Evidence-based Intervention Programs Research Articles

Coalition for Global Hearing Health Hearing Care Pathways Working Group: Guidelines for Clinical Guidance for Readiness and Development of Evidence-Based Early Hearing Detection and Intervention Programs.

Editor's Note: The following article discusses the timely topic Clinical Guidance in the areas of Evidence-Based Early Hearing Detection and Intervention Programs. This article aims to discuss areas of services needed, guidance to countries/organizations attempting to initiate early hearing detection and intervention systems. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. In Ear and Hearing, our long-term goal for the Point of View article is to stimulate the field's interest in and to enhance the appreciation of the author's area of expertise. Hearing is an important sense for children to develop cognitive, speech, language, and psychosocial skills. The goal of universal newborn hearing screening is to enable the detection of hearing loss in infants so that timely health and educational/therapeutic intervention can be provided as early as possible to improve outcomes. While many countries have implemented universal newborn hearing screening programs, many others are yet to start. As hearing screening is only the first step to identify children with hearing loss, many follow-up services are needed to help them thrive. However, not all of these services are universally available, even in high-income countries. The purposes of this article are (1) to discuss the areas of services needed in an integrated care system to support children with hearing loss and their families; (2) to provide guidance to countries/organizations attempting to initiate early hearing detection and intervention systems with the goal of meeting measurable benchmarks to assure quality; and (3) to help established programs expand and improve their services to support children with hearing loss to develop their full potential. Multiple databases were interrogated including PubMed, Medline (OVIDSP), Cochrane library, Google Scholar, Web of Science and One Search, ERIC, PsychInfo. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. Eight essential areas were identified to be central to the integrated care: (1) hearing screening, (2) audiologic diagnosis and management, (3) amplification, (4) medical evaluation and management, (5) early intervention services, (6) family-to-family support, (7) D/deaf/hard of hearing leadership, and (8) data management. Checklists are provided to support the assessment of a country/organization's readiness and development in each area as well as to suggest alternative strategies for situations with limited resources. A three-tiered system (i.e., Basic, Intermediate, and Advanced) is proposed to help countries/organizations at all resource levels assess their readiness to provide the needed services and to improve their integrated care system. Future directions and policy implications are also discussed.

Abstract PO2-19-04: Trial in Progress: The REJOIN Trial to Use Exercise and Education to Relieve Joint Pain in Older Breast Cancer Survivors Taking Aromatase Inhibitors

Abstract Background: Physical activity (PA) is a recommended part of breast cancer survivorship. PA promotes survival and mitigates symptoms in older breast cancer survivors (BCS), especially in reducing joint pain associated with Aromatase Inhibitors (AIs). The purpose of the study is to test if a self-management intervention (including education and exercise instruction) improve joint pain management better than standard care. Trial Design: This two-armed randomized controlled pilot trial (NCT03955627) includes insufficiently active BCS, 60 years and older, diagnosed with stage I-III hormone-sensitive breast cancer, who have completed primary cancer treatment and are within 6 months of initiating AIs. We adapted an evidence-based PA program for older adults (Fit and Strong!) that includes bi-weekly, supervised exercise sessions plus education (90 minutes total). The 16-week, evidence-based intervention program includes: 8-weeks of supervised sessions delivered remotely plus 8-weeks of self-guided home sessions with periodic phone coaching. We are conducting select geriatric assessments (e.g., cognitive assessment, polypharmacy) plus measurements of exercise (both self-reported and objectively measured by accelerometer), joint pain (brief pain inventory), and AI adherence (confirmed by self-report and prescription records) assessed four times (baseline, 4, 6 and 12 months). Eligibility Inclusion criteria: • Female, aged ≥ 60 years at enrollment • Planning to initiate (or are < 24 weeks from initiating) AIs • Diagnosed stages I-III breast cancer • ER+ tumor (at least 5% of cells) • Completed surgery, radiation and/or chemotherapy • Independent ambulator (verified by treating clinician/staff) • Physician approval to start an exercise program • Insufficiently active (less than 150 minutes per week of moderate intensity activity or less than two sessions per week of strength training) • Able to complete surveys and forms/understand English • Agree to random assignment to treatment or control group • Can commit to 8 weeks, bi-weekly classes offered by Zoom video and 8 Weeks of at-home exercise. • Must have internet access or data plan to support video conferencing software • Minimum cognitive impairment (verified by cognitive screening questions administered by phone) Specific Aims: The primary aim is to test the efficacy of a self-management intervention (exercise plus education) on AI-associated arthralgia. Hypothesis: Participants in the treatment group will report less pain than the control group. –A secondary aim is to test the effect of the pilot intervention on adherence to AIs. Hypothesis: Participants in the treatment group will report better AI Adherence than controls. Statistical Methods: We will use the Wilcoxon-Mann-Whitney t-test to assess the effect size from the start to the end of the trial, assuming a power calculation of 80%, a two-sided alpha of 10%, and a pooled standard deviation of one between the outcomes of the two groups (usual care and treatment) being compared. Present Accrual and Target Accrual REJOIN enrolled 12 participants in 2022, but two withdrew after randomization. We now have data on 10 participants with a target accrual of 24 overall. The original 12 were accrued at Penn State College of Medicine. We subsequently opened a second site at Wake Forest University and are recruiting the remaining participants. Contact information: For more information about REJOIN, please contact the study director, Dr. Shirley Bluethmann at sblueth@wakehealth.edu or the REJOIN project manager, Angela Grubb, at agrubb@wakehealth.edu Citation Format: Shirley Bluethmann, Peri Newman, Cristina Truica, Nancy Olsen, Heidi Klepin. Trial in Progress: The REJOIN Trial to Use Exercise and Education to Relieve Joint Pain in Older Breast Cancer Survivors Taking Aromatase Inhibitors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-19-04.

자폐 조기중재의 부모 코칭에 대한 사례 연구

This case study explores the factors that may influence the parent coaching fidelity and intervention fidelity in a parent-implemented intervention within the context of early intervention for autism. Drawing from Stahmer et al.’s (2020) research, the study involved one early intervention provider, two parents, and two toddlers either diagnosed with or at a high likelihood of autism. Video behavior coding was used as the primary method for data collection, focusing on (1) the duration spent on each coaching strategy, (2) the frequency of feedback types, and (3) the frequency of toddlers’ behaviors that were challenging to address. The study data, parent coaching fidelity, and intervention fidelity outcomes were analyzed and compared, and implications and recommendations for early intervention settings were summarized based on the results. The discussion focuses on the importance of adopting the implementation science framework for promoting effective parent coaching and parent-implemented intervention practices, the significance of support for early intervention providers and families, the need for factor analysis in studies with larger sample sizes to facilitate more statistically meaningful outcomes, and the importance of implementing cultural adaptation processes when introducing evidence-based parent-implemented intervention programs from other countries to South Korea.

What would you do? Developing, implementing and evaluating a coach bystander intervention to prevent sexual violence in youth sports clubs

With current estimates of up to one in three children experiencing some form of sexual violence in sports, the need for effective measures to prevent sexual violence in sports is high. Survivors’ narratives of sexual violence in sports uncover the lack of (adequate) bystander action and the urgent need for stakeholder education to effectively prevent sexual violence in youth sports. This study presents the “All Aboard” educational program, targeting youth sports coaches in Flanders (Belgium). The program aimed to stimulate the intentions of youth coaches to engage in positive bystander behavior to adequately detect, assess, and respond to signs of sexual violence toward young athletes. After two pilot studies, this program was implemented in nine Flemish sports clubs. Coaches’ readiness to change, intentions and attitudes, perceived norms, and perceived behavioral control were measured before and after they participated in the program using the “And what would you do?” questionnaire, constructed according to the Reasoned Action Approach. After the program, positive change was found in coaches’ intentions to be a positive bystander, e.g., they acknowledged the value of being a positive bystander, felt more comfortable being a positive bystander and believed that doing so would improve the situation. This article is one of the first to report on an evidence-based intervention program to prevent sexual violence in sports by fostering positive attitudes toward positive bystander behaviors by coaches. Opportunities and challenges of implementing education to prevent sexual violence in local sports clubs are discussed.

Effectiveness of Robotic Intervention on Improving Social Development and Participation of Children with Autism Spectrum Disorder - A Randomised Controlled Trial.

Evidence-based robotic intervention programmes for children with autism spectrum disorder (ASD) have been limited. As yet, there is insufficient evidence to inform therapists, teachers, and service providers on effectiveness of robotic intervention to enhance social development and participation of children with ASD in a real context. This study used a randomised controlled trial to test the efficacy of robotic intervention programmes in enhancing the social development and participation of children with ASD. 60 children with ASD were included. The participants were randomly assigned to the following groups: (1) robotic intervention programme (n = 20), (2) human-instructed programme (n = 20), and (3) control group (n = 20). Both the performance-based behavioural change in social communication and parent-reported change in social responsiveness were evaluated. The participants in the robotic intervention group demonstrated statistically significant changes in both the performance-based assessment and parent-reported change in social participation. Significant differences were found in the communication and reciprocal social interactions scores between the experimental group and the control and comparison groups in the performance-based assessment (p < 0.01). The effectiveness of robotic intervention programme to enhance the social communication and participation was confirmed. Future studies may also consider adding a maintenance phase to document how the effects of the intervention carry over to the participants over a longer period. (Clinical trial number: NCT04879303; Date of registration: 10 May 2021).

Factors affecting nursing practice of patient physical restraint among nurses

BackgroundThis study was aimed to identify perception, knowledge, attitude and nursing practice toward use of physical restraints among clinical nurses.MethodsThe research participants were 180 nurses from general hospitals located in Korea. Data were collected using self-report questionnaires regarding perception, attitude, knowledge, and nursing practice on application of physical restraints and analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression.ResultsThere were significant negative relationships attitudes towards the use of physical restraints with knowledge (r = -.32, p < .001). Knowledge showed a positive correlation with nursing practice (r = .28, p < .001). Factors affecting nursing practice of clinical nurses were identified as knowledge (β = .23), education experiences on physical restraints (Yes) (β = .18), and work unit (ICU) (β = .43). The explanation power of this regression model was 22% and it was statistically significant (F = 7.45, p < .001).ConclusionThis study suggests that knowledge, education experiences on physical restraints, and work unit were the strongest predictor on nursing practice toward use of patient physical restraints. Therefore, developing and applying evidence-based educational intervention programs by work unit to reduce the inappropriate use of physical restraints in hospitals are required.

Analysis of the Relationship Between Sexual Violence and Assertive Behavior in Young Spanish Adults

Abstract Introduction Research on sexual violence is of particular importance because of the prevalence and consequences of such violence in the young adult population. The identification of possible protective factors may be one step towards helping ameliorate this problem. We therefore analyzed the relationship between sexual violence and assertive behaviors in a population of young adults. Method A cross-sectional, correlational study. Data were collected between February 7, 2022, and August 9, 2022, in a population of young adults from Spanish universities. The sample consisted of 473 young adults between 19 and 24 years of age. Results The prevalence of violence perpetrated and experienced in the sample was high. Men reported a higher level of violence perpetration than women. Relationships are indicated between different types of assertive behaviors and sexual violence. In this regard, a higher degree of assertive behavior as a response is a protective factor against experiencing sexual violence in both sexes, while non-assertive behavior is a risk factor. In the case of sexual violence perpetration, overly assertive behavior is a risk factor. Conclusions A number of assertive behaviors were identified that may be considered risk or protective factors for sexual violence. Policy Implications Research enables the development of targeted, evidence-based intervention programs that can lead to a reduction in sexual violence in the young adult population.

PROMOTING HONG KONG ADULTS TO AGE WELL: INTERVENTION EFFECTS ON AGING PREPARATION ACROSS FOUR DOMAINS

Abstract Preparations for old age benefit physical and psychological health in later life. The population in Hong Kong has the longest life expectancy in the world. However, Hong Kong residents prepare less for their old age than their counterparts in the US and Europe. Hence, an evidence-based intervention program was developed to improve old-age preparation in Hong Kong. The program aimed to comprehensively cover the preparation for old age by involving four domains (finance, health, social relationship, and leisure activity). Specifically, the program started with four workshops where participants learned from experts on how to prepare for old age in four domains. Then, participants were grouped according to their domains of interest, and guided planning was provided to empower them to hold their old age-preparation activities for six months. A tracking survey was conducted every two weeks during the period. Finally, 140 adults (31 males; 45-83 years of age, Mage = 65.21, SD = 7.52) finished the intervention program. Findings showed that participants increased their levels of self-control, readiness for, and satisfaction with aging preparation in three domains (all except finance) after joining the workshop. After six months of intervention, a reduction in anxiety and an improvement in meaningfulness were also found in all four domains. These findings suggest that the intervention program motivates individuals to engage more in age-related preparatory behaviors across domains. This has practical implications for training old-age preparation.

IDENTIFYING AND PREVENTING RESIDENT-TO-RESIDENT AGGRESSION IN LONG-TERM CARE: EMERGING GLOBAL PERSPECTIVES

Abstract Resident-to-resident aggression (RRA) is a widespread form of mistreatment in long-term care facilities, affecting 1 in 5 residents every month. Despite its high frequency and adverse consequences for residents, staff, and family members, RRA remains under-recognized and insufficiently studied. Several reasons exist for this, including challenges in obtaining high-quality data to inform evidence-based prevention and intervention strategies. Improved understanding of RRA aligns with recent national policy imperatives to increase nursing home safety and quality of care. To accelerate knowledge-to-practice translation, this symposium highlights expertise from North America and Asia to review the latest evidence and experiences that characterize and improve RRA. Dr. E-Shien Chang will identify the role of racial and ethnic conflicts in RRA using data from the largest RRA prevalence cohort study of U.S. nursing home residents. Dr. Elsie Yan will examine resident and environment risk factors of RRA in Hong Kong, illustrating the needs for improved dementia care training among direct care workers. Dr. David Burnes will discuss barriers, successes, and lessons learned in replicating and adapting a gold standard U.S. based RRA prevalence study in the unique context of Canada. Dr. Karl Pillemer will describe a novel dissemination model to expand program reach of Improving Resident Relationships in Long Term Care (IRRL), an evidence-based RRA intervention program. Finally, Dr. Laura Mosqueda, as policy expert of long-term care services and discussant, will moderate a discussion on translating RRA research to practice and policy changes within the global contexts of long-term care. This is a collaborative symposium between the Abuse, Neglect and Exploitation of Older Persons and Research in Quality of Care Interest Groups.

Ethno-religious discrimination and adjustment among Muslim adolescents: the promotive and protective roles of ethnic and religious identification

ABSTRACT Due to rising Islamophobia in Europe today, Muslim ethnic minority adolescents are at great risk of experiencing identity-based harassment at school. We extend previous research on ethnic discrimination by focusing on religious discrimination of Muslim adolescents and its effect on their psychological (i.e., depressive symptoms and self-esteem) and behavioural adjustment (i.e., disruptive behaviour at school). Further, we consider Muslim adolescents’ ethnic and religious identification as two factors that may promote adolescents’ adjustment and protect them from the negative consequences of discrimination. We used data from N = 105 Muslim ethnic minority adolescents (M age = 13.30, SD = 0.75, 45% female). Factor analysis revealed that adolescents did not differentiate between ethnic and religious discrimination. Results show that higher perceived ethno-religious discrimination (PERD) was related to more depressive symptoms. While higher ethnic identification was associated with greater self-esteem, higher religious identification was related to fewer depressive symptoms. Contrary to our expectation, Muslim adolescents who were highly identified with their ethnic group reported more depressive symptoms when experiencing more PERD. Their self-esteem was negatively affected by higher PERD when possessing high religious identification, while for low religious identification a positive effect of higher PERD on self-esteem emerged. Results highlight the importance of developing evidence-based intervention programmes for schools to tackle identity-based harassment.

Treatment-seeking young people enrolled in a United States vaping cessation intervention trial report high frequency of use and nicotine dependence

ObjectiveThis study examines characteristics of participants enrolled in a vaping cessation intervention trial and study generalizability of the treatment-seeking sample to the broader population of young people interested in quitting vaping to evaluate dissemination of an evidence-based treatment program. MethodsData was obtained from 697 treatment-seeking participants (aged 13–24 years) from a vaping cessation intervention trial conducted between February and March 2023 with This is Quitting and 665 participants who expressed intent to quit vaping in the Truth Longitudinal Cohort, a nationally representative longitudinal study of United States youth and young adults (aged 15–24 years), collected October 2022 to February 2023. Comparisons were made using two-sample Pearson Chi-square tests and t-tests. ResultsTreatment-seeking young people were younger, less racially diverse, more diverse in sexual orientation, and reported higher psychological distress, frequency of e-cigarette use, and nicotine dependence, relative to the nationally representative sample of young people expressing intentions to quit vaping. ConclusionsParticipants enrolled in treatment reported higher levels of dependence and use frequency than the broader population, suggesting that many young e-cigarette users with lower dependence who want to quit might not be reached by current treatment dissemination efforts. The implication of these findings is that communications for vaping cessation programs may need to be adjusted to have broader appeal among young people.

A Summary of Fatal Injury Surveillance Methods in Australian Agriculture and Their Impact on Safety Policies and Practices

ABSTRACT Agriculture is one of the most important and also hazardous industries in Australia. Having a sound knowledge and understanding of the circumstance of injury events is critical to developing evidence-based intervention programs. This paper aims to provide a brief historical snapshot of the development of data systems underpinning the assessment of fatal farm injury in Australia and how it has impacted on safety policy and practice. The first Australian studies used coronial information to explore agricultural fatalities, these studies reviewed paper-based records (in-situ) and collected the information for analysis and reporting. This task was laborious and costly. When the National Coronial Information System (NCIS) was established in 2000, this allowed access to coronial records online. Information provided about the deceased includes demographics, contextual details on the nature of the fatality and autopsy, toxicology, and police reports, as-well-as the coroner’s finding. Information from the NCIS, along with media reports, have been used to develop the farm fatality database. This information has been used to inform the safety goals and targets for farm commodity groups, identify key risks, provide long-term benchmark indicators and underpin the development of prevention materials and training resources. Without accurate, timely, concise and relevant data about injury occurring on farms, there is no evidence to drive policy and practice or to evaluate programs of work. As such, the continued utilization and extension of the NCIS data will prove crucial to further reducing the burden of preventable fatal injuries on Australian farms.

Addressing Attrition from Psychotherapy for PTSD in the U.S. Department of Veterans Affairs

The United States Department of Veterans Affairs (VA) uses a systematized approach for disseminating evidence-based, trauma-focused psychotherapies for post-traumatic stress disorder (PTSD). Within this approach, veterans with PTSD must often choose between Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), each delivered in their standard protocols. Many veterans have been greatly helped by this approach. Yet limiting trauma-focused therapy to these two options leaves the VA unable to fully address the needs of a variety of veterans. This limitation, among other factors, contributes to the suboptimal attrition rates within the VA. The present review proposes solutions to address treatment barriers that are both practical (such as time and travel constraints) and psychological (such as resistance to trauma exposure). By reducing barriers, attrition may lessen. Proposed countermeasures against practical barriers include intensive protocols, shortened sessions, telehealth, smartphone application delivery, or any combination of these methods. Countermeasures against psychological barriers include alternative evidence-based treatment programs (such as Acceptance and Commitment Therapy), intensive protocols for exposure-based treatments, and the integration of components from complementary treatments to facilitate PE and CPT (such as Motivational Interviewing or family therapy). By further tailoring treatment to veterans’ diverse needs, these additions may reduce attrition in VA services for PTSD.

Pakistan’s Opioid Squeeze: Impacts of Taliban Edicts, Indian Synthetics and Chinese Regulations

This study examines how the Taliban’s opium poppy eradication edict and the westward shift in illicit fentanyl production from China to India potentiates an opioid squeeze on Pakistan from its east-west flanks, influencing Pakistan’s opioid production, distribution and use. As opioid output sputters in Afghanistan, while Indian chemists increasingly normalise illicit fentanyl production in South Asia, opportunistic Pakistani chemists will be incentivised to supply synthetic opioids to high-demand international markets, just as Pakistani farmers supply opium and heroin to international clients. This convergence has ramifications for Pakistani law, drug enforcement and public health, as domestic production increases domestic access to synthetic opioids. The article conducts an empirical examination of current trends in South Asian opioid production, distribution and use, along with an exegesis of the legal and regulatory systems in Pakistan, Afghanistan and China. This study also details how the Pakistani government should respond to this challenge legislatively, foremost through blanket ban of fentanyl and its precursors. Pakistan can reduce domestic use through evidence-based treatment programmes, including discrete and confidential treatment administered by females to female users, opioid substitution therapy, safe needle exchange programmes, culturally sensitive drug awareness campaigns, and increased data collection to detect geographic hotspot locations of opioid use and overdoses.

Effectiveness of Parent-Child Interaction Therapy(PCIT) for Children with Problem Behavior: Meta-Analysis

Parent-Child Interaction Therapy (PCIT) is an evidence-based short-term treatment program designed for preschool children (2 to 7 years old) and parents with behavior or emotional problems, and is an effective intervention method to improve parent-child relationships and reduce children’s problem behavior. The purpose of this study is to estimate the effect of PCIT studied in Korea and to prepare an integrated basis. From 1991 to February 2022, papers studied in Korea were selected as exploration and target studies. A total of 17 studies were selected, and 11 studies (212 children, 12 father, 212 mother, 436 total) were finally included in the meta-analysis study, excluding 3 studies that presented the ranking sum. As a result of this study, the effect of PCIT improved children's problem behavior (1.32), reduced parenting stress (1.06) and mother's depression (0.99), and increased parenting efficacy (1.06) and spouse's parenting cooperation (0.86), which showed a significant effect (d&gt;.8). This study is the first to conduct a meta-analysis on the effects of PCIT based on domestic literature and is expected to be widely used as a child counseling and parent education program.

The Association between Executive Function and Performing Instrumental Daily Activities in People with Intellectual Disabilities.

Institutionalized individuals with intellectual disabilities have few opportunities to participate in instrumental activities of daily living (IADLs), which probably affects higher cognitive functions, or vice versa. The objectives of this study were to evaluate the possible difference in the ability to perform IADLs and executive functioning between individuals with and without intellectual disabilities and to determine if executive functions are associated with the performance of IADLs in people with intellectual disabilities. This was a multi-center cross-sectional study, conducted between July 2019 and May 2020. Participants with intellectual disabilities were recruited from four centers for people with intellectual disabilities. Adults without these disabilities were gathered from several community centers. The sample consisted of 90 individuals with moderate intellectual disabilities and 79 individuals with no intellectual disability. Executive functions were evaluated using the Wechsler Adult Intelligence Scale-WAIS-IV, the INECO Frontal Screening test, the Semantic Verbal Fluency Test, and the Behavioural Assessment of the Dysexecutive Syndrome-BADS-Scale. The performance of the IADLs was assessed by the Lawton and Brody Scale. The results showed that the higher the function in instrumental activities, the lower the impairment of executive functions. Executive functions accounted for 81% of the total variance in the ability to perform the IADLs. In conclusion, individuals with moderate intellectual disabilities demonstrated limitations in executing the IADLs, which were partially associated with low performance in executive functions. This information could help in the development of evidence-based intervention programs and facilitate the formulation of appropriate support strategies to enhance participation in these activities.

Child ViReal Support Program: A Randomized Controlled Trial Study for Effective Support of Parents Raising Children with Attention Deficits.

Attention deficit hyperactivity disorder (ADHD) results in various functioning impairments in children's lives and families. Parents of children with ADHD report high levels of parenting stress, low levels of parental self-efficacy, and use of more authoritarian and/or permissive parenting practices than parents of typically developing children. Intervention programs need to address both children's and parents' needs and multimodal intervention programs could cover this demand. The aim of this study was to examine the efficacy of "Child ViReal Support Program"-a multi-level evidence-based comprehensive program-on parenting stress, parental self-efficacy, parenting practices, and the core symptoms of children's ADHD. Families with a child diagnosed with ADHD (n = 16) were randomly allocated to two groups (PC and CP; P = parent training, C = child training), and a cross-over design was utilized. Participating parents completed, in four different times during the study, the Parenting Stress Index-Short Form, the Parenting Sense of Competence Scale, the Parenting Styles and Dimensions Questionnaire-Short Version, and the parent form of the ADHD Rating Scale-IV. Parents from both groups, after their participation in the parent training, demonstrated reduced parenting stress, enhanced parental self-efficacy, and increased the employ of democratic parenting practices. More than that, they reported decreased levels of inattention and impulsivity/hyperactivity for their children. Evidence-based multi-level intervention programs could produce positive effects on parents and children by incorporating effective methods and tools in accordance with the needs and the demands of the family context.

A cluster randomized trial of a comprehensive intervention nesting family and clinic into school centered implementation to reduce myopia and obesity among children and adolescents in Beijing, China: study protocol

BackgroundMyopia and obesity in children and adolescents have become serious public health problems that endanger public health, especially in China. Unhealthy lifestyle behaviors are environmental drivers of both myopia and obesity. This protocol describes a study to evaluate the effectiveness of “22510SS”, that is 2 h of daytime outdoor activities (‘2’); Limit screen time to no more than 2 h per day (‘2’); Consume at least 5 servings of fruits and vegetables daily (‘5’); Attain 1 h of physical activity daily (‘1’); Consume 0 sugar-sweetened beverages (‘0’); Reasonable sleep duration (‘S’); Regular supervision (‘S’). A school-based, multifaceted intervention strategy for myopia and obesity prevention, and to assess and explore the implementation of “22510SS” with regards to acceptability, feasibility, adoption, usage and maintenance.Methods and analysisThis study aims to develop a comprehensive intervention strategy "22510SS" based on the socio-ecological model, and A two-arm cluster randomized trial with a parallel-group of a 1:1 allocation ratio in 36 primary and secondary schools to test its evidence-based intervention programs on the effects and implementation of myopia and obesity epidemics in children and adolescents in grades 4 and 7. The primary outcomes will include differences in visual acuity, body mass index, outdoor activity indicators, screen time, fruit and vegetable intake, high-quality protein intake, sugar-sweetened beverage intake, sleep duration, and level of monitoring among children and adolescents. Secondary outcomes will assess the acceptability, feasibility, uptake, use, and maintenance of the intervention. Effects on the primary and secondary outcomes will be analyzed using linear and logistic regression analyses, as well as difference-in-difference analysis, taking into account cluster effects and possible confounding factors. Process assessments will also be conducted through quantitative and qualitative analyses, including acceptability, feasibility, gender, adoption, implementation, and sustainability.DiscussionThis study will evaluate the effectiveness of “22510SS” and examine its implementation in the school-based network nesting family and clinic. Following this intervention study, the integrated intervention program focused on myopia and obesity among children and adolescents have great potential to be implemented in China to promote and support healthy lifestyle behavior change and reduce the risk of myopia and obesity in children and adolescents.Trial registrationNCT05275959. Registered 23 Mach 2022.

Characteristics of RCTs focusing on health promotion in community samples: a scoping review protocol based on the d-CoSPICO framework

IntroductionDeveloping the capabilities of individuals, groups and communities to enhance their health has received a great deal of attention in the literature. One essential source of results is evidence-based intervention...

Risk Behavior Among Emerging Adults: The Role of Adverse Childhood Experiences (ACE), Perceived Family and Interpersonal Environment

Background: Evidence demonstrates that ambiance provided during childhood and the interactions of children with different social agents during childhood have an impact on their adult behaviour. Objective: The current research tries to explore the role of adverse childhood experiences and perceived family and interpersonal interactions in their resultant adult risk behaviour. Method: Around 613 emerging adults (18–24 years; Male 343 and Female 270) from the northern districts of Kerala, India took part in the study. The participants were selected using multistage sampling techniques. A Semi-structured Questionnaire was used to understand the perceived family and interpersonal environment. In addition, a checklist (adopted from the risk behaviour scale and youth risk behaviour survey) was also employed. The checklist assisted to understand the presence of actual risk behaviours. Results: Hierarchical Logistic Regression analysis is used to test the hypotheses. The results revealed that 87.2 % of the participants were engaged in at least one type of risk behaviour. Socio-demographic variables (gender and family type) and items of perceived family and interpersonal relationships and adverse childhood experiences were found to be significant predictors of emerging adult’ risk behaviour. Conclusion: The results further highlight the significance of childhood experiences and the current family environment of emerging adults in understanding their behaviour, and in designing evidence-based intervention program for emerging adults.