Prevention Intervention Programs Research Articles

Assessing the Contribution of the Level of Knowledge and Awareness of HIV and AIDS to the Effective Implementation of Desired HIV/AIDS Prevention Intervention Programs in Higher Tertiary Institutions

Assessing the Contribution of the Level of Knowledge and Awareness of HIV and AIDS to the Effective Implementation of Desired HIV/AIDS Prevention Intervention Programs in Higher Tertiary Institutions

Telephone-based joint protection education in lateral epicondylitis: A randomized controlled trial.

Lateral epicondylitis (LE) can occur for many different reasons such as compelling repetitive movements in daily readings, incorrect posture use and work-related factors. Although several treatments are available for LE, the optimal evidence-based treatment remains uncertain. Joint protection techniques have been developed as a self-management intervention to reduce pain and disability and improve functionality by applying ergonomic approaches. This study aimed to investigate the effects of telephone-based follow up on top of a home-based joint protection education programme on pain and functionality in individuals with LE. Individuals were randomly assigned into 2 groups; 1) telephone-based group, receiving telephone-based follow-up on top of a home-based joint protection education programme, and 2) home-based group, receiving home-based joint protection education alone. Both groups were given training that increased awareness in LE and home-based exercise programme. In addition, telephone-based group was followed up by telephone three days a week for four weeks. Improvements from baseline to 4th week in Turkish version of the Patient-Rated Tennis Elbow Evaluation-pain (p = 0.001; effect size = 1.11) and function (p < 0.001; effect size = 1.77), Upper Extremity Functional Index (p = 0.001; effect size = 0.85) and The Turkish version of the Joint Protection Behavior Assessment-Short Form (p < 0.001; effect size = 1.54) in the telephone-based group were significantly higher than the improvements in the home-based group. Telephone-based follow-up in individuals with LE contributed to the awareness of pain, functionality and joint protection methods. Telephone-based joint protection education programmes can offer a health service within the scope of preventive and protective intervention programmes for LE.

The effectiveness of a golf injury prevention program (GRIPP intervention) compared to the usual warm-up in Dutch golfers: protocol design of a randomized controlled trial

BackgroundSixty million golfers around the world play golf. Golf injuries are most frequently located in the spine, elbow, wrist, hand and shoulder. Those injuries are often seen in golfers with more playing hours and suboptimal swing biomechanics, resulting in overuse injuries. Golfers who do not perform a warm-up or do not warm-up appropriately are more likely to report an injury than those who do. There are several ways to warm-up. It is unclear, which warm-up is most useful for a golfer to perform. Moreover, there is currently no evidence for the effectiveness of a warm-up program for golf injury prevention. We previously have developed the Golf Related Injury Prevention Program (GRIPP) intervention using the Knowledge Transfer Scheme (KTS). We aim to evaluate the effect of the GRIPP intervention on golf-related injuries. The hypothesis is that the GRIPP intervention program will reduce the number of golf-related injuries.Methods and designThe GRIPP study is a two-armed randomized controlled trial. Twenty-eight golf clubs with 11 golfers per club will be randomly allocated to the intervention or control group. The intervention group will perform the GRIPP intervention program, and the control group will perform their warm-up as usual. The GRIPP intervention is conducted with the Knowledge Transfer Scheme framework, which is a systematic process to develop an intervention. The intervention consists of 6 exercises with a maximum total of 10 min. The primary outcome is the overall prevalence (%) of golf injuries measured with the Oslo Sports Trauma Research Center (OSTRC-H) questions on health problems every fortnight. The secondary outcome measures will be exposure to golf and compliance to the intervention program.DiscussionIn other sports warm-up prevention programs are effective in reducing the risk of injuries. There are no randomized trials on golf injury prevention. Therefore, an individual unsupervised golf athlete intervention program is conducted which reflects the daily practice of predominantly unsupervised exposure of amateur golfers.Trial registrationThe trial is retrospectively (28 October 2021) registered at the Dutch Trial Register: NL9847 (https://trialsearch.who.int).

"Learning from “Our Relations” Indigenous Peoples of Australia, Canada, New Zealand, and United States: A Review of Culturally Relevant Diabetes and Obesity Interventions for Health

Globally, Indigenous Peoples suffer disproportionately higher rates and complications of diabetes and obesity than non-Indigenous people. Western health interventions combined with culturally appropriate Traditional approaches can reduce incidence, prevalence, and related co-morbidities. This literature review reports effective culturally relevant Traditional and Western diabetes and obesity prevention and management intervention programs for Indigenous populations in Australia, Canada, New Zealand, and the United States. Experiential, immediate, interactive, and low-cost programs, co-developed and delivered by local Indigenous people within the communities they live, are most effective in improving health and wellbeing. Key themes of success of Togetherness, Empowerment, and Local Familiarity inform action for policy and practice changes adaptable for chronic disease prevention, treatment, and self-management programs for Indigenous Peoples globally.

‘What's the magic word?’: mapping oral language interventions implemented in prevention and early intervention programmes

ABSTRACT The nationally funded Prevention and Early Intervention (PEI) programme aimed to design, deliver and evaluate interventions to improve a range of outcomes for children growing up in areas of low socio-economic status (SES). A key focus for many PEI programmes was to improve the oral language abilities of children, recognising its important link to a range of literacy, learning, social, emotional and behavioural indicators. This paper reviewed the published reports of PEI and community programmes that implemented oral language interventions for children, parents and practitioners. This mapping exercise demonstrated that the oral language interventions implemented varied extensively and were predominantly evaluated through gathering the perspectives of those receiving the supports. A noticeable gap was the lack of a national evaluation framework of the oral language interventions provided, resulting in difficulties making comparisons, determining impact and contributing to the evidence base of the effectiveness of bespoke interventions designed and delivered. Implications of this mapping exercise are outlined for the future implementation and evaluation of universal and targeted oral language interventions.

Effects of a web-based relapse prevention program on abstinence: Secondary subgroup analysis of a pilot randomized controlled trial.

AimThe effect of a web‐based relapse prevention program might vary depending on a specific population if the study participants included drug users with various characteristics. This secondary analysis explored subgroups among Japanese drug users that may benefit from a web‐based relapse prevention program.MethodsOutpatients with drug use disorder (n = 48) were randomly assigned to an 8‐week, six‐session web‐based relapse prevention program (intervention group) or web‐based self‐monitoring only (control group). We tested the effects of the intervention on abstinence in different subgroups divided by a primary abused drug (methamphetamine vs other drugs), previous face‐to‐face relapse prevention (received vs not received), and outpatient treatment term (long‐term: ≥3 years vs short‐term: <3 years). Consecutive abstinence duration from the primary abused drug was compared in the subgroups, and the interaction between the intervention condition and the subgroup condition was assessed.ResultsIn the subgroup with short‐term outpatient treatment, the intervention group maintained better abstinence than the control group. For those who used methamphetamine or those who had previously received a face‐to‐face relapse prevention program, the intervention group showed larger effect sizes than the results from all the participants. However, the interaction between the intervention condition and the subgroup condition was not significant for any subgroup.ConclusionsThis study suggests that patients with short‐term treatment may benefit from a web‐based relapse prevention program as an alternative treatment. We need to recruit and allocate patients considering their treatment term in a future definitive trial.

Study of donor deferral during blood donation: A single centre teaching hospital study

Background: Safe blood transfusion can be a crucial lifesaving intervention in many clinical situations.For safe blood products donor selection is the first and foremost measure of blood donation. Objective:Aim of the study to determine the incidence and causes for deferral in blood donors. Materials and Methods: This cross-sectional retrospective study was done at Transfusion medicine department in Delta Medical College and Hospital, Bangladesh during 6 months period. In current study data were extracted from the register book and analyzed. Prospective donors were confidentially interviewed and examined and screened for causes of temporary and permanent deferral of blood donation. Data were presented as charts, table and analyzed with Microsoft Excel. Result: A total of 2215 directed donors were studied,of them, 1555 (73.52%) were male and 560 (26.48%) females. Predominantly blood donors belonged to 31–40 years of age group (38.01%). Out of 2115 directed donors, 423 (20%) were deferred. Deferral was significantly more likely in female. The most common cause for deferralwere history of anemia (27.66%). Other causes were antibiotic &amp; medications, high blood pressure, low blood pressure, frequent donation, Positive HBsAg, HCV markers, suspected addiction, and vaccination. Conclusion: Effective measures are required for documenting the deferred donors and appropriate preventive intervention program should be undertaken for prevalent causes of deferrals, like low Hb, Infections with HBV etc. Anemia is the most prevalent reason of temporary deferral for blood donation in this region of Bangladesh. Other reasons were hypertension, hypotension,suspected addiction, vaccination etc. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 645-647

AI-Based Predictive Modelling of the Onset and Progression of Dementia

Dementia, the most severe expression of cognitive impairment, is among the main causes of disability in older adults and currently affects over 55 million individuals. Dementia prevention is a global public health priority, and recent studies have shown that dementia risk can be reduced through non-pharmacological interventions targeting different lifestyle areas. The FINnish GERiatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) has shown a positive effect on cognition in older adults at risk of dementia through a 2-year multidomain intervention targeting lifestyle and vascular risk factors. The LETHE project builds on these findings and will provide a digital-enabled FINGER intervention model for delaying or preventing the onset of cognitive decline. An individualised ICT-based multidomain, preventive lifestyle intervention program will be implemented utilising behaviour and intervention data through passive and active data collection. Artificial intelligence and machine learning methods will be used for data-driven risk factor prediction models. An initial model based on large multinational datasets will be validated and integrated into an 18-month trial integrating digital biomarkers to further improve the model. Furthermore, the LETHE project will investigate the concept of federated learning to, on the one hand, protect the privacy of the health and behaviour data and, on the other hand, to provide the opportunity to enhance the data model easily by integrating additional clinical centres.

Quality of Life and Mental Health in Children and Adolescents after the First Year of the COVID-19 Pandemic: A Large Population-Based Survey in South Tyrol, Italy.

Background: Methodological heterogeneity of studies and geographical variation limit conclusions about the impact of the COVID-19 pandemic on the mental health of youth. This study aimed to explore the health-related quality of life and mental health of children and adolescents in the second year of the pandemic in South Tyrol, Italy. Methods: An online survey representative for the age and gender of the children and adolescents in South Tyrol was conducted among 5159 families with children and adolescents aged 7–19 years, between 28 May and 16 June 2021. The survey collecting parental ratings and self-rated questionnaires from children and adolescents aged 11–19 years included instruments to measure health-related quality of life (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). The results were compared with data from corresponding studies conducted in Germany. Results: Decreased health-related quality of life and increased conduct problems, peer-related mental health problems, anxiety, and depressive and psychosomatic symptoms in children and adolescents observed in the second year of the pandemic in Germany were confirmed in the second year in South Tyrol. Children and adolescents with low socioeconomic status, a migration background, and limited living space were significantly affected. Female sex and older age were associated with increased psychosocial problems and a positive family climate supported the mental health of children and adolescents during the pandemic. Conclusions: Confirmation of findings of decreased health-related quality of life and increased emotional problems after the first year of the pandemic supports the ongoing call for low-threshold health promotion, prevention, and early intervention programs to support children and adolescents who have been severely affected by the pandemic.

Corona Virus Disease 2019 Pandemic Contributed to Pregnancy Devastating Outcomes in Low Income Countries

Corona Virus Disease 2019 (COVID-19) pandemic has been a public health threat of the 21st century. This pandemic has unexpectedly occurred, and countries have faced challenges to implement the preventive strategies against this unexpected killer. Pregnancy is a critical state among women, and special care should be provided to prevent pregnancy related complications as early as possible. COVID-19 pandemic has restricted services provided to pregnant women due to some prevention measures and treatment programs. Previous studies reported the high increase of obstetric complications among women infected or ever infected by COVID-19. Depression, suicidal intention, low quality of life during pregnancy, gestational hypertension and gestational diabetes mellitus, the premature rupture of membranes, miscarriage, preterm delivery, edema, maternal death, and hypoxia and other respiratory conditions were observed among women infected by COVID-19. Strategies for protecting pregnant women during pandemics should be enhanced to prevent pregnancy related complications and maternal death. There should be home health care nurses and midwives working with community health workers to assist pregnant women at home. Governments should develop policies and plans about maintaining maternal and child health during pandemics requiring travel ban and other prevention measures.

Knowledge, attitudes and practices relating to tobacco smoking in undergraduate students in a selected university of Bangladesh

Background: Tobacco smoking is one of the leading causes of preventable morbidity and mortality in the world, and is responsible for many premature deaths. The prevalence of smoking and smoking-related mortality are still high in developing and low-income countries. This survey was aimed to determine knowledge, perception and practices of tobacco smoking behavior in the undergraduate students of Bangladesh University of Health Sciences, Bangladesh.Methods: A descriptive type of cross-sectional study was conducted among the Health Sciences students during January 2018. A self-administered semi-structured questionnaire was used for data collection from 260 undergraduate students. Data was analyzed using SPSS version 25 (Statistical Package for Social Studies).Results: The prevalence of overall current tobacco smokers was 12.3% (21.2% for males and 0.9% for females). Nonsmokers had a better knowledge than smokers regarding smoking as a risk factor for lung cancer (98.4%; versus 92.9%; p=0.038), association between second hand smoke and serious illness (94.2% versus 82.9%; p&lt;0.001) and likelihood of dying earlier than nonsmokers (84.2% versus 61.4%; p&lt;0.001). In general, students had positive antismoking perception.Conclusions: Despite having a good understanding of the detrimental effects of tobacco smoking, smoking prevalence among students at Bangladesh University of Health Sciences is high. To reduce smoking among university students, effective smoking prevention and cessation intervention programs are necessary.

Relationship of family related factors with dental caries prevalence in 5 years old children of different schools of Hyderabad.

Introduction: The habits children have included in life; continues to make the choices they make as adults. According to social learning theory these habits are derived through supervision, learning and modelling. For a child, most significant are primarily father and mother and their immediate family members. All these factors have the collective ability to influence the child's oral health outcomes.&#x0D; Objective: To examine the dental caries rate in 5 year’s old school children and influence of their family related habits and socio demographic factors on child’s dental caries experience and their oral health behavior.&#x0D; Methodology: This study conducted upon sample of 600 school children selected through random sampling from primary private and Government primary schools of Qasimabad Hyderabad Sindh during period of October 2015 to December 2015. &#x0D; Results: shows that out of 600 children 330 (55%) were boys and 270 (45%) were girls. Boys 245 (40%) were affected from caries and 85 (14%) were free from caries. In relation to parental education; 44 (7.3%) child boys whom parents were highly educated were found affected by caries 44(7.3%), while 3 (0.5%) boys were free from caries. Girls whose parents were highly educated affected by caries were 44(7.3%), caries free were 12(2%) Boys whose parents have incomplete secondary education/ vocational school were affected by caries 162(27%) and caries free were 82(13.6%). Girls whose parents have incomplete secondary / vocational school were affected by caries 145 (24.1%). Boys whose parents were having low level of education affected by caries were 39(6.5%) while caries free were 0 (0%). Girls whose parents have low level of education were affected by caries were 69 (11.5%) while caries free were 0 (0%) .&#x0D; Conclusion: Life style choices are the habits that are formed in childhood and dictated as in adult hood. Thus, assessing family related risk factor regarding oral health is essential when conducting preventive treatment programs for children because education on oral hygiene maintenance and regular preventive dental health checkups are very important in order to prevent oral diseases.&#x0D; Key words: Dental Caries, primary dentition.&#x0D;

'Shall We Send a Panda?' A Practical Guide to Engaging Schools in Research: Learning from Large-Scale Mental Health Intervention Trials.

The substantial time that children and young people spend in schools makes them important sites to trial and embed prevention and early intervention programmes. However, schools are complex settings, and it can be difficult to maintain school engagement in research trials; many projects experience high levels of attrition. This commentary presents learning from two large-scale, mixed-methods mental health intervention trials in English schools. The paper explores the barriers and challenges to engaging schools in promotion or early intervention research and offers detailed recommendations for other researchers.

Prodromal phase: Differences in prodromal symptoms, risk factors and markers of vulnerability in first episode mania versus first episode psychosis with onset in late adolescence or adulthood.

ObjectiveThis study was aimed at identifying differences in the prodromal symptoms and their duration, risk factors and markers of vulnerability in patients presenting a first episode mania (FEM) or psychosis (FEP) with onset in late adolescence or adulthood in order to guide tailored treatment strategies.MethodsPatients with a FEM or FEP underwent a clinical assessment. Prodromes were evaluated with the Bipolar Prodrome Symptom Scale‐Retrospective (BPSS‐R). Chi‐squared tests were conducted to assess specific prodromal symptoms, risk factors or markers of vulnerability between groups. Significant prodromal symptoms were entered in a stepwise forward logistic regression model. The probabilities of a gradual versus rapid onset pattern of the prodromes were computed with logistic regression models.ResultsThe total sample included 108 patients (FEM = 72, FEP = 36). Social isolation was associated with the prodromal stage of a FEP whilst Increased energy or goal‐directed activity with the prodrome to a FEM. Physically slowed down presented the most gradual onset whilst Increased energy presented the most rapid. The presence of obstetric complications and difficulties in writing and reading during childhood were risk factors for FEP. As for markers of vulnerability, impairment in premorbid adjustment was characteristic of FEP patients. No specific risk factor or marker of vulnerability was identified for FEM.ConclusionEarly characteristics differentiating FEP from FEM were identified. These findings might help shape early identification and preventive intervention programmes.

Early Preventive Intervention for Young Children With Sex Chromosome Trisomies (XXX, XXY, XYY): Supporting Social Cognitive Development Using a Neurocognitive Training Program Targeting Facial Emotion Understanding.

BackgroundSex Chromosome Trisomies (SCTs; XXX, XXY, XYY) are genetic conditions that are associated with increased risk for neurodevelopmental problems and psychopathology. There is a great need for early preventive intervention programs to optimize outcome, especially considering the increase in prenatal diagnoses due to recent advances in non-invasive prenatal screening. This study is the first to evaluate efficacy of a neurocognitive training in children with SCT. As social behavioral problems have been identified as among the key areas of vulnerability, it was targeted at improving a core aspect of social cognition, the understanding of social cues from facial expressions.MethodsParticipants were 24 children with SCT and 18 typically developing children, aged 4–8 years old. Children with SCT were assigned to a training (n = 13) or waiting list (no-training) group (n = 11). Children in the training group completed a neurocognitive training program (The Transporters), aimed to increase understanding of facial emotions. Participants were tested before and after the training on facial emotion recognition and Theory of Mind abilities (NEPSY-II), and on social orienting (eyetracking paradigm). The SCT no-training group and typically developing control group were also assessed twice with the same time interval without any training. Feasibility of the training was evaluated with the Social Validity Questionnaire filled out by the parents and by children's ratings on a Visual Analog Scale.ResultsThe SCT training group improved significantly more than the SCT no-training and TD no-training group on facial emotion recognition (large effect size; = 0.28), performing comparable to typical controls after completing the training program. There were no training effects on ToM abilities and social orienting. Both children and parents expressed satisfaction with the feasibility of the training.ConclusionsThe significant improvement in facial emotion recognition, with large effect sizes, suggests that there are opportunities for positively supporting the development of social cognition in children with an extra X- or Y-chromosome, already at a very young age. This evidence based support is of great importance given the need for preventive and early training programs in children with SCT, aimed to minimize neurodevelopmental impact.

Changes in help‐seeking intentions among young people living in families impacted by mental illness attending Australian Kookaburra Kids Foundation camps

AbstractYoung people living in families impacted by familial mental illness are at increased risk of various negative mental and physical health outcomes. Prevention and early intervention programmes are useful in mitigating the risk of transgenerational transmission of mental illness. Therapeutic recreation camps constitute a novel approach to mental health early intervention and prevention for these young people, incorporating educational experiences within a peer‐based environment. This study assessed the outcomes of attending the Australian Kookaburra Kids Foundation camps for young people living in families impacted by familial mental illness. A pre‐post design was used with 237 young people between 8 and 18 years old. Mixed analyses of variance (ANOVAs) found significant improvements in young people's mental health knowledge and intentions to seek help using an anonymous telephone helpline after attending the programme. Results also revealed that males became more likely to seek help from regular contacts within their established networks after attending the programme. These findings contribute towards an increased understanding of the extant help‐seeking processes involved among an at‐risk population, with focused attention on subgroups who are less likely to seek help for their issues.

Minimising young children\u2019s anxiety through schools (MY-CATS): protocol for a cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of an online parent-led intervention compared with usual school practice for young children identified as at risk for anxiety disorders

BackgroundIdentifying and supporting young children who are at risk of developing anxiety disorders would benefit children, families, and wider society. Elevated anxiety symptoms, inhibited temperament, and high parental anxiety are established risk factors for later anxiety disorders, but it remains unclear who is most likely to benefit from prevention and early intervention programmes. Delivering an online intervention through schools to parents of young children who have one or more of these risks could maximise reach. The primary aim of this trial is to evaluate the effectiveness and cost-effectiveness of delivering an online parent-led intervention, compared with usual school provision only, for children (aged 4–7) identified as at risk for anxiety disorders on the basis of at least one risk factor. We also aim to identify the characteristics of children who do and do not benefit from intervention and mechanisms of change from the intervention.MethodsThe design will be a parallel group, superiority cluster randomised controlled trial, with schools (clusters) randomised to intervention or usual school practice arms in a 1:1 ratio stratified according to level of deprivation within the school. The study will recruit and randomise at least 60 primary/infant schools in England, and on the basis of recruiting 60 schools, we will recruit 1080 trial participants (540 per arm). Parents of all children (aged 4–7) in sampled Reception, Year 1, and Year 2 classes will be invited to complete screening questionnaires. Children who screen positive on the basis of anxiety symptoms, and/or behavioural inhibition, and/or parent anxiety symptoms will be eligible for the trial. Parents/carers of children in schools allocated to the intervention arm will be offered a brief online intervention; schools in both arms will continue to provide any usual support for children and parents throughout the trial. Assessments will be completed at screening, baseline (before randomisation), 6 weeks, 12 weeks, and 12 months post-randomisation. The primary outcome will be the absence/presence of an anxiety disorder diagnosis at 12 months.DiscussionThe trial will determine if delivering an online intervention for parents of young children at risk of anxiety disorders identified through screening in schools is effective and cost-effective.Trial registrationISRCTN 82398107. Prospectively registered on Jan. 14, 2021.

Heavy Drinking among High School Student Athletes and Non-Athletes: Do Differences Emerge as Early as the Ninth Grade?

Background: High school athletes have been identified as a high-risk group for heavy drinking. Little is known, however, about the timing of when student athlete heavy drinking begins to diverge from that of non-athletes. Objectives: The aim of the current study is to examine differences in changes in heavy drinking among ninth grade student athletes and non-athletes across the academic year. We hypothesized that student athletes would report greater increases in heavy drinking compared to non-athletes from fall to spring semester. Methods: Ninth grade students (N = 217) aged 13 to 15 completed questionnaires on heavy drinking indices, quantity of peak drinking, frequency of binge drinking, and estimated blood alcohol concentration (eBAC) during the fall and spring semesters. Results: Consistent with our hypothesis, student athletes reported significantly greater increases in heavy drinking compared to non-athletes from fall to spring semester. Additionally, there was a significant increase in all three indices of heavy drinking for student athletes, whereas there were no significant changes for non-athletes. Conclusions: Results demonstrate divergence in the quantity and frequency of heavy drinking between student athletes and non-athletes during the ninth grade. These findings indicate the optimal timing of preventive intervention programs may be different for student athletes and non-athletes. Results also suggest that preventive intervention program targeting heavy drinking should be implemented for high school student athletes as early as the fall semester of the ninth grade when students are transitioning to high school.

Assessing the Efficacy of an Individualized Psychological Flexibility Skills Training Intervention App for Medical Student Burnout and Well-being: Protocol for a Randomized Controlled Trial.

BackgroundMedical student burnout is a prevalent problem with adverse long-term outcomes. Incorporating psychological resource-building interventions into comprehensive burnout prevention approaches during medical training is an identified priority among educators. These interventions could reduce burnout risk by buffering students against nonmodifiable career stressors. However, there is a need for rigorous investigation into optimal intervention targets and methods. Psychological flexibility (PF) is an adaptive behavioral skill set that has demonstrated relationships with medical student burnout and well-being. More broadly, there is evidence that PF mediates burnout and well-being outcomes and may be a protective factor. Efficacy studies assessing the benefits of interventions targeting PF among medical students are needed. Research also supports the need to establish optimal methods for increasing intervention efficacy in the context of individual differences in burnout and PF by using individualized approaches.ObjectiveThis study aims to assess whether an app-delivered PF intervention (Acceptance and Commitment Training) reduces burnout and improves well-being among medical students. We will examine whether changes in burnout and well-being are mediated by changes in PF. The potential benefits of an individualized version of the app versus those of a nonindividualized version will also be evaluated.MethodsIn this 3-arm, parallel, randomized controlled study, a sample of medical students will be randomly allocated to 1 of 3 intervention arms (individualized, nonindividualized, and waiting list) by using a 1:1:1 allocation ratio. Participants in the individualized and nonindividualized intervention arms will have 5 weeks to access the app, which includes a PF concepts training session (stage 1) and access to short PF skill activities on demand (stage 2). Stage 2 will be either individualized to meet participants’ identified PF training needs at each log-in or nonindividualized.ResultsBurnout, well-being, and PF will be assessed at baseline and after the intervention. Quantitative analyses will include descriptive and inferential statistics. We hypothesize that the Acceptance and Commitment Training intervention app will be effective in improving burnout and well-being and that changes in these outcomes will be mediated by changes in PF. We further hypothesize that participants in the individualized intervention group will demonstrate greater improvements in burnout and well-being outcomes than those in the nonindividualized group.ConclusionsThe findings of this study could guide the development of burnout prevention and well-being initiatives for medical students. Identifying PF as a mediating process would provide support for the delivery of preventive intervention programs that train individuals to strengthen this psychological resource before burnout symptoms emerge. This would be an important step in addressing and potentially offsetting the significant costs of burnout among medical students and physicians. Demonstrating the superiority of an individualized version of the app over a nonindividualized version would have implications for enhancing intervention precision and efficacy by using scalable interventions.Trial RegistrationAustralian New Zealand Clinical Trials Registry ANZCTR 12621000911897; https://www.anzctr.org.au/ACTRN12621000911897.aspxInternational Registered Report Identifier (IRRID)PRR1-10.2196/32992

Reasons for Suicide During the COVID-19 Pandemic in Japan

Although the suicide rate in Japan increased during the COVID-19 pandemic, the reasons for suicide have yet to be comprehensively investigated. To assess which reasons for suicide had rates that exceeded the expected number of suicide deaths for that reason during the COVID-19 pandemic. This national, population-based cross-sectional study of data on suicides gathered by the Ministry of Health, Labor, and Welfare from January 2020 to May 2021 used a times-series analysis on the numbers of reason-identified suicides. Data of decedents were recorded by the National Police Agency and compiled by the Ministry of Health, Labor, and Welfare. For category analysis, we compared data from January 2020 to May 2021 with data from December 2014 to June 2020. For subcategory analysis, data from January 2020 to May 2021 were compared with data from January 2019 to June 2020. The main outcome was the monthly excess suicide rate, ie, the difference between the observed number of monthly suicide deaths and the upper bound of the 1-sided 95% CI for the expected number of suicide deaths in that month. Reasons for suicide were categorized into family, health, economy, work, relationships, school, and others, which were further divided into 52 subcategories. A quasi-Poisson regression model was used to estimate the expected number of monthly suicides. Individual regression models were used for each of the 7 categories, 52 subcategories, men, women, and both genders. From the 29 938 suicides (9984 [33.3%] women; 1093 [3.7%] aged <20 years; 3147 [10.5%] aged >80 years), there were 21 027 reason-identified suicides (7415 [35.3%] women). For both genders, all categories indicated monthly excess suicide rates, except for school in men. October 2020 had the highest excess suicide rates for all cases (observed, 1577; upper bound of 95% CI for expected number of suicides, 1254; 25.8% greater). In men, the highest monthly excess suicide rate was 24.3% for the other category in August 2020 (observed, 87; upper bound of 95% CI for expected number, 70); in women, it was 85.7% for school in August 2020 (observed, 26; upper bound of 95% CI for expected number, 14). In this study, observed suicides corresponding to all 7 categories of reasons exceeded the monthly estimates (based on data from before or during the COVID-19 pandemic), except for school-related reasons in men. This study can be used as a basis for developing intervention programs for suicide prevention.