Efficacy Of Referral Research Articles

Preliminary Feasibility, Acceptability and Referral Efficacy of a Drop-In Dialectical Behavior Therapy (DBT) Skills Group to Promote Enrollment in Standard DBT Skills Group

Pretreatment interventions have been shown to increase treatment readiness, initiation, and participation in evidence-based treatments. To promote enrollment in an evidence-based Dialectical Behavior Therapy Skills Group (DBT; Linehan, 2015; Linehan et al., 2015), we developed a pretreatment Drop-In DBT Skills Group and evaluated the group’s feasibility, acceptability, and referral efficacy. Each session included a mindfulness practice and one of four introductory DBT skills. We assessed the Drop-In DBT Skill Group’s feasibility (clients attending ≥1 session), acceptability (clients attending ≥2 sessions), and referral efficacy (clients who sought referrals to the standard DBT Skills Group). In 8 months, 44 clients were referred to the Drop-In DBT Skills Group; 37 clients completed the screening process (84%). Of the 37 clients who responded to outreach, 32 attended ≥1 group or had already started the DBT Skills Group (86.5%; feasibility). Of the 32 clients who attended at least one group, 29 clients attended ≥2 Drop-In DBT Skills Groups or started the DBT Sills Group (90.6%; acceptability). Ultimately, 17 clients, including 13 DBT-ambivalent clients and 4 waitlisted clients, requested a referral to the standard DBT Skills Group. The Drop-In DBT Skills Group shows strong feasibility, acceptability, and referral efficacy in helping more ambivalent clients enroll in DBT Skills Group.

Referrals, Symptoms and Treatment of Patients Referred to a Secondary Spine Centre-How Can We Help?

Spinal disorders are amongst the conditions with the highest burden of disease. To limit the increase of healthcare-related costs in the ageing population, the selection of different types of care for patients with spinal disorders should be optimized. The first step is to investigate the characteristics of these patients and the relationship with treatment. The primary aim of this study was to provide insights in the characteristics, symptoms, diagnosis and treatment of patients referred to a specialized spinal health care centre. The secondary aim was to perform an in-depth analysis of resource utilization for a representative subgroup of patients. This study describes the characteristics of 4855 patients referred to a secondary spine centre. Moreover, an extensive analysis of a representative subgroup of patients (~20%) is performed. The mean age was 58.1, 56% of patients were female, and the mean BMI was 28. In addition, 28% of patients used opioids. Mean self-reported health status was 53.3 (EuroQol 5D Visual Analogue Scale), and pain ranged from 5.8 to 6.7 (Visual Analogue Scale neck/back/arm/leg). Additional imaging was received by 67.7% of patients. Surgical treatment was indicated for 4.9% of patients. The majority (83%) of non-surgically treated patients received out-of-hospital treatment; 25% of patients received no additional imaging or in-hospital treatment. The vast majority of patients received non-surgical treatments. We observed that ~10% of patients did not receive in-hospital imaging or treatment and had acceptable or good questionnaire scores at the time of referral. These findings suggest that there is potential for improvement in efficacy of referral, diagnosis, and treatment. Future studies should aim to develop an evidence base for improved patient selection for clinical pathways. The efficacy of chosen treatments requires investigation of large cohorts.

Depression screening in low vision rehabilitation services in Australia: exploring barriers and solutions to implementation using a theoretical framework

Rationale: Depression is commonly co-morbid with vision impairment yet often remains undetected and therefore untreated. This study aimed to use a theoretical framework of behaviour change to identify issues surrounding the implementation of depression screening in a low vision rehabilitation service in Australia. Evidence-based strategies to address barriers are highlighted.Method: Twenty-two low vision rehabilitation staff, who had undergone training in using a depression screening tool, took part in semi-structured interviews covering 11 theoretical domains of behaviour change. Interviews were audio-taped and transcribed. Two researchers independently coded the transcripts from each interview and assigned a score to determine whether the transcript showed evidence of poor, partial, or good implementation within each domain.Results: Major barriers to depression screening included lack of time, face-to-face contact with clients and private workspace. Limited referral options and concerns about the efficacy of referrals to primary care services were highlighted. Negative emotions anticipated during depression screening (e.g., feeling awkward, uncomfortable or nervous) and concerns that depression screening would have a detrimental impact on the client and client relationship were also barriers to depression screening in practice.Conclusions: Enhancing knowledge and skill around depression screening is not sufficient to create change. Practical-based training needs to be combined with the development of strong referral pathways to ensure implementation success.

Efficacy of referral for physical activity counseling: Protocol for an RCT to compare face-to-face and telephone counseling

Efficacy of referral for physical activity counseling: Protocol for an RCT to compare face-to-face and telephone counseling