Effectiveness Of Interventions Research Articles

Gut Microbiome Changes among Undernutrition and Stunting Infants and Children under 2 Years: A Scoping Review

Background Undernutrition and stunting are significant public health concerns globally, particularly in low- and middle-income countries. Nutritional intervention is the cornerstone of the management and prevention of these conditions. However, the gut microbiome has recently emerged as an essential modulator of the effects of nutritional interventions in undernutrition and stunting. This scoping review aims to examine the impact of nutrition intake (including if there is any intervention) over time on gut microbiome changes in infants and children under the age of 2 who experience undernutrition and stunting. Methods A literature search was conducted in PubMed and Cochrane Library, including studies from 2013 to 2023, using terms related to malnutrition, stunting, failure to thrive, and gut microbiome. Inclusion criteria were applied to select eligible studies for review. Five studies were chosen to be included in this review. Results The findings indicate that nutrition intake over time, including dietary supplementation and prebiotics, can influence the gut microbiome composition, diversity, and functionality in undernutrition and stunting infants and children. These may promote the growth of beneficial bacteria while reducing the abundance of harmful pathogens. Moreover, improvements in nutritional status, growth parameters, and immune function were observed in association with positive changes in the gut microbiota. Conclusion Nutrition intake can positively modulate the gut microbiome in undernutrition and stunting infants by supporting the growth of beneficial gut bacteria such as Actinobacteria, Bacteroides, Streptococcus, Bifidobacterium, Prevotella sp, and other bacterial taxa that vary with age, ultimately contributing to enhanced growth and development outcomes. Further studies are needed to better understand the mechanisms underlying these effects and to develop targeted nutritional interventions that optimize the gut microbiome in undernutrition and stunting infants and children under 2 years.

The effectiveness of an exergame intervention for college students with subthreshold depression: protocol for a mixed methods study.

Subthreshold depression (StD) is a condition that significantly influences the mental health and quality of life of college students and increases the risk of developing major depressive disorder (MDD). Exercise therapy has been found to be effective, but may not be enjoyable for everyone. exergames, as a form of exercise therapy, address the limitations of traditional exercise by incorporating gaming elements to make physical activity more entertaining and interactive. Currently, the Nintendo Switch is one of the most widely used exergame devices. To explore the effectiveness of a Nintendo Switch-based exergame intervention on college students with StD compared to a control group, and to analyze their perceptions of the program. This study will employ an explanatory sequential design, starting with a quantitative evaluation using a randomized controlled trial (RCT), followed by a supplementary qualitative study. College students identified as having StD will be randomly allocated in a 1:1 ratio into the exergame intervention group (EIG) or the control group (CG). College students in the EIG will participate in a Nintendo Switch-based exergame program for 8 weeks, with 2-3 sessions per week, lasting 50-60 min each. Participant outcomes in both conditions will be assessed at pre-intervention (T0, week 0), post-intervention (T1, week 8), 1 month after the intervention (T2, week 12), and 2 months after the intervention (T3, week 16), and a generalized linear mixed model will be used for analysis. In the qualitative part of this study, interviews will be conducted with college students with StD from the EIG at T1 to explore their experiences of receiving the intervention, and content analysis will be applied to the data collected. Nintendo provides a user-friendly platform for college students with StD to engage in electronic gaming. Limited research has explored the mental health outcomes of interventions using this type of technology in young people with StD. If the exergame program proves to be effective, it could offer a convenient and feasible intervention for further enhancing the psychological well-being of college students. This study was registered in the Chinese Clinical Trial Registry (number: ChiCTR2300068970) on 2nd March 2023.

Effects of Expressive Writing Intervention for Women Undergoing Fetal Loss in China: A Randomized Controlled Study

Effects of Expressive Writing Intervention for Women Undergoing Fetal Loss in China: A Randomized Controlled Study

Smartphone-Delivered Attentional Bias Modification Training for Mental Health: Systematic Review and Meta-Analysis.

Smartphone-delivered attentional bias modification training (ABMT) intervention has gained popularity as a remote solution for alleviating symptoms of mental health problems. However, the existing literature presents mixed results indicating both significant and insignificant effects of smartphone-delivered interventions. This systematic review and meta-analysis aims to assess the impact of smartphone-delivered ABMT on attentional bias and symptoms of mental health problems. Specifically, we examined different design approaches and methods of administration, focusing on common mental health issues, such as anxiety and depression, and design elements, including gamification and stimulus types. Our search spanned from 2014 to 2023 and encompassed 4 major databases: MEDLINE, PsycINFO, PubMed, and Scopus. Study selection, data extraction, and critical appraisal were performed independently by 3 authors using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. When necessary, we pooled the standardized mean difference with a 95% CI. In addition, we conducted sensitivity, subgroup, and meta-regression analyses to explore moderator variables of active and placebo ABMT interventions on reducing symptoms of mental health problems and attentional bias. Our review included 12 papers, involving a total of 24,503 participants, and we were able to conduct a meta-analysis on 20 different study samples from 11 papers. Active ABMT exhibited an effect size (Hedges g) of -0.18 (P=.03) in reducing symptoms of mental health problems, while the overall effect remained significant. Similarly, placebo ABMT showed an effect size of -0.38 (P=.008) in reducing symptoms of mental health problems. In addition, active ABMT (Hedges g -0.17; P=.004) had significant effects on reducing attentional bias, while placebo ABMT did not significantly alter attentional bias (Hedges g -0.04; P=.66). Our understanding of smartphone-delivered ABMT's potential highlights the value of both active and placebo interventions in mental health care. The insights from the moderator analysis also showed that tailoring smartphone-delivered ABMT interventions to specific threat stimuli and considering exposure duration are crucial for optimizing their efficacy. This research underscores the need for personalized approaches in ABMT to effectively reduce attentional bias and symptoms of mental health problems. PROSPERO CRD42023460749; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=460749.

Medication Adherence and Health Outcomes: A Public Health Perspective

Medicine is a two-edged sword: while it can treat a patient's illness, when applied carelessly, it also has the potential to do more harm than good. Ensuring that patients receive appropriate medication for their clinical condition at the appropriate time, by the appropriate channel, and in the appropriate doses should be the top priority for any healthcare system. Polypharmacy can be helpful because numerous morbidities are common, but it can also have unintended harmful effects. The co-morbidity-polypharmacy score uses the patient's physiological age rather than their chronological age to predict how their therapy will turn out. Any departure from the medication's intended therapeutic impact may be regarded as a drug-related issue. The purpose of this study was to examine the effects of clinical pharmacist interventions on drug-related issues in prescriptions for polypharmacy as well as the cost-benefit analysis of clinical pharmacy services. The particular goals were to recognise and address drug-related issues, find out how well health care providers received clinical pharmacist interventions, analyse the cost-benefit of clinical pharmacy services, and create and suggest a clinical pharmacists intervention form to standardise and record drug-related issues.

Boosting effects of mindfulness-based intervention with a multi-modal adaptive supplement: a preliminary investigation

Boosting effects of mindfulness-based intervention with a multi-modal adaptive supplement: a preliminary investigation

Weight Loss Differentially Impacts Sex Hormones in Women and Men with Type 2 Diabetes: Look AHEAD Sex Hormone Study.

Despite sex differences in T2D, few studies have examined the role of sex hormones. We sought to assess the impact of weight loss, the cornerstone of T2D management, on sex hormone levels. This was an ancillary study to the Look AHEAD (Action for Health In Diabetes) Study (n=850 postmenopausal females, n=890 males, with T2D and BMI ≥25 kg/m2). We measured total testosterone (T), estradiol (E2) and sex hormone binding globulin (SHBG) and calculated bioavailable T (bioT). We examined the effect of the intensive lifestyle intervention (ILI) on hormone changes, whether changes were mediated by waist circumference and sex differences in treatment effect. The baseline mean age was 60 years with a higher proportion of Black females (21%) vs. males (9%) and higher mean BMI in females vs. males (36.3 vs. 34.8 kg/m2). At year 1 in females, ILI decreased E2 by 15% and bioT by 13% and increased SHBG by 21%. At year 1 in males, ILI did not change E2 levels, but increased T by 14% and increased SHBG by 18%. The effect was attenuated over 4 years, there were statistically significant sex differences in treatment effect and change in waist circumference due to ILI at year 1 was a significant mediator of sex hormone changes. Weight loss in T2D resulted in sex hormone changes, which varied by sex and were mediated by changes in WC. Changes in sex hormone due to weight loss in T2D should be considered in the context of an individual's health risks, including cardiovascular, bone health, menopausal symptoms and cognition.

Inhibition of MAT2A Impairs Skeletal Muscle Repair Function

The regenerative capacity of muscle, which primarily relies on anabolic processes, diminishes with age, thereby reducing the effectiveness of therapeutic interventions aimed at treating age-related muscle atrophy. In this study, we observed a decline in the expression of methionine adenosine transferase 2A (MAT2A), which synthesizes S-adenosylmethionine (SAM), in the muscle tissues of both aged humans and mice. Considering MAT2A’s critical role in anabolism, we hypothesized that its reduced expression contributes to the impaired regenerative capacity of aging skeletal muscle. Mimicking this age-related reduction in the MAT2A level, either by reducing gene expression or inhibiting enzymatic activity, led to inhibiting their differentiation into myotubes. In vivo, inhibiting MAT2A activity aggravated BaCl2-induced skeletal muscle damage and decreased the number of satellite cells, whereas supplementation with SAM improved these effects. RNA-sequencing analysis further revealed that the Fas cell surface death receptor (Fas) gene was upregulated in Mat2a-knockdown C2C12 cells. Suppressing MAT2A expression or activity elevated Fas protein levels and increased the proportion of apoptotic cells. Additionally, inhibition of MAT2A expression or activity increased p53 expression. In conclusion, our findings demonstrated that impaired MAT2A expression or activity compromised the regeneration and repair capabilities of skeletal muscle, partially through p53–Fas-mediated apoptosis.

Effectiveness of a short, intensive, art-based group intervention on attention level in children with autism spectrum disorders: a pre-post experimental study

Background The rate of autism spectrum disorder (ASD) is dramatically rising globally, especially in the Middle East and North Africa. There has been little research on the effects of art-based interventions on attention impairments among children with ASD. Objective To examine the effectiveness of a short, intensive, art-based intervention on attention switching and attention to detail in children with moderate-severe ASD. Methods In this pre- and post-experimental study, children previously diagnosed with levels 2 and 3 ASD were invited to join a one-month, art-based course. The art-based intervention was held 3 days/week for 2 hours per day. Results The mean age of subjects was 8.33 (range 5 to 11) years; there were 10 (83.33%) males and 2 (16.67%) females. The total Autism Spectrum Quotient (AQ-Child) scores from baseline to one week after completion of the art-based course were not significantly different. In addition, mean social skills scores of attention switching and attention to detail, as well as communication scores were not significantly changed from baseline to after course completion. However, the children had significantly worse median imagination scores after the course compared to baseline scores (18.0 vs. 16.0, respectively) (P=0.0020). Conclusion After a one-month, art-based, group intervention, AQ-Child scores did not change significantly in total score, social skills, attention switching, attention to detail, or communication. The median imagination score worsened after, compared to before, the intervention. However, these results need to be interpreted with caution due to the very small sample size.

Proyecto de concientización ambiental “Granito de Arena”

The "Granito de Arena" project aims to increase environmental awareness among children in Huanchaco, Peru. It focuses on providing children with tools and knowledge to contribute to environmental protection from an early age. The methodology used involves data collection before and after program implementation, aiming to assess its impact on children's environmental awareness. A combination of surveys and interviews was used to gather information on participants' prior knowledge and subsequent changes in environmental perception. The results show significant improvements in children's knowledge and environmental awareness, as well as in the internalization of sustainable practices. In conclusion, the study highlights the effectiveness of educational interventions in instilling environmental values from an early age and emphasizes the importance of continuing to strengthen these efforts to achieve lasting impact on environmental protection.

Effectiveness of a minecraft education intervention for improving spatial thinking in primary school children: A mixed methods two-level cluster randomised trial

BackgroundSpatial thinking plays a crucial role in STEM success. Minecraft Education, a digital game-based learning platform, provides opportunities for developing students’ spatial thinking while supporting curricular content. AimThis study evaluated the effectiveness of a Minecraft Education intervention, integrated into the curriculum, in improving spatial thinking and creativity. SampleFifth and sixth year primary school students (Mage = 11.53, SDage = 0.58) and their teachers. MethodsThe study used a mixed-methods, two-level cluster randomised-controlled trial design. Thirty-two classes (N = 885 students) were randomly assigned to the intervention or education-as-usual control group. Assessments of spatial thinking and creativity were completed at pre-test, post-test and 6-week follow up. Teacher interviews were conducted to understand their experiences of the intervention. ResultsWhile no overall intervention-related improvements in spatial thinking were found, subgroup analyses revealed that 5th year demonstrated improved spatial thinking compared to 6th year at post-test. This may be attributable to 5th year students’ higher levels of engagement in the intervention. Unexpectedly, creativity scores were higher in the control group at post-test. Qualitative interviews identified four themes: 1) Improving spatial thinking, 2) Improving creativity, 3) Engagement, and 4) Difficulties implementing the programme. ConclusionThis study highlights the importance of increasing student engagement in spatial interventions to improve their spatial skills. Finally, the study suggests that sustained practice is required to maintain the benefits of spatial instruction/training.

Psychometrics of the modified family-centered care assessment short version for childhood obesity

BackgroundIncorporating principles of family-centered care into pediatric weight management interventions can improve the effectiveness and quality of treatment and reduce attrition rates. To assess the family-centeredness of interventions, reliable, valid, and easy-to-administer scales are needed. The purpose of the study was to develop a shortened version of the modified Family Centered Care Assessment (mFCCA) and assess its psychometric properties.MethodsThe mFCCA, a scale to assess the family-centeredness of interventions for childhood obesity, was administered to families following the Connect for Health randomized control trial evaluating the effectiveness of a primary care-based pediatric weight management intervention. We iteratively removed items from the mFCCA and used Rasch modeling to examine the reliability and validity of the shortened scale.ResultsWe included data from 318 parents and the exploratory factor analysis showed the presence of a single factor. The results of the Rasch modeling demonstrated acceptable internal consistency of the scale (0.7) and strong validity as evidenced by the overall model fit and range of item difficulty. Following the psychometric analyses, we reduced the number of items from 24 to 8 items.ConclusionThe mFCCA short version demonstrates good psychometrics and can be used to evaluate the family-centeredness of childhood obesity interventions with reduced participant burden, thereby improving outcomes for children with obesity.Trial registrationClinicaltrials.gov NCT02124460 registered on April 24, 2014.

Integration of digital twins to simulate community health scenarios and evaluate the effectiveness of public health interventions led by pharmacists

Public health emergencies such as the 2019 coronavirus disease (COVID-19) have increased the focus on digital technology. A digital twin (DT) is a cybernetic representation of a physical object (e.g., a person or a community) that helps us comprehend the complexity of the real thing and makes it easier to foresee, avoid, track, and improve its actual performance. To prepare for a new age of reliable and precise public health and medical care, DT technology can propel a much-needed radical transformation of conventional electronic health and medical records, which centre on individuals and their aggregates covering populations. Hence, this paper presents the Digital Twin-based Public Health Intervention Model (DT-PHIM) to simulate community health led by pharmacists. The use of digital twins in healthcare has the potential to revolutionize workflow analysis and resource allocation, ultimately resulting in better patient care and more efficient operations. In addition, healthcare providers may hone their abilities and rehearse intricate treatments in a secure and realistic environment with the help of digital twins. There is great promise for digital twin technology to revolutionize healthcare by boosting innovation, patient safety, and overall patient outcomes. On top of that, DTs may help doctors and other medical staff, such as hospital pharmacists, make decisions by simulating how therapy would affect these patients. The experimental outcomes demonstrate that the suggested DT-PHIM model increases the patient data access ratio by 97.4%, the monitoring efficiency ratio by 96.2% and the decision-making ratio by 98.2% compared to other existing models.

Efficacy of lifestyle interventions to treat pediatric obesity: A systematic review and multivariate meta-analysis of randomized controlled trials.

The aim of this study was to provide a quantitative synthesis of the effects of randomized controlled pediatric lifestyle interventions in treating obesity among 11-17-year-old children. We conducted a systematic review and meta-analysis on the randomized controlled trials, consisting of actual exercise training and nutrition education, published between January 2000 and August 2022. The initial search yielded 2598 articles, with eight articles meeting the inclusion criteria. The articles were analyzed using a multivariate random effects model. The primary outcome variables were body mass index (BMI), standardized BMI (BMIz), and waist circumference (WC). Our analyses showed that lifestyle interventions were efficacious in improving BMI (-1.77 kg/m2, 95% CI [-2.70, -0.83], p< 0.001), BMIz (-0.30, 95% CI [-0.45, -0.16], p< 0.001), and WC (-3.32 cm, 95% CI [-5.35, -1.29], p <0.001) in children with overweight and obesity. In addition, moderation analyses suggested that the efficacy of the lifestyle interventions correlated positively with participants' weight status and was enhanced when an intervention was boosted with a longer intervention duration and higher frequency. In conclusion, the current evidence suggests that lifestyle interventions are efficacious in treating children with obesity. The available evidence further indicates that duration, frequency, along weight status, were moderating the effectiveness of these lifestyle interventions.

Conclusions Regarding the Role of Expectations in Placebo Analgesia Studies May Depend on How We Investigate It: A Meta-Analysis, Systematic Review, and Proposal for Methodological Discussions.

Expectations are highlighted as a key component in placebo effects. However, there are different approaches to whether and how placebo studies should account for expectations, and the direct contribution has yet to be estimated in meta-analyses. Using different methodological approaches, this meta-analysis and systematic review examines the extent to which expectations contribute to pain in placebo studies. The databases PubMed, PsycINFO, Embase, and Web of Science were searched for placebo analgesia mechanism studies with numerical measures of both expectations and pain. Thirty-one studies, comprising 34 independent study populations (1566 subjects: patients and healthy participants) were included. Two meta-analyses were conducted: meta-analysis 1, using study-level data, estimated the effect of expectation interventions without taking measures of expectations into account (expectations assumed); and meta-analysis 2, using individual-level data, estimated the direct impact of participants' expectations on pain (expectations assessed). Risk of bias was assessed using the Cochrane risk-of-bias tool. Meta-analysis 1 showed a moderate effect of expectation interventions over no expectation intervention on pain intensity (Hedges g = 0.45, I2 = 54.19). Based on 10 studies providing individual-level data, meta-analysis 2 showed that expectations predicted pain intensity in placebo and control groups ( b = 0.36, SE = 0.05), although inconsistently across study methodologies. Participants' expectations contributed moderately to pain in placebo analgesia studies. However, this may largely be influenced by how we measure expectations and how their contribution is conceptualized and analyzed-both within and across studies.

RETRACTION: Effects of comprehensive nursing intervention on pressure ulcer after traumatic brain injury surgery: A meta-analysis.

Retraction: D.-H. Huang , Y.-C. Xie , and C.-L. Zhang , "Effects of comprehensive nursing intervention on pressure ulcer after traumatic brain injury surgery: A meta-analysis," Int Wound J 21, no. 3 (2023): e14494, https://doi.org/10.1111/iwj.14494. The above article, published online on 20 November 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction of this article has been agreed on because the peer review and publishing process for this article were found to have been manipulated. The authors did not respond to our notice of retraction.

RETRACTION: Effects of predictive nursing interventions on pressure ulcer in older bedridden patients: A meta-analysis.

Retraction: Z.-F. L., J. Meng , N. Jing , and X.-Y. Liu , "Effects of predictive nursing interventions on pressure ulcer in older bedridden patients: A meta-analysis," Int Wound J 21, no. 3 (2023): e14676, https://doi.org/10.1111/iwj.14676. The above article, published online on 04 March 2024, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction of this article has been agreed on because the peer review and publishing process for this article were found to have been manipulated. The authors did not respond to our notice of retraction.

Mindfulness Training in High-Demand Cohorts Alters Resting-State Electroencephalography: An Exploratory Investigation of Individual Alpha Frequency, Aperiodic 1/f Activity, and Microstates

BackgroundMindfulness training (MT) programs have demonstrated utility as cognitive training tools, but there is little consensus on the neurophysiological processes that may underlie its benefits. It has been posited that intrinsic brain activity recorded at rest reflects the functional connectivity of large-scale brain networks and may provide insight into neuroplastic changes that support MT. In the current study, we indexed changes in several resting-state electroencephalography (EEG) parameters to investigate the neurophysiological underpinnings of MT. MethodsResting-state EEG data were collected from active-duty U.S. military personnel (n = 80) at 2 testing sessions: before (time [T] 1) and after (T2) engaging in an 8-week MT or active comparison intervention (positivity training). We examined longitudinal and/or groupwise differences in several EEG parameters through parameterization of power spectra (individual alpha frequency and 1/f activity) and microstate analysis. ResultsWhile no significant group × time differences were observed in individual alpha frequency, significant group × time effects were observed in several EEG parameters from T1 to T2. Compared with MT, positivity training was associated with a steepening of the 1/f slope and higher 1/f intercepts together with decreased duration and increased global field power of microstates. ConclusionsTaken together, these results suggest that the effects of interventions may be differentiated in resting-state brain activity in a sample of military personnel. Such findings provide insight into the neural underpinnings of MT-related brain changes, but more research is required to elucidate how these may relate to task-related neural and performance changes with MT and whether results generalize to other mindfulness interventions in alternative cohorts and contexts.

Spillover effects of an information intervention on food handling behavior and the stimulus of survey in rural China

A substantial proportion of foodborne illnesses arise at home as a result of poor food handling practices. Consumer information intervention has usually been conducted to prevent such illness; however, few studies have examined the spillover effect of these interventions. This study aimed to identify whether an information intervention focused on one target food handling behavior has spillover effects on other aspects of food handling behaviors (nontargeting behaviors) through a randomized controlled trial (RCT) conducted in rural China. The results estimated by the difference-in-difference model reveal that information intervention has a significant impact on both target and nontarget food handling behaviors. The existence of positive spillover effects is mainly due to the release of limited attention resources from information interventions and the motivation of consumers to maintain other aspects of behaviors as regulated as the target behaviors. In addition, the results also show that being surveyed spurs a stimulus to subsequent behavior. The survey effect is taken into account when calculating the spillover effects in this paper, so a more accurate estimate is obtained. These findings can motivate governments to conduct more consumer education campaigns, especially in emerging countries, and can also contribute to experimental design, data collection methods and cost‒benefit analyses of interventions, thereby helping researchers avoid biased parameter estimation.

Interventions to reduce harms related to drug use among people who experience incarceration: systematic review and meta-analysis

Mortality, suicide, self-harm, and substance use are elevated among people who are incarcerated. There is a wide range of heterogeneous interventions aimed at reducing these harms in this population. Previous reviews have focused on specific interventions or limited their findings to drug use and recidivism and have not explored interventions delivered after release from prison. Our aim is to examine the effect of interventions delivered to people who use drugs during incarceration or after release from incarceration, on a wide range of outcomes. In this systematic review and meta-analysis, we searched Embase, MEDLINE, and PsycINFO databases up until Sept 12, 2023 for studies published from Jan 1, 1980 onwards. All studies evaluating the effectiveness of any intervention on drug use, recidivism outcomes, sexual or injecting risk behaviours, or mortality among people who use psychoactive drugs and who were currently or recently incarcerated were included. Studies without a comparator or measuring only alcohol use were excluded. Data extracted from each study included demographic characteristics, interventions, and comparisons. Pooled odds ratios and risk ratios were calculated using random-effects meta-analyses. We identified 126 eligible studies (47 randomised controlled trials and 79 observational studies) encompassing 18 interventions; receiving opioid-agonist treatment (OAT) in prison reduced the risk of death in prison (one study; hazard ratio 0·25; 95% CI 0·13-0·48), whereas receiving OAT in the first 4 weeks following release reduced risk of death in the community (two studies; relative risk 0·24; 95% CI 0·15-0·37). Therapeutic community interventions reduced re-arrest at 6-12 months (six studies; odds ratio [OR] 0·72; 95% CI 0·55-0·95) and reincarceration at 24 months (two studies; OR 0·66; 95% CI 0·48-0·96). There was scarce evidence that OAT and syringe service provision are effective in reducing injecting risk behaviours and needle and syringe sharing. There are effective interventions to reduce mortality and recidivism for people who use drugs who have been incarcerated. Nonetheless, there are also substantial gaps in the research examining the effect of interventions on risk behaviours and mortality during incarceration and a need for randomised designs examining outcomes for people who use drugs after release. Australian National Health and Medical Research Council.