Low-cost Intervention Research Articles

Review of Low-Cost Interventions for Reducing Neonatal Mortality and Morbidity in Low- and Middle-Income Countries.

This review examines low-cost interventions for reducing neonatal mortality and morbidity in low- and middle-income countries (LMICs). A systematic PubMed search and neonatal care data from World Health Organization (2014-2024) were used to revise interventions including prenatal care, early essential newborn care (EENC), resuscitation and therapeutic hypothermia, Kangaroo mother care (KMC), respiratory support, breastfeeding, sepsis prevention, safe neonatal transfer, neonatal network in LMICs and suggestions for improvement. Out of 9295 initially identified articles, 252 studies were selected as relevant to the research objectives. In LMICs, the use of antenatal corticosteroids and magnesium sulfate remains limited in routine obstetric practice. Although EENC, KMC and early breastfeeding significantly reduce neonatal mortality, these interventions are under-prioritised and insufficiently implemented. Neonatal resuscitation and respiratory support are constrained by inadequate equipment and a shortage of trained healthcare personnel. Healthcare-associated sepsis, compounded by antibiotic resistance, continues to strain neonatal intensive care units. Additionally, unsafe neonatal transfers and poor coordination among different levels of neonatal care highlight the need for better integration within regional health systems. To reduce neonatal mortality and enhance care in LMICs, systematic training, effective implementation and the sustainable delivery of proven, low-cost, high-impact interventions are urgently needed.

Effect of Remote Ischemic Conditioning and Red Blood Cells Biomarkers on Outcomes in Patients With Acute Stroke.

Remote ischemic conditioning (RIC) is a simple and low-cost intervention that is thought to increase collateral blood flow through the vasodilatory effects of nitric oxide (NO) produced by the endothelium and red blood cells (RBCs). The aim of this study was to investigate whether RBC form and function are associated with short- and long-term outcomes in patients with acute ischemic stroke, and whether RIC treatment modified this effect. This is a predefined substudy to the RESIST (Remote Ischemic Conditioning in Patients with Acute Stroke Trial) randomized clinical trial conducted in Denmark. RIC was started in the ambulance and continued at the hospital for 7 days. RBC deformability and erythrocyte aggregation rate were assessed using ektacytometry, NO using flowcytometry, and nitrite content using ozone chemiluminescence. Logistic regression and mixed effect models were used. Out of 1500 prehospital randomized patients, and between July 28, 2020 and November 11, 2023, 486 patients had blood samples taken. Of these 249 (51%) had acute ischemic stroke and were included in this study. In the acute phase, higher levels of RBC deformability, aggregation, and RBC NO content were associated with worse clinical outcome if patients were treated with RIC compared with sham. Similar results were found at 24 hours, except for a potential effect on early neurological improvement in RIC-treated patients with an increased deformability level at 24 hours. RIC may have time-dependent and biomarker-specific effects on stroke outcomes, and detrimental interactions between increasing biomarker levels and RIC were observed. This may explain previous failures to translate RIC into an effective neuroprotective therapy in the hyperacute phase.

Parental involvement in school-based mental health interventions for young people in low-resource settings: A qualitative study from Zimbabwe and Ghana.

Young people in low-resource settings are disproportionately affected by mental health problems, yet access to formal mental healthcare remains limited. However, schools in these regions have increasingly become the primary settings for mental health interventions, offering an accessible and supportive environment for mental health services. Recognising the critical role schools play in providing mental health services for young people, there has been a growing emphasis on involving parents in school-based mental health (SBMH) interventions in low-resource settings. This study explored the mechanisms for effectively involving parents in SBMH interventions for young people in Zimbabwe and Ghana. Cross-sectional qualitative research was conducted in Harare, Zimbabwe and Navrongo, Ghana. This study is a sub-analysis of a larger formative qualitative study which aimed to identify evidence for adapting interventions for depression and anxiety for young people aged 15-24 in Zimbabwe, and 15-18 in Ghana, and test the feasibility of the adapted intervention. We utilised semi-structured in-depth interviews, key informant interviews and focus group discussions with various stakeholders until data saturation was achieved. All interviews were audiotaped and later transcribed verbatim and translated to English for analysis. Data for this study were inductively coded and analysed using thematic analysis. Effective mechanisms for engaging parents in SBMH include routine parent-teacher meetings, interface meetings between parents and school-based mental healthcare providers, and direct parental participation in sessions. However, while parental involvement is key for SBMH interventions, it can be problematic. In some cases, parents may unintentionally breach their children's privacy and confidentiality or may be the source of their children's mental health problems. The study's findings underscore the importance of parents as vital partners in SBMH interventions. Given the positive impact of parental involvement, it is essential to incorporate parents into the design and implementation of these interventions. By leveraging the insights from this study, interventionists can develop and implement more effective and low-cost SBMH interventions, which can significantly improve mental health outcomes for young people in low-resource settings.

A hope intervention for adolescents: a randomized controlled trial delivered by paraprofessionals

IntroductionA workshop for adolescents was derived from an interdisciplinary model of hope. The workshop was created for delivery by professionals or lay helpers and is structured around the needs for attachment, survival, mastery, and spirituality.MethodsAdolescents, 13 to 17 years of age, received a five-week group intervention led by pairs of advanced psychology students. Hope, depression, anxiety, coping, and self-acceptance were assessed before and after the intervention. A delayed waitlist control group, matched for age, received identical outcome measures, also five-weeks apart. Group membership was randomly assigned.ResultsMore than three-quarters of the participants found the more left-brain writing exercises helpful, and nearly 85% rated the more right-brain reflections and meditative exercises favorably. Significant increases in hope as well as greater utilization of social coping methods and self-acceptance were found for the treatment group but not controls. Group participants (but not controls) also reported a significant reduction in depression. Anxiety levels were not impacted. Secondary analysis suggested that participant engagement and socioeconomic status may play a role in moderating the efficacy of this intervention.DiscussionThis relatively low-cost intervention offers new hope for counteracting the global increase in youth despair. The effect sizes obtained in this study compare favorably with outcome data for cognitive-behavioral treatments and a few available agency-centered hope interventions. There is a potential for broad impact via the implementation of an accessible training program as well as online deliveries in either synchronous or asynchronous modes.

Implementation and evaluation of the 3 Wishes Project in safety-net hospitals: Protocol for a hybrid effectiveness-implementation study.

Palliative care interventions in the intensive care unit have been shown to improve communication and the quality of death and dying. However, few interventions have been implemented in safety-net hospitals (SNHs), which provide healthcare to low income and uninsured patients. The 3 Wishes Project (3WP) is a low-cost intervention that aims to enhance compassionate end-of-life (EOL) experiences by empowering the clinical team to elicit and fulfill small wishes for patients who are dying in the ICU. To implement and evaluate the 3WP in three SNHs in Los Angeles. We conduct a pragmatic cluster-randomized stepped wedge type 2 hybrid effectiveness-implementation study to implement and evaluate the effect of the 3WP (compared to usual care) on quality of EOL ICU care, bereaved families' psychological symptoms, and clinician burnout. Prior to implementation, interviews with stakeholders from each hospital will refine the implementation strategy. Starting 6-10 months prior to 3WP implementation at each site and continuing throughout the study, we will survey bereaved families once 3 months after each patient's death. Surveys will query: EOL care, anxiety, depression, and post-traumatic stress disorder (PTSD). Each SNH ICU starts the 3WP at a randomly assigned time that is staggered by 2 months. Nurses are surveyed on burnout before implementation, 6 months, and 12 months after 3WP implementation. Semi-structured interviews are conducted with 10-12 family members per SNH who received 3WP and 10-12 nurses per SNH a year after implementation. We will use the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to guide a mixed-methods evaluation of the 3WP implementation in SNHs. We hypothesize that it will be feasible to adapt and implement the 3WP in SNHs. We will evaluate how the 3WP improves EOL care in this setting and provide valuable insight regarding the adaptations necessary to tailor palliative care interventions for SNH ICUs. ClinicalTrials.gov NCT06277310.

Litigation Involving Delay of Spinal Care During the COVID-19 Pandemic: A Review of Reported Legal Cases in the United States.

Litigation Involving Delay of Spinal Care During the COVID-19 Pandemic: A Review of Reported Legal Cases in the United States.

CKD Knowledge and CKD Report Card Use During a Nephrology Encounter: A Randomized Trial.

CKD Knowledge and CKD Report Card Use During a Nephrology Encounter: A Randomized Trial.

Prehospital to emergency department handoff: can team-based reporting improve markers of clinical efficiency in an adult emergency department?

Interdisciplinary communication is a critical component of quality patient care. On emergency medical services (EMS) arrival to the emergency department (ED), the pre-existing opportunity-based reporting (OBR) handoff paradigm may result in disjointed, repetitive and incomplete transition of patient care to the ED, adversely impacting patient care. This quality improvement study was conducted at a tertiary care, academic university hospital ED and evaluated the impact of team-based reporting (TBR) during EMS patient handoff in the ED on several markers of clinical efficiency (CE). The standard OBR handoff protocol was compared with the TBR protocol, which brings the patient's ED care team to bedside shortly after patient arrival, allowing EMS to give a single, synchronous handoff. The use of TBR during prehospital-ED handoffs was associated with statistically and clinically significant improvement across multiple CE quality indicators. A team-based handoff strategy is a low-cost policy intervention that provides meaningful improvements related to CE and quality care.

THE EFFECT OF EXERCISE TRAINING AT HOME ON LIFE QUALITY OF OSTEOARTHRITIS ELDERLY PATIENTS

Background. Osteoarthritis (OA) is a degenerative joint disease characterized by chronic pain, stiffness, and decreased joint function, which significantly impairs the quality of life in older adults. As OA progresses, it limits mobility and daily functioning, leading to psychological distress and reduced independence. This study aimed to evaluate the effectiveness of Home-Based Exercise Training (HBET) in improving the quality of life among elderly patients with osteoarthritis. Research Methods. A quasi-experimental study with a one-group pretest and posttest design was conducted at the Surabaya Square Public Health Center. Sum of 26 elderly patients diagnosed with knee osteoarthritis were selected through consecutive sampling, meeting specific inclusion criteria. Participants performed HBET knee exercises at home for 2 weeks under guidance. The Osteoarthritis of Knee and Hip Quality of Life (OAKHQOL) questionnaire was used to assess the quality of life before and after the intervention. Data were analyzed using the paired t-test with a significance level set at p <0.05. Findings. Statistical analysis revealed a significant improvement in life quality after the intervention, p-value 0.0001. Participants experienced notable enhancements in physical functioning, pain reduction, emotional well-being, and social engagement after performing regular HBET knee exercises. Conclusions. Home-Based Exercise Training (HBET) effectively enhances life quality for older patients knee osteoarthritis. It is a practical, low-cost, and sustainable intervention that can be implemented in community health programs. Further research is recommended to explore HBET's benefits in other aging-related conditions.

Is Breastfeeding an Effective Approach to Reduce Metabolic Risk After GDM in Mothers and Infants?

Gestational diabetes mellitus (GDM) leads to increased lifelong cardiometabolic risk in both mothers and their offspring. The identification of effective strategies to contain the future risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) is of utmost importance to reduce the burden of the disease. Breastfeeding (BF) is effective in reducing short- and long-term child morbidity. In recent years, BF has emerged as a candidate low-cost intervention to prevent future cardiometabolic complications both in mothers and infants exposed to GDM. The aim of this review is to provide an overview of the evidence about the possible metabolic benefits of BF for both mothers with a history of GDM and their offspring. Increasing evidence supports the positive effects of exclusive BF over formula feeding (FF) or mixed feeding on glucose homeostasis and the lipid profile in women with previous GDM in the early postpartum period. Studies with a longer observation suggest clear benefits of intensive and longer BF on the risk of diabetes and prediabetes in mothers after adjustment for confounders. In regards to infants, in most studies, the intensity and duration of BF are positively associated with slower infant growth curves compared with FF, indicating that the positive effect of BF on growth trends might contrast the increased risk of obesity and metabolic diseases observed in infants exposed to GDM. Considering these findings, a global effort should be made to support BF practice to possibly reduce cardiometabolic morbidity after GDM.

Maternal Anaemia and Congenital Heart Disease in Offspring: A Case-Control Study Using Linked Electronic Health Records in the United Kingdom.

Assessment of whether maternal anaemia in early pregnancy is associated with offspring congenital heart disease (CHD). Matched case-control study. January 1998-October 2020, United Kingdom. Women with a haemoglobin measurement in the first 100 days of pregnancy and a CHD-diagnosed child. Data were extracted from the United Kingdom Clinical Practice Research Datalink GOLD database of electronic health records. Cases were 2,776 women with a CHD-diagnosed child. These were compared to 13 880 matched controls, women without a CHD-diagnosed child. Anaemia was classified as < 110 g/L haemoglobin following the WHO definition. A conditional logistic regression analysis was conducted, adjusted for potential maternal demographic and health-related confounders. Offspring CHD diagnosed within 5 years of birth. 123 (4.4%) cases and 390 (2.8%) controls had anaemia. After adjusting for potential confounders, the odds of giving birth to a CHD-diagnosed child were 47% higher among anaemic mothers (adjusted OR 1.47, 95% CI 1.18,1.83, p < 0.001). The observed association between maternal anaemia in early pregnancy and increased risk of offspring CHD supports our recent evidence in mice. Approximately two-thirds of anaemia cases globally are due to iron deficiency. A clinical trial of periconceptional iron supplementation might be a minimally invasive and low-cost intervention for the prevention of some CHD if iron deficiency anaemia is proven to be a cause.

Pilot of Interactive Texting for Diabetes Self-Management Education and Support.

Pilot of Interactive Texting for Diabetes Self-Management Education and Support.

Technical Requirements, Design, and Automation Process for a Statewide Registry-Based Tailored Text Messaging System: Protocol for a Longitudinal Observational Study.

Tailored text messaging is a low-cost mobile health intervention approach shown to effectively improve self-care behaviors and clinical outcomes for patients with chronic cardiometabolic conditions. Given the ubiquitous nature of mobile phones, text messages have the potential to reach a large audience. However, automating and disseminating tailored text messages to large populations at low cost presents major logistical challenges that serve as barriers to implementation. This study aimed to describe the protocol for a longitudinal observational study designed to assess the feasibility of an innovative approach for automating and disseminating personalized and tailored text messages to large populations at risk of cardiovascular events using a low-cost registry-based tailored text messaging system known as the Heart Health Messages (HHM) program. Further, it describes the technical requirements, architectural design, automation process, and challenges associated with program implementation. Patients at high risk of cardiovascular diseases are identified using a statewide population health registry known as the Tennessee Population Data Network. Tailored invitation messages and enrollment surveys are sent to eligible patients via Twilio. Upon completion of the receipt of consent and enrollment forms, participants receive tailored text messages from a library of generic messages based on participant-selected frequency of message delivery (daily or every other day). In addition, participants receive monthly text-based check-in survey messages designed to assess intervention adherence and improvement in self-care. Participants are also sent quarterly follow-up surveys to update enrollment information and preferences. All enrolled participants will receive tailored text messages for a 12-month intervention period. Since the start of the program, 18,974 patients from 2 major health systems have met the inclusion criteria and were eligible for the HHM program. A total of 3 phases of HHM 1.0 have been implemented so far, reaching 225 eligible patients in phase 1, a total of 5288 patients in phase 2, and 13,461 patients in phase 3, with an enrollment of approximately 2% (n=4/225), 3% (n=137/5228), and 3% (n=350/13461), respectively. Efforts are underway to implement strategies in collaboration with the health systems to enhance the HHM program rollout and patient participation. The HHM program is a low-cost tailored text messaging intervention set for broader dissemination and potential replication. The program has the capacity to improve outcomes for people with chronic medical conditions. DERR1-10.2196/62874.

Immediate Skin-to-Skin Contact in Very Preterm Neonates and Early Childhood Neurodevelopment

Preterm neonates are at risk for neurodevelopmental impairments, and there is a need to identify protective factors that can modify the harmful effects of preterm birth on the immature brain. To evaluate whether immediate skin-to-skin contact (SSC) for preterm neonates improves early childhood neurodevelopmental outcomes. This open-label randomized clinical trial was conducted in 3 Norwegian neonatal units between February 2014 and October 2020. Participants were preterm neonates born at 28 weeks 0 days' to 31 weeks 6 days' gestation with birth weight greater than 1000 g and no major congenital malformations or need for intubation or oxygen supplementation of more than 40%. Intention-to-treat analysis was conducted from July 2023 to July 2024. Neonates were randomized 1:1 to immediate SSC between mother and neonate in the delivery room for 2 hours or to standard care with direct transport to the neonatal unit in an incubator. The primary outcome was cognitive development at 2 to 3 years of age, measured by the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Secondary outcomes were language and motor neurodevelopment measured by the BSID-III, parental questionnaires at 3 and 12 months and 2 to 3 years, and breastfeeding practices up to 12 months. Of 108 included neonates (68 [63%] male; mean [SD] gestational age, 30 weeks 3 days [1 week 1 day]), 51 received SSC and 57 received standard care. Eighty-six (80%) had follow-up at 2 to 3 years, and 81 (75%) completed the BSID-III and were analyzed for the primary outcome. The mean difference in BSID-III cognitive composite scores was 0.21 (95% CI, -5.26 to 5.68; P = .94). There was no difference between the groups in the proportion at risk of developmental delay at 2 to 3 years: 21 of 41 (51%) and 22 of 45 (49%) in the SSC and standard care groups, respectively (odds ratio, 1.10 [95% CI, 0.47-2.56]; P = .83). More neonates in the SSC group were breastfed at hospital discharge (42 of 50 [84%] vs 36 of 54 [67%]; P = .04). In this randomized clinical trial, 2 hours of mother-neonate SSC in the delivery room did not enhance neurodevelopmental outcomes at 2 to 3 years of age. However, the SSC group demonstrated improved breastfeeding practices up to 12 months compared with standard care, suggesting that the feasible and low-cost SSC intervention should be encouraged in clinical practice. ClinicalTrials.gov Identifier: NCT02024854.

More done, more drained: Being further along in a mundane experience feels worse.

Life is full of mundane tasks such as commuting, attending meetings, and filing paperwork. Despite their ubiquity, experience with mundane tasks remains understudied in the literature. Across a series of lab and field studies, we show that the negative feelings about a mundane experience are impacted by people's perception of how much of the task has been completed, which we term relative task completion. Contrary to people's intuition, we find that the same ongoing task (e.g., sitting through a boring meeting for 20 min) feels less aversive when relative completion is lower (e.g., in a 60-min meeting) than when it is higher (e.g., in a 30-min meeting). Our studies suggest this may occur due to ratio sensitivity: People infer that they have endured less after completing a smaller, rather than a larger, proportion of a mundane task, which reduces negative feelings. Data also showed that people lack insight into the impact of relative task completion and ruled out alternative explanations including response scale anchoring, progress focus, and preparation while suggesting mood regulation and attention as parallel explanations in some contexts. Finally, we identify busyness as a moderator and develop three low-cost interventions to manipulate perceived relative task completion and improve mundane experiences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Longitudinal field evaluation of outdoor Anopheles and non-Anopheles host-seeking in response to a volatile pyrethroid spatial emanator (SE) product among forest-dwelling indigenous residents of Sumatra, Indonesia

BackgroundInterventions against adult Anopheles mosquitoes responsible for malaria transmission have traditionally been aimed at indoor spaces and biting behaviours. However, no globally recommended intervention exists which directly interrupt or target outdoor biting behaviours. A volatile pyrethroid spatial emanator (SE) containing transfluthrin aims to address this gap in protection via a simple-to-use, readily deployable device to provide multiple weeks of protection. The device was tested in open-walled households of the forest-dwelling Orang Rimba people in Sumatra, Indonesia, over the course of sixteen weekly entomological visits.MethodsDouble-net traps were used for all mosquito collections. Collections occurred near Bukit Duabelas National Park in central Sumatra, an area characterized by secondary forests undergoing widespread conversion to palm and rubber plantations. Four collections occurred per collection night within ten geographically separated small familial groups for a total of 40 trap-nights per week. Groups were assigned the SE or a control device after a seven-week baseline trapping period. Devices were replaced every four weeks. Results were compared using generalized linear models, incorporating treatment, weather, and landscape parameters as fixed effects, with date and location included as random effects.ResultsAnopheles mosquitoes were captured on 63.2% of all collection nights. Overall nightly Anopheles host-seeking activity was lower in the presence of SE devices (RR: 0.29 [0.19–0.45], p < 0.001). Non-Anopheles mosquitoes experienced a smaller nightly decline in behaviour (RR: 0.78 [0.64–0.93], p = 0.007). The age of the device (1 month) did not impact modeled efficacy. Anopheles host-seeking activity was also positively correlated with humidity, topographic wetness, and local human structure density.ConclusionsThe SE device evaluated in this field trial was effective in reducing outdoor human exposure to Anopheles and non-Anopheles mosquito host-seeking activity. The effect was not found to depend upon the age of the device, suggesting that the protection was persistent over the 4-week replacement period during this study. There was an association between hour of collection and intervention efficacy, suggesting the possibility of species-specific effects which were not further investigated. The SE device is a promising, low-cost, easily deployable, and distributable intervention that reduces exposure to mosquitoes with consequent impacts on transmission in outdoor environments.

Exploring Engagement With and Effectiveness of Digital Mental Health Interventions in Young People of Different Ethnicities: Systematic Review.

The prevalence of mental health difficulties among young people has risen in recent years, with 75% of mental disorders emerging before the age of 24 years. The identification and treatment of mental health issues earlier in life improves later-life outcomes. The COVID-19 pandemic spurred the growth of digital mental health interventions (DMHIs), which offer accessible support. However, young people of different ethnicities face barriers to DMHIs, such as socioeconomic disadvantage and cultural stigma. This review aimed to summarize and evaluate the engagement with and effectiveness of DMHIs among young people of different ethnicities. A systematic search was conducted in MEDLINE, Embase, and PsycINFO for studies published between January 2019 and May 2024, with an update in September 2024. The inclusion criteria were participants aged <25 years using DMHIs from various ethnic backgrounds. Three reviewers independently screened and selected the studies. Data on engagement (eg, use and uptake) and effectiveness (eg, clinical outcomes and symptom improvement) were extracted and synthesized to compare findings. Studies were assessed for quality using the Mixed Methods Appraisal Tool. The final search yielded 67 studies, of which 7 (10%) met inclusion criteria. There were 1853 participants across the 7 studies, all from high-income countries. Participants were predominantly aged 12 to 25 years, with representation of diverse ethnic identities, including Black, Asian, Hispanic, mixed race, and Aboriginal individuals. Engagement outcomes varied, with culturally relatable, low-cost interventions showing higher retention and user satisfaction. Linguistic barriers and country of origin impeded the effectiveness of some interventions, while near-peer mentorship, coproduction, and tailored content improved the effectiveness of DMHIs. While initial results are promising, small sample sizes, heterogeneity in outcome assessments, and a paucity of longitudinal data impeded robust comparisons and generalizability. DMHIs show potential as engaging and effective mental health promotional tools for young people of different ethnicities, especially when coproduced and culturally relatable. Initial data suggest that interventions facilitating near-peer mentoring, linguistic adaptation, low cost, and cultural relatability have improved engagement and effectiveness. Future research should focus on developing a consensus definition of DMHIs, exploring DMHIs in children aged <12 years, and conducting detailed qualitative and quantitative research on use factors and treatment efficacy of DMHIs for young people of different ethnicities. PROSPERO CRD42024544364; https://tinyurl.com/yk5jt8yk.

Pragmatic clustered randomised control trial to evaluate a self-regulated learning intervention to be implemented in South Australian primary schools—study protocol

BackgroundSelf-regulated learning (SRL) is described as a process whereby learners actively take control of their learning by setting goals, planning, monitoring, evaluating, and adjusting their learning strategies to improve performance and achieve desired outcomes Panadero (Front Psychol 8:422, 2017). SRL proficiency has been shown to predict educational success and lifelong outcomes, such as income and health. While SRL is recognised as a key lifelong competency, there remain questions regarding how educators can best develop and promote SRL in school settings. A scalable, low-cost intervention targeted at grade 1 students (6–7 years old) in Germany was found to have substantial effects on impulse control and self-regulated learning, with sustained impacts on long-term academic success Schunk (Nat Hum Behav 6(12):1680-90, 2022). This study protocol seeks to adapt the Schunk et al. (2022) randomised trial to the Australian content and extend it to grades levels 2, 4 and 6.MethodsWe will use a standard pragmatic clustered (by school) randomised controlled superiority trial with an additional population-wide matched parallel control arm. Effectively, we will conduct three trials—one for each age/grade level. Each trial will be powered to assess the impact of the intervention on the age/grade groups independently: grade 2 (early primary, 7–8 years), grade 4 (mid primary, 9–10 years), and grade 6 (late primary, 11–12 years). Schools assigned to the treatment group will have all three grade levels (grades 2, 4, and 6) receiving the treatment (at least one class per grade); no classes in the schools assigned to the control group will receive the intervention. A minimum of 56 schools with an average cluster size of 19 children/class will be required to detect a minimum impact of 0.25 SD effect size at 80% power taking into account the clustered design with an intraclass correlation coefficient (ICC) of 0.05. This results in a total sample of 1064 per grade and thus 3192 students in total (56 schools per arm × 19 students in an average-sized class × three grade levels). Randomisation will occur on a 1:1 ratio, such that half of the schools (n = 28), and effectively about half of the students (n = 1596) will receive the intervention. The primary outcome will be improved self-regulation assessed at 6 weeks, 6 months and 12 months post the intervention. Longer-term secondary outcomes will include academic and wellbeing measures obtained through administrative data linkage to the National Assessment Program in Literacy and Numeracy (NAPLAN) outcomes and the Wellbeing and Engagement Collection (WEC) outcomes measures in the year following implementation (grades 3, 5, and 7). Follow-up via the South Australia Data Linkage Systems will allow for longer-term academic outcomes, mental health, school completion, criminal justice, and tax data.DiscussionThis protocol paper provides a detailed record of the trial design. We also discuss our analytical plan, especially highlighting the opportunities associated with the linkage of the trial participants to South Australia’s population-wide administrative data linkage systems.Trial registrationACTRN12623001331628. Registered on 9th of November 2023.

A pilot randomized controlled trial of a brief intervention targeting positive valence systems function to prevent internalizing symptoms in college students.

Depression and anxiety are major mental health concerns for college students, and accessible, low-cost interventions are urgently needed. Although traditional treatments focus on negative emotions, there is growing support for the efficacy of positive emotion-focused interventions. We extended this prior work by developing a peer-delivered brief promoting positive emotion (BPPE) intervention that aims to enhance positive valence systems processes and reduce internalizing risk in college students. The goal of this study was to examine the feasibility, acceptability, and initial mental health outcomes of BPPE. In this pilot randomized controlled trial, 92 unselected college students (Mage = 19.44, SD = 1.15) completed measures of depressive and social anxiety symptoms, perceived stress, well-being, and positive and negative affect before being randomized to the BPPE intervention (n = 47) or a comparison study skills instruction (n = 45). Participants repeated the affect measure immediately after the intervention and repeated the rest of the measures 1 month later (n = 66). Intention-to-treat linear mixed-effect models were used to examine group differences. We found that BPPE can be delivered with high fidelity by peer-trained skills coaches and was rated as highly satisfactory by participants. Positive affect increased pre- to immediately postintervention in the BPPE group. Significant group by time interactions were observed for depression, social anxiety, and perceived stress across the 1-month follow-up, such that BPPE appeared to buffer against worsening symptoms across time. Our findings provide preliminary support for a brief, scalable, preventive intervention targeting positive valence systems functions among college students. Future studies warrant a fully powered randomized controlled trial to test the efficacy of the intervention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Guidelines for animal models of endurance and resistance exercise.

Guidelines for animal models of endurance and resistance exercise.