Design Of Interventions Research Articles

Development of a group-based behaviour change intervention for people with severe obesity informed by the social identity approach to health.

Interventions to support behaviour change in people living with chronic health conditions increasingly use patient groups as the mode of delivery, but these are often designed without consideration of the group processes that can shape intervention outcomes. This article outlines a new approach to designing group-based behaviour change interventions that prioritizes recipients' shared social identity as group members in facilitating the adoption of established behaviour change techniques (BCTs). The approach is illustrated through an example drawn from research focused on people living with severe obesity. A prioritization process was undertaken in collaboration with stakeholders, including behaviour change experts, clinicians, and a former patient to develop an evidence-based, group intervention informed by the social identity approach to health. Three phases of development are reported: (1) identification of the health problem; (2) delineation of intervention mechanisms and operationalization of BCTs for group delivery and (3) intervention manualization. The fourth phase, intervention testing and optimization, is reported elsewhere. A group-based behaviour change intervention was developed, consisting of 12 group sessions and 3 one-to-one consultations. The intervention aimed to support the development of shared social identity among recipients, alongside the delivery of evidence-based BCTs, to improve the likelihood of successful intervention and health outcomes among people living with severe obesity. A manualized intervention, informed by the social identity approach to health, was systematically designed with input from stakeholders. The development approach employed can inform the design of behavioural interventions in other health contexts where group-based delivery is planned.

The First Nation Community Experiences with the SOAR Research Program: Improving Type 2 Diabetes Prevention and Management

ObjectiveIndigenous peoples in Canada are considered the highest-risk populations for type 2 diabetes mellitus (T2DM). Quality improvement (QI) strategies may be considered effective interventions to improving T2DM health outcomes. The purpose of this study was to understand experiences associated with the implementation of the SOAR QI program to improve prevention and management of T2DM. MethodA qualitative study was conducted, and in-depth, semi-structured interviews were held with QI team members and key contacts, in person and through videoconference with two First Nations communities. Interviews were audio recorded and transcribed for data analysis. Results10 interviews were conducted and emerging themes from the data analysis were organized into two categories, namely facilitators and barriers. Four subthemes were identified. Two subthemes emerged under the category of facilitators (cultural relevance, and partnership building). Two subthemes emerged under the category of barriers, (workload burden, role ambiguity). DiscussionThis study highlighted the necessity of implementing diabetes QI strategies that foster cultural sensitivity and provide opportunities for partnership building, to strengthen community relationships. The study also highlighted the importance of diminishing role ambiguity, and increased workload burdens, which can hinder the successful implementation of QI programs long-term. ConclusionThe findings of this study can be utilized to improve future adaptations of SOAR and other diabetes First Nations focused QI strategies, to benefit Indigenous people in acquiring optimal outcomes relative to T2DM care. Findings can also inform the design, practices, and policies of such QI interventions in support of the spread and sustainability of the intervention long-term.

Identifying the active ingredients in payment for performance programmes using system dynamics modelling

Payment for performance (P4P) is not a uniform intervention, with programme effect dependent on several interconnected factors. In this study, a system dynamics model was developed to explore the pathways to improved outcomes and how changes in the design, implementation and context of a P4P programme affected maternal and child health (MCH) service delivery outcomes in Tanzania. A previously developed causal loop diagram of the programme effects was used to inform model development, with further data sources (including an impact evaluation of programme, health surveys, stakeholder feedback and relevant literature) used to build the model. A number of pathways were identified to improved services under P4P, with increased availability of drugs underpinning the content of care outcome (intermittent preventative treatment during ANC), which together with increased supervision, enhanced health worker motivation. This in turn increased perceived quality of care at the facility which improved the coverage of services outcome (facility-based deliveries), and with increased outreach, increased awareness of services also boosted demand. Minor delays in payment reduced provider purchasing power for medicines, with severe delays driving erosion of provider trust and motivation for programme participation. Allocating a larger share of funds for facility operations can enhance performance effects, particularly for those services that rely on efficient drug administration. Contextual factors including limited baseline provision of essential medications, lower community awareness of facility services and dispersed/distant populations reduced programme effect. This paper demonstrates the feasibility and the potential of such models to inform the design of effective health system interventions.

Quality of Life in Children With Chronic Health Conditions and Its Contribution to Unmet Supportive Care Needs of Families.

While theoretical models have established the bidirectional relationship between health and wellbeing of parents and children with chronic health conditions (CHCs), previous work has predominantly emphasised the impact of parent functioning on child outcomes. This study examines how quality of life (QoL) domains in children with CHCs are associated with unmet supportive care needs (SCN) of their parents and explores whether these associations vary by health condition. Parents of children with congenital heart disease (CHD), type 1 diabetes (T1D) and cancer diagnosed before the age of 12 years and receiving treatment within the last 5 years were eligible. Parents recruited through charity organisations and social media platforms completed a secure, online survey via Qualtrics. The PedsQL examined child QoL across four dimensions: physical, emotional, social and school functioning. A 34-item survey assessed parents' unmet SCN in the previous month across six need domains (e.g., care and informational). Linear regressions examined associations between child QoL and unmet SCN domains and moderation analyses determined whether associations varied as a function of CHC. The study included 186 parents (age range 25-56 years) of children diagnosed with various CHCs (52% CHD; 27% T1D, 21% cancer). The child's emotional functioning was inversely related to all unmet SCN domains, social functioning was inversely related to three domains (physical and social; support; financial), school functioning was inversely related to two domains (physical and social; care), and child's physical functioning was not associated with any SCN domains. Only the association between child school functioning and unmet care needs was significantly moderated by CHC type (p < 0.05). Poorer emotional functioning in children with a CHC is a key factor in determining parents unmet SCN. Larger studies are required to replicate these findings and inform design of interventions addressing QoL and unmet SCN in families of children with common CHCs.

Too old to be a diversity hire: Choice bundling shown to increase gender-diverse hiring decisions fails to increase age diversity.

Past research has shown that people are more likely to make the decision to hire candidates whose gender would increase group diversity when making multiple hiring choices in a bundle (i.e., when selecting multiple team members simultaneously) compared to making choices in isolation (i.e., when selecting a single team member). However, it is unclear if this bundling effect extends to age diversity and the selection of older candidates, as older workers are often the target of socially acceptable negative stereotypes and bias in recruitment, leaving them unemployed for longer than their younger counterparts. Across five preregistered experiments (total N = 4,096), we tested if the positive effect of bundling on diversity of selections extends to older candidates in hiring decisions. We found evidence of bias against older job candidates in hiring decisions but found inconsistent effects of choice bundling on the selection of older candidates across experiments. An effect of bundling was found in two of five experiments, with no meta-analytic effect found across the five studies. Making older candidates more competitive and introducing a diversity statement aimed at increasing their selection both significantly increased older candidate selections, but failed to activate the bundling effect. We discuss the theoretical implications for choice bundling interventions and for age as a diversity characteristic to support the design of interventions that meet the challenges of an aging workforce. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Combining OpenStreetMap mapping and route optimization algorithms to inform the delivery of community health interventions at the last mile.

Community health programs are gaining relevance within national health systems and becoming inherently more complex. To ensure that community health programs lead to equitable geographic access to care, the WHO recommends adapting the target population and workload of community health workers (CHWs) according to the local geographic context and population size of the communities they serve. Geographic optimization could be particularly beneficial for those activities that require CHWs to visit households door-to-door for last mile delivery of care. The goal of this study was to demonstrate how geographic optimization can be applied to inform community health programs in rural areas of the developing world. We developed a decision-making tool based on OpenStreetMap mapping and route optimization algorithms in order to inform the micro-planning and implementation of two kinds of community health interventions requiring door-to-door delivery: mass distribution campaigns and proactive community case management (proCCM) programs. We applied the Vehicle Routing Problem with Time Windows (VRPTW) algorithm to optimize the on-foot routes that CHWs take to visit households in their catchment, using a geographic dataset obtained from mapping on OpenStreetMap comprising over 100,000 buildings and 20,000 km of footpaths in the rural district of Ifanadiana, Madagascar. We found that personnel-day requirements ranged from less than 15 to over 60 per CHW catchment for mass distribution campaigns, and from less than 5 to over 20 for proCCM programs, assuming 1 visit per month. To illustrate how these VRPTW algorithms can be used by operational teams, we developed an "e-health" platform to visualize resource requirements, CHW optimal schedules and itineraries according to customizable intervention designs and hypotheses. Further development and scale-up of these tools could help optimize community health programs and other last mile delivery activities, in line with WHO recommendations, linking a new era of big data analytics with the most basic forms of frontline care in resource poor areas.

Does Momentary Outcome-Based Reflection Shape Bioethical Views? A Pre-Post Intervention Design.

Many bioliberals endorse broadly consequentialist frameworks in normative ethics, implying that a progressive stance on matters of bioethical controversy could stem from outcome-based reasoning. This raises an intriguing empirical prediction: encouraging outcome-based reflection could yield a shift toward bioliberal views among nonexperts as well. To evaluate this hypothesis, we identified empirical premises that underlie moral disagreements on seven divisive issues (e.g., vaccines, abortion, or genetically modified organisms). In exploratory and confirmatory experiments, we assessed whether people spontaneously engage in outcome-based reasoning by asking how their moral views change after momentarily reflecting on the underlying empirical questions. Our findings indicate that momentary reflection had no overall treatment effect on the central tendency or the dispersion in moral attitudes when compared to prereflection measures collected 1 week prior. Autoregressive models provided evidence that participants engaged in consequentialist moral reasoning, but this self-guided reflection produced neither moral "progress" (shifts in the distributions' central tendency) nor moral "consensus" (reductions in their dispersion). These results imply that flexibility in people's search for empirical answers may limit the potential for outcome-based reflection to foster moral consensus.

Interventions for left-behind children in Mainland China: A scoping review

BackgroundAs the discussion of Chinese left-behind children (LBC) continues, intervention programs dedicated to this population increase and diversify. While reviews have summarized intervention programs promoting LBC’s health and psychological wellbeing, there is no synthesis depicting a comprehensive picture. This scoping review systematically examines interventions tackling LBC’s various issues and identifies their design and foci. MethodWe performed a systematic literature search to extract intervention studies from four English (i.e., Web of Science, Scopus, Embase, & PsycINFO) and one Chinese (i.e., CNKI) database. The quality of the studies was assessed using the Mixed Methods Assessment Tool (MMAT). Two main rounds of deductive coding were performed on Nvivo 12 plus to identify the design and foci of the interventions. ResultsThirty-three articles were identified for our final review. Twenty-six were published in Chinese and seven in English. Existing interventions have tackled multiple psychological, social, physical, developmental, and sexual problems or needs of Chinese rural left-behind children. Among them, LBC’s psychological wellbeing has drawn the most attention. The majority of the reviewed studies performed a randomized controlled trial (N=20). Quantitative evaluation is prevalent, with only one study applying a purely qualitative evaluation. In addition, only two studies adopted validated interventions, while the others are self-designed. ConclusionsThe review results indicate several gaps in intervention studies for LBC. First, many existing interventions have considered LBC’s psychological and social wellbeing, while little effort has been paid to address their educational and intellectual development. Further, while existing interventions are concerned with LBC’s temporary needs, their long-term life planning, as well as their current self-efficacy and self-concept driving their actions towards future self, were neglected. As for the intervention design, empirically validated interventions are recommended for future studies for their verified efficacy and evidence-based standardized practice. In addition, a qualitative evaluation should be considered because it might be more powerful in eliciting realistic and viable solutions to improve the effectiveness and reliability of the interventions from the participants.

Designing Health Interventions to Meet the Needs and Experiences of Minoritized Adolescents: #DoubleTap4Health.

Engagement in preventive health behaviors (PHBs; i.e., healthy eating, sleep, and physical activity) during adolescence is associated with reduced risks for chronic conditions, such as diabetes, in adulthood. Although several interventions seek to improve adolescents' engagement in health promoting behaviors, racial- and income-based disparities across PHBs persist and may be even more pronounced for adolescents with multiple minoritized identities (e.g., Black adolescents in low-income communities). Therefore, targeted interventions that better meet the needs of minoritized adolescents are critical. The design of such interventions should include: (1) adolescent involvement, (2) cultural tailoring, (3) developmental theory, and (4) consideration of the social determinants of health. This article describes how these elements have been successfully incorporated into adolescent preventive health interventions and used to design #DoubleTap4Health, a community-based social media health intervention for Black adolescents from a low-income community. The results of a feasibility pilot of #DoubleTap4Health suggest that (1) attention to these elements in the intervention design process is feasible and advantageous to ensuring that the intervention components are appropriate and well received by adolescents, and (2) the intervention demonstrated promise as adolescents showed improved engagement in PHBs and media literacy skills. Lessons learned and next steps for intervention development are discussed. Including the above four elements in the design of preventive health interventions for adolescents from minoritized communities is critical to promoting health equity.

Spinal cord stimulation combined with exercise in patients diagnosed with persistent spinal pain syndrome. Study protocol for a randomized control trial.

Administration of spinal cord stimulation to individuals with PSPS-T1/2 may induce supraspinal descending activation. Similarly, exercise is recognized as a fundamental aspect of spinal pain management. Studies have demonstrated its impact on neurophysiological factors, including the release of spinal and supraspinal beta-endorphins, which activate μ-opioid receptors. Therefore, the purpose of this study will be to examine the effect of SCS in combination with lumbo-pelvic stability core training on perceived low back pain, quality of life and disability in PSPS-T2 patients. A double-blind randomized clinical trial (RCT) has been designed. All participants will be randomized from a pre-set sequence. The intervention design has been elaborated from the CONSORT guidelines. This study has been registered at Clinicaltrial.gov (NCT06272539). Sample size was calculated using G Power® Sample size software (University of Düsseldorf). The calculation was based on a moderate effect size of 0.7 (partial η2 = 0.70, α = .05, power = 0.95), resulting in a total of 40 patients. Assuming a 30% dropout rate, 52 participants will be recruited in total. Two sessions per week will be scheduled for 8 weeks with a total of 16 sessions. Each work session will have a duration of 60 minutes. The exercise will be adapted according to the phases based on the results already published, limiting in each phase the degrees of flexion and extension of the spine to avoid the risk of electrode migration. Primary outcomes will be functionality, satisfaction, strength, psychosocial variables, quality of life and pain perception.

Toward a whole-of-virtual school framework for promoting student physical activity: a scoping review protocol

BackgroundThe advent of full-time virtual schooling presents unique challenges and opportunities for the promotion of physical activity (PA) among children and adolescents. Despite the recognized benefits of PA as an essential component for combating non-communicable diseases and ensuring holistic development, there is a notable gap in understanding how to effectively integrate PA within the digital learning environments of full-time virtual schools. Current efforts to promote student PA are targeted for implementation exclusively in contexts characterized by physical school campuses that are bound to their surrounding local communities. This is problematic given the digital, widely distributed, and contextually unmoored nature of virtual schooling. Our aim in this scoping review is to advance research on whole-of-school physical activity promotion within full-time virtual schools by examining the published literature on whole-of-school PA promotion within full-time virtual schools. Specifically, this review will map the literature, consolidate knowledge claims and practical implications, and identify evidence gaps that merit further investigation.Methods/designThis review will be conducted using evidence-informed scoping review methodology and reporting guidelines. Articles will be included if they are peer-reviewed English-language research, commentary, practical, or grey literature and relate to the participation, support, design, development, and/or provision of remote online PA interventions delivered through primary/elementary and/or secondary/middle school/high schools. Searches will be conducted in PsycInfo, ERIC, SportDiscus, and Web of Science. Additional hand-searching, reference scans, and grey literature searches will also be performed. Two trained research assistants will independently complete study screening and selection and data charting with guidance from a senior author. Charted data will be displayed in table form, and depending on the results, data will also be synthesized through qualitative content analysis using the Active Schools guiding framework as an analytical and interpretive lens.DiscussionThis scoping review will serve as a guidepost for the application and advancement of research on whole-of-school PA promotion through full-time virtual schools. The results will address the increased importance of equitable online learning and PA promotion due to the expanding virtual education landscape, with implications for public health and education policy.Systematic review registrationOpen Science Framework: https://osf.io/f6wau/.

Cost-effectiveness of hearing and vision support for residents with dementia in long-term care in Ireland: A Health Economic Analysis Plan (HEAP) for a simulation model for the SENSE-Cog Care feasibility trial

Introduction Sensory challenges exacerbate the dementia symptoms of nursing home residents. The Sense-Cog Care trial is piloting a multi-faceted intervention to investigate whether optimising and supporting hearing, vision, and sensory-friendly environments through the “sensory champion” model in Irish nursing homes can improve quality of life and dementia-related outcomes and be cost-effective (Connelly et al., 2023). A Health Economic Analysis Plan (HEAP) provides a standardised and comprehensive framework by outlining the systematic approach, methodologies, and key considerations involved in assessing the cost-effectiveness of a healthcare intervention. The HEAP presented in this paper describes the alongside-trial decision modelling approach used for preliminary estimates of cost-effectiveness and to inform the design of the final intervention. Methods A Markov model will be used to simulate residents' health progression with and without the intervention. Costs will be estimated from the Irish health and social care perspective. A key output of the planned economic analysis will be the Incremental-Cost-Effectiveness Ratio (ICER) which describes the cost over one additional unit of Quality-Adjusted Life Year (QALY). A Probabilistic Sensitivity Analysis (PSA) will be conducted in the form of a Monte Carlo simulation to examine parameter uncertainty and the probability of a sensory champion being cost-effective. Results Tables for inputs and outputs are presented, and graphical representations for uncertainty, such as a tornado plot and a Cost-Effectiveness Analysis Curve (CEAC), will be produced. The results will be interpreted in the context of the Irish cost-effectiveness thresholds of €20,000 and €45,000 per QALY. Discussion To our knowledge, this is the first study to model the cost-effectiveness of a sensory intervention for nursing home residents with dementia. We aim to develop an early-stage Bayesian model that serves as a prior for further research.

A look into the cancer continuum for the development of a physical activity intervention: qualitative investigation of the physical activity experiences and preferences of female cancer survivors.

Clinical guidelines recommend cancer survivors (i.e., people with a cancer diagnosis) engage in regular physical activity (PA) during and post treatment, yet most do not. Additionally, PA promotion for cancer survivors has primarily focused on post treatment, calling for an understanding of PA promotion during treatment. This study explores the PA experiences and preferences of both in-treatment and post-treatment breast and gynecologic cancer survivors (BGCS) to inform the design of a PA intervention. Semi-structured interviews were conducted with postmenopausal women aged ≥ 50years, diagnosed with breast or gynecological cancer (stages 1-3), who were undergoing, or recently completed (12 to 24months) chemotherapy and/or primary treatment. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to explore themes. Participants (N = 26; Mage: 63.9years) had a breast (92.3%) and gynecologic (7.7%) cancer diagnosis and 46.2% (n = 12) were in treatment whereas 53.8% (n = 14) were post treatment. BGCS experienced several side effects of cancer treatment and both groups felt PA was an important goal. In-treatment BGCS focused on managing side effects (e.g., fatigue) and recognized energy fluctuated around treatments, making those periods less ideal for PA. In-treatment BGCS strongly endorsed a flexible, at-home intervention. Post-treatment BGCS emphasized recovery and relapse prevention, also favoring at-home, flexible interventions but showing greater interest towards support groups to aid with their recovery journey. Preferred activities included walking, dancing, and muscle-strengthening. Findings highlight the unique challenges postmenopausal BGCS face in participating in PA, especially in-treatment, emphasizing the importance of a tailored PA intervention.

Suppression of ZBP1-mediated NLRP3 inflammasome by the tegument protein VP22 facilitates pseudorabies virus infection.

Z-DNA binding protein 1 (ZBP1) functions as a pivotal innate immune sensor that regulates inflammatory cell death during viral infections. However, its role in pseudorabies virus (PRV) infection remains unknown. Here, we demonstrate that ZBP1 serves as a restrictive factor by triggering the activation of the NLR family pyrin domain-containing 3 inflammasome, a process counteracted by PRV-encoded protein VP22. Furthermore, VP22 interferes with the interaction between ZBP1 and receptor-interacting protein kinase 3/Caspase-8, particularly through its N-terminal 1-50 amino acids. Importantly, deficiency in ZBP1 enhances the replication and virulence of recombinant viruses lacking VP22 or its N-terminal 1-50 amino acids. These findings reveal how PRV escapes ZBP1-mediated inflammatory responses during infection, potentially informing the rational design of therapeutic interventions.

Capturing the complexity of veterinarians' antibiotic prescribing practices in the livestock sector: a meta-ethnography across contexts: Veterinarians' antibiotic prescribing in different contexts.

Strategies and policies to tackle the global public health threat of antimicrobial resistance are increasingly addressing antimicrobial use prescribing practices in both the human and animal health sectors. Veterinarians' antibiotic prescribing practices are influenced by different factors and conditioned by the context within which antibiotic prescribing decisions are made, complexifying the implementation of behaviour change interventions. A better understanding of these factors could therefore help in the design and application of such interventions. Meta-ethnography was used to explore the antibiotic prescribing behaviour of veterinarians in different contexts and to construct a new conceptual framework. A search was conducted in PubMed, Web of Science Core Collection and SciELO Citation Index between 2016 and 2024. The final sample consisted of 29 articles, 27 of which were selected from the 561 articles identified in the search and 2 of which were added by the authors. The results were synthesized and presented through four contextual situations influencing antibiotic prescribing by livestock veterinarians: priorities and pressures, uncertain field conditions, systemic challenges and an enabling environment. The results are presented as a conceptual framework that views veterinarians' antibiotic prescribing behaviour as dynamic, adapting in response to the different contextual situations they encounter. The findings provide an integrated and contextualized understanding of veterinarians' antibiotic prescribing behaviours, which could be implemented to facilitate the development and application of future antimicrobial stewardship interventions.

Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis

BackgroundBurnout among resident physicians during training has been prevalent, prompting training centers to introduce interventions at the individual or organizational level. However, empirical evidence is crucial before implementing such programs in practice.MethodsA systematic review and meta-analysis was carried out to evaluate the effectiveness of individual and organizational interventions in reducing burnout among resident physicians. Searching was done across five databases—PubMed, Scopus, ScienceDirect, Embase, and Cochrane Library from 1 December 2023 to 26 August 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used for our reporting of study selection process. Eligibility criteria were randomized or non-randomized designs, with prospective intervention, with a comparator group focused on individual or organizational interventions reducing burnout, in any language and publication date. The Maslach Burnout Inventory scores for emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were the three outcome measures. Two investigators independently extracted the data. The risk of bias was evaluated using Cochrane risk-of-bias tool for randomized trials (RoB2) and non-randomized studies of interventions (ROBINS-I). Cohen’s d and heterogeneity was estimated using a random-effects DerSimonian-Laird model and visualized by forest plots. Sensitivity analyses were carried out by leave-one-out meta-analysis.ResultsWe identified 33 eligible studies (n = 2536), comprising 25 (75.8%) individual intervention studies and 8 (24.2%) organizational intervention studies. Cohen’s d for individual intervention versus control were as follows: EE -0.25 (95% CI -0.40 to -0.11, p < 0.01, I2 = 49.3%), and DP -0.17 (95% CI -0.32 to -0.03, p = 0.02, I2 = 50.0%). The organizational intervention showed no significant association with any domain. Sensitivity analyses were robust in all outcomes, with differences in intervention description and design identified as potential contributors to heterogeneity.ConclusionsVarious interventions, including individual coaching, meditation, and organization interventions, have been implemented to improve resident burnout. The effectiveness of intervention demonstrated none to small practical significance in improving burnout. Data inconsistency and high risk of bias across studies limited the validity of the pooled results. Further studies should focus on a combined approach.RegistrationThe study was registered on PROSPERO, under PROSPERO registration number CRD42022349698.

Efficacy of Beetroot Juice Supplementation on Lowering Blood Pressure in Hypertensive Patients – A Single Centre Study

I Background : Quasi -interventional pretest posttest research design was adopted to investigate beetroot juice supplementation on reduction of blood pressure and serum cholesterol levels among 60 hypertensive clients with hyperlipidemia using non probability purposive sampling technique Methodology: On Day-1: The demographic and clinical information was gathered by using a self-structured questionnaire . On Day -2, the pretest level of hyperlipidemia was estimated and also, the pretest blood pressure level was assessed using sphygmomanometer. From Day-3, 200ml of beetroot juice was administered once a day for 30 days. On Day- 34 study participants were re-assessed to estimate the levels hyperlipidemia and blood pressure. Results: The study results concluded that, the pretest and posttest mean score with mean difference score of SBP and DBP in the Interventional Group was141.46±10.43,88.60±5.48 and 128.40±7.13 ,83.20±4.65 with mean difference score was13.06, 5.40 The calculated paired ‘t’ test value of SDP and DBP t =12.558 , 5.964 was statistically significant at p&lt;0.001 Level. The pretest and posttest with mean difference score of total cholesterol,LDL,HDL, triglyceride , cholesterol/HDLratio in the interventional group was 176.86±14.26,103.60±9.68,36.96±4.73,156.53±32.48, 4.45±0.82 and 170.10±15.37,92.96±9.20,41.96±6.08,138.83±26.48,4.00±0.75with mean difference score was 6.76,10.64,5.0,17.70, 0.45.The calculated Paired ‘t’ test value of t =10.329,15.804, 7.816,10.652,14.879 was statistically significant at p&lt;0.001 level.this clearly shows that after administered beetroot juice the blood pressure and serum cholesterol levels was significantly reduced in the Interventional group. Conclusion: administered Beetroot juice proved to be an effective intervention in reducing the blood pressure and serum cholesterol level among hypertensive patients with hyperlipidemia

Developing a mobile-based brief intervention to reduce cannabis-impaired driving among youth: An intervention mapping approach

Behaviour change interventions delivered via smartphones have the potential to reduce youth cannabis use and driving under the influence of cannabis (DUIC). Countless smartphone applications (either downloadable or web-based) are available to help reduce substance use and impaired driving. However, most are developed without evidence-based content and theory, and many have poor user engagement. This study aims to: (1) describe the systematic development and theoretical foundations of a youth DUIC smartphone intervention, and (2) describe the pre-testing among a sample of youth and adult cannabis educators (prior to efficacy testing). A 6-step Intervention Mapping approach was utilized to combine theory, evidence, and user feedback to develop and implement the ‘High Alert’ intervention. This evidence-based and iterative process entailed: (1) conducting a needs assessment, (2) identifying intervention objectives, which map on the following DUIC determinants: knowledge, attitudes, risk perception, perceived norms, and self-efficacy, (3) selecting intervention theory and design, (4) developing of the intervention, (5) implementation, and (6) evaluation. Application of Intervention Mapping resulted in a smartphone web-based application that could support reductions in cannabis use and DUIC. The ‘High Alert’ intervention was created to include four modules with contents focusing on educating youth on the dangers and legal risks of DUIC, limiting risky situations, avoiding riding with an impaired driver, planning a safe ride home, and promoting safer cannabis use. Future research will test the efficacy of the intervention in reducing risky cannabis use and DUIC among youth.

Exploring Belief Systems in Kinship Fostering Practice in Igbo Indigenous Communities of Southeast Nigeria

ABSTRACTKinship fostering in Igbo indigenous communities is an enduring alternative child care practice that promotes collective responsibility for child care in a family environment. The practice is believed to be fundamental for family and community continuity. Weakening extended family ties and a lack of social work support services in this care arrangement have cast doubt on the continual viability of this alternative child care practice This is an exploratory study using grounded theory. In‐depth interviews with six community leaders and six senior public social welfare officers provided insight on belief systems promoting kinship fostering in Igbo indigenous communities. Findings were thematically analysed to show continuity of lineage, preservation of family name and challenges associated with kinship fostering. Belief systems on kinship fostering provides insights on how children are viewed in Igbo culture, which can help policymakers design intervention programme that are culturally relevant in child‐care formation in Nigeria given challenges in kinship fostering. The study promotes indigenous knowledge that is vital for social work education and practice in Nigeria. Further study suggests exploring the belief of foster children and their experiences in kinship fostering.

A Tailored Postpartum eHealth Physical Activity Intervention for Individuals at High Risk of Postpartum Depression-the POstpartum Wellness Study (POW): Protocol and Data Overview for a Randomized Controlled Trial.

Postpartum depression (PPD) is associated with significant health consequences for the parent and child. Current recommendations for PPD prevention require intense health care system resources. Evidence-based interventions for PPD prevention that do not further burden the health care system are needed. Evidence suggests that physical activity (PA) can generally reduce depressive symptoms. Technology-based interventions may help decrease common barriers to PA. This study aims to report the protocol and provide a data overview of the POstpartum Wellness study (POW)-an effectiveness trial evaluating whether an eHealth PA intervention tailored for postpartum individuals increased PA and decreased depressive symptoms among individuals at high PPD risk. This remote parallel-group randomized controlled trial included postpartum individuals with a history of depression or at least moderate current depressive symptoms not meeting the PPD diagnostic threshold and with low PA levels from an integrated health care delivery system. Participants were randomized to an eHealth PA intervention or usual care. The intervention group received access to a library of web-based workout videos designed for postpartum individuals, which included interaction with their infants. At baseline and follow-up (3 and 6 months), PA was measured using questionnaires and a wrist-worn accelerometer. Depressive symptoms were measured using the Patient Health Questionnaire-8 (PHQ-8). Data were collected to assess exploratory outcomes of sleep, perceived stress, anxiety, parent-infant bonding, and infant development. The study was funded in January 2020. Participants were enrolled via REDCap (Research Electronic Data Capture) or telephonically between November 2020 and September 2022; data collection ended in April 2023. Randomized participants (N=99) were 4 months post partum at baseline with moderately severe depressive symptoms (mean PHQ-8 score 12.6, SD 2.2). Intervention (n=50) and usual care (n=49) groups had similar sociodemographic characteristics, months post partum, baseline depressive symptoms, number of children at home, and prepregnancy PA levels. Retention in assessments was ≥66% for questionnaires and ≥48% for accelerometry, with modest differences by group. At 3-month follow-up, 73 of 99 (74%) participants (intervention: 35/50, 70%; usual care: 38/49, 78%) completed questionnaires; 53 of 99 (54%) wore the accelerometer for 7 days (27 of 50 (54%) intervention, 26 of 49 (53%) usual care). At 6-month follow-up, 66 of 99 (67%) participants (30 of 50 (60%) intervention, 36 of 49 (73%) usual care) completed questionnaires and 43 of 99 (43%) wore the accelerometer for 7 days (21 of 50 (42%) intervention, 22 of 49 (45%) usual care). Data analysis is completed, and a manuscript with these findings is currently under review for publication. The POW trial evaluates the effectiveness of an eHealth PA intervention for improving depressive symptoms and increasing PA among postpartum individuals at high PPD risk. Results have implications for the design and delivery of behavioral interventions among vulnerable patients. ClinicalTrials.gov NCT04414696; https://clinicaltrials.gov/ct2/show/NCT04414696. DERR1-10.2196/56882.