Knowledge-based Intervention Research Articles

Improving household food safety through combining nudge strategies with knowledge-based intervention: The effectiveness and mechanism

The role of household settings is vital in the global challenge of foodborne diseases, serving as key areas for outbreaks. Despite significant efforts by governmental and research institutions to promote safe food handling, traditional knowledge-based interventions often are short in boosting motivation. Our study addressed this issue by integrating motivational nudge strategies with declarative and procedural knowledge-based interventions, targeting 914 primary household food handlers. Through randomized controlled trials, the impact of these interventions was rigorously evaluated. We found that a combination of mindful nudging and declarative knowledge-based intervention significantly improved compliance with food safety guidelines. Additionally, our analysis highlighted the critical mediating role of attitudes in this process. This research may present practical multidisciplinary intervention strategies for promoting safe food-handling behaviors.

Dietary Knowledge, Attitude, Practice Survey and Nutritional Knowledge-Based Intervention: A Cross-Sectional and Randomized Controlled Trial Study among College Undergraduates in China.

Understanding undergraduates' dietary literacy, including dietary knowledge, attitude and practice (KAP), is important for future health promotion policies. Therefore, this study aimed to investigate the current status and influencing factors of dietary literacy in Chinese college undergraduates and explore whether a nutritional lecture could improve their dietary literacy. This study included two parts: a cross-sectional study (n = 1026) conducted by a dietary literacy questionnaire, and a randomized controlled trail (RCT) that enrolled 99 college undergraduates who were randomized to a control group or a nutritional lecture group. Data from the questionnaire and 72 h food records were obtained on day 0, day 3 and day 100 before and after intervention. This cross-sectional study showed that the mean scores of dietary KAP were respectively 100.0 (33.3), 59.1 (13.6) and 71.7 (11.7), with an excellent rate of 36.6%, 1.9% and 3.4%. Female upper-grade undergraduates and those with medicine-related majors illustrated higher dietary knowledge scores (p < 0.001). Dietary attitude rather than dietary knowledge had a significant impact on dietary practice (p < 0.001). This finding was in line with the results in the RCT study. Compared with the control group, dietary knowledge was significantly improved in the nutritional lecture group on both day 3 (p = 0.002) and day 100 (p = 0.023) after intervention. However, dietary behavior was improved only on day 3 post nutritional lecture (p = 0.029) but decreased to the original level 100 days later (p < 0.001). This study discovered the unsatisfying status and discrepancy between dietary literacy among college undergraduates of different sex, majors and college years. Dietary attitude instead of dietary knowledge was discovered as a determining role in dietary practice. One nutritional lecture could improve undergraduates' dietary literacy but the effect was not long-lasting. Further studies with more reinforced and durable interventions are warranted.

Knowledge-based intervention improves older adult recognition memory for novel activity, but not event segmentation or temporal order memory

Although episodic memory declines with age, older adults are often able to make use of relevant knowledge to support episodic memory. More specifically, prior knowledge may support the perception of meaningful events through the process of event segmentation. We sought to test whether increasing older adults’ knowledge for novel activities (i.e., Tai chi, making gyozas) would improve segmentation and memory. We conducted an online, pre-registered intervention in which eighty older adults were recruited based on being novices in each of the targeted activities. Participants completed segmentation and memory tests before and after being randomly assigned to one of two interactive virtual workshops (learning how to practice Tai chi or make gyozas). Each workshop consisted of two one-hour sessions during which an expert provided information about the activity and demonstrated it in a step-by-step fashion. We found that the intervention led to increased learning and recognition memory for the trained activity; however, there were no significant improvements in segmentation behavior, free recall, or memory of sequential information. These findings indicate that either more knowledge training is necessary to affect segmentation, or that segmentation is guided by perceptual features in the environment rather than one’s conceptual understanding of the activity.

Increasing Colorectal Cancer Screening Among Black Men in Virginia: Development of an mHealth Intervention.

In the United States, colorectal cancer (CRC) is the third leading cause of cancer death among Black men. Compared to men of all other races or ethnicities, Black men have the lowest rates of CRC screening participation, which contributes to later-stage diagnoses and greater mortality. Despite CRC screening being a critical component of early detection and increased survival, few interventions have been tailored for Black men. This study aims to report on the multistep process used to translate formative research including prior experiences implementing a national CRC education program, community advisory, and preliminary survey results into a culturally tailored mobile health (mHealth) intervention. A theoretically and empirically informed translational science public health intervention was developed using the Behavioral Design Thinking approach. Data to inform how content should be tailored were collected from the empirical literature and a community advisory board of Black men (n=7) and reinforced by the preliminary results of 98 survey respondents. A community advisory board identified changes for delivery that were private, self-paced, and easily accessible and content that addressed medical mistrust, access delays for referrals and appointments, lack of local information, misinformation, and the role of families. Empirical literature and survey results identified the need for local health clinic involvement as critical to screening uptake, leading to a partnership with local Federally Qualified Health Centers to connect participants directly to clinical care. Men surveyed (n=98) who live or work in the study area were an average of 59 (SD 7.9) years old and held high levels of mistrust of health care institutions. In the last 12 months, 25% (24/98) of them did not see a doctor and 16.3% (16/98) of them did not have a regular doctor. Regarding CRC, 27% (26/98) and 38% (37/98) of them had never had a colonoscopy or blood stool test, respectively. Working with a third-party developer, a prototype mHealth app that is downloadable, optimized for iPhone and Android users, and uses familiar sharing, video, and text messaging modalities was created. Guided by our results, we created 4 short videos (1:30-2 min) including a survivor vignette, animated videos about CRC and the type of screening tests, and a message from a community clinic partner. Men also receive tailored feedback and direct navigation to local Federally Qualified Health Center partners including via school-based family clinics. These content and delivery elements of the mHealth intervention were the direct result of the multipronged, theoretically informed approach to translate an existing but generalized CRC knowledge-based intervention into a digital, self-paced, tailored intervention with links to local community clinics. ClinicalTrials.gov NCT05980182; https://clinicaltrials.gov/study/NCT05980182.

A Brief Media Intervention Influences Collegiate Males’ Attitude and Knowledge Towards Breastfeeding

ABSTRACT Breastfeeding is the optimal source of infant nutrition, yet the motherʻs decision to breastfeed is complex and influenced by factors including social support and breastfeeding knowledge and attitudes. This study employed a two-group pretest-posttest design to examine whether brief, online video presentations (<2.5 minutes in length) could improve breastfeeding knowledge and attitude among males and compare the outcomes between a knowledge-based and attitude-based intervention. Collegiate male participants (N = 213, 18–40 years of age) demonstrated high breastfeeding exposure (90.1% had friends/family breastfeed) and positive attitudes (89.2% accepted women could breastfeed and work outside home) yet knowledge deficits concerning breastfeeding health benefits were identified. Breastfeeding exposure was positively associated with baseline attitude (r(212)=.186, p = .006 and knowledge (r(212)=.229, p = .001. Both intervention groups reported similar gains in attitude scores; only the knowledge-based intervention reported significant gains in knowledge (M = 1.5, SD = 2.63 vs M = −.07, SD = 1.44, (t = −5.496, df = 211, p < .05). Brief online video presentations may constitute an additional exposure to or nudging toward breastfeeding, and breastfeeding knowledge and attitudes can be positively influenced in young adult males with similar interventions that are affordable and require a minimal time commitment.

Approaching the risk perception gap: effects of a subject matter knowledge-based intervention in a health context

ABSTRACT We conducted a short subject matter knowledge-based intervention in a quasi-experimental design and explored whether providing health-related subject matter knowledge affects university students’ risk perception and their behavioural intentions. We chose the everyday context of using antiperspirants that contain aluminium and focused on the presumption that antiperspirants facilitate Alzheimer’s disease development. This study was devoted to a risk perception gap caused by the epistemic and ontological uncertainty involved in the contextual background of using antiperspirants and developing Alzheimer’s disease . By computing repeated measures ANOVA, we found that imparting subject matter knowledge as system, action-related and effectiveness health knowledge increased students’ cognitive and affective risk perception. Path analyses revealed that cognitive and affective risk perception had an indirect, negative effect on behavioural intentions towards using antiperspirants. Attitudes and perceived behavioural control fully mediated the relationship between risk perception and intention. The mediation effect differed between students who received subject matter knowledge and students who did not. We discuss the findings from our study related to the role of subject matter knowledge for understanding risk perception, the ambiguity of overcoming and creating a risk perception gap when uncertainty holds and how risk perception relates to attitudes and behavioural intention.

Knowledge, Practices, and Factors Associated with Cervical Cancer Screening Among Women Attending Outpatient Clinics in Meru District, Arusha Region, and Northern Tanzania

Introduction&#x0D; Cervical cancer is most prevalent in low- and middle- income countries. Inadequate knowledge on and bad attitude towards cervical cancer preclude cervical cancer screening practices. This study aimed at determining knowledge and practices of cervical cancer screening, and its associated factors among outpatient clinics in Arusha region, more specifically in Meru district.&#x0D; Methods&#x0D; A hospital-based cross-sectional study was conducted in Meru district between March and April 2019. A total of 706 women aged 18-55 years who attended outpatient clinics in Meru District Hospital, and the USA River Health Centre were studied. Face-to-face interview was conducted. Multivariable log-binomial regressions model was used to analyse data, and to determine factors associated with cervical cancer screening practices. Stata version 14.0 aided the analysis of data.&#x0D; Results&#x0D; Majority of participants had poor knowledge on signs of and risk factors for cervical cancer. Over seventy percent (77.2%) had little knowledge on signs, and 62.8% had little knowledge on risk factors for cervical cancer. However, approximately half of participants (53%) had good knowledge on cervical cancer prevention. One-third (32.9%) of participants mentioned that they happened to screen for cervical cancer. Factors associated with cervical cancer screening included, women aged 25-34 years (PR=2.11, 95% CI: 1.37-3.25) and ≥35 years (PR=3.62, 95% CI: 2.36-5.56), having health insurance (PR=1.28, 95% CI: 1.09-1.50), and good knowledge of cervical cancer signs and prevention [(PR=1.50, 95% CI: 1.25-1.80) vs. (PR=1.30, 95%CI 1.05-1.60)].&#x0D; Conclusion&#x0D; Few women, a third of participants happened to screened for cervical cancer. Therefore, Knowledge-based intervention is crucial to the uptake of cervical cancer screening.

Mechanisms of Salmonella Attachment and Survival on In-Shell Black Peppercorns, Almonds, and Hazelnuts.

Salmonella enterica subspecies I (ssp 1) is the leading cause of hospitalizations and deaths due to known bacterial foodborne pathogens in the United States and is frequently implicated in foodborne disease outbreaks associated with spices and nuts. However, the underlying mechanisms of this association have not been fully elucidated. In this study, we evaluated the influence of storage temperature (4 or 25°C), relative humidity (20 or 60%), and food surface characteristics on the attachment and survival of five individual strains representing S. enterica ssp 1 serovars Typhimurium, Montevideo, Braenderup, Mbandaka, and Enteritidis on raw in-shell black peppercorns, almonds, and hazelnuts. We observed a direct correlation between the food surface roughness and S. enterica ssp 1 attachment, and detected significant inter-strain difference in survival on the shell surface under various storage conditions. A combination of low relative humidity (20%) and ambient storage temperature (25°C) resulted in the most significant reduction of S. enterica on shell surfaces (p < 0.05). To identify genes potentially associated with S. enterica attachment and survival on shell surfaces, we inoculated a library of 120,000 random transposon insertion mutants of an S. Enteritidis strain on almond shells, and screened for mutant survival after 1, 3, 7, and 14 days of storage at 20% relative humidity and 25°C. Mutants in 155 S. Enteritidis genes which are involved in carbohydrate metabolic pathways, aerobic and anaerobic respiration, inner membrane transport, and glutamine synthesis displayed significant selection on almond shells (p < 0.05). Findings of this study suggest that various food attributes, environmental factors, and an unexpectedly complex metabolic and regulatory network in S. enterica ssp 1 collectively contribute to the bacterial attachment and survival on low moisture shell surface, providing new data for the future development of knowledge-based intervention strategies.

Efficacy testing of the SAVOR (Sisters Adding Fruits and Vegetables for Optimal Results) intervention among African American women: A randomized controlled trial.

Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a SistersAdding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks).SAVOR (n=26) was compared to an equivalent knowledge-based intervention (n=28). Process evaluation was done for program fidelity and satisfaction. A validated 38-item self-reported questionnaire was used to measure changes in MTM constructs and past 24-hour consumption of fruits and vegetables. Results: The SAVOR intervention resulted in improvement of mean consumption of fruits and vegetables in the experimental group from pre-test (2.78) to posttest (4.77) to recommended levels at follow-up (5.04) while in the comparison group they remained at around 3 (P<0.0001)Statistically significant changes (P<0.05) were noted for all MTM constructs except for participatory dialogue. Conclusion: The SAVOR intervention was found to be efficacious and established the robustness of MTM. SAVOR can be replicated for future effectiveness trials.

The Effect of a Knowledge-Based Intervention on the Use of Respirators in the Norwegian Smelter Industry.

IntroductionThe present study investigated the effect of interventions aiming to improve attitudes toward the use of respiratory protective equipment (RPE), knowledge of RPE and the use of RPE in the Norwegian smelter industry.MethodThe surveys received 567 respondents to baseline and 240 respondents 2 weeks after the intervention. Participants were invited to either a fit-testing of respirators [Group 1] or a fit-testing combined with a lecture on exposure [Group 2], health effects and RPE. The control group [Group 3] received no training. Questionnaires containing measures of subjective knowledge, attitudes and behavior regarding RPE use were assessed.ResultsTesting indicated an improvement in knowledge of RPE and a reduction in perceived inconveniences regarding the use of RPE for both intervention groups. Group 1 showed an improvement in attitudes and organizational support, while intervention Group 2 showed an improvement in subjective norms related to RPE use. Intention to use or rate of respirator use was not shown to change significantly for any group using paired testing. Regression analysis indicated that participation in either intervention influenced intention to use respirators. The effect was significant for Group 1 and was marginally significant for intervention Group 2.ConclusionThe results indicate that interventions can increase workers’ knowledge and attitudes, and reduce perceived inconvenience regarding the use of respiratory protective equipment. However, even though some variables seemed to positively change, reported respirator use did not improve for either groups participating in the study. It may be that physical barriers with regards to using RPE, such as fogging of protective goggles, sweating, breathing and communication issues outweigh individual attitudes, intentions and social pressure to use respirators.Practical ApplicationsThe tailored course and practical training in RPE use in the current intervention can be applied in the smelting industry to provide up to date information on dust exposure, health effects and protective equipment. Some adjustments may be warranted for the content to fit specific risks and exposures of other industries. However, the general pedagogical framework of the educational material regarding health effects and RPE should be useful for most heavy industries.

Next of kin\u2019s quality of life before and after implementation of a knowledge-based palliative care intervention in nursing homes

PurposeThe purpose of this study was to evaluate whether an educational palliative care intervention improved the quality of life for next of kin to older persons in nursing homes.MethodsAltogether, 90 next of kin in the intervention group and 105 next of kin in the control group were included. Data were collected using the WHOQOL-BREF questionnaire, answered before and 3 months after the intervention was completed. Descriptive and comparative analyses were performed.ResultsThis study found a statistically significant increase in the Physical health subscale in the intervention group but not in the control group. In contrast, the General health score decreased in the control group but not in the implementation group. Furthermore, we found an increase in the item able to perform activities of daily living in the intervention group and a decrease in the item energy and fatigue in the control group.ConclusionThe results indicated small statistical changes regarding next of kins’ QoL in favour of the intervention. Lessons learned from the study for future research are to include next of kin as participants at meetings about next of kin and to include more meetings about the theme next of kin. Both approaches would bring a stronger focus on the family-centred care aspect of the intervention into the education component, which this study indicates the need for.Trial registryTrial registration NCT02708498. Date of registration 26 February 2016.

The evaluation of a fourth-generation multi-theory model (MTM) based intervention to initiate and sustain physical activity.

Background: The United States Department of Health and Human Services (USDHHS)recommends that adults achieve 150 minutes per week of moderate-intensity aerobic activity.Most African American women do not meet these guidelines. The purpose of this study was to determine the efficacy of an intervention based on the fourth generation, multi-theory model (MTM) of health behavior change for initiating and sustaining physical activity among African American women when compared to a first generation, knowledge-based intervention. Methods: The randomized controlled trial (RCT) utilized a pre-test, post-test and 6-week followup evaluation with an experimental (n=25) group and a comparison group (n=23). Process evaluation for satisfaction and program fidelity was conducted along with impact evaluation for changes in MTM constructs, intent to initiate and sustain physical activity, minutes of physical activity, body mass index (BMI), waist circumference and blood pressure in hypertensives. Results:The MTM-based intervention proved significantly efficacious in increasing the minutes of physical activity from pre-test mean of 37 minutes to 172 minutes at follow-up (mean difference135.08 minutes, 95% CI: 106.04 to 164.13, P<0.0001), reducing waist circumference from pretest mean of 39 inches to 38 inches at follow-up (mean difference -1.12 inches, 95% CI: -1.70 to-0.545, P<0.001) and modifying the MTM construct of changes in physical environment from a mean of 7 units at pre-test to 9 units at follow-up (mean difference 2.08 units, 95% CI: 0.73 to 3.43, P<0.004) when compared to the knowledge-based intervention over time. Conclusion: There were directional improvements in the mean scores for most of the study variables over time for the MTM intervention group and statistically significant improvement in minutes of physical activity and waist circumference.

Two-Year Outcomes of the Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial.

Childhood overweight and obesity is a public health epidemic with far-reaching medical, economic, and quality of life consequences. Brief, web-based interventions have received increased attention for their potential to combat childhood obesity. The purpose of our study was to evaluate a web-based, maternal-facilitated childhood obesity prevention intervention dubbed Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER), for its capacity to elicit sustained effects at the 2-year postintervention follow-up mark. Two interventions were evaluated using a randomized controlled trial design. The experimental, EMPOWER arm received a social cognitive theory intervention ( n = 29) designed to improve four maternal-facilitated behaviors in children (fruit and vegetable consumption, physical activity, sugar-free beverage intake, screen time). The active control arm received a knowledge-based intervention dubbed Healthy Lifestyles ( n = 28), which also targeted the same four behaviors. We identified a significant group-by-time interaction of small effect size for child fruit and vegetable consumption ( p = .033; Cohen's f = 0.139) in the EMPOWER group. The construct of maternal-facilitated environment was positively associated to improvements in child fruit and vegetable behavior. We also found significant main effects for child physical activity ( p = .024; Cohen's f = 0.124); sugar-free beverage intake ( p < .001; Cohen's f = 0.321); and screen time ( p < .001; Cohen's f = 0.303), suggesting both groups improved in these behaviors over time. The EMPOWER arm of the trial resulted in an overall increase of 1.680 daily cups of fruits and vegetables consumed by children, relative to the comparison group ( p < .001, 95% confidence interval = [1.113, 2.248]). Web-based maternal-facilitated interventions can induce sustained effects on child behaviors.

Evaluation of the mobile nurse training (MNT) intervention \u2013 a step towards improvement in intrapartum practices in Bihar, India

BackgroundEvidence shows that improving the quality of intrapartum care is critical for maternal survival. However, a significant rise in the proportion of facility-based births over the last decade in India - attributable to a cash transfer program - has not resulted in a corresponding reduction in maternal mortality, thanks, in part, to low-skilled care at facilities. The current study evaluated a mobile knowledge-based intervention aimed at improving quality of care by mentoring in-service staff nurses at public obstetric facilities.MethodsAn independent evaluation team conducted baseline and post-intervention assessments at every facility using a mix of methods that included training assessments and Direct Observation of Deliveries. The assessment involved passive observation of pregnant women from the time of their admission at the facility and recording the obstetric events and delivery-related practices on a pre-formatted checklist-based tool. Maternal practices were classified into positive and negative ones and scored. Linear regression analysis was used to evaluate the association of MNT intervention with summary scores for positive, negative and overall practice scores. We evaluated retention of intervention effect by comparing the summary scores at baseline, immediately following intervention and 1 year after intervention.ResultsIn both unadjusted and adjusted analyses, the intervention was found to be significantly associated with improvement in positive practice score (Unadjusted: parameter estimate (β) = 16.90; 95% confidence interval (CI) = 15.20, 18.60. Adjusted: β = 13.14; 95% CI = 10.97, 15.32). The intervention was also significantly associated with changes in negative practice score, which was reverse coded to represent positive change (Unadjusted: β = 11.66; 95% CI = 10.06, 13.27. Adjusted: β = 2.99; 95% CI = 1.35, 4.63), and overall practice score (Unadjusted: β = 15.74; 95% CI = 14.39, 17.08; Adjusted: β = 10.89; 95% CI = 9.18, 12.60). One year after the intervention, negative practices continued to improve, albeit at a slower rate; positive labor practices and overall labor practice remained higher than the baseline but with some decline over time.ConclusionsFindings suggest that in low resource settings, interventions to strengthen quality of human resources and care through mentoring works to improve intrapartum maternal care.

Assessing the effectiveness of a knowledge-based intervention to tackle barriers to cervical screening: A pilot study.

Key Points • Knowledge and fear may act as barriers to cervical screening • Women (N = 402) received no information about screening, statistical information or barrier-tackling information • Statistical and barrier-tackling information improved knowledge of how frequently women should be screened • Barrier-tackling information reduced the false belief that screening tests for cancer • Screening intention did not vary between the conditions

Creating a climate for change: Interventions, efficacy and public discussion about climate change

Interpersonal discussions about climate change among the public are important for creating positive social change to addressing the issue, yet a majority of the public does not regularly discuss the topic. Previous correlational research connects avoidance of climate change discussions to low efficacy about these discussions. The present research tests whether a knowledge-based intervention which 1) uses evidence-based communication techniques to increase science knowledge and 2) highlights community-level solutions can promote public discussion through improving efficacy beliefs. A lab experiment (N = 173) with university students and a field quasi-experiment with two nationally representative samples of visitors to informal science learning centers (e.g., aquariums, Na = 1068, Nb = 907) demonstrates that those that received a knowledge-based intervention (vs. those who do not receive this intervention) report higher efficacy beliefs, which subsequently enhance engagement in climate change discussion. Our results suggest the potential for national-level knowledge-based interventions which improve efficacy beliefs to catalyze public engagement.

Impact of a Nursing Skill-Improvement Intervention on Newborn-Specific Delivery Practices: An Experience from Bihar, India.

High neonatal mortality in India had previously been attributed to the low proportion of institutional deliveries. However, a significant rise in the proportion of facility-based births over the last decade has not achieved the desired reduction in neonatal mortality possibly as a result of low-skilled care at facilities. This study evaluated the effectiveness of "Mobile Nurse Training," a knowledge-based intervention for nurses to improve essential newborn-specific delivery practices. Eighty health centers with obstetric care facilities were selected from eight districts of Bihar. The intervention teams were composed of two trained nurses who conducted a week-long workshop per month at every health facility for 6 months. An independent evaluation team conducted baseline and postintervention assessments at every facility. The assessments included passive observation of newborn-specific delivery practices and recording of results on a preformatted checklist-based tool. The intervention was associated with significant increases in the odds of four recommended practices: placing the newborn on mother's abdomen (adjusted odds ratio (AOR) 4.2 [95% CI 3.0-5.9]), wiping the eyes with sterile gauze (AOR 2.2 [95% CI 1.4-3.4]), skin-to-skin care (AOR 2.7 [95% CI 2.0-3.5]), and guidance for initiation of breastfeeding (AOR 1.6 [95% CI 1.2-2.1]). The intervention was also found to be positively associated with the summary score for improvements in all newborn-specific delivery practices. One year after the intervention, the summary practice score remained higher than at baseline, but with some decline over time. The "Mobile Nurse Training" intervention provides a pathway for improving adherence to recommended newborn-specific delivery practices among institutional birth attendants in rural Bihar.

Developing an Evidence-Based, Nurse-Led Psychoeducational Intervention With Peer Support in Gynecologic Oncology.

The physical and psychosocial impact of radiotherapy for gynecologic cancer requires complex interventions to address treatment-related, psychosocial, and psychosexual and survivorship needs. A multidisciplinary approach is required to address these needs, but standard practice is varied and lacks a sound evidence base. The aim of this study was to describe the process of development and pilot testing of a novel evidence-based, complex psychoeducational intervention aiming to improve psychosocial outcomes for gynecologic-oncology patients treated curatively with radiotherapy. The intervention combines tailored nursing consultations with telephone peer support pretreatment, midtreatment, end of treatment, and posttreatment. The UK Medical Research Council framework for developing complex interventions was used to produce an evidence-based, feasible, and acceptable intervention. Intervention manuals and study materials were informed by literature reviews of best-available evidence, relevant theory, and iterative consumer and expert consultations. The nurse manual specified content for consultations providing self-care information, coaching tailored to individual needs, and multidisciplinary care coordination. The peer manual described phone consultations aimed at providing psychosocial support and encouraging adherence to self-care strategies. Three peers and 1 nurse underwent rigorous skills and knowledge-based intervention delivery training. The intervention was pilot tested with 6 patients. Qualitative feedback led to minor design and content changes. The intervention was found to be feasible, relevant, and acceptable to participants and clinicians and is currently being tested in a national randomized controlled trial (PeNTAGOn). The Medical Research Council framework is useful in developing nursing interventions. The specific methods and strategies described are useful for designing future complex studies targeting patient supportive care.

One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial.

The purpose of this study was to evaluate the efficacy of the Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention at 1-year, postintervention follow-up. A mixed between-within subjects design was used to evaluate the trial. Independent variables included a two-level, group assignment: EMPOWER (experimental intervention) based on social cognitive theory (SCT) as well as a knowledge-based intervention Healthy Lifestyles (active control intervention). Dependent variables were evaluated across four levels of time: baseline (Week 0), posttest (Week 4), 1-month follow-up (Week 8), and 1-year follow-up (Week 60). Dependent variables included five maternal-facilitated SCT constructs (environment, emotional coping, expectations, self-control, and self-efficacy) as well as four child behaviors (minutes of child physical activity, cups of fruits and vegetables consumed, 8-ounce glasses of sugar-sweetened beverages consumed, and minutes of screen time). Null hypotheses implied no significant group-by-time interactions for the dependent variables under investigation. A significant group-by-time interaction for child fruit and vegetable consumption was found in the experimental group (p = .012) relative to the control group. At 1 year, results suggested an overall increase of 1.847 cups of fruits and vegetables (95% confidence interval = 1.207-2.498) in the experimental group (p < .001). Analysis suggested changes in the maternal-facilitated home environment accounted for 13.3% of the variance in the change in child fruit and vegetable consumption. Improvements in child physical activity, sugar-free beverage intake, and screen time first detected at 1-month follow-up in both groups were no longer significant at 1-year follow-up. An online family-and-home-based intervention was efficacious for improving child fruit and vegetable consumption. Follow-up booster sessions may assist in maintaining treatment effects.

Designing and Evaluating a Health Belief Model-Based Intervention to Increase Intent of HPV Vaccination among College Males

Since 2009, HPV vaccine has been approved by the FDA for use in boys and young men, but less than 1% of eligible males in the United States have taken this vaccine. This study developed and evaluated a Health Belief Model (HBM)-based intervention to increase vaccination rates in college men. In a randomized controlled trial, HBM-based intervention was compared with a traditional knowledge-based intervention in 90 U.S. college-aged men ages 18-25 years. Repeated measures of ANOVA indicated significant positive changes in the intervention group for knowledge and HBM constructs. Results from the pretest/posttest regression analysis indicated self-efficacy for taking the vaccine (p = 0.000), perceived barriers (p = 0.007), and perceived severity (p = 0.004) were significant positive predictors of vaccine acceptability. The model had an adjusted R2 of 0.351. Overall, the intervention proved to be effective in creating positive change toward HPV vaccine acceptability.