Phone Messages Research Articles

Automated Opt-Out vs Opt-In Patient Outreach Strategies for Breast Cancer Screening

Optimal strategies for population-based outreach for breast cancer screening remain unknown. To evaluate the effect on breast cancer screening of an opt-out automatic mammography referral strategy compared with an opt-in automated telephone message strategy. This pragmatic randomized clinical trial was conducted from April 2022 to January 2023 at a single Veterans Affairs (VA) medical center. Participants were female veterans aged 45 to 75 years who were eligible for breast cancer screening and enrolled in VA primary care. Veterans were randomized 1:1 to receive either an automatic mammography referral (opt-out arm) or an automated telephone call with an option for mammography referral (opt-in arm). The primary outcome was completed mammography 100 days after outreach. Secondary outcomes were scheduled or completed mammography by 100 days after outreach and referrals canceled if mammography was not scheduled within 90 days. Both intention-to-treat analyses and a restricted analysis were conducted. The restricted analysis excluded veterans who were unable to be reached by telephone (eg, a nonworking number) or who were found to be ineligible after randomization (eg, medical record documentation of recent mammography). Of 883 veterans due for mammography (mean [SD] age, 59.13 [8.24] years; 656 [74.3%] had received prior mammography), 442 were randomized to the opt-in group and 441 to the opt-out group. In the intention-to-treat analysis, there was no significant difference in the primary outcome of completed mammography at 100 days between the opt-out and opt-in groups (67 [15.2%] vs 66 [14.9%]; P = .90) or the secondary outcome of completed or scheduled mammography (84 [19%] vs 106 [24.0%]; P = .07). A higher number of referrals were canceled in the opt-out group compared with the opt-in group (104 [23.6%] vs 24 [5.4%]; P < .001). The restricted analysis demonstrated similar results except more veterans completed or scheduled mammography within 100 days in the opt-out group compared with the opt-in group (102 of 388 [26.3%] vs 80 of 415 [19.3%]; P = .02). In this randomized clinical trial, an opt-out population-based breast cancer screening outreach approach compared with an opt-in approach did not result in a significant difference in mammography completion but did lead to substantially more canceled mammography referrals, increasing staff burden. ClinicalTrials.gov Identifier: NCT05313737.

Challenges and interpersonal dynamics during a two-person lunar analogue Arctic mission

Introduction: This case study was designed as an analog for aspects of NASA’s planned Artemis missions to the lunar surface. The specific aims were to examine emerged mission challenges and dyadic affective and process dynamics over the course of a three-month lunar habitat analog Arctic mission.Methods: Participants were two men who also had key roles in designing the habitat. Pre- and post- expedition interviews were conducted and daily satellite phone messages to mission control over the three-month mission were assessed. An integrated mixed methods approach was used to analyze challenges, group affect, and group processes, with the goal of furthering the understanding of coping and psychosocial work experiences in challenging conditions.Results: The findings indicated that different challenges took distinct temporal trajectories across mission phases; based on the relational themes, several challenges were identified, primarily physical challenges related to the experience of coping in an ICE environment, and psychosocial challenges associated with the preparation and execution of mission tasks. Physical challenges, positive tone, and action processes were the themes most connected to each other. To deal with these challenges, the team adapted by more frequently engaging in action and transition processes. The specific training for the mission the participants engaged in, and prior knowledge about each other enabled team members to deal with mission exigencies while maintaining a positive outlook.Discussion: Fostering strong positive relationships was an important mechanism to build resilience and effective performance while under ongoing, extreme conditions.

Program Report: Improving Patient Experience at an Outpatient Clinic Using Continuous Improvement Tools.

Patient satisfaction with prompt and high-quality healthcare services plays a pivotal role in healthcare settings. The delivery of high-quality services within the healthcare sector is closely associated with continuous quality improvement (CQI), which is an incremental and progressive process that prioritizes the safety of all participants, favorable outcomes, systematic processes, and a regulated and improved working environment, particularly in later stages. Surprisingly, these aspects are less frequently explored in Middle Eastern countries. Thus, this research paper aims to assess the impact of quality services on patient satisfaction in tertiary care clinics located in the Middle East. To improve the quality of services in our clinic, we employed patient feedback as a valuable resource. We proactively reached out to all patients who had visited our hospital via mobile phone messages and requested their feedback on the services they received. Approximately 5% of all visitors responded and completed a comprehensive questionnaire. The majority of respondents expressed satisfaction with the services provided across various departments. However, they also offered valuable suggestions that helped us identify further areas for improvement and enhance the overall patient experience within our clinic. Drawing upon the feedback received, we meticulously considered the identified issues, redesigned our policies, and implemented strategic changes. Following the implementation of these new approaches, we once again sought patients' feedback on the quality of our services. Patient feedback highlighted the significant impact of optimized service delivery methods, resulting in a substantial increase in patient satisfaction. Overall, this study sheds light on the vital factors that can enhance patients' experience in outpatient clinics, emphasizing the importance of integrating patient feedback into continuous quality improvement initiatives. By utilizing this approach, healthcare providers, administrators, and researchers can effectively improve service quality and patient satisfaction. Consequently, this research paper serves as a valuable reference for public health stakeholders, administrators, and researchers in their pursuit of delivering exceptional healthcare experiences.

Consumer Wearables Define a Normative Recovery Trajectory Following the Modified Nuss Procedure

IntroductionThe modified Nuss procedure is an elective procedure associated with a lengthy recovery, uncontrolled pain, and risk of infrequent, yet life-threatening complications. The absence of objective measures of normative postoperative recovery creates uncertainty about the postdischarge period, which remains highly dependent on the patients' and their caregivers’ expectations and management of recovery. We aimed to describe an objective-normative, physical activity recovery trajectory after the modified Nuss procedure, using step counts from the Fitbit. MethodsThis observational study enrolled children ≤18 y with pectus excavatum who underwent the modified Nuss procedure from 2021 to 2022. The Fitbit was worn for 21 postoperative days. Postdischarge outcomes and health-care utilization were evaluated. For patients without postoperative complications, piecewise linear regression analysis was conducted to generate a normative recovery trajectory model of daily step counts. ResultsOf 80 patients enrolled, 66 (86%) met eligibility criteria (mean age, 15.1 ± 1.3 y; 89.4% male, 62.1% non-Hispanic White). The mean number of telephone and electronic message encounters regarding concerns with the patient's recovery within 30 d postoperatively was 2.1 (standard deviation = 2.7). Ten patients (15.2%) returned to the emergency department (ED) within the 30-d postoperative period. Seven patients (10.6%) presented to the ED one time, and three patients (4.5%) presented to the ED twice. Thirty-day readmission rate was four patients (6.0%). Piecewise regression model showed that patients without complications steadily increased their daily step count on each postoperative day and plateaued on day 18. ConclusionsWe have developed a normative recovery trajectory following the modified Nuss procedure using step count data collected by a consumer wearable device. This offers the potential to inform preoperative patient expectations and reduce avoidable health-care utilization through informed preoperative counseling, thus laying the ground work for the use of consumer wearable devices as a postdischarge remote monitoring tool.

Tech Neck Syndrome: A global epidemic of the modern era among students at the University of Abomey Calavi in Benin

Context and Objective“Tech neck” is a recent term used to describe neck pain related to smartphone use. It is a health problem that has been increasing considerably since the last decade. The objective of this study was to determine the prevalence of Teck Neck syndrome among young students at the University of Abomey Calavi, in order to highlight the different factors that contribute to the occurrence of this condition. Patients and MethodThis is a prospective descriptive study with consecutive sampling conducted over a period of 3 months. The study involved 1,835 young students at the University of Abomey Calavi in Benin, 850 of whom had symptoms of Tech Neck.Epi Data 3.1 software was used for data entry and R software for statistical analysis. Proportions were calculated for qualitative variables. Quantitative variables were expressed as mean ± standard deviation. The Wilcoxon test was used to compare means. The significance level was set at risk alfa = 0.05. A p-value < 0.05 was considered statistically significant. ResultsFor 421 (49.52%) of the participants, their symptoms would be caused by prolonged neck flexion when writing messages. Of the 1835 students, 1368 (74.55 %) reported constant communication by telephone message. In this study, 55.91 % and 89.43 % of participants respectively stated that they could not determine how often they handled their smartphone within 1 h and 24 h. None of the participants kept their neck straight when writing a message. ConclusionThe Tech neck syndrome is a health problem that has increased considerably over the last decade, especially among students, due to the misuse of NICT.

30년 이상 고경력 국⋅공립 유치원 교사의 교직 생애 경험의 의미

Objectives The purpose of this study was to study the life and teaching experiences of high-career kindergarten teachers in national and public kindergartens and explore their meaning.&#x0D; Methods To this end, in-depth interviews were conducted for 5 teachers with more than 30 years of experience in national and public kindergartens in Gyeongsangnamdo for two sessions each from early January ~ early April 2023, and additional data were collected through phone calls and messages and the interview data of the research participants were conducted in open coding using the nomadic analysis method. Afterward it was categorized by topic, and the process of research results and interpretation was carried out through an iterative comparison process and an inductive process.&#x0D; Results The participants experienced setbacks and conflicts as they began a grueling first-time teaching career without a mentor, but they found it rewarding and grew as teachers. In response to the change from an authoritarian era to an era where individual rights are valued, high-career national and public kindergarten teachers have made efforts to adapt to changes in their relationships, curricula, and educational environment with the people they meet in the educational field, and sometimes their professionalism is shaken. It was also seen that institutional support needed to be provided to overcome problems such as the fall of the teaching authority and the heavy administrative workload.&#x0D; Conclusions The teaching life experience and significance of high-career national and public kindergarten teachers is the history of the educational field in Korea, and it was the basis for understanding the field of early childhood education and what kind of efforts and institutional support are needed for the development of kindergarten teachers.

Requesting HIV Results Be Conveyed in-Person: Perspectives of Clinicians and People Recently Diagnosed with HIV

IntroductionGuidelines recommend that, where possible, clinicians convey HIV-positive test results in person in Australia. However, HIV-negative and all other STI results are routinely delivered by phone or text message. Requesting individuals to obtain positive HIV test results in person could be a deviation from the standard delivery of healthcare and be interpreted as indicating a positive HIV diagnosis.MethodsThis paper is based on two related, ongoing qualitative studies conducted in Australia with HIV healthcare providers and people recently diagnosed with HIV. In study one, in-depth, semi-structured interviews were conducted with people who had recently received a positive HIV diagnosis. In study two, in-depth, semi-structured interviews were conducted with HIV healthcare and peer support providers. Interviews were analyzed thematically.ResultsWhile clinicians were willing to convey HIV-positive diagnoses by phone, most preferred in-person delivery. In-person delivery enabled clinicians to assess visual cues to better respond to the psychological and emotional needs of patients. For some participants living with HIV, however, the requirement to return to the clinic was interpreted as an unofficial HIV-positive diagnosis. This led to a period in which recently diagnosed participants believed they were HIV-positive without having received an explicit diagnosis.ConclusionProtocols for delivering HIV diagnoses by phone, followed by a face-to-face appointment, may reduce the period of anxiety for some patients and assist with an early connection to HIV care and support.Policy ImplicationsIn some instances, conveying HIV diagnoses by phone may be more appropriate than recalling individuals to the clinic to deliver a positive HIV diagnosis in person.

Evolution of a Project to Improve Inpatient-to-Outpatient Dermatology Care Transitions: Mixed Methods Evaluation.

In-hospital dermatological care has shifted from dedicated dermatology wards to consultation services, and some consulted patients may require postdischarge follow-up in outpatient dermatology. Safe and timely care transitions from inpatient-to-outpatient specialty care are critical for patient health, but communication around these transitions can be disjointed, and workflows can be complex. In this 3-phase quality improvement effort, we developed and evaluated an intervention that leveraged an electronic health record (EHR) feature, known as SmartPhrase, to enable a new workflow to improve transitions from inpatient care to outpatient dermatology. Phase 1 (February-March 2021) included interviews with patients and process mapping with key stakeholders to identify gaps and inform an intervention: a SmartPhrase table and associated workflow to promote collection of patient information needed for scheduling follow-up and closed-loop communication between dermatology and scheduling teams. In phase 2 (April-May 2021), semistructured interviews-with dermatologists (n=5), dermatology residents (n=5), and schedulers (n=6)-identified pain points and refinements. In phase 3, the intervention was evaluated by triangulating data from these interviews with measured changes in scheduling efficiency, visit completion, and messaging volume preimplementation (January-February 2021) and postimplementation (April-May 2021). Preintervention pain points included unclear workflow for care transitions, limited patient input in follow-up planning, multiple messaging channels (eg, EHR based, email, and phone messages), and time-inefficient patient tracking. The intervention addressed most pain points; interviewees reported the intervention was easy to adopt and improved scheduling efficiency, workload, and patient involvement. More visits were completed within the desired timeframe of 14 days after discharge during the postimplementation period (21/47, 45%) than the preimplementation period (28/41, 68%; P=.03). The messaging workload also decreased from 88 scheduling-related messages sent for 25 patients before implementation to 30 messages for 8 patients after implementation. Inpatient-to-outpatient specialty care transitions are complex and involve multiple stakeholders, thus requiring multifaceted solutions. With deliberate evaluation, broad stakeholder input, and iteration, we designed and implemented a successful solution using a standard EHR feature, SmartPhrase, integrated into a standardized workflow to improve the timeliness of posthospital specialty care and reduce workload.

An XGBoost approach to detect driver visual distraction based on vehicle dynamics

Objectives Distracted driving such as reading phone messages during driving is risky, as it increases the probability of severe crashes. This study proposes an XGBoost model for visual distraction detection based on vehicle dynamics data from a driving simulation study. Methods A simulated driving experiment involving thirty-six drivers was launched. We obtained the vehicle dynamics parameters required for the model using the time window and fast Fourier transform methods, totaling 26 items. Meanwhile, the effects of varied time window sizes (1–7 s) and amount of input indications on model performance were studied. Results By conducting a comparative analysis, it has been determined that the ideal time window size is 5 s. Additionally, the optimal number of input indicators was found to be 23. The XGBoost model for distinguishing distractions achieved an accuracy rate of 85.68%, a precision rate of 85.83%, a recall rate of 83.85%, an F1 score of 84.82%, and an AUC value of 0.9319, which were higher than SVM and RF. The gain-based feature rank demonstrated that the standard deviation of vehicle sideslip rate and the mean amplitude of the 0–1 Hz spectrum component of the steering wheel angle were more crucial than other features. Conclusions The research results indicate that the steering wheel angle and vehicle sideslip angle may be more conducive to identifying distractions. This XGBoost model could potentially be applied in advanced driving assistant systems (ADAS) to warn driver and reduce cellphone involved distracted driving.

Standing in the Forest of Being Alive by Katie Farris

Reviewed by: Standing in the Forest of Being Alive by Katie Farris Alina Stefanescu (bio) KATIE FARRIS Standing in the Forest of Being Alive Farmington, Maine. Alice James Books. 2023. 100 pages. A FOOT OF FIERY RED HAIR chopped from the poet's head, a hand curled around the braid—this cover image is the initial offering of Katie Farris's poetry collection, Standing in the Forest of Being Alive. Subtitled "A Memoir in Poems," the book probes the tension between giving, taking, and theft. Holding no marvel loosely, Farris moves with defiance and dolor through the mystery of breast cancer, literary lineage, love, partnership, and poetry. Opening with an ars poetica, "Why Write Love Poetry in a Burning World," Farris answers the titular question in the closing couplet: "To train myself, in the midst of a burning world / to offer poems of love to a burning world." The breast cancer diagnosis, delivered in a blunt phone message days prior to the poet's thirty-sixth birthday, is unbelievably ordinary, as Farris conveys in "Tell It Slant," which begins in the slant rhyme of "You float in the MRI gloam." The spirit of Emily Dickinson stalks the stanzas in the slant, in the shorn lines, in the elliptical dashes, in the gestural work done by punctuation, in the abrupt turns and archaic diction, and in the poems that nominate her presence. Sitting in the oncology waiting room, Farris addresses Dickinson: "I meet / your sweet velocity in every / thing that flies—" "I return to this point of wonder:" the speaker tells us in the first line of "Outside Atlanta Cancer Care," a staggering poem punctuated with Dickinsonian dashes. The wonder of it all is that the unbelievable can happen, that we can live without realizing how life is divided by the knowledge of diagnosis. Farris asks us to witness this—to live in the space of mystery and terror sharpened by love for her husband, and love for the world. All routes include Ilya Kaminsky, Farris's longtime partner and fellow poet. Many of these poems were initially published in Farris's A Net to Catch My Body in Its Weaving, winner of the 2021 Chad Walsh Chapbook prize from Beloit Poetry Journal. The chapbook's title comes from the closing lines of "In the Event of My Death," a poem addressed to Farris's husband as a sort of last will and testament. Midway through this moving poem, Farris turns, saying: "Promise you will find my heavy braid / and bury it—" By ending this midway stanza with an open dash, the rupture ripples throughout the poem. Sutured with love, each poem careens toward the beloved. In "A Row of Rows," intellectual ardor emerges in a dispute over whether Walt Whitman (his view) or Emily Dickinson (her view) is the "greatest epic poet"—an argument Farris takes up in the slant of this book, in the sharp lines and hairpin curves of line breaks, and in the Whitmanesque anaphora of her political poems. But the porch is the stage where love fights over lecture rights. Seductress of the unspeakable, Farris approaches cancer and eros in the same breath. Stripped bare, exiled from her own flesh, confrontational in her resistance to shame, the poet is shameless. "Rachel's Chair" uses an object to reflect on the freedom of sex in a careless body, in the before-cancer when so much remains undetermined. The poem opens with a memory ("Once, many / years ago, we made / love at a friend's / house") and then turns into a reflection on the chair they used as a site for sex. Farris's defiance embraces the imperfection of bodies that offer indescribable pleasure and unfathomable pain. Metaphor becomes a weapon, a strategy of insubordination to reduce the power of cancer over the mind. The symptoms of treatment make the poet visible to strangers who identify the patient with the disease rather than the individual life and person. Farris alludes to this sense of overexposure in "After the Mastectomy," where the person of "Cancer Patient" becomes public. To lose one's hair is to be stripped of protection ("how can a watchtower hide?"). Crossing the page in brisk...

Penyeleksian Penerimaan Teleservice Representative dengan Penerapan Metode ARAS dan Pembobotan ROC

Company Refers to a business entity or organization established by one or several individuals with the intention of producing or selling goods or services with the aim of making a profit. In helping to increase company sales by promoting new products or services to customers and establishing better relationships with existing customers, a teleservice representative is needed. A teleservice representative is a customer service professional who works via a remote communication device such as a telephone, email or text message. . To achieve this, they must have the criteria of Experience, Good Negotiation, Communication Articulation, Interpersonal and Confidence. The presence of a Teleservice Representative is very important for the company in ensuring that the quality of customer service is continuously improved and customers are satisfied with the company's products or services. So companies must make the right selection of teleservice representatives because teleservice representatives have a very vital role for the company because they are a direct line in providing superior customer service and guaranteeing customer satisfaction. To solve problems in the selection of teleservice representatives, an information system is needed, namely a decision support system (SPK). In this study, the Additive Ratio Assessment (ARAS) method and ROC weighting are applied, which are methods that can be used to make decisions and produce values on selection weights in the selection of teleservice representatives. so that the alternative that produces the selection of teleservice representatives, which can be seen in table 10, is alternative A4, namely Nisa Fadillah with a value of 1.0000

Twelve-month effectiveness of telephone and SMS support to mothers with children aged 2 years in reducing children’s BMI: a randomized controlled trial

Background/objectivesFew quality intervention studies have assessed whether a combined telephone and short message service (SMS) intervention to mothers is effective in reducing BMI and obesity risk behaviors of children at 3 years of age. This study aimed to assess effectiveness of telephone and SMS support in reducing children’s body mass index (BMI) and obesity risk behaviors.Subjects/MethodsA randomized controlled trial (RCT) with 662 women of 2-year-old children (with the proportion of overweight and obesity being similar to the general population) was conducted in Sydney, Australia, March 2019–October 2020. The mothers in the intervention group received three telephone support sessions plus SMS messages and mailed-intervention-booklets over a 12 months period i.e., 24–26, 28–30, and 32–34 months of the child’s age. Mothers in the control group received usual care and two mailed booklets on information not related to the intervention. The primary outcome was child’s BMI at 3 years of age. Secondary outcomes were children’s dietary and activity behaviors. All outcome measures were based on mothers’ self-report using standardized tools due to COVID-19 pandemic restrictions.Results537 (81%) mothers completed the post-intervention assessment at 3 years with only 470 (71%) children having weight and height measures. Multiple imputation analysis showed no statistically significant difference in mean BMI between the groups. Children in the intervention group were more likely not to eat in front of the TV [AOR 1.79 (95% CI 1.17–2.73), P = 0.008], more likely to meet the dietary recommendations [AOR 1.73 (95% CI 0.99–3.02), P = 0.054] and meet the activity recommendations [AOR 1.72 (95% CI 1.11–2.67), P = 0.015] than those in the control group respectively. Among those with an annual household income (<AUD$80,000), the intervention was significantly associated with a lower mean BMI [16.26 (SD 2.22) kg.m−2] in the intervention group than [16.84 (SD 2.37)] in the control, a difference of −0.59 kg/m2 (95% CI: −1.15 to −0.03, P = 0.040).ConclusionsA staged telephone and SMS support intervention to mothers with children aged 2 years was associated with improved dietary and activity behaviors. The intervention was also associated with reduced children’s BMI at age 3 years only for those from lower income households.Trial registrationThe trial is registered with the Australian Clinical Trial Registry (ACTRN12618001571268)

Adapting Our SCOPE: Lessons Learned from Spreading and Scaling Efforts to Integrate Care.

SCOPE (Seamless Care Optimizing the Patient Experience) launched in 2012 to support primary care in downtown Toronto with live navigation and rapid access to acute and community care resources for primary care providers (PCPs) and their patients. Ten years later, over 1,800 PCPs across Ontario have signed up for SCOPE and over 48,000 interactions in the form of e-mail, fax, phone and secure messaging have been conducted. Case examples illustrate the ways in which SCOPE has been adapted across a range of Ontario Health Teams, including under-resourced, small urban and rural sites. Primary care engagement, change management strategies and flexibility to meet the individual needs of each site have been key factors in the successful spread and scale of SCOPE's services.

Telemedicine efficacy and satisfaction of patients and headache specialists in migraine management.

Migraine follow-up is difficult for outpatients, especially after the COVID-19 pandemic, we tried to identify the most appropriate telemedicine methods for migraine in terms of efficacy, safety, patient compliance, and patient and physician satisfaction. Migraine patients were screened from the Headache Center of the First Affiliated Hospital of Chongqing Medical University from September 2019 to December 2021 and randomly classified into an outpatient group and four telemedicine groups: social software, telephone, E-mail, and short message. Headache specialists followed up with the patients 3 and 6 months after their visit and asked about their satisfaction with the follow-up in each instance, as were the headache specialists. A total of 147 migraine patients were included, of whom 65 completed the follow-up. After 3 and 6 months of follow-up, the proportion of patients whose monthly headache frequency decreased by over 50% in the social-software, telephone, and E-mail groups was no different from that in the outpatient group. A similar result was obtained from evaluations with the Visual Analog Scale, the Headache Impact Test and the Migraine Disability Assessment compared with baseline in social software and telephone groups. The compliance in social-software group was not worse than that in the outpatient group. The proportion of patients in the E-mail group who completed the follow-up and the proportion of patients in the telephone group who consistently took preventive medication were significantly lower than those in the outpatient group. After 6 months, the majority of patients in the outpatient, social-software, and telephone groups and headache specialists in the outpatient, social-software groups were satisfied with the follow-up, while fewer patients in the E-mail group and fewer specialists in the telephone and E-mail group showed their satisfaction. Compared with outpatient visits, it is safe and effective to use social software and telephone to follow up on migraine patients, and E-mail and short-message follow-up have lower feasibility. Migraine patients prefer social-software and telephone follow-up, while specialists prefer social-software follow-up.

Mediators of physical activity maintenance during a 12-month randomized controlled trial among breast Cancer survivors.

To explore the theoretical constructs that functioned as mediators of interventions for moderate-to-vigorous physical activity (MVPA) maintenance among breast cancer survivors. 161 survivors were randomized into 3 groups: Reach Plus, Reach Plus Message or Reach Plus Phone. All participants received a 3-month theory-based intervention delivered by volunteer coaches. During months 4-9, all participants monitored their MVPA and received feedback reports. Additionally, Reach Plus Message received weekly text/email messages and Reach Plus Phone received monthly calls from their coaches. Assessments of weekly MVPA minutes and theoretical constructs (self-efficacy, social support, physical activity [PA] enjoyment and PA barriers) were obtained at baseline, 3, 6, 9 and 12-months. Using a multiple mediator analysis with a product of coefficients approach, we examined mechanisms associated with between-group differences over time in weekly MVPA minutes. Self-efficacy mediated effects of Reach Plus Message vs. Reach Plus at 6 (ab = 16.99) and 9M (ab = 27.45); social support mediated effects at 6 (ab = 4.86), 9 (ab = 14.30) and 12M (ab = 6.18). Self-efficacy mediated effects of Reach Plus Phone vs. Reach Plus at 6 (ab = 18.76), 9 (ab = 28.93) and 12M (ab = 18.18). Social support mediated effects of Reach Plus Phone vs. Reach Plus Message at 6 (ab=-5.50) and 9M (ab=-13.20); PA enjoyment mediated effects at 12M (ab=-3.63). PA maintenance efforts should focus on strengthening breast cancer survivors' self-efficacy and obtaining social support.The trial was registered at ClinicalTrials.Gov: NCT02694640 (Feb. 26, 2016).

A Randomized Controlled Trial using Brief Educational Messages Directed to Adults with Intellectual Disability and Hypertension or their Helpers Reduces Hospital Stays.

We assessed an educational intervention to reduce the number of emergency department (ED) and inpatient stays for cardiovascular diagnoses, among South Carolina adult Medicaid Members with intellectual and developmental disability and hypertension (Members). This Randomized Controlled Trial (RCT) included Members or the person who helped them with their medications (Helpers). Participants, who included Members and/or their Helpers, were randomly assigned to an Intervention or Control group. South Carolina Department of Health and Human Services, which administers Medicaid, identified eligible Members. 412 Medicaid Members - 214 Intervention (54 Members participating directly; 160 Helpers participating in lieu of Members) who received the messages about hypertension and surveys about knowledge and behavior and 198 Controls (62 Members; 136 Helpers) who only received surveys of knowledge and behavior. Educational intervention about hypertension included a flyer and monthly text or phone messages for one year. Input measures - characteristics of the Members; Outcome measures - hospital emergency department (ED) and inpatient visits for cardiovascular conditions. Quantile regression tested the association of Intervention/Control group status with ED and inpatient visits. We also estimated models using Zero-inflated Poisson (ZIP) models for sensitivity analysis. Participants in the Intervention group with highest baseline hospital use (top 20% ED; top 15% Inpatient) had significant reductions in Year 1 (.57 fewer ED and 2 fewer inpatient days) compared to the Control group. For ED visits, improvement continued in year two. The intervention reduced the frequency of cardiovascular disease-related ED visits and Inpatient days for participants in the Intervention group in the highest quantiles of hospital use, and the improvement was better for those who had a Helper.

Feasibility and Preliminary Outcomes of a Mobile Intervention Combining Cognitive Behavioral Therapy, Virtual Coaching, and Nicotine Replacement Therapy for Nicotine Vaping Cessation.

Despite research demonstrating that those who use e-cigarettes, also known as vaping, express an interest in quitting, evidence-based vaping cessation interventions are lacking. The purpose of this study was to examine the feasibility and preliminary outcomes of an mHealth vaping cessation intervention. Adults (N = 51) who were vaping nicotine were recruited online and enrolled in a 6-week mHealth intervention combining nicotine replacement therapy (NRT), self-guided cognitive behavioral therapy (CBT), and coaching support through telephone and asynchronous messaging. Feasibility and self-reported 7- and 30-day abstinence were assessed at baseline and 1-month postquit date. The majority of participants completed treatment (45/51) and found the intervention helpful in supporting their vaping behavior change objectives. At 1-month postquit date, 48.9% (22/45) of study completers reported 7-day point prevalence abstinence and 28.8% (13/45) reported continuous 30-day abstinence. Findings provide preliminary support for an mHealth intervention approach to vaping cessation combining remote CBT-based coaching with NRT.

Preferences for Breast and Cervical Cancer Screening Among Women and Men in Kenya: Key Considerations for Designing Implementation Strategies to Increase Screening Uptake.

Breast and cervical cancer incidence rates and mortality rates in Kenya are high. Screening is globally accepted as a strategy for early detection and downstaging of these cancers for better outcomes, but despite the efforts established by the Kenyan government to provide these services to eligible populations, uptake has remained disproportionately low. Using data from a larger study aimed at understanding the implementation and scale-up of cervical cancer screening services, we analyzed data to compare the preferences for breast and cervical cancer screening services between men and women (25-49years) in rural and urban communities in Kenya. Participants were recruited in concentric circles starting at the center of six subcounties. One woman and one man per household were enrolled for data collection on a continuous basis. More than 90% of both men and women had a monthly income of less than US $500. The top three preferred sources of information on screening for cancers affecting women were health care providers; community health volunteers; and media such as television, radio, newspapers, and magazines. More women (43.6%) than men (28.0%) trusted community health volunteers to provide health information on cancer screening. Printed materials and mobile phone messages were preferred by approximately 30% of both genders. Over 75% of both men and women preferred an integrated model of service delivery. These findings show that there are many similarities that can be leveraged when designing implementation strategies for population-wide breast and cervical cancer screening hence reducing the challenge of addressing diverse preferences of men and women which may not be easy to reconcile.

What Does Doodling do in Chinese tasks: measuring the difference between Chinese and English with expected outcomes

Previous studies have demonstrated that different types of doodling, a way of passing time to release boredom, have either positive or negative influences on one's ability to concentrate and memory. However, previous studies are limited to alphabetic languages, such as English, whereas character-based languages, such as Chinese, are underrepresented to a great extent. Therefore, the current study attempts to extend the extant research by considering the effects of two types of doodling on attention and recall during Chinese tasks and their difference between Chinese and English. In the present experiment, a total of 200 participants, including 100 individuals whose mother language is Chinese and English respectively, are randomly allocated to one of three conditions (structured doodling, unstructured doodling, and control). The concentration and recall performance of participants are measured by writing down the names and places during and after listening to a mundane telephone message. The results suggest that although structured doodling aids concentration in Chinese, the assistance is less than that in English.

예비부부의 사례 개념화 기반 단회 상담 참여경험에 관한 내러티브 탐구

Objectives The purpose of this study aims to provide basic data on single-session counseling conducted in the clinical field by examining the counseling experience of single-session counseling clients based on case conceptualization and what the experience means in the context of their lives.&#x0D; Methods As a narrative exploration method that can help participants separate problems from themselves and explore exceptional situations outside the problem, this researcher conducted a study on a pair of prospective couples who have experienced single counseling. To this end, after three in-depth video interviews were conducted from June 16, 2021 to November 8, 2021, additional interviews were conducted by phone or text message.&#x0D; Results The results of the study are as follows. First, participants were disappointed, but they participated in counseling more honestly and actively since it was a single counseling. Second, through single counseling, participants increased their self-understanding as well as self-acceptance. Third, as the participant participated in the single consultation, recognized and accepted problems, and decided to try for change, so felt lighthearted. Fourth, through the experience of single counseling, participants were able to have a positive perception of counseling, and if they faced problems that were difficult to solve alone in their daily lives again, they wanted to be consulted again.&#x0D; Conclusions Based on the results of the study, the counseling implications and limitations were presented, and the single counseling experience improved the image of counseling, but it was regrettable to experience the changed results directly by changing one's old habits in daily life. Therefore, it is necessary to study so that case conceptualization education is conducted in detail and in detail so that the effect of single counseling can be further improved through counselor training. It can be seen that this study has implications in that it showed how to approach and conduct single counseling in the clinical field.