Effectiveness Of Interventions For Adults Research Articles

Supplemental Material for Evaluating the Effectiveness of Compensatory Memory Interventions in Adults With Acquired Brain Injury: A Systematic Review and Meta-Analysis of Memory and Everyday Outcomes

Supplemental Material for Evaluating the Effectiveness of Compensatory Memory Interventions in Adults With Acquired Brain Injury: A Systematic Review and Meta-Analysis of Memory and Everyday Outcomes

Comparing the effectiveness of behavioral interventions in adults with co-occurring tobacco and substance use disorders: a systematic review of literature

ABSTRACTThis systematic literature review compares the effectiveness of various behavioral interventions delivered to persons with co-occurring tobacco and substance use disorders. It examines findings of six randomized trials and three secondary analyses from randomized trials. Based on the findings of this literature review, support is given to the following: (1) The consequences of tobacco use and smoking are deadly, costly, and can have an inhibitory effect on the progress of people in substance abuse treatment, (2) tobacco cessation options are a preventive intervention that can be easily incorporated into a treatment facility’s standard of practice and should be made available within the context of all substance abuse treatment facilities, and (3) concurrently treating tobacco use disorder and substance use disorder(s) is an effort that will help meet the social work profession’s Grand Challenge to ‘Close the Health Gap.’

Overweight and obesity: Effectiveness of interventions in adults

ObjectiveTo identify the most effective interventions in overweight and obese adults. MethodA narrative review through a search of the literature in databases PubMed, Cochrane, Joanna Briggs Institute, EMBASE, Cuiden y Cinahl with free and controlled language (MeSH terms) using Boolean operators AND and NOT. The research was limited to articles published between 2007 and 2015. Eighteen articles were selected based on the established inclusion and exclusion criteria. ResultsDifferent types of interventions were identified based on the modification of lifestyles, mainly diet, physical activity and behaviour. Major differences were found in specific content, degree of intensity of interventions, time tracking and elements evaluated. Most of studies found statistically significant weight loss but this was limited in terms of weight and number of people. Web-based interventions have no uniform effect on weight loss but achieve similar levels to face-to-face interventions in maintaining weight loss. ConclusionsThe combination of personalised diet, exercise and cognitive behavioural therapy is the most effective form of intervention in overweight and obesity. There is insufficient data to indicate whether group or individual interventions are more effective. Online intervention allows greater accessibility and lower cost.

Overweight and obesity: effectiveness of interventions in adults.

To identify the most effective interventions in overweight and obese adults. A narrative review through a search of the literature in databases PubMed, Cochrane, Joanna Briggs Institute, EMBASE, Cuiden y Cinahl with free and controlled language (MeSH terms) using Boolean operators AND and NOT. The research was limited to articles published between 2007 and 2015. Eighteen articles were selected based on the established inclusion and exclusion criteria. Different types of interventions were identified based on the modification of lifestyles, mainly diet, physical activity and behavior. Major differences were found in specific content, degree of intensity of interventions, time tracking and elements evaluated. Most of studies found statistically significant weight loss but this was limited in terms of weight and number of people. Web-based interventions have no uniform effect on weight loss but achieve similar levels to face-to-face interventions in maintaining weight loss. The combination of personalised diet, exercise and cognitive behavioural therapy is the most effective form of intervention in overweight and obesity. There is insufficient data to indicate whether group or individual interventions are more effective. Online intervention allows greater accessibility and lower cost.

Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis.

There is a lack of available evidence in relation to the effectiveness of interventions for adults with mild to moderate intellectual disability and mental health problems. To evaluate the efficacy of interventions for adults with mild to moderate intellectual disabilities and co-occurring mental health problems. An electronic literature search of the databases Medline, EMBASE, PsycINFO and EBM Reviews aimed at identifying randomised controlled trials (RCTs) and controlled trials testing any type of intervention (psychotherapy, biological or system level) for people with mild to moderate intellectual disabilities (IQ score 35-69) targeting comorbid mental health problems. Additionally a meta-analysis was conducted. Twelve studies met the inclusion criteria. No significant effect was found for the predefined outcome domains behavioural problems, depression, anxiety, quality of life and functioning. The effect size for depression (d = 0.49) was moderate but non-significant. Quality of studies was moderate and heterogeneity was high. There is no compelling evidence supporting interventions aiming at improving mental health problems in people with mild to moderate intellectual disability. The number of available trials is too low for definite conclusions. Some interventions are promising and should be evaluated further in larger and more rigorous trials.

Walk Well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol.

BackgroundWalking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness.Methods/designThis study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme.A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change.DiscussionSince there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities.Trial registrationISRCTN: ISRCTN50494254

A systematic review of the effectiveness of weight management interventions in adults with learning disabilities

Background: The increased prevalence of overweight and obesity in adults with a learning disability (LD) was highlighted by the Disability Rights Commission report (DRC 2006) as causing significant health risk and major health problems. The report called urgently for the development of evidence-based guidelines of effective weight loss methods for this target group, NICE (2006) guidelines similarly require clinicians working in weight management to promote interventions that are effective and evidence-based. Despite one review no systematic reviews in this area existed, thus the aim of this research was to systematically review current literature on weight management interventions for adults with LD to identify effective interventions. Method: A comprehensive, systematic search of the literature was conducted (via Academic Search Complete, AMED, CINAHL, Cochrane, Medline, PsycINFO and SCOPUS's electronic bibliographic databases) using key terms, and supplemented with hand searching of key journals, references and citations. Inclusion and exclusion criteria were applied to studies identified. Studies were included if they examined one or more weight management interventions recommended by NICE (2006): diet, physical activity, behavioural interventions, anti-obesity medication or bariatric surgery, in adults with a LD. Exclusion criteria were a mixed population, weight loss not reported and diagnosis of Prader-Willi Syndrome. The literature was assessed for quality using the validated Critical Appraisal Skills Programme tools (Public Health Resource Unit 2006) and the data synthesised for evaluation. Results: A total of 11 studies were identified: six quasi-experimental trials and five pre-experimental studies, no studies of anti-obesity medication or bariatric surgery were found. Weight loss was modest across all types of interventions; only one study showed clinically significant weight loss of 5–10% but had poor external validity and thus was not able to be generalised to the wider LD population; one study provided low level evidence for weight maintenance however did not demonstrate clinically significant weight loss. The overall quality of evidence reviewed was judged to be poor. Discussion: With the exception of one study, findings indicated modest, clinically insignificant weight loss which falls short of weight loss achieved by the general population using the same interventions, suggesting further adaptation to the programmes may be needed. However, the research reviewed has major methodological flaws relating to the research design, absence of randomisation, limited use of control groups, studies which are underpowered and insufficient long-term follow-up. Future research should take account of these flaws and also give greater consideration to the heterogeneity of this population with regards to inclusion criteria and analysis in order to draw out more useful conclusions for practice. Conclusion: There was insufficient evidence to support the effectiveness of currently recommended interventions for weight loss and weight maintenance in adults with LD and a need for further high quality research to inform clinical practice and decision-making in this area, thereby improving the long term health and well-being of this population.

Interventions for the treatment of Morton's neuroma.

Morton's neuroma is a common, paroxysmal neuralgia affecting the web spaces of the toes, typically the third. The pain is often so debilitating that patients become anxious about walking or even putting their foot to the ground. Insoles, corticosteroid injections, excision of the nerve, transposition of the nerve and neurolysis of the nerve are commonly used treatments. Their effectiveness is poorly understood. To examine the evidence from randomised controlled trials concerning the effectiveness of interventions in adults with Morton's neuroma. We searched the Cochrane Neuromuscular Disease Group trials register (searched January 2003), MEDLINE (January 1966 to January Week 2 2003), EMBASE (January 1980 to February Week 2 2003), and CINAHL (January 1982 to February Week 1 2003). Randomised or quasi-randomised (methods of allocating participants to an intervention which were not strictly random e.g. date of birth, hospital record, number alternation) controlled trials of interventions for Morton's neuroma were selected. Studies where participants were not randomised into intervention groups were excluded. Two reviewers selected trials for inclusion in the review, assessed their methodological quality and extracted data independently. Three trials involving 121 people were included. There is, at most, a very limited indication that transposition of the transected plantar digital nerve may yield better results than standard resection of the nerve in the long term. There is no evidence to support the use of supinatory insoles. There are, at best, very limited indications to suggest that dorsal incisions for resection of the plantar digital nerve may result in less symptomatic post-operative scars when compared to plantar excision of the nerve. There is insufficient evidence with which to assess the effectiveness of surgical and non-surgical interventions for Morton's neuroma. Well designed trials are needed to begin to establish an evidence base for the treatment of Morton's neuroma pain.