Systematic Review Of Behavioral Interventions Research Articles

A Systematic Review of Behavioral Interventions for Elementary School Children with Social, Emotional and Behavioral Difficulties: Contributions from Single-Case Research Studies

<p style="text-align:justify">Challenges arising from the classroom behavioral management of students with social, emotional and behavioral difficulties are a concern for educational professionals. The purpose of this study is to review common elements of behavior interventions for the disruptive behaviors of children with social, emotional and behavioral difficulties. A systematic review was conducted through an electronic search of studies (from 2000 to 2017) on ERIC, Web of Science, FRANCIS, and MEDLINE databases. The inclusion criteria involved: (i) an intervention improving behaviors at school of children with disruptive behaviors; (ii) elementary school children with the majority of the sample or average age between 6-11 years old; (iii) at least one measurable outcome focusing on social/emotional/behavioral outcomes; (iv) single-case designs. Of the 5339 articles that were identified in the initial screening, 27 met the criteria to be included in the review. Common characteristics of successful interventions are discussed to make recommendations for future implementation.</p>

A Systematic Review of Behavioral Interventions to Reduce Restricted or Repetitive Behavior of Individuals with Visual Impairment

Restricted or repetitive behavior (RRB) is common for individuals with visual impairment (VI), autism spectrum disorder (ASD), and intellectual disability. Previous reviews have suggested that VI may moderate the effectiveness of behavioral interventions to decrease RRB. A search of the single case literature resulted in 30 studies and 40 experiments involving participants with VI to test behavioral interventions to reduce RRBs. Nearly all participants had significant intellectual disability, half were deafblind, and only two had an ASD diagnosis. Success rates were higher for participants with low vision (88.9%) than for participants with blindness (68.4%) and to reduce non-self-injurious behavior (81%) than for self-injurious behavior (68.4%). Although most interventions in this review involved punishment and more research on reinforcement-based interventions is needed, multi-component interventions combining differential reinforcement with brief restraint or specific response contingent on RRB appear to hold the most promise for reducing RRBs for individuals with VI.

A systematic review of behavioral interventions for rural breast cancer survivors.

Rural breast cancer survivors (RBCS) are at greater risk for poorer health outcomes and face greater treatment barriers compared to their urban counterparts, necessitating behavioral interventions tailored for the unique needs of RBCS. A systematic review of studies examining behavioral interventions delivered to RBCS living in the United States from 2000 to 2020 was conducted following PRIMSA guidelines. Nineteen unique studies were included: eight randomized controlled trials, two matched-control studies, six pre-post intervention feasibility studies, and three post-intervention satisfaction studies. Thirteen interventions aimed to improve psychosocial support, three to improve weight management, and three to improve education. Results indicate interventions' feasibility and acceptability. Six out of eight intervention conditions reported favorable outcomes compared to control conditions, suggesting promise for efficacy. However, variability in intervention objective, duration, delivery, and follow-up timing, and small sample sizes prevent overarching conclusions. Research involving larger sample sizes, higher quality control groups, and longer follow-up data is needed.

Systematic Review of Behavioral Interventions Using Digital Technology to Reduce Problem Behavior in the Classroom

Problem behavior in the classroom leads to challenges for teachers who often feel ill equipped to address such behavior. Behavior analytic interventions have been shown to be effective for reducing problem behavior in the classroom. Less is known about the impact of these interventions when implemented using digital technology. The purpose of the current systematic review was to synthesize and evaluate the quality of the literature. We identified 19 studies which demonstrated the effectiveness of these interventions in both general education and special education classrooms. Across these studies, touch-screen devices and computers were the most frequently used form of digital technology. Implications for practice and future research will be discussed.

Systematic Review of Behavioral Interventions to Increase Family Support for Maternal and Child Nutrition in Low- and Middle-Income Countries

Abstract Objectives To examine the scope and impact of behavioral interventions to increase family support for maternal, infant, and young child nutrition (MIYCN) practices in low- and middle-income countries (LMICs). Despite the recognized influence of fathers, grandmothers, and other family members, we lack a comprehensive review of how interventions engage them and how engagement impacts MIYCN. Methods We first conducted a scoping review to identify family-focused interventions and then a mixed methods review to assess impacts. We systematically searched PubMed, Scopus, Web of Science, Global Health, and CINAHL for peer-reviewed studies of behavioral interventions to increase family support for MIYCN. We screened 5733 abstracts and evaluated 142 full-text articles. Quantitative and qualitative results were examined independently. (PROSPERO ID# CRD42018090273) Results The scoping review of intervention approaches included 48 studies; the mixed methods systematic review assessing impact included 16 comparative quantitative studies and 13 qualitative studies. A wide range of approaches were used to engage family members to support MIYCN, including multi-channel strategies with community outreach. Most comparative research relied on direct counseling and focused on breastfeeding in first 6 months, primarily engaging fathers (9) or, less often, grandmothers (2) or both (2). Most (10/13) found positive impacts on exclusive breastfeeding rates and some associated practices and on family members’ awareness and support to mothers. The 3 studies on maternal nutrition, complementary feeding, or multiple MIYCN indicators also suggested benefits of engaging family members. Qualitative themes included improved nutrition behaviors, enhanced relationships, and challenges due to social norms. Conclusions Interventions engaging family members in LMICs can increase awareness, build support for MIYCN, and improve practices. While many positive outcomes were reported, more rigorous study designs testing causal relationships, and implementation research to elucidate pathways and identify factors shaping effectiveness, are needed. Important gaps include research on interventions that support maternal nutrition and complementary feeding, include nutrition-sensitive activities, and utilize gender transformative approaches. Funding Sources USAID.

Mixed-Methods Systematic Review of Behavioral Interventions in Low- and Middle-Income Countries to Increase Family Support for Maternal, Infant, and Young Child Nutrition during the First 1000 Days.

ABSTRACTFathers, grandmothers, and other family members’ influence on maternal, infant, and young child nutrition (MIYCN) is widely recognized, yet synthesis of the effectiveness of engaging them to improve nutrition practices during the first 1000 d is lacking. We examined the impact of behavioral interventions to engage family members in MIYCN in low- and middle-income countries through a mixed-methods systematic review. We screened 5733 abstracts and included 35 peer-reviewed articles on 25 studies (16 with quantitative and 13 with qualitative data). Most quantitative studies focused on early breastfeeding, primarily engaging fathers or, less often, grandmothers. Most found positive impacts on exclusive breastfeeding rates and family members’ knowledge and support. The few quantitative studies on complementary feeding, maternal nutrition, and multiple outcomes also suggested benefits. Qualitative themes included improved nutrition behaviors, enhanced relationships, and challenges due to social norms. Interventions engaging family members can increase awareness and build support for MIYCN, but more rigorous study designs are needed. This systematic review is registered at PROSPERO as CRD42018090273, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=90273.

Abstract ES8-3: Everything Comes at a Price - Toxicity, Cost and Adherence to Endocrine Therapy

Abstract Despite the proven efficacy of aromatase inhibitors (AIs) for the treatment of hormone-sensitive breast cancer (BC) adherence to therapy for the full duration of 5-years is suboptimal. Adherence is likely even lower for extended adjuvant therapy for up to 10-years. Issues related to non-adherence are increasingly important, as analyses from prospective randomized trials show compliance to endocrine therapy is associated with improved disease-free survival. The reasons for non-adherence to hormonal therapy are multifactorial. Barriers to compliance include patient, physician, medication and system related variables and poor compliance is usually associated with a combination of these factors. Characteristics associated with non-adherence include very high and low age, minority race, being single, increased number of comorbidities, lack of knowledge about efficacy of AI therapy, history of non-adherence to other chronic medications, limited insurance status, and higher out of pocket costs. Side effects from hormonal therapy is the most common reason for early discontinuation. AI arthralgia has been estimated to affect 45-60% of patients, many of whom report severe or continuous pain. One study reported an overall AI discontinuation rate of 32.4% within 2 years due to adverse effects, 24.3% specifically due to musculoskeletal symptoms, which was the primary reason for discontinuation. There is no consensus on the best treatment for AI arthralgia. The most commonly used therapy is NSAIDs, although there are no formal data testing their efficacy for AI arthralgia, and they are associated with potentially severe adverse effects. Randomized controlled trials have shown benefits from exercise (aerobic and strength training exercises), acupuncture, omega-3-fatty acids and duloxetine compared to placebo for AI arthralgia. Studies have also demonstrated improvement in symptoms over time even among patients receiving placebo. Various educational interventions have also been studied to improve adherence. A systematic review of behavioral interventions to enhance adherence to hormone therapy found five articles that met inclusion criteria and none reported the interventions significantly enhanced adherence compared to usual care. All evaluated educational interventions with or without reminders or navigation. In addition, a multicenter randomized clinical trial of patients with early stage breast cancer on AI’s found that bi-weekly unidirectional text messages for 36 months focused on overcoming potential barriers to medication adherence did not result in improved adherence to hormonal therapy. It is likely that improving long-term adherence will likely require sustained behavioral interventions and support. Citation Format: DL Hershman. Everything Comes at a Price - Toxicity, Cost and Adherence to Endocrine Therapy [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr ES8-3.

A Systematic Review of Behavioral Interventions to Decrease Opioid Prescribing After Surgery.

The aim of this study was to summarize strategies to reduce postsurgical opioid prescribing at discharge. Current practices for the prescription of opioids at discharge after surgery are highly variable and often excessive. We conducted a systematic review to identify behavioral interventions designed to improve these practices. We searched MEDLINE, EMBASE, CINAHL, and PsycINFO until December 14, 2018 to identify studies of behavioral interventions designed to decrease opioid prescribing at discharge among adults undergoing surgery. Behavioral interventions were defined according to the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy. We assessed the risk of bias of included studies using criteria suggested by Cochrane EPOC and the Newcastle-Ottawa scale. Of 8048 citations that were screened, 24 studies were included in our review. Six types of behavioral interventions were identified: local consensus-based processes (18 studies), patient-mediated interventions (2 studies), clinical practice guidelines (1 study), educational meetings (1 study), interprofessional education (1 study), and clinician reminder (1 study). All but one study reported a statistically significant decrease in the amount of opioid prescribed at discharge after surgery, and only 2 studies reported evidence of increased pain intensity. Reductions in prescribed opioids ranged from 34.4 to 212.3 mg morphine equivalents. All studies were found to have medium-to-high risks of bias. We identified 6 types of behavioral strategies to decrease opioid prescription at discharge after surgery. Despite the risk of bias, almost all types of intervention seemed effective in reducing opioid prescriptions at discharge after surgery without negatively impacting pain control.

2019 Canadian Surgery Forum Abstracts.

# 01. The future of general surgery training: a Canadian resident nationwide Delphi consensus statement {#article-title-2} Various pedagogical models have been introduced in an attempt to improve and restructure surgical training, but significant obstacles remain. Before implementing national

Systematic Review of Behavioural Interventions Targeting Men to Prevent Heterosexual Transmission of HIV in Developing Countries

Background: People in developing countries and especially sub-Saharan Africa bear a huge brunt of HIV/AIDS pandemic. Transmission in adults is mostly heterosexual with men playing a key role in such dynamics. They do so because of risky sexual practices and behaviours which are shaped by cultural norms. Behavioural interventions are likely to reduce such transmissions. The primary objective of this study is to examine the evidence of the effectiveness of behavioural interventions targeting men to prevent heterosexual transmission of HIV in developing countries. Method: We conducted a systematic review of studies evaluating the effect of behavioural interventions in developing countries published from 1990 to 2011. Five databases were searched; Pub Med, MEDLINE, Cochrane, Trip database, Eldis, Africa Health line, CINAHL and AIDSLINE. Contact has been made to SFH (Nigeria) and International AIDS Alliance at Brighton, UK and USAID (Nigeria). Data were extracted and qualitative thematicsynthesis was done to pool evidence, which was presented in a narrative format. Results: Some 6339 articles yielded from the search. 501 titles of abstracts were reviewed, 82 studies were thoroughly examined and 22 met the inclusion criteria. All studies that met the inclusion criteria were critically appraised and reviewed. Only 5 RCT was found, reflecting the paucity of published rigorous studies in comparison to HIV/AIDS burden in this region. Other non-randomized evaluation studies were included in the analysis. Multi-component interventions produced more positive changes in behavioural outcomes. Interventions with short delivery time, targeting experienced men in workplaces were associated with more positive changes. Behavioural outcomes like knowledge of men about HIV, condom use, attitude towards condom, gender roles/GBV are easier to change than reduction in number of sexual partners/episodes of unprotected sex with CSW/other partners. Very few studies evaluated interventions impact on biological outcomes though also reported positive changes. Only limited evidence exists to show that interventions in which men participated in the evaluation process are more effective. Conclusion: Although the evidence base is narrow, behavioural interventions can prevent heterosexual transmission of HIV by men in developing countries. Only a few rigorous studies evaluated intervention impacts on behavioural outcomes, though reported positive impacts. Policymakers and programmers should consider contextual factors in designing new interventions. Researchers should employ more rigorous methods in evaluating interventions to expand the existing body of evidence.

Adverse childhood experiences and obesity: Systematic review of behavioral interventions for women.

Studies have demonstrated a relationship between adverse childhood experiences (ACEs) and adult obesity. Group interventions addressing the psychosocial sequelae of ACES using a trauma-informed approach for adults are well described in the literature. There is also a significant body of literature on the efficacy and proposed structure of interventions addressing weight reduction in adults. However, it is unknown how often interventions addressing attainment of a healthy weight incorporate a specific focus on adult women with a history of ACEs, including childhood abuse and trauma. A systematic review of the literature was conducted using standard approaches. Two additional reviews used broadened inclusion criteria to identify and include group-level interventions that addressed intended outcomes other than obesity. Studies that examined the link between ACEs and obesity as a primary outcome and that provided a description of any potential mediating variables were also identified. The current literature search was conducted as the first step in a multifaceted approach to the development of a set of proposed research protocol designs for an Office on Women's Health-sponsored trauma-informed healthy weight pilot intervention for obese women with a history of ACEs. No articles describing interventions for the treatment of obesity or overweight women with a history of ACEs were identified. Eleven articles describing ACE-related interventions and 15 studies identifying mediators were reviewed. Intervention studies for women with ACEs, other than psychotherapy, are limited. Significant mediators to be considered include anxiety symptoms and internalizing behaviors. Specific recommendations for interventions are provided. (PsycINFO Database Record

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People.

Because eating habits are inseparably linked with people’s physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases—PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies’ duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people’s dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.

A Systematic Review of Behavioral Interventions to Reduce Condomless Sex and Increase HIV Testing for Latino MSM.

Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV, and there have been calls to improve availability of culturally sensitive HIV prevention programs for this population. This article provides a systematic review of intervention programs to reduce condomless sex and/or increase HIV testing among Latino MSM. We searched four electronic databases using a systematic review protocol, screened 1777 unique records, and identified ten interventions analyzing data from 2871 Latino MSM. Four studies reported reductions in condomless anal intercourse, and one reported reductions in number of sexual partners. All studies incorporated surface structure cultural features such as bilingual study recruitment, but the incorporation of deep structure cultural features, such as machismo and sexual silence, was lacking. There is a need for rigorously designed interventions that incorporate deep structure cultural features in order to reduce HIV among Latino MSM.

Supplemental Material for Adverse Childhood Experiences and Obesity: Systematic Review of Behavioral Interventions for Women

Supplemental Material for Adverse Childhood Experiences and Obesity: Systematic Review of Behavioral Interventions for Women

Critical Review: When the Party is Over: A Systematic Review of Behavioral Interventions for Substance-Using Men Who Have Sex with Men.

Because problematic patterns of alcohol and other substance use are prevalent drivers of the HIV/AIDS epidemic, comprehensive interventions are needed for substance-using men who have sex with men (SUMSM). We conducted a systematic review of 12 randomized controlled trials (RCTs) of behavioral interventions for reducing condomless anal intercourse (CAI) in SUMSM. Three RCTs observed that cognitive behavioral or motivational interviewing interventions achieved a 24% to 40% decrease in CAI. Interventions also tended to demonstrate greater efficacy for reducing CAI and substance use among those who had lower severity of substance use disorder symptoms. Although behavioral interventions for SUMSM are one potentially important component of biobehavioral HIV/AIDS prevention, further research is needed to examine whether integrative approaches that cultivate resilience and target co-occurring syndemic conditions demonstrate greater efficacy. Multilevel intervention approaches are also needed to optimize the effectiveness of pre-exposure prophylaxis and HIV treatment as prevention with SUMSM.

Systematic Review of Behavioral Interventions to Prevent Pressure Ulcers in Adults with Spinal Cord Injury

Systematic Review of Behavioral Interventions to Prevent Pressure Ulcers in Adults with Spinal Cord Injury

Using qualitative comparative analysis in a systematic review of a complex intervention.

BackgroundSystematic reviews evaluating complex interventions often encounter substantial clinical heterogeneity in intervention components and implementation features making synthesis challenging. Qualitative comparative analysis (QCA) is a non-probabilistic method that uses mathematical set theory to study complex phenomena; it has been proposed as a potential method to complement traditional evidence synthesis in reviews of complex interventions to identify key intervention components or implementation features that might explain effectiveness or ineffectiveness. The objective of this study was to describe our approach in detail and examine the suitability of using QCA within the context of a systematic review.MethodsWe used data from a completed systematic review of behavioral interventions to improve medication adherence to conduct two substantive analyses using QCA. The first analysis sought to identify combinations of nine behavior change techniques/components (BCTs) found among effective interventions, and the second analysis sought to identify combinations of five implementation features (e.g., agent, target, mode, time span, exposure) found among effective interventions. For each substantive analysis, we reframed the review’s research questions to be designed for use with QCA, calibrated sets (i.e., transformed raw data into data used in analysis), and identified the necessary and/or sufficient combinations of BCTs and implementation features found in effective interventions.ResultsOur application of QCA for each substantive analysis is described in detail. We extended the original review findings by identifying seven combinations of BCTs and four combinations of implementation features that were sufficient for improving adherence. We found reasonable alignment between several systematic review steps and processes used in QCA except that typical approaches to study abstraction for some intervention components and features did not support a robust calibration for QCA.ConclusionsQCA was suitable for use within a systematic review of medication adherence interventions and offered insights beyond the single dimension stratifications used in the original completed review. Future prospective use of QCA during a review is needed to determine the optimal way to efficiently integrate QCA into existing approaches to evidence synthesis of complex interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0256-y) contains supplementary material, which is available to authorized users.

A systematic review of behavioural interventions to reduce preoperative alcohol use.

Preoperative alcohol use is associated with an increase in postoperative morbidity and mortality. Short-term abstinence prior to elective surgery has been shown to reduce postoperative risks. Therefore, behavioural intervention (BI) targeting risky drinking may have significant utility in preventing surgical complications. The literature was systematically reviewed to identify the scope and outcomes of BIs aiming to reduce alcohol use in risky drinkers before they underwent surgery. Five databases were searched using PRISMA criteria. Of 1243 studies identified, four met pre-established inclusion criteria: (i) implementation of a BI prior to an elective surgery; (ii) the BI-targeted alcohol use among risky drinkers; and (iii) printed in English. Two studies indicated significant reductions in alcohol use at follow ups, and one study demonstrated reductions in postoperative risks. These findings are encouraging, but in light of methodological limitations, the efficacy of preoperative BIs for risky drinking could not be determined. Future efforts to screen and implement BIs addressing alcohol use in preoperative patients should carefully define risky drinking, allow ample time for recruitment prior to surgery, implement empirically supported interventions, examine the impact of relevant covariates, and consider the statistical power needed to detect change in postoperative complications. Given the strong link between preoperative alcohol use and postoperative risks, additional research on preoperative BIs is critically needed. Existing research suggests several promising directions for research that may enhance future intervention efforts with this high-risk population. [Fernandez AC, Claborn KR, Borsari B. A systematic review of behavioural interventions to reduce preoperative alcohol use. Drug Alcohol Rev 2015;34:508-20].

Behavioral Interventions to Reduce Sexual Risk Behavior in Adults with HIV/AIDS Receiving HIV Care: A Systematic Review.

Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-randomized controlled trials (with standard-of-care control groups), considering at least one of a list of HIV-related behavioral or biological outcomes in PLWHA aged ≥18 receiving HIV care with at least 3-month follow-up were included. No language or publication status restrictions were set. Standardized search, data abstraction, and evaluation methods were used. Five randomized controlled trials were included in the review. We found limited evidence that sexual risk reduction interventions increase condom use consistency in HIV transmission risk acts, and reduce the number of (casual) sexual partners. We still believe that regular interactions between HIV care providers and PLWHA provide valuable opportunities for theory-based sexual risk reduction interventions to restrain the spread of HIV.

Successful behavioural strategies to increase physical activity and improve glucose control in adults with Type2 diabetes.

AimsTo explore which behaviour change techniques and other intervention features are associated with increased levels of physical activity and improved HbA1c in adults with Type 2 diabetes.MethodsModerator analyses were performed on a dataset of 21 behaviour change techniques and six intervention features identified in a systematic review of behavioural interventions (N = 1975 patients with Type 2 diabetes) to establish their associations with changes in physical activity and HbA1c.ResultsFour behaviour change techniques (prompt focus on past success, barrier identification/problem‐solving, use of follow‐up prompts and provide information on where and when to perform physical activity) had statistically significant associations with increased levels of physical activity. Prompt review of behavioural goals and provide information on where and when to perform physical activity behaviour had statistically significant associations with improved HbA1c. Pedometer use was associated with decreased levels of physical activity.ConclusionsThese data suggest that clinical care teams can optimise their consultations by incorporating specific behaviour change techniques that are associated with increased levels of physical activity and improved long‐term glycaemic control.