Effective Intervention Components Research Articles

Incorporating Technology into Instruction in Early Childhood Classrooms: a Systematic Review.

The purpose of this review is to describe the variety and effectiveness of instructional technologies used in the early childhood setting. A systematic review of three databases was completed, and studies were reviewed by two independent coders to determine if they met inclusion criteria. Studies were excluded from this review if (a) the technology was used to train teachers and was not directly used with early childhood students, (b) participants were all enrolled in 2nd grade or higher, (c) the setting was not an early childhood education setting, or (d) studies were descriptive in nature or utilized a survey methodology. Data were extracted from each article related to participant characteristics, setting characteristics, research design, technology type, and dependent variables. Thirty-five studies met criteria were included in this review. A wide range of technologies were used to provide or facilitate instruction on (a) academics, (b) social and communication skills, and (c) cognitive skills. Academic outcomes targeted in Head Start preschools were the most common across studies. The results ranged from no effect to highly effective. The findings from the included studies varied widely in their outcomes from reporting no difference between traditional instruction and technology-aided instruction to reporting significant difference between groups or reporting a functional relation between the technology-based intervention and the target behavior or skill. Studies that included students identified with neurodevelopmental disorders demonstrated a positive impact in the outcomes of students who experience an intervention that included technology-aided instruction. Future research is needed to identify critical components of effective technology-based interventions in early childhood educational settings.

Effects of Palliative Care for Progressive Neurologic Diseases: A Systematic Review and Meta-Analysis.

To determine the association of palliative care for progressive neurologic diseases with patient- and caregiver-centered outcomes. Systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies, including pilot studies. Adults with progressive neurologic diseases (dementia, multiple sclerosis, Parkinson's disease, motor neuron disease, multiple system atrophy, and progressive supranuclear palsy) and their caregivers. MEDLINE, EMBASE, CINAHL PLUS, Cochrane CENTRAL, and PubMed were searched from inception to September 2021. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tools. Narrative synthesis was conducted. Patient quality of life (QoL), symptom burden, caregiver burden, and satisfaction with care were meta-analyzed using a random-effects model. Fifteen trials provided data on 3431 patients (mean age, 73.9years). Compared with usual care, palliative care was statistically significantly associated with lower symptom burden [standardized mean difference (SMD),-0.34 (95% Cl,-0.59 to-0.09)] and higher caregiver satisfaction [SMD, 0.41 (95% Cl, 0.12 to 0.71)] and patient satisfaction [SMD, 0.43 (95% Cl,-0.01 to 0.87)]. However, the associations were not significant after excluding studies with high risk of bias. Insignificant associations of palliative care with caregiver burden [SMD,-0.09 (95% Cl,-0.21 to 0.03)] and patient QoL [SMD, 0.19 (95% Cl,-0.07 to 0.44)] were observed. Palliative care is likely to improve symptom burden and satisfaction with care among patients with progressive neurologic diseases and their caregivers, while its effects on QoL and caregiver burden remains inconclusive. Specific intervention components including interdisciplinary team, palliative care physicians, home visits, and spiritual care appeared to be associated with increased effects on improving palliative outcomes. More rigorous designed studies are warranted to examine the effects of neuropalliative care, effective intervention components, optimal timing, and symptom triggers of palliative care referrals.

Differential effects of mindful breathing and loving kindness meditations: a component analysis study

ABSTRACT Objective Mindful breathing meditation (MBM) and loving-kindness meditation (LKM) are common components of effective mindfulness-based interventions (MBIs). This study examined the differential effects of MBM and LKM on purported therapeutic process variables and mental health outcomes via component analysis. Method The research design was a randomized controlled trial with four conditions: MBM, LKM, combined (MBM + LKM), and a relaxation control. All conditions consisted of 10-min. audio-recorded guided meditations that were self-implemented over the course of two weeks. Participants were college undergraduates (N = 52). Results Findings indicated statistically significant and very large main effects of time, regardless of condition. Statistically significant time by condition interactions were only observed for one process variable (i.e., defusion) and one mental health outcome (i.e., depression). Follow-up descriptive evaluation of between-group effect sizes indicated patterns of favorable effects for MBM and LKM over the combined and relaxation control conditions. Treatment integrity and treatment acceptability data indicated very favorable social validity across conditions. Discussion We conclude that our findings make a modest yet value-added contribution to the MBI component analysis literature, suggesting differentiated performance among isolated MBM and LKM exercises compared to combined and control conditions. Yet further research is warranted to improve upon the limitations of this study.

Digital Health Behavioural Interventions to Support Physical Activity and Sedentary Behaviour in Adults after Stroke: A Systematic Literature Review with Meta-Analysis of Controlled Trials.

Background: As the global prevalence of stroke continues to rise, it becomes increasingly pressing to investigate digital health behaviour change interventions that promote physical activity and reduce sedentary behaviour for stroke patients to support active lifestyles. Purpose: The primary aim of this study is to investigate the effectiveness of digital health interventions in promoting physical activity and reducing sedentary behaviour for stroke patients. The secondary aim is to investigate the intervention components that explain intervention effectiveness to further inform intervention development and policy making. Methods: A systematic search of the literature was conducted in four databases (Scopus, MEDLINE (PubMed), Web of Science, and PsychINFO) to identify the most robust evidence in the form of randomised controlled trials of digital interventions for patients with stroke. A random-effects meta-analysis were utilized to quantify the intervention effects on behaviour change, and subgroup analyses to characterise intervention effective components. Results: In total, 16 RCTs were deemed eligible and included in the systematic review. Meta-analyses suggested significant improvements in physical activity (SMD = 0.39, 95% CI 0.17, 0.61, N = 326, p < 0.001, I2 = 0%), and reductions in time of sedentary behaviour (SMD= -0.45, 95% CI -0.76, -0.14, N = 167, p = 0.00, I2 = 0%) after stroke. The 10 m walk test for physical activity, and the timed up and go test for sedentary behaviour, were the objective outcome measures in the most effective behavioural change interventions. Subgroup analyses found that most effective interventions were underpinned by theories of self-regulation and utilised interactive functions to engage patients with the processes of behaviour change. Conclusions: Digital self-monitoring behavioural interventions are effective in promoting physical activity for stroke patients in adjunct to usual care clinical practice and rehabilitation programmes. Rigorous studies are required to provide evidence to disentangle the most effective intervention components for preventative practices and rehabilitation programs and to inform policymaking for stroke treatment.

Non-pharmacological interventions for sleep disturbances in people with dementia.

Non-pharmacological interventions for sleep disturbances in people with dementia.

Mixed-methods evaluation of a group psychosocial intervention for refugee, migrant and host community women in Ecuador and Panamá: Results from the Entre Nosotras cluster randomized feasibility trial.

Community-based psychosocial interventions are key elements of mental health and psychosocial support; yet evidence regarding their effectiveness and implementation in humanitarian settings is limited. This study aimed to assess the appropriateness, acceptability, feasibility and safety of conducting a cluster randomized trial evaluating two versions of a group psychosocial intervention. Nine community clusters in Ecuador and Panamá were randomized to receive the standard version of the Entre Nosotras intervention, a community-based group psychosocial intervention co-designed with community members, or an enhanced version of Entre Nosotras that integrated a stress management component. In a sample of 225 refugees, migrants and host community women, we found that both versions were safe, acceptable and appropriate. Training lay facilitators to deliver the intervention was feasible. Challenges included slow recruitment related to delays caused by the COVID-19 pandemic, high attrition due to population mobility and other competing priorities, and mixed psychometric performance of psychosocial outcome measures. Although the intervention appeared promising, a definitive cluster randomized comparative effectiveness trial requires further adaptations to the research protocol. Within this pilot study we identified strategies to overcome these challenges that may inform adaptations. This comparative effectiveness design may be a model for identifying effective components of psychosocial interventions.

Successful ingredients of effective Collaborative Care programs in low- and middle-income countries: A rapid review.

Integrating mental health care in primary healthcare settings is a compelling strategy to address the mental health treatment gap in low- and middle-income countries (LMICs). Collaborative Care is the integrated care model with the most evidence supporting its effectiveness, but most research has been conducted in high-income countries. Efforts to implement this complex multi-component model at scale in LMICs will be enhanced by understanding the model components that have been effective in LMIC settings. Following Cochrane Rapid Reviews Methods Group recommendations, we conducted a rapid review to identify studies of the effectiveness of Collaborative Care for priority adult mental disorders of mhGAP (mood and anxiety disorders, psychosis, substance use disorders and epilepsy) in outpatient medical settings in LMICs. Article screening and data extraction were performed using Covidence software. Data extraction by two authors utilized a checklist of key components of effective interventions. Information was aggregated to examine how frequently the components were applied. Our search yielded 25 articles describing 20 Collaborative Care models that treated depression, anxiety, schizophrenia, alcohol use disorder or epilepsy in nine different LMICs. Fourteen of these models demonstrated statistically significantly improved clinical outcomes compared to comparison groups. Successful models shared key structural and process-of-care elements: a multi-disciplinary care team with structured communication; standardized protocols for evidence-based treatments; systematic identification of mental disorders, and a stepped-care approach to treatment intensification. There was substantial heterogeneity across studies with respect to the specifics of model components, and clear evidence of the importance of tailoring the model to the local context. This review provides evidence that Collaborative Care is effective across a range of mental disorders in LMICs. More work is needed to demonstrate population-level and longer-term outcomes, and to identify strategies that will support successful and sustained implementation in routine clinical settings.

Transforming nutritional behaviors of basic school children through school-based participatory nutrition education program: A study protocol

Dietary habits build on in the formative years persist across the lifespan; therefore, developing healthy nutritional behaviors is crucial among school-going children. The school education can be a powerful influence in modifying the nutritional behaviors of children. Available evidence indicates that school-based nutrition education may promote improved dietary behaviours of school children if it is integrated with motivation, action, and a supportive environment. This study aims to design, implement and evaluate a school-based participatory nutrition education program (SBPNEP) to transform the nutritional behavior of students through participatory action research (PAR). This study uses a transformative mixed-method design as part of the PAR methodology. Five co-educational community schools are selected from Chitwan district of Nepal following the inclusion criteria of NORHED Rupantran Project under Tribhuvan University. Among the five schools, one is selected as the ‘action school’ where intervention sessions will be implemented. The remaining four schools serve as the ‘reference schools’ where effective intervention components of the action school will be replicated. Basic school students, their parents, basic school science and health education teachers, and school leaders are the co-researchers of this study. Both quantitative tools and qualitative methods will be used to generate the data. Quantitative data will be analyzed using inferential statistics (bivariate and multivariate), whilst the interpretive phenomenological analysis (IPA) method will be used for meaning making process of the qualitative data. Three components of the intervention also said to be PAR cycles: sensitization and motivation’, ‘nutrition pedagogy’ and ‘creating a supportive environment for sustainability’ will be implemented following an iterative process of planning, acting, observing, and reflecting of the PAR cycle. The effectiveness of the intervention activities will be evaluated under three phases: short-term, mid-term, and long-term.

Effectiveness of Digital Interventions for Deficit-Oriented and Asset-Oriented Psychological Outcomes in the Workplace: A Systematic Review and Narrative Synthesis.

Background: Digital psychological interventions can target deficit-oriented and asset-oriented psychological outcomes in the workplace. This review examined: (a) the effectiveness of digital interventions for psychological well-being at work, (b) associations with workplace outcomes, and (c) associations between interventions’ effectiveness and their theory-base. Methods: six electronic databases were searched for randomised controlled trials (RCT) and quasi-experimental studies. The methodological quality of studies that used randomisation was conducted with the “Cochrane Collaboration’s Risk of Bias” tool, while the “JBI Critical Appraisal Checklist” was used for non-randomised studies. Studies’ theory-base was evaluated using an adaptation of the “theory coding scheme” (TSC). Due to heterogeneity, narrative synthesis was performed. Results: 51 studies were included in a synthesis describing four clusters of digital interventions: (a) cognitive behavioural therapy, (b) stress-management interventions and workplace well-being promotion, (c) meditation training and mindfulness-based interventions, and (d) self-help interventions. Studies demonstrated a high risk of contamination effects and high attrition bias. Theory-informed interventions demonstrated greater effectiveness. Cognitive behavioural therapy demonstrated the most robust evidence for reducing depression symptoms among healthy employees. With the exception of the Headspace application, there was weak evidence for meditation training apps, while relaxation training was a key component of effective stress-management interventions.

Scaling Interventions to Manage Chronic Disease: Innovative Methods at the Intersection of Health Policy Research and Implementation Science

Policy implementation is a key component of scaling effective chronic disease prevention and management interventions. Policy can support scale-up by mandating or incentivizing intervention adoption, but enacting a policy is only the first step. Fully implementing a policy designed to facilitate implementation of health interventions often requires a range of accompanying implementation structures, like health IT systems, and implementation strategies, like training. Decision makers need to know what policies can support intervention adoption and how to implement those policies, but to date research on policy implementation is limited and innovative methodological approaches are needed. In December 2021, the Johns Hopkins ALACRITY Center for Health and Longevity in Mental Illness and the Johns Hopkins Center for Mental Health and Addiction Policy convened a forum of research experts to discuss approaches for studying policy implementation. In this report, we summarize the ideas that came out of the forum. First, we describe a motivating example focused on an Affordable Care Act Medicaid health home waiver policy used by some US states to support scale-up of an evidence-based integrated care model shown in clinical trials to improve cardiovascular care for people with serious mental illness. Second, we define key policy implementation components including structures, strategies, and outcomes. Third, we provide an overview of descriptive, predictive and associational, and causal approaches that can be used to study policy implementation. We conclude with discussion of priorities for methodological innovations in policy implementation research, with three key areas identified by forum experts: effect modification methods for making causal inferences about how policies’ effects on outcomes vary based on implementation structures/strategies; causal mediation approaches for studying policy implementation mechanisms; and characterizing uncertainty in systems science models. We conclude with discussion of overarching methods considerations for studying policy implementation, including measurement of policy implementation, strategies for studying the role of context in policy implementation, and the importance of considering when establishing causality is the goal of policy implementation research.

The OPTIMISE study protocol: a multicentre optimisation trial comparing continuous glucose monitoring, snacking habits, sleep extension and values-guided self-care interventions to improve glucose time-in-range in young people (13–20 years) with type 1 diabetes

PurposeThe OPTIMISE study uses a Multiphase Optimisation Strategy (MOST) to identify the best combination of four interventions targeting key diabetes self-care behaviours for use in clinical practice to improve short-term glycaemic outcomes.MethodsThis 4-week intervention trial will recruit 80 young people (aged 13–20 years) with type 1 diabetes ≥ 6 months duration), and pre-enrolment HbA1c ≥ 58 mmol/mol (7.5%) in the prior 6 months. Both main intervention and interaction effects will be estimated using a linear regression model with change in glucose time-in-range (TIR; 3.9–10.0 mmol/L) as the primary outcome. Participants will be randomised to one of 16 conditions in a factorial design using four intervention components: (1) real-time continuous glucose monitoring (CGM), (2) targeted snacking education, (3) individualised sleep extension, and (4) values-guided self-care goal setting. Baseline and post-intervention glucose TIR will be assessed with blinded CGM. Changes in self-care (snacking behaviours, sleep habits and duration, and psychosocial outcomes) will be assessed at baseline and post-intervention to determine if these interventions impacted behaviour change.DiscussionThe study outcomes will enable the selection of effective and efficient intervention components that increase glucose TIR in young people who struggle to achieve targets for glycaemic control. The optimised intervention will be evaluated in a future randomised controlled trial and guide the planning of effective clinical interventions in adolescents and young adults living with type 1 diabetes.Trial registrationThis trial was prospectively registered with the Australian New Zealand Clinical Trials Registry on 7 October 2020 (ACTRN12620001017910) and the World Health Organisation International Clinical Trails Registry Platform on 26 July 2020 (Universal Trial Number WHO U1111-1256-1248).

Child protection training for professionals to improve reporting of child abuse and neglect.

Child protection training for professionals to improve reporting of child abuse and neglect.

Travel behaviour change research: A scientometric review and content analysis

A travel behaviour change approach complements hard transport measures to develop more sustainable transport systems. Travel behaviour change is a growing field of research, with a range of theories, behaviours and tools being studied. Consequently, a wide-angled review is critical for synthesising knowledge in this field. This study conducted a scientometric review of travel behaviour change literature, identifying the main characteristics, key journals, research categories, keywords, authors, institutions, countries and cited references. In addition, a content analysis was conducted to identify current research trends and gaps in the field and develop a future research agenda. The scientometric component of the review analysed the bibliographic data of 323 academic records. The review identified that the field has a long history and has grown significantly since 2011. The content analysis of recent research (n = 17 articles) supported previous findings that travel behaviour change interventions can result in changing behaviour. The main target behaviours are private motor vehicle use, bicycling and public transport. Notably absent is trip avoidance research. Information dissemination strategies are the main tools trialled, including personalised travel plans, websites and apps. Finally, we propose six research directions for the travel behaviour change field: multiple research methods; identify effective intervention components; locally contextualised research; further segmentation research; longer-term studies; and trip avoidance research. Trip avoidance research is most urgent, as experiences due to COVID-19 have shown, working from home could have a significant positive impact on the sustainability of our transport systems.

Valued attributes of professional support for people who repeatedly self-harm: A systematic review and meta-synthesis of first-hand accounts.

Therapeutic interventions are an important adjunct to self‐help strategies for people who self‐harm. There is little guidance for those offering therapy on the effective components of interventions for people who self‐harm. This was a systematic review aiming to identify the factors that contribute to positive experiences of therapy as described by people who have reduced or stopped self‐harm. The review followed PRISMA guidelines to locate and synthesize peer‐reviewed qualitative studies describing experiences of therapy among people who had reduced or stopped self‐harm. Study selection, data extraction, and quality assessment were peer reviewed and conducted for at least two researchers independently. Relevant first‐hand quotations were extracted from eligible studies and synthesized using a thematic analysis in collaboration with experts with personal and professional experience of self‐harm. Twenty‐three studies met eligibility criteria. Themes identified in the reported accounts were arranged under two meta‐themes. ‘Positive aspects of seeing a professional’ identified aspects of professional care that were common to all encounters: the value of sharing, space to talk and reflect, and the boundaries inherent in contact with a professional. ‘Positive attributes of individual professionals’ depended upon individual characteristics: the ability to build reciprocal trust by being non‐judgemental, showing genuine empathic concern, and being confident to talk about and respond directly to self‐harm. Our review indicates that therapeutic alliance is perceived as key to effective professional help for self‐harm, irrespective of underlying principles of therapy. All forms of therapy should be timely and reliable and centred around the needs of the individual and their experience of self‐harm.

Optimization of an mHealth lifestyle intervention for families with hereditary cancer syndromes: Study protocol for a multiphase optimization strategy feasibility study

BackgroundIndividuals at increased hereditary risk of cancer are an important target for health promotion and cancer prevention interventions. Health-4-Families uses the Multiphase Optimization STrategy (MOST) framework and is designed to pilot digital delivery strategies for a distance-based, 16-week intervention to promote weight management, healthy diet, and increased physical activity among individuals with BRCA1/BRCA2 or DNA mismatch repair (MMR) pathogenic germline variants. This communication describes participant recruitment and the design of the Health-4-Families pilot study. MethodsHealth-4-Families is a full-factorial (16 condition) randomized pilot study of four lifestyle intervention components: social networking, telephone or email coaching, text messaging, and self-monitoring. The primary outcome was feasibility and satisfaction with these study components. Participants with pathogenic germline variants were identified via clinic surveillance lists and advocacy organizations and were invited to participate with family members. All participants had to report meeting at least one of the following criteria: (1) having a BMI ≥ 25 kg/m2, (2) consuming <5 servings of fruit and vegetables per day, or (3) getting <150 min of moderate-to-vigorous intensity activity per week. ResultsThe majority of screened potential participants with pathogenic variants (83%) were eligible; 86% of those eligible provided informed consent and 79% (n = 104) completed baseline. A total of 206 family members were nominated by study participants and 49% (n = 102) completed baseline. DiscussionRecruitment data suggest that individuals with pathogenic germline variants, who are at increased risk for hereditary cancers, are motivated to participate in digital lifestyle interventions. This recruitment success highlights the importance of identifying and prioritizing effective and efficient intervention components for hereditary cancer families. We intend to use the outcomes of our pilot study to inform a fully-powered factorial study for this community.

Statistical Mediation Analysis for Models with a Binary Mediator and a Binary Outcome: the Differences Between Causal and Traditional Mediation Analysis

Mediation analysis is an important statistical method in prevention research, as it can be used to determine effective intervention components. Traditional mediation analysis defines direct and indirect effects in terms of linear regression coefficients. It is unclear how these traditional effects are estimated in settings with binary variables. An important recent methodological advancement in the mediation analysis literature is the development of the causal mediation analysis framework. Causal mediation analysis defines causal effects as the difference between two potential outcomes. These definitions can be applied to any mediation model to estimate natural direct and indirect effects, including models with binary variables and an exposure–mediator interaction. This paper aims to clarify the similarities and differences between the causal and traditional effect estimates for mediation models with a binary mediator and a binary outcome. Causal and traditional mediation analyses were applied to an empirical example to demonstrate these similarities and differences. Causal and traditional mediation analysis provided similar controlled direct effect estimates, but different estimates of the natural direct effects, natural indirect effects, and total effect. Traditional mediation analysis methods do not generalize well to mediation models with binary variables, while the natural effect definitions can be applied to any mediation model. Causal mediation analysis is therefore the preferred method for the analysis of mediation models with binary variables.

The effectiveness of e-health interventions for the treatment of overweight or obesity in children and adolescents: A systematic review and meta-analysis.

The aim of this systematic review and meta-analysis was to examine the effectiveness of e-health interventions for the treatment of children and adolescents with overweight or obesity. Databases were searched up to November 2020. Studies were randomized controlled trials where interventions were delivered via e-health (e.g., computers, tablets, and smartphones, but not phone calls). Studies should target the treatment of overweight or obesity in children or their agent of changes and report body mass index (BMI) or BMI z-score. A meta-analysis using a random-effects model was conducted. Nineteen studies met the inclusion criteria, and 60% were of high quality. The narrative review revealed variation in behavior change strategies and modes of delivery. The pooled mean reduction in BMI or BMI z-score showed evidence for a nonzero effect (standardized mean difference = -0.31, 95% confidence interval -0.49 to -0.13), with moderately high heterogeneity between studies (I2 = 74%, p < 0.001). Subgroup analysis revealed high heterogeneity in studies with a high or unclear risk of bias. E-health interventions can be effective in treating children and adolescents with overweight and obesity and should be considered by practitioners and policymakers. However, an understanding of the most effective and acceptable intervention components, long-term benefits, and sustainability should be further studied.

The effectiveness of weight loss and health promotion interventions for healthy adult women: A systematic review protocol

Introduction: Overweight and obesity is a global public health concern. In Australia, approximately 60% of women are categorised as being overweight or obese, and this rate has been growing steadily since 1995. Positive lifestyle behaviours such as regular participation in physical activity and healthy, well balanced dietary intake can assist with weight loss and weight management, however, many adult women fail to meet recommended guidelines for these behaviours. Currently many interventions have focussed on improving these weight and lifestyle behaviours amongst specific populations (e.g., pregnant or chronically diseased), however such interventions are not always transferrable to the general healthy adult female population. The aim of this review is to systematically collate and synthesise evidence on weight loss and lifestyle behaviour interventions targeting healthy adult women. Methods: This systematic review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Four electronic databases (CINAHL, Medline, CENTRAL, and SPORTDiscus) will be searched to identify potentially relevant studies. The reference lists of all studies included in this review will also be screened to identify further studies for inclusion. The eligibility criteria for inclusion will be studies that: sample adult women (aged 18-64 years), use a randomised controlled trial study design, have weight loss or other health related behaviours (e.g., physical activity, dietary intake) as primary outcomes, and are published in English. The search strategy will include terms (and synonyms) for: weight loss, physical activity, randomised controlled trials, and lifestyle behaviours. Data on participants, study duration, mode of recruitment, study design, and outcome measures will be extracted from the studies which have been selected for inclusion. If possible, results will also be pooled for meta-analyses. Discussion: This systematic review will provide information on the effectiveness of weight loss and health promotion programs for healthy adult women, along with the components of effective interventions, and strategies for successful recruitment. Consequently, the results will help inform the development and design of future gender-tailored weight loss and health promotion programs for women. Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.

How the LiveWell Dorset lifestyle behaviour change service influences older adults’ physical activity behaviour: A generic qualitative study

ObjectivesThere is uncertainty around the most effective characteristics and components of interventions to increase older adults' physical activity (PA) levels. This study aimed to explore how LiveWell Dorset (LWD), a lifestyle behaviour change support service based in Dorset, South-West England, influences older adults’ PA behaviour. Study designA qualitative study using a generic approach. MethodsSemi-structured telephone interviews were held with 12 individuals aged 55 to 65 who had accessed LWD's support to increase their PA levels, to gather their views and experiences of the service. A thematic analysis of the interview data was conducted using a hybrid approach that incorporated both inductive and deductive processes. Additionally, interview content was coded for behaviour change techniques using the Behaviour Change Technique Taxonomy version 1. ResultsA number of key factors were identified that highlighted how the LWD service influences older adults’ PA behaviour. These included using a broad range of promotional and behaviour change strategies to facilitate initial engagement, providing opportunities for service users to receive social support from both professionals and peers, and emphasising person-centredness and empathy in interactions with service users. ConclusionsThe findings provide valuable information regarding the needs and preferences of older adults when attempting to influence their PA behaviour, and on the reportedly helpful components of interventions that aim to do so. The findings also support the need for future research into previously highlighted topics of interest such as the roles of systemic and contextual factors and professional empathy on PA intervention engagement and outcomes.

Suicide Prevention Among College Students Before and During the COVID-19 Pandemic: Protocol for a Systematic Review and Meta-analysis.

BackgroundSuicide is the second leading cause of death for college-aged individuals worldwide and in the United States. Recent studies have identified preliminary evidence of widening disparities in suicidal behaviors across sex, sexual orientation, race/ethnicity, age, and socioeconomic status among college students. Few systematic reviews and meta-analyses offer a comprehensive understanding of on-campus and off-campus suicide interventions, nor is collated information available for different types of screening, assessment, treatment, and postvention plans. Further challenges have been identified since the COVID-19 pandemic, calling for cost-effective and innovative interventions to address increased rates of suicidal behaviors among college students facing unprecedented stressors.ObjectiveThis research protocol describes the first systematic review and meta-analysis to identify the most effective and cost-effective intervention components for universal and targeted (indicated and selected) suicide prevention among college students in a global context. Special attention will be placed on disparities in suicide prevention across sociodemographic subgroups, inclusive interventions beyond campus, global context, and intervention responses to the COVID-19 pandemic.MethodsA sensitive search strategy will be executed across MEDLINE (Ovid), EMBASE, PsycINFO (EBSCO), ERIC (EBSCO), Cochrane Library, Dissertations and Theses Global (ProQuest), Scopus, Global Index Medicus, SciELO, African Journals Online, Global Health (CABI), and Google Scholar. Data extraction and evaluation will be conducted by three independent researchers. Risk of bias will be assessed. A multilevel meta-regression model and subgroup analysis will be used to analyze the data and estimate effect sizes.ResultsThe initial search was completed in December 2020 and updated with additional other-language studies in March 2020. We expect the results to be submitted for publication in mid-2021.ConclusionsDespite increasing rates of suicidal behaviors among college students, few preventative efforts have targeted this population, and fewer focus on factors that might place specific demographic groups at heightened risk. The impact of COVID-19 on suicidal behaviors among college students highlights and exacerbates the urgent need for rapid and effective interventions that might differ from traditional approaches. This equity-focused study will address these gaps and provide a valuable analysis of the effectiveness of suicide prevention programs and interventions. Findings will inform clinicians, researchers, policy makers, families, and organizations about evidence-based interventions for reducing the gaps in the suicide crisis among college students from different sociodemographic groups.Trial RegistrationPROSPERO CRD42020225429; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225429International Registered Report Identifier (IRRID)DERR1-10.2196/26948