Impact Of Program Research Articles

Move out of the land: certification and migration in China

Abstract Motivated by the emphasis on securing property rights as an important tool for the efficient allocation of resources, including land and labour, we use three rounds of China Rural Household Panel Survey data to assess the impact of a land certification programme (LCP) on the labour and land allocation in rural China. We find that the LCP results in increased rural–urban migration, more active land rental markets, as well as higher household income and consumption in rural China. These effects vary with age and are larger for younger individuals and households with heads aged 50 years or younger. Improving property rights could be a central task for the Chinese government to tackle issues related to labour and land misallocation.

Assessing the impact of a video literacy program on emotional intelligence and resilience to extremism in primary school children

This research aimed to enhance emotional awareness and engender empathy among primary school students in Pakistan through education, ultimately fostering emotional regulation and preventing disruptive behaviors. While emotional intelligence (EI) is increasingly recognized as a vital component in counter-terrorism efforts, it is seldom emphasized by young primary school students. Research suggests that educational programs based on videos and cartoons can help children retain information effectively over time. Therefore, an educational program was designed around a video/animated cartoon series focusing on EI themes of developing empathy and emotional awareness. This program included teaching aids, worksheets, and activity-based learning. It was conducted using a mixed methods approach within a quasi-experimental design in two primary schools in Pakistan’s Rawalpindi/Islamabad region. Pre- and post-test assessments revealed that students initially lacked awareness of core EI concepts and had limited prior knowledge of empathy. However, significant improvements were observed in their post-test scores across all EI-related areas. The findings suggest that incorporating EI training into school curricula could help nurture emotional resilience and mitigate extremist tendencies among children in the future.

Characterizing Individuals Who Elect and Decline Opioid Overdose Education and Naloxone Distribution to Tailor Programs and Expand Impact.

In response to the opioid epidemic, federal agencies have stressed the importance of targeted naloxone distribution through avenues such as Opioid Overdose Education and Naloxone Distribution (OEND). OEND effectively reduces mortality by training laypersons to respond to overdose situations. Despite demonstrated effectiveness, OEND remains underutilized. This project aimed to characterize those who illicitly use opioids to determine avenues for future tailoring of OEND programs. Individuals who illicitly used opioids within the past 6 months were recruited via online social media. Participants completed an online questionnaire that assessed history of opioid use and were given the option to receive opioid overdose and naloxone administration training. Those who elected training (n = 111) and those who declined (n = 193) were compared on opioid use, severity of use, and overdose experiences. Participants (N = 304) were 47% male and 83% White. Tests of between group differences with measures of effect size were used for analyses. Those who elected training endorsed greater intravenous administration (χ2 = 4.18, P = 0.041, Cramer's V = 0.12). Individuals who declined training reported more frequent nonprescribed methadone use (χ2 = 7.51, P = 0.006, Cramer's V = 0.16), overdose hospitalizations (t(298) = 2.13, P = 0.034, Cohen's d = 0.26), and observed overdoses (t(300) = 3.01, P = 0.003, Cohen's d = 0.36). After adjusting for multiple comparisons, only the differences in nonprescribed methadone use and observed overdoses remained statistically significant. Individuals who declined training were more likely to report ever use of nonprescribed methadone and having witnessed others overdose. They may have had greater exposure to naloxone, hence decreasing perceived need for training. Understanding characteristics of those who elect and refuse training could inform structuring of programs and recruitment approaches.

Strengthening healthcare providers’ leadership capabilities, interprofessional collaboration, and systems thinking: a conceptualization of the Clinical Scholars program impact

BackgroundHealthcare provider leadership programs represent an intervention opportunity to support advancement of the national system of care and an evaluation of their program impacts is needed. Between 2016 and 2023, the Robert Wood Johnson Foundation (RWJF) funded Clinical Scholars (CS), a three-year equity-centered leadership training program for US healthcare providers. CS recruited participants (referred to as Fellows) in cohorts and engaged them as members of interprofessional teams to transform their careers and the health of their communities. The aim of this study was to evaluate Fellows’ perspectives on the success of CS, specifically the program elements and their importance for community well-being and sustainability.MethodsWe used the mixed methods group concept mapping (GCM) approach to evaluate Fellows’ perspectives on program success. First, we conducted the qualitative phases of brainstorming, sorting, and rating with Fellows. Secondly, we conducted the quantitative phases using multi-dimensional scaling and hierarchical cluster analysis and integrated the sorting and rating information from each Fellow to develop a series of concept maps. Finally, we conducted the interpretation phase to synthesize findings. Fellows (N = 177) across five cohorts were invited to participate in the study.ResultsFifty-seven Fellows (32%) completed one or more GCM phases. A conceptual map emerged, consisting of seven thematic clusters, which showed that program value could be attributed to the following elements: “Resources”, “Wicked Problem Impact Project (WPIP) Support”, “Curriculum”, “Thinking Bigger”, “Leadership Training”, “Networking”, and “Teamwork.” The pattern match showed that all seven clusters were highly rated by Fellows across the Community Well-being Impact and Sustainability domains.ConclusionStudy findings support the value of the RWJF-CS program strategy of long-term investment in the development of healthcare leaders with applied skills in interprofessional collaboration who will be prepared to continue addressing complex, multi-faceted challenges in the system of care.

A sleep promotion program for insufficient sleep among adolescents: a pilot feasibility randomized controlled trial.

To examine the feasibility, acceptability, and impact of a Sleep Promotion Program (SPP). This pilot trial randomized adolescents (13-15y) with insufficient sleep duration and irregular sleep timing to SPP-continuation (n=24; SPP in month 1, continuation treatment in month 2) or monitoring-SPP (n=20; monitoring in month 1, SPP in month 2). SPP included one clinician session and at-home delivery of web-based reports of each youth's sleep diary data with accompanying intervention questions that prompt youth to engage in sleep behavior change. Attrition rate primarily measured feasibility. Program satisfaction measured acceptability. Total sleep time (TST), sleep timing, and sleep timing regularity were measured via sleep diary at baseline, follow-up 1, and follow-up 2 (each ∼1 month apart). Linear mixed effects models compared treatment arms on changes in sleep from baseline to follow-up 1 (month 1). We also compared changes in sleep during month 1 to changes in sleep during month 2 among SPP-continuation participants. Attrition rate was 8.5%. 96.5% participants rated the quality of care received as good or excellent. In month 1, SPP-continuation youth showed a significantly greater increase in mean TST than monitoring-SPP youth (0.57 vs. -0.38 hours; contrast=0.95; CI=0.14, 1.76, p=0.024). SPP-continuation participants showed an increase in TST during month 1 (0.51h) but a decrease during month 2 (-0.74 h; contrast=-1.24, CI=-2.06, -0.42, p=0.005). No other significant effects were observed. SPP is highly feasible, acceptable, and associated with a significant increase in TST early in treatment. Registry: ClinicalTrials.gov; Name: Targeted Intervention for Insufficient Sleep among Typically-Developing Adolescents; Identifier: NCT04163003; URL: https://clinicaltrials.gov/ct2/show/NCT04163003.

Non-invasive Streptococcus pneumoniae infections are associated with different serotypes than invasive infections, Belgium, 2020 to 2023.

BackgroundDespite widely implemented pneumococcal vaccination programmes, Streptococcus pneumoniae remains a global risk for human health. Streptococcus pneumoniae can cause invasive (IPD) or non-invasive pneumococcal disease (NIPD). Surveillance is mainly focusing on IPD, assessing the full impact of pneumococcal vaccination programmes on pneumococcal disease is challenging.AimWe aimed to prospectively investigate serotype distribution and antimicrobial resistance (AMR) of S. pneumoniae isolates from patients with NIPD and compare with data on IPD isolates and with a 2007-2008 dataset on NIPD.MethodsBetween September 2020 and April 2023, we collected isolates and patient data from patients with NIPD from 23 clinical laboratories in Belgium. Capsular typing was performed by a validated Fourier-Transform Infrared spectroscopic method, and AMR was assessed with broth microdilution, using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints.ResultsWe received S. pneumoniae isolates from 1,008 patients with lower respiratory tract infections (n = 760), otitis media (n = 190) and sinusitis (n = 58). Serotype 3 was the most prevalent serotype among the NIPD isolates. Serotypes not included in the 20-valent pneumococcal conjugate vaccine (PCV20) were significantly more common among the NIPD than among the IPD isolates. Antimicrobial resistance levels were significantly higher among the NIPD isolates (n = 539; 2020-2022) compared with the IPD isolates (n = 2,344; 2021-2022). Resistance to several β-lactam antimicrobials had increased significantly compared with 15 years before.ConclusionsThe NIPD isolates were strongly associated with non-vaccine serotypes and with increased AMR levels. This underlines the importance of continued NIPD surveillance for informed policy making on vaccination programmes.

Effect of a Sensorimotor Training Program for Aerial Maneuvers in Junior Surfers

The purpose of this study was to examine the impact of a sensorimotor training program on maximum ankle dorsiflexion (ankle DF), coordination, dynamic balance and postural control, and lower-limb muscle power, in competitive junior surfers, and its relation to parameters of sensorimotor control required to perform aerial maneuvers. Twelve junior competitive surfers followed a 7-week sensorimotor training program, being assessed pre- and post-program with the knee-to-wall test (KW), Y-Balance test—lower quarter (YBT-LQ), and the countermovement jump test (CMJ). Post-training assessment revealed positive effects on the KW (ankle DF) distance, which increased approximately 2 cm (p < 0.001) for both ankles, and all scores for the YTB-LQ (coordination, dynamic balance, and postural control) variables increased, being significant (p < 0.005) for some reach distances (YBT-LQ—Anterior Left, YBT-LQ—Postero-medial Left, and YTB-LQ Anterior Right). YBT-LQ Anterior Reach Asymmetry also improved by decreasing 1.62 cm (p < 0.001) and the CMJ height (lower limb muscle power) increased 2.89 cm (p < 0.001). The training program proved to effectively enhance parameters of physical performance for this sample, including ankle DF, coordination, dynamic balance, postural control, and lower limb muscle power. This tailored-made task approach can help to optimize surfing performance capabilities and contribute to reducing the risk of injuries while performing aerials.

Impact of various training programs on lower limb biomechanics in adolescent Latin dancers

Latin dance attracts many young dancers globally. While these adolescents exhibit flexibility and imitation skills, their muscular strength and neuromuscular control often fall short, making complex movements challenging. Thus, incorporating functional training methods is essential for enhancing performance and reducing injury risk. This study, a total of 30 adolescent female Latin dancers aged 12–14 years with at least one year of training and competition experience were recruited for this study and randomly divided into two groups: One group of 15 students (average height 154.37 ± 3.82 cm, average weight 45.31 ± 5.29 kg) received traditional Latin dance training, and the other group of 15 students (15 students average height 154.73 ± 4.28 cm, average weight 44.63 ± 4.37 kg) received traditional Latin dance training and based on traditional Latin dance training, functional exercise was carried out for 12 weeks. A Vicon motion capture system, force platform, and electromyography were used to collect biomechanical data. Paired samples t-tests assessed significant differences between groups pre- and post-intervention. The experimental group showed significant improvements post-intervention: in the sagittal plane, ankle joint angles improved by 14.01% to 52.21% (p < 0.001); in the coronal plane, knee joint angles increased by 0% to 31.21% (p < 0.001) and 66.67% to 100% (p < 0.001); in the horizontal plane, hip joint angles improved by 4.99% to 76.00% (p < 0.001). Muscle activation showed significant increases in gastrocnemius lateral (p = 0.016), gluteus maximus (p = 0.001), tibialis anterior (p = 0.014), and rectus femoris (p < 0.001). Functional training enhances joint flexibility, muscle activation, balance, and overall performance in adolescent Latin dancers. Integrating functional training into regular routines can improve athletic performance and lower injury risk, informing the development of targeted training programs.

Social Assistance and Family Functioning: A Study on the Family Functions of Individuals Benefiting from Social and Economic Support Services

Social assistance can be defined as programs, policies, or institutions aimed at preventing, reducing, or eliminating poverty. Through out history, various social assistance programs have been implemented to address poverty. In Turkey, the Ministry of Family and Social Services (MFSS) and various organizations provide social assistance. A notable service offered by ASHB is the Social and Economic Support (SES) program, which holds significant importance in supporting children in need of protection with in families. In a study evaluating the impact of the SES program on family functions, a socio-demographic information form and the Family Assessment Scale were administered to 194 families benefiting from the SES program through the Karadeniz Ereğli Social Services Center Directorate. The study aimed to determine if there were significant statistical relationships between the duration of receiving SES services (in months) and various subscales of the assessment tools. Statistical analyses, including t-tests to investigate differences between means of two data groups and ANOVA tests to explore differences among more than two data groups, were conducted. Post-hoc analyses were performed to identify specific group differences when significant differences emerged from the ANOVA analysis.The results indicated that an increase in the duration of SES service utilization led to improvements in problem-solving, communication, roles, behavior control, and over all family functions. Therefore, the duration of SES service utilization appears to positively influence family functions.

Racial Disparities in a Teen Pregnancy Prevention Program: Abstinence-Only Versus a Comprehensive Sexuality Education Program.

Despite overall declines in risky teen sexual activity, racial and ethnic disparities persist. This study compared abstinence-only and comprehensive teen pregnancy prevention (TPP) programs to explore the effects of the programs on teen sexual activity-related outcomes that may differ by race/ethnicity. Program evaluation data were collected from 7th-grade students in comprehensive (N = 3244) and abstinence-only (N = 3172) TPP programs. Differences between outcomes by TPP program were analyzed using chi-square tests and logistic regression for each racial/ethnic group. Black and Hispanic students were significantly less likely to indicate positive attitudes, intentions, and behaviors at baseline. Only white students significantly improved in both programs from pre- to post-assessment. Native American students in the abstinence-only program were significantly less likely than Native American students in the comprehensive sexuality programming to improve from pre- to post-assessment regarding male sexuality, refusal skills, sex and teen norms, and sexual abstinence. The findings suggest that youth of diverse racial/ethnic backgrounds do not enter TPP programs with similar attitudes, intentions, or behavior regarding appropriate sexual behavior and that the impact of such programs also may vary by race and ethnicity.

Maternal and perinatal death surveillance and response in Bangladesh: A case study on measuring impact through health information systems

The health sector in Bangladesh is thriving, and the Maternal and Perinatal Death Surveillance and Response (MPDSR) program has been in place to investigate the causes of maternal and perinatal death. This study aimed to investigate the availability of information systems for measuring the status of an MPDSR program and the planning process and actions developed based on real-time information. This study delved into innovative information systems that can be used to monitor and measure the impact of health programs. The study included both the primary and secondary data. A total of six key informant interviews were conducted to explore the enablers and strengths of information systems. Secondary data were collected from government websites and MPDSR action plans. This study highlights the potential and challenges of governmental health information systems in notifying maternal and neonatal deaths. While the current notification rates are not up to national standards, it is encouraging to see health managers develop action plans and address this issue. The MPDSR information system is a valuable tool to help health managers measure changes in maternal and perinatal mortality rates and design locally targeted interventions. However, several obstacles must be addressed, such as insufficient data, lack of monitoring, and irregularities in MPDSR review meetings. By finding ways to overcome these challenges, we can unlock the full potential of MPDSR and improve maternal and neonatal health outcomes. The success of an MPDSR program relies on how the information is utilized to take action and measure the outcome. Advanced information systems, such as health dashboards, scorecards, and administrative data, can play a vital role in measuring the progress and impact of a program. The primary challenge lies in capturing all deaths, including their causes, and having the capacity to analyze the data effectively to develop action plans for health managers.

Impact of a 20-Week Resistance Training Program on the Force–Velocity Profile in Novice Lifters Using Isokinetic Two-Point Testing

Objectives: This study aimed to assess the impact of a 20-week resistance training program on force–velocity (F-V) parameters using an isokinetic two-point method and comparing one-repetition maximum (1-RM) methods in novice lifters. Methods: Previously untrained individuals completed a supervised, three-session weekly resistance training program involving concentric, eccentric, and isometric phases, repeated every 2 to 4 weeks. Isokinetic dynamometry measured the strength of elbow flexors/extensors at 60°/s and 150°/s, and knee flexors/extensors at 60°/s and 240°/s at Baseline, 3 months, and 5 months. F-V parameters, including maximal theoretical force (F0) and the F-V slope, were calculated. Participants also performed 1-RM tests for the upper and lower limbs. Repeated measures ANOVA with effect size (η2 > 0.14 as large) was used to analyze changes in F-V parameters and repeated measures correlation was used to test their association with 1-RM outcomes. Results: Eighteen male participants (22.0 ± 3.4 years) were analyzed. F0 significantly increased for all muscle groups (η2 = 0.423 to 0.883) except elbow flexors. F-V slope significantly decreased (steeper) for knee extensors and flexors (η2 = 0.348 to 0.695). Knee extensors showed greater F0 gains and steeper F-V slopes than flexors (η2 = 0.398 to 0.686). F0 gains were associated with 1-RM changes (r = 0.38 to 0.83), while F-V slope changes correlated only with lower limb 1-RM (r = −0.37 to −0.68). Conclusions: The 20-week resistance training program significantly increased F0 and shifted the F-V profile towards a more “force-oriented” state in knee muscles. These changes correlated with improved 1-RM performance. Future studies should include longer follow-ups and control groups.

Quantifying the Impact of Career Preparedness Programs for Saudi Students with Disabilities

This study examines the impact of job readiness programs on Saudi students with impairments, utilizing a quantitative research methodology. Using a purposive selection strategy, people were selected, and a standardized survey questionnaire was used to gather data on program participation, perceived skill development, cultural factors, and employment outcomes. Descriptive data, t-tests, regression analyses, correlation analyses, and ANCOVA have been employed for data analysis. The findings track strong relationships between application components, perceived skill gain, and employment outcomes. Regression analyses indicate that both the extent of program engagement and the perceived learning of skills significantly impact employment outcomes. The ANCOVA analysis suggests that application involvement has a greater influence on employment outcomes compared to cultural factors, however, both factors contribute to the overall model. Suggestions entail addressing cultural sensitivity in program design, prolonging program durations, and cultivating a supportive environment for inclusive training and career advancement. The purpose of these insights is to provide information for improving career readiness programs for students with impairments in Saudi Arabia. Received: 9 June 2024 / Accepted: 28 October 2024 / Published: 05 November 2024

Developing the ACG Leadership Pipeline: Impact of the ACG Institute Leadership Programs 2018-2023.

Developing the ACG Leadership Pipeline: Impact of the ACG Institute Leadership Programs 2018-2023.

Making space for grief: The impact of remembrance programs for pediatric healthcare providers.

While caring for seriously ill children is a rewarding experience, pediatric healthcare providers may experience sadness and emotional distress when their patient dies. These feelings, particularly when not addressed, can lead to negative health and occupational outcomes. Remembrance practices can provide a safe space for staff to process their grief. This study explored pediatric healthcare providers' perceptions of an annual Pediatric Remembrance Ceremony (PRC) and a quarterly program, Good Grief and Chocolate at Noon (GGCN), to learn what components of the programs were considered meaningful and the personal impact on those who attended. The programs pivoted to a virtual platform during the COVID-19 pandemic, and the study also assessed providers' perspectives of attending the programs virtually. A 19 multiple choice survey instrument was designed, reviewed, piloted, revised, and re-piloted by an interdisciplinary bereavement committee prior to administration. The survey included 2 open-ended questions, inviting additional insights into personal impact and future directions for remembrance programs. The survey was administered on an encrypted online platform. Components of the PRC respondents most valued included the opportunity for staff to choose a name of a patient they cared for and to light a candle for that patient as their name is read. Those who participated in GGCN found story sharing helpful, along with having a speaker address a topic around loss and grief during the second half of the session. Both programs provided reflection, solidarity, and memorialization. Most respondents prefer having both in-person and virtual options. Healthcare providers are affected by the death of the children they care for and value opportunities provided to join colleagues in remembering their patients. The findings underscore the value of remembrance programs in supporting bereaved staff.

Exploring the impact of a clinical extern program on readiness to practice.

The COVID-19 pandemic created an increased demand for healthcare professionals across all healthcare sectors globally. Attrition, retirement, delayed graduations, and sick leaves resulted in an inadequate supply of knowledgeable, skilled, and experienced nurses to care for hospitalized patients and help address hospital capacity pressures. In response to this health human resource crisis in Canada, the Ontario Ministry of Health offered hospitals funding to support the employment of Clinical Externs (CEs), that is, students in nursing, respiratory therapy, physiotherapy, occupational therapy medicine, and paramedicine, hired to work as unregulated staff, alongside an inter-professional team. This mixed-methods study evaluated the CE program that was implemented in one large academic hospital. The primary aim was to identify the outcomes of the clinical extern program from the perspectives of CEs, CE coordinators, and clinical leaders. Findings indicate the clinical extern program reinforces student confidence and supports their transition to formal nursing and respiratory therapy roles.

Outcome Domains of Professional Doctorates in Nursing: An International Three-Phase Exploratory Study.

Professional Doctorate Programmes (PDP) in nursing continue to develop across many countries. However, there is a lack of evidence demonstrating the impact on nurses who graduate from these programmes and the outcomes they deliver. This exploratory study aims to identify graduate outcome domains that can be applied internationally to evaluate professional doctorate programmes in nursing. Underpinned by Kim's theory of knowledge development in nursing, this innovative exploratory study was carried out in three phases: (1) a scoping review of literature published between 1 January 2000 and 1 July 2023, guided by the methodology developed by Arksey and O'Malley; (2) a document analysis of the graduate outcomes of three different universities' Professional Doctorate Programmes in Nursing and (3) a thematic analysis and coalescence of the findings from the initial two study phases. A scoping review revealed three patterns in the literature related to graduate outcomes: personal transformation, critical self-awareness and bridging the theory-practice divide. An analysis of three universities' Professional Doctorate Programmes revealed insights into documented graduate outcomes. The third and final research phase identified five graduate outcome domains: Personal achievement, critical self-awareness and professional identity, professional citizenship, discipline, research and information literacy and community-based academic practice. The impact of Professional Doctorate Programmes in nursing has traditionally lacked consensus and clarity. However, this research has led to the identification of graduate outcome domains that offer valuable insights for establishing new professional doctoral programmes and conducting meaningful evaluations of the outcomes of existing PDP and their graduates globally. This exploratory study establishes five graduate outcome domains for evaluating the effectiveness of PDP in nursing internationally. These domains offer valuable benchmarks for the development and assessment of such nursing programmes globally. Not applicable.

Deradicalization Through Multicultural Islamic Religious Education at The Islamic University

In the context of preventing radicalism, it is important to research educational institutions that have implemented multicultural Islamic education. This article explains how deradicalization is pursued through Multicultural Islamic Education at Universitas Islam Malang (UNISMA. This research uses a qualitative method with a phenomenological approach to understand the role of Islamic religious education in shaping students' multicultural attitudes. Data were collected through observations, interviews with 15 alumni from three cohorts, and documentation, focusing on the integration of multiculturalism concepts in the course materials. The findings indicate that the Multicultural PAI doctoral program at UNISMA significantly contributes to preventing radicalism by promoting tolerance and inclusive religious education. The program encompasses both theological and socio-cultural aspects, which help transform students' mindsets to become more open and reinforce the values of Bhinneka Tunggal Ika and Pancasila within the framework of Islamic education. The curriculum serves as a deradicalization tool by deepening the understanding of diversity and encouraging positive interactions within and between religious communities. However, its effectiveness is influenced by students' subjective factors, such as their attitudes, and external factors like the sociopolitical context. Further research is needed to assess the program's long-term impact and refine the curriculum based on student feedback.

Exploring the effect of diet programs on the behavior of Sudanese children with autism and the prevalence and association of gastrointestinal symptoms: a multi-center cross-sectional study.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social difficulties, speech and nonverbal communication issues, and restricted behaviors. Nutritional issues, such as food allergies and intolerances, can affect children with ASD. This study aimed to evaluate the impact of diet programs on ASD behavior and gastrointestinal symptoms, which would be considered as a starting point to increase the family's knowledge about how to practice healthy and suitable dieting for their children. The study was a cross-sectional observational study on 45 children with an autism spectrum disorder in four centers aged 2-18 in Khartoum state. Data was collected through an interview questionnaire, which included sociodemographic, diet, gastrointestinal, and behavioral assessments. The data was analyzed using SPSS to find the correlation between the various variables. Independent t-test, Analysis of Variance, and Mann-Whitney test were used in univariant analysis to assess the association between study variables, while multiple linear regression was used in multivariant analysis for the same purpose. The study involved a large number of children with autism spectrum disorder (ASD), with 80% being male and 73.3% being school-aged. Most had parents as guardians and 71.1% were in intermediate financial status. About 20% were overweight or obese, and 57.8% did not have a specific diet program. Food selectivity was prevalent, with 22.7% having allergies to milk and wheat. ASD children experienced vomiting, gastric reflux, abdominal pain, and changes in stool characteristics. A significant link was found between financial status, behavioral status and gastrointestinal changes. High financial status was significantly different from intermediate and low statuses based on behavioral changes. However, no significant association was found in multivariant analysis. The study found that ASD children generally have good nutritional health, with a higher degree of dietary selection. The financial status of guardians significantly influenced behavioral and gastrointestinal changes in the children. Further interventional studies are recommended to assess the direct impact of diet programs on these symptoms.

The impact of a lifestyle behaviour change program on healthcare costs: Quasi-experimental real-world evidence from an open-access mobile health app in the Netherlands

ObjectiveRecognizing the substantial role of modifiable risk factors such as physical inactivity, unhealthy diets, and substance use in driving global healthcare expenses, this study aims to assess the impact of a lifestyle behaviour change mobile health (mHealth) app on healthcare costs within a real-world setting. MethodsEmploying a difference-in-difference approach, this research compared healthcare costs between users of an mHealth app (treatment group) and a propensity score-matched control group of non-users. The study included data from 15,506 participants in the Netherlands, covering healthcare cost records collected from 2015 to 2019. ResultsThe implementation of the mHealth app was linked to a steady reduction in healthcare costs, achieving a 4.9 % decrease (β=−0.05,95%CI:−0.10to0.00) during the first year following the program's implementation, and a further 5.3 % decrease (β=−0.05,95%CI:−0.10to−0.00) in the second year. This healthcare costs reduction is associated with lower expenses for general practitioner services as well as diminished specialist visits. Additionally, increased app use led to further cost reductions, with frequency of use proving more important than intensity. ConclusionsThis study demonstrates that a behaviour change mHealth app is linked to significant reductions in healthcare costs, with more frequent and intense use leading to greater savings. Given their relatively low cost and ability to reach diverse population groups, such apps not only enhance individual health outcomes but can also serve as effective policy tools for large-scale health promotion, supporting broader societal health improvements.