Data were extracted using a standardised template and the key questions were addressed via a qualitative analysis. Searches yielded 407 articles from electronic databases. Of these, 290 articles were excluded, and 47 full-text studies were assessed for eligibility, with 23 studies and two systematic reviews finalised for inclusion. In addition, a PEARL search was conducted from the reference lists of other studies. Most studies (91.3%) focused on educating children directly; 8.7% indirectly influenced parents, guardians, and teachers. Interventions focused largely on traditional oral health education presented in diverse forms and via different platforms. Studies differentiated clinical outcomes (indices) from non-clinical outcomes (knowledge, behaviour). All included RCTs were of different quality regarding selection, performance and detection bias. But all studies indicated a low risk of bias in attrition and Reporting bias. Seventeen of the 25 studies (68%) were not based on any behaviour change theory. Oral health interventions based on motivational interviewing and the social cognitive theory have been shown to be to be effective. Interventions could also include practical tooth brushing activities, gamification, audio-visual components, as well as reinforcement and repetition in the longer term. Future oral health promotion in children should be designed to include these elements. There is a need for higher quality studies in this field, with future research being urged to provide detailed intervention descriptions and incorporate longer follow-up periods.

Swallowing, speech and voice impairments in head and neck cancer patients treated at a multidisciplinary integrated patient unit.

Head and neck cancer (HNC) is amongst the 10 most common cancers worldwide and has a major effect on patients' quality of life. Given the complexity of this unique group of patients, a multidisciplinary team approach is preferable. Amongst the debilitating sequels of HNC and/or its treatment, swallowing, speech and voice impairments are prevalent and require the involvement of speech-language pathologists (SLPs). In 2018, an integrated patient unit (IPU) for HNC patients was established which includes healthcare professionals from diverse fields including SLPs. To characterize the demographic and clinical profiles of HNC patients and assess SLP therapy efficacy in these patients with respect to swallowing, speech and voice functionality. Demographic and clinical information was collected for the first 100 HNC patients referred to SLP evaluation in the IPU. In addition, different measures of swallowing, speech and voice functionality were taken pre- and post-SLP therapy to estimate if and how the therapy improved the patients' performance in these aspects. Analysis revealed that 84%, 36.2% and 33% of the patients suffered from swallowing, speech and voice impairments, respectively. Treatment types (surgery and radiation, chemotherapy and radiation) and the prevalence of speech and voice impairments varied amongst tumour locations (larynx, oral cavity, pharynx), whilst swallowing impairments were highly prevalent across all tumour locations. Speech impairments were more common in patients treated with a combination of surgery and radiation. Comparison between pre- and post-SLP therapy-related measures revealed that swallowing, speech and voice functionality significantly improved following SLP therapy. The holistic, multidisciplinary approach in the IPU contrasts with the more segmented care typically provided in out-patient/community clinics, making SLP therapy within the IPU uniquely integrated and effective. The protocol established at the IPU provides a valuable framework for SLP assessment and therapy in HNC patients exhibiting swallowing, speech and voice impairments with the ultimate goal of improving their quality of life. What is already known on the subject Many HNC patients suffer from swallowing, speech and voice impairments which have a substantial impact on their quality of life. Nevertheless, many current clinical practices do not include SLPs as an integral part of the healthcare team. Moreover, there are no common guidelines for SLP therapy in this unique group of patients. What this paper adds to the existing knowledge In this study we provide a detailed demographic and clinical profile of a large cohort of HNC patients that were referred to SLP evaluation in a newly developed and designated IPU. We provide a comprehensive description of clinical interventions that were applied based on the location of the tumour and specific impairments related to it. Additionally, SLP therapy outcomes are described, showing a significant improvement in swallowing, speech and voice functionality. What are the potential or actual clinical implications of this work? Study results support the inclusion of an SLP in HNC patients' IPUs. The multidisciplinary healthcare approach enabled the provision of a tailored SLP therapy to the specific tumour types and impairments and proved efficient, resulting in favourable outcomes.

Intervention description of pharmacist-facilitated medication reviews in Nordic primary care settings: a scoping review

Background Multicomponent interventions are increasingly utilized to tackle the complexity of aging and co-morbid patients. However, descriptions of interventions are generally poor, making it difficult for healthcare providers to implement successful programs. Objectives This study aimed to explore the completeness of intervention description of pharmacist-facilitated medication reviews (MRs) in Nordic primary care settings. Methods We performed a scoping review of studies reporting on pharmacist-facilitated MRs in Nordic primary care settings. Medline, Embase, CINAHL and Web of Science were searched on 24 January 2024. We used Arksey and O’Mally’s framework for scoping studies and applied an adapted version of the Template for Intervention Description and Replication (TIDieR) checklist to evaluate intervention reporting. The Pharmaceutical Care Network Europe (PCNE) classification of MR levels was used to identify the components of different MRs. Results Sixteen studies were included in this scoping review. The studies were conducted in Sweden (n = 7), Norway (n = 6), Finland (n = 2) and Denmark (n = 1). Information on the participating pharmacists’ expertise, qualifications and training was fully reported in only two studies. Twelve studies did not provide any information related to intervention cost, dose or duration, making it challenging to estimate the economic impact of the intervention. Only one study made an evaluation of intervention fidelity. Conversely, 15 studies lacked information on this topic which can lead to inaccurate conclusions about the program’s effectiveness. Conclusion The studies included in this scoping review do not provide sufficient MR information for intervention replication. We recommend that pharmacy trials use reporting checklists to increase the replicability and transferability of effective interventions.

A Systematic Review and Meta-Analysis of Type 2 Diabetes Prevention Through Lifestyle Interventions in Women with a History of Gestational Diabetes-A Summary of Participant and Intervention Characteristics.

Objectives: We aimed to review the effect of lifestyle interventions in women with a history of gestational diabetes mellitus (GDM) based on the participants and intervention characteristics. Methods: We systematically searched seven databases for RCTs of lifestyle interventions published up to 24 July 2024. We included 30 studies that reported the incidence of type 2 diabetes mellitus (T2DM) or body weight. A random effects model was used to calculate the relative risk and mean difference with a 95% confidence interval. Subgroup analyses were conducted for participants' characteristics (age, body mass index (BMI)) and intervention characteristics according to the Template for Intervention Description and Replication (TIDieR). Results: A greater T2DM risk reduction was seen in trials that started within one year postpartum, in participants with a mean baseline BMI of 30 kg/m2 or more, or based on behavioral change theory. For body weight reduction, studies on participants with a mean baseline BMI of 25 kg/m2 or more or ones that included electronic/mobile delivery (text message, web, phone call) were more effective. Conclusions: Diabetes prevention trials in women with a history of GDM are more effective when commencing within one year postpartum, underpinned by behavior change theory, and in participants with overweight or obesity.