Evidence-based Prevention Programs Research Articles

P-524. Comparative Costs of Implementing an Evidence-Based Online HIV Prevention Program: Direct-to-Consumer Marketing vs. Community-Based Organization Recruitment

Abstract Background Black/African American and Hispanic/Latino men who have sex with men face a disproportionate burden of new HIV diagnoses. The Keep It Up! (KIU) program, an evidence-based online intervention, is effective in reducing risk behaviors. The KIU 3.0 study, conducted between 2019-2022, compared two delivery strategies: centralized, national direct-to-consumer (DTC) recruitment, and decentralized recruitment via community-based organizations (CBO). Here, we report strategy costs. Methods We conducted interviews to identify and quantify start-up (e.g. equipment, training), time-dependent (e.g. advertisements, payroll), and variable (e.g. incentives, medical materials) costs for both delivery models. We report costs in 2021 USD. We analyzed cost variation among CBOs and present a hypothetical scenario where all CBOs match the efficiency of the two with the lowest cost per participant. Results The DTC arm enrolled 1,468 participants. Start-up costs totaled $398,384 of which $376,393 was content design and development. Ongoing costs per participant totaled $501 (66.8% variable, 29.8% time-dependent, and 3.4% overhead, Table 1). The CBO arm enrolled 656 participants across 22 sites. Start-up costs totaled $511,528 of which $401,141 was content design and development. Ongoing costs per participant totaled $4,239 (9.2% variable, 69.3% time-dependent, and 21.4% overhead, Table 1). Site-specific costs ranged from $467 - $26,950 per participant with no correlation to the number of participants (Table 2, Figure 1, Spearman’s Rho = 0.007). In a hypothetical optimized CBO scenario, we estimated that 1,991 participants would enroll, start-up costs would be $470,653 and ongoing costs per participant would be $573, demonstrating that CBO delivery has the potential for similar costs to DTC delivery. Conclusion DTC implementation demonstrated lower costs per participant than CBO distribution. CBO costs were highly variable with no correlation to enrollment. It is important to note the challenges related to the COVID-19 pandemic (clinic closures and restrictions, material shortages, and price increases) when contextualizing these costing outcomes. Efficient implementation models are crucial for scaling evidence-based interventions. Disclosures Brian Mustanski, PhD, Hologic: Grant/Research Support

Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study

BackgroundAfrican Americans experience cardiovascular disease (CVD) disparities, and the burden is greatest in the rural south. Although evidence-based CVD prevention and management programs have been tailored to this context, implementation has been limited and not sustained long-term. To understand how to implement and sustain evidence-based CVD programs at scale, we must explore the perspectives of organizations serving rural African American communities and situate findings within foundational Implementation Science frameworks.MethodsThis study used group concept mapping (GCM) to elicit and synthesize stakeholder perspectives into an action-focused conceptual model depicting factors influencing implementation of evidence-based CVD programs. Representatives of community-based, faith, and healthcare organizations serving African Americans in five rural North Carolina counties were recruited via purposive sampling techniques. Participants (total n = 31) completed three activities: 1) brainstorming in response to an open-ended prompt (n = 31); 2) sorting brainstorm data into wider concepts and rating each in terms of relative importance and feasibility (n = 26); and 3) collaborative interpretation and refinement of the concept map (n = 19). Multivariate statistical analysis was used to generate a concept map. Absolute pattern matches comparing ratings of the relative importance and feasibility of each factor were generated and depicted via ladder graphs.ResultsThe final concept map included five factors: Accessibility, Community and Social Factors, Education and Training, Financial/Resource Development, and Organization Capacity and Staffing. There was high agreement (r = .98) between ratings of importance and feasibility. Education and Training, both within organizations and the wider community, was rated as the most important and feasible factor and Financial/Resource Development was the least important and feasible.ConclusionsThe concept map emphasizes aspects of organizations (inner setting), their surrounding community (outer setting), and individual stakeholders (participants, implementers) as influencing implementation of evidence-based CVD prevention and management programs in rural African American communities. The nature of the intervention or implementation processes were de-emphasized. Organizations in rural African American communities may feel equipped to implement a range of evidence-based programs, provided strategies address the contextual and structural barriers that impede their success. Group concept mapping helped distill and prioritize initial leverage points for action in our project catchment area by facilitating a community-engaged process of data generation and interpretation.

A Scale-Out Study of an Evidence-Based Family Meals Program Delivered in the Head Start Setting: Results, Challenges, and Opportunities.

Background: There is need to identify evidence-based early childhood obesity prevention programs that are feasible and demonstrate cost-effectiveness for a broader health impact. This scale-out study leveraged community-engaged principles to compare the feasibility and cost-effectiveness of three delivery modes of a childhood obesity prevention family meals program (Simple Suppers) that demonstrated positive impacts on child and caregiver diet/nutritional health-related outcomes in a previous experimental trial tested among elementary-aged children. Methods: This three-arm (in-person, online, hybrid) pre-(T0) and post-(T1)-test study included families recruited from Head Start. Forty-five families (45 caregivers; 55 children) completed the study. The program was adapted to families with younger children (3-5 years). During the 8-week program, participants received weekly group education and meals through in-person, online, or hybrid format. Feasibility outcomes were attendance, acceptability (post-test survey; focus groups), fidelity, and cost (food; staff). Participant outcomes were related to diet/nutritional health. Kruskal-Wallis test was used to compare T0 to T1 differences in participant outcomes across delivery modes. Qualitative data were analyzed using thematic analysis. Cost-effectiveness was calculated as the net-cost of the program by changes in outcomes. Results: Overall attendance was 51.2%, and higher for in-person (72.0%) and hybrid (59.7%). Program satisfaction rate was highest for hybrid (93.0%), as well as program fidelity (96.7%). Focus group results revealed areas of program improvement, behavior change, and program approval. Cost was lowest for hybrid ($17.09/family). Children in the hybrid group had a reduced waist circumference (p = 0.02) versus in-person and online groups. Conclusion: The hybrid mode of Simple Suppers demonstrated the greatest scaling potential for a broader public health impact.

Call to action for Clinicians in the South-East Asian Regions on Primary Prevention of Diabetes in people with Prediabetes- A Consensus statement.

Primary prevention of diabetes still remains as an unmet challenge in a real world setting. While, translational programmes have been successful in the developed nations, the prevailing social and economic inequities in the low and middle income countries, fail to integrate diabetes prevention into their public health systems. The resulting exponential increase in the prevalence of diabetes and the cost of treatment has put primary prevention in the back seat. As a call to action, an expert group was formed to lay down practical guidelines for clinicians in the South East Asian regions to implement primary prevention programmes at an individual or at a community level. The guideline was developed based on the outcomes of the evidence based prevention programmes conducted in India. This decentralised self-guided approach for primary prevention of diabetes follows a three step implementation process of screening, diagnosis of intermediate hyperglycaemia and design and delivery of personalized interventions. Recommendations provided on dietary intake and physical activity can be tailored by the clinician to suit individual needs. Initiation of pharmacological treatment to achieve desired targets has also been addressed. A personalised approach by the clinician may be effective and offer a sustainable solution to curb the rising epidemic.

ADVANCING OLDER ADULTS’ QUALITY OF LIFE AND INDEPENDENCE WITH FITNESS: INNOVATIVE APPROACHES AND STRATEGIES

Abstract This symposium by the Fitness, Exercise, and Wellness (FEW) Interest Group showcases diverse approaches to enhancing well-being and quality of life for older adults through innovative exercise interventions and research methodologies. Dr. Sara Pappa’s work outlines the success of the Northern Virginia Falls Prevention Alliance in deploying community-based evidence-based fall prevention programs, highlighting the effectiveness of academic-community partnerships in implementing and scaling such initiatives. Dr. James Dowd delves into the motivations of older runners, revealing that while health benefits play a role, the habit and joy of running are fundamental factors in their persistence, shedding light on the fortitude of this demographic and the new insights that this research is contributing to the field. Dr. Julie Ries and colleagues address research redundancy in meta-analyses evaluating exercise interventions for older adults with cognitive impairments, advocating for more strategic and ethical research practices to optimize resources and knowledge accumulation. Finally, Dr. Patricia C. Heyn and colleagues present a case study of implementing the 4Ms framework in dementia care in Brazil, emphasizing personalized approaches and the role of technology in maintaining family engagement and improving caregiving quality and connectivity from afar. Together, these innovative presentations highlight the importance of interdisciplinary collaborations, personalized care approaches, and technological innovations in promoting older adults’ functional well-being and autonomy, particularly in the realms of fall prevention, physical activity performance, cognitive health, and dementia care.

Article RETRACTED due to manipulation by the authors A systematic review and meta-analysis of the impact of muscle fatigue on the biomechanics of joint range of motion (ROM) in badminton

This study aims to evaluate the impact of muscle fatigue on the biomechanics of joint range of motion (ROM) in badminton athletes through a systematic literature review and meta-analysis. Muscle fatigue can affect athletic performance, particularly in dynamic movements such as lunges and smashes. Using the Systematic Literature Review (SLR) method and PRISMA, this study identified and analyzed 9 scientific articles from the Scopus and WoS databases published between 2019 and 2024. Meta-analysis was conducted by calculating the Standardized Mean Difference (SMD) and the 95% confidence interval (95% CI). The results showed that ROM in the hip joint significantly decreased after fatigue, with an SMD of -0.56 (95% CI: -0.76 to -0.36), which increases the risk of adductor and abductor injuries. On the other hand, ankle ROM showed no significant changes between pre-fatigue and post-fatigue conditions (SMD = 0.06, 95% CI: -0.13 to 0.25). For the knee joint, significant heterogeneity was found among studies with an I² value of 52% and an overall SMD of -0.01 (95% CI: -0.28 to 0.26), indicating that the effect of fatigue on knee ROM was inconsistent. This study concludes that muscle fatigue plays a crucial role in biomechanical changes that may increase the risk of injury in badminton athletes. Coaches are advised to implement interventions such as dynamic stretching and foam rolling to reduce muscle stiffness and maintain optimal ROM during matches. This study provides a critical scientific basis for developing evidence-based injury prevention programs.

Developing Culturally Sensitive Suicide Prevention Programs for Medical Professionals in Indonesia

Introduction: Medical professionals in Indonesia experience high levels of stress, increasing their risk for mental health problems and suicidal behavior. Culturally appropriate suicide prevention programs are critical to address this issue. This study aimed to develop and evaluate the feasibility and acceptability of a culturally adapted suicide prevention program for Indonesian medical professionals. Methods: This mixed-methods study had two phases. Phase 1 involved program development, adapting an existing evidence-based suicide prevention program using a Delphi method with Indonesian mental health experts (n=10) and cultural consultants (n=5). Phase 2 comprised a pilot implementation of the program with 30 medical professionals. Quantitative data on program feasibility (attendance, completion rates) and acceptability (satisfaction surveys, qualitative feedback) were collected and analyzed. Results: The Delphi method resulted in a culturally adapted program incorporating Indonesian values related to collectivism, family support, religious beliefs, and stigma associated with mental health. Pilot implementation showed high attendance (87%) and program completion rates (93%). Participants expressed high satisfaction with the program's content, cultural relevance, and delivery format. Qualitative feedback emphasized the importance of peer support, spiritual integration, and addressing workplace stressors. Conclusion: This study provides preliminary evidence for the feasibility and acceptability of a culturally sensitive suicide prevention program for Indonesian medical professionals. Further research is needed to evaluate the program's effectiveness in reducing suicidal ideation and behavior.

Fall Prevention in Older Adults: Insights from Saudi Arabian Physical Therapists on the Otago Exercise Program.

Falls among older adults are a growing public health concern in Saudi Arabia. The Otago Exercise Program (OEP) is an evidence-based intervention aimed at reducing fall risk in this population. This study assessed the knowledge and attitudes of Saudi Arabian physical therapists toward the OEP and examined potential gender-based differences. A cross-sectional survey was conducted between November 2023 and April 2024, involving 120 licensed physical therapists from Saudi Arabia, recruited via Email and social media. The survey captured sociodemographic data, knowledge, and attitudes regarding the OEP. Responses were analyzed using descriptive statistics, chi-square tests, and Cramér's V to assess the strength of associations, with a significance level set at p < 0.05. Most physical therapists reported knowledge of the OEP's clinical effectiveness (36.7%), cultural compatibility (35.0%), and fall prevention benefits (28.3%). Gender was not significantly associated with knowledge of clinical effectiveness (χ² = 3.84, p = 0.57), contraindications (χ² = 4.44, p = 0.48), cost-effectiveness (χ² = 4.15, p = 0.52), or fall prevention in older adults (χ² = 2.44, p = 0.78), with moderate effect sizes observed (Cramer's V = 0.233 to 0.467). Attitudes toward the OEP were generally positive, with 51.7% supporting its use in regular aging care and 45.0% expressing confidence in delivering the program. There were no significant gender differences in understanding the OEP's recommendations (χ² = 7.45, p = 0.11) or confidence in program delivery (χ² = 7.62, p = 0.10), although strong association effects were noted (Cramer's V = 0.696 and 0.680, respectively). This study highlights the strong knowledge and positive attitudes of Saudi physical therapists toward the OEP, underscoring its potential for integration into national healthcare strategies to improve geriatric care and reduce fall-related risks. The findings emphasize the importance of continuous professional development to address knowledge gaps and optimize the implementation of evidence-based fall prevention programs.

Assessing the Effectiveness of a Non-Punitive Fall Prevention Program.

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results. Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive format and included all staff members directly involved in fall-related incidents. Protocols for implementing an evidence-based prevention program were developed to (1) address environmental concerns, (2) educate clinical workers and patients' families, (3) enforce interventions, (4) conduct weekly non-punitive, round table discussions, and (5) provide leadership support. Measures were implemented to proactively prevent falls. Data was collected and reported to all departments monthly. Following implementation of the program, results showed a statistically significant decrease in average fall rates per 1000 patient days from pre-intervention (4.05) to post-intervention (2.54) (P = .0001). Results showed improvement below the national average (3-5 falls per 1000 patient days), resulting in cost savings for the institution due to fewer falls. Inpatient medical-surgical and progressive care units had a noteworthy decline in the total number of falls, with notable estimated cost savings. Preventative interventions have shown effective results with compassionate, non-punitive leadership, an interdisciplinary team, and continuous follow-up education. Heeding to the Just Culture Algorithm as the foundation of weekly reviews, staff were empowered to engage in fall reduction strategies. A comprehensive weekly fall review program with ongoing staff education and transparent data reporting yielded a significant, sustained reduction in patient falls, with a substantial cost savings in excess of $1.6 million dollars over the life of the program.

Developing an Evidence-Based Primary Cancer Prevention Repository: insights from the PIECES project

Abstract Introduction Up to 40% of cancer cases could be avoided through effective primary prevention. However, cancer prevention tends to be fragmented across Europe, leading to geographical health differences. The dissemination and scale-up of effective primary cancer prevention interventions may address this. Although effective cancer prevention programs exist, finding them and their materials (especially regarding implementation) can be challenging. Repositories of evidence-based interventions provide insight into “what is out there” and can support dissemination within and across national borders. The PIECES project aims to develop and disseminate a repository of evidence-based primary cancer prevention programs adaptable to European contexts, with information to aid adaptation and implementation across countries. Methods The development of the PIECES repository has been informed by established repositories such as NCI’s Evidence-Based Cancer Control Programs. The project team developed a scoring sheet with a selection of items that could be included in the repository. All participants rated each item on relevance and applicability and provided comments and suggestions. A final framework, including a set of minimal requirement items, was agreed upon during three online consensus building meetings. Results We created a repository of evidence-based primary cancer prevention interventions targeting modifiable risk factors suitable for implementation in European healthcare settings. This 22-item repository provides information about an intervention’s logic model, implementation practices, and appraisal of published evidence of effectiveness. Conclusions This repository is innovative as it includes practical information and tools to facilitate implementation. While initially built to serve the PIECES project, the repository is designed to be a valuable tool for European policymakers, researchers, and implementers. Lessons learned from this process will inform future developers. Key messages • A comprehensive cancer prevention intervention repository avoids “reinventing the wheel” and allows for more efficient use of existing interventions by building upon the best available evidence. • The ongoing efforts of the PIECES project represent a significant contribution to reduce cancer prevention disparities and to facilitate the adoption of evidence-based interventions in Europe.

A National Strategy for Preventing Substance and Opioid Use Disorders Through Evidence-Based Prevention Programming That Fosters Healthy Outcomes in Our Youth.

The recently released National Drug Control Strategy (2022) from the White House Office of National Drug Control Policy (ONDCP) lays out a comprehensive plan to, not only enhance access to treatment and increase harm reduction strategies, but also increase implementation of evidence-based prevention programming at the community level. Furthermore, the Strategy provides a framework for enhancing our national data systems to inform policy and to evaluate all components of the plan. However, not only are there several missing components to the Strategy that would assure its success, but there is a lack of structure to support a national comprehensive service delivery system that is informed by epidemiological data, and trains and credentials those delivering evidence-based prevention, treatment, and harm reduction/public health interventions within community settings. This paper provides recommendations for the establishment of such a structure with an emphasis on prevention. Systematically addressing conditions known to increase liability for behavioral problems among vulnerable populations and building supportive environments are strategies consistently found to avert trajectories away from substance use in general and substance use disorders (SUD) in particular. Investments in this approach are expected to result in significantly lower rates of SUD in current and subsequent generations of youth and, therefore, will reduce the burden on our communities in terms of lowered social and health systems involvement, treatment needs, and productivity. A national strategy, based on strong scientific evidence, is presented to implement public health policies and prevention services. These strategies work by improving child development, supporting families, enhancing school experiences, and cultivating positive environmental conditions. Appeared originally in Clin Child Fam Psychol Rev 2023; 26:1-16.

Teachers' Perceptions of the Impact of the COVID-19 Pandemic and Their Implementation of an Evidence-based HIV Prevention Program in the Bahamas.

Information on how school-based programs is implemented and sustained during crises is limited. In this study, we assessed the impact of the COVID-19 pandemic on the implementation of a HIV prevention intervention in The Bahamas. Data were collected from 139 Grade 6 teachers in 2021-2022. Teachers attended virtual training and received implementation monitoring from coordinators. On average, teachers taught 26.4 (SD = 9.2) of the 35 core activities, and 7.4 (SD = 2.4) out of 9 sessions. More than half (58.3%) of teachers completed 28 or more core activities; 69.1% covered eight or all nine sessions, which is equivalent to 80% of the HIV intervention curriculum. Almost half of the teachers (43%) reported that the pandemic negatively impacted their ability to teach the program; 72% of teachers maintained that the program remained "very important" during times of crisis. Greater self-efficacy and supports increased implementation fidelity.

Study protocol: process and outcome evaluation of the Walk with Ease program for fall prevention

BackgroundFalls are the leading cause of injury related morbidity and mortality in older adults. Primary and secondary prevention strategies that address modifiable risk factors are critically important to reduce the number of falls and fall related injuries. A number of evidence-based fall prevention programs are available, but few offer potential for broad dissemination and public health impact due to implementation barriers, such as a need for trained program leaders and clinicians.MethodsThe study will use a randomized controlled trial design to evaluate incorporating physical therapy exercises (primary prevention strategy) within an existing intervention called Walk with Ease. While Walk with Ease has an established evidence-base related to the management of arthritis pain and symptoms, the present study will determine the potential to also reduce falls and fall risk in community-dwelling older adults. The integrated process and outcome evaluation will determine the relative effectiveness of individually-prescribed exercises (compared to standardized exercises) as well as the potential of ‘habit training’ resources (relative to generic behavior prompts) to improve compliance with exercises in this population.DiscussionThe study, conducted through a local clinical-community partnership will advance both the science and practice of community-based fall prevention programming, while also informing implementation strategies needed to promote broader dissemination.Trial registrationClinicalTrials.gov, NCT05693025, Registered January 20, 2023, Updated March 1, 2023.

Adoption, Implementation, and Maintenance of Evidence-Based Falls Prevention Programs.

We evaluate the implementation of evidence-based falls prevention programs (EBFPPs) of the Administration for Community Living (ACL) Grantees by (1) describing adoption; (2) evaluating implementation through participant adherence; and (3) describing program maintenance. Secondary data analysis of a national data repository included forty-four ACL grantees spanning 31 states who were funded between September 2014 and December 2019 and provided information on over 80,000 older adult participants. Descriptive statistics including frequencies, percentages, and means were used to describe adoption, implementation (adherence), and maintenance of EBFPPs. Senior centers were the most common organizations to adopt EBFPPs. Most programs were maintained at their respective organizational site through repeat offerings, with several programs (60%) being offered greater than 10 times. Information regarding adoption, implementation, and maintenance of EBFPPs is valuable in identifying the best programs suited for different organizations and their clientele, which can inform policy for scaling and sustaining EBFPPs across the nation.

Translation, extension, and evaluation of usability, usefulness, and safety of a fall prevention and management program for people living with spinal cord injury and multiple sclerosis who use wheelchairs or scooters full time.

Falls are prevalent among people living with Multiple Sclerosis (PwMS) and Spinal Cord Injury (PwSCI) who use wheelchairs or scooters (WC/S) full time, however, there is a scarcity of evidence-based fall prevention and management programs. To describe the systematic translation of an in-person fall prevention and management program (Individualized Reduction Of FaLLs - iROLL) for PwMS to an online platform, extending its scope to include PwSCI, and to evaluate the preliminary useability, usefulness, and safety of the intervention. iROLL was systematically translated to an online platform (iROLL-O). PwMS and PwSCI who use a WC/S full time, experienced at least one fall within the past 36 months, and could transfer independently or with minimal to moderate assistance, enrolled in iROLL-O. Usability, usefulness, and safety were evaluated through 1:1 semi-structured interviews, gathering feedback on: perceived impact of the intervention on falls and functional mobility, program experiences, adverse events, and recommendations for improvement. Five participants successfully completed the iROLL-O program. No safety concerns were raised by participants. Themes emerging from the semi-structured interviews included: (1) barriers and facilitators to program access, (2) motivation for participation, (3) program outcomes, and (4) program content and structure. Participants reported reduced concerns about falling, enhanced functional mobility skills, and highlighted the supportive nature of synchronous group meetings for learning. No adverse events occurred during the implementation of iROLL-O and participants found the program to be useable and useful. Further testing is needed to examine efficacy among a large and diverse population.

“He flattered me”. A comprehensive look into online grooming risk factors: Merging voices of victims, offenders and experts through in-depth interviews

Online grooming is the process by which an adult uses the Internet to initiate a dynamic of sexual persuasion and victimisation through online contact to obtain an encounter or sexual content from a minor. Although there is an abundant literature of attempts to define the risk factors for grooming, fewer studies have addressed the risk factors qualitatively through direct interviews with offenders, victims and experts. Further understanding such characteristics of the grooming process allows the development and improvement of evidence-based prevention programmes, designed to target specific risk factors. To deepen our understanding of how risk factors operate and how offenders exploit minors’ vulnerabilities, the European H20201 project RAYUELA conducted 15 in-depth interviews with offenders, 8 with victims, and 23 with subject-matter experts from different European countries. The results, based on a categorical content analysis, are consistent with previously reported risk factors for victims. Social isolation was revealed as the most relevant factor. The age of greatest risk is in adolescence due to the characteristics of this developmental stage, among which sexual curiosity stands out. In relation to gender, although girls receive more requests from groomers, boys are more likely to accept them, showing a different perception of the risk. Other relevant factors found non-heterosexual sexual orientation, and poor family communication. In addition, a high percentage of offenders were found to be from the victims’ environment. Thus, a relevant conclusion is that risk factors cannot be separated from structural aspects of the offline reality, such as gender stereotypes and lack of sex education, so focusing on them in prevention may be more effective than addressing exclusively Internet aspects.

208 - How can evidence-based early childhood obesity prevention programs achieve adoption, integration and scale-up: A comparative case study

208 - How can evidence-based early childhood obesity prevention programs achieve adoption, integration and scale-up: A comparative case study

Evaluation of a Schema Therapy-Based Prevention Group Program for Children and Their Parents

Although Schema Therapy has emerged as an effective treatment for a large range of psychopathology, there is limited research on its effectiveness with children and adolescents, especially for preventive purposes, in individual or group settings and with the involvement of parents. Therefore, the aim of this study was to conduct a preliminary evaluation of a newly developed group prevention program based on Schema Therapy (rationale, principles, and techniques) for children and their parents. It is a psychoeducational, developmentally-appropriate program addressing core emotional needs, early maladaptive schemas, schema modes, coping styles, and parent-child relationship with the aim of preventing the emergence of psychopathology in children. Participants were 90 Greek children (aged 9-13) who attended 16 weekly meetings and their parents who attended 10 biweekly meetings. The effectiveness of the program was evaluated with pre-and-postintervention assessment (i.e., pre-experimental design). Children’s early maladaptive schemas (self-reports) and strengths and difficulties (self- and parent-reports), as well as parents’ early maladaptive schemas (self-reports) were assessed. Results showed a significant decrease in most early maladaptive schemas of children and in many early maladaptive schemas of parents. A significant decrease was found in children’s emotional symptoms, peer relationship problems and total difficulties score and a significant increase in prosocial behavior. The supporting evidence for the effectiveness of the program and the necessity of evidence-based prevention programs based on Schema Therapy for children and parents are discussed.

A mixed-methods approach to assessing implementers’ readiness to adopt digital health interventions (RADHI)

BackgroundDespite being the primary setting for HIV prevention among men who have sex with men (MSM) since the start of the epidemic, community-based organizations (CBOs) struggle to reach this historically stigmatized and largely hidden population with face-to-face interventions. HIV researchers have readily turned to the internet to deliver critical HIV education to this group, with evidence of high effectiveness and acceptability across studies. However, implementation outside of research contexts has been limited and not well studied. We aimed to assess HIV CBOs’ readiness to adopt digital health interventions and identify contextual factors that may contribute to differing levels of readiness.MethodsWe recruited 22 CBOs across the US through a pragmatic request-for-proposals process to deliver Keep It Up! (KIU!), an evidence-based eHealth HIV prevention program. We used mixed methods to examine CBO readiness to adopt digital health interventions (RADHI). Before implementation, CBO staff completed a 5-item RADHI scale (scored 0–4) that demonstrated concurrent and predictive validity. We interviewed CBO staff using semi-structured questions guided by the Consolidated Framework for Implementation Research and compared RADHI score groups on determinants identified from the interviews.ResultsEighty-five staff (range = 1–10 per CBO) completed the RADHI. On average, CBOs reported moderate-to-great readiness (2.74) to adopt KIU!. High RADHI CBOs thought KIU! was a top priority and an innovative program complementary to their existing approaches for their clients. Low RADHI CBOs expressed concerns that KIU! could be a cultural mismatch for their clients, was lower priority than existing programs and services, relied on clients’ own motivation, and might not be suitable for clients with disabilities. Value, appeal, and limitations did not differ by RADHI group.ConclusionsWhile HIV CBOs are excited for the opportunities and advantages of digital interventions, additional pre-implementation and implementation support may be needed to increase perceived value and usability for different client populations. Addressing these limitations is critical to effective digital prevention interventions for HIV and other domains such as mental health, chronic disease management, and transitions in care. Future research can utilize our novel, validated measure of CBOs’ readiness to adopt digital health interventions.Trial registrationNCT03896776, clinicaltrials.gov, 1 April 2019.

An initial assessment of an opinion leader-informed intervention to improve concussion-related outcomes among middle school parents: a randomized controlled trial

Introduction There is a need for evidence-based prevention programming that can reduce head impacts and increase reporting and disclosure of concussion. This study assessed an intervention to decrease concussion risk and improve concussion management through improving concussion-related knowledge, attitudes, intentions, and self-efficacy among parents in the middle school (MS) sport setting. Patients and methods This randomized controlled trial (NCT04841473) examined parents of MS-aged children. Participants were randomized into one of two study arms: (1) CDC, which completed an education training module that compiled concussion education from the Centers for Disease Control and Prevention (CDC); and (2) TRAIN + CDC, which completed the CDC training module and an additional TRAIN educational module that provided strategies (originating from the Popular Opinion Leader framework) on communicating such information with one’s personal peer networks and children. Validated measures of concussion-related knowledge, attitudes, intentions, and self-efficacy were collected before completing the training modules and one week following completion. Linear mixed model analyses examined differences in outcomes between study arms. Results Overall, 103 parents completed the training modules and had valid pre- and post-intervention data (TRAIN + CDC n = 49; CDC n = 54). Analyses found that the study arms did not differ in the change scores from pre- to post-intervention across concussion-related outcomes. However, scores from pre- to post-intervention improved across both study arms for knowledge metrics, such as ‘Concussions are less likely to happen when athletes play by the rules of the sport’ (p < 0.001), and self-efficacy metrics, such as feeling confident in one’s knowledge and recognition of concussion symptoms (p < 0.001 and p = 0.001, respectively). Conclusions Although study arms did not differ in change scores from pre- to post-intervention, beneficial increases were nonetheless found across both knowledge and self-efficacy. Additional research is needed to further examine the beneficial manners in which concussion education can be best delivered and the most effective.