Six-week Intervention Research Articles

A combined heart rate variability biofeedback and progressive aerobic exercise intervention for remediating persistent post-concussive symptoms. (P7-1.006)

<h3>Objective:</h3> Evaluate the combined benefit of heart-rate variability biofeedback (HRVB) and progressive aerobic exercise (PAE) for remediating persistent post-concussive symptoms (PPCS). <h3>Background:</h3> Cardio-autonomic dysfunction is a key patho-physiological process underlying PPCS. Therefore, any interventions targeting cardioautonomic dysfunction should help ameliorate PPCS. Preliminary research suggests PAE and HRVB can improve cardio-autonomic dysfunction and clinical symptoms. However, none have evaluated whether there is a combined benefit. <h3>Design/Methods:</h3> Participants were randomized into a six-week intervention consisting of either HRVB, PAE or HRVB+PAE. Concussion symptoms, HRV, cognition, and mood states were assessed pre- and post-intervention. The HRVB group practiced resonant-frequency breathing for 20 minutes, four nights a week. The PAE group completed a three-day-a-week aerobic exercise protocol that gradually increased in intensity and duration. The HRVB+PAE group completed HRVB training four nights a week and PAE three days a week. <h3>Results:</h3> Each intervention resulted in significant improvement in concussion symptoms, HRV, cognition, and mood states (ps≤.05). PAE resulted in greater reductions in sleep disturbance, depressive symptoms, and total mood disturbance than HRVB (ps≤.05). HRVB+PAE resulted in the largest improvements in cognition, depressive symptoms, and mood disturbance (ps≤.05), but had no additional benefit beyond HRVB or PAE for concussion symptoms, or PAE for sleep disturbance. Each intervention improved cardio-autonomic function as indexed by changes in both time and frequency domain measures of HRV (ps≤.05). Surprisingly, HRVB did not result in greater changes on any HRV metric than PAE (ps≥.19). However, HRVB+PAE resulted in greater changes in the time domain (RMSDD) and frequency domain (HF, coherence ratio) metrics beyond HRVB or PAE. <h3>Conclusions:</h3> Both HRVB and PAE can help ameliorate cardio-autonomic dysfunction but HRVB+PAE resulted in additive benefits in cardio-autonomic function, cognition, and psycho-affective health beyond HRVB or PAE alone. These interventions are low-cost, easy to implement, and may be a feasible non-pharmacological treatment for PPCS. <b>Disclosure:</b> Dr. Moore has nothing to disclose. Mr. Gunn has nothing to disclose. Mr. Kay has nothing to disclose.

Efficacy of exposure and response prevention therapy in mixed reality for patients with obsessive-compulsive disorder: study protocol for a randomized controlled trial

Many patients with obsessive-compulsive disorder (OCD) do not receive cognitive behavioral therapy with exposure and response prevention (first line treatment for OCD), for example, due to patients’ fear of the exposure and reservations of the therapists. Technology-supported exposure (e.g., exposure therapy with response prevention in mixed reality [MERP]) for patients with OCD may help to overcome this obstacle. Building upon findings of our pilot study objectives of this study are to evaluate the efficacy, expectations of treatment success, feasibility, and acceptance of MERP as well as to identify possible limitations. In total, 64 outpatients with contamination-related OCD will be recruited and randomized to one of two conditions: MERP (six sessions in six weeks) and self-guided exposure therapy (six exercises in six weeks). Participants will be assessed before (baseline), after the six-week intervention period (post), as well as three months after post assessment (follow-up) regarding symptomatology (Yale-Brown Obsessive Compulsive Scale; Y-BOCS), their subjective evaluation of MERP (acceptance) and sense of presence. The planned study is the first to investigate MERP in patients with OCD.

Effects of Velocity-Based versus Percentage-Based Resistance Training on Explosive Neuromuscular Adaptations and Anaerobic Power in Sport-College Female Basketball Players

The purpose of this study was to compare the impact of velocity-based resistance training (VBRT) and percentage-based resistance training (PBRT) on anaerobic ability, sprint performance, and jumping ability. Eighteen female basketball players from a Sport College were randomly divided into two groups: VBRT (n = 10) and PBRT (n = 8). The six-week intervention consisted of two sessions per week of free-weight back squats with linear periodization from 65% to 95%1RM. In PBRT, the weights lifted were fixed based on 1RM percentage, while in VBRT, the weights were adjusted based on individualized velocity profiles. The T-30m sprint time, relative power of countermovement jump (RP-CMJ), and Wingate test were evaluated. The Wingate test assessed peak power (PP), mean power (MP), fatigue index (FI), maximal velocity (Vmax), and total work (TW). Results showed that VBRT produced a very likely improvement in RP-CMJ, Vmax, PP, and FI (Hedges' g = 0.55, 0.93, 0.68, 0.53, respectively, p < 0.01). On the other hand, PBRT produced a very likely improvement in MP (Hedges' g = 0.38) and TW (Hedges' g = 0.45). Although VBRT showed likely favorable effects in RP-CMJ, PP, and Vmax compared to PBRT (p < 0.05 for interaction effect), PBRT produced greater improvements in MP and TW (p < 0.05 for interaction effect). In conclusion, PBRT may be more effective in maintaining high-power velocity endurance, while VBRT has a greater impact on explosive power adaptations.

Safety, Feasibility and Efficacy of Lokomat® and Armeo®Spring Training in Deconditioned Paediatric, Adolescent and Young Adult Cancer Patients

Rehabilitation robotics is a field of study which aims to understand and augment rehabilitation through the use of robotics devices. This proof of concept study aimed to test the safety (no. adverse events, incidence of infection), feasibility (program demand, adherence, participant satisfaction) and efficacy (Peak Oxygen uptake (VO2peak), 6-min walk test, gait speeds, Canadian Occupational Performance Measure, quality of life) of Lokomat® and Armeo®Spring training in children and adolescents and young adults (AYAs) during or soon after cancer treatment. This was a 6-week single arm pre-post study. Cancer patients with significant musculoskeletal, neurological, gait and/or upper limb deficiency aged 5 to 25 years were recruited. The rehabilitation program included access to two robotic orthoses: the Lokomat® and/or Armeo®Spring. Robotic devices utilised real-time biofeedback and computer games to engage and guide participants through a repetitive functional range of movement aimed at improving functional deficiencies. Progressive increases in exercise intensity and duration were encouraged. Twentey-eight participants were approached for study; twenty-one consented. Seventy-six percent completed the six-week intervention with an overall adherence of 83%. The mean participant satisfaction score was 8.8/10. Forty-nine adverse events were recorded throughout the course of the study, forty-five grade 1, three grade 2 and one grade 3. No adverse events led to withdrawal from the study. Preliminary efficacy results indicate large beneficial effects on VO2peak (r = 0.63), 10 m comfortable pace walk (r = 0.51) and maximal pace walk (r = 0.60), 6-min walk test (r = 0.60), maximal back and leg strength (r = 0.71), trunk flexibility (r = 0.60), The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30) (r = 0.61), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT F) r = 0.53 and the Canadian Occupational Performance Measure, satisfaction (r = 0.88) and performance scores (r = 0.83), and moderate beneficial effects on Leisure Score Index (LSI) (r = 0.30). Our results suggest that Lokomat® and Armeo®Spring training is safe and feasible for use in children and AYAs who are currently undergoing or have recently completed cancer therapy. A larger controlled trial investigating the efficacy of robotics rehabilitation in this cohort is warranted.

Anxiety and enjoyment among young teenagers learning English as a foreign language outdoors: a mixed-methods study

ABSTRACT Purpose The aim of this study is to explore how outdoor education can influence foreign language anxiety (FLA) and foreign language enjoyment (FLE) when young teenagers are learning a foreign language (FL). We applied a dynamic perspective to investigate if using English in an outdoor context would reduce FLA and boost FLE, leading to a stronger willingness to communicate (WTC) in the FL. Design/methodology/approach The design was a pre-post intervention study with an experimental group (EG) and a control group (CG). Both groups engaged in fluency-oriented activities during a six-week intervention. The EG conducted the activities outdoors whereas the CG conducted them in their classrooms. A mixed-methods approach was applied collecting data through student questionnaires and group interviews with both students and their English teachers. Observations and recordings of participants’ speech were also conducted. Findings Statistical analyses indicated a small effect of the intervention for both FLA and FLE but the difference in gain scores between groups was found to be non-significant. The qualitative data revealed a strong appreciation of the outdoor experience in English. Originality/value Most previous studies have investigated emotions in FL learning inside the classroom. The current study investigates emotions in FL learning among young teenagers in an outdoor environment.

Arithmetic Fact Fluency Supported by Artificial Intelligence

The main purpose of this study was to investigate to what extent students aged eight years developed their arithmetic fact fluency by using artificial intelligence to practice number combinations. The study compares the effects of three different ways of practicing number combinations: Artificial Intelligence (AI), Memorization (Mem), and Guided Learning (GL). The design was a split-plot factorial design with group as a between-subject factor and time (i.e., before and after a six-week intervention) as a within-subject factor. Pre- and post-test were performed to assess students’ fluency with respect to basic number combinations, i.e., addition, such as 3 + 4, 2 + 1, 6 + 3, etc. The results show that students developed their fluency significantly with respect to basic number combinations when practicing this skill with support of artificial intelligence. It seems that the technique is effective at analyzing and recommending content based on students’ learning patterns and what has worked best for similar students. The results therefore strengthen the findings of previous studies that artificial intelligence presents great opportunities to offer individual support to maximize learning. The results also show that practicing number combinations with artificial intelligence is more effective compared to practicing with a focus on memorization and guided learning.

Telerehabilitation for patients who have been hospitalised with covid-19: a qualitative study

Purpose The aim of this qualitative study was to explore the views of participants of a group-based, supervised, telerehabilitation programme, following discharge from hospital with Covid-19. This study was part of a single-centre, fast-track (wait-list), randomised, mixed-methods, feasibility trial of telerehabilitation (Registration: Clinicaltrials.gov reference:285205). Methods Semi-structured interviews were conducted over a virtual teleconference platform with 10 participants who took part in a telerehabilitation programme following Covid-19 after discharge from an acute hospital. Data were transcribed verbatim and analysed using thematic analysis. Results Five themes were important from the participant perspective: telerehabilitation programme as part of the Covid-19 journey; the telerehabilitation programme design and delivery; peer aspects; the role of the instructor; and the role of technology and online delivery. Conclusions Overall, the telerehabilitation programme was a positive experience for participants. The instructors were central to this positive view as was the group nature of the programme. The group aspect was particularly important in supporting the broader perceived wellbeing gains, such as the sense of enjoyment and reduced social isolation. Several participants would have liked to have continued with the exercises beyond the six-week intervention indicating that the programme could be a way to help people sustain a physically active lifestyle. IMPLICATIONS FOR REHABILITATION Participants who were recovering from Covid-19 following hospital admission perceived the telerehabilitation to be a positive experience overall. The group aspect of the telerehabilitation programme was important in supporting the broader perceived wellbeing gains such as the sense of enjoyment and reduced social isolation. Telerehabilitation programmes for Covid-19 may need to include pathways for participants to continue to engage in exercise beyond the time-limited six-week intervention to support ongoing self-management.

Effectiveness of Ankle Stretching and Strengthening Exercises to Improve Rounded Shoulder Posture: A Pilot Study

Introduction: Incorrect posture habits and reduced physical activity can predispose individuals to various changes in the muscular and skeletal structures. Rounded Shoulder Posture (RSP) is one such clinical manifestation that deforms the normal relationship of various structures. Different treatment protocols have been devised for correcting RSP; however, postural changes in the musculoskeletal system can also be addressed by focusing on muscular imbalances elsewhere in the biomechanical kinetic chain. Aim: To analyse and investigate the efficacy of ankle muscle stretching and strengthening exercises in enhancing the correction of RSP in young adults. Materials and Methods: The present pilot study was conducted at Amity Institute of Physiotherapy in Noida, Uttar Pradesh, and Prime Hospital and Ortho Centre in Faridabad, Haryana, India, from January 2021 to July 2021. A total of 30 young adults with RSP were randomly allocated into two groups of 15 each. Group 1 (control group) received six weeks of conventional exercises consisting of scapular stabilisation and stretching of the pectoralis minor muscle. Group 2 (experimental group) received ankle plantar flexor stretching and ankle dorsiflexor strengthening in addition to the conventional exercises, three times per week for six weeks, with each session lasting between 30 to 45 minutes. RSP and ankle Dorsi-Flexion (DF) were assessed using the posterior Acromion to Table Distance (ATD) in a supine lying position and a universal goniometer, respectively, pre-intervention and post-intervention for the dominant and non-dominant sides. For statistical analysis, after determining the normality of the data, either a Paired-test or Wilcoxon rank sum test was used to compare the data within each group. Further, either a two-sample Independent t-test or WilcoxonMann-Whitney U test was used to find statistical differences between the two groups at a 5% level of significance. Results: The subjects had an average age of 24.8±4.07 years and a Body Mass Index (BMI) of 24.10±4.39 kg/m2 , with 11 male and 19 female participants (p-value=0.70), with the right side being the dominant side for all. At baseline, there was no significant difference in the variables between the two groups (p-value&gt;0.05). After the six-week intervention, a significant difference was found in the ATD (dominant pre: 6.17±1.02, dominant post: 3.47±1.05, p-value&lt;0.0001; non-dominant pre: 6.07±1.05, non-dominant post: 3.32±0.92, MD=-2.75; p-value&lt;0.0001) and DF (dominant pre: 16.23±1.37, dominant post: 19.27±1.33, MD=3.03; non-dominant pre: 15.67±1.05, non-dominant post: 19.53±0.74, MD=3.87; p-value&lt;0.0001) in the experimental group. However, the control group revealed a significant difference only for ATD (dominant pre: 6.51±0.89, dominant post: 4.47±0.84, MD=-2.05; non-dominant pre: 6.23±1.00, non-dominant post: 4.41±0.90, MD=-1.82; p-value&lt;0.0001). Additionally, when compared to the control group, the experimental group showed statistically significant results for ATD and DF (p-value&lt;0.05). Conclusion: The incorporation of ankle muscle strengthening and stretching exercises was found to be more effective compared to the conventional treatment used for correcting RSP.

Development of AGRONUTRI-X M-Learning Application using MIT App Inventor 2 Platform

Education today is changing, in line with technology development that has been embedded in our lives. Thus, to meet the needs of today’s generation, there is a need to revolutionize conventional instructional methods by integrating technological elements in line with today’s advancements. The thriving smartphone technology with high ownership rates needs to be leveraged as a learning medium known as M-learning. Compared to E-learning, M-learning has been deemed a more forward-looking trend in learning as it allows learning to be accessed anytime and anywhere without needing specialized facilities or laboratories. However, the optimal use of M-learning as a learning medium in agricultural TVET has yet to be explored. This gap is demonstrated by the small amount of M-learning materials developed for learning agricultural subjects. This study focuses on developing specific M-learning applications for Crop Agro-industry students in Vocational College, specifically to improve their competency in preparing formulations for fertigation fertilizer. The design and development of the AGRONUTRI-X M-learning application are based on the ADDIE model. The model has five phases in its learning material development process: analysis, design, development, implementation, and testing. Balsamiq Wireframes software was used in designing the storyboard and application interface, and the MIT App Inventor 2 platform was used for the application development using the storyboard and interface provided during the design phase. The application was evaluated by five experts, and the results of the expert content evaluation showed that the application has a high content validity (89.2%). The application was tested on 30 vocational college students during a six-week intervention process which was conducted concurrently with conventional learning. The AGRONUTRI-X M-learning application usability questionnaire was then distributed to these students, and the results showed a high level of application usability with a mean score of 4.41. Overall, the development of AGRONUTRI-X M-learning applications has successfully achieved the objectives and contributed to developing M-learning applications for agriculture students.

Prioritising the content and delivery of a work-focused intervention for women with breast cancer using the nominal group technique.

Increased breast cancer survivorship has prompted a focus on optimising quality of life for this cohort, including reintegration into employment. Despite this, there remains a lack of work-focused interventions to support work outcomes for women living with and beyond breast cancer. The aim of this study was to prioritise the content and delivery of a work-focused intervention for women living with and beyond breast cancer. Twelve stakeholders including women living with and beyond breast cancer, healthcare professionals, cancer support centre staff, and policy informers were invited to participate in an online discussion using the Nominal Group Technique (NGT) to determine priorities for a work-focused intervention. The NGT seeks consensus through four steps; (i) idea generation, (ii) discussion among the group, (iii) refining ideas, and (iv) ranking preference for ideas through anonymised voting. Intervention content prioritised included managing cancer-related symptoms and work-specific factors. Consensus was made for a blended delivery format (mix of group and individual sessions), and blended delivery (face-to-face and online). Findings indicated a preference for a six-week intervention, with 90-120 minute sessions. Community-based settings were preferred over hospital-based services for the setting of a work-focused intervention. Zoom Video Communications Inc. was the preferred setting to deliver an online intervention. Stakeholder priorities informed the content and delivery of a work-focused intervention for women with breast cancer. A pilot of the proposed intervention will be conducted to test for feasibility and acceptability.

The effect of an intervention of porcine protein versus maltodextrin supplement on CONvalescence of FUnCtional outcomes after IcU Stay (CONFUCIUS): Study protocol for a randomized controlled, single-center, double-blind trial.

Patients discharged from the Intensive Care Unit (ICU) frequently suffer from ICU-acquired weakness because of immobilization and massive inflammation-induced muscle mass loss. Consequently, rehospitalization, reduced quality of life (QoL), increased disabilities, and higher post-ICU mortality is observed. Exercise rehabilitation and optimal nutrition, particularly protein intake, are pivotal to regaining muscle mass and function. Studies have shown that protein requirements in the post-ICU phase are often unmet. Furthermore, protein supplementation in other patient groups has shown beneficial effects. However, a study on protein supplementation during the post-ICU period is lacking. This study aims to investigate the effect of a six-week intervention of daily porcine protein supplementation versus an isocaloric control (maltodextrin) on functional outcomes in the post-ICU period in patients with moderately severe ICU-acquired weakness. 72 post-ICU patients with moderately severe ICU-acquired weakness of Hospital Gelderse Vallei will be randomly assigned to either the intervention or the control group (36 per arm). The intervention group receives a porcine protein supplement twice a day. The control group receives a maltodextrin supplement twice a day. The intervention starts on the first day in the general ward and lasts 42 days (6 weeks). The primary outcome is the between-group difference in physical function at hospital discharge (t;=2), the end of the intervention (t;=3, day 42), and the 3-month follow-up (t;=4) expressed as a composite score consisting of handgrip strength, muscle strength leg, muscle strength arm and exercise capacity. Secondary outcomes encompass physical function, QoL, Activity of daily living (ADL), and plasma amino acids concentrations. Lastly, ICU readmission after ICU discharge, hospital readmission after hospital discharge, and overall survival status will be considered. Linear mixed models will be used to test the treatment effect for the primary and secondary outcome measures. This trial will be the first to investigate porcine protein supplementation compared with carbohydrate supplementation in the post-ICU period aiming to improve functional outcomes of ICU survivors with moderately severe ICU-acquired weakness. The study has been registered at ClinicalTrials.gov. Number: NCT05405764.

Long-term effects of imaginal retraining in overweight and obesity: A controlled study

BackgroundImaginal retraining (IR) is a self-help technique that targets automatic approach tendencies toward appetitive stimuli. In a randomized controlled trial (RCT; N = 384), IR reduced craving for high-calorie foods after a six-week intervention period (small effect). The aim of the present study was to evaluate long-term effects of IR in this sample. MethodsOne year after baseline, participants from the initial RCT were recontacted. A visual analogue scale measuring craving, the Food Cravings Questionnaire-Trait-reduced (FCQ-T-r), the Three-Factor Eating Questionnaire, the Beck Depression Inventory, quality of life, and subjective appraisal of the intervention were assessed online. Participants were classified as users or nonusers based on self-reported usage of IR over the previous year. ResultsLinear-mixed models showed no significant interaction effects of time and group for any outcome (trend level effects were found for two subscales of the FCQ-T-r). Yet, higher usage of IR was associated with greater symptom reduction. Although overall subjective appraisal of the intervention was comparably good to the initial study, usage of IR and completion rate were unsatisfactory. LimitationsMain limitations of the present study include the nonrandomized group allocation and the low completion rate. ConclusionsThis study did not find evidence for the long-term efficacy of IR in individuals with craving for high-calorie foods. Only upon high usage of IR, improvement was found. However, low completion rate and usage of the intervention may have resulted in a Type-II error. Future studies may consider low-intensity professional guidance to increase adherence and assess the long-term effects of IR in RCTs.

The impact of combining SRSD instruction with a brief growth mindset intervention on sixth graders’ writing motivation and performance

Self-Regulated Strategy Development (SRSD) is an evidence-based instructional approach combining background knowledge, writing, and self-regulation strategies to improve students’ writing motivation and performance. While the positive impact of SRSD on writing performance variables is well-established, mixed findings were found for motivational variables, namely self-efficacy. In addition, the impact of SRSD on motivational constructs other than self-efficacy—such as implicit theories—has received considerably less attention. In this study, we examined the impact of an SRSD instructional program about opinion text writing on two extensively studied writing performance variables (i.e., text quality and text length) and on two motivational variables (i.e., self-efficacy and implicit theories). Moreover, we tested whether adding a brief growth mindset intervention to SRSD instruction would result in gains in writing motivation and performance. To this end, we enrolled 191 sixth graders, from 11 classes, and their Portuguese language teachers to participate in a six-week intervention study. Using a quasi-experimental design, the classes were assigned to one of three conditions: (a) an active control condition (three classes); (b) an SRSD group (four classes); (c) an SRSD plus growth mindset intervention group (henceforth, SRSD + GM; four classes). Our results showed that both the SRSD and the SRSD + GM generally did not significantly differ from the active control group in self-efficacy and implicit theories of writing at posttest. The only exception was self-efficacy for ideation. Of note, the SRSD and the SRSD + GM groups outperformed the active control group in terms of text quality and text length. Our findings did not reveal an added value of a brief growth mindset intervention for SRSD instruction. Overall, our study showed that a six-week SRSD instructional program was effective in improving students’ self-efficacy for ideation and writing performance. However, the brief nature of both SRSD and mindset interventions may have precluded a broader positive impact on motivational beliefs, such as self-efficacy for conventions, self-efficacy for self-regulation, and implicit theories.

Improving Health and Diabetes Self-Management in Immigrants with Type 2 Diabetes Through a Co-Created Diabetes Self-Management Education and Support Intervention

To examine the impact of a co-created culturally sensitive diabetes self-management education and support (DSMES) intervention on the physical and mental health of immigrants with type 2 diabetes (T2D). Pre- and post-test among people with T2D whose primary language was Urdu, Arabic or Turkish (n = 97). Participants were offered a six-week intervention based on a person-centred approach using research-based dialogue tools to facilitate learning and reflection, which was developed in co-creation with immigrants and healthcare professionals. Data were collected at baseline, post-intervention and after 6 months and analysed using paired t-tests, Wilcoxon signed-rank tests, chi-square tests and regression models when appropriate. Several clinical outcomes were improved post-intervention, including HbA1c (P < 0.001), body fat percentage (P = 0.002), self-rated general health (P = 0.05), well-being (P = 0.004) and several self-management behaviours, e.g., physical activity (P < 0.001). Most outcomes remained improved after 6 months, but the effect on HbA1c was no longer statistically significant. Some outcomes were improved only at 6 months, including waist circumference (P < 0.001) and diabetes-related emotional distress (P < 0.001). Fatigue did not change. Attendance at more programme sessions was associated with better outcomes. The DSMES intervention developed in a co-creation process was highly effective in improving the health of immigrants with T2D.

Perceptions on the Use of the Flipped Classroom in the EFL Class

The present action-research study analyzes students’ basic perceptions about the use of the Flipped Classroom as part of their EFL class in a Mexican technical high school. To this end, 47 5th-semester students took two versions of a survey, which combined provided an understanding of their views after having taken part of a six-week intervention. The intervention focused on what is typically considered the most challenging topic of the semester: the simple past and its functions included in the official syllabus. On the one hand, the ‘flipped’ part of the lessons was divided into before and after-class online activities following a set of principles for the Flipped Classroom, Communicative Language Teaching, and Multimedia Instruction. On the other hand, in-class activities focused on reviewing content and communicative oral practice. The Flipped Classroom was favorably regarded. Students perceived it as a technique to facilitate a rapid improvement of certain aspects of speaking performance, especially in regards to fluency, comprehension, and vocabulary.

Co-construct, implement and evaluate an intervention to prevent a sedentary lifestyle in children

Abstract Background In children a sedentary lifestyle is associated with the development of chronic diseases, as well as unfavorable body composition and physical condition, lower levels of self-esteem, sociability, and school results. In Europe 39,8% of children (6-9 years) spend on average more than 2h/day in front of a screen, and 14,6% over 3h/day. In this context, designing and testing effective interventions to decrease sedentary behavior in children is a major public health research gap. The CIPRES intervention aims to reduce sedentary time in school-age children (7-10 years). Methods The CIPRES intervention is co-constructed with key local actors, by using a socio-ecological approach, and theory-based on the transcontextual model. The intervention is evaluated by a cluster-randomized controlled study currently ongoing. The target population is made up of 1000 children from 13 primary schools (in years 4-5) from southeast of France with different levels of social deprivation. Main outcomes are assessed by accelerometer and questionnaires before (T0) and after a six-week intervention (T1) and include sedentary behavior, physical activity (PA) and variables of the transcontextual model. Results Preliminary data were available in 152 children (53 intervention and 99 control). There was no significant difference across the time in sedentary time between intervention and control group (p = 0.11; η2=0,017); however, moderate-to-vigorous physical activity (MVPA) tended to be better in intervention vs control (p = 0.06; η2=0,023). In the intervention group, sedentary time and MVPA were significantly better across the time (p = 0.028 and p = 0.011, respectively) for children having a father with a university diploma as compared to children having a father with a lower education level. Conclusions Preliminary results on a small group of subjects (n = 152) are encouraging and suggest a positive impact of the intervention on children. More results will be available by summer 2022. Key messages • Based on the socio-ecological model, the CIPRES intervention aims to prevent sedentary in school-aged children. • Preliminary data suggests a favorable impact of the intervention on physical activity.

Fostering Need-Supportive Behaviors in Physical Education Teachers and Parents: A Cluster Randomized Controlled Trial Study Protocol of a Web-Based Intervention on Secondary School Students' Physical Activity.

Despite various benefits of physical activity, children are increasingly inactive. Both school physical education classes and support from parents are important determinants of physical activity level of children and adolescents. We aim to develop a web-based intervention for physical education teachers and parents to teach them to be more need-supportive towards children when discussing physical activity and thus increase children’s autonomous motivation towards it. The study will adopt a waitlist-control design with cluster randomization by schools. The intervention content is based on self-determination theory. Specifically, the teachers and parents will be introduced to a series of motivation and behavior change techniques to help them satisfy the children’s psychological needs for autonomy, competence, and relatedness in physical activity. The targeted group in the six-week intervention is comprised of students aged 12–14 years. The primary outcome variable, physical activity of students, will be assessed via self-report questionnaires at baseline, post-intervention, one-month and six-month follow-up. Web-based intervention programs are cost-effective, allow self-paced learning and enable reaching larger audiences. If this project proves to be effective, a highly valuable web-based solution would be available for PE teachers and parents to help increase students’ physical activity levels.

Evaluating the effectiveness of supporting young quiet, shy and/or anxious primary school children in Wales, using two targeted intervention programmes

ABSTRACT Quiet shy and/or anxious (QSA) children are often viewed negatively in primary school. This study employed two six-week intervention programmes entitled Special Me Time (SMT) for children in the Early Years (ages 3–7) and Quality Me Time (QMT) for children in years 3–4 (ages 7–9). Interventions were designed to support children: in vocalising feelings; accessing classroom opportunities; communication; and in developing friendships. Children were withdrawn from the mainstream classroom and sessions were led by practitioners in small groups. The programmes were delivered in primary schools across Wales. Findings evidenced benefits to children’s personal and social development in improving confidence and self-esteem both within and outside the classroom environment. Our research suggests the value of addressing emerging QSA behaviours in children by providing space and time to develop relationships and self-expression. Research findings suggest a risk to academic and social adjustment if inhibiting QSA behaviours are not addressed.

Treating postpartum insomnia: a three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy.

Insomnia symptoms are common during the postpartum period, yet interventions remain scarce. This trial aimed to simultaneously examine the efficacy of cognitive behavioural therapy (CBT) and light dark therapy (LDT), targeting different mechanisms, against treatment-as-usual (TAU), in reducing maternal postpartum insomnia symptoms. This three-arm randomised controlled trial recruited from the general community in Australia. Nulliparous females 4-12 months postpartum with self-reported insomnia symptoms [Insomnia Severity Index (ISI) scores >7] were included; severe medical/psychiatric conditions were excluded. Participants were randomised 1:1:1 to CBT, LDT, or TAU stratified by ISI (< or ⩾14) and infant age (< or ⩾8 months). Participants and principal investigators were unblinded. Six-week interventions were delivered via digital materials and telephone. The primary outcome was insomnia symptoms (ISI), assessed pre-, midpoint-, post- (primary endpoint), and one-month post-intervention. Analyses were intention-to-treat using latent growth models. 114 participants (CBT = 39, LDT = 36, TAU = 39; Mage = 32.20 ± 4.62 years) were randomised. There were significantly greater reductions in ISI scores in CBT and LDT (effect sizes -2.01 and -1.52 respectively, p < 0.001) from baseline to post-intervention compared to TAU; improvements were maintained at follow-up. Similar effects were observed for self-reported sleep disturbance. There were greater reductions in fatigue in CBT (effect size = 0.85, p < 0.001) but not LDT (p = 0.11) compared to TAU. Changes in sleepiness, depression, and anxiety were non-significant compared to TAU (all p > 0.08). Four participants (11%) in the LDT group reported headaches, dizziness, or nausea; no others reported adverse events. Therapist-assisted CBT and LDT were feasible during the first postpartum year; data at post-intervention and 1-month follow-up support their safety and efficacy in reducing postpartum insomnia symptoms.

Critically appraised paper: In people with chronic obstructive pulmonary disease, a six-week behaviour change intervention was not superior to a sham intervention at reducing time spent in sedentary behaviour [commentary

Critically appraised paper: In people with chronic obstructive pulmonary disease, a six-week behaviour change intervention was not superior to a sham intervention at reducing time spent in sedentary behaviour [commentary