Impact Of Structured Intervention Research Articles

Impact of Structural Interventions on Morphological Changes of Teesta River Using River Sensing Approach

Impact of Structural Interventions on Morphological Changes of Teesta River Using River Sensing Approach

Self-Efficacy as a Mediator Between Lifestyle and Self-Perceptions of Aging

A growing body of literature demonstrates the public health impacts of negative self-perceptions of aging (SPA). However, minimal research has explored mediating mechanisms as well as which lifestyle activities may influence SPA. Based on theory and prior research in successful aging, this study explored the impact of lifestyle activities on SPA and tested self-efficacy as a mediator between lifestyle activities and SPA. This study analyzed cross-sectional data from the psychosocial module in the 2018 wave of the Health and Retirement study (N = 2,675; mean age = 65.67/ SD = 9.95). Eight SPA items (e.g., “Things keep getting worse as I get older”) were derived from the Attitudes Toward Own Aging subscale of the Philadelphia Geriatric Center Morale Scale. 10 items measure self-efficacy on a 6-point Likert-type scale from strongly disagree to strongly agree. 21 lifestyle activities covering physical, intellectual, social, and spiritual domains were dichotomized into whether respondents participate at least monthly. Multiple regression analyses were utilized. Results indicate that self-efficacy explained 23% of the variance in SPA while holding constant age, gender, and functional ability. Sobel’s test showed that self-efficacy mediated the relationship between lifestyle activities and SPA. Exercise explained the most variance in SPA, followed by computer use and volunteering. Building upon successful aging literature, this study demonstrates the impact of self-efficacy and helps distinguish which lifestyle activities may be most effective in improving SPA. In addition to individual-level lifestyle activities, the impact of structural interventions on SPA should be tested in future research.

The Inter-ministerial National Structural Intervention trial (INSTRUCT): protocol for a parallel group cluster randomised controlled trial of a structural intervention to reduce HIV infection among young women in Botswana

BackgroundWide recognition that structural factors are important in the HIV epidemic has not generated much evidence of impact of structural interventions. Few randomised controlled trials of structural interventions for HIV prevention have an HIV endpoint, and most of those did not show a significant impact. It has proved difficult to prevent new HIV infections in Botswana, especially among young women, many of whom are unable to act on HIV preventive choices. Proposed by a government think tank in Botswana, the Inter-ministerial National Structural Intervention trial (INSTRUCT) tests whether addressing social and economic factors, including gender inequality, gender violence, poverty, and poor access to education, can lower HIV infection rates among young women. Focussed on increasing access by marginalised young women to government support programs, the intervention seeks to change their structural position, reducing their vulnerability to transactional sex, and thus to HIV infection.MethodsThis parallel group cluster randomised controlled trial compares HIV rates among young women in districts with and without the structural interventions. The 30 administrative districts in the country, stratified by HIV prevalence and development status, will be randomly assigned to 5-district implementation waves. The intervention in the first-wave districts will include: (i) recruiting and preparing vulnerable young women to apply to government support programs, (ii) making the support programs more accessible to young women by engaging local program officers and young women in co-evaluation of programs and co-design of solutions; and (iii) generating an enabling environment for change in communities through an audio-drama edutainment program. In year five, an impact survey will measure HIV rates among vulnerable young women (15–29 years) in a random sample of communities in the five intervention districts and in the five second-wave (control) districts. Fieldworkers will undertake rapid HIV screening and interview young women and young men, collecting information on secondary outcomes of attitudes and behaviours.DiscussionThis is the first step in a planned stepped-wedge design that will roll out the intervention, modified as necessary, to all districts. Strong government commitment provides an important opportunity to reduce new HIV cases in Botswana, and guide prevention efforts in other countries.Trial registrationRegistration number: ISRCTN 54878784. Registry: ISRCTN. Date of registration: 11 June 2013.

Impact of Structural Interventions on Sediment Management of Large Canals: A Case Study of Marala Barrage, Pakistan

Marala Barrage was constructed in 1968 on River Chenab as a replacement of old Marala weir, which was constructed in 1912. Two canals, Marala Ravi Link (MRL) Canal and Upper Chenab Canal (UCC) off-take from left side of the barrage. It has an old history of varying sediment problems in both of these canals. Several attempts were made to investigate the problems and suggest remedial measures in the past and some of them were partially implemented as well. This paper reviews the major sediment management problems at Marala Barrage and their possible causes. The previous interventions are critically examined for their suitability and effectiveness in general and the effect of raising crest of MR Link canal in particular. The paper concludes that some of the past interventions have a positive effect on silt control entry in the off-taking canals. The analysis of data regarding sediment entry at the head of the canals indicate that the raising of crest of MR Link in the year 2000–2001 has improved the sediment intake in this canal to some extent, but its effect on the UCC is almost negligible. The data regarding sediment entry at the head of the UCC which had a scouring tendency, does not show any significant effect of this intervention as was perceived at the implementation stage. However, it is worth mentioning that analysis of data related to cross-sections and L-sections of the head reaches of these canals show a different trend, which makes it difficult to assess the long term and sustainable effect of this intervention on both of the canals. A critical review of data collection process and effective monitoring of the system is compulsory for meaningful analysis and future course of action if the present tendency seems to be changing, the possibility of which does exist.

Structural factors in HIV prevention: concepts, examples, and implications for research.

HIV-prevention behavior is affected by the environment as well as by characteristics of individuals at risk. HIV-related structural factors are defined as barriers to, or facilitators of, an individual's HIV prevention behaviors; they may relate to economic, social, policy, organizational or other aspects of the environment. A relatively small number of intervention studies demonstrates the potential of structural interventions to increase HIV prevention in the United States and internationally. The promise of structural interventions has also been shown in studies of interventions to prevent disease or promote public health in areas other than HIV. Frameworks help define and exemplify structural barriers and facilitators for HIV prevention. One framework developed at Centers for Disease Control and Prevention gives examples of structural facilitators in terms of the economic resources, policy supports, societal attitudes, and organizational structures and functions associated with governments, service organizations, businesses, workforce organizations, faith communities, justice systems, media organizations, educational systems, and healthcare systems. Frameworks should assist researchers and health officials to identify important areas for structural research and programming. A structural approach is timely and innovative. Despite limitations, including the challenge of a new perspective on prevention and the difficulty of evaluating their effects, researchers and public health officials are urged to pursue structural interventions to prevent HIV.