Effectiveness Of Improvement Interventions Research Articles

Effectiveness of Capacity-Building and Quality Improvement Interventions to Improve Day-of-Birth Care in Kinshasa, Democratic Republic of the Congo.

In sub-Saharan African settings like the Democratic Republic of the Congo, high-quality care during childbirth and the immediate postpartum period is lacking in public facilities, necessitating multipronged interventions to improve care. We used a pre-post design to examine the effectiveness of a low-dose, high-frequency capacity-building and quality improvement (QI) intervention to improve care for women and newborns around the day of birth in 16 health facilities in Kinshasa, Democratic Republic of the Congo. Effectiveness was assessed based on changes in provider skills, key health indicators, and beneficiary satisfaction. To assess changes in the competency of the 188 providers participating in the intervention, we conducted objective structured clinical examinations on care for mothers and newborns on the day of birth, immediate postpartum family planning (PPFP) counseling and method provision, and postabortion care before and after implementation of training and at 6 and 12 months after training. Interrupted time series (ITS) analysis techniques were used to analyze routine health service data for changes in select maternal, newborn, and postpartum outcomes before and after the intervention. To assess changes in clients' perceptions of care, 2 rounds of telephone surveys were administered. Before the intervention, less than 2% of participating providers demonstrated competency in skills. Immediately after training, more than 80% demonstrated competency, and 70% retained competency after 12 months. ITS analyses show the risk of early neonatal death declined significantly by 9% (95% confidence interval [CI]=4%, 13%, P<.001), and likelihood of immediate PPFP uptake increased significantly by 72% (95% CI=53%, 92%, P<.001). Client satisfaction improved by 58% over the life of the project. These findings build on previous studies documenting the effectiveness of clinical capacity-building and QI approaches. If implemented at scale, this approach has the potential to substantively contribute to improving maternal and perinatal health in similar settings.

Effectiveness and Experiences of Quality Improvement Interventions in Older Adult Care: Protocol for a Mixed Methods Systematic Review.

Quality improvement (QI) interventions are designed to resolve the recurring challenges of care for older individuals, such as working conditions for staff, roles of older individuals in their own care and their families, and relevant stakeholders. Therefore, there is a need to map the impacts of QI interventions in older adult care settings and further improve health and social care systems associated with older adults. This review aims to compile and synthesize the best available evidence regarding the effectiveness of policy and practice QI interventions in older adult care. The secondary aim is to understand the care of older individuals and QI intervention-related experiences and perspectives of stakeholders, care providers, older individuals, and their families. The mixed methods review will follow the standard methodology used by Joanna Briggs Institute. The published studies will be searched through CINAHL, MEDLINE, PsycINFO, ASSIA, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative analyses of patients undergoing older adult care and any health and care professionals involved in the care delivery for older adults; a broad range of QI interventions, including assistive technologies, effects of training and education, improved reporting, safety programs, and medical devices; the experiences and perspectives of staff and patients; the context of older adult care setting; and a broad range of outcomes, including patient safety. The standard procedure for reporting, that is, PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, will be followed. A result-based convergent synthesis design will be used in which both quantitative and qualitative studies will be analyzed separately, and the results of both syntheses will be then integrated during a final (convergent) synthesis. The integration will compare the findings of quantitative and qualitative evidence using tables in light of the results of both syntheses. This comprehensive review is expected to reflect on the insights into some QI interventions and their impact, outline some common challenges of quality for older adult care, and benefit both the practical usefulness of care service activities and the society at large. PRR1-10.2196/56346.

Community Engagement in Implementation Science: the Impact of Community Engagement Activities in the DECIPHeR Alliance.

The translation of evidence-based interventions into practice settings remains challenging. Implementation science aims to bridge the evidence-to-practice gap by understanding multilevel contexts and tailoring evidence-based interventions accordingly. Engaging community partners who possess timely, local knowledge is crucial for this process to be successful. The Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) Alliance aims to address cardiopulmonary health disparities by engaging diverse community partners to improve the implementation of evidence-based interventions. The goal of the Community Engagement Subcommittee is to strengthen community engagement practice across DECIPHeR. This paper presents the subcommittee's "Why We Engage Communities" statement that outlines why community engagement is critical for implementation science. The paper also provides case examples of DECIPHeR community engagement activities. To develop the "Why We Engage Communities" statement, we conducted a literature review, surveyed subcommittee members to assess the importance of community engagement in their work, and integrated community partner feedback. We synthesize the findings into three key themes and present examples of community engagement activities and their impact across DECIPHeR projects. The statement presents three themes that illustrate why community engagement increases the impact of implementation and health equity research. Community engagement (1) engages local knowledge and expertise, (2) promotes authentic relationships, and (3) builds community and researcher capacity. The statement provides a guiding framework for strengthening DECIPHeR research and enhancing community partnerships. Community engagement can improve the implementation of evidence-based interventions across diverse settings, improving intervention effectiveness in underserved communities and furthering health equity.

Making Community Connections for Minority Outreach in Alzheimer’s Disease

AbstractBackgroundRecognizing the gap in communication that exists between minority populations and Alzheimer’s disease (AD)research community, education and outreach are a critical step in the effort to understand and address disparities. African‐Americans (AA) and Hispanics, are significantly more likely to have Alzheimer’s disease and related dementia (ADRD) as compared to non‐Hispanic Whites. In addition to biological risk, widespread and significant misperceptions about aging process, diagnosis and clinical management influence the way in which AD/ADRD is recognized and subsequently treated in minority populationsMethodAn Alzheimer’s’ Community Engagement ‐Empower Minorities (ACE‐EM) center is proposed as an addition to existing research programs at Delaware State University (DSU). As a Historically‐Black university DSU is uniquely positioned to coordinate Alzheimer’s outreach programs in minority communities of interest. Organizations with strong ties to minority populations improve intervention effectiveness and increase impact. ACE‐EM plans to foster education and training of DSU students under the guiding framework of the Alzheimer’s disease Public Health Curriculum to develop community trusted dementia advocates – an investment for a competent future public health workforce. We recognize the importance of having conversations with family and community members about aging, AD/ADRD and how we can work together to reduce the risks of Alzheimer’s disease for future generations as outlined in the CDC Healthy Brain Initiative Road Map (2018‐2023).ResultCenter will provide a hub for scientific and community exchange for research dissemination specific to cognitive health and AD/ADRD among minorities and 2) engage community members, their families, and partners through culturally targeted and linguistically appropriate education, training, and measurements. Preliminary targeted outreach efforts and data collection in process.ConclusionTo build empowered communities with increased awareness and understanding of cognitive health, through a range of community‐informed and community‐engaged dissemination activities.

Feasibility and Acceptability of the Project Faith Influencing Transformation Intervention in Faith-Based Settings.

African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings.

Applying after-action reviews to child and family teams to improve mental health service linkage within child welfare services: a study protocol

BackgroundHalf of child-welfare-involved children and adolescents meet the criteria for at least one mental health diagnosis. This project proposes to improve successful mental health service linkage in child welfare services (CWS) by adapting and testing the after-action review (AAR) team effectiveness intervention to augment the child and family team (CFT) services’ intervention. Despite being both required and a collaborative approach to service planning, CFT meetings are implemented with questionable fidelity and consistency, rarely including the voice of children and families as intended.MethodsUsing a parallel group trial design, with non-equivalent comparison groups, and qualitative and quantitative methodology, this study will tailor and assess the impact of the AAR on enhancing CFT outcomes. The authors will conduct a qualitative needs assessment targeting the ongoing implementation of the CFT services intervention in a large, publicly funded, CWS system. A qualitative inquiry consisting of interviews and focus groups with key stakeholders will result in the preparation of an action plan to address identified gaps between the current and desired CFT services intervention outcomes. The AAR implementation strategy will be adapted and tailored to address the CFT services’ intervention needs. To test the effectiveness of the AAR on improving outcomes associated with the CFT services intervention, we will utilize blocked randomization of four CWS caseworkers from two CWS system regions to either the intervention condition (CFT + AAR) or standard implementation (CFT as usual). The authors will collect data from the CWS caseworkers and additional CFT members via web-based surveys. Mechanisms of the AAR team effectiveness intervention for CFT implementation will be assessed.DiscussionBy inclusion of child and family voice, the AAR-enhanced CFT should lead to increased fidelity to the CFT intervention and greater levels of parental satisfaction with the service and shared decision-making, thus resulting in enhanced follow-through with service plans and linkage to mental health treatment services for children. The knowledge gained by this randomized clinical trial has the potential to benefit service delivery and integration for CWS leaders, caseworkers, formal and informal CFT member support persons, parents/caregivers, and children with open cases. Improving intervention effectiveness, both at the system and family levels, is crucial for practice efficiencies and improved child and family outcomes.Trial registrationNCT05629013. Approval date: November 28, 2022 (version 1).Trial sponsorUniversity of California, San Diego.Responsible partyDanielle Fettes.

Quality improvement interventions to prevent the use of hospital services among nursing home residents: protocol for a systematic review and meta-analysis

IntroductionQuality improvement interventions are a promising strategy for reducing hospital services use among nursing home residents. However, evidence for their effectiveness is limited. It is unclear which characteristics of the...

Including Community Partners in the Development and Adaptation of Intervention Strategies to Prevent Initiation or Escalation of Opioid Misuse.

Current literature lacks clear examples of how to engage with communities in the development of opioid misuse interventions for diverse populations and across various settings. The National Institutes of Health (NIH) Helping to End Addiction Long-term® Initiative (HEAL) Prevention Cooperative (HPC) research projects work collaboratively with communities to develop and adapt their opioid misuse interventions to increase both feasibility and sustainability. Ten HPC projects were selected to receive NIH funding and are required to have partnerships with communities where their intervention is being conducted. This paper applies the Centers for Disease Control and Prevention (CDC)-adapted Public Participation Framework to examine the levels of community engagement used by each of these 10 HPC projects (Clinical and Translational Science Awards Consortium Community Engagement Key Function Committee Task Force on the Principles of Community Engagement, 2015). Using this framework, this paper illustrates the range of community engagement approaches and levels that the HPC projects rely on to develop, adapt, and adopt opioid prevention interventions across diverse populations and settings. This paper also lays a foundation for future examinations of the role of community engagement in intervention implementation and effectiveness and the level of community engagement that is necessary to improve intervention effectiveness.

Discrimination and adherence in a cross-sectional study of Latino sexual minority men with HIV: Coping with discrimination as a mediator and coping self-efficacy as a moderator.

Discrimination is associated with antiretroviral therapy non-adherence and reduced well-being among people with HIV. We examined the potential for coping to mediate the associations between intersectional discrimination and non-adherence and coping self-efficacy (confidence in one's ability to cope with discrimination) as a moderator that may buffer the negative effects of discrimination on non-adherence in a cross-sectional convenience sample of 82 Latino sexual minority men with HIV. In bivariate linear regressions, discrimination targeting Latino ethnic origin, undocumented residency status, and sexual orientation were each significantly associated with lower self-reported antiretroviral therapy non-adherence (percentage of prescribed doses taken in the last month) and greater use of disengagement coping (denial, substance use, venting, self-blame, behavioral disengagement). Associations between discrimination targeting Latino ethnicity and non-adherence, and discrimination targeting undocumented residency status and non-adherence, were each mediated by disengagement coping responses. Moderation analyses highlighted significant discrimination by coping self-efficacy interaction effects-both coping self-efficacy for problem solving and stopping unpleasant emotions/thoughts each moderated the associations between Latino discrimination and adherence, between undocumented residency status discrimination and adherence, and between HIV discrimination and adherence. Coping self-efficacy for getting social support moderated the association between undocumented residency status discrimination and adherence. Further, the interaction coefficients across models indicated that the negative effects of discrimination on adherence were attenuated at higher levels of coping self-efficacy. Findings highlight the need for structural interventions that reduce-and ultimately eliminate-discrimination, and interventions that address the harmful effects of discrimination and adherence improvement interventions to enhance coping skills among people faced with intersectional discrimination.

Effect of positive emotion intervention during late pregnancy on improving colostrum secretion: a randomised control trial protocol

IntroductionThough evidence has revealed the beneficial effects of cognitive improvement interventions on breastfeeding, the effect of psychological interventions has rarely been studied. This study aims to test whether promoting a...

The prevalence and determinant of overweight and obesity among residents aged 40–69 years in high-risk regions for upper gastrointestinal cancer in southeast China

Being overweight or obese is one of the public health concerns worldwide, and its prevalence is gradually increasing. Obesity has been proven to be associated with some cancers, including upper gastrointestinal cancer (UGC). However, studies on the prevalence of obesity among residents of areas at high risk of UGC in China are minimal. The aim of this study is to assess the prevalence of obesity and its influencing factors among people aged 40–69 years (high-risk population) in high-risk areas for UGC in Jiangsu Province, southeast China. This cross-sectional study involved 45,036 subjects aged 40–69 years identified in the Rural Early Diagnosis and Treatment of UGC Project database in Jiangsu Province from 2017 to 2021. Differences in prevalence across gender and age were assessed using the Chi-square test. Using a multinomial logistic regression model, we examined independent risk factors for overweight/obesity and their gender and age differences. The prevalence of overweight, obesity, and overweight/obesity varied based on the standards used: Chinese standard (42.1%, 11.9%, and 54.0%) and WHO standard (34.7%, 4.7%, and 39.4%), respectively. Being overweight was more common in men than women, while obesity was more common in women than men. Age of 50–59 years, married, household size of 7–9, drinking, soy products, pickled food, and hot food intake were positively associated with overweight/obesity. Females, 60–69 years, higher education level, household size of 4–6, annual family income of more than 60,000 CNY, smoking, and fresh fruit intake were negatively associated with overweight/obesity. Stratified analysis showed that the effects of age, education and meat, egg and dairy products on overweight/obesity were different across gender. The impact of fresh fruit and vegetables on overweight/obesity was also heterogeneous between the younger (40–59 years) and older (60–69 years) groups. In conclusion, the prevalence of overweight and obesity is high among adults aged 40–69 years from high-risk areas for UGC of Jiangsu Province, southeast China. Independent influencing factors of being overweight/obese included gender, age, marital status, education, household size, annual family income, smoking, drinking, fresh fruit, soy products, pickled food and hot food intake, and may vary by gender and age. Screening-based interventions should be considered to control obesity levels among screened participants. Besides, heterogeneity of influencing factors across subgroups could be focused on to improve intervention effectiveness.

A qualitative exploration of participants’ preferred elements of the 4-week, youth-led, youth-focused, group-based Shamiri intervention: A brief overview

Introduction: Adolescent mental health challenges have been identified as a public health concern globally, especially in low- and middle-income countries (LMICs), due to the scarcity of services, where help-seeking is often hampered by social stigma. A strategy to increase the availability of services is to implement, brief, stigma-free, and scalable interventions. The Shamiri Intervention (the Kiswahili word for “thrive”) is an example of a 4-week, group-based intervention which is implemented via 1-hour sessions within high school settings. Purpose: The present study employed qualitative methods to explore participant feedback on their preferred elements of Shamiri Intervention. The aim is to use the feedback to help to guide and improve intervention effectiveness, acceptability, and appropriateness. The results have the potential to understand better lay-provided mental health service delivery and design among high school students in LMICs, particularly in sub-Saharan Africa. Methodology: The project employed a qualitative phenomenological design to collect participant feedback, and reflective thematic analysis was used to analyze the data. Results: The researchers constructed the following themes to summarize the participants’ responses: learning (acquiring new knowledge related to the core components of the Shamiri Intervention, i.e., growth mindset, values affirmation, and gratitude); rewards (e.g., prizes award that encouraged participation); positive interaction (i.e., the peer-lead delivery); and solutions-oriented (e.g., the practicality of the Shamiri Intervention). Conclusion: The preferred components of the Shamiri Intervention were learning, rewards for participation, positive interactions with other people, and the solution-oriented nature of the sessions. The mentioning of the features of the Shamiri Intervention could also suggest that, indeed, they are appropriate for the target population. Additionally, the support for the lay providers is critical in Shamiri intervention cost-effectiveness, accessibility, and scalability

Patient-centered care and geriatric knowledge translation among healthcare providers in Vietnam: translation and validation of the patient-centered care measure

BackgroundPeople are living longer, and the majority of aging people reside in low- and middle-income countries (LMICs). However, inappropriate healthcare contributes to health disparities between populations of aging people and leads to care dependency and social isolation. Tools to assess and evaluate the effectiveness of quality improvement interventions for geriatric care in LMICs are limited. The aim of this study was to provide a validated and culturally relevant instrument to assess patient-centered care in Vietnam, where the population of aging people is growing rapidly.MethodsThe Patient-Centered Care (PCC) measure was translated from English to Vietnamese using forward-backward method. The PCC measure grouped activities into sub-domains of holistic, collaborative, and responsive care. A bilingual expert panel rated the cross-cultural relevance and translation equivalence of the instrument. We calculated Content Validity Indexing (CVI) scores at both the item (I-CVI) and scale (S-CVI/Ave) levels to evaluate the relevance of the Vietnamese PCC (VPCC) measure to geriatric care in the Vietnamese context. We piloted the translated instrument VPCC measure with 112 healthcare providers in Hanoi, Vietnam. Multiple logistic regression models were specified to test the a priori null hypothesis that geriatric knowledge is not different among healthcare providers with perception of high implementation compared with low implementation of PCC measures.ResultsOn the item level, all 20 questions had excellent validity ratings. The VPCC had excellent content validity (S-CVI/Ave of 0.96) and translation equivalence (TS- CVI/Ave of 0.94). In the pilot study, the highest-rated PCC elements were the holistic provision of information and collaborative care, while the lowest-rated elements were the holistic attendance to patients’ needs and responsive care. Attention to the psychosocial needs of aging people and poor coordination of care within and beyond the health system were the lowest-rated PCC activities. After controlling for healthcare provider characteristics, the odds of the perception of high implementation of collaborative care were increased by 21% for each increase in geriatric knowledge score. We fail to reject the null hypotheses for holistic care, responsive care and PCC.ConclusionThe VPCC is a validated instrument that may be utilized to systemically evaluate the practice of patient-centered geriatric care in Vietnam.

Algorithm development to improve intervention effectiveness for parents with mental health signs and symptoms.

In this study we aimed to describe and compare groups formed by a rules-based algorithm to prospectively identify clients at risk of poor outcomes in order to guide tailored public health nursing (PHN) intervention approaches. Data-driven methods using standardized Omaha System PHN documentation. Clients ages 13-40 who received PHN home visiting services for both the Caretaking/parenting and Mental health problems (N=4109). We applied a theory-based algorithm consisting of six rules using existing Omaha System data. We examined the groups formed by the algorithm using standard descriptive, inferential statistics, and Latent Class Analysis. Clients (N=4109) were 25.1 (SD=5.9) years old and had an average of 7.3 (SD=3.2) problems, 250 (SD=319) total interventions, and 32 (SD=44) Mental health interventions. Overall outcomes improved after PHN interventions (p<.001 for all) and having more Mental health signs/symptoms was negatively associated with outcome scores (p<.001 for all). This algorithm may be helpful in identifying high-risk clients during a baseline assessment who may benefit from more intensive mental health interventions. Findings show there is value using the Omaha System for PHN documentation and algorithm clinical decision support development. Future research should focus on algorithm implementation in PHN clinical practice.

The relationship between trait emotional intelligence and disordered eating as mediated by body dissatisfaction and body image inflexibility

This study aimed to explore the relationship between trait emotional intelligence and disordered eating by proposing and testing the mediating roles of body dissatisfaction and body image inflexibility. A total of 500 Chinese adults (48.8 % women) completed questionnaires for assessing trait emotional intelligence, body dissatisfaction, body image inflexibility, and disordered eating. Correlation analyses were conducted to evaluate the relationships between the study variables. Mediation analysis was performed to examine the mediating roles of body dissatisfaction and body image inflexibility in the relationship between trait emotional intelligence and disordered eating. Multi-group analysis was further conducted to assess the invariance of the mediation model across men and women. Correlation analyses revealed significant bivariate relationships among the four study variables. In both men and women, the relationship between trait emotional intelligence and disordered eating was fully mediated by body dissatisfaction and body image inflexibility. Multi-group invariance analysis showed that this mediation model was invariant across men and women. The findings shed light on the potential mechanisms in the relationship between trait emotional intelligence and disordered eating. In developing interventions for reducing disordered eating, the findings of the current study may be considered to improve intervention effectiveness.

The Cloud-to-Edge-to-IoT Continuum as an Enabler for Search and Rescue Operations

When a natural or human disaster occurs, time is critical and often of vital importance. Data from the incident area containing the information to guide search and rescue (SAR) operations and improve intervention effectiveness should be collected as quickly as possible and with the highest accuracy possible. Nowadays, rescuers are assisted by different robots able to fly, climb or crawl, and with different sensors and wireless communication means. However, the heterogeneity of devices and data together with the strong low-delay requirements cause these technologies not yet to be used at their highest potential. Cloud and Edge technologies have shown the capability to offer support to the Internet of Things (IoT), complementing it with additional resources and functionalities. Nonetheless, building a continuum from the IoT to the edge and to the cloud is still an open challenge. SAR operations would benefit strongly from such a continuum. Distributed applications and advanced resource orchestration solutions over the continuum in combination with proper software stacks reaching out to the edge of the network may enhance the response time and effective intervention for SAR operation. The challenges for SAR operations, the technologies, and solutions for the cloud-to-edge-to-IoT continuum will be discussed in this paper.

Quality improvement interventions to prevent unplanned extubations in pediatric critical care: a systematic review

BackgroundAn unplanned extubation is the uncontrolled and accidental removal of a breathing tube and is an important quality indicator in pediatric critical care. The objective of this review was to comprehensively synthesize literature published on quality improvement (QI) practices implemented to reduce the rate of unplanned extubations in critically ill children.MethodsWe included original, primary research on quality improvement interventions to reduce the rate of unplanned extubations in pediatric critical care. A search was conducted in MEDLINE (Ovid), Embase, and CINAHL from inception through April 29, 2021. Two reviewers independently screened citations in duplicate using pre-determined eligibility criteria. Data from included studies were abstracted using a tool created by the authors, and QI interventions were categorized using the Behavior Change Wheel. Vote counting based on the direct of effect was used to describe the effectiveness of quality improvement interventions. Study quality was assessed using the Quality Improvement Minimum Quality Criteria Set (QI-MQCS). Results were presented as descriptive statistics and narrative syntheses.ResultsThirteen studies were included in the final review. Eleven described primary QI projects; two were sustainability studies that followed up on previously described QI interventions. Under half of the included studies were rated as high-quality. The median number of QI interventions described by each study was 5 [IQR 4–5], with a focus on guidelines, environmental restructuring, education, training, and communication. Ten studies reported decreased unplanned extubation rates after the QI intervention; of these, seven had statistically significant reductions. Both sustainability studies observed increased rates that were not statistically significant.ConclusionsThis review provides a comprehensive synthesis of QI interventions to reduce unplanned extubation. With only half the studies achieving a high-quality rating, there is room for improvement when conducting and reporting research in this area. Findings from this review can be used to support clinical recommendations to prevent unplanned extubations, and support patient safety in pediatric critical care.Systematic review registrationThis review was registered on PROSPERO (CRD42021252233) prior to data extraction.

Development and psychometric evaluation of the High-Risk Pregnancy Well-Being Index in Mashhad: a methodological study

BackgroundAssessment of well-being in high-risk pregnancy (HRP) is the key to achieve positive maternal and fetal outcomes. Although there are a wide range of instruments for well-being assessment, none of them is comprehensive for well-being assessment in HRP. The present study aimed at the development and psychometric evaluation of the High-Risk Pregnancy Well-Being Index (HRPWBI).MethodsThis methodological study was conducted using the Waltz’s four-step method. The dimensions of well-being in HRP were determined based on a conceptual model and the blueprint and the item pool of HRPWBI were developed. Then, the face and the content validity were assessed and item analysis was performed. Construct validity was also assessed through exploratory factor analysis with principal component analysis on the data obtained from 376 women with HRP in Mashhad, Iran. Finally, internal consistency, test–retest stability, sensitivity, and interpretability of HRPWBI were assessed.ResultsThe scale- content validity index (SCVI) of HRPWBI was 0.91. In factor analysis, 33 items were loaded on seven factors which explained 53.77% of the total variance. Internal consistency, relative stability, absolute stability, sensitivity, and interpretability of HRPWBI were confirmed with a Cronbach’s alpha of 0.84, a test–retest intraclass correlation coefficient of 0.97, a standard error of measurement of 0.92, a minimal detectable change of 8.09, and a minimal important change of 2.92, respectively.ConclusionHRPWBI is a valid and reliable instrument for well-being assessment among women with HRP. It can be used to assess well-being and the effects of well-being improvement interventions on well-being among women with HRP.

Does matching a personally tailored physical activity intervention to participants' learning style improve intervention effectiveness and engagement?

This study aims to compare the effectiveness, engagement, usability, and acceptability of a web-based, computer-tailored physical activity intervention (provided as video or text) between participants who were matched or mismatched to their self-reported learning style (visual and auditory delivery through video or text-based information). Generalised linear mixed models were conducted to compare time (baseline, 3 months) by group (matched, mismatched) on ActiGraph-GT3X+measured moderate-to-vigorous physical activity (MVPA) and steps. Generalised linear models were used to compare group (matched and mismatched) on session completion, time-on-site, usability, and acceptability. MVPA and steps improved from baseline to 3-months, however this did not differ between participants whose learning styles were matched or mismatched to the intervention they received. Session completion, time-on-site, usability, and acceptability did not differ between matched and mismatched participants. Therefore, aligning intervention delivery format to learning style is unlikely to influence intervention effectiveness or engagement.

Changes in children's self-perceived physical fitness: results from a Physical Education internet-based intervention in COVID-19 school lockdown.

BackgroundChildren have a higher chance of decreasing health-related physical fitness during periods of school lockdown due to pandemic situations such as with COVID-19 disease.AimsTo establish the changes in children’s self-perceived physical fitness (SPPF) during pandemic COVID-19 social distancing in a school lockdown and to describe the individual prevalence of changes in SPPF according to sex.MethodsIt is an intervention study with a convenient sample, 67 children (6–13 years old; 50.7% girls). An intervention occurred according to the Brazilian Base Nacional Comum Curricular (BNCC) and the State Education Secretary orientations for remote Physical Education classes. SPPF was evaluated through a questionnaire (QAPA). Generalized estimative equations (GEE) and the prevalence of changes in individual score delta (Δ) from baseline to follow-up determined the effects.ResultsPositive individual changes in SPPF were observed for 21.2% of girls and 26.4% of boys. Older children presented fewer SPPF total points. There was no interaction between the evaluation period, sex, and age. However, higher baseline SPPF values presented a negative association with the individual SPPF variation (β = − 2.52%; CI 95% − 3.97 to − 1.07; p = 0.001).ConclusionA remote Physical Education intervention effectively maintained or even increased individual results of children’s SPPF. Thereby, this study suggests that this kind of initiative should be retained for the duration of social distancing and pandemic conditions to help children maintain an active lifestyle and, consequently, achieve health benefits. Improving intervention effectiveness by focusing on girls seems to be a challenge in this matter.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11332-022-00897-1.