Implementation Of Package Research Articles

PyWitness 1.0: A python eyewitness identification analysis toolkit

pyWitness is a python toolkit for recognition memory experiments, with a focus on eyewitness identification (ID) data analysis and model fitting. The current practice is for researchers to use different statistical packages to analyze a single dataset. pyWitness streamlines the process. In addition to conducting key data analyses (e.g., receiver operating characteristic analysis, confidence accuracy characteristic analysis), statistical comparisons, signal-detection-based model fits, simulated data generation, and power analyses are also possible. We describe the package implementation and provide detailed instructions and tutorials with datasets so that users can follow. There is also an online manual that is regularly updated. We developed pyWitness to be user-friendly, reduce human interaction with pre-processing and processing of data and model fits, and produce publication-ready plots. All pyWitness features align with open science practices, such that the algorithms, fits, and methods are reproducible and documented. While pyWitness is a python toolkit, it can also be used from R for users more accustomed to this environment.

Healthy Parent Carers: Acceptability and practicability of online delivery and learning through implementation by delivery partner organisations.

Parent carers of disabled children are at increased risk of physical and mental health problems. The Healthy Parent Carers (HPC) programme is a manualised peer-led group-based programme that aims to promote parent carer health and wellbeing. Previously, the programme had been delivered in person, with recruitment and delivery managed in a research context. This study explored implementation by two delivery partner organisations in the United Kingdom. Facilitator Training and Delivery Manuals were modified for online delivery using Zoom due to COVID-19. The study methodology utilised the Replicating Effective Programs framework. A series of stakeholder workshops informed the development of the Implementation Logic Model and an Implementation Package. After delivering the programme, delivery partner organisations and facilitators participated in a workshop to discuss experiences of implementing the programme. A wider group of stakeholders, including commissioners, Parent Carer Forums and charity organisations representatives and researchers subsequently met to consider the sustainability and potential barriers to delivering the programme outside the research context. This study explored implementation by two delivery partner organisations in the United Kingdom that were able to recruit facilitators, who we trained, and they recruited participants and delivered the programme to parent carers in different localities using Zoom. The co-created Implementation Logic Model and Implementation Package were subsequently refined to enable the further roll-out of the programme with other delivery partner organisations. This study provides insight and understanding of how the HPC programme can be implemented sustainably outside of the research context. Further research will evaluate the effectiveness of the programme and refine the implementation processes. Parent carers, delivery partner organisation staff and service commissioners were consulted on the design, delivery and reporting of the research.

Comparative Study on Integrated Psychosocial Stimulation, Nutritional Support, Water Sanitation Hygiene Interventions among Malnourished Children in Kanam, North Central Nigeria

This study is determined to compare the effect of integrated psychosocial stimulation, nutritional support, and water sanitation hygiene interventions on malnourished children. An individual randomized trial design comprising weekly home visits for 3 months in four locations of Kanam Local Government Area, Plateau state, was adopted. The eligible malnourished children were identified through a door–to–door survey using standard procedures of anthropometric measurements (weight, height, mid-upper arm circumference) and children with body mass index (BMI) < 16Kg/m2 were selected. A focus group discussion session, follow-up home visitation on weekly and monthly facilitation/support of mother-to-mother, weekly distribution of food supplements, home stimulation environment through the provision of WASH material and age-specific psychosocial stimulation activities were part of intervention strategies adopted for the study. The result shows a significant difference between base-line and end-line data, impacted by integrated package delivery which enhanced and improved nutritional and developmental outcomes of malnourished children over the period of intervention. Furthermore, the findings reveal that there is a non-significant difference among the study groups. However, the observed effect on outcomes based on average BMI indicators is at causal pathways to improve child nutritional status outcomes. The study concludes that the integrated intervention package improved the developmental and nutritional outcomes in malnourished children. Implementation of these integration packages over a longer duration is needed to witness a significant improvement.

Tackling dynamic prediction of death in patients with recurrent cardiovascular events.

In the field of cardiovascular disease, recurrent events such as stroke or myocardial infarction (MI) are often encountered, leading to an increase in the risk of death. Accurately evaluating the prognosis of patients and dynamically predicting the risk of death by considering the historical recurrent events can improve medical decisions and lead to better health care outcomes. Recently proposed joint modeling approaches within the Bayesian framework have inspired the development of a dynamic prediction tool, which can be applied for subject-level prediction of death with implementation in software packages. The prediction model incorporates subject heterogeneity with subject-level random effects that account for unobserved time-invariant factors and an extra copula function capturing the part caused by unmeasured time-dependent factors. Thereafter, given the prespecified landmark time , the survival probability for a prediction horizon time of interest can be estimated for each individual. The prediction accuracy is assessed by time-dependent receiving operating characteristic curve and the area under the curve and the Brier score with calibration plots is compared to traditional joint frailty models. Finally, the tool is applied to patients with multiple attacks of stroke or MI in the Cardiovascular Health study and the Atherosclerosis Risk in Communities study for illustration.

Effect of the postpartum hemorrhage intervention package implementation in a fourth-level hospital in Latin America.

To evaluate the effectiveness of the implementation of intervention packages for postpartum hemorrhage (PPH) management in pregnant women hospitalized in a High Obstetric Complexity Unit in a Latin American country. Retrospective cohort study including pregnant women with PPH attended between January 2011 to December 2019. Three periods of time were defined according to management strategies We performed univariate and multivariate robust Poisson regression logistic models for each of the outcomes derived from each period. We included 602 patients. There was a reduction in period 3 of the incidence of massive PPH (16% versus 12% P < 0.001, relative risk [RR] 0.61, 95% confidence interval [CI] 0.44-0.85; P = 0.003), major surgery (24%, 13%, 11%, P = 0.002, RR 0.54, 95% CI 0.33-0.883; P = 0.014), and admission to the intensive care unit (ICU) (14%, 7%, 6.1%, P = 0.0, RR 0.40, 95% CI 0.17-0.96 P = 0.00). The implementation of PPH intervention packages in a hospital in a middle-income country from Latin America, led to a significant decrease in the incidence of massive bleeding, the rate of major surgery, and the ICU stay of pregnant women affected by this condition.

Rapid ethnography and participatory techniques increase onchocerciasis mass drug administration treatment coverage in Benin: a difference-in-differences analysis

BackgroundOnchocerciasis, a neglected tropical disease (NTD) that causes blindness, is controlled via mass drug administration (MDA) where entire endemic communities are targeted with preventative chemotherapeutic treatment. However, in many settings, MDA coverage remains low. The purpose of this project was to determine if engaging communities in the development of implementation strategies improves MDA coverage.MethodsThis study took place in an intervention and a control commune in Benin, West Africa. We conducted rapid ethnography in each commune to learn about community member perceptions of onchocerciasis, MDA, and opportunities to increase MDA coverage. Findings were shared with key stakeholders and a structured nominal group technique was used to derive implementation strategies most likely to increase treatment coverage. The implementation strategies were delivered prior to and during onchocerciasis MDA. We conducted a coverage survey within 2 weeks of MDA to determine treatment coverage in each commune. A difference-in-differences design was used to determine if the implementation package effectively increased coverage. A dissemination meeting was held with the NTD program and partners to share findings and determine the perceived acceptability, appropriateness, and feasibility of implementing rapid ethnography as part of routine program improvement.ResultsDuring rapid ethnography, key barriers to MDA participation included trust in community drug distributors, poor penetration of MDA programs in rural or geographically isolated areas, and low demand for MDA among specific sub-populations driven by religious or socio-cultural beliefs. Stakeholders developed a five-component implementation strategy package, including making drug distributor trainings dynamic, redesigning distributor job aids, tailoring community sensitization messages, formalizing supervision, and preparing local champions. After implementing the strategy package, MDA coverage increased by 13% (95% CI: 11.0–15.9%) in the intervention commune relative to the control commune. Ministry of Health and implementing partners found the approach to be largely acceptable and appropriate; however, there was mixed feedback regarding the feasibility of future implementation of rapid ethnography.ConclusionsImplementation research conducted in Benin, and indeed throughout sub-Saharan Africa, is often implemented in a top-down manner, with both implementation determinants and strategies derived in the global North. This project demonstrates the importance of participatory action research involving community members and implementers to optimize program delivery.

Feedback from clinical psychologists on the online version of the Communication and Interaction Training (CAIT) package

The Communication and Interaction Training (CAIT) programme is a six module package designed to enhance caregiver communication skills. It builds on, and extends, caregivers‘existing skills in managing behaviours that challenge (BtC) in dementia care. An on-line version of the training was produced between 2020-2022, during the Covid-19 pandemic, to enhance the delivery of CAIT, and to further support caregivers’ good practice. To aid the development of on-line CAIT a number of pilot sessions were organised to obtain feedback on the package. This article provides data from the first of these pilots.Feedback was obtained from 16 clinical psychologists who attended a 5.5 hour workshop on CAIT. Satisfaction ratings for the modules varied between 87–96 per cent. Qualitative feedback was analysed using thematic analysis, and four key themes emerged: (i) Applicability in practice, (ii) Delivery and visual learning, (iii) Consolidation of content, (iv) Implementation of package. The overall analyses showed CAIT to be a well delivered and highly applicable training programme for staff working in dementia care. Specfic recommendations were made to improve CAIT, particularly in relation to its on-line delivery.

PAKEJ RANGSANGAN EKONOMI BAGI KELESTARIAN INDUSTRI PELANCONGAN DI MALAYSIA

The spread of the Covid-19 pandemic is a threat to the lives of all over the world including Malaysia. This is exacerbated by the tourism industry which lives through interaction between tourists and hosts in tourist destinations. Covid-19 pandemic has had a direct impact on crisis management in the tourism industry. The Covid-19 pandemic is a security issue that has crippled the tourism industry globally and Malaysia. The introduction of economic incentives is necessary to ensure the economic development of the tourism industry and the level of security at the destination can be sustains at the tourism destination. This study aims to analyze the economic strategy that has been carried out by Malaysia when the Covid-19 pandemic hit Malaysia. Choosing Malaysia as an example in detailing the strategy to face the Covid19 pandemic in the tourism industry. This study is aimed at analyzing the economic strategies that Malaysia has undertaken during the Covid-19 pandemic. Malaysia has been chosen in detailing the strategy for the Covid-19 pandemic in the tourism industry. A qualitative approach through the analysis of documents was carried out. The findings showed that there are nine economic stimulus packages and one 2021 budget with a total value of RM 872.5 Billion. This shows the economic benefits in preserving the tourism industry that has not been affected has been done covering all aspects of the economy, and security for the development of the country and the interests of the people. The economic stimulus package is a step to achieve the goal of sustainable development that is needed in the face of the Covid-19 pandemic for the safety and welfare of Malaysians. The economic stimulus package is a necessary as sustainability development strategy in countering the Covid-19 pandemic for the safety and welfare of Malaysians. The implementation of the economic stimulus package requires the cooperation from the stakeholders in revitalizing the tourism industry. A National Tourism Crisis Recovery Policy needs to be established for the involvement of stakeholders in the Malaysian tourism industry.

Impact of community strategy package on uptake of reproductive tract infections health services among young street females in the municipality of Eldoret, Kenya

BackgroundDespite the intervention of free medical care services for street children by a dedicated clinic in Eldoret municipality, health care service of young street females (YSFs) is still deficient. The...

An Evaluation of Virtual Training for Teaching Dance Instructors to Implement a Behavioral Coaching Package.

Few dance instructors receive formal training on how to teach dance skills using behavioral coaching methods and may employ an authoritarian teaching style that utilizes coercive feedback, which can adversely affect dancers' experiences. A behavior analytic approach to dance education may provide dance instructors with strategies that increase the accuracy of dance movements and positively affect dancers' satisfaction with their dance classes. Using a concurrent multiple-baseline design across five dance instructors, we evaluated the outcomes of a virtual training informed by the behavioral skills training framework on dance instructors' implementation of an introductory behavior analytic coaching package consisting of four strategies: task analyzing, emphasizing correct performance with focus points, assessing performance through data collection, and using behavior-specific feedback. We selected these strategies to provide dance instructors with a solid foundation to behavioral coaching methods. It is promising that all dance instructors who participated in virtual training met mastery criteria and maintained their performance at a 1-month follow-up. Future research may consider exploring virtual adaptations that promote more efficient training methods for teaching dance instructors to implement behavioral coaching methods.

Development and implementation of a training package to improve the confidence, skills and knowledge of multi-disciplinary clinicians in the use of telepractice for outpatient services

Introduction: Telepractice is recognised as an effective and efficient medium of service delivery; however, despite this evidence, implementation has been inconsistent. Clinician confidence and perceptions are integral factors to the successful implementation of telepractice in routine care. This study aimed to develop, implement and evaluate a telepractice training package for clinicians in a single hospital service. Methods: Forty-one clinicians from Speech Pathology, Physiotherapy and Chronic Disease departments participated in a training package with a specific focus on staff skills training, access to resources and embedding telepractice models of care into organisational culture. Questionnaires were used to evaluate clinician self-reported skills and confidence at baseline, post-training and 6-months post-training. Thematic analysis of open-ended questions was used to glean a deeper understanding of perceived barriers and facilitators to using telepractice. Results: Participants’ perceived knowledge and confidence significantly increased from baseline to immediately post-training ( p &lt; .001) and increased further to 6-months post-training ( p &lt; .001). Thematic analysis revealed three main enabling themes: (a) perceived benefits to patient care; (b) training and practice; and (c) resources and support; and four main barriers: (a) staff knowledge and training; (b) staff confidence; (c) client factors; and (d) infrastructure and resources. Conclusion: The telepractice training package improved staff skills and confidence which was sustained over time. Facilitating the uptake of telepractice is multidimensional and it is integral to address all relevant factors to ensure its success.

Translating knowledge into action for child obesity treatment in partnership with Parks and Recreation: study protocol for a hybrid type II trial

BackgroundSafe and effective treatment exists for childhood obesity, but treatment recommendations have largely not been translated into practice, particularly among racial and ethnic minorities and low-wealth populations. A key gap is meeting the recommended treatment of ≥26 h of lifestyle modification over 6–12 months. Fit Together is an effective treatment model that meets these recommendations by integrating healthcare and community resources. Pediatric providers screen children for obesity, deliver counseling, and treat co-morbidities, while Parks and Recreation partners provide recreation space for a community nutrition and physical activity program.MethodsThis study will use a hybrid type II implementation-effectiveness design to evaluate the effectiveness of an online implementation platform (the Playbook) for delivering Fit Together. Clinical and community partners in two North Carolina communities will implement Fit Together, using the Playbook, an implementation package designed to facilitate new partnerships, guide training activities, and provide curricular materials needed to implement Fit Together. An interrupted time series design anchored in the Process Redesign Framework will be used to evaluate implementation and effectiveness outcomes in intervention sites. Implementation measures include semi-structured interviews with partners, before and after the implementation of Fit Together, and quantitative measures assessing several constructs within the Process Redesign Framework. The participants will be children 6–11 years old with obesity and their families (n=400). Effectiveness outcomes include a change in child body mass index and physical activity from baseline to 6 and 12 months, as compared with children receiving usual care. Findings will be used to inform the design of a dissemination strategy guided by the PCORI Dissemination Framework.DiscussionThis project addresses the knowledge-to-action gap by developing evidence-based implementation tools that allow clinicians and communities to deliver effective pediatric obesity treatment recommendations. Future dissemination of these tools will allow more children who have obesity and their families to have access to effective, evidence-based care in diverse communities.Trial registrationClinicalTrials.gov identifier: NCT05455190. Registered on 13 July 2022

International recruitment of radiographers and the development of a workplace integration support package: Project evaluation

IntroductionIn October 2020, a regional workforce action group was established jointly by Health Education England (HEE) and NHS England and Improvement (NHSEI) in the South West to work collaboratively to address the workforce challenges within diagnostic imaging. Fifty-eight internationally recruited radiographers were offered employment in departments across the region, the majority of them taking up their posts in the UK in early 2021. The aim of the study presented here was to evaluate the efficacy of a training resource developed by Plymouth Marjon University, with input from HEE and NHSEI, to support workplace and cultural integration for the new recruits. MethodsThe training package to help newly recruited radiographers from outside the UK integrate into their host departments was developed using flexible learning opportunities centred on reusable digital learning assets. Self-paced e-learning sessions were augmented by group ‘connected’ sessions online. Two surveys were undertaken, exploring the impact of this workforce integration programme for International radiographers joining the NHS. ResultsSurvey results indicate that the integration programme's three-phase strategy has seen an impact on 6 out of 12 self-efficacy measures, raised awareness of challenges, and increased personal awareness of implications for practice. By the end of the programme, delegates were in the top two quintiles for their average well-being score. ConclusionPrincipal recommendations include ensuring digital accessibility for new recruits as part of the on-boarding process, considering the timing of delivery of any online connected support sessions, the provision of long-term pastoral support; and mandating the training requirement for managers and team leaders. Implications for practiceSuccess of international recruitment campaigns can be enhanced through the implementation of an online integration package

A Sustainable Method for Evaluating the Activity of Logistics Service Providers (LSPs) in a Turbulent Environment—Case Study Analysis (2020–2021)

As a result of the COVID-19 pandemic, the ongoing war and the implementation of the so-called Mobility Package there are profound changes taking place in the Polish LSP sector. The competitive struggle on the market is intensifying, and it mobilizes the management to diagnose the condition of companies with the use of effective comparative tools. This article aims to present the conclusions of the study of 46 entities on the Polish LSP market. It uses an original, multi-faceted evaluation method. The authors hope to popularize this method for evaluating LSPs by making it cyclical. The comparative evaluation of LSPs was carried out with the use of economic (index) and statistical analysis tools. A model of rank correlation was used for the values of all variables (ten economic parameters and one greening parameter). LSPs were grouped up based on the average value of the economic variables and according to investment attractiveness and then clustered. Sets of the most correlated characteristics in the assessment of the LSPs were developed based on the k-means method and the Spearman coefficient. A collective ranking of LSPs has been prepared.

Evaluation of an implementation package to deliver the COPD CARE service

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is estimated to be the leading cause of death in the next 15 years. Patients with...

SG-APSIC1080: Surveillance and control efforts for carbapenemase-producing gram-negative bacteria at a high-burden tertiary-care healthcare facility in Ho Chi Minh City, Vietnam

Objectives: In Vietnam, although surveillance and control of multidrug-resistant organisms is a national priority, information on the burden of these pathogens remains scarce. At the University Medical Center in Ho Chi Minh City, we assessed the proportion of carbapanemase-producing carbapenem-resistant organisms (CP-CRO) and evaluated an intervention package to prevent transmission of carbapenemase-producing carbapenem-resistant Enterobacterieacea (CP-CRE) in the intensive care unit (ICU). Methods: All gram-negative isolates collected between November 2018 to April 2019 were tested for carbapenem resistance using the disc-diffusion method. Carbapenem-resistant bacteria, defined as meropenem resistant, were tested for phenotypic carbapenemase-production using the Becton Dickinson Phoenix CPO Detect assay. An intervention package, including placement of patients in cohorts, enhanced barrier precautions, enhanced discharge environmental cleaning, and CP-CRE rectal screening, was implemented from July 2019 through December 2020. During this period, all ICU patients were screened on admission, and negative patients were rescreened every 2 days or 7 days until discharge, death, or CRE-positive result. Admission prevalence and incidence of CP-CRE transmission was calculated among CP-CRE infected or colonized patients. Results: Among 599 gram-negative isolates collected, 108 were carbapenem-resistant isolates, of which 107 (99%) were CP-CRO by the phenotypic method. Most CP-CRO were Acinetobacter baumannii (42%) and Klebsiella pneumoniae (36%). Of 1,206 patients, 433 (35.9%) were already colonized or infected with CP-CRE before admission to the ICU. The incidence rate (cases per 100 risk days) of CP-CRE colonization or infection during ICU treatment decreased from 11.5 before the intervention to 2.9 after the implementation of the intervention package. The average number of days to change from a negative to positive screening result in the intervention phase was 7.4, compared with 4.9 days during preintervention phase. Conclusions: Nearly all CROs isolated from our ICU are carbapenemase-producing CROs, with high presence on admission as well as new acquisition during an ICU stay. An intervention package containing enhanced infection control measures was effective in reducing CP-CRE transmission.

Implementation of a novel ultrasound training programme for midwives in Malawi: A mixed methods evaluation using the RE-AIM framework.

Despite recommendation that all women receive an ultrasound in pregnancy prior to 24 weeks', this remains unavailable to many women in low-income countries where trained practitioners are scarce. Although many programmes have demonstrated efficacy, few have achieved longterm sustainability, with a lack of information about how best to implement such programmes. This mixed-methods study aimed to evaluate the implementation of a novel education package to teach ultrasound-naive midwives in Malawi basic obstetric ultrasound, assessing its impact in the context of the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. The study ran across six sites in Malawi between October 2020 and June 2021, encompassing three phases; pre-implementation, implementation and post-implementation. Twenty nine midwives underwent a bespoke education package with matched pre and post course surveys assessed their knowledge, attitudes and confidence and "hands on" assessments evaluating practical skills. Training evaluation forms and in-depth interviews explored their satisfaction with the package, with repeat assessment and remote image review evaluating maintenance of skills. 28/29 midwives completed the training, with significant increases in knowledge, confidence and practical skills. Adherence to the education package varied, however many changes to the proposed methodology were adaptive and appeared to facilitate the efficacy of the programme. Unfortunately, despite reporting approval regarding the training itself, satisfaction regarding supervision and follow up was mixed, reflecting the difficulties encountered with providing ongoing in-person and remote support. This programme was successful in improving trainees' knowledge, confidence and skill in performing basic obstetric ultrasound, largely on account of an adaptive approach to implementation. The maintenance of ongoing support was challenging, reflected by trainee dissatisfaction. By evaluating the success of this education package based on its implementation and not just its efficacy, we have generated new insights into the barriers to sustainable upscale, specifically those surrounding maintenance.

Criminal-Legal Counteraction to Illegal Turnover of Means of Payments (Article 187 of the Criminal Code of the Russian Federation)

Criminal and legal counteraction to crimes in the sphere of turnover of means of payments is provided within the framework of the implementation of the entire package of measures to counteract economic crime. The peculiarity of the criminal law norms regulating the sphere in question is the use of categories in them that are regulated by other branches of law, which requires the law enforcement officer to identify significant signs of the corpus delicti. This article is devoted to topical issues of criminal law protection of the turnover of means of payments. The features and characteristics of the subject of the crime under Article 187 of the Criminal Code of the Russian Federation are analyzed. A critical analysis of the construction of the criminal law norm is given. The author comes to the conclusion that changes in the disposition of Article 187 of the Criminal Code of the Russian Federation, due to the improvement of industry legislation, cause certain difficulties in law enforcement practice. This is largely due to the innovative nature of public relations, the protection of which is provided by this criminal law norm, which have not yet received appropriate comprehensive legal regulation. Formulated in art. 187 of the Criminal Code of the Russian Federation, the legal mechanism as a whole makes it possible to counteract modern threats in this area, at the same time, in order to ensure clarity, clarity, un ambiguity of this legal norm, it is advisable to make appropriate adjustments to it.

A Review on Optimization of Cooling Rate in Pressure Die Casting with Time Domain.

This review paper represents the analysis and optimization for the selection of input variable based on controlling casting regime in order. This review uses specific example of introduced advantage of concurring new products with modern software package comparing to conventional manner. It refers implementation of modern software packages reduces time necessary for concurring new product, reinstates better control over process, increases quality and reduces price of new product. This review paper facilitates not only numerical casting simulation but the optimization of the present casting process design can be done but also an entirely new casting process design for a new casting can be quickly and efficiently made.

Impact of comprehensive interventional package on behavioural outcomes regarding management of menstrual problems among adolescents: A pilot study

Introduction: Dysmenorrhea is the most common gynecologic disorder among female adolescents, with a prevalence of 60% to 93%. Primary dysmenorrhea, painful menstruation without pelvic abnormalities, may be associated with vomiting, fatigue, back pain, headaches, dizziness, and diarrhea. Objective: The aim of the present study is to determine the Impact of comprehensive interventional package on behavioural outcomes regarding management of menstrual problems among adolescents from selected educational institutions. Methodology: The quantitative research approach and true experimental Pre-test Post-test control group design was used in the study. Sample size consisted of 60 (30 in each group) and recruited in the study by using Simple random sampling technique. Results: There is no significant changes were observed in any of the subscales between both groups, were found equal in physiological, psychological and behavioural symptoms at pre-intervention level but instantaneously following the comprehensive interventional package, the adolescent girls in the experimental group had significantly increased self-esteem and improvement in management of Premenstrual problems and even class abseeentism and academic performance has improved so that Behavioural outcome variables of adolescents were upgraded after implementation of comprehensive interventional package from baseline to 3 months follow-up. Conclusion: The comprehensive intervention package proved to be effective in reduction of menstrual symptoms and also clarifying their doubts regarding menstrual problems.