Dialogue-based Intervention Research Articles

Evaluating Open Dialogue in Italian mental health services: evidence from a multisite prospective cohort study.

This longitudinal study aimed to quantitatively document and evaluate the implementation and outcomes of the Open Dialogue (OD) approach within Italian Mental Health Departments (MHDs), focusing on the ratings of OD-network meetings by patients and their families and assessing the clinical outcomes over a span of 12 months. Over the course of the study, 58 patients participated in 517 OD-network meetings, demonstrating a high level of satisfaction with the care received, as evidenced by the Session Rating Scale (SRS) and Outcome Rating Scale (ORS). Clinically, significant improvements were observed in the Global Assessment of Functioning (GAF), Clinical Outcomes in Routine Evaluation (CORE-OM), and the Lubben Social Network Scale (LSNS), indicating enhanced psychological and social functioning. The SRS scores showed that satisfaction with the meetings increased over time, while the ORS indicated that both patients and their social networks perceived gradual improvements throughout the therapy. The OD approach within Italian MHDs was successfully implemented and well-received by patients and their social networks, yielding significant clinical improvements. These findings suggest the feasibility and effectiveness of integrating the OD model into the Italian public mental health system, supporting its potential for broader application in diverse healthcare settings. The study highlights the importance of continuous engagement and evaluation to maintain high standards of practice and suggests that OD can be a valuable addition to existing mental health care practices, promoting recovery through inclusive, dialogue-based interventions.

Reviewer training for improving grant and journal peer review.

Funders and scientific journals use peer review to decide which projects to fund or articles to publish. Reviewer training is an intervention to improve the quality of peer review. However, studies on the effects of such training yield inconsistent results, and there are no up-to-date systematic reviews addressing this question. To evaluate the effect of peer reviewer training on the quality of grant and journal peer review. We used standard, extensive Cochrane search methods. The latest search date was 27 April 2022. We included randomized controlled trials (RCTs; including cluster-RCTs) that evaluated peer review with training interventions versus usual processes, no training interventions, or other interventions to improve the quality of peer review. We used standard Cochrane methods. Our primary outcomes were 1. completeness of reporting and 2. peer review detection of errors. Our secondary outcomes were 1. bibliometric scores, 2. stakeholders' assessment of peer review quality, 3. inter-reviewer agreement, 4. process-centred outcomes, 5. peer reviewer satisfaction, and 6. completion rate and speed of funded projects. We used the first version of the Cochrane risk of bias tool to assess the risk of bias, and we used GRADE to assess the certainty of evidence. We included 10 RCTs with a total of 1213 units of analysis. The unit of analysis was the individual reviewer in seven studies (722 reviewers in total), and the reviewed manuscript in three studies (491 manuscripts in total). In eight RCTs, participants were journal peer reviewers. In two studies, the participants were grant peer reviewers. The training interventions can be broadly divided into dialogue-based interventions (interactive workshop, face-to-face training, mentoring) and one-way communication (written information, video course, checklist, written feedback). Most studies were small. We found moderate-certainty evidence that emails reminding peer reviewers to check items of reporting checklists, compared with standard journal practice, have little or no effect on the completeness of reporting, measured as the proportion of items (from 0.00 to 1.00) that were adequately reported (mean difference (MD) 0.02, 95% confidence interval (CI) -0.02 to 0.06; 2 RCTs, 421 manuscripts). There was low-certainty evidence that reviewer training, compared with standard journal practice, slightly improves peer reviewer ability to detect errors (MD 0.55, 95% CI 0.20 to 0.90; 1 RCT, 418 reviewers). We found low-certainty evidence that reviewer training, compared with standard journal practice, has little or no effect on stakeholders' assessment of review quality in journal peer review (standardized mean difference (SMD) 0.13 standard deviations (SDs), 95% CI -0.07 to 0.33; 1 RCT, 418 reviewers), or change in stakeholders' assessment of review quality in journal peer review (SMD -0.15 SDs, 95% CI -0.39 to 0.10; 5 RCTs, 258 reviewers). We found very low-certainty evidence that a video course, compared with no video course, has little or no effect on inter-reviewer agreement in grant peer review (MD 0.14 points, 95% CI -0.07 to 0.35; 1 RCT, 75 reviewers). There was low-certainty evidence that structured individual feedback on scoring, compared with general information on scoring, has little or no effect on the change in inter-reviewer agreement in grant peer review (MD 0.18 points, 95% CI -0.14 to 0.50; 1 RCT, 41 reviewers, low-certainty evidence). Evidence from 10 RCTs suggests that training peer reviewers may lead to little or no improvement in the quality of peer review. There is a need for studies with more participants and a broader spectrum of valid and reliable outcome measures. Studies evaluating stakeholders' assessments of the quality of peer review should ensure that these instruments have sufficient levels of validity and reliability.

Transforming the educational experiences of marginalized students in Ghana through dialogic literary gatherings

Discrimination and educational inequalities continually affect lifelong learning opportunities among marginalized groups in the 21st century. In Ghana and many parts of Sub-Saharan Africa, children from rural and urban poor communities, ethnic and linguistic minorities and those in displaced situations have experienced discrimination and marginalization in education for decades. However, few studies propose ways marginalized students in Ghana can transform their experiences in school. This paper explores how participating in a dialogue-based intervention named Dialogic Literary Gatherings (DLGs) transformed the educational experiences of marginalized students. An ethnographic-case study was conducted with 8th-grade students in a compulsory school in Southeastern Ghana. Focusing on the personal accounts of seven students, our findings show that the DLGs created affordances for marginalized students to engage in egalitarian dialogue, share their grievances while transforming relationships and attitudes with their peers and boost participants’ self-confidence, eventually transforming their educational experiences. This is relevant for practitioners and stakeholders seeking innovative strategies that potentially transform discriminated and marginalized students’ experiences and potentially keep them in school.

Embracing context: Lessons from designing a dialogue-based intervention to address vaccine hesitancy.

Dialogue with people who are vaccine hesitant has been recommended as a method to increase vaccination uptake. The process of cultivating dialogue is shaped by the context in which it occurs, yet the development of interventions addressing vaccine hesitancy with dialogue often overlooks the role of context and favors relatively fixed solutions. This reflexive paper shares three key lessons related to context for dialogue-based interventions. These lessons emerged during a participatory research project to develop a pilot intervention to create open dialogue among healthcare workers in Belgium about COVID-19 vaccination concerns. Through a mixed methods study consisting of in-depth interviews, focus group discussions, and surveys, we engaged healthcare workers in the design, testing, and evaluation of a digital platform featuring text-based and video-based (face-to-face) interactions. The lessons are: (1) what dialogue means, entails, and requires can vary for a population and context, (2) inherent tension exists between helping participants voice (and overcome) their concerns and exposing them to others' ideas that may exacerbate those concerns, and (3) interactional exchanges (e.g., with peers or experts) that matter to participants may shape the dialogue in terms of its content and form. We suggest that having a discovery-orientation-meaning to work not only inductively and iteratively but also reflexively-is a necessary part of the development of dialogue-based interventions. Our case also sheds light on the influences between: dialogue topic/content, socio-political landscape, population, intervention aim, dialogue form, ethics, researcher position, and types of interactional exchanges.

Addressing Barriers to COVID-19 Vaccination Among Older U.S. Veterans.

Efforts are being made to ensure that COVID-19 vaccination among older adults is as complete as possible. Dialogue-based interventions tailored to patients’ specific concerns have shown potential for effectiveness in promoting vaccination. We implemented a quality improvement project intended to help patients in an outpatient geriatrics clinic overcome barriers to COVID-19 vaccination. We offered tailored conversations by telephone in which we discussed the barriers to vaccination that the patients were facing and offered to provide relevant information and/or logistical assistance. Of the 184 patients reached by phone, 125 (68%) endorsed having already been vaccinated and 59 (32%) did not. About one third of the unvaccinated patients were willing to participate in tailored conversations (20 patients = 34% of the unvaccinated). In follow-up calls 30 days after the intervention we found that four of these 20 patients had received COVID-19 vaccination, one patient was scheduled for vaccination, 10 continued to be deciding about vaccination, four had decided against it and one could not be reached. Dialogue-based interventions that are conducted by telephone and are tailored to the specific barriers to vaccination being faced by older adults may have some effectiveness in encouraging vaccination against COVID-19. The effectiveness of such interventions may be decreased in populations that already have high vaccination rates and in which many patients have already formed strong opinions regarding vaccination against COVID-19. Completion of Plan-Do-Study-Act cycles is a feasible way to design, implement and work to optimize quality improvement efforts related to COVID-19 vaccination.

What's Lost in Translation: A Dialogue-Based Intervention That Improves Interpreter Confidence in Palliative Care Conversations

BackgroundFor US patients with limited English proficiency (LEP), diversity of language and culture can create potential health care disparities in discussions of prognosis and goals of care. Although professional medical interpreters are often thought of as language conduits, they are also trained as clarifiers and mediators of cultural barriers between providers, patients and their families. Identifying interpreter challenges in Palliative Care (PC) conversations and brainstorming and rehearsing solutions could improve their confidence interpreting PC encounters and being cultural mediators. MeasuresPre- and Pre/Postintervention PC confidence questionnaires. Intervention: six-session monthly dialogue-based course. OutcomesInterpreters showed significant increases in postintervention confidence in PC communication compared with pre-intervention (z = −5.646, P< 0.000). Conclusions/Lessons learnedThis dialogue-based intervention eliciting ongoing interpreter challenges, with PC social work facilitation and role-play with PC clinicians in a mutually respectful environment, significantly improved interpreter confidence in partnering with clinicians in PC conversations.

The effects of a dialogue-based intervention to promote psychosocial well-being after stroke: a randomized controlled trial

Objective: To evaluate the effect of a dialogue-based intervention targeting psychosocial well-being at 12 months post-stroke. Design: Multicenter, prospective, randomized, assessor-blinded, controlled trial with two parallel groups. Setting: Community. Subjects: Three-hundred and twenty-two adults (⩾18 years) with stroke within the last four weeks were randomly allocated into intervention group (n = 166) or control group (n = 156). Interventions: The intervention group received a dialogue-based intervention to promote psychosocial well-being, comprising eight individual 1–1½ hour sessions delivered during the first six months post-stroke. Main measures: The primary outcome measure was the General Health Questionnaire-28 (GHQ-28). Secondary outcome measures included the Stroke and Aphasia Quality of Life Scale-39g, the Sense of Coherence scale, and the Yale Brown single-item questionnaire. Results: The mean (SD) age of the participants was 66.8 (12.1) years in the intervention group and 65.7 (13.3) years in the control group. At 12 months post-stroke, the mean (SE) GHQ-28 score was 20.6 (0.84) in the intervention group and 19.9 (0.85) in the control group. There were no between-group differences in psychosocial well-being at 12 months post-stroke (mean difference: −0.74, 95% confidence interval (CI): −3.08, 1.60). The secondary outcomes showed no statistically significant between-group difference in health-related quality of life, sense of coherence, or depression at 12 months. Conclusion: The results of this trial did not demonstrate lower levels of emotional distress and anxiety or higher levels of health-related quality of life in the intervention group (dialogue-based intervention) as compared to the control group (usual care) at 12 months post-stroke.

Impact of a low-cost classroom dialogue-based intervention on preschool children’s emotion understanding

ABSTRACTChildren's emotion understanding has emerged as one of the best predictors of their psychological well-being, pro-social competences and school achievement. The main goal of this study was to evaluate for the first time the impact of an easy-to-use and not time-consuming classroom dialogue-based intervention (a) on preschool children's understanding of both simple and complex components of emotions and (b) on the range of individual differences in children's understanding of emotions. Participants were 112 typical 5-year-old children attending 10 different preschools in Canada and France. They were divided into an intervention group (N = 55, 7 classrooms) and a control group (N = 57, 7 classrooms). The intervention, The Tales of Audrey-Anne, lasted over 8–9 months (15 h in total) and was conducted in the classroom by the children's habitual teachers without previous training in using the intervention. Children were assessed before and after the intervention for their emotion understanding with the Test of Emotion Comprehension (TEC). Four results were found. First, the intervention had a positive impact on children's both overall and specific levels of emotion understanding. Second, it did not change the hierarchical order of the specific levels (i.e. external, mental and reflective). Third, it did not have an impact on the range of individual differences (considerable both before and after the intervention). Fourth, it had a positive impact on the longitudinal stability of these differences (much smaller for the children in the experimental group after the intervention). These findings are discussed in terms of the theoretical and applied implications.

Effect of a dialogue-based intervention on psychosocial well-being 6 months after stroke in Norway: A randomized controlled trial.

To evaluate the effect of a dialogue-based intervention on psychosocial well-being 6 months after stroke. Multicentre, prospective, randomized controlled trial. Adults (aged ≥ 18 years) who had their first or recurrent stroke within the last month, were medically stable, had sufficient cognitive functioning to participate and understood and spoke Norwegian. A total of 322 participants were randomly assigned to the intervention (n = 166) or control (n = 156) group. Participants in the intervention group received up to 8 individual sessions aimed at supporting the coping and life skills of stroke survivors in addition to usual care. The primary outcome was the proportion of participants with normal mood measured by the General Health Questionnaire-28 (GHQ-28). The secondary outcomes included health-related quality of life (Stroke and Aphasia Quality of Life Scale; SAQOL-39g), depression (Yale-Brown single-item questionnaire; Yale) and sense of coherence (SOC-13). After controlling for the baseline values, no significant benefit was found in the intervention group over the control group (odds ratio (OR): 0.898: 95% confidence interval (95% CI): 0.54-1.50, p = 0.680) 6 months post-stroke. Psychosocial well-being improved during the first 6 months after stroke in both arms of the trial, but no statistically significant benefit of the dialogue-based intervention was found compared with usual care.

Promoting psychosocial well-being following stroke: study protocol for a randomized, controlled trial

BackgroundStroke is a major public health threat globally. Psychosocial well-being may be affected following stroke. Depressive symptoms, anxiety, general psychological distress and social isolation are prevalent. Approximately one third report depressive symptoms and 20% report anxiety during the first months or years after the stroke. Psychosocial difficulties may impact significantly on long-term functioning and quality of life, reduce the effects of rehabilitation services and lead to higher mortality rates. The aim of the study is to evaluate the effect of a previously developed and feasibility tested dialogue-based psychosocial intervention aimed at promoting psychosocial well-being and coping following stroke among stroke survivors with and without aphasia.MethodsThe study will be conducted as a multicenter, randomized, single blind controlled trial with one intervention and one control arm. It will include a total of 330 stroke survivors randomly allocated into either an intervention group (dialogue-based intervention to promote psychosocial well-being) or a control group (usual care). Participants in the intervention group will receive eight individual sessions of supported dialogues in their homes during the first six months following an acute stroke. The primary outcome measure will be psychosocial well-being measured by the General Health Questionnaire (GHQ). Secondary outcome measures will be quality of life (SAQoL), sense of coherence (SOC), and depression (Yale). Process evaluation will be conducted in a longitudinal mixed methods study by individual qualitative interviews with 15–20 participants in the intervention and control groups, focus group interviews with the intervention personnel and data collectors, and a comprehensive analysis of implementation fidelity.DiscussionThe intervention described in this study protocol is based on thorough development and feasibility work, guided by the UK medical research council framework for developing and testing complex interventions. It combines classical effectiveness evaluation with a thorough process evaluation. The results from this study may inform the development of further trials aimed at promoting psychosocial well-being following stroke as well as inform the psychosocial follow up of stroke patients living at home.Trial registrationNCT02338869; registered 10/04/2014 (On-going trial).

Safety and perception: What are the greatest enemies of HPV vaccination programmes?

Vaccines stimulate a person’s immune system to produce an adequate reaction against a specific infectious agent; i.e. the person is protected from that disease without having to get it first. As vaccines are administrated to healthy subjects, they are held to the highest standards of safety. Regarding human papillomavirus (HPV) vaccines, at present three prophylactic vaccines are licensed (bivalent HPV 16/18, quadrivalent HPV 6/11/16/18 and the nonovalent HPV 6/11/16/18/31/33/45/52/58 vaccine). Pre- and post-licensure studies (i.e. not yet for nonovalent HPV vaccine) confirm that HPV vaccines are generally safe and well-tolerated, site injections symptoms are the most common adverse events (AEs) reported, and pain is the most frequently referred local symptom. Serious AEs are rare and not associated with severe sequelae, at least no vaccine-related deaths have occurred. Despite these scientific evidences, it is still difficult to explain to the population the importance of a good vaccination programme. There are many determinants for HPV vaccines hesitancy which represent a barrier that must be overcome in order to increase vaccine coverage, including psychological reactions, religious or cultural aspects, and fear of possible AEs (demyelinating diseases, Complex Regional Pain Syndrome – CRPS, or Postural Orthostatic Tachycardia Syndrome – POTS). A weak communication strategy which frequently suffers due to spread of unverified news by media and websites may lead to the failure of a vaccination programme. Such a situation happened in Japan (2013), due to which a great number of women remain vulnerable to HPV-related cancers. In order to resolve the issues around HPV vaccines acceptance, it is necessary to use good communication strategies. Multicomponent and dialogue-based interventions seem to be the most effective, especially if an adequate language is used, customized according to the vaccination programme target.

Dialogue and Interaction in Early Childhood Education: A Systematic Review

&lt;p&gt;There is solid evidence that high quality Early Childhood Education (ECE hereafter) have substantial impact on later life outcomes. A growing literature suggests that interventions that develop social competency as well as cognitive, language and academic skills in the earliest years play a role in later educational, social and economic success. Less is known about the most conducive interactions –verbal and non-verbal- underpinning such pedagogical practices in early childhood education. This article aims at reviewing the last decade’s early childhood education with a twofold objective: (a) to describe how dialogue and interaction take place in high-quality early childhood education settings; (b) to identify the effects, if any, on children’s learning and development as a result of implementing dialogue-based interventions in ECE. The studies were identified through systematic search of electronic databases and analyzed accordingly. Several types of interactions given in high quality ECE programs and its short and long-term effects are discerned in this review. &lt;/p&gt;

Theater and Dialogue to Increase Youth’s Intentions to Advocate for LGBTQQ People

Objective: This study evaluates the effectiveness of an intervention using theater and dialogue to raise awareness about homophobia and transphobia and increase intentions to participate in macro-level change efforts around lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQQ) issues. Methods: Using a pretest–posttest design, this study examines changes in advocacy intentions around LGBTQQ issues among middle school and high school students who participated in the intervention ( n = 515). Results: Students reported a significant increase in intentions to advocate. Existing intervention behaviors and increased recognition of homophobia/transphobia as problems were associated with greater increases in intention to advocate. Respondents with higher existing intervention behaviors, as well as White students and cisgender women, reported higher advocacy intentions compared to students of color and cisgender men. Further, we found indication of greater awareness of homophobia/transphobia as a problem in school. Conclusions: Youth-led theater and dialogue-based interventions may be a promising strategy for addressing heterosexism and genderism in schools.

Promoting psychosocial well-being following a stroke: Developing a theoretically and empirically sound complex intervention

BackgroundThe psychosocial consequences of stroke are complex and comprehensive and include substantial and longlasting impacts on mood, identity, social relationships, return to work and quality of life. Many studies have explored possible interventions to prevent or treat psychosocial problems, but the results have generally been disappointing. Very few studies have provided adequate theoretical accounts of the mechanisms assumed to contribute to positive outcomes. ObjectivesTo describe the development of a psychosocial nursing intervention aimed at promoting psychosocial health and well-being and to stimulate dialogue about how to develop and report theoretically and empirically sound complex interventions in nursing. DesignA systematic, stepwise approach was used, consistent with the framework recommended for developing and evaluating complex interventions by the UK Medical Research Council. Data sourcesSystematic reviews of empirical studies regarding the psychosocial consequences and needs of patients following stroke; qualitative, experiential studies of stroke and stroke recovery; theories of psychosocial well-being, coping, life skills, narrative approaches to rehabilitation and guided self-determination. Review methodsEach systematic review was examined to determine the major psychosocial challenges and needs experienced by stroke survivors, focusing on how these challenges and needs developed over the illness trajectory, how previous interventions had sought to address them and the effective mechanisms assumed to affect the level of success of interventions. Qualitative studies were examined to reveal the subjective experiences of stroke and stroke recovery, paying particular attention to the development of needs across time and context. A qualitative synthesis of the major characteristics of the trajectory of stroke rehabilitation and recovery during the first year was developed. Theories were examined to illuminate possible effective mechanisms and actions aimed at promoting psychosocial well-being during the stroke recovery process. ResultsA dialogue-based intervention comprising eight encounters between stroke survivors and trained health care workers was designed, based on narrative theories, empowerment philosophy and guided self determination. Worksheets and a guiding topical outline were developed to support the dialogue. ConclusionsThe UK Medical Research Council framework facilitated the systematic development of an empirically and theoretically informed complex nursing intervention aimed at promoting post-stroke psychosocial well-being.