Pre-post Pilot Study Research Articles

Mobile App (WHEELS) to Promote a Healthy Lifestyle in Wheelchair Users With Spinal Cord Injury or Lower Limb Amputation: Usability and Feasibility Study.

BackgroundMaintaining a healthy lifestyle is important for wheelchair users’ well-being, as it can have a major impact on their daily functioning. Mobile health (mHealth) apps can support a healthy lifestyle; however, these apps are not necessarily suitable for wheelchair users with spinal cord injury or lower limb amputation. Therefore, a new mHealth app (WHEELS) was developed to promote a healthy lifestyle for this population.ObjectiveThe objectives of this study were to develop the WHEELS mHealth app, and explore its usability, feasibility, and effectiveness.MethodsThe WHEELS app was developed using the intervention mapping framework. Intervention goals were determined based on a needs assessment, after which behavior change strategies were selected to achieve these goals. These were applied in an app that was pretested on ease of use and satisfaction, followed by minor adjustments. Subsequently, a 12-week pre-post pilot study was performed to explore usability, feasibility, and effectiveness of the app. Participants received either a remote-guided or stand-alone intervention. Responses to semistructured interviews were analyzed using content analysis, and questionnaires (System Usability Score [SUS], and Usefulness, Satisfaction, and Ease) were administered to investigate usability and feasibility. Effectiveness was determined by measuring outcomes on physical activity, nutrition, sleep quality (Pittsburgh Sleep Quality Index), body composition, and other secondary outcomes pre and post intervention, and by calculating effect sizes (Hedges g).ResultsSixteen behavior change strategies were built into an app to change the physical activity, dietary, sleep, and relaxation behaviors of wheelchair users. Of the 21 participants included in the pilot study, 14 participants completed the study. The interviews and questionnaires showed a varied user experience. Participants scored a mean of 58.6 (SD 25.2) on the SUS questionnaire, 5.4 (SD 3.1) on ease of use, 5.2 (SD 3.1) on satisfaction, and 5.9 (3.7) on ease of learning. Positive developments in body composition were found on waist circumference (P=.02, g=0.76), fat mass percentage (P=.004, g=0.97), and fat-free mass percentage (P=.004, g=0.97). Positive trends were found in body mass (P=.09, g=0.49), BMI (P=.07, g=0.53), daily grams of fat consumed (P=.07, g=0.56), and sleep quality score (P=.06, g=0.57).ConclusionsThe WHEELS mHealth app was successfully developed. The interview outcomes and usability scores are reasonable. Although there is room for improvement, the current app showed promising results and seems feasible to deploy on a larger scale.

Telerehabilitation for Post-Hospitalized COVID-19 Patients: A Proof-of-Concept Study During a Pandemic.

PurposeTelerehabilitation could prevent sequelae from COVID-19. We aimed to assess the feasibility of telerehabilitation; describe pulmonary and functional profiles of COVID-19 patients; and explore the effect of telerehabilitation on improving pulmonary symptoms and quality of life.MethodsWe conducted a pre-experimental, pre-post pilot study. We recruited COVID-19 patients who had returned home following hospitalization. The intervention included eight weeks of supervised physiotherapy sessions. We documented technological issues, success of recruitment strategies, and participants' attendance to supervised sessions. We measured the impact of pulmonary symptoms on quality of life and functional health.ResultsWe scheduled 64 supervised sessions with seven participants with few technological issues. Initial scores showed that pulmonary symptoms moderately to highly impacted quality of life. At eight weeks, all patients had improved from 10 to 45 points on the EuroQol-Visual Analog Scale (EQ-VAS) instrument, indicating clinical significance.ConclusionWe developed and administered a telerehabilitation intervention during a global pandemic that targets key symptoms of the relevant disease.

The impact of an additional nurse assistant during evening shifts on nurses' perceptions of job demands, job resources and well-being.

AimWorkloads and other job demands jeopardize nurses’ well‐being, especially during evening shifts when there are less resources than during the day. The current study aims to shed light on how the addition of a nurse assistant to ward staffing during evening shifts has an impact on nurses’ perceptions of job demands, job resources, and well‐being.DesignWe performed a pre‐post pilot study, whereby we compared nurses’ perceptions of job demands, job resources, and well‐being before and after the addition of a nurse assistant to ward staffing during evening shifts.MethodsAll nurses at the ward of a top‐clinical hospital (N = 28) completed a baseline and follow‐up survey including validated measures on job demands (workload and physical demands), job resources (autonomy and task clarity), and well‐being (recovery from work and sleep problems).ResultsCompared with baseline, nurses reported fewer job demands (lower workloads and fewer physical demands) and sleep problems at follow‐up. No statistically significant changes in job resources (autonomy and task clarity) and recovery difficulties were found.ConclusionsWe found preliminary evidence that the addition of a nurse assistant during evening shifts could reduce workloads, physical demands, and sleep problems among nurses.ImpactThis study highlighted that heavy job demands and sleep problems associated with evening shifts may be addressed by adding a nurse assistant to the nursing team. Future studies with larger samples and a control group are needed to provide better estimates of the magnitude of the beneficial effects and of the cost‐effectiveness of an intervention of this kind.

Laryngeal Dysfunction in Severe Asthma: A Cross-Sectional Observational Study

Laryngeal disorders can contribute to disease burden in severe asthma yet the nature of laryngeal disorders in severe asthma is poorly understood. The aim of this study was to examine laryngeal function in patients with severe asthma. A cross-sectional observational study involving 97 participants compared laryngeal function in patients with severe asthma (n= 53) with patients with laryngeal disorders of vocal cord dysfunction/inducible laryngeal obstruction (n= 16) and muscle tension dysphonia (n= 14), and with healthy controls (n= 13). A pre-post pilot study of speech pathology intervention for laryngeal symptoms was then provided to 11 participants with severe asthma and laryngeal dysfunction. Laryngeal dysfunction was common in severe asthma. The majority of participants with severe asthma (87%) had laryngeal dysfunction, which affected respiration, phonation, or both. Three distinct patterns of laryngeal dysfunction in severe asthma were identified: (1) phonatory laryngeal dysfunction, (2) respiratory laryngeal dysfunction, and (3) combined laryngeal dysfunction. Laryngeal hypersensitivity and impaired voice measures were common in severe asthma. Patient-reported outcome measures improved after therapy, and laryngeal dysfunction improved in 7 (64%) participants. Laryngeal dysfunction affects respiration and phonation in severe asthma. It requires identification and treatment to minimize its impact on asthma symptoms.

Short-term aerobic training improves heart rate variability in men living with HIV: a pre-post pilot study

Background Heart rate variability (HRV) a feasible predictor of prognosis in cardiovascular outcomes shown to be reduced in people living with HIV (PLWH). Objective This study sought to understand the effects of short-term aerobic training (AT) on the resting HRV and endothelial function in this population. Methods PLWH performed 24 sessions of AT protocol. The protocol consists of 40 min of treadmill (60 to 80% of the VO2max), 3 times per week, for 8 weeks. HRV (standard deviation of all normal RR intervals - SDNN; root mean square of the successive differences - rMSSD; low frequency - LF; high frequency - HF; LF:HF ratio) and endothelial function parameters were evaluated by EndoPAT system pre and post intervention. Results 7 men, the median age of the sample was 49 years (range, 38–68 years), completed the protocol. AT improved resting HRV parameters: SDNN (p = 0.02, power analysis (PA) 0.54), rMSSD (p = 0.02, PA = 0.99), LF (p = 0.02, PA = 0.85). HF, LF:HF ratio and endothelial function parameters showed no changes. Conclusions The results suggest the short-term AT may improve HRV in men living with HIV.

Walking endurance, muscle oxygen extraction, and perceived fatigability after overground locomotor training in incomplete spinal cord injury: A pilot study

Objective: The purpose of this study was to examine the effects of overground locomotor training (OLT) on walking endurance and gastrocnemius oxygen extraction in people with chronic cervical motor-incomplete spinal cord injury (SCI). Design: Prospective single-arm pre–post pilot study. Setting: Human Performance Research Laboratory. Participants: Adult men with traumatic chronic cervical SCI (n = 6; age = 30.8 ± 12.5). Intervention: Twenty-four sessions of structured OLT. Outcome measures: Walking endurance was determined during a constant work-rate time-to-exhaustion treadmill test. Normalized perceived fatigability was calculated by dividing subjective ratings of tiredness by walking time. Cardiorespiratory outcomes and muscle oxygen extraction were analyzed using breath-by-breath gas-exchange and near-infrared spectroscopy. Results: OLT resulted in large effects on walking endurance (1232 ± 446 s vs 1645 ± 255 s; d = 1.1; P = 0.045) and normalized perceived fatigability (5.3 ± 1.5 a.u. vs 3.6 ± 0.9 a.u.; d = 1.3; P = 0.033). Small-to-medium effects on absolute (2.8 ± 2.5 a.u. vs 4.2 ± 3.5 a.u.; d = 0.42; P = 0.035) and isotime (2.8 ± 2.5 a.u. vs 3.8 ± 3.0 a.u.; d = 0.33; P = 0.023) muscle oxygen extraction were also observed after OLT. Conclusion: These findings provide preliminary data supporting the potential for improved walking endurance, enhanced muscle O2 extraction, and reduced perceived fatigability in people with chronic cervical motor-incomplete SCI following the OLT program described in this study.

O28 Utilization of a Teaching Kitchen Within a Nutrition Course to Reduce Food Insecurity Among College Students

Background Food insecurity among college students in the United States is high. Inclusion of teaching kitchens at the college level may enhance food security, but evidence of its potential impact is limited. Objective To evaluate whether a college course utilizing a teaching kitchen to teach basic nutrition concepts and cooking skills affected students’ food security. Study Design, Setting, Participants We used a pre-post pilot study design to assess whether participation in a semester-long nutrition course for undergraduate students at a public university reduced food insecurity. Course content included basic nutrition and cooking concepts, meal planning, food safety, and food budgeting. Students attended a faculty-led weekly 50-minute lecture followed by a 2-hour cooking class in a 9-station teaching kitchen on campus. This pilot study was implemented for 5 semesters. Measurable Outcome/Analysis Students completed an online questionnaire before and after taking the class. Past-month food security was assessed using the USDA six-item module where higher scores indicate food insecurity. We also measured attitudes and perceived self-efficacy in cooking abilities and eating more fruits, vegetables, and whole grains, and self-reported intake of these food groups. Descriptive statistics were used to describe the sample and outcome variables. The McNemmar's test (categorical variables) and paired t-test (continuous variables) were used to compare pre- and post-test data. Results A total of 216 students enrolled in the course, and 161 completed the pre and post questionnaire. Before the class, 48% were food secure and 52% were food insecure. After the class, food security increased to 70%, while food insecurity decreased to 30% (P Conclusion Including a teaching kitchen within a nutrition college class may enhance food security among students. Future research including a comparison group could ascertain causality. Funding None.

Improving the Wellbeing of Female Prisoners via Psychological Skills Training: A Feasibility Study.

Prisoners display significantly higher rates of mental disorders and lower mental wellbeing than the general population. The integration of positive psychological interventions in offender supervision has received recent advocacy. The aim of the current pre-post pilot study was to determine the short-term effects of group-based resilience training on mental health outcomes for female offenders and explore intervention acceptability. Offenders (n = 24) self-selected to partake in a multi-component psychological skill program based on positive psychology, cognitive-behavioural therapy, and mindfulness-based activities. The training was taught in nine sessions of 1.5 hr each. Baseline and follow-up measurements of mental wellbeing and psychological distress were collected and focus groups conducted to investigate participants' experiences, acceptability, and appropriateness of the training. Moderate to large effect sizes indicating significant improvements were observed for wellbeing, g = 0.75 and distress, g = 0.56. Training was well received by participants and staff and was delivered feasibly within the prison context. The results are encouraging, and a future well-powered study using a rigorous controlled design is warranted.

Effects of mechanical perturbation gait training on gait and balance function in patients with stroke: A pre-post research study

Patients with stroke (PwS) demonstrate impaired gait and balance, and asymmetric gait, placing them at high risk of falls. We aimed to investigate the effects of a single training session that included mechanical external perturbation which resists forward movement of the paretic leg during its swing phase of walking on gait and balance in PwS. In a pre-post pilot study, gait asymmetry and balance function were assessed in 22 first-event chronic PwS (i.e., unilateral hemiparesis). PwS underwent tests during baseline and one week later, after participating in a single training session that resisted forward stepping during the swing phase of walking with a device secured around the patient's waist and connected diagonally to the patient’s foot by a tension cord. Ground reaction forces and center of pressure were sampled during treadmill gait to assess step length asymmetry. Performance-oriented mobility assessment (POMA), a two-minute walk test (2MWT), and the voluntary step execution test were also measured. We found no significant improvement in step length asymmetry. However, POMA scores, as well as voluntary step execution tests improved with a moderate effect size. It seems that applying diagonal resistance force to the swinging leg resulted in insufficient horizontal force. However, the improvement in the preparation phase, i.e., better weight-bearing abilities during the voluntary stepping, may be due to the compression force applied to the lower limb joints thus providing proprioceptive training. This suggests that proprioceptive training may improve gait performance in stroke patients in a very short training period.

Impact of protocolized diuresis for de-resuscitation in the intensive care unit

ObjectiveAdministration of diuretics has been shown to assist fluid management and improve clinical outcomes in the critically ill post-shock resolution. Current guidelines have not yet included standardization or guidance for diuretic-based de-resuscitation in critically ill patients. This study aimed to evaluate the impact of a multi-disciplinary protocol for diuresis-guided de-resuscitation in the critically ill.MethodsThis was a pre-post single-center pilot study within the medical intensive care unit (ICU) of a large academic medical center. Adult patients admitted to the Medical ICU receiving mechanical ventilation with either (1) clinical signs of volume overload via chest radiography or physical exam or (2) any cumulative fluid balance ≥ 0 mL since hospital admission were eligible for inclusion. Patients received diuresis per clinician discretion for a 2-year period (historical control) followed by a diuresis protocol for 1 year (intervention). Patients within the intervention group were matched in a 1:3 ratio with those from the historical cohort who met the study inclusion and exclusion criteria.ResultsA total of 364 patients were included, 91 in the protocol group and 273 receiving standard care. Protocolized diuresis was associated with a significant decrease in 72-h post-shock cumulative fluid balance [median, IQR − 2257 (− 5676–920) mL vs 265 (− 2283–3025) mL; p < 0.0001]. In-hospital mortality in the intervention group was lower compared to the historical group (5.5% vs 16.1%; p = 0.008) and higher ICU-free days (p = 0.03). However, no statistically significant difference was found in ventilator-free days, and increased rates of hypernatremia and hypokalemia were demonstrated.ConclusionsThis study showed that a protocol for diuresis for de-resuscitation can significantly improve 72-h post-shock fluid balance with potential benefit on clinical outcomes.

A topical cell therapy approach for diabetic chronic ulcers: Effects of mesenchymal stromal cells associated with platelet-rich plasma.

Diabetic cutaneous ulcers are subjected to several physiological and biochemical defects, which contribute to wound chronicity and therapeutic failure. Platelet-rich plasma (PRP) has been used for stimulating tissue regeneration, and mesenchymal stromal cells (MSCs) have demonstrated therapeutic properties in all phases of skin regeneration in cell therapy studies. The objective of this study was to evaluate the therapeutic effects related to the use of a biomembrane composed of autologous MSCs and PRP on chronic wounds of diabetic patients (pre-post pilot study). Six diabetic patients with chronic wounds for more than 6months were subjected to adipose tissue collection for isolation of MSCs, blood collection for PRP preparation, and topical administration of a biomembrane of MSCs and PRP on each chronic wound. The statistical difference regarding the evolution of ulcers was calculated by means of paired t test. There was granulation tissue formation starting from 7days after topical application. Total re-epithelialization occurred in 5 of the 9 lesions treated, and the mean wound healing rate (WHR) was 74.55% (±32.55%) after 90days. No cicatricial hypertrophy or retraction was observed. Mesenchymal stromal cells topical therapy associated with PRP is well-tolerated and able to provide a reduction in ulcer area of diabetic chronic wounds.

A Novel Mobile Phone App Intervention With Phone Coaching to Reduce Symptoms of Depression in Survivors of Women's Cancer: Pre-Post Pilot Study.

BackgroundPsychological distress is a major issue among survivors of women’s cancer who face numerous barriers to accessing in-person mental health treatments. Mobile phone app–based interventions are scalable and have the potential to increase access to mental health care among survivors of women’s cancer worldwide.ObjectiveThis study aimed to evaluate the acceptability and preliminary efficacy of a novel app-based intervention with phone coaching in a sample of survivors of women’s cancer.MethodsIn a single-group, pre-post, 6-week pilot study in the United States, 28 survivors of women’s cancer used iCanThrive, a novel app intervention that teaches skills for coping with stress and enhancing well-being, with added phone coaching. The primary outcome was self-reported symptoms of depression (Center for Epidemiologic Studies Depression Scale). Emotional self-efficacy and sleep disruption were also assessed at baseline, 6-week postintervention, and 4 weeks after the intervention period. Feedback obtained at the end of the study focused on user experience of the intervention.ResultsThere were significant decreases in symptoms of depression and sleep disruption from baseline to postintervention. Sleep disruption remained significantly lower at 4-week postintervention compared with baseline. The iCanThrive app was launched a median of 20.5 times over the intervention period. The median length of use was 2.1 min. Of the individuals who initiated the intervention, 87% (20/23) completed the 6-week intervention.ConclusionsThis pilot study provides support for the acceptability and preliminary efficacy of the iCanThrive intervention. Future work should validate the intervention in a larger randomized controlled study. It is important to develop scalable interventions that meet the psychosocial needs of different cancer populations. The modular structure of the iCanThrive app and phone coaching could impact a large population of survivors of women’s cancer.

Supporting workforce practice change: protocol for a pilot study of a motivational interviewing virtual client software tool for health professionals

IntroductionMotivating behavioural change during client consultations is of crucial importance across all health professions to address the growing burden of chronic conditions. Yet health professionals often lack the skills and...

Fish oil reduces subclinical inflammation, insulin resistance, and atherogenic factors in overweight/obese type 2 diabetes mellitus patients: A pre-post pilot study

ObjectiveInsulin resistance-associated obesity and type 2 diabetes mellitus (T2DM) are commonly accompanied with metabolic lipid abnormalities and are characterized by hypertriglyceridemia and low HDL-c levels (atherogenic index plasma, AIP). The primary molecular mechanism that is known to cause insulin resistance is chronic low-grade inflammation. Considering that omega-3 fatty acid reduces subclinical inflammation, we hypothesized that fish oil could affect insulin resistance and AIP. Therefore, the present study evaluated the effects of fish oil supplementation on the inflammatory, insulin resistance, and atherogenic factors in overweight/obese T2DM patients. Research designs and methodsIn this study, we recruited 32 overweight and/or obese patients diagnosed with T2DM for over one year and who exhibited hypertriglyceridemia. These patients received fish oil supplementation (4.0 g/day) for eight weeks. Anthropometric and body composition measurements were obtained. In addition, blood samples were collected before and after omega-3 supplementation for the evaluation of lipid profile, glycemia, insulin, and inflammation. ResultsAs expected, patients showed reduction in the TNFα, IL-1β, and Il-6 levels after fish oil supplementation and showed improved insulin sensitivity (HOMA-IR) without observed alterations in anthropometric and body composition. These observations were followed by reduction in the levels of triglycerides and non-esterified fatty acids, increase in HDL cholesterol levels, and a significant reduction in triglycerides/HDL-c ratio, and total cholesterol/HDL-c ratio. ConclusionFish oil supplementation is effective in reducing the levels of proinflammatory cytokines, improving insulin resistance, and reducing atherogenic factors in overweight/obese and T2DM patients independent of weight loss.

The feasibility of using smartphone apps to manage self-harm and suicidal acts in adolescents admitted to an inpatient mental health ward.

ObjectiveThe aim of this study is to assess the feasibility (uptake, retention and adherence) and acceptability of a combination of smartphone apps to deliver a digitized safety plan, BeyondNow, and personalized management strategies, BlueIce, with adolescents discharged from a mental health inpatient ward following self-harm, suicidal ideation and/or behavior.MethodsParticipants in this pre-post pilot study included 20 adolescents between 13–18 years, presenting with self-harming or suicidal behaviors in an inpatient psychiatric ward at a tertiary pediatric hospital. Participants were familiarized with the apps and completed baseline measures prior to discharge. They used the apps for six weeks before completing the follow-up survey, which measured feasibility and acceptability of the apps, as well as suicide resilience.ResultsSeventeen participants completed the pilot. Most of the sample accessed both apps at least once, three accessed the BeyondNow safety plan five times or more, and six used the BlueIce toolbox five times or more. A total of 73.5% of the sample that experienced a crisis used at least one of the apps at least once. Forty seven percent felt that the apps would not keep them safe when in crisis, although almost all of the sample rated both apps as easy to use (94% for BeyondNow, and 82% for BlueIce). Medium to large effect sizes were also found with regard to improvements in suicide resilience.ConclusionBoth apps were found to be feasible and acceptable in this population, and easy to use, although no conclusions can be drawn regarding the clinical efficacy of the apps.

Time-restricted feeding improves markers of cardiometabolic health in physically active college-age men: a 4-week randomized pre-post pilot study

Time-restricted feeding (TRF) has been shown to improve body composition, blood lipids, and reduce markers of inflammation and oxidative stress. However, most of these studies come from rodent models and small human samples, and it is not clear if the benefits are dependent upon a caloric deficit, or the time restriction nature of TRF. Based off of previous research, we hypothesized that humans following an ad libitum TRF protocol would reduce caloric intake and this caloric deficit would be associated with greater improvements in cardiometabolic health including blood pressure, body composition, blood lipids, and markers of inflammation and antioxidant status compared to an isocaloric TRF protocol. The purpose of this study was to: (1) examine the impact of TRF on markers of cardio-metabolic health and antioxidant status and (2) determine if the adaptations from TRF would differ under ad libitum compared to isocaloric conditions. Twenty-three healthy men were randomized to either an ad libitum or isocaloric 16:8 (fasting: feeding) TRF protocol. A total of 22 men completed the 28-day TRF protocol (mean ± SD; age: 22 ± 2.5 yrs.; height: 178.4 ± 6.9 cm; weight: 90.3 ± 24 kg; BMI: 28.5 ± 8.3 kg/m2). Fasting blood samples were analyzed for glucose, lipids, as well as adiponectin, human growth hormone, insulin, cortisol, C-reactive protein, superoxide dismutase, total nitrate/nitrite, and glutathione. Time-restricted feeding in both groups was associated with significant (P < .05) reductions in body fat, blood pressure, and significant increases in adiponectin and HDL-c. No changes in caloric intake were detected. In summary, the results from this pilot study in metabolically healthy, active young men, suggest that TRF can improve markers of cardiometabolic health.

Delivery of a patient-friendly functioning report to improve patient-centeredness of dialysis care: a pilot study

BackgroundProvider recognition of level of functioning may be suboptimal in the dialysis setting, and this lack of recognition may lead to less patient-centered care. We aimed to assess whether delivery of an app-based, individualized functioning report would improve patients’ perceptions of patient-centeredness of care.MethodsIn this pre-post pilot study at three outpatient dialysis facilities in metropolitan Atlanta, an individualized functioning report—including information on physical performance, perceived physical functioning, and community mobility—was delivered to patients receiving hemodialysis (n = 43) and their providers. Qualitative and quantitative approaches were used to gather patient and provider feedback to develop and assess the report and app. Paired t test was used to test for differences in patient perception of patient-centeredness of care (PPPC) scores (range, 1 = most patient-centered to 4 = least patient-centered) 1 month after report delivery.ResultsDelivery of the reports to both patients and providers was not associated with a subsequent change in patients’ perceptions of patient-centeredness of their care (follow-up vs. baseline PPPC scores of 2.35 vs. 2.36; P > 0.9). However, patients and providers generally saw the potential of the report to improve the patient-centeredness of care and reacted positively to the individualized reports delivered in the pilot. Patients also reported willingness to undergo future assessments. However, while two-thirds of surveyed providers reported always or sometimes discussing the reports they received, most (98%) participating patients reported that no one on the dialysis care team had discussed the report with them within 1 month.ConclusionsPotential lack of fidelity to the intervention precludes definitive conclusions about effects of the report on patient-centeredness of care. The disconnect between patients’ and providers’ perceptions of discussions of the report warrants future study. However, this study introduces a novel, individualized, multi-domain functional report that is easily implemented in the setting of hemodialysis. Our pilot study provides guidance for improving its use both clinically and in future pragmatic research studies, both within and beyond the dialysis population.

An Italian pilot study of a psycho-social intervention to support family caregivers\u2019 engagement in taking care of patients with complex care needs: the Engage-in-Caring project

BackgroundThe raising of disability and chronic illness burden among European population is calling for a new paradigm of care, focused on primary health care interventions. Engage-In-Caring is a novel multicomponent intervention clearly dedicated to improve family caregiver engagement in the care of patients with complex care needs, by supporting them to develop a stronger consciousness of their role, needs and skills.MethodEngage-In-Caring intervention’s efficacy and feasibility have been evaluated through a single arm pre-post observational pilot study settled in Rome. A qualitative phase, consisting of literature analysis of caregivers’ unmet needs and a final revision from an experts’ group, led to the structuration of the intervention, following the Caregiver Health Engagement Model (CHE-Model). Afterwards, a quantitative phase allowed understanding the feasibility of the intervention through Kruskal-Wallis test on a sample of 47 caregivers.ResultsResults showed a reduction of the physical burden (Chi Squared = 6,483; p = .01) perceived by the caregivers and increase of the health literacy (Chi Squared = 3,560; p = .059) after the intervention.ConclusionsFeasibility tests on caregivers of patients with complex care needs are promising: this pilot study suggests a first effectiveness evidence, particularly concerning aspects related to burden perception and improvements in health literacy. Randomised controlled trials on larger samples are needed.

Smart Software Can Increase Sit-Stand Desk Transitions During Active Computer Use.

The objective use of table top adjustable sit–stand desks has yet to be determined, due to the lack of an effective digital evaluation method. The objective of this study was to evaluate the impact of computer prompt software on table top sit–stand desks to determine if there was a difference in the frequency of desk position changes. This five month, pre-post pilot study on 47 university staff members used a novel USB accelerometer sensor and computer software reminders to continuously record and prompt increases in desk usage to promote physical activity at the workstation. During the baseline phase (3 months), desk usage data were continuously recorded for all workers. Following the baseline, the results from a two-month intervention of personalized computer reminders doubled the number of desk position changes per work day from 1 desk position change every 2 work days to 1 change every work day. Furthermore, those who changed desk positions once or twice a day increased from 4% to 36% from baseline to intervention. Overall, the intervention was encouraging, but longer intervention studies are warranted to determine if the desk usage behavior change can be improved and sustained for years and whether that change results in health gains.

P67 Flint Kids Cook: Feasibility and Preliminary Effectiveness of a Cooking and Nutrition Education Program for Children

Background Programs that include cooking may be more effective in improving diet quality among children than nutrition education alone. Flint Kids Cook was created in October 2017 as a pilot cooking and nutrition program for children in Flint, Michigan. Unique in design, the program was co-facilitated by a chef and dietitian and offered inside a farmers’ market commercial kitchen. Objective To assess feasibility and preliminary effectiveness of Flint Kids Cook. Study Design, Settings, Participants This pre-post pilot study included six weekly sessions (90 minutes each) at a local farmers’ market. Children were recruited from partnering pediatric offices and community-based organizations in Flint. Sessions included 10-12 children (8-18 years) who actively prepared two dishes that highlighted a specific food group. The final session was a celebratory meal that children prepared for their families. Measurable Outcome/Analysis Feasibility was assessed using retention rates. To evaluate effectiveness, baseline and exit scores related to attitude towards cooking and cooking self-efficacy were compared using paired samples t-tests. Attitude towards cooking scores ranged from 6-30 (lower scores indicated a more positive cooking attitude) and cooking self-efficacy from 8-40 (lower scores reflected greater cooking self-efficacy). Results Of the 71 children who attended the program, the majority (73%) completed at least four sessions. Most participants (mean age 10.8 ± 2.3 years) were African American (86%) and Flint residents (78%). Approximately half were female (51%). Among the 51 children who completed assessments, significant improvements ( P = .012) were observed in mean attitude towards cooking scores from baseline (8.75 ± 2.89) to program exit (7.87 ± 2.46). Mean cooking self-efficacy scores also improved significantly ( P = .002) from baseline (13.75 ± 4.50) to program exit (11.53 ± 3.88). Conclusion Flint Kids Cook could be modeled in similar communities to engage children and promote positive changes in cooking attitudes and self-efficacy.