Post-intervention Effects Research Articles

Mindful Coping Power Effects on Children's Autonomic Nervous System Functioning and Long-Term Behavioral Outcomes.

Mindful Coping Power (MCP) was developed to enhance the effects of the Coping Power (CP) preventive intervention on children's reactive aggression by integrating mindfulness training into CP. In prior pre-post analyses in a randomized trial of 102 children, MCP improved children's self-reported anger modulation, self-regulation, and embodied awareness relative to CP but had fewer comparative effects on parent- and teacher-reported observable behavioral outcomes, including reactive aggression. It was hypothesized that MCP-produced improvements in children's internal awareness and self-regulation, if maintained or strengthened over time with ongoing mindfulness practice, would yield improvements in children's observable prosocial and reactive aggressive behavior at later time points. To appraise this hypothesis, the current study examined teacher-reported child behavioral outcomes at a one-year follow-up. In the current subsample of 80 children with one-year follow-up data, MCP produced a significant improvement in children's social skills and a statistical trend for a reduction in reactive aggression compared with CP. Further, MCP produced improvements in children's autonomic nervous system functioning compared with CP from pre- to post-intervention, with a significant effect on children's skin conductance reactivity during an arousal task. Mediation analyses found that MCP-produced improvements in inhibitory control at post-intervention mediated program effects on reactive aggression at the one-year follow-up. Within-person analyses with the full sample (MCP and CP) found that improvements in respiratory sinus arrhythmia reactivity were associated with improvements in reactive aggression at the one-year follow-up. Together, these findings indicate that MCP is an important new preventive tool to improve embodied awareness, self-regulation, stress physiology, and observable long-term behavioral outcomes in at-risk youth. Further, children's inhibitory control and autonomic nervous system functioning emerged as key targets for preventive intervention.

Behavior Change Techniques That Prevent or Decrease Obesity in Youth With a Low Socioeconomic Status: A Systematic Review and Meta-Analysis.

Background: Interventions, targeting youth, are necessary to prevent obesity later in life. Especially youth with low socioeconomic status (SES) are vulnerable to develop obesity. This meta-analysis examines the effectiveness of behavioral change techniques (BCTs) to prevent or reduce obesity among 0 to 18-year-olds with a low SES in developed countries. Method: Intervention studies were identified from systematic reviews or meta-analyses published between 2010 and 2020 and retrieved from PsycInfo, Cochrane systematic review, and PubMed. The main outcome was body mass index (BMI), and we coded the BCTs. Results: Data from 30 studies were included in the meta-analysis. The pooled postintervention effects of these studies indicated a nonsignificant decrease in BMI for the intervention group. Longer follow-up (≥12 months) showed favorable differences for intervention studies, although that BMI change was small. Subgroup analyses showed larger effects for studies with six or more BCTs. Furthermore, subgroup analyses showed a significant pooled effect in favor of the intervention for the presence of a specific BCT (problem-solving, social support, instruction on how to perform the behavior, identification of self as role model, and demonstration of the behavior), or absence of a specific BCT (information about health consequences). The intervention program duration and age group of the study population did not significantly influence the studies' effect sizes. Conclusions: Generally, the effects of interventions on BMI change among youth with low SES are small to neglectable. Studies with more than six BCTs and/or specific BCTs had a higher likelihood of decreasing BMI of youth with low SES.

Effects of Aerobic Exercise on Cardiorespiratory Fitness, Cardiovascular Risk Factors, and Patient-Reported Outcomes in Long-Term Breast Cancer Survivors: Protocol for a Randomized Controlled Trial.

Anthracycline-based chemotherapy has been mainstay of adjuvant breast cancer therapy for decades. Although effective, anthracyclines place long-term breast cancer survivors at risk of late effects, such as reduced cardiorespiratory fitness and increased risk of cardiovascular disease. Previous research has shown beneficial effects of exercise training on cardiorespiratory fitness, but the effects of exercise on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes in long-term survivors are less clear. Whether previous exposure to breast cancer therapy modulates the effects of exercise is also unknown. The primary aim of the CAUSE (Cardiovascular Survivors Exercise) trial is to examine the effect of aerobic exercise on cardiorespiratory fitness in anthracycline-treated long-term breast cancer survivors. Secondary aims are to examine effects of exercise training on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes, and to compare baseline values and effects of exercise training between similar-aged women with and those without prior breast cancer. A third aim is to examine the 24-month postintervention effects of aerobic exercise on primary and secondary outcomes. The CAUSE trial is a 2-armed randomized controlled trial, where 140 long-term breast cancer survivors, 8-12 years post diagnosis, are assigned to a 5-month nonlinear aerobic exercise program with 3 weekly sessions or to standard care. Seventy similar-aged women with no history of cancer will undergo the same exercise program. Cardiorespiratory fitness measured as peak oxygen consumption (VO2peak), limiting factors for VO2peak (eg, cardiac function, pulmonary function, hemoglobin mass, blood volume, and skeletal muscle characteristics), cardiovascular risk factors (eg, hypertension, diabetes, dyslipidemia, obesity, physical activity level, and smoking status), and patient-reported outcomes (eg, body image, fatigue, mental health, and health-related quality of life) will be assessed at baseline, post intervention, and 24 months post intervention. A total of 209 patients were included from October 2020 to August 2022, and postintervention assessments were completed in January 2023. The 24-month follow-up will be completed in February 2025. The findings from the CAUSE trial will provide novel scientific understanding of the potential benefits of exercise training in long-term breast cancer survivors. ClinicalTrials.gov NCT04307407; https://clinicaltrials.gov/ct2/show/NCT04307407. DERR1-10.2196/45244.

Mindfulness-based intervention for clinical and subthreshold perinatal depression and anxiety: A systematic review and meta-analysis of randomized controlled trial

ObjectivesAbout one in four mothers will experience depression and anxiety during pregnancy and within their first year following childbirth. The meta-analysis aggregated the findings of randomized controlled trials (RCTs) evaluating the immediate post-intervention and maintenance effects of MBI on perinatal depression and anxiety. MethodsA systematic search was conducted in PubMed, PsycINFO, Medline, Scopus, and Web of Science for English-language journal articles from the first available date until Oct 27th, 2022. ResultsTwenty-five published RCTs were identified and reviewed, with a total of 2495 perinatal women. MBI was superior to controls for clinical and subthreshold perinatal depression and anxiety. The benefit for depression reduction was stable over time and sustained to the postpartum period, but the maintenance effect on perinatal anxiety was less conclusive. Moreover, MBI's post-intervention effects on depression and anxiety were moderated by perinatal women's symptom severity. The post intervention effects were significantly greater among women in Low- and Middle-Income countries, where perinatal mental health care is less available and accessible. Greater improvement in mindfulness was also associated with a significantly larger post-intervention effect on perinatal depression. ConclusionsThis meta-analysis suggests that MBIs may complement and extend the available range of effective interventions for clinical and subthreshold perinatal depression and anxiety.

Cooling Off and the Effects of Mandatory Breaks in Online Gambling: A Large-Scale Real-World Study

The prevention of problematic online gambling behavior is a topic of major interest for regulators, the gambling industry, and researchers. Many gambling operators approach this issue by using responsible gambling tools. Among such tools, mandatory play breaks are used to interrupt long online gambling sessions, providing “cooling off” periods for players to take a reflective “time out”. The present study investigated the effects of mandatory play breaks in a large-scale experiment with 23,234 online gamblers engaging in more than 870,000,000 gambling transactions on Norsk Tipping’s gambling platform over a 1-month period. The gamblers were randomly assigned to several intervention groups with varying duration of mandatory play breaks and one control group with Norsk Tipping’s standard play break duration. More specifically, the study analyzed the relationship between the mandatory break received and the gambler’s acceptance of this tool, the interaction patterns with the tool, and how quickly they started to gamble again, as well as post-intervention effects on gambling behavior. Results showed that gamblers who were treated with longer mandatory breaks (i) tended to take longer voluntary breaks, and (ii) interacted more frequently with the tool (for instance, by clicking the “logout” button). Furthermore, gamblers appeared to accept longer mandatory play breaks. However, only a fraction of post-intervention effects remained, and mainly only for gamblers who received a substantial number of long mandatory play breaks. Overall, the present study provides actionable insights for both researchers and the gambling industry to improve the effectiveness of mandatory play breaks as a responsible gambling tool.

Parent training programs for preventing and treating antisocial behavior in children and adolescents: A comprehensive meta-analysis of international studies

This article presents a comprehensive meta-analysis of international studies on the effects of parent training programs (PTP) on antisocial behavior (ASB) in children and adolescents. From systematic literature searches of 7219 reports, we finally selected 239 eligible reports with 241 independent studies and 279 comparisons between a program and a control condition up to the publication year 2020. Although most interventions were based on a cognitive-behavioral approach, we also found a great variety of programs and applications. Overall, the mean effect for PTP was positive for parent/family and ASB outcomes ( d = 0.46 and d = 0.47, respectively using the random effect model at postintervention). We also found higher effects on more proximal parental outcomes such as parental stress, parental competencies, and parent–child interaction/relation. However, more distal outcomes such as marital satisfaction or parent psychopathology revealed lower effect sizes. In addition, the link between changes in parental/family outcomes and changes in ASB was significant across several outcome types, thus confirming the general causal assumption of PTP. Postintervention effects were stable across several moderators, although clinical applications revealed slightly higher effect sizes than preventive applications. Several findings cast some doubt on these generally positive results: For example, effect sizes decreased considerably in not only short- (3 to 12 months) but also especially long-term follow ups (12 months or more), and the vast majority of outcome assessments stemmed from parent ratings. Finally, we found a clear negative connection between sample and effect size. Whether this is due to publication bias or indicates a better implementation quality in smaller studies remains an open question. • Reviews the results of more than 240 international studies evaluating parent training programs for preventing and treating antisocial behavior problems • Parents training programs showed medium size effectiveness in preventing and treating antisocial behavior problems • The promotion of parental competences are clearly linked to changes in antisocial behavior problems • Effects of parent training programs are not stable. • Long-term effects are rather small.

The effectiveness of the ego competency model in improving students’ ability to use coping mechanisms

The ego competency model (ECM) presented to students in a structured education program uses a pre-experimental design with a one group pre- and posttest approach to evaluate whether the ego competency model will result in an increase in ego competence while improving adaptive coping. This study aims to assess the effectiveness of the ego competency model in improving students' ability to use coping mechanisms. A pre-experimental design with a pretest group and a posttest approach was chosen to carry out the study. A total of 30 students were selected using a simple random sampling technique while studying at selected private schools in Makassar for the ego competency model intervention (14 sessions; each learning session is 50 minutes). Primary outcomes will include post-intervention effects on students' use of adaptive coping mechanisms. The pretest mean for coping mechanisms was 3.77 ± 1.69, which increased to 8.97 ± 0.72 in the posttest. The results showed that the ego competency model was effective in improving students’ ability to use coping mechanisms was statistically significant, p = 0.001

Hypnosis Intervention for Couples Confronted with Alzheimer's Disease: Promising Results of a First Exploratory Study.

Dementia has a negative impact on the quality of life of the person with dementia and their spouse caregivers, as well as on the couple's relationship, which can lead to high levels of distress for both partners. Hypnosis has been shown to be effective in managing distress and increasing the quality of the relationship. The aim was to develop a standardized hypnosis intervention for couples confronted with Alzheimer's disease and evaluate its feasibility, acceptability, and helpfulness in managing the distress of both partners and increasing the quality of the relationship. In a single-arm study, sixteen couples received the 8-week intervention. Qualitative and quantitative assessments were conducted pre- and post-intervention as well as three months after. 88.9% of couples (n = 16) of the final sample (n = 18) completed the intervention. Despite the negative representations of hypnosis, several factors led couples to accept to participate in this study: positive expectations, professional endorsement, medical application, non-drug approach, home-based, free, flexible, and couple-based intervention. The results showed a significant decrease in distress for both partners. These effects were maintained three months after the intervention. Couples felt more relaxed, had fewer negative emotions, accepted difficulties more easily, were more patient, and reported better communication and more affection in the relationship. Overall, this pilot study shows the feasibility and acceptability of hypnosis with couples confronted with Alzheimer's disease. Although measures of the preliminary pre- and post-intervention effects are encouraging, confirmatory testing with a randomized controlled trial is needed.

Effect of exercise-based cardiac rehabilitation on the ischemic threshold in patients with high-risk ischemic heart disease

Abstract Introduction Coronary artery disease is a complex condition and is not always resolved after an interventional or surgical procedure, due to the remaining obstructions in the coronary tree or the severity of the atherosclerosis, leaving anginal symptoms, ischemic threshold (IU) in the exercise, decreased cardiorespiratory fitness, and poor quality of life (QoL). Exercise-based cardiac rehabilitation programs (Ex-CRP) usually develop ischemic preconditioning mechanisms thanks to their direct anti-inflammatory, antioxidant, antithrombotic and coronary neovascularization effects, thus improving coronary reserve flow. We hypothesize that an Ex-CRP is capable of favorably impacting the UI in these patients. Therefore, the objective of this study is to evaluate the effects of an Ex-CRP on the UI in patients with high-risk ischemic heart disease. Methods Quasi-experimental study with 121 patients with ischemic threshold due to high-risk ischemic heart disease (with perfusion defects in nuclear medicine, complex coronary anatomy or partially revascularized) and presence of ischemic threshold in the exercise test. An Ex-CRP of 4–6 weeks duration was performed, consisting of supervised and monitored training concurrent with 30-minute aerobic exercise sessions at 70% of heart rate reserve, 3 times per week, supplemented with resistance exercise. and an educational understanding program for the control of risk factors and nutritional and psycho-emotional care. At the end of the program, a stress test was performed to compare the post-intervention effects and ischemic threshold was defined as the presence of angina or electrocardiographic changes of ischemia with negative ST-segment depression in 2 consecutive beats more than 80 ms from the J point. and in more than two contiguous leads. Results The 121 patients with ischemic threshold were 61±10 years old and 75% were male. On the other hand, 29.7% had a diagnosis of heart failure and an average LVEF of 53.1±12.9%. After Ex-CRP, an improvement was found in calculated VO2p (24.7±7.8 vs 34.23±7.5; p=0.000), METs at maximum effort from 7.06±2.15 to 9.78±1.14 (p<0.0001) and submaximal load in watts from 44±21.32 to 61±24.49; p<0.0001. 40.5% of the patients who were admitted with UI resolved it (absence of post-intervention ischemic diagnosis) after Ex-CRP and the remaining percentage with UI (59.5%) displaced it by 2.62 METs (p<0.0001). With this, the cardiovascular risk calculated by the Duke Score also decreased from −7 to −2 (p<0.0001), and the myocardial efficiency index improved from 8 to 6 (p<0.0001), strength (79±15 to 92±8%; p<0.0001) and QoL (65±17 vs 82±12; p<0.0001). Conclusions Ex-CRP had a significant effect on the resolution or displacement of the UI in patients with high-risk ischemic heart disease. In addition, it improved muscle strength, quality of life, myocardial efficiency, and reduced the cardiovascular risk index calculated by the Duke score. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Centro de Estudios e Investigaciόn FISICOL. Cúcuta, ColombiaCardioFit. CDMX, México

Social network moderators of brief alcohol intervention impact.

This investigation examined the impact of social networks on drinking reduction efforts following a brief alcohol intervention. In a reanalysis of data from an earlier randomized controlled trial with nonstudent emerging adult drinkers (Lau-Barraco et al., 2018), we aimed to test three domains of preintervention social network features as potential factors influencing intervention response: (a) general network characteristics (i.e., network size, network stability), (b) general network alcohol use (i.e., network alcohol abstainers, network heavy/problem drinkers), and (c) risky peers in network (i.e., proportion of drinking buddies, presence of drinking buddies identified as heavy/problem drinker). Participants were 164 emerging adult heavy drinkers recruited from the community (65.9% men; mean age = 21.98 years; 56.2% ethnic minority). Participants were randomly assigned to either a brief personalized feedback intervention (PFI) or assessment-only control and provided data at 1-month and 3-month follow-ups. Greater network stability and greater representation of alcohol abstainers in one's social network were associated with improved initial postintervention response. Heavy/problem drinkers in the network did not moderate initial postintervention effects on drinking outcomes, but there was potentially a stronger intervention effect on risk reduction for those with higher proportions of drinking buddies in their network. Study findings provided evidence that a PFI was efficacious in mitigating some risky social network influence. However, findings did not support a consistent impact across all the network variables examined. Future research is needed to further clarify social network influences and how they may be targeted to enhance intervention efficacy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cognitive behavior therapy for insomnia in cancer patients: a systematic review and network meta-analysis.

The aim of this study was to examine the most effective delivery format of cognitive behavioral therapy for insomnia (CBT-I) on insomnia in cancer patients. We searched five databases up to February 2021 for randomized clinical trials that compared CBT-I with inactive or active controls for insomnia in cancer patients. Outcomes were insomnia severity, sleep efficiency, sleep onset latency (SOL), wake after sleep onset (WASO), and total sleep time (TST). Pairwise meta-analyses and frequentist network meta-analyses with the random-effects model were applied for data analyses. Sixteen unique trials including 1523 participants met inclusion criteria. Compared with inactive control, CBT-I could significantly reduce insomnia severity (mean differences [MD]=-4.98 points, 95% confidence interval [CI]: -5.82 to -4.14), SOL (MD=-12.29 min, 95%CI: -16.48 to -8.09), and WASO (MD=-16.58 min, 95%CI: -22.00 to -11.15), while increasing sleep efficiency (MD=7.62%, 95%CI: 5.82% to 9.41%) at postintervention. Compared with active control, CBT-I could significantly reduce insomnia severity (MD=-2.75 points, 95%CI: -4.28 to -1.21), SOL (MD=-13.56 min, 95%CI: -18.93 to -8.18), and WASO (MD=-6.99 min, 95%CI: -11.65 to -2.32) at postintervention. These effects diminished in short-term follow-up and almost disappeared in long-term follow-up. Most of the results were rated as "moderate" to "low" certainty of evidence. Network meta-analysis showed that group CBT-I had an increase in sleep efficiency of 10.61%, an increase in TST of 21.98 min, a reduction in SOL of 14.65 min, and a reduction in WASO of 24.30 min, compared with inactive control at postintervention, with effects sustained at short-term follow-up. CBT-I is effective for the management of insomnia in cancer patients postintervention, with diminished effects in short-term follow-up. Group CBT-I is the preferred choice based on postintervention and short-term effects. The low quality of evidence and limited sample size demonstrate the need for robust evidence from high-quality, large-scale trials providing long-term follow-up data.

The Effects of Zentangle® on Affective Well-Being Among Adults: A Pilot Randomized Controlled Trial.

Zentangle® is a self-help art modality purported to have repetitive, mindful, and meditative qualities. It can be a cost-effective intervention, but its effect on affective well-being has been underresearched. To evaluate the immediate and 2-wk postintervention effects of Zentangle delivered by a certified Zentangle teacher on affective well-being in the general population. Two-armed parallel-groups pilot randomized controlled trial. Thirty-eight participants from a nonclinical population. Participants were randomized into the Zentangle group, which participated in a 2-hr Zentangle class and were encouraged to practice for 2 wk, or the waitlist control group. Participants learned basic Zentangle principles and drew two Zentangles under the teacher's instructions. The Positive and Negative Affect Schedule, 21-item Depression Anxiety Stress Scale, and Self-Compassion Scale-Short Form were used to assess positive and negative affect; depression, anxiety, and stress symptoms; and self-compassion. Significant reductions in negative affect were found in the Zentangle group compared with the waitlist control group at both immediate and 2-wk postintervention assessments (ds = 1.04 and 0.79, respectively, p < .001). Participants who practiced Zentangle for >80 min per week had a significant reduction in anxiety symptoms and an improvement in self-compassion (ds = 0.84 and 0.24, ps < .05 and .005, respectively). No significant between-groups difference was found for other measures. Our results shed light on the effects of Zentangle on improving affective well-being in the general population. With sufficient practice, Zentangle can also help improve self-compassion and reduce anxiety. What This Article Adds: The results of this study could provide information to determine whether Zentangle can be used as a tool in occupational therapy intervention to improve affective well-being.

A Randomized Control Trial on the Effects of MoBeGo, a Self-Monitoring App for Challenging Behavior

The purpose of this study was to examine the effects of MoBeGo, a mobile self-monitoring app, on the initial and sustained academic engagement and disruptive behavior of third- to eighth-grade students with challenging behavior. Student–teacher pairs ( N = 57) were randomly assigned to the treatment (MoBeGo) or control (business-as-usual) condition. We conducted systematic direct observation of students’ behavior throughout prebaseline, baseline, intervention, and postintervention conditions of the study. Multivariate multilevel models revealed differential improvement for the MoBeGo group in student outcomes (less disruptive behavior; more academic engagement) from baseline to intervention, as well as successful postintervention effects for disruptive behavior. Limitations, future directions, and implications for practice are discussed.

Hyperbaric Oxygen Therapy for Pain, Opioid Withdrawal, and Related Symptoms: A Pilot Randomized Controlled Trial

BackgroundPain, drug cravings, and opioid withdrawal symptoms can interfere with substance use disorder or opioid tapering treatment goals. AimThis pilot study investigated the feasibility of a protocol designed to test opioid withdrawal symptom relief relative to a sham condition after two consecutive days of hyperbaric oxygen therapy (HBOT) for adults prescribed daily methadone for opioid use disorder. MethodUsing a double-blind protocol, eight adults were randomized to receive either a full 90-minute HBOT dose in a pressurized chamber with 100% oxygen at 2.0 atmospheres absolute (ATA) or a sham condition receiving 21% oxygen (equivalent to room air within the chamber) at a minimal pressure of ≤1.3 ATA. Measures included study retention, treatment satisfaction, and pre- and post-intervention effects for opioid withdrawal symptoms, drug cravings, pain intensity and interference, sleep quality, and mood. ResultsStudy retention and treatment satisfaction was high. All measurements improved more, on average, for participants receiving full-dose HBOT treatment than among participants receiving sham treatments except for clinically observed withdrawal symptoms. The largest positive effects were observed in measurements of pain intensity and drug craving. ConclusionsThese pilot results provide evidence to support a fully powered study of HBOT as a potential treatment adjunct for adults receiving methadone for opioid use disorder. Trends towards symptom improvements were detected from pre- to post-HBOT in the full treatment arm versus sham condition. More research into novel non-pharmacologic options to relieve distressing symptoms related to pain and opioid use disorder is essential to improve clinical outcomes.

Testing a New Protocol of Nature-Based Intervention to Enhance Well-Being: A Randomized Control Trial.

This study aims to test the associations of nature contact with multiple dimensions of psychological functioning. A total of 90 university employees were randomly assigned to spend their lunch breaks on (1) a 30-min structured protocol of nature contact and (2) a control group for 10 consecutive weekdays. Psychological distress, psychological well-being, and work-related psychological outcomes were assessed at baseline (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3). Mixed-design analyses of variance (ANOVA) were conducted. Overall, significant intervention effects were found in the structured protocol of nature contact on psychological distress, well-being outcomes, and work engagement (all p < 0.05), whereas the 3-month post-intervention effects were non-significant. Our study showed that nature-based activities during lunch breaks could enhance office workers’ mental health in general, but the effects could be short-lived, calling for regular nature-based programs in occupational settings.

Abstinence-contingent wage supplements to promote drug abstinence and employment: Post-intervention outcomes

BackgroundSubstance use disorder, unemployment, and poverty are interrelated problems that have not been addressed adequately by existing interventions. This study evaluated post-intervention effects of abstinence-contingent wage supplements on drug abstinence and employment. MethodsUnemployed adults enrolled in opioid agonist treatment were randomly assigned to an abstinence-contingent wage supplement group (n = 44) or a usual care control group (n = 47). All participants could work with an employment specialist throughout a 12-month intervention period. Those in the abstinence-contingent wage supplement group earned stipends for working with the employment specialist and, after gaining employment, abstinence-contingent wage supplements for working in their community job but had to provide opiate- and cocaine-negative urine samples to maximize pay. To assess post-intervention effects of abstinence-contingent wage supplements and compare those effects to during-intervention effects, we analyzed urine samples and self-reports every 3 months during the 12-month intervention and the 12-month post-intervention period. ResultsDuring the intervention, abstinence-contingent wage supplement participants provided significantly more opiate- and cocaine-negative urine samples than usual care control participants; abstinence-contingent wage supplement participants were also significantly more likely to become employed and live out of poverty than usual care participants during intervention. During the post-intervention period, the abstinence-contingent wage supplement and usual care control groups had similar rates of drug abstinence, similar levels of employment, and similar proportions living out of poverty. ConclusionsLong-term delivery of abstinence-contingent wage supplements can promote drug abstinence and employment, but many patients relapse to drug use and cease employment when wage supplements are discontinued.

Prenatal intervention program for Japanese first-time fathers to adapt to the paternal role: A mixed methods study.

This study aimed to develop a prenatal intervention program focused on the formation of paternal identity for adapting to the paternal role. The intervention program allowed participants to create a postpartum schedule using a uniquely developed paternity portfolio. Pre and postintervention effects were evaluated using a convergent design of mixed methods. This intervention effect was quantitatively evaluated between the two groups. To qualitatively examine the intervention's effects, participants were interviewed for effective prenatal education, and their paternal role behaviors were identified by the intervention. Details of actual postpartum paternal role behavior and effective prenatal education were collected. Obtained data were inductively analyzed and compared with those in the proposed prenatal intervention program. There were 10 pairs in the intervention group and 31 pairs in the control group. Intergroup comparison of evaluation data showed no significant difference. However, qualitative results clarified the effective nursing intervention, confirming the achievement of intervention goals by all participants. Intervention expressions were adjusted based on the results, and a revised prenatal intervention program was developed.

Physical education interventions improve the fundamental movement skills in kindergarten: a systematic review and meta-analysis

Fundamental motor skills (FMS) are the foundation for the development of advanced motor skills. To assess the effect of physical activity intervention on the promotion of FMS and explore the influencing factor of physical activity intervention on the development of FMS in preschool children. Trails with children aged 3-7yeas in kindergarten settings that applied physical activity intervention programs were included. We calculated the effects on overall FMS, locomotor skill and object control skill subscales (LMS and OCS) by weighted standardized mean differences using random-effects models. In this study, 23 trials involving 2258 preschoolers (aged 3.3-6.5years) were selected, including 7 high quality studies, 11 medium quality studies and 5 low quality studies. Analysis of the effects of physical activity intervention revealed significant differences among groups in favor of intervention group, FMS (SMD = 1.50, 95% CL [1.29, 1.71], I2 = 89.7%), locomotor skills (SMD = 1.56, 95% CL [1.38, 1.75], I2 = 59.2%), object control skills (SMD = 1.43, 95% CL [1.25, 1.61], I2 = 93.8%). Physical activity interventions can significantly improve FMS in healthy preschool aged children. However, we should be cautious due to the limited researches, low-quality evidence and immediate post-intervention effects without long-term follow-up.

Increasing cessation motivation and treatment engagement among smokers in pain: A pilot randomized controlled trial.

Tobacco smokers with co-occurring pain report greater difficulty quitting, face unique cessation challenges, and may benefit from targeted smoking interventions. We developed and tested a brief motivational intervention aimed at increasing knowledge of pain-smoking interrelations, motivation to quit, and cessation treatment engagement among smokers in pain. Nontreatment seeking daily cigarette smokers with chronic pain (N = 76, 57.9% women, 52.6% White) were randomized to the targeted or ask, advise, refer (AAR) intervention. The targeted intervention included personalized feedback and pain-smoking psychoeducation to help participants develop discrepancy between continued smoking and desired pain outcomes. At postintervention, the targeted intervention (vs. AAR) increased knowledge of pain-smoking interrelations and several indices of motivation to quit smoking (ps < .01). Participants who received the targeted intervention were also more likely to accept information about and report intention to engage evidence-based cessation treatments (ps < .05). Increased knowledge of pain-smoking interrelations mediated postintervention effects on motivation to quit and willingness to learn about treatments. At 1-month follow up, gains in knowledge of pain-smoking interrelations were maintained (p = .009). Participants who received the targeted intervention were more likely to report having subsequently engaged cessation treatment (p = .019), but this was not mediated by increased knowledge of pain-smoking interrelations. Smokers with chronic pain may benefit from targeted interventions that address smoking in the context of pain. Smokers in pain may become increasingly motivated to quit and engage cessation treatment as they become aware of how smoking may exacerbate their pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Payment for ecosystem services and motivational crowding: Experimental insights regarding the integration of plural values via non-monetary incentives

Incentives based on extrinsic motivations such as Payments for ecosystem Services (PES) could negatively affect intrinsic motivations (i.e., motivational crowding-out). This effect may be evidenced when conservation levels, after PES intervention, decline relative to those existing before PES implementation. However, still few experimental studies have assessed PES effects on motivations once economic incentives are missing. Moreover, experimental research still lacks insights on PES designs that may reduce the risk of motivational crowding-out. This paper aims to assess the post-intervention effects of integrating plural values via non-monetary incentives (i.e. environmental awareness, social recognition) into PES design. We conducted a lab-in-the-field experiment followed by a questionnaire involving 120 participants in rural Cali, Colombia. We use non-parametric and Differences in Differences regression analysis to show that integrating plural values (intrinsic and relational) via non-monetary incentives may have a long-lasting effect on conservation (motivational crowding-in) in comparison with a PES alone. We did not find strong evidence of PES motivational crowding-out. We conclude that PES effectiveness and equity-related outcomes could be fostered by integrating the multiple ways of knowing, relating and caring for Nature.