Health Education Intervention Group Research Articles

A community-based, multi-level, multi-setting, multi-component intervention to reduce weight gain among low socioeconomic status Latinx children with overweight or obesity: The Stanford GOALS randomised controlled trial

There are few long-term studies of interventions to reduce in low socioeconomic status children with overweight or obesity. The Stanford GOALS trial evaluated a 3-year, community-based, multi-level, multi-setting, multi-component (MMM) systems intervention, to reduce weight gain among low socioeconomic status, Latinx children with overweight or obesity. We did a two-arm, parallel group, randomised, open-label, active placebo-controlled trial with masked assessment over 3 years. Families from low-income, primarily Latinx communities in Northern California, CA, USA, with 7-11-year-old children with overweight or obesity were randomly assigned to a MMM intervention or a Health Education (HE) comparison intervention. The MMM intervention included home environment changes and behavioural counselling, community after school team sports, and reports to primary health-care providers. The primary outcome was child BMI trajectory over three years. Secondary outcomes included one- and two-year changes in BMI. This trial is registered with ClinicalTrials.govNCT01642836. Between July 13, 2012, and Oct 3, 2013, 241 families were recruited and randomly assigned to MMM (n=120) or HE (n=121). Children's mean age was 9·5 (SD 1·4) years, 134 (56%) were female and 107 (44%) were male, and 236 (98%) were Latinx. 238 (99%) children participated in year 1, 233 (97%) in year 2, and 227 (94%) in year 3 of follow-up assessments. In intention-to-treat analysis, over 3 years, the difference between intervention groups in BMI trajectory was not significant (mean adjusted difference -0·25 [95% CI -0·90 to 0·40] kg/m2; Cohen's d=0.10; p=0·45). Children in the MMM intervention group gained less BMI over 1 year than did children in the HE intervention group (-0·73 [-1·07 to -0·39] kg/m2, d=0.55); the same was true over 2 years (-0·63 [-1·13 to -0·14] kg/m2; d =0.33). No differential adverse events were observed. The MMM intervention did not reduce BMI gain versus HE over 3 years but the effects over 1 and 2 years in this rigorous trial show the promise of this systems intervention approach for reducing weight gain and cardiometabolic risk factors in low socioeconomic status communities. US National Institutes of Health.

Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial.

Lack of awareness about Diabetic Retinopathy (DR) is the most commonly cited reason why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinal screening. The purpose of this study was to evaluate the efficacy of a culturally, geographically and socially appropriate, locally adapted five-month-long health education on referral compliance of participants. A prospective randomized, open-label parallel group study was conducted on persons with type 2 diabetes who underwent basic eye screening at a diabetes hospital between September 2017 and August 2018. Participants who were noncompliant with referral instruction to visit a hospital for advanced DR management were randomly divided into health education intervention group (n = 143) and control group (n = 156). Both groups received information regarding DR and referral instruction at the diabetes hospital. The intervention group was provided personalized education followed by telephonic reminders. The primary endpoint was 'increase in referral compliance' and the secondary endpoint was 'increase in knowledge of DR'. Multivariate logistic regression model was used to identify significant predictors of compliance to referral. A total of nine participants dropped and 290 completed the post intervention survey. The compliance rate in intervention group was found to be significantly higher than the control group (64.3% vs 28.2%; OR 4.73; 95% CI 2.87-7.79; p<0.001). Participants in the intervention group acquired better knowledge on DR (p<0.05). Apart from intervention, referral compliance rate was also found to be significantly associated with participants' self-perception of vision problem (OR 2.02; 95% CI 1.02-4.01; p = 0.045) and participants' income (OR 1.24; 95% CI 1.06-1.44; p = 0.008). Our results suggest that intensive health education on DR should be integrated with diabetes education as it may result in significantly improved referral compliance. Outcomes may be sustainable if interventions are institutionalized at referral point. Clinical Trials.gov (Registration # NCT03658980); https://clinicaltrials.gov/ct2/show/NCT03658980.

Pendidikan Kesehatan Menggunakan Media Booklet + Aplikasi SDIDTK Efektif Meningkatkan Kemandirian Keluarga dalam Pemantauan Tumbuh Kembang Balita

This study aims to identify the effect of health education using booklet media and SDIDTK application media on family independence in monitoring the growth and development of children under five in the work area of ​​West Bajo Health Center. This study uses Quasi Experimental with a pre and post-test approach without control. The results showed that there was an effect of health education using Booklet media (Δ = 6.80, p value = 0.012), SDIDTK application media (Δ = 7.90, p value = 0.007) Booklet media + SDIDTK Application (Δ = 10.80, p value = 0.005) of family independence in monitoring growth and development. Conclusion, the average score of family independence is very good in the health education intervention group by using the booklet + SDIDTK application because it shows the highest increase so it is recommended to use the media booklet + SDIDTK application for health education related to stimulation, detection and growth and intervention in infants. .&#x0D; &#x0D; Keywords: SDIDTK application, booklet, family independence, growth and development

Acute and long-term cannabis use among stimulant users: Results from CTN-0037 Stimulant Reduction Intervention using Dosed Exercise (STRIDE) Randomized Control Trial

AimsThe aim of this study was to examine the impact of vigorous intensity, high dose exercise (DEI) on cannabis use among stimulant users compared to a health education intervention (HEI) using data from the Stimulant Reduction Intervention using Dosed Exercise, National Institute of Drug Abuse National Drug Treatment Clinical Trials Network Protocol Number 0037 (STRIDE). MethodsAdults (N = 302) enrolled in the STRIDE randomized clinical trial were randomized to either the DEI or the HEI. Interventions included supervised sessions three times a week during the Acute phase (12 weeks) and once a week during the Follow-up phase (6 months). Cannabis use was measured at each assessment via Timeline Follow Back and urine drug screens. Cannabis use was compared between the groups during the Acute and Follow-up phases using both the intent-to-treat sample and a complier average causal effects (CACE) analysis. FindingsApproximately 43% of the sample reported cannabis use at baseline. The difference in cannabis use between the DEI and HEI groups during the Acute phase was not significant. During the Follow-up phase, the days of cannabis use was significantly lower among those in the DEI group (1.20 days) compared to the HEI group (2.15 days; p = 0.04). ConclusionsFor those who adhered to the exercise intervention, vigorous intensity, high dose exercise resulted in less cannabis use. Results suggest that there were no significant short-term differences in cannabis use between the groups. Further study on the long-term impact of exercise as a treatment to reduce cannabis use should be considered.

Effects of Active Learning on Health Literacy and Behavior in Older Adults: A Randomized Controlled Trial.

To investigate the effects of active learning education on health literacy, cognitive and physical function, physical activity, and dietary habits in older adults. Randomized controlled trial. Rural community in Japan. Individuals aged 65 and older (N=84) randomly assigned to a health education intervention group (n=42) or a control group (n=42). The intervention group attended a weekly 90-minute active learning program on exercise, diet and nutrition, and cognitive activity for health promotion in older age for 24 weeks. Active learning included exploratory learning, group work, and self-planning for behavioral change, which promoted a healthy lifestyle. Outcome measures were obtained at baseline before randomization and at 24 weeks. Comprehensive health literacy was assessed as the primary outcome using the Health Literacy Scale-14 (HLS-14) and the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16). Cognitive function was evaluated in 4 domains: processing speed, verbal fluency, working memory, and memory. Physical function and amounts of physical activity were also objectively measured. HLS-14, the disease prevention domain of the HLS-EU-Q16, category verbal fluency test, Scenery Picture Memory Test, and Timed Up and Go test scores; gait speed; number of steps per day; physical activity levels; and dietary variety scores were significantly improved in the intervention group than the control group. This study suggests that health education through active learning is effective in enhancing comprehensive health literacy, verbal fluency, memory, gait speed, balance ability, physical activity, and dietary variety in older adults.

Interventions do not enhance medication persistence and compliance in patients with overactive bladder: a 24 weeks, randomised, open-label, multi-center trial.

Anticholinergics are currently the mainstay for the management of overactive bladder (OAB). However, low drug adherence has been noted with these medications. The aim of this study was to determine whether a health education intervention (HEI) could improve drug persistence with anticholinergics in OAB patients. We enrolled 682 OAB patients who were randomly distributed into either the HEI plus fesoterodine (HEI) group or the fesoterodine alone (control) group. The HEI consists of four education sections: understanding OAB disease, dietary control, bladder training and understanding anticholinergics. The primary end-point was the difference in drug persistence between the HEI and control groups at 24 weeks. Persistence was defined as a gap ≤ 30 days between successive prescription pills. Among the 682 patients, 210 (30.8%) completed 24 weeks of study. Persistence of the HEI group at 6 months was not statistically higher than that of the control group (40.4% vs. 34.9%, p = 0.181). Compliance at 6 months was also similar between the two groups (38.5% vs. 32.5%, p = 0.128). Using OAB symptom score questionnaire, the efficacy of the two groups was not different at each follow-up (p > 0.05). The global response was similar between the two groups. However, the HEI group was more satisfied with treatment than the control group (p = 0.034). The most common reason for discontinuation was satisfaction with the treatment so that they did not need to follow-up, followed by inadequate efficacy in both groups. Adverse events were reported in 12.3% of patients. The health education intervention was not effective to increase drug persistence in OAB patients on anticholinergics.

Abstract 19187: Impact of a Tailored Behavioral Intervention on Lowering Sodium Intake in Adults With Uncontrolled Hypertension

Introduction: : Sodium is related to elevated blood pressure (BP) and reducing sodium intake is a key non-pharmacological approach to lowering BP. We conducted a randomized controlled trial testing whether a tailored or non-tailored behavioral intervention would lead to lower BP. Sodium intake was one of the key dietary behaviors targeted. METHODS: This 3-arm randomized controlled trial evaluated the effectiveness of two active interventions, each compared to the usual care (UC) control group. Participants in the active intervention groups received either a tailored stage-matched intervention (SMI) based on the transtheoretical model (TTM) or a non-tailored health education intervention (HEI) to lower BP through six monthly telephone calls targeting diet, exercise and medication adherence. Participants were adult patients with repeated uncontrolled blood pressure. Urinary sodium levels were measured at baseline and post-intervention (6 months). We indexed sodium intake using urinary sodium-to-creatinine ratio to standardize for time and urine volume since last urination. To compare the two intervention groups with the usual care group at the 6-month follow-up we conducted planned contrasts comparing SMI and HEI with UC in a robust regression model adjusting for baseline sodium-to-creatinine ratio. RESULTS: At baseline, there were no differences between the groups with the median sodium-to-creatinine ratios being 9.28 for SMI, 10.08 for HEI and 8.99 for UC. At the 6-month follow-up, the median sodium-to-creatinine ratio was 7.99 for SMI, 8.76 for HEI and 9.39 for UC. Participants in the SMI group showed on average lower sodium-to-creatinine ratio than participants in the usual care group (SMI-UC contrast: p = .04). Participants in the HEI group did not differ from participants in the usual care group (HEI-UC contrast: p = .45). CONCLUSIONS: A TTM-based tailored behavioral intervention leads to lower sodium intake. Such an intervention shows promise for lowering sodium intake in adults with uncontrolled hypertension.

The impact of Community health education to impaired glucose tolerance with hyperlipidemia

Objective To investigate the community health education on glucose metabolism in patients with impaired glucose tolerance associated with hyperlipidemia. Methods 90 cases of diagnosed patients with impaired glucose tolerance were randomly divided into health education intervention group and control group. Patients in health education groups were carry out health behavior guidance, provided with an appropriate diet and exercise prescription. The control group did not carry out health education. Blood glucose and lipid were detected 3 months later with or without continuous intervention. Results Blood glucose and changes in adverse lifestyle of patients in health Education group were significantly better than the control group. Conclusion Health education can effectively reduce blood glucose levels in patients with impaired glucose tolerance associated with hyperlipidemia. Key words: Health education; Impaired glucose tolerance; Hyperlipidemia; Glucose metabolism; Impact

Evaluation of interventions to reduce smoking: An evaluation of two school-based interventions to reduce smoking prevalence among 8–13 year olds.

This paper reports some of the findings from a large-scale (N = 4970) longitudinal study evaluating the efficacy of two types of school-based intervention designed to discourage cigarette smoking in children between the ages of nine and thirteen. The interventions were in the form of a Theatre in Health Education (THE) programme and a school smoking policy which involved changes in adult behaviour. The research adopted a quasi-experimental design, following children from primary to secondary education where necessary over a period of two and a half years. Five waves of questionnaire data were collected with biochemical markers in the form of saliva samples which served as a “bogus pipeline”. Though absolute levels of smoking were low, the findings indicate a weak positive effect over the longer term of both interventions on smoking behaviour (past and current) for girls but no such effect for boys. Conversely, there was no impact for girls on a measure of intention to smoke, although a small long term effect was found for boys in the Theatre in Health Education intervention group. Effects of the interventions on targeted psychological variables were also minor. Possible reasons for these effects are discussed.

Evaluation of interventions to reduce smoking 1We would like to thank those members of the Eastern Surrey Health Promotion Unit, both past and present, who were involved with this project for their invaluable help and our thanks also go to the Eastern Surrey Health Authority whose funding made this research possible. Our gratitude is due to the Head Teachers and

This paper reports some of the findings from a large-scale (N = 4970) longitudinal study evaluating the efficacy of two types of school-based intervention designed to discourage cigarette smoking in children between the ages of nine and thirteen. The interventions were in the form of a Theatre in Health Education (THE) programme and a school smoking policy which involved changes in adult behaviour. The research adopted a quasi-experimental design, following children from primary to secondary education where necessary over a period of two and a half years. Five waves of questionnaire data were collected with biochemical markers in the form of saliva samples which served as a “bogus pipeline”. Though absolute levels of smoking were low, the findings indicate a weak positive effect over the longer term of both interventions on smoking behaviour (past and current) for girls but no such effect for boys. Conversely, there was no impact for girls on a measure of intention to smoke, although a small long term effect was found for boys in the Theatre in Health Education intervention group. Effects of the interventions on targeted psychological variables were also minor. Possible reasons for these effects are discussed.