Effectiveness Of Interventions Research Articles

A Brief Biofeedback Training, Integrated with Breathing and Relaxation Exercises, in Treating Tinnitus Disorders within Routine Medical Care.

Tinnitus, a distressing condition, significantly impacts psycho-social functioning. While medical interventions have been the norm for treating tinnitus, few studies have explored the efficacy of psychological treatments and their enduring effects. This study aims to evaluate the effectiveness of a brief biofeedback training program in alleviating perceived tinnitus handicap severity over a 3-month follow-up period. Engaging 431 tinnitus outpatients from a medical center, the study allocated the control group to treatment as usual, involving monthly visits to an otolaryngologist and specific pharmacological interventions. Concurrently, the experimental group participated in a brief biofeedback training, using Procomp Infinity by Thought Technology Ltd., an eight-channel computer-operated encoder, integrated with breathing and relaxation exercises. No biofeedback booster sessions were provided to the experimental group during the 3-month follow-up period. Changes in tinnitus severity were assessed using the Tinnitus Handicap Inventory (THI). The analysis, conducted via ANCOVA, demonstrated that biofeedback, integrated with relaxation training and breathing exercises, had a positive impact on both the follow-up THI total score and its three sub-scales (Functional, Emotional, Catastrophic). Notably, the experimental group displayed reduced psycho-physiological parameters in all aspects compared to their baseline measurements at 3-month follow-up. This study's findings underline the effectiveness of non-pharmacological intervention in treating tinnitus. It had a positive impact on the emotional, functional, and physical dimensions of daily life affected by tinnitus.

Education and training interventions for healthcare workers to prevent sexual harassment.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of education and training interventions on improving knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings. We will include all forms of sexual harassment committed by patients, visitors, and co-workers.

Industry data on alcohol sales in South Africa between 1995 and 2022 and its value in detecting the impact of policy interventions related to packaging and Covid-19 alcohol availability

Aims: To assess changes in total alcohol consumed over time, changes in consumption of different alcoholic beverages and the utility of industry sales data to evaluate the impact of policy changes related to a packaging ban on wine products in September 2007 and bans on alcohol sales during the Covid-19 pandemic in 2020 and 2021 in South Africa. Design. Alcohol industry sales data as a proxy for consumption was assessed using statistics presented in South African Wine Industry Information & Systems (SAWIS) booklets released annually between 1995 and 2022 and used to describe changes over time in consumption overall, and by product, and the impact on consumption from changes in policy. Results. Per capita consumption of alcoholic beverages overall has held steady or declined over time, but declines were noted in the market share of wine and beer (especially) and a massive increase for RTDs. The consumption data also indicated short term effects of Covid-19 interventions (especially in 2020) in terms of reducing overall alcohol consumption, with a return to prior levels in 2022. Industry data on packaging for wine was able to show the immediate and longer-term impact of the 2007 ban on wine sold in foil-bags. Conclusion. Industry data are a useful adjunct to consumer measures of alcohol use, as well as in detecting the impact of policy changes related to availability and packaging, notwithstanding gaps in information on illicit/unrecorded sales and other limitations.

Psychosocial interventions for smoking cessation in people with coronary heart disease.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To examine the benefits and harms of different types of psychosocial interventions for smoking cessation in people with CHD. Secondary objectives To examine the benefits and harms of psychosocial interventions aimed solely at smoking cessation compared with multi-risk factor interventions for smoking cessation in people with CHD. To examine the benefits and harms of brief (duration of < one month) compared to extended (duration of ≥ one month) psychosocial interventions for smoking cessation in people with CHD. To explore whether using a validated biochemical assessment versus a self-report of abstinence moderates the effectiveness of smoking cessation interventions in people with CHD. To assess the equity of psychosocial interventions for smoking cessation in people with CHD.

What are the effects of combined psychological and educational interventions to prevent falls among older people living in the community?

What are the effects of combined psychological and educational interventions to prevent falls among older people living in the community?

Smartphone-Based Intervention Targeting Norms and Risk Perception Among University Students with Unhealthy Alcohol Use: Secondary Mediation Analysis of a Randomized Controlled Trial

Background Many digital interventions for unhealthy alcohol use are based on personalized normative feedback (PNF) and personalized feedback on risks for health (PFR). The hypothesis is that PNF and PFR affect drinkers’ perceptions of drinking norms and risks, resulting in changes in drinking behaviors. This study is a follow-up mediation analysis of the primary and secondary outcomes of a randomized controlled trial testing the effect of a smartphone-based intervention to reduce alcohol use. Objective This study aimed to investigate whether perceptions of drinking norms and risks mediated the effects of a smartphone-based intervention to reduce alcohol use. Methods A total of 1770 students from 4 higher education institutions in Switzerland (mean age 22.35, SD 3.07 years) who screened positive for unhealthy alcohol use were randomized to receive access to a smartphone app or to the no-intervention control condition. The smartphone app provided PNF and PFR. Outcomes were drinking volume (DV) in standard drinks per week and the number of heavy drinking days (HDDs) assessed at baseline and 6 months. Mediators were perceived drinking norms and perceived risks for health measured at baseline and 3 months. Parallel mediation analyses and moderated mediation analyses were conducted to test whether (1) the intervention effect was indirectly related to lower DV and HDDs at 6 months (adjusting for baseline values) through perceived drinking norms and perceived risks for health at 3 months (adjusting for baseline values) and (2) the indirect effects through perceived drinking norms differed between participants who overestimated or who did not overestimate other people’s drinking at baseline. Results The intervention’s total effects were significant (DV: b=–0.85, 95% bootstrap CI –1.49 to –0.25; HDD: b=–0.44, 95% bootstrap CI –0.72 to –0.16), indicating less drinking at 6 months in the intervention group than in the control group. The direct effects (ie, controlling for mediators) were significant though smaller (DV: b=–0.73, 95% bootstrap CI –1.33 to –0.16; HDD: b=–0.39, 95% bootstrap CI –0.66 to –0.12). For DV, the indirect effect was significant through perceived drinking norms (b=–0.12, 95% bootstrap CI –0.25 to –0.03). The indirect effects through perceived risk (for DV and HDD) and perceived drinking norms (for HDD) were not significant. Results of moderated mediation analyses showed that the indirect effects through perceived drinking norms were significant among participants overestimating other people’s drinking (DV: b=–0.17, 95% bootstrap CI –0.32 to –0.05; HDD: b=–0.08, 95% bootstrap CI –0.15 to –0.01) but not significant among those not overestimating. Conclusions Perceived drinking norms, but not perceived risks, partially mediated the intervention’s effect on alcohol use, confirming one of its hypothesized mechanisms of action. These findings lend support to using normative feedback interventions to discourage unhealthy alcohol use. Trial Registration ISRCTN Registry 10007691; https://doi.org/10.1186/ISRCTN10007691

Effectiveness of interventions for improving educational outcomes for people with disabilities in low‐ and middle‐income countries: A systematic review

Effectiveness of interventions for improving educational outcomes for people with disabilities in low‐ and middle‐income countries: A systematic review

Interventions that prevent or reduce perinatal loneliness and its proximal determinants: a restricted scoping review

Abstract Background The World Health Organisation’s Commission on Social Connection (2024–2026) highlights the importance of addressing loneliness because of its negative impact on health and well-being. The perinatal period carries an increased risk of loneliness for mothers and fathers which is elevated by intersectional inequalities, such as having a low income, being LGBTQ+, or being from a minoritised community. Perinatal loneliness is associated with perinatal mental illness, which can have lasting negative impacts on parents and their children. The aim of this review was to synthesise studies exploring interventions for perinatal loneliness. Methods We conducted a restricted scoping review following the Joanna Briggs Institute Methodology to develop a categorisation of interventions and intervention-mechanisms to reduce perinatal loneliness. We included studies that described and/or evaluated interventions in published studies that intentionally or unintentionally reduced loneliness, or its proximate determinants, such as social connectedness and social support. We searched eight electronic databases for peer-reviewed academic papers published in any country describing or evaluating these interventions between 2013–2023. Results Fifty papers were included in the review, from which the following categorisation of interventions was developed: 1) synthetic social support, 2) shared-identity social support groups, 3) parent and baby groups, 4) creative health approaches (arts, nature or exercise based), 5) holistic, place-based and multidisciplinary support that worked with parents to overcome a range of barriers to connection, and 6) awareness campaigns. Five mechanisms were identified within included papers: 1) opportunities for social connection to similar others, 2) positive relationships with a professional or volunteer, 3) normalisation and acceptance of difficulties, 4) meaningful activities and 5) support to overcome barriers (including cultural and financial) to connection. Few studies collected comprehensive demographic data, few considered fathers, and none were LGBTQ+ specific. Conclusions The review identified and synthesised approaches that might address perinatal loneliness and its proximate determinants. Further research is needed to scope the grey literature, review papers in the global south, appraise intervention effectiveness, and co-produce interventions, including for fathers, LGBTQ+ parents, and cultural and religious minorities. Trial registration The protocol for the trial was registered on Figshare.

The Effect of an Online Growth Mindset Intervention on the Academic Performance for Community College Students in Corequisite Math Courses

ABSTRACT This study examined the effect of a virtual growth mindset intervention in enhancing the perceived flexibility of intelligence and academic outcomes of community college students enrolled in corequisite math courses during the COVID-19 pandemic. Prior research suggests that growth mindset interventions can positively influence students’ beliefs about intelligence and academic performance, but effects may vary based on individual sociodemographic characteristics and college readiness. Employing a randomized pre-posttest design, this investigation assessed the impact of the intervention on students’ perceived intelligence flexibility and course grades for those enrolled in corequisite math courses. Results indicate a significant increase in growth mindset among participants in the intervention group. However, no significant differences in self-report course grades existed between the intervention and control groups. These findings underscore the complex relationship between growth mindset, academic performance, and contextual factors. The results call for further research to elucidate the long-term effects of growth mindset interventions for underprepared college students.

Effectiveness of a Social Cognitive Theory-based health education intervention on depression (SCODESS) among mothers of children with cancer in Klang Valley, Selangor, Malaysia-A quasi-experimental study.

Mothers caring for children with cancer often experience depression, affecting maternal and family well-being. Prior studies suggest that theory-based health education can significantly reduce this depression. This study aimed to develop, validate, implement, and evaluate the effects of a Social Cognitive Theory (SCT)-based health education intervention on depression (SCODESS), as well as cancer-related knowledge, self-efficacy, perceived stress, coping skills, and social support among mothers of children with cancer at University Hospitals in Klang Valley. A quasi-experimental study was conducted with mothers from two University Hospitals in Klang Valley, Selangor. The intervention group is Hospital Pakar Kanak-Kanak Universiti Kebangsaan Malaysia (HPKK UKM) and the control group is the Universiti Malaya Medical Centre (UMMC). A total of 95 participants were included (50 intervention, 45 control). The intervention comprised online health education videos delivered over one week, and the control group received a poster. Data were collected at baseline (T1), immediately post-intervention (T2), and at two months post-intervention (T3). The effects of SCODESS intervention were analysed using Generalised Estimating Equation (GEE) analysis. The baseline response rate was 60.53% with a 2.17% loss to follow-up at T2 and 7.60% at T3. The GEE analysis showed no significant effects of SCODESS intervention on depression scores at T2 (p = 0.909) and T3 (p = 0.622) compared to the control group at baseline. However, statistically significant increases were observed in cancer-related knowledge scores at T2 (β = 0.66, 95%CI: 0.21, 9.20, p = 0.002) and T3 (β = 1.18, 95%CI: 0.65, 1.70, p<0.001), and in the problem-focused coping scores at T2 (β = 2.50, 95% CI 0.42, 4.58, p-value = 0.018), and T3 (β = 2.42, 95% CI 0.13, 4.72, p-value = 0.038) in the intervention group compared to the control group at baseline. No significant intervention effects were observed on other outcomes. This study validated the applicability of SCT-based intervention on depression scores among mothers of children with cancer. The SCODESS intervention did not significantly reduce depression scores but significantly increased cancer-related knowledge and problem-focused coping scores. As a potential preventive strategy for depression, the content of the SCODESS intervention should be revisited, emphasizing cancer-related knowledge and problem-focused coping as crucial components. It is recommended that tailored interventions focusing on these areas be offered to every mother of children with cancer, whether they are in the ward, clinic, or daycare.

The effect of educational intervention based on the mobile application on women’s knowledge, attitude, and practice on microplastics and health: study protocol for a randomized controlled trial

BackgroundThe pervasive issue of microplastic (MP) contamination is undeniable. The primary solution to this global problem lies in significantly reducing the amount of plastic entering the environment. Addressing such a large-scale issue is no easy feat. However, a necessary strategy involves public education. In parallel, a randomized controlled trial (RCT) aims to evaluate the effect of interventional education via a mobile phone application on improving women’s knowledge, attitude, and practice regarding the health effects of MPs.MethodsThis randomized controlled trial includes three phases. In the first phase, a questionnaire assessing women’s knowledge, attitudes, and practices (KAP) regarding microplastics will be developed and validated. In phase two, educational content for the mobile application “PlastiWise” will be created based on behavior change constructs. In phase three, a two-arm, parallel-design RCT will be conducted with 136 women aged 18 years and older who own smartphones, have basic literacy skills, and provide informed consent. Participants will be recruited through an online call disseminated via social media platforms and health system networks in Iran. They will be randomly assigned to an intervention group (n = 68) receiving the educational program through the app or a control group (n = 68). The sample size was calculated using G*Power software to ensure sufficient power (80%) with an alpha level of 0.05, factoring in a 15% dropout rate. Primary outcome data (KAP scores) will be collected at baseline, immediately post-intervention, and 8 weeks post-intervention using self-reported questionnaires. Data analysis will include descriptive statistics and inferential tests, such as independent t-tests and paired t-tests, to assess group differences and within-group changes over time.DiscussionImplementing an educational intervention on knowledge, attitude, and practice (KAP) about MPs using a mobile application will be a first in Iran. This research is expected to benefit Iranian women by contributing evidence on factors that might influence the effectiveness of educational training related to MP consumption.Trial status Protocol version 1, 2024–07-12. The enrolment of participants began on 2024–09-22. The recruitment is estimated to be completed by 2024–11-21.Trial registration Iranian Clinical Trial Register IRCT20240529061941N1.https://irct.behdasht.gov.ir/user/trial/77069/view. Date is July 12, 2024.

The Effect Of Using The Fishbowl Strategy Toward Students' Speaking Ability

The Fishbowl teaching strategy has been investigated for its impact on enhancing students' speaking proficiency in secondary education. Despite regular engagement in English through day-to-day interactions, students often find English instruction monotonous and uninspired, primarily due to the reliance on traditional pedagogical approaches. In response, this study aimed to collect empirical data on the efficacy of the Fishbowl strategy in a classroom setting. Utilizing a quasi-experimental design, the research population comprised second-grade students from SMAN 06 Bengkulu Utara, focusing specifically on their speaking abilities as influenced by the Fishbowl method. The sample population consisted of 68 students, classified into two distinct groups: the experimental group, which experienced the Fishbowl intervention, and the control group, which did not. A comparative analysis of average pre-test and post-test speaking scores was conducted using SPSS software to assess the intervention's effectiveness. The statistical significance of the results was evaluated with the t-test formula. Findings indicated a significant difference in speaking abilities between students instructed through the Fishbowl strategy and those in the control group, with the experimental group achieving a t-test score of 70.00, demonstrating pronounced improvements in their speaking competencies. The implementation of the Fishbowl strategy was noted to be not only compelling but also inspiring, fostering a more engaging and productive learning environment.

Effects of School Nurse-Led Asthma Interventions for Students: A Systematic Review.

School nurse-led asthma interventions play a critical role in managing asthma among students. This study evaluates the effectiveness and key components of interventions for children with asthma. A systematic search of multiple databases was conducted up to September 2023. Two independent reviewers assessed the risk of bias using the Mixed Methods Appraisal Tool, and descriptive evidence synthesis with albatross plots was used to analyze the findings. Results revealed that school nurse-led asthma interventions positively influenced asthma symptoms, medication use, asthma-related quality of life, and self-management in schoolchildren. However, emergency visits, hospitalization, and absence outcomes remain inconclusive. Effective components identified across studies included chronic disease management, direct care, and collaborative communication. Further, well-designed randomized controlled trials with standardized outcome measurements are needed to examine objective outcomes, including emergency visits, hospitalization, and school absences, and strengthen the evidence base for school nurse-led asthma interventions.

Constitutional Guarantees for Linguistic Minorities in India

Linguistic and religious minorities in India represent distinct groups whose rights and identities are often shaped by dominant cultural and societal norms. Linguistic minorities face challenges related to language usage, educational access, and social integration, while religious minorities experience issues such as discrimination, violence, and underrepresentation in political and administrative spheres. Despite constitutional guarantees, both groups often struggle to assert and protect their rights in practice. This paper critically examines the legal frameworks protecting linguistic and religious minorities in India, focusing on key case laws that highlight the constitutional provisions designed to safeguard their rights. It explores the implications of these legal protections and assesses the effectiveness of judicial interventions in ensuring equal rights for minorities. The study delves into the broader social and political challenges faced by minorities, examining how discrimination, communal tensions, and inadequate representation impact their access to justice and equal opportunities. Finally, the paper offers recommendations for improving the protection of minority rights in India, suggesting reforms to enhance the inclusivity and fairness of the legal and political system for linguistic and religious minorities.

Effectiveness of exercise interventions on functional outcomes in frail adults with a previous or current diagnosis of cancer: a systematic review and meta-analysis.

Exercise improves functional outcomes in individuals with frailty and individuals with cancer, but it is unknown how exercise impacts function in individuals with both cancer and frailty. This systematic review aimed to determine if adults with cancer who are frail and participate in an exercise program have better functional outcomes compared to those who do not. Five databases (OVID Medline, Embase, CINAHL, EMCARE, and Ageline) were searched from inception to March 2024 for RCTs that investigated the impact of exercise on functional outcomes in individuals with cancer who are frail and ≥ 18years. Title/abstract, full text review, and data extraction were done in duplicate. Cochrane ROB2 was used to assess risk of bias and GRADE for certainty of results. Eleven RCTs with 1419 participants were included in this review. Meta-analysis did not find a significant difference between intervention and control groups for submaximal walking tests (95% CI 0.24 (- 0.05-0.53), Short Physical Performance Battery (95% CI - 0.50 (- 1.15-0.15)), and grip strength (95% CI 1.83 (- 0.75 to 4.41). However, positive trends emerged for those participating in exercise programs related to submaximal walking test, grip strength, sit to stand, SPPB, and TUG scores. There are few RCTs investigating exercise in this population, with high heterogeneity of existing interventions. This leads to low certainty in the results of the current study. Cancer survivors and patients need to be screened for frailty and be engaged in appropriate exercise. Further work should be done investigating appropriate parameters of exercise interventions for this population.

Effect of an intensive care unit virtual reality intervention on relatives´ mental health distress: a multicenter, randomized controlled trial

BackgroundRelatives of intensive care unit (ICU) patients often endure symptoms of post-traumatic stress, anxiety, and depression during and after treatment of a family member’s hospitalization. The aim of this study was to evaluate the effect of ICU-specific virtual reality (ICU-VR) on mental health among relatives, 6 months after patient’s ICU discharge.MethodsThis multicenter, randomized controlled trial included relatives of ICU patients who were assigned to receive either standard care or standard care plus ICU-VR, by randomizing the ICU patients. Relatives were assessed up to 6 months after patient discharge from the ICU for post-traumatic stress, anxiety, depression, quality of life, relatives’ understanding of ICU care, and appreciation of ICU-VR.ResultsOne hundred relatives of 81 patients and 89 relatives of 80 patients were randomized to the intervention and control groups, respectively. Relatives’ median age was 48 years and 53% were female. Compared to the control group, relatives who received ICU-VR did not experience a decrease in post-traumatic stress (23% vs. 18%; p = 0.99), anxiety (22% vs. 30%; p = 0.35), or depression (17% vs. 23%; p = 0.44). There was no significant difference between median mental quality of life (50.2 vs. 52.6; p = 0.51), physical quality of life (56.1 vs. 54.3; p = 0.16), or understanding of ICU care between groups. Patients in the intervention group highly endorsed ICU-VR (90%), favoring it over traditional informational brochures and the majority (82%) stated it improved their understanding of ICU treatment.ConclusionICU-VR did not significantly improve mental health distress symptoms among relatives 6-months after a patient’s discharge. Relatives highly endorsed ICU-VR and self-reported that it improved their understanding of ICU treatment.

Effectiveness of Virtual Reality Technology Interventions in Improving the Social Skills of Children and Adolescents With Autism: Systematic Review.

Virtual reality (VR) technology has shown significant potential in improving the social skills of children and adolescents with autism spectrum disorder (ASD). This study aimed to systematically review the evidence supporting the effectiveness of VR technology in improving the social skills of children and adolescents with ASD. The search for eligible studies encompassed 4 databases: PubMed, Web of Science, IEEE, and Scopus. Two (XY and JW) researchers independently assessed the extracted studies according to predefined criteria for inclusion and exclusion. These researchers also independently extracted information regarding gathered data on the sources, samples, measurement methods, primary results, and data related to the main results of the studies that met the inclusion criteria. The quality of the studies was further evaluated using the Physiotherapy Evidence Database scale. This review analyzed 14 studies on using VR technology interventions to improve social skills in children and adolescents with ASD. Our findings indicate that VR interventions have a positive effect on improving social skills in children and adolescents with ASD. Compared with individuals with low-functioning autism (LFA), those with high-functioning autism (HFA) benefited more from the intervention. The duration and frequency of the intervention may also influence its effectiveness. In addition, immersive VR is more suitable for training complex skills in individuals with HFA. At the same time, nonimmersive VR stands out in terms of lower cost and flexibility, making it more appropriate for basic skill interventions for people with LFA. Finally, while VR technology positively enhances social skills, some studies have reported potential adverse side effects. According to the quality assessment using the Physiotherapy Evidence Database scale, of the 14 studies, 6 (43%) were classified as high quality, 4 (29%) as moderate quality, and 4 (29%) as low quality. This systematic review found that VR technology interventions positively impact social skills in children and adolescents with ASD, with particularly significant effects on the enhancement of complex social skills in individuals with HFA. For children and adolescents with LFA, progress was mainly observed in basic skills. Immersive VR interventions are more suitable for the development of complex skills. At the same time, nonimmersive VR, due to its lower cost and greater flexibility, also holds potential for application in specific contexts. However, the use of VR technology may lead to side effects such as dizziness, eye fatigue, and sensory overload, particularly in immersive settings. These potential issues should be carefully addressed in intervention designs to ensure user comfort and safety. Future research should focus on optimizing individualized interventions and further exploring the long-term effects of VR interventions. International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202420079U1; https://inplasy.com/inplasy-2024-2-0079/.

A qualitative analysis of unintended effects of a digital conditional cash transfer intervention to encourage healthcare utilization in Southern Madagascar

IntroductionCash transfer interventions, including those using mobile money, are becoming increasingly widespread, particularly in Sub-Saharan Africa. As such interventions can have significant positive and negative unintended consequences, further analyses are needed to identify these consequences.MethodsWe investigated the unintended consequences of a digital conditional cash transfer intervention implemented at fifteen health facilities in Southern Madagascar. The intervention offered partial cost coverage for patients seeking care for potentially life-threatening conditions, accidents and injuries, maternal or pediatric care between February 2021 and June 2022. We conducted a qualitative analysis of in-depth interviews with policymakers, healthcare providers, (non-) beneficiaries of the intervention, and staff that implemented the intervention using reflexive thematic analysis.ResultsWe identified three key positive and three key negative unintended consequences of the intervention. The key positive unintended consequences were: i) improved quality of care, ii) improved interpersonal relationships, including between patients and providers and between healthcare providers, and iii) digital skills development of healthcare providers and increased trust in mobile money. The three key negative consequences we identified were i) facility overcrowding, ii) an increase in costs of care, and iii) cases of hospital imprisonment.ConclusionsDesigners and implementers of future (digital) cash transfer interventions should carefully consider and proactively seek to leverage the positive and mitigate the negative unintended consequences of cash transfer interventions for healthcare such as those highlighted in our work.

Examining the Effectiveness of Interventions for Criminal Justice-Involved Women: A Meta-Analytic Review

Academic understanding of women’s gendered pathways into the criminal justice system has grown significantly over the last 20 years. Allied to this development has been an increasing number of gender-responsive practices and interventions designed to address the needs of criminal justice-involved women. This meta-analysis summarizes the trends in 71 interventions extracted from 64 papers involving justice-involved women. Subgroup analysis and meta-regression were used, which shows that gender-responsive interventions are up to 42% more effective compared with gender-neutral, even when controlling for several covariates. Other findings in our case demonstrate features of interventions, such as intervention, format, focus, and length, that appear to be effective in reducing recidivism for criminal justice-involved women. Our findings strengthen the case for investment in gender-responsive interventions and diversion programs.

Validity and reliability of an abbreviated Copenhagen Burnout Inventory in Canadian emergency physicians and residents.

Emergency physicians have the highest rates of burnout among all medical specialties. There is a need for accurate and reliable burnout assessment tools to monitor changes and assess the effects of interventions. However, existing tools are typically long and/or costly. We sought to validate an abbreviated Copenhagen Burnout Inventory among emergency physicians and trainees in Canada. We conducted a planned secondary analysis of a national, cross-sectional survey of emergency physicians and trainees in Canada. Exploratory factor analysis was performed followed by confirmatory factor analysis. Kaiser's eigenvalues rule, a scree plot, and Horn's parallel analysis guided the number of factors to extract. Structural validity fit indices and internal consistency were compared to pre-specified cutoffs. Criterion validity was assessed compared to the full Copenhagen Burnout Inventory (burnout defined as mean ≥ 50/100). One hundred eighty-two responses were randomly split into separate cohorts for exploratory factor analysis and confirmatory factor analysis. Data were confirmed to be statistically suitable for factor analysis. Using exploratory factor analysis, a ten-item, two-factor abbreviated Copenhagen Burnout Inventory was reached after removing items based on over correlation (≥ 0.80), cross-loading (≥ 75%), and low factor loading (< 0.60). In confirmatory testing, the abbreviated inventory had a good Comparative Fit Index (0.91) though did not meet cutoffs for the remaining fit indices. Internal consistency was 0.92 (95%CI 0.90-0.95). Using a cutoff of 33/50, sensitivity was 0.99, specificity was 0.82, and area under the ROC curve was 0.86. With further validation, an abbreviated ten-item Copenhagen Burnout Inventory has potential to serve as a short, freely available burnout assessment tool among Canadian emergency physicians and trainees. This abbreviated inventory has evidence to support its internal consistency and criterion validity, albeit with inconsistent structural validity. Future validation with larger samples is required, with special attention paid to content validity, test-retest reliability, and correlation with important outcomes.