Intervention System Research Articles

일반계 고등학생이 지각한 부모의 긍정적 양육태도, 자아존중감, 학업열의, 진로적응력 간의 구조적 관계

Objectives This study was conducted to draw implications that can be used to establish a systematic intervention plan to help the smooth career development of general high school students in Korea. Methods To this purpose, This study used data from the fifth year of the KCYPS 2018 to test how high school students' perceived parental positive nurturing attitude affect their career adaptability through mediating self-esteem and academic engagement by setting up a SEM. Results First, the paths through which parental positive nurturing attitude influenced high school students' self-esteem, academic engagement, and career adaptability, the paths through which self-esteem influenced academic engagement and career adaptability, and the respective paths through which academic engagement influenced career adaptability were all significant and static. Second, there were partial mediation effects of self-esteem and academic engagement on the relationship between high school students' perceived parental positive attitude and career adaptability, and a dual mediation effect in which parental positive nurturing attitude sequentially mediated self-esteem and academic engagement to affect career adaptability. Conclusions The operational and content factors to be considered when conducting career counseling and education in general high schools were suggested.

Correlation Between Radiological Grading and Clinical Scoring in Knee Osteoarthritis Patients.

Osteoarthritis is characterized by mechanical joint abnormalities, primarily involving articular cartilage and subchondral bone degradation. Diagnosis of knee osteoarthritis relies on American College of Rheumatology criteria, and severity assessment utilizes the Western Ontario and McMaster Universities Osteoarthritis Index score and Kellgren and Lawrence grading. Despite reported associations, discrepancies persist in the correlation between Western Ontario and McMaster Universities Osteoarthritis Index and Kellgren and Lawrence grade. Descriptive cross-sectional study was conducted at the National Trauma Centre, over six months with consecutive convenience sampling. Demographic and clinico-radiological data were collected. Mean, SD and correlation coefficient was calculated. Consecutive convenient sampling yielded 80 participants meeting American College of Rheumatology criteria, aged 52-81 years, predominantly female (67.50%). Significant positive correlations were identified between age, Western Ontario and McMaster Universities Osteoarthritis Index score, and KL grade. Results showed most cases with Kellgren and Lawrence grade III and strong correlations (r=0.73, p=0.00) between total Western Ontario and McMaster Universities Osteoarthritis Index scores and Kellgren and Lawrence grading. Notably, pain, stiffness and physical functions individually exhibited a significant possitive correlation with Kellgren and Lawrence grading. The study affirms age-related influences on osteoarthritis, emphasizes female predilection, and underscores the importance of assessing both clinical and radiological parameters. In conclusion, this study supports Western Ontario and McMaster Universities Osteoarthritis Index efficacy in dynamic disease assessment and management, especially in settings where radiological examinations may be impractical, thus establishing Western Ontario and McMaster Universities Osteoarthritis Index as a versatile tool for systematic monitoring and intervention in knee osteoarthritis.

Peningkatan Kreativitas Anak Di Panti Asuhan Bala Keselamatan (Salvation Army) Dengan Menggunakan Metode Casework

The purpose of this study is to improve the children's creativity at the Salvation Army Orphanage by using casework procedures. One tactic to stress problem solutions through organized and systematic social interventions is the casework technique. Children who took part in the program shown gains in their ability to think creatively, express themselves, and solve problems. Youngsters who had a natural desire to work and greater self-confidence also benefited. This journal's goal is to foster the imaginations and inventiveness of the kids at the Salvation Army Orphanage through the application of casework techniques, which span the engagement, intake, contract, assessment, planning, intervention, monitoring, evaluation, and termination phases.

Perceptions and factors influencing exercise interventions in elderly patients with debilitating spinal surgery and healthcare professionals: A qualitative study

BACKGROUND Older spine surgery patients have a high incidence of debilitation, which can be managed with certain exercises. AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals. METHODS Descriptive research methods were used to classify and summarize patients and professionals’ perceptions and factors affecting exercise interventions. Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes. RESULTS A total of 7 themes were identified: (1) The current status of patients' exercise is unsatisfactory; (2) patients' health literacy is low, coupled with a lack of social and family support; (3) there are numerous challenges with systematic exercise interventions; (4) healthcare professionals acknowledge the importance and need for exercise interventions; (5) there's a pronounced willingness among patients to participate in exercise intervention programs; (6) healthcare professionals believe that exercise interventions are beneficial; and (7) participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery. CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.

Speech-to-text intervention to support text production among students with writing difficulties: a single-case study in nordic countries

Studies report that speech-to-text applications (STT) may support students with writing difficulties in text production. However, existing research is sparse, shows mixed results, and lacks information on STT interventions and their applicability in schools. Therefore, this study aimed to investigate whether a systematic and intensive assistive technology intervention focusing on STT can improve text production. A modified multiple-baseline across-subject design was used involving eight middle school students, four Norwegian and four Swedish. Their STT-produced narrative texts were collected during and after the intervention and the productivity, accuracy, and text quality were analysed. Keyboarding was the baseline control condition. The results demonstrated that seven of the eight students increased text productivity and that the proportion of word-level accuracy was maintained or improved. The use of punctuation progressed in participants with poor baseline skills. Most students’ STT-produced texts had at least a similar ratio of meaningfulness and text quality as keyboarding. However, the magnitude of the changes and development patterns varied, with three students showing the most notable impacts. In conclusion, this study’s intervention seemed beneficial in initially instructing STT, and the progress monitoring guided individually adapted future interventions such as balancing productivity and formal language aspects. Removing the spelling barrier with STT provided an opportunity for students to improve their higher-order skills, such as vocabulary diversity and overall text quality. Furthermore, visible progress, such as the ability to produce longer texts, might motivate continued STT usage. However, such development may not always be immediate.

Examining primary healthcare services following earthquake shocks in Turkiye: A critical analysis of the initial 3months and the vital role of humanitarian policy transfer for rapid response.

The purpose of this article is to discuss the importance of policy transfer by humanitarian NGOs to post-disaster regions and the effectiveness of mobile Primary Health Care (PHC) services immediately after disasters. This study also focused on analysing the first 3months aftermath of the earthquake and assessed the changes in the access and needs of vulnerable groups in emergency response creation and systematic interventions after disasters. In disasters that require urgent response such as earthquakes, the importance of the existing NGOs (Such as MdM) capacity in the countries has emerged in terms of rapid response and experience sharing. During the field work, it is observed that MdM Mobile Medical Units (MMU) teams had played a key role in terms of tracking PHC needs, functioning as early warning system for epidemics, and prevention of communicable diseases in the EQ effected areas. In this aspect, the changes in diagnoses in the first trimester is examined using the comparative analysis methods. This study used a cross-sectional mixed-method approach in terms of objective evaluation. The results from a quantitative needs assessment were complemented by qualitative data. Herein, the data were collected in two stages: First, primary data was collected through the field activities of MMU, and second field-based assessments was conducted with health professionals who have been working in the MMU teams since the first moments of the earthquake.

Successful Aging and Subjective Aging: Toward a Framework to Research a Neglected Connection.

Research related to subjective aging, which describes how individuals perceive, interpret and evaluate their own aging, has substantially grown in the past two decades. Evidence from longitudinal studies shows that subjective aging predicts health, quality of life, and functioning in later life. However, the existing literature on successful aging has mostly neglected the role of subjective aging. This paper proposes an extended framework of successful aging linking subjective aging conceptually and empirically to Rowe and Kahn's (1997) three original key criteria of successful aging (i.e., avoiding disease and disability, maintaining high cognitive and physical function, and engagement with life). A particular focus is placed on subjective aging as an antecedent of successful aging. A review of the empirical subjective aging literature shows that subjective aging concepts consistently predict all three of Rowe and Kahn's criteria of successful aging. Mechanisms underlying these relations are discussed at three levels, namely psychological, behavioral, and physiological pathways. The proposed addition also takes into consideration the interconnections between subjective aging and successful aging throughout the lifespan and across historical time. Finally, we discuss the importance of facilitating successful aging through systematic interventions that support more positive views of aging at the individual and societal level.

Comparison of two audit and feedback approaches: descriptive analysis of personal and contextual dynamics.

Audit and feedback (A&F) is a systematic intervention that can be used to improve the quality of health care. The EASY-NET Network Project proposes an innovative A&F model. This study aimed to describe the newly proposed A&F model. An analysis was conducted, examining the participants' attitudes and their individual and interpersonal mechanisms to understand how they influence the work context and vice versa. Two A&F models were compared, involving emergency and rehabilitation health workers, who were divided into two groups. The classic A&F model was compared with a new model, using a desk audit followed by interactive feedback. Communication training was provided to the audit team by psychologists before commencement of the project. The experimental group underwent psychological screening using two standardized tools (COPE-NVI and ProQoL) to evaluate personal and relational dynamics using the context-mechanism-outcome (CMO) paradigm. The exchange of ideas among health professionals is more effective when using face-to-face feedback than written feedback. The COPE-NVI and ProQoL questionnaires highlighted the difficulties experienced by health care professionals in implementing effective coping strategies to deal with stressful events. Identifying signs of stress in health care workers is essential for improvement strategies to be implemented and for establishing new, optimal conditions. Remote feedback makes it possible to overcome logistical barriers and, in the future, this method can be used for inter-organizational collaboration. http://links.lww.com/IJEBH/A203.

You can count on your fingers: Finger-based intervention improves first-graders’ arithmetic learning

The question of whether finger use should be encouraged or discouraged in early mathematics instruction remains a topic of debate. Scientific evidence on this matter is scarce due to the limited number of systematic intervention studies. Accordingly, we conducted an intervention study in which first-graders (Mage = 6.48 years, SD = 0.35) completed a finger-based training (18 sessions of ∼ 30 min each) over the course of the first school year. The training was integrated into standard mathematics instruction in schools and compared with business-as-usual curriculum teaching. At the end of first grade and in a follow-up test 9 months later in second grade, children who received the finger training (n = 119) outperformed the control group (n = 123) in written addition and subtraction. No group differences were observed for number line estimation tasks. These results suggest that finger-based numerical strategies can enhance arithmetic learning, supporting the idea of an embodied representation of numbers, and challenge the prevailing skepticism about finger use in primary mathematics education.

The Exploration of Youth School Refusal Problem: Causes, Intervention, and Case Study from Ecological Perspective

兒童青少年拒學問題一直以來都是複雜和難解的課題。研究者基於生態系統觀點探討拒學原因與介入方法，並認為若能分別主要與次要影響因素，先針對主要影響因素進行介入，將更能在有限的時間和資源內改善出席率，故提出三個層次的原因與介入模式。此模式中不同層次差別在主要影響因素的數量不同，層次一包含兩個因素的相互影響，如：個人與家庭。層次二包含三個因素的相互影響，如：個人、家庭與學校。層次三包含四個因素的相互影響。原因部分，個人因素包含身體狀況、心理狀況和特質；家庭因素包含五點，即家長特質與身心健康、家庭功能與動力、家庭期待與參與度...等；學校因素包含六點，即轉換學校、學校氛圍、管教與出席...等；社會因素包含五點，即經濟拉力、文化價值觀、政策或法規...等。介入部分，個人因素包含醫療介入、提升行為技巧、增進認知技巧、提供專業資源；家庭因素包含五點，即進行意外或風險管理訓練、提供諮詢或家訪、提供認知訓練...等；學校因素包含七點，即辨識和轉介高風險學生、推動反霸凌政策、鼓勵學習社群與生涯活動...等；社會因素包含社區資源、警政與司法、社會機構與媒體、教育、諮商與醫療。最後提出中年級拒學案例說明如何改善拒學。Problematic school refusal in youth has long been a complex and vexatious issue. This article reviews the literature that affect school refusal based on ecological perspective. It is believed that if we can differentiate between primary and secondary influencing factors and first intervene with the primary influencing factors, we can better improve school attendance within limited time and resources. Furthermore, a three-level model that emphasizes on comprehensive causes and user-friendly systematic intervention recommendations is proposed. Level one includes the interaction of two factors, such as the individual and the family. Level two includes the interaction of three factors, namely the individual, family, and school. Level three includes the interaction of four factors. Among the causes, personal factors can be addressed through physical condition, mental condition and trait. Family factors include five points, such as parents’ trait, mental and physical health, family function and family dynamic, family expectations and involvement... etc... School factors include six points, namely transferring schools, school atmosphere, discipline and attendance policies...etc.. Social factors include five points, such as economic pressures, cultural values, policies or regulations...etc.. Regarding interventions, personal factors can be addressed through medical treatment, enhancing behavioral skills, increasing cognitive skills, and providing professional resources. Family factors include five points, namely conducting accident or risk training, consultation and home visits, providing cognitive training...etc.. School factors include seven points, such as identifying and referring high-risk students, promoting an anti-bullying policy, encouraging learning groups and career activities...etc... Social factors include community resources, policing and Justice, social organizations and media, education, counseling and medical services. In the end, there is a case example of a fourth-grade child, explains how to address school refusal.

Folding Fun Boosts Early Childhood Fine Motor Skills Globally

This study investigates the efficacy of folding activities to enhance fine motor skills in Group A children at RA An Nur Kedung Jumputrejo Sukodono Sidoarjo, utilizing Classroom Action Research (CAR) with the Kemmis and McTaggart models. Fourteen children (9 boys, 5 girls) participated in Pre Cycle, Cycle 1, and Cycle 2 interventions, with data collected via observation, documentation, and interviews. Results show a remarkable improvement from a baseline fine motor skill percentage of 35% in Pre Cycle to 95% in Cycle 2, surpassing the 75% success indicator. These findings underscore the effectiveness of folding activities in early childhood education and provide valuable insights for educators aiming to enhance motor skill development in young learners. Highlight: Improved fine motor skills through folding activities. Utilization of Classroom Action Research for systematic intervention. Valuable insights for educators enhancing motor skills in young learners. Keyword: Fine motor skills, Folding activities, Classroom Action Research, Early childhood education, Motor skill development

The burden of neurological conditions in north Africa and the Middle East, 1990–2019: a systematic analysis of the Global Burden of Disease Study 2019

The burden of neurological conditions in north Africa and the Middle East is increasing. We aimed to assess the changes in the burden of neurological conditions in this super-region to aid with future decision making. In this analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 data, we examined temporal trends of disability-adjusted life-years (DALYs; deaths and disabilities combined), deaths, incident cases, and prevalent cases of 14 major neurological conditions and eight subtypes in 21 countries in the north Africa and the Middle East super-region. Additionally, we assessed neurological DALYs due to 22 potentially modifiable risk factors, within four levels of classification, during the period 1990-2019. We used a Bayesian modelling estimation approach, and generated 95% uncertainty intervals (UIs) for final estimates on the basis of the 2·5th and 97·5th percentiles of 1000 draws from the posterior distribution. In 2019, there were 441·1 thousand (95% UI 347·2-598·4) deaths and 17·6 million (12·5-24·7) neurological DALYs in north Africa and the Middle East. The leading causes of neurological DALYs were stroke, migraine, and Alzheimer's disease and other dementias (hereafter dementias). In north Africa and the Middle East in 2019, 85·8% (82·6-89·1) of stroke and 39·9% (26·4-54·7) of dementia age-standardised DALYs were attributable to modifiable risk factors. North Africa and the Middle East had the highest age-standardised DALY rates per 100 000 population due to dementia (387·0 [172·0-848·5]), Parkinson's disease (84·4 [74·7-103·2]), and migraine (601·4 [107·0-1371·8]) among the global super-regions. Between 1990 and 2019, there was a decrease in the age-standardised DALY rates related to meningitis (-75·8% [-81·1 to -69·5]), tetanus (-88·2% [-93·9 to -76·1]), stroke (-32·0% [-39·1 to -23·3]), intracerebral haemorrhage (-51·7% [-58·2 to -43·8]), idiopathic epilepsy (-26·2% [-43·6 to -1·1]), and subarachnoid haemorrhage (-62·8% [-71·6 to -41·0]), but for all other neurological conditions there was no change. During 1990-2019, the number of DALYs due to dementias, Parkinson's disease, multiple sclerosis, ischaemic stroke, and headache disorder (ie, migraine and tension-type headache) more than doubled in the super-region, and the burden of years lived with disability (YLDs), incidence, and prevalence of multiple sclerosis, motor neuron disease, Parkinson's disease, and ischaemic stroke increased both in age-standardised rate and count. During this period, the absolute burden of YLDs due to head and spinal injuries almost doubled. The increasing burden of neurological conditions in north Africa and the Middle East accompanies the increasing ageing population. Stroke and dementia are the primary causes of neurological disability and death, primarily attributable to common modifiable risk factors. Synergistic, systematic, lifetime, and multi-sectoral interventions aimed at preventing or mitigating the burden are needed. Bill & Melinda Gates Foundation. For the Persian, Arabic and Turkish translations of the abstract see Supplementary Materials section.

Study on the Influencing Factors and Countermeasures of Drug Addicts' Relapse

The relapse of drug addicts is a global problem and has serious effects on social and personal health. The purpose of this study was to investigate the influencing factors and countermeasures of drug addicts. By reviewing the literature method, the research results are summarized and analyzed. In terms of individuals, the degree of addiction and mental health status have important effects on relapse behavior; in terms of families, the quality of family relationships and family economic status are related to relapse behavior; in terms of society, social rejection, social networks, and employment barriers are related to relapse. Based on the research results, we propose systematic prevention and intervention measures, such as strengthening mental health services, strengthening government supervision and support, and strengthening family and social support. This study provides a comprehensive perspective and solution to the relapse problem of drug addicts, and provides a scientific basis for relevant policy making and improving the success rate of drug rehabilitation.

Social prescribing for people living with dementia (PLWD) and their carers: what works, for whom, under what circumstances and why – protocol for a complex intervention systematic review

IntroductionDementia is a complex medical condition that poses significant challenges to healthcare systems and support services. People living with dementia (PLWD) and their carers experience complex needs often exacerbated by...

Navigating Pacific nutrition and health at Brown Buttabean Motivation (BBM): Process evaluation and systems dynamics research at a flax-roots organization

Brown Buttabean Motivation (BBM) is a Māori and Pacific-driven community-based organisation operating in Tāmaki Makaurau (Auckland) and Tokoroa. It provides free community exercise bootcamps and other social and health support programs. BBM’s foundational mission was to reduce, among Māori and Pacific people, the prevalence of obesity in Auckland through exercise and nutrition programs.1 This study aimed to understand participants’ engagement with BBM, and the meaning it has had in their lives, with a focus on nutrition. Combining Pacific Fonofale and Te Whare Tapa Wha frameworks, this was a process evaluation to understand the impact of BBM’s services on the community using qualitative methods and a systems analysis to identify program sustainability and improvement. Semi-structured interviews explored the benefits and values of engagement with BBM. Followed by cognitive mapping interviews (CMI) and group model building (GMB) to identify the motivations and challenges of sustained engagement. Participants described holistic health benefits and impacts on community wellbeing. BBM responds to inequitable nutrition contexts, through its FoodShare (food bank), community kitchen, and BBM Kai (nutrition literacy). Engagement changed family nutrition patterns, and benefits included healthier spending habits, and addressing food insecurity. Social inclusiveness represented the Fonofale foundation (family) and the roof (culture) was described as ethnic cultural practices and BBM culture. Nutrition was not highlighted by BBM participants in CMI or GMB activities. However, participants suggested BBM increase nutrition initiatives to enable all members to improve their health journeys. BBM was seen as not just an exercise program but their own and their family’s new way of life, that health was a journey, not a destination. Moreover, although participants mentioned nutrition and health benefits, there was an overwhelming understanding that the values of BBM, Pacific culture, and social collectivism were the drivers of engagement, motivating healthier practices. BBM could leverage existing strengths by incorporating nutrition-enabling initiatives that are achieved collectively. Opportunities for systematic intervention will be presented.

Application of System Nursing in the Prevention of Postoperative Nonstructural Scoliosis in Patients With Ear Reconstruction.

To evaluate whether early systematic nursing can reduce the occurrence of postoperative nonstructural scoliosis in patients undergoing ear reconstruction. A total of 136 patients with congenital microtia who underwent ear reconstruction surgery at the Department of Plastic Surgery, Chinese Academy of Medical Sciences from, January 2022 to July 2022 were included as study subjects. They were randomly divided into a routine nursing group and a systematic nursing group. After preoperative and postoperative education, as well as continuous follow-up intervention after surgery, spinal CT three-dimensional imaging examination was performed 6 months later to measure the Cobb angle and observe the occurrence of spinal scoliosis. Compared with the routine nursing group, the incidence and severity of postoperative nonstructural scoliosis were significantly reduced in patients who received systematic nursing. Systematic nursing intervention for patients undergoing ear reconstruction can help prevent the occurrence of postoperative nonstructural scoliosis and has a positive effect on improving patient prognosis. It is worth promoting in clinical treatment.

Secondary Cardiovascular Disease Prevention Deficit Persists over the Years: A Multicenter Cross-Sectional Study Involving 1003 Consecutive Patients from Greece

Purpose: Lipid lowering treatments (LLTs) can reduce the risk of atherosclerotic cardiovascular disease (ASCVD). Despite the availability of potent LLTs, our clinical observations suggest an inadequate use of such agents. To evaluate this treatment deficit, we designed the present study. Methods: We reviewed the charts of all patients with a history of ASCVD (coronary artery disease—CAD; carotid stenosis—CS; or peripheral artery disease—PAD) diagnosed prior to their first visit to one of our clinics. We recorded their gender, age, ASCVD risk factors (diabetes, hypertension, tobacco use, body mass index), lipid values during that visit and the LLT used. We estimated the rates of the attainment of guideline-specific lipid goals by year, and assessed factors influencing the likelihood of treatment success. Results: Overall, n = 1003 subjects were recruited: CAD n = 703 (70.1%), PAD n = 168 (16.8%), CS n = 325 (32.4%); age 64.7 ± 11.2 years; n = 376 (37.5%) females; n = 642 (64.0%) had diabetes; n = 740 (73.8%) had hypertension; n = 299 (29.8%) were former and n = 367 (36.6%) were current smokers. An appropriate LLT was used in 361 (36.0%) subjects, n = 159 (15.9%) were on no treatment, n = 483 (48.2%) were receiving inadequate therapy, n = 434 (43.3%) were on a high-intensity LLT and n = 361 (36.0%) had achieved the year-specific LDL goals. Success rates ranged from 5.7% to 81.5%, with the lowest being 2020–2023 (5.7–14.5%), p < 0.001. The use of a combination of LLTs and PCSK9 inhibitors led to higher rates of LDL-C goals achievement (p < 0.001). Discussion: Recent secondary ASCVD risk prevention guidelines’ goals are rarely achieved in daily clinical practice, producing a major treatment deficit in this population. Newer systematic interventions are needed to curb this public health issue.

Abstract P324: Training and Technical Assistance to Improve Hypertension Control in Community Health Centers

Introduction: About 47% of adults in the U.S. have high blood pressure (BP), a contributing factor to major adverse health conditions including heart attack, heart failure, and stroke. Hypertension has also been linked to worse outcomes from COVID-19 infection, resulting in higher rates of hospitalization and death. In 2021, the AHA launched the National Hypertension Control Initiative (NHCI) in 350 community health centers (CHCs). The 3-year initiative aimed to improve BP control and COVID-19 outcomes through training and technical assistance (T/TA) in CHCs with systematic, multi-sector, culturally sensitive and evidence-based interventions, including self-measured blood pressure (SMBP) monitoring. We hypothesize that T/TA with guideline-directed and evidence-based systematic processes can improve BP control in CHCs. Methods: The initiative included complementary components: patient and public education, community outreach and integration, health care professional and organization training, and project management and evaluation. Year one focused on laying a foundation of BP control fundamentals to strengthen knowledge and skills with webinars, office hours, tools, and resources. Years two and three reinforced key concepts, introduced new resources, and provided 1:1 support to CHCs, informed by ongoing evaluation. The adoption of systematic processes with evidence-based and guideline-directed practices were encouraged in CHCs. Recognizing potential differences across CHCs, several T/TA methods were deployed during phases of the initiative in anticipation of evolving CHC needs and readiness. The methods for T/TA include providing a core educational curriculum, developing and distributing customized CHC reports with individualized data, using new and existing resources, including a BP measurement policy and procedure and a BP treatment algorithm, and evaluating methods and practice findings. Early Results: Based on UDS data, overall, BP control rates increased in NHCI CHCs from 51.3% to 57.6% (as defined by the performance measure <140/90 mm Hg), demonstrating a 6.3% absolute increase and a 12.3% relative increase from 2020 to 2022. This is compared to all HRSA CHCs, where BP control rates increased from 58.0% to 63.4%, demonstrating a 5.4% absolute increase and a 9.3% relative increase from 2020 to 2022. While all NHCI CHCs started with BP control rates less than 58.9%, some health centers have demonstrated control rates higher than 70%. Discussion: T/TA with guideline-directed and evidence-based systematic processes may have contributed to increased BP control rates in CHCs. The degree of CHC progress may have been influenced by challenges and limitations, such as the impact of the COVID-19 pandemic on participation, clinical leadership engagement, CHC team staffing turnover, and technology interoperability.

Promoting Lung Cancer Screen Decision-Making and Early Detection Behaviors: A Systematic Review and Meta-analysis.

Promoting lung cancer screening (LCS) is complex. Previous studies have overlooked that LCS behaviors are stage based and thus did not identify the characteristics of LCS interventions at different screening stages. The aims of this study were to explore the characteristics and efficacy of interventions in promoting LCS decision making and behaviors and to evaluate these interventions. We conducted a study search from the inception of each bibliographic database to April 8, 2023. The precaution adoption process model was used to synthesize and classify the evidence. The RE-AIM framework was used to evaluate the effectiveness of LCS programs. Heterogeneity tests and meta-analysis were performed using RevMan 5.4 software. We included 31 studies that covered 4 LCS topics: knowledge of lung cancer, knowledge of LCS, value clarification exercises, and LCS supportive resources. Patient decision aids outperformed educational materials in improving knowledge and decision outcomes with a significant reduction in decision conflict (standardized mean difference, 0.81; 95% confidence interval, -1.15 to -0.47; P < .001). Completion rates of LCS ranged from 3.6% to 98.8%. Interventions that included screening resources outperformed interventions that used patient decision aids alone in improving LCS completion. The proportions of reported RE-AIM indicators were highest for reach (69.59%), followed by adoption (43.87%), effectiveness (36.13%), implementation (33.33%), and maintenance (9.68%). Evidence from 31 studies identified intervention characteristics and effectiveness of LCS interventions based on different stages of decision making. It is crucial to develop targeted and systematic interventions based on the characteristics of each stage of LCS to maximize intervention effectiveness and reduce the burden of lung cancer.

Secular trends in sleep and circadian problems among adolescents in Hong Kong: From 2011-2012 to 2017-2019

ObjectiveThe study aimed to investigate secular trends in sleep and circadian problems in Hong Kong Chinese adolescents. MethodsThis study analyzed cross-sectional data from two large-scale school-based sleep surveys conducted in 2011-2012 and 2017-2019. Sleep and circadian problems, including sleep-wake pattern, insomnia, chronotype, social jetlag, daytime sleepiness, and other sleep-related factors, were compared between two survey years. ResultsA total of 8082 adolescents (5639 students in 2011-2012 [Mean age: 14.4 years, 50.9% boys] and 2443 students in 2017-2019 [Mean age: 14.7 years, 54.0% boys]) were included in this 7-year study. The average time in bed of Hong Kong adolescents decreased from 8.38 hours to 8.08 hours from 2011-2012 to 2017-2019. There was a 0.28-hour delay in weekday bedtime, 0.54-hour advance in weekend wake-up time, and a 0.36-hour decline in average time in bed, resulting in increased trends of sleep loss (Time in bed <8h: OR = 2.06, 95%CI: 1.44–2.93, p < 0.01; Time in bed <7h: OR = 2.73, 95%CI: 1.92–3.89, p < 0.01), daytime sleepiness (OR = 1.70, 95%CI: 1.34–2.16, p < 0.01), and evening chronotype (OR = 1.26, 95%CI: 1.08–1.48, p < 0.01). The increased trend in insomnia disorder, however, was insignificant when covariates were adjusted. ConclusionA secular trend of reduced time in bed, delay in weekday bedtime, advance in weekend wake-up time, increase in evening chronotype and daytime sleepiness from 2011-2012 to 2017-2019 were observed. There is a timely need for systematic intervention to promote sleep health in adolescents.