Knowledge-based Interventions Research Articles

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.

Wie wirksam sind schulbasierte Interventionen zur Prävention und/oder Reduktion von Substanzkonsum bei Schülern/-innen in Grund- und Sekundarschulen? Eine systematische Übersicht vorhandener Reviews

The aim of this study is to provide a current overview of the effectiveness of school-based interventions on prevention and/or reduction of substance use among children and adolescents aged 5-19 years. A systematic literature search was conducted in PubMed, Cochrane Library, Campbell Collaboration, NICE and ERIC. Systematic reviews and meta-analyses published between 2007 and 2013 were included in the analysis. 2 reviewers assessed the quality of the identified review articles and extracted the data. 14 review articles of moderate to good quality fulfilled the a-priori defined inclusion criteria. Capacity-promoting interventions, e. g., those focusing on strengthening self-confidence and peer resistance, show promising evidence of effectiveness. Multi-component and multi-level interventions are more suitable for the prevention of alcohol and cannabis consumption. Findings on the prevention of tobacco consumption are inconsistent. The effectiveness of knowledge-based interventions is limited. The long-term effectiveness of smoke-free competitions cannot be conclusively evaluated as the findings are discrepant. School-based interventions should include capacity-promoting components and should address further levels beyond the individual, for example, organisational changes of the school setting. Further research is needed, in particular on the effectiveness of multi-component and multi-level interventions for the prevention of tobacco consumption.

Factors associated with good adherence to self-care behaviours amongst adolescents with food allergy.

Our understanding of factors which affect adherence to health sustaining self-care behaviours in adolescents with food allergy is limited. This study used the Health Belief Model to explore the relationship between food allergic adolescents' health beliefs, demographic, structural and social psychological factors with adherence to self-care behaviours, including allergen avoidance and carrying emergency medication. A cross-sectional study of 188 13- to 19- olds identified from hospital prescribed auto-injectable epinephrine for food allergy. Data were collected on demographics, structural factors, social psychological factors, health beliefs and current adherence behaviour using a postal questionnaire. Full adherence was reported by 16% of participants. Multivariate analysis indicated that adherence was more likely to be reported if the adolescents belonged to a support group (OR=2.54, (1.04, 6.20) 95% CI), had an anaphylaxis management plan (OR=3.22, (1.18, 8.81) 95% CI), perceived their food allergy to be more severe (OR=1.24, (1.01, 1.52) 95% CI) and perceived fewer barriers to disease management (OR=0.87, (0.79, 0.96) 95% CI). Membership of a patient support group and having an anaphylaxis management plan were associated with good adherence to self-care behaviours in adolescents with food allergy. Our results suggest that interventions to improve provision and utilisation of management plans, address adolescents' perceptions of the severity of anaphylaxis and reduce barriers to disease management may facilitate good adherence behaviours than focussing on knowledge-based interventions.

Food hygiene knowledge in adolescents and young adults

Purpose – The purpose of this paper is to utilise the comprehensive Food Safety Knowledge Instrument to compare food hygiene knowledge across a population of high school and university students in Australia and the UK. Design/methodology/approach – In total, 475 students from secondary schools and universities in Australia and the UK took part in a survey, which included a Food Safety Knowledge Instrument and demographic items. Findings – Food safety knowledge was generally very low. High school students had a mean score of only 38 per cent, while university students just reached a “pass” with a mean of 54 per cent. Demographics accounted for 41 per cent of variance in food knowledge scores. Female gender, being at university rather than high school, and living out of home rather than with parents were associated with greater food knowledge. Residing in Australia rather than the UK and being older were also associated with greater knowledge; however, these findings were subsumed by education group. Socio-economic status was not a significant predictor of food knowledge. Practical implications – Identifying demographic and cultural differences in food knowledge can help to identify at-risk populations to better target in theory and knowledge-based interventions. Originality/value – This study is the first to apply the knowledge instrument in an Australian population. Understanding the baseline knowledge in this population is an important first step at developing effective interventions for food safety.

Pilot Study of Pesticide Knowledge, Attitudes, and Practices among Pregnant Women in Northern Thailand

An estimated 200,000 children born in Thailand each year are at risk of prenatal exposure to pesticides and associated neurodevelopmental outcomes because of their mothers’ agricultural occupations. Children born to non-agricultural workers may also be at risk of exposure from other pathways of maternal pesticide exposure, including exposure through home use, diet, and other environmental media. Pesticide exposure in Thailand has been linked to unsafe practices and beliefs about pesticides. However, limited information exists on pesticide knowledge, attitudes, and practices among pregnant women in Thailand or elsewhere. Obtaining this information is essential to understand the factors associated with prenatal pesticide exposure, identify populations potentially at risk, and ultimately protect pregnant women and their children. We administered surveys to 76 pregnant women in northern Thailand and used multivariable logistic regression to evaluate associations among pesticide-related knowledge, pregnancy trimester, and pesticide use behavior. In this pilot study, lower knowledge score and earliest trimester of pregnancy were marginally (p < 0.1) associated with unsafe practices in the home, but not at work. Women who worked in agriculture or applied pesticides before becoming pregnant, or who had a previous child were significantly (p < 0.05) more likely to engage in unsafe behaviors in the home during their current pregnancy. We preliminarily conclude that increasing pesticide-related knowledge among pregnant women may help promote safe practices and reduce prenatal exposure. Knowledge-based interventions may be most effective when implemented early in pregnancy and targeted to agricultural workers and other sub-populations at risk of pesticide exposure.

Improvement in Smallholder Farmer Knowledge of Cattle Production, Health and Biosecurity in Southern Cambodia between 2008 and 2010

Farmer knowledge surveys were conducted in 2008 and 2010 in Cambodia to evaluate the impact of a research project studying interventions that can improve cattle production and health, including biosecurity and practices relating to risks of transmission of transboundary diseases. The project hypothesis is that by increasing the value of smallholder-owned large ruminants through nutritional interventions and improved marketing, knowledge-based interventions including risk management for infectious diseases such as foot-and-mouth disease (FMD) can be implemented into a more sustainable pathway for rural development. Between 2008 and 2010, significant improvements in farmer knowledge and attitudes were recorded in three villages in three provinces of southern Cambodia. This was achieved through participatory 'applied field research', 'on the job' training plus 'formal' training programmes. No cases of FMD were recorded during the study period in the 'high-intervention' (HI) villages despite the common occurrence of the disease in a nearby 'low-intervention' and many other villages in the three provinces. Whilst it is likely that protection of these villages from FMD infection was from increasing the herd immunity by vaccination, it could also have been partly because of a decrease in risk behaviours by farmers as a result of their increasing knowledge of biosecurity. The research indicates that smallholder farmers are motivated by nutritional interventions that improve the value of their cattle 'bank' and offer better marketing opportunities. This provides a more receptive environment for introduction of disease risk management for infectious and other production limiting diseases, best implemented for smallholder farmers in Cambodia by intensive training programmes. In lieu of a widespread public awareness programme to deliver mass education of smallholder farmers in disease prevention and biosecurity, livestock development projects in South-East Asia should be encouraged to include training in disease risk management as an important intervention if the current momentum for trade in large ruminant livestock and large ruminant meat is to continue to progress and contribute to addressing global food security concerns.

Perspectives on Australian Animal Health Aid Projects in South-East Asia

Future food security poses many challenges and with increasing prosperity and demand for meat, the emerging but largely unregulated trade in livestock and their products from developing countries in South-East Asia and particularly the Mekong region, pose enormous risks of transboundary disease epidemics. However this is a challenge that should be met as substantial improvements in large ruminant production through appropriate knowledge-based interventions can potentially move the largely rural smallholder populations of Lao PDR and Cambodia from subsistence to a productivity focus, offering a new pathway for poverty alleviation. Large development projects have been implemented in the Mekong region to facilitate this process and research is needed to define problems, identify and test solutions, and then suggest the most appropriate delivery mechanisms for promulgating the interventions that are most sustainable. Animal health aid projects are needed to improve livestock productivity, minimize risk to trade and human health and enhance the capacities of countries where there are significant gaps in the provision of veterinary services. Improving large ruminant production, particularly through forages technology and infectious disease risk management including village-level biosecurity, provides a potential driver of foot and mouth disease (FMD) control and eventual eradication in the region. A perspective on issues involved in Australian aid projects addressing regional animal health research and development and a checklist of strategies to consider when designing and managing such projects is provided.

Can knowledge management enhance technology adoption in healthcare? A review of the literature

The rate of adoption of new technologies into healthcare systems is considered to be slower than in other settings. A range of knowledge-based facilitators of adoption exist, including: technology specification and assessment; dissemination tools (including electronic decision support tools); networks and facilitated interaction; and skills and leadership development. A review of the evidence relating to each of these is reported in this paper. The authors identify the absence of a single knowledge-related ‘magic bullet’ before proposing an analytical framework for the future assessment of knowledge-based interventions and their impact on technology adoption.

Introduction to the Special Section on Families, Youth, and HIV: Family-Based Intervention Studies

Every year, a new generation at-risk for human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) emerges, posing unique challenges for prevention and intervention. Young people are now at the center of the acquired immunodeficiency syndrome (AIDS) epidemic; 25% of STIs reported annually occur among youth, and around half of the people who acquire HIV become infected before they turn 25. AIDS is currently the leading cause of death in 15- to 24-year olds (National Center for Health Statistics, 2005). Most young people acquire HIV through unprotected sexual activity, and, thus, reducing adolescent sexual risk taking has become a national and international public health priority. Substance use also confers increased risk of exposure to HIV by impairing sexual decision-making and leading to inaccurate condom use. Unfortunately, rates of adolescent sexual behavior and substance use remain high. National surveys indicate that 60.7% of males and 62.3% of females report having had sexual intercourse by 12th grade, whereas only 67% of males and 48.5% of females report using a condom during their last sexual encounter (Grunbaum et al., 2004). Similarly, by 12th grade, males and females report high rates of alcohol (82.6 and 83.3%, respectively) and marijuana (51.7 and 44.9%, respectively) use, and notably 17.6% of females and 33.5% of males report using alcohol or drugs before last sexual intercourse (CDC, 2004). Reducing adolescent risky sexual and drug use behavior requires innovative solutions that are tailored to youths’ unique risk mechanisms. This special section describes four cutting edge prevention programs designed to reduce exposure to HIV/STIs among youth. HIV and STI prevention programs for young people have changed over the course of the epidemic. At the beginning of the 1980s, the first generation of AIDS prevention programs designed for youth focused on increasing knowledge about HIV transmission and prevention. These efforts assumed that knowledge alone would produce necessary behavioral changes. Unfortunately, although these programs successfully increased accurate knowledge about the modes of transmission and strategies for prevention, they did not lead directly to behavior change (Coyle, Boruch, & Turner, 1991). The second generation of HIV prevention programs sought to address these limitations by going beyond increasing knowledge. In the 1990s, HIV prevention interventions for youth drew on social cognitive theories to address perceptions of risk, safer-sex intentions, assertive communication, and condom use skills, in addition to HIV/STI knowledge. These programs yielded promising results, showing targeted reductions in sexual risk taking and other proximal factors, such as exposure to risk situations. Like HIV knowledge-based interventions, however, these programs focused on individual behavior, and few have produced long-term behavioral changes.

Intervention ABCs for Children with Asperger Syndrome

The number of children identified with Asperger syndrome (AS) is rapidly rising throughout the world. The purpose of this article is to promote understanding of the characteristics and behaviors associated with AS and to introduce a range of school-based interventions. First, a description of the indicators of AS is provided, followed by an overview of screening and diagnostic procedures. Next, the Application ABCs section covers knowledge-based interventions addressing deficits in Academics, Behavior, and Communication. Implications for speech language pathologists and related professionals working with youngsters with this autistic spectrum disorder are addressed.

Components of the optimal ambulatory care computing environment.

We present here a framework of core components of an ambulatory care computing environment, based on clinical and functional needs and workflow scenarios. We have established this framework through the use of two study devices: a vision of the clinical office of the future, and a survey of possible computer applications, both designed to help clinicians and practice directors communicate their information needs to systems designers. Clinicians prioritize applications based on strategic and practice goals: support for clinical users' workflow, improved quality of care, reduced cost of care, and the ability to measure performance and status. By reorganizing the needed functionality from a clinical viewpoint into a technical viewpoint, we are able to identify core information components for systems design. Based on this analysis, information needs in the ambulatory environment can be divided into five primary functions: patient data retrieval, documentation, communication, knowledge resources, and aggregate reporting. Three other fundamental processes--knowledge-based interventions, information integration, and confidentiality--run through all of these front-line functions. Component applications and data structures built with this framework in mind will afford a maximum combination of functionality and flexibility to handle future changes in the clinical environment.

Career choice of Vietnamese Australian Tertiary Students

The process of career choice undertaken by Australian tertiary students from Vietnamese-speaking backgrounds is investigated and findings are compared to related research. The purpose was to provide an informed knowledge base for interventions that might affect the course participation and employment rates of these students. The survey results revealed that the process was culturally determined in some areas, but showed evidence of an individualistic awareness of self as independent decision-makers which was not described in the literature consulted.