Social Interaction Interventions Research Articles

Influence of Social Interaction Interventions Used by Teachers on School Readiness among Pre-Primary Learners in Konoin Sub-County, Bomet County. Kenya

Transitioning to school is a significant developmental milestone for young children, and it is seen as a crucial "sensitive period" for future academic success. Despite the potential for such programs to have broad effects, little is known about the effects of intervention tactics in early childhood education programs on school preparation. This paper aimed at finding out the influence of social interaction interventions used by teachers on school readiness among pre-primary learners in Konoin Sub-County, Kenya. The study used descriptive survey design and targeted 312 pre-primary school teachers and 5 Ward Education Coordinators. A sample size of 172 teachers and 5 Ward Education Coordinators was used. Questionnaires and interview guides were used to collect data. Expert judgement was used to ascertain the validity while reliability was ascertained through piloting and use of Cronbach Alpha Coefficient. Quantitative data was analysed using frequencies, percentages and Pearson Correlation analysis. Qualitative data were thematically analyzed. The analyzed information was presented in tables and Figures. The study found out that there was a significant correlation between social interaction interventions (r = .278; p = .000), and school readiness. The study concluded that social interaction interventions influenced learners’ school readiness. For effective pre-school readiness, instructional support needs to be tailored to the needs of each child by the teachers, considering their strengths, interests, and learning styles. The study findings would enable early childhood education teachers to learn how to introduce learners to the school learning process by assisting them to adjust to a different environment from home.

Supporting social interactions to improve MOOC participants’ learning outcomes: a literature review

IntroductionThe need for more scalable, accessible and affordable education, coupled with technological advancements in information sharing technology and collaborative platforms has led to the growth of MOOCs (massive open online courses). The growth of MOOCs has resulted in learning becoming increasingly distributed, affordable and flexible compared to traditional classroom education, allowing individuals in disadvantaged groups to access high quality educational materials. However, new challenges emerge, most notably with MOOCs’ low completion rates. Among the reasons for a low completion rate, lack of interaction with peers is cited as a major reason, yet, interventions to promote social interaction has received relatively less attention. From a constructivist perspective, social interactions among peers are essential in helping individuals learn. This systematic literature review aimed to understand social interaction interventions in MOOC settings. This includes constructs measured as learning outcomes and how they were measured.MethodsLiterature articles were sourced from multiple databases and filtered for inclusion using the PRISMA process and its four phases. Twenty articles were included in the final review.ResultsResults of the review showed that social interactions fall into three categories: discussion forums, learning groups and one-to-one interactions with peers. Learning outcomes investigated were grouped into four categories: knowledge, social engagement, learning engagement and learner experience.ConclusionAcross the studies, there were clear positive effects of social interaction on learning outcomes. Intervention strategies include sending prompts for individuals to use discussion boards and also grouping learners by homogeneity based on their learning engagement. However, more experimental studies are necessary to bolster the evidence of a causal impact of social interactions. Also, further research should be done to understand potential mediating factors that contribute to the success of implementing social interactive elements in MOOCs.

Effects of square dance exercise on cognitive function in elderly individuals with mild cognitive impairment: the mediating role of balance ability and executive function

BackgroundSquare dancing is a kind of aerobic fitness exercise without environmental restrictions that yields many benefits for physical and mental health; this exercise is popular among middle-aged and elderly people in China and in these populations in other countries. This study aimed to evaluate the effects of square dance exercise on the overall cognitive function of elderly individuals with mild cognitive impairment (MCI) and to research its mechanisms.MethodsA total of 60 elderly people with MCI (60–69 years old) without square dance experience were selected and randomly divided into an experimental group (n = 30) and a control group (n = 30). The experimental group participated in square dance exercise for 12 weeks, while the control group maintained their original lifestyle habits. One week before and after the intervention period, the overall cognitive function, physical fitness, and executive function of both groups were measured.ResultsAccording to the results, square dance exercise directly improved the overall cognitive function of elderly individuals with MCI and indirectly affected overall cognitive function through the mediating effects of balance ability and executive function.ConclusionsSquare dance exercise represents a nonpharmacological intervention for the prevention and treatment of MCI. Importantly, it is best to combine this exercise with other forms of physical exercise and comprehensive treatment programs such as cognitive training, social interaction, and psychological intervention to realize its maximum effect.

Pathways to peer interaction in ASD and TD through individual and dyadic joint-action motor abilities.

Any social engagement, especially with peers, requires children's effective activation of social and motor mechanisms. Children and adolescents with autism spectrum disorder (ASD) often display dysfunctions both in individual motor functioning (e.g., fine/gross) and in dyadic joint action (JA), where two partners coordinate movement toward a shared goal. Yet, these mechanisms' contribution to peer interaction has been underexplored. This study examined the contribution of individual motor functioning and JA performance to peer interaction (cooperation, attentiveness, social engagement, and dyadic quality), while comparing children and adolescents' (youngsters) with ASD versus those with typical development (TD). Results indicated more competent peer interaction in TD than in ASD. Interestingly, only the ASD group showed significant maturation with age for social engagement and dyadic interaction quality, calls for further examination of developmental trajectories. However, even the oldest participants with ASD continued to lag behind the youngest TD group. Also, findings indicated that better individual motor functioning and JA performance explained better peer interactive competence; yet, the contribution of individual motor functioning to social cooperation and dyadic quality was moderated by JA performance. Thus, youngsters' individual motor system was found to be an important contributor to peer interaction in those with low to moderate JA coordination capabilities, but not for those with high JA. Results emphasize possible distinct contributions of each motor mechanism and their interaction for facilitating social interaction, hence, encouraging incorporation of individual and dyadic motor skills explicitly into social interaction interventions for youngsters ASD.

Parents Involvement in Social Interaction Intervention for Children with Autism Spectrum Disorder (ASD): A Review

Two basic characteristics characterize autism spectrum disorder: a difficulty in social communication and the prevalence of repetitive activities and/or restricted interests. The most frequently cited explanation for insufficient social contact or skill development is a lack of social cognition. Numerous interventions have been utilized to help children with this issue, including social storytelling, scheduled physical exercise programs, and peer-mediated intervention. Typically, interventions are performed in a clinical setting by experts such as occupational therapists. However, research indicates that parents’ involvement has a significant contribution to helping children to improve their children's social interactions and skills, particularly those with an autistic spectrum disorder. Thus, this study emphasizes social interaction intervention, its benefits, and the involvement of parents in social interaction intervention with autistic children. According to the previous research, early learning experiences through early intervention with the social contract approach significantly enhance development progress among ASD Children. Autistic children's behavior may improve with parental involvement in the intervention, and it may also reduce parenting stress because of improved behavior.

Efficacy of a Social Interaction Intervention in Early Postoperative Period to Improve Coping in Persons With an Ostomy: A Randomized Controlled Trial.

The purpose of this study was to analyze the efficacy of a social interaction intervention delivered during the early postoperative time period on the coping process in persons with a new ostomy. Randomized controlled trial. The sample comprised 52 persons who underwent surgical management of colorectal including a fecal ostomy; 27 were randomly allocated to the intervention group and 25 to the control group. One participant allocated to the control group died before data collection; thus, findings are based on data from 51 participants. The study setting is the Regional University Hospital of Malaga, located on the southern coast of Spain. Ostomy visitors (persons living with an ostomy) were taught to listen to the experiences and the concerns of the participant and to serve as an example of an individual who has successfully learned to live with a fecal ostomy. The intervention was a visit with a person with a new ostomy during the early postoperative period. Control group participants were offered standard care that did not include the visit from a person with an ostomy. Outcome measures were taken from the Nursing Outcomes Classification taxonomy. The main outcome measure was coping; secondary outcome measures were health beliefs and acceptance of health status. Bivariate analyses were performed to evaluate differences between groups in terms of the primary and secondary outcomes. A multivariate linear regression analysis was performed to identify predictor variables of the primary outcome, and effect size calculations were used to differentiate statistical significance versus clinical relevance. There were no differences in demographic or pertinent characteristics of participants in the 2 groups. Participants who received the intervention achieved a higher mean coping process scores: 3.90 vs 3.19, P = .002 and Cohen d = 0.97. In addition, intervention group participants achieved a higher mean efficacy for the secondary outcomes: 3.78 versus 2.97 (P = .0004) and Cohen d = 1.11 for health beliefs, and 3.68 versus 2.83 (P = .0001) and Cohen d = 1.24 for acceptance of health status. Linear regression analysis indicated that the social interaction intervention (β= .799; P = .000) and undergoing urgent versus routine ostomy surgery (β=-.610; P = .005) were related to coping. Findings indicate that a visit with a trained person living with an ostomy facilitated coping and improved health beliefs and acceptance of health status.

Therapeutic Outcome of Self-Control and Social Interaction Interventions on Negative Body Image among in-school Adolescents with Low Health literacy in Southwest Nigeria

Low health literacy is found to be consistently associated with negative body image. This study examined the effectivenessof Self-Control Therapy (SCT) and Social Interaction Skills Training (SIST) in managing negative body image among senior secondary school students with low health literacy in Southwest Nigeria. The design is pretest-post-test, control group quasi-experimental while the factorial matrix adopted was 3×2×3. Through multi-stage sampling, three Catholic Senior Secondary Schools in Southwest Nigeria were selected. Ninety (90) students, (Males=34, Females= 56) with age range of 14 years to 16 years were randomly selected and assigned to treatment conditions. The experimental groups were exposed to ten Sessions of treatments while the control group served as a comparison group. Body Self-Image Questionnaire-Short Form (BSIQ-SF) (α=0.83), Health Literacy Scale(α=0.88), and Rosenberg Self Esteem Scale (α=0.81) were used for data collection while Analysis of Covariance (ANCOVA) and Bonferroni test were used for data analysis. Results showed a significant main effect of the treatments on the negative body image of the adolescents (F (2, 90) = 1602.50; partial η2=0.98). Participants in SCT had the least adjusted post-test mean score (34.07), followed by SIST (35.23) and control (66.13) groups. Sex of the participants had no significant interaction effect on the treatment outcome. Participants with high self-esteem had a better reduction in managing negative body image (44.27) than those with moderate self-esteem (44.51) and low self-esteem (47.30). A two-way interaction effect of treatments and self-esteem was found. This result provides support for the use of SCT and SIST to manage negative body image of senior secondary school students. These two therapies are therefore, recommended to stakeholders as viable therapies for the treatment of negative body image.

Autism spectrum as a communication disorder: A case study

Communication is a vital social phenomenon; therefore, its study must be related to theories of social structure, social behavior, and human interaction. Successful communication is substantially crucial for better social life in all contexts. Unfortunately, the process of communication in medical settings and healthcare is challenging, especially when communicating with patients who are affected by cognitive communicative disorders including people with Autism Spectrum Disorders. This paper aims to address the difficulties and the different encumbrances related to autism and communication in the Algerian context. It attempts to evaluate the effectiveness of communication interventions in children with ASD, and look for reliable methods to help families promote their children's communication abilities. The current research is a case study of a six-year-old child with ASD, in addition to the participants involved; his caregivers, parents, escorts, and the speech therapist. The study shows that the child suffers from language impairments that are typical of autistic children's verbal repertoire: lexical, grammatical, morphological, and syntactic impairments that lead to a failure in the communicative task. The analysis of the data indicates that patients with ASD suffer also from different extra-linguistic problems which can be diminished through successful social interaction and effective therapeutic interventions.

Promoting Physical Activity in Japanese Older Adults Using a Social Pervasive Game: Randomized Controlled Trial.

BackgroundPervasive games aim to create more fun and engaging experiences by mixing elements from the real world into the game world. Because they intermingle with players’ lives and naturally promote more casual gameplay, they could be a powerful strategy to stimulate physical activity among older adults. However, to use these games more effectively, it is necessary to understand how design elements of the game affect player behavior.ObjectiveThe aim of this study was to evaluate how the presence of a specific design element, namely social interaction, would affect levels of physical activity.MethodsParticipants were recruited offline and randomly assigned to control and intervention groups in a single-blind design. Over 4 weeks, two variations of the same pervasive game were compared: with social interaction (intervention group) and with no social interaction (control group). In both versions, players had to walk to physical locations and collect virtual cards, but the social interaction version allowed people to collaborate to obtain more cards. Changes in the weekly step counts were used to evaluate the effect on each group, and the number of places visited was used as an indicator of play activity.ResultsA total of 20 participants were recruited (no social interaction group, n=10; social interaction group, n=10); 18 participants remained active until the end of the study (no social interaction group, n=9; social interaction group, n=9). Step counts during the first week were used as the baseline level of physical activity (no social interaction group: mean 46,697.2, SE 7905.4; social interaction group: mean 45,967.3, SE 8260.7). For the subsequent weeks, changes to individual baseline values (absolute/proportional) for the no social interaction group were as follows: 1583.3 (SE 3108.3)/4.6% (SE 7.2%) (week 2), 591.5 (SE 2414.5)/2.4% (SE 4.7%) (week 3), and −1041.8 (SE 1992.7)/0.6% (SE 4.4%) (week 4). For the social interaction group, changes to individual baseline values were as follows: 11520.0 (SE 3941.5)/28.0% (SE 8.7%) (week 2), 9567.3 (SE 2631.5)/23.0% (SE 5.1%) (week 3), and 7648.7 (SE 3900.9)/13.9% (SE 8.0%) (week 4). The result of the analysis of the group effect was significant (absolute change: η2=0.31, P=.04; proportional change: η2=0.30, P=.03). Correlations between both absolute and proportional change and the play activity were significant (absolute change: r=0.59, 95% CI 0.32 to 0.77; proportional change: r=0.39, 95% CI 0.08 to 0.64).ConclusionsThe presence of social interaction design elements in pervasive games appears to have a positive effect on levels of physical activity.Trial RegistrationJapan Medical Association Clinical Trial Registration Number JMA-IIA00314; https://tinyurl.com/y5nh6ylr (Archived by WebCite at http://www.webcitation.org/761a6MVAy)

Desire Revolution

How might historical queer and trans activist tactics and visions of the future be used to invigorate contemporary LGBTQ+ politics and thought? This article provides an introduction to the ‘Imagining Queer Europe Then and Now’ special issue of Third Text, an issue which emerges from the final conference of the pan-European queer history project ‘Cruising the Seventies’. We identify the uneven and complex ways in which LGBTQ+ activism, networks, erotic connections, and forms of cultural expression manifested across Europe in the 1970s, and the ways in which these intersected with anti-racist, anti-colonial, anti-fascist and feminist struggles in the same era. We argue for the excavation of the unrealised possibilities of queer pasts and futures, proposing that forms of social and erotic interaction, and aesthetic and cultural intervention, can provide fresh perspectives on the queer past and the politics of its recovery.

Successful Transitions to Remote Assessments and Technology Installations due to COVID-19: The I-CONECT Project

I-CONECT is a randomized controlled clinical trial to examine the impact of social interaction delivered via video-chat on cognitive function (clinicaltrials.gov number: NCT02871921, project website: www.I-CONECT.org ). We aimed to enroll 320 community-dwelling socially isolated older adults (age >=75 years). The recruitment of participants has started in 2018 and was ongoing when COVID-19 pandemic began. Video chat and telephone-based social interaction interventions did not change during COVID-19. However, new recruitment and cognitive assessments, which require in-person contact and deployment and retrieval of video chat devices in participant homes, were suspended due to the nature of our study population (i.e., older age, higher likelihood of comorbidities). Recently we were able to successfully switch to complete remote assessments including 1) telephone-based cognitive assessments using T-COG (Telephone Cognitive Assessment battery), and 2) contactless delivery of our study devices (Chrome books and electronic pill boxes) for subject self-installation. Our creative approach to self-installations includes color coded pictures and an easy-to-follow installation manual, accompanied by remote instruction and support via telephone. This poster introduces our remote assessment and installation protocol and participant and technical support team feedback regarding this new contactless protocol. This presentation provides useful guidance for future studies considering completely remote assessment and telemedicine approaches.

The Effects of Social Skill Interventions for Adolescents With Autism: A Meta-Analysis

Communicating with peers often poses challenges for individuals with autism spectrum disorder (ASD); these social interactions, however, can be especially difficult during the teenage years. For many adolescents with ASD, peer interaction is often limited or nonexistent, even for those taught in general education settings. The purpose of this meta-analysis was to investigate social interaction interventions for adolescents with ASD within public school settings, with a focus on studies that utilized single-case design. Studies were evaluated per the What Works Clearinghouse guidelines. This meta-analysis includes 24 studies with participants with ASD ranging in ages from 13 to 21 years. The effects of social skill interventions were evaluated using visual analysis, Tau- U, and a parametric effect size ( d-Hedges–Pustejovsky–Shadish [DHPS]). Combined effect sizes were calculated and compared. Results provide evidence that interventions can produce positive change in social behavior of adolescents with ASD. Effect sizes were generally large. Interpretations and implications are discussed.

Brothers as Playmates for Their Siblings with Developmental Disabilities: A Multiple-Baseline Design Study

The feasibility of using typically developing siblings as social interaction intervention agents has been suggested in the literature addressing interactions and relationships between children with disabilities and their siblings. However, the outcomes are not completely understood. This study evaluated an intervention that targeted the social play of children with developmental disabilities (DD) that was implemented by typically developing brothers in the children’s home settings. A multiple-baseline design across three sibling dyads was used to examine the effectiveness of the social interaction intervention. The findings resulted in a moderate change in social behaviors of children with DD and increased social skill strategies used by typically developing boy siblings. Percentage of non-overlapping data and Tau-U indices were provided and discussed for the use of sibling-mediated social play intervention with children with DD. The goal of sibling-mediated social interaction intervention is to provide typically developing siblings with specific techniques to engage children with disabilities in play, with the intention of encouraging their active participation to improve the quality of their interaction. By individually fine-tuning the activities to meet the interests of both children with disabilities and their siblings, typically developing siblings can be taught some social competencies that have value not only for children with disabilities, but also for themselves. They can become cognitively aware of their own thought processes.

An Analysis of Research Trends on Social interaction interventions in young children with developmental delays in the Inclusive classroom: A Single-Subject Research

An Analysis of Research Trends on Social interaction interventions in young children with developmental delays in the Inclusive classroom: A Single-Subject Research

Sociocultural Approach toward Creativity: When Vygotsky Considers Mediating ‘C’ Creativity

인간은 사회문화적인 동물로서 다른 사람과의 상호작용의 과정을 제외하고는 인간의 발달에 대해서 온전히 이해하기 어렵다. 이것은 단순한 일반적인 진리로 보이지만 배움과 가르침의 학교 환경에서는 상당한 교육적 함의를 가지고 있다. 이는 창의력 교육 분야에서도 예외는 아닌데 본 논문은 비고스키의 사회문화적 이론을 기반으로 개인의 창의력의 발달 과정이 어떻게 이해되어야 하는지, 또한 교실 안에서 어떻게 학습되고 장려되어야 하는지에 대해서 심도 깊은 고찰을 한다. 이를 위해 본 논문은 첫째, 기존의 창의성에 대한 실험실 위주의 연구 들이 창의력을 개인적인 특징과 결과물로만 인식하는 것에 따른 한계점들에 대해 언급하고 둘째, 비고스키의 사회문화적 이론을 바탕으로 창의력에 대한 이해와 발달이 협력을 기반으로한 과정 중심의 사회문화적인 상호작용으로 이해되어야 하는 근거에 대해서 설명한다. 셋째, 비고스키의 사회문화적 이론 중 가장 대표적인 근접발달지대에 대한 여러 학자들의 의견을 바탕으로 창의력을 강화시키기 위해 어떠한 모방, 비계, 협력의 단계가 있어야 하는지에 대해서 연구한다. 이를 바탕으로 본 논문은 기존의 창의력에 대한 큰 “C”와 작은 “c”의 구조에서 벗어나 비고스키가 어떠한 방식으로 창의성의 잠재력을 설명했는지를 중재하는 ‘C’라는 새로운 용어로 접근하여 교육현장에서 창의적인 과정 중심의 학습과 놀이가 장려되어 질수 있는 방안에 대해 함께 제시한다.As a human creature, we are living in the world as a sociocultural being. This is a simple truth, but it offers a deep and profound proposition when it comes to learning, teaching, and schooling. Through the lens of Vygotsky’s sociocultural theory, which spotlights the importance of social interaction and cultural intervention in individual development and learning, this paper sheds new light on the sociocultural understanding of creativity development. Specifically, in a move away from a dichotomous understanding of creativity in terms of Little ‘c’ and Big ‘C,’ this paper adopts an idea of Mediating ‘C’ which falls in-between laid out by the individual creative development and its relation to sociocultural and cooperative learning and intervention. This approach sharply contrasts with the traditional view of creativity as an individual trait and a final product. In order to accomplish this, this paper firstly fills in the research gap with the current literature in studies and theories of creativity from a Vygotskian perspective on creative processes. Especially, it focuses on how the creative development is mediated and facilitated in the sequence of imitative, instructed, and collaborative learning, which results in one of the most important Vygotskain themes: the Zone of Proximal Development (ZPD). Furthermore, as the focus of the sociocultural theory is often associated with children’s practices as a form of play, the discussion of the pedagogical implications will be also situated on the importance of playful instruction and collaboration that help develop learners’ mediating ‘C’ creativity.

Changes in health parameters in older lay volunteers who delivered a lifestyle-based program to frail older people at home

SummaryObjectiveTo measure health effects in lay volunteers who made home visits consisting of social interaction, nutritional and physical exercise interventions to pre-frail and frail older people (trial registration ClinicalTrials.gov, NCT01991639).MethodsAfter baseline, participants were followed-up at 12 (V1) and 24 (V2) weeks. A one-repetition maximum (1-RPM) and handgrip were measured with the Concept2®DYNO and a dynamometer. The Physical Activity Scale for the Elderly was used to assess physical activity, and Food Frequency Questionnaire and the Mediterranean Diet Adherence Screener for nutrition. Additionally, quality of life (QoL) was measured with the World Health Organization (WHO) quality of life brief questionnaire and anthropometric measurements were performed using bioelectrical impedance analysis.ResultsHandgrip values significantly increased from 32.14 ± 7.94 kg to 33.69 ± 6.72 kg at V1 and 34.36 ± 6.96 kg at V2. The 1‑RPM on the leg press showed a significant increase from 72.47 ± 25.37 kg to 78.12 ± 23.77 kg and 80.85 ± 27.99 kg, respectively. We observed a significant decrease of protein intake from 0.38 ± 0.26 g/kgBW/day to 0.32 ± 0.19 g/kgBW/day and 0.26 ± 0.16 g/kgBW/day, respectively. There were no changes in physical activity, QoL and anthropometric measurements.ConclusionThe findings indicate that projects involving aging healthy volunteers may have additional limited health benefits.

Investigating the Effects of Robot-Assisted Therapy among Children with Autism Spectrum Disorder using Bio-markers

Therapeutic pet robots designed to help humans with various medical conditions could play a vital role in physiological, psychological and social-interaction interventions for children with autism spectrum disorder (ASD). In this paper, we report our findings from a robot-assisted therapeutic study conducted over seven weeks to investigate the changes in stress levels of children with ASD. For this study, we used the parrot-inspired therapeutic robot, KiliRo, we developed and investigated urinary and salivary samples of participating children to report changes in stress levels before and after interacting with the robot. This is a pioneering human-robot interaction study to investigate the effects of robot-assisted therapy using salivary samples. The results show that the bio-inspired robot-assisted therapy can significantly help reduce the stress levels of children with ASD.

A Meta-analysis of School-Based Social Interaction Interventions for Adolescents with Autism Spectrum Disorder

The purpose of this meta-analysis was to identify and evaluate the effectiveness of school-based social interaction interventions for adolescents with autism spectrum disorder (ASD). All 27 studies meeting predetermined inclusion criteria utilized single-case designs. Peer-mediated interventions, peer networks, behavioral skills training, and the teaching interaction procedure were the most frequently utilized strategies and produced large effects for lower, moderate, and higher functioning adolescents with ASD. Teachers rarely implemented interventions, though large effects were reported when they served as intervention agents. Future research concerning the acceptability and feasibility of using social interaction interventions in the classroom is needed in order to facilitate evidence-based practice. Additionally, research that targets more complex and nuanced social behaviors and assesses collateral effects such as academic performance and friendship quality appears warranted.

Impact of antipsychotic review and non-pharmacological intervention on health-related quality of life in people with dementia living in care homes: WHELD-a factorial cluster randomised controlled trial.

Very few interventional studies have directly examined the impact of treatment approaches on health-related quality of life (HRQL) in people with dementia. This is of particular importance in therapies to address behavioural symptoms, where HRQL is often severely affected. Analysis within the WHELD cluster randomised factorial study in 16 UK care homes examining the impact of person-centred care in combination with antipsychotic review, social interaction and exercise interventions. This study analysed impact on HRQL through the DEMQOL-Proxy. Data on HRQL were available for 187 participants. People receiving antipsychotic review showed a significant worsening in two DEMQOL-Proxy domains (negative emotion: p = 0.02; appearance: p = 0.04). A best-case scenario analysis showed significant worsening for total DEMQOL-Proxy score. Social interaction intervention resulted in a significant benefit to HRQL (p = 0.04). There was no deterioration in HRQL in groups receiving both antipsychotic review and social interaction (p = 0.62). This demonstrates an important detrimental impact of discontinuation of antipsychotics in dementia on HRQL, highlighting the need for careful review of best practice guidelines regarding antipsychotic use and emphasising the importance of providing evidence-based non-pharmacological interventions in conjunction with antipsychotic review. Copyright © 2016 John Wiley & Sons, Ltd.

Impact of Antipsychotic Review and Nonpharmacological Intervention on Antipsychotic Use, Neuropsychiatric Symptoms, and Mortality in People With Dementia Living in Nursing Homes: A Factorial Cluster-Randomized Controlled Trial by the Well-Being and Health for People With Dementia (WHELD) Program

This study evaluated the impact of antipsychotic review, social interaction, and exercise, in conjunction with person-centered care, on antipsychotic use, agitation, and depression in people with dementia living in nursing homes. A cluster-randomized factorial controlled trial with two replications was conducted in people with dementia in 16 U.K. nursing homes. All homes received training in person-centered care. Eight homes were randomly assigned to antipsychotic review, to a social interaction intervention, and to an exercise intervention for 9 months, with most homes assigned to more than one intervention. The primary outcome measures were antipsychotic use, agitation, and depression. Secondary outcome measures were overall neuropsychiatric symptoms and mortality. Antipsychotic review significantly reduced antipsychotic use by 50% (odds ratio 0.17, 95% confidence interval [CI] 0.05 to 0.60). Antipsychotic review plus the social interaction intervention significantly reduced mortality (odds ratio 0.26, 95% CI 0.13 to 0.51) compared with the group receiving neither. The group receiving antipsychotic review but not the social intervention showed significantly worse outcome in neuropsychiatric symptoms compared with the group receiving neither (score difference +7.37, 95% CI 1.53 to 13.22). This detrimental impact was mitigated by concurrent delivery of the social intervention (-0.44, CI -4.39 to 3.52). The exercise intervention significantly improved neuropsychiatric symptoms (-3.59, 95% CI -7.08 to -0.09) but not depression (-1.21, CI -4.35 to 1.93). None of the interventions had a significant impact specifically on agitation. While reductions in antipsychotic use can be achieved by using a "real world" intervention, this may not be of benefit to people with dementia in the current climate of more judicious prescribing unless nonpharmacological interventions such as social interaction or exercise are provided in parallel.