Health Intervention Model Research Articles

Findings from the 'Ask Me About PrEP' HIV Pre-Exposure Prophylaxis Awareness Programme in England.

HIV incidence has decreased in England by over a third since 2019. Despite the early success of HIV Pre-Exposure Prophylaxis (PrEP) in reducing HIV transmission in the United Kingdom, many people who could benefit from HIV PrEP do not yet know about it, or know how to access it. This paper presents the findings of the first England-wide national peer-to-peer based diffusion model to disseminate information about PrEP. Ask Me About PrEP (AMAP) was a 5-month pilot programme which commenced in November 2021. Volunteer mobilisers were encouraged to use their existing knowledge of their communities and geographical areas to assist them in discussing PrEP with their peers. 12 enrolled mobilisers took part in three project evaluation focus groups between November 2021 and March 2022, and five AMAP project staff took part in one focus group in March 2022. Additionally, descriptive statistical analysis explored volunteer mobiliser recruitment to the AMAP project, demographical data of project staff and volunteer mobilisers, volunteer mobiliser attrition rates, and the project's impact. 96 volunteers enrolled, completed training and volunteered as mobilisers. Thoroughout the project, mobilisers engaged their peers in 11,889 conversations about PrEP through individual conversations, online group conversations, online workplace educational events, and social media. The focus groups enabled key stakeholders to reflect on their experiences of the pilot programme. Four key themes were identified during the focus groups: motivations to mobilise and recruitment experiences; training, learning, and materials; mobilisation activity; and support and social networking. Our evaluation demonstrates that peer-to-peer diffusion models used to increase awareness of HIV PrEP in key unreached groups, offer an acceptable public health intervention model for volunteers and project staff.

The PHEM-B toolbox of methods for incorporating the influences on Behaviour into Public Health Economic Models

BackgroundIt is challenging to predict long-term outcomes of interventions without understanding how they work. Health economic models of public health interventions often do not incorporate the many determinants of individual and population behaviours that influence long term effectiveness. The aim of this paper is to draw on psychology, sociology, behavioural economics, complexity science and health economics to: (a) develop a toolbox of methods for incorporating the influences on behaviour into public health economic models (PHEM-B); and (b) set out a research agenda for health economic modellers and behavioural/ social scientists to further advance methods to better inform public health policy decisions.MethodsA core multidisciplinary group developed a preliminary toolbox from a published review of the literature and tested this conceptually using a case study of a diabetes prevention simulation. The core group was augmented by a much wider group that covered a broader range of multidisciplinary expertise. We used a consensus method to gain agreement of the PHEM-B toolbox. This included a one-day workshop and subsequent reviews of the toolbox.ResultsThe PHEM-B toolbox sets out 12 methods which can be used in different combinations to incorporate influences on behaviours into public health economic models: collaborations between modellers and behavioural scientists, literature reviewing, application of the Behaviour Change Intervention Ontology, systems mapping, agent-based modelling, differential equation modelling, social network analysis, geographical information systems, discrete event simulation, theory-informed statistical and econometric analyses, expert elicitation, and qualitative research/process tracing. For each method, we provide a description with key references, an expert consensus on the circumstances when they could be used, and the resources required.ConclusionsThis is the first attempt to rigorously and coherently propose methods to incorporate the influences on behaviour into health economic models of public health interventions. It may not always be feasible or necessary to model the influences on behaviour explicitly, but it is essential to develop an understanding of the key influences. Changing behaviour and maintaining that behaviour change could have different influences; thus, there could be benefits in modelling these separately. Future research is needed to develop, collaboratively with behavioural scientists, a suite of more robust health economic models of health-related behaviours, reported transparently, including coding, which would allow model reuse and adaptation.

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

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

Leveraging community-based mental health services to reduce inequities for children and families living in United States who have experienced migration-related trauma.

Trauma systems therapy for refugees (TST-R) is a trauma-focused, culturally responsive mental health prevention and intervention model designed to meet the needs of children and families who are fleeing their home countries and seeking humanitarian refuge. TST-R provides trauma-focused mental health treatment and addresses problems in part exacerbated by harsh U.S. immigration policies (e.g., poor mental health, stigma, fear) that have implications for the psychosocial well-being of immigrant children and families, especially those who have experienced migration-related trauma. Informed by a community-based participatory research approach, TST-R was developed as an adaptation of trauma systems therapy to address common barriers to care experienced by those of refugee and immigrant backgrounds, including mental health stigma, distrust of service systems, and cultural and linguistic barriers. TST-R is a multitiered and phase-based intervention that strategically addresses stressors and needs across levels of the social ecology. Most TST-R services are delivered in easily accessible, nonstigmatizing settings (e.g., school) by a cultural broker and a clinician who work in partnership. TST-R has been disseminated and implemented with multiple cultural groups (e.g., Somali, Bhutanese) across the United States and Canada. Given the unique stressors, strengths, and needs of immigrant children and their families, mental health services must be equitable, community based, and sustainable. TST-R demonstrates promise as a prevention and intervention model especially for those experiencing immigration policy-related stressors and may serve as a guide for developing child mental health policies and immigration policies that promote mental well-being for immigrant families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The COVID-19 pandemic on immigrants: a national project for the impact assessment of the disease and effective interventions to reduce the spread and promote health

Within the prevention programmes of the Italian Ministry of Health, a project aimed to containing the circulation of SARS-CoV-2 virus in the immigrant population in Italy has entrusted to the Regional Health Authority of Sicily Region (Southern Italy). New evidence has been promoted to disseminate and share public health intervention models. The project involved public health institutions across the national territory and was carried out during the COVID-19pandemic. The project reached the general aim through specific objectives, identifying information sources and health indicators, evaluating the impact of COVID-19, and promoting intervention programmes for taking charge immigrant population. Social distancing, although necessary, has further amplified the gap of inequalities in health, confirming major vulnerability for infection. Having filled some knowledge gaps and proposed prevention tools has been useful for the containment of the virus, for a possible resurgence of the phenomenon, for application in other emergency contexts, and for recalibration in new epidemic events.

Are sport and traditional Inuit games identified as tools in current Inuit suicide prevention strategies?: A content analysis

ABSTRACT Eekeeluak Avalak, an 18-year-old Inuk wrestler who won the first-ever gold medal for Nunavut at the Canada Summer Games in 2022, dedicated his win to his late brother who died by suicide in 2015. Avalak openly attributed sport – specifically wrestling – to saving his own life. This story raises important questions about the role of sport and traditional games in Inuit suicide prevention strategies. Few studies have examined the role of sport or traditional games in Inuit suicide prevention strategies. In an attempt to reduce Inuit suicide rates, in addition to the National Inuit Prevention Strategy, three of the four land claim regions that constitute Inuit Nunangat have suicide prevention strategies. In this study, we used settler colonial theory, critical Inuit studies, and content analysis to examine if and how sport and Inuit traditional games are identified as prevention tools in these Inuit suicide prevention strategies. The results demonstrate that sport and traditional games have largely been overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Moving forward, evidence-based and community-driven approaches could be funded, created, implemented, and evaluated as culturally-safe Inuit mental health intervention models to address the disproportionately high suicide rates among Inuit in Inuit Nunangat.

Constructing synthetic populations in the age of big data

BackgroundTo develop public health intervention models using micro-simulations, extensive personal information about inhabitants is needed, such as socio-demographic, economic and health figures. Confidentiality is an essential characteristic of such data, while the data should reflect realistic scenarios. Collection of such data is possible only in secured environments and not directly available for open-source micro-simulation models. The aim of this paper is to illustrate a method of construction of synthetic data by predicting individual features through models based on confidential data on health and socio-economic determinants of the entire Dutch population.MethodsAdministrative records and health registry data were linked to socio-economic characteristics and self-reported lifestyle factors. For the entire Dutch population (n = 16,778,708), all socio-demographic information except lifestyle factors was available. Lifestyle factors were available from the 2012 Dutch Health Monitor (n = 370,835). Regression model was used to sequentially predict individual features.ResultsThe synthetic population resembles the original confidential population. Features predicted in the first stages of the sequential procedure are virtually similar to those in the original population, while those predicted in later stages of the sequential procedure carry the accumulation of limitations furthered by data quality and previously modelled features.ConclusionsBy combining socio-demographic, economic, health and lifestyle related data at individual level on a large scale, our method provides us with a powerful tool to construct a synthetic population of good quality and with no confidentiality issues.

Knowledge, Attitude and Self-efficacy Towards Blood Donation Among University Students: An Online Intervention Study

Long-term shortages in the blood supply perpetuate increased morbidity and mortality from treatable diseases. However, how much people are motivated to donate blood was less studied, especially among university students. This study aimed to determine the effectiveness of online intervention for knowledge, attitude, and self-efficacy towards blood donation among undergraduate university students. A pre-and post-test study was conducted among undergraduate students. Four hundred students were invited to the study. Knowledge, positive and negative attitudes, and self-efficacy towards blood donation were measured using a structured questionnaire. Two digital infographics for blood donation and one 10-minute video were used as intervention materials. Following the intervention, statistical and practical significance was reported. Multivariate analysis was done to determine the differences in invention effect across age, gender, and study discipline. Following the intervention, 29.1% and 5.1% increased knowledge and self-efficacy from the base, respectively. The positive attitude towards blood donation increased by 2.8%, while the negative attitude decreased by 2.1%. Multivariate analysis of variance showed that online health education on blood donation is effective irrespective of age, gender, and discipline of study. Due to the Covid-19 pandemic, the intervention was integrated into a remote health intervention model based on the internet or mobile communication network. This study has provided a scientific conclusion on whether the intervention could motivate people to donate blood.

Do Right, Be Bright: A Protocol on the Development of an Inter-Professional Health Intervention Model for Pre-School Children Through a Community-Based Service-Learning Initiative.

An inter-professional project with a collaborative endeavor between the programs of Dentistry, Nutrition and Medicine was carried out with the aim to emphasise oral health maintenance, making the right nutritional choices and effective hand washing among pre-school children. The purpose of this paper is to share a detailed description of the design, development process, implementation, and planned evaluation of an interprofessional school-based health promotion intervention model "Do Right, Be Bright". This model is part of a quasi-experimental study, targeting pre-school children as the "Targets of Change" through the empowerment of school teachers as the "Agents of Change". The program design was based on Bartholomew's Intervention Mapping Approach, which proposes a direction for developing a theory-based health promotion intervention and on the most extensively applied theories of health behavior, the Health Belief Model. Therefore, based on a thorough literature review and needs assessment, three key areas of needs were identified for the targeted preschool children: oral hygiene, hand hygiene and nutrition. The efficacy of this model will be pilot tested in a preschool in Kuala Lumpur Malaysia.

Geolocation Patterns, Wi-Fi Connectivity Rates, and Psychiatric Symptoms Among Urban Homeless Youth: Mixed Methods Study Using Self-report and Smartphone Data.

Despite significant research done on youth experiencing homelessness, few studies have examined movement patterns and digital habits in this population. Examining these digital behaviors may provide useful data to design new digital health intervention models for youth experiencing homelessness. Specifically, passive data collection (data collected without extra steps for a user) may provide insights into lived experience and user needs without putting an additional burden on youth experiencing homelessness to inform digital health intervention design. The objective of this study was to explore patterns of mobile phone Wi-Fi usage and GPS location movement among youth experiencing homelessness. Additionally, we further examined the relationship between usage and location as correlated with depression and posttraumatic stress disorder (PTSD) symptoms. A total of 35 adolescent and young adult participants were recruited from the general community of youth experiencing homelessness for a mobile intervention study that included installing a sensor data acquisition app (Purple Robot) for up to 6 months. Of these participants, 19 had sufficient passive data to conduct analyses. At baseline, participants completed self-reported measures for depression (Patient Health Questionnaire-9 [PHQ-9]) and PTSD (PTSD Checklist for DSM-5 [PCL-5]). Behavioral features were developed and extracted from phone location and usage data. Almost all participants (18/19, 95%) used private networks for most of their noncellular connectivity. Greater Wi-Fi usage was associated with a higher PCL-5 score (P=.006). Greater location entropy, representing the amount of variability in time spent across identified clusters, was also associated with higher severity in both PCL-5 (P=.007) and PHQ-9 (P=.045) scores. Location and Wi-Fi usage both demonstrated associations with PTSD symptoms, while only location was associated with depression symptom severity. While further research needs to be conducted to establish the consistency of these findings, they suggest that the digital patterns of youth experiencing homelessness offer insights that could be used to tailor digital interventions.

Willingness to Use and Pay for Digital Health Care Services According to 4 Scenarios: Results from a National Survey

Smartphones and their associated technology have evolved to an extent where these devices can be used to provide digital health interventions. However, few studies have been conducted on the willingness to use (WTU) and willingness to pay (WTP) for digital health interventions. The purpose of this study was to investigate how previous service experience, the content of the services, and individuals' health status affect WTU and WTP. We conducted a nationwide web-based survey in 3 groups: nonusers (n=506), public service users (n=368), and private service users (n=266). Participants read scenarios about an imagined health status (such as having a chronic illness) and the use of digital health intervention models (self-management, expert management, and medical management). They were then asked to respond to questions on WTU and WTP. Public service users had a greater intention to use digital health intervention services than nonusers and private service users: scenario A (health-risk situation and self-management), nonusers=odd ratio [OR] .239 (SE .076; P<.001) and private service users=OR .138 (SE .044; P<.001); scenario B (health-risk situation and expert management), nonusers=OR .175 (SE .040; P<.001) and private service users=OR .219 (SE .053; P<.001); scenario C (chronic disease situation and expert management), nonusers=OR .413 (SE .094; P<.001) and private service users=OR .401 (SE .098; P<.001); and scenario D (chronic disease situation and medical management), nonusers=OR .480 (SE .120; P=.003) and private service users=OR .345 (SE .089; P<.001). In terms of WTP, in scenarios A and B, those who used the public and private services had a higher WTP than those who did not (scenario A: β=-.397, SE .091; P<.001; scenario B: β=-.486, SE .098; P<.001). In scenario C, private service users had greater WTP than public service users (β=.264, SE .114; P=.02), whereas public service users had greater WTP than nonusers (β=-.336, SE .096; P<.001). In scenario D, private service users were more WTP for the service than nonusers (β=-.286, SE .092; P=.002). We confirmed that the WTU and WTP for digital health interventions differed based on individuals' prior experience with health care services, health status, and demographics. Recently, many discussions have been made to expand digital health care beyond the early adapters and fully into people's daily lives. Thus, more understanding of people's awareness and acceptance of digital health care is needed.

Magnetic Isolation, RNA Extraction, and Nanostring Analysis of Human Peripheral Blood Leukocytes Subsets.

Advancements in multiplexed molecular biology techniques have allowed for blood samples and specific circulating blood leukocytes to be a useful sample source when examining systemic changes associated with changes in body weight, muscle injury, disease onset/progression, and other common conditions. One gap in the current scientific knowledge relates to the impact of changes in individual leukocyte subsets on the overall systemic response. While many studies have published data related to changes observed in a mixed population of circulating leukocytes (i.e., whole blood sample), few studies have identified which cell(s) are responsible for the overall change. Since it is established that leukocyte subsets respond differently to various experimental challenges, it may be possible to gain new insight regarding overall biological state. This has application to a variety of health, nutrition, and exercise intervention models. Despite the need to examine changes in mRNA expression levels in individual leukocyte subsets they are not always easy to isolate and perform mRNA analysis on. In this report we describe a method to magnetically isolate, stabilize RNA, and analyze 800+ mRNA in a single sample analysis. Further we compared total leukocyte and leukocyte subset (i.e., granulocytes, monocytes, and T-cells) mRNA expression to better understand how subset changes contribute to overall response. Examination of subset responses may provide targets for future intervention studies. © 2023 Wiley Periodicals LLC. Basic Protocol 1: Automated magnetic isolation of granulocytes, monocytes, and T-cells Basic Protocol 2: RNA extraction from magnetically sorted granulocytes, monocytes, and T-cells Basic Protocol 3: Nanostring analysis of RNA extracted from magnetically sorted granulocytes, monocytes, and T-cells.

Mental health among rural Latino immigrants during the COVID-19 pandemic

The mental health of the United States' Latino population significantly deteriorated during the SARS-CoV-2 (COVID-19) pandemic, and Latino immigrants living in rural areas faced unique vulnerabilities. However, few studies have specifically examined the mental health burden and experiences of rural Latino immigrants during the COVID pandemic. To understand the mental health experiences of first- and second-generation Latinos in rural areas, we conducted semi-structured interviews with 35 Latino residents of rural California counties during July 2020-February 2021 and screened all respondents for major depression and generalized anxiety symptoms using the Patient Health Questionnaire [PHQ]-2 and Generalized Anxiety Disorder [GAD]-2 screeners. We explored the prevalence of symptoms of depression and anxiety in our sample, iteratively analyzed participants' narratives regarding the mental health impact of the pandemic, and used their mental health screener status to contextualize these narratives. Results indicated that nearly all respondents viewed mental health as a major concern, and 34% (n ​= ​12) of respondents screened positive for major depression or generalized anxiety disorder. Respondents connected their mental health concerns to experiences of financial precarity, fear of contracting COVID-19, social isolation, and the challenges of remote schooling. Additional themes emerged around problems accessing the mental health care system, the utility of pre-pandemic mental health services, and using healthy coping mechanisms to alleviate psychological problems. Respondents’ narratives tended to focus on the mental health challenges facing their family members, particularly their children. Our findings suggest that mental health intervention models that engage with multiple family members, policies that support infrastructure for encouraging exercise and outdoor activity, and ensuring access to culturally and linguistically appropriate mental health care for Latino communities may be important for protecting population mental health.

Mental health treatments in an Italian prison: the Parma integrated approach

IntroductionMental health interventions for Italian (and European) prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. Indeed, according to the American Psychological Association, 64% of incarcerated individuals report mental health concerns.Objectives The aim of this study is to describe the mental health intervention model implemented since January 2020 for prisoners allocated in the Parma Penitentiary Institutes (PPI). This approach is specifically based on specialized, “person-centered” and “person-tailored” therapeutic-rehabilitation plans in line with psychiatric treatments usually provided in community mental health-care centers of the Parma Department of Mental Health.MethodsAll the processes and procedures included in the PPI intervention model were first carefully described, paying special attention to the service for newly admitted prisoners and each typology of specialized therapeutic-rehabilitation treatment potentially provided. Additionally, a preliminary descriptive process analysis of the first six months of clinical activity was also performed.Results Since January 2020, 178 individuals entered the PPI service for newly admitted prisoners. In total, 83 (46.7%) of them were engaged in the services of the PPI mental health-care team (35 with pathological addiction and 48 with mental disorders): 56 prisoners were offered an integrated mental health intervention and 27 exclusively an individual psychological or psychiatric treatment.ConclusionsThe results support the potential applicability of an integrated mental health intervention in prison, planning a person-tailored rehabilitation in close collaboration with the prisoners, their families and the local mental health/social services.DisclosureNo significant relationships.

Meeting families where they sleep: a collaborative approach to improving sleep health for urban children.

Meeting families where they sleep: a collaborative approach to improving sleep health for urban children.

Rural residence and adherence to continuous positive airway pressure therapy: have we overcome a barrier?

Rural residence and adherence to continuous positive airway pressure therapy: have we overcome a barrier?

POSB65 Economic Burden of COPD in the United Kingdom (2021–2040) Estimated with the COPD Health Outcome Policy and Intervention (CHOPIN) Model

Chronic obstructive pulmonary disease (COPD) is associated with substantial clinical and economic burden, with estimated annual US costs being over $50 billion in 2010 and European costs over €48 billion in 2011. However, cost estimates must be up-to-date and evaluated at individual country levels for decision-makers to enact policies and reduce COPD burden. This study estimated healthcare costs of United Kingdom (UK) patients with COPD using the COPD Health Outcome Policy and INtervention (CHOPIN) model.

The ICECAP-A instrument for capabilities: assessment of construct validity and test\u2013retest reliability in a general Dutch population

PurposeThe ICEpop CAPability measure for Adults (ICECAP-A) assesses five capabilities that are important to one’s well-being. The instrument might be an important addition to generic health questionnaires when evaluating quality of life extending beyond health. This study aimed to conduct a psychometric assessment of the Dutch translation of the ICECAP-A.MethodsConstruct validity of the instrument was assessed in two ways. First, by measuring correlations with the EQ-5D-5L questionnaire and a measure of self-efficacy and, second, by investigating the ability to distinguish between groups known to differ on the construct the ICECAP-A means to capture. Additionally, test–retest reliability was evaluated.ResultsIn total, 1002 participants representative of the general Dutch population completed an online survey. For test–retest reliability, 252 participants completed the same questionnaire 2 weeks later. The ICECAP-A indicated moderate to strong correlations with the EQ-5D-5L and a strong correlation with self-efficacy. Furthermore, it was capable of differentiating known groups. Moreover, results indicated adequate test–retest reliability with an intraclass correlation coefficient of 0.79.ConclusionIn summary, results suggest adequate test–retest reliability and construct validity and indicate that the ICECAP-A might be of added value, especially when considering areas outside of the traditional health intervention model.

Intersectional Trauma of Women of Color in Academe: Cultivating Trauma-informed Organizations

Women faculty of color endure gendered racial (intersectional) trauma in the workplace that often results in posttraumatic stress symptoms (e.g., cognitive intrusions and avoidance) and poor work outcomes. However, organizational interventions often place the onus on the worker to alleviate such deleterious stressors rather than eradicating its discriminatory practices on a systemic level. Oppressive and psychological injurious practices toward women of color in academe include isolation from academic networks, epistemological exclusion, and invisible labor. Facing both sexism and racism, women faculty of color are also uniquely ascribed stereotyped gendered racial roles (e.g., Strong Black Woman and lotus blossom) and are more sexually harassed and objectified than White women and men of all races and ethnicities. Such harmful encounters elicit trauma-induced safety checking coping behaviors that prioritizes the needs of the dominant group over that of their own. A multilevel trauma-informed approach, however, could attenuate the psychological demands of the worker and generate accountability at organizational and management levels. As such, this symposium will highlight the use of intersectionality theory and the public health intervention model (primary, secondary, and tertiary interventions) as an integrated framework to cultivate trauma informed organizations, thereby mitigating re-traumatization and promoting the well-being and career advancement of women faculty of color.

Cura de barri. Sperimentazioni di salute comunitaria a Barcellona

Since the early 2000s, several projects have taken place in the barrio of Poble-Sec in Barcelona with the goal of building an alternative to the medicalization of social problems. The neighbourhood is therefore the minimum space for experimenting with policies aimed at spreading well-being and combating social inequalities. The practices reported here describe potential alternatives to the current health intervention models. This shifts the focus on relational dimension and reciprocity of care. The research aim of the present study is not assessing to what extent the feminist or transfeminist approach guides these urban practices, but rather identifying their potentials and limits useful for the debate on the construction of new urban imaginaries.