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Feasibility of an Alcohol Intervention Programme for TB Patients with Alcohol Use Disorder (AUD) - A Qualitative Study from Chennai, South India  [PDF]
Beena Thomas, Mohanarani Suhadev, Jamuna Mani, B. Gopala Ganapathy, Asaithambi Armugam, F. Faizunnisha, Mohanasundari Chelliah, Fraser Wares
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0027752
Abstract: Background The negative influences of alcohol on TB management with regard to delays in seeking care as well as non compliance for treatment has been well documented. This study is part of a larger study on the prevalence of AUD (Alcohol Use Disorder) among TB patients which revealed that almost a quarter of TB patients who consumed alcohol could be classified as those who had AUD. However there is dearth of any effective alcohol intervention programme for TB patients with Alcohol Use Disorder (AUD). Methodology This qualitative study using the ecological system model was done to gain insights into the perceived effect of alcohol use on TB treatment and perceived necessity of an intervention programme for TB patients with AUD. We used purposive sampling to select 44 men from 73 TB patients with an AUDIT score >8. Focus group discussions (FGDs) and interviews were conducted with TB patients with AUD, their family members and health providers. Results TB patients with AUD report excessive alcohol intake as one of the reasons for their vulnerability for TB. Peer pressure has been reported by many as the main reason for alcohol consumption. The influences of alcohol use on TB treatment has been elaborated especially with regard to the fears around the adverse effects of alcohol on TB drugs and the fear of being reprimanded by health providers. The need for alcohol intervention programs was expressed by the TB patients, their families and health providers. Suggestions for the intervention programmes included individual and group sessions, involvement of family members, audiovisual aids and the importance of sensitization by health staff. Conclusions The findings call for urgent need based interventions which need to be pilot tested with a randomized control trial to bring out a model intervention programme for TB patients with AUD.
The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems
Mairead Corrrigan, Margaret E Cupples, Susan M Smith, Molly Byrne, Claire S Leathem, Pauline Clerkin, Andrew W Murphy
BMC Health Services Research , 2006, DOI: 10.1186/1472-6963-6-90
Abstract: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis.Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour change training, providing more practical information about stress management and removing self-monitoring of lifestyle change.Qualitative research is integral to developing the design detail of a complex intervention and tailoring its components to address individuals' needs in different healthcare systems. The findings highlight how qualitative research may be a valuable component of the preparation for complex interventions and their evaluation.Coronary heart disease (CHD) morbidity and mortality in the Republic of Ireland (ROI) and the United Kingdom (UK) are among the highest in Europe [1,2]. Health service initiatives in both countries [1,3] have promo
Testing the feasibility and effects of a self-management support intervention for patients with cancer and their family caregivers to reduce pain and related symptoms (ANtiPain): Study protocol of a pilot study  [PDF]
Antje Koller, Monika Hasemann, Karin Jaroslawski, Sabina De Geest, Gerhild Becker
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.42012
Abstract:

Despite effective treatment options, more than 40% of cancer patients receive inadequate pain management. Our previous pilot study resulted in substantial adaptations of a cancer pain self-management intervention, the German PRO-Self? Plus Pain Control Program originally developed in the United States. This program will be implemented into clinical practice at the Medical Center-University of Freiburg. The purpose of this multiple methods pilot study is to test the implementation regarding feasibility and effects in clinical practice. In a randomized, wait-list controlled pilot study, adult oncology in-patients of a palliative care consultation service with pain >3/10 will be recruited. The intervention will be performed by a specialized advanced practice nurse with an in-hospital visit and, after discharge, via phone calls and visits. The follow-up will be personalized according to a clinical algorithm that factors in pain intensity, satisfaction with pain management, and patient adherence. The intervention includes structured and tailored components and is based on three key strategies: information, skill building and nurse coaching. The specific aims of this study are threefold: 1) to test the feasibility of the study and intervention procedures; 2) to establish effect sizes of main outcome variables (e.g. decrease pain intensity, reduce the number of patients with pain as main symptom) for subsequent power calculation; 3) to explore participants’ experiences with pain self-management support and their view of burden and benefit from study participation in a qualitative substudy. During the study period, which includes three data collection time points (T0 before, T1 one week and T2 six weeks after discharge), data will be collected via field notes of study nurses and questionnaires of patients. The results of this pilot study will build the basis for a larger comparative effectiveness study in which long term outcomes of a cancer pain self-management intervention in clinical practice will be evaluated.

Do Personally Tailored Videos in a Web-Based Physical Activity Intervention Lead to Higher Attention and Recall? – An Eye-Tracking Study  [PDF]
Stephanie Alley,Cally Jennings,Nayadin Persaud,Ronald C. Plotnikoff,Corneel Vandelanotte
Frontiers in Public Health , 2014, DOI: 10.3389/fpubh.2014.00013
Abstract: Over half of the Australian population does not meet physical activity guidelines and has an increased risk of chronic disease. Web-based physical activity interventions have the potential to reach large numbers of the population at low-cost, however issues have been identified with usage and participant retention. Personalized (computer-tailored) physical activity advice delivered through video has the potential to address low engagement, however it is unclear whether it is more effective in engaging participants when compared to text-delivered personalized advice. This study compared the attention and recall outcomes of tailored physical activity advice in video- vs. text-format. Participants (n = 41) were randomly assigned to receive either video- or text-tailored feedback with identical content. Outcome measures included attention to the feedback, measured through advanced eye-tracking technology (TobiiX 120), and recall of the advice, measured through a post intervention interview. Between group ANOVA’s, Mann–Whitney U tests and chi square analyses were applied. Participants in the video-group displayed greater attention to the physical activity feedback in terms of gaze-duration on the feedback (7.7 vs. 3.6 min, p < 001), total fixation-duration on the feedback (6.0 vs. 3.3 min, p < 001), and focusing on feedback (6.8 vs. 3.5 min, p < 001). Despite both groups having the same ability to navigate through the feedback, the video-group completed a significantly (p < 0.001) higher percentage of feedback sections (95%) compared to the text-group (66%). The main messages were recalled in both groups, but many details were forgotten. No significant between group differences were found for message recall. These results suggest that video-tailored feedback leads to greater attention compared to text-tailored feedback. More research is needed to determine how message recall can be improved, and whether video-tailored advice can lead to greater health behavior change.
Development of a nurse home visitation intervention for intimate partner violence
Susan M Jack, Marilyn Ford-Gilboe, C Nadine Wathen, Danielle M Davidov, Diane B McNaughton, Jeffrey H Coben, David L Olds, Harriet L MacMillan, NFP IPV Research Team
BMC Health Services Research , 2012, DOI: 10.1186/1472-6963-12-50
Abstract: Following a preliminary needs assessment, an exploratory multiple case study was conducted to identify the core components of the proposed IPV intervention. This included qualitative interviews with purposeful samples of NFP clients and community stakeholders, and focus groups with nurse home visitors recruited from four NFP sites. Conventional content analysis and constant comparison guided data coding and synthesis. A process for developing complex interventions was then implemented.Based on data from 69 respondents, an IPV intervention was developed that focused on identifying and responding to IPV; assessing a client's level of safety risk associated with IPV; understanding the process of leaving and resolving an abusive relationship and system navigation. A need was identified for the intervention to include both universal elements of healthy relationships and those tailored to a woman's specific level of readiness to promote change within her life. A clinical pathway guides nurses through the intervention, with a set of facilitators and corresponding instructions for each component.NFP clients, nurses and stakeholders identified the need for modifications to the existing NFP program; this led to the development of an intervention that includes universal and targeted components to assist NFP nurses in addressing IPV with their clients. Plans for feasibility testing and evaluation of the effectiveness of the IPV intervention embedded within the NFP, and compared to NFP-only, are discussed.Over the past two decades, there has been a substantial increase in what is known about the epidemiology of intimate partner violence (IPV). In a multi-country World Health Organization (WHO) study, the lifetime prevalence of physical or sexual violence ranged from 15 to 71% [1]. There is now a significant body of research that documents a broad range of mental and physical health problems associated with IPV [1-4]. Among pregnant women, past and current IPV has been associated
The working mechanisms of an environmentally tailored physical activity intervention for older adults: a randomized controlled trial
Maartje M van Stralen, Hein de Vries, Aart N Mudde, Catherine Bolman, Lilian Lechner
International Journal of Behavioral Nutrition and Physical Activity , 2009, DOI: 10.1186/1479-5868-6-83
Abstract: A clustered randomized controlled trial with two computer tailored interventions and a no-intervention control group was conducted among 1971 adults aged ≥ 50. The two tailored interventions were developed using Intervention Mapping and consisted of three tailored letters delivered over a four-month period. The basic tailored intervention targeted psychosocial determinants alone, while the environmentally tailored intervention additionally targeted environmental determinants, by providing tailored environmental information. Study outcomes were collected with questionnaires at baseline, three and six months and comprised total physical activity (days/week), walking (min/week), cycling (min/week), sports (min/week), environmental perceptions and use and appreciation of the interventions.Mediation analyses showed that changes in cycling, sports and total physical activity behaviour induced by the environmentally tailored intervention were mediated by changes in environmental perceptions. Changes in environmental perceptions did not mediate the effect of the basic tailored intervention on behaviour. Compared with the basic tailored intervention, the environmentally tailored intervention significantly improved cycling behaviour (τ = 30.2). Additionally, the tailored letters of the environmentally tailored intervention were better appreciated and used, although these differences did not mediate the intervention effect.This study gave some first indications of the relevance of environmental perceptions as a determinant of changing physical activity behaviours and the potential effectiveness of providing environmental information as an intervention strategy aimed at enhancing physical activity behaviour among older adults.Sufficient physical activity [PA], defined as meeting the international recommendation of 30 minutes of moderate PA a day for at least five days of the week [1], has been associated with a decreased risk of health problems that are particularly salient amo
A tailored lifestyle intervention to reduce the cardiovascular disease risk of individuals with Familial Hypercholesterolemia (FH): design of the PRO-FIT randomised controlled trial
Karen Broekhuizen, Mireille NM van Poppel, Lando LJ Koppes, Johannes Brug, Willem van Mechelen
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-69
Abstract: This project is designed as a randomised controlled trial in which individuals with FH will be assigned randomly to a control or intervention group. In the intervention group (n = 200), participants will receive a personalized intervention which is a combination of web-based tailored lifestyle advice and personal counselling by a lifestyle coach. The control group (n = 200) will receive care as usual. Primary outcomes are biological indicators of CVD risk: systolic blood pressure, glucose, BMI, waist circumference and lipids (triglycerides, total, LDL and HDL cholesterol). Secondary outcomes are: healthy lifestyle behaviour (with regard to smoking, physical activity, dietary pattern and compliance to statin therapy) and psychological correlates and determinants of healthy lifestyle behaviour (knowledge, attitude, risk perception, social influence, self-efficacy, cues to action, intention and autonomy). Measurement will take place at baseline, and at 3 and 12 months after randomisation. Additionally, a throughout process-evaluation will be conducted to assess and monitor intervention implementation during the trial.Results of the PRO-FIT project will provide information about the effects and implementation of a healthy lifestyle intervention for individuals with FH. Our experiences with this intervention will be indicative about the suitability, feasibility and benefits of this approach for future interventions in other high-risk groups, such as Familial Combined Hypercholesterolemia (FCH) and diabetes.NTR1899Familial hypercholesterolemia (FH) is an autosomal dominant disorder of the lipoprotein metabolism. Due to a defect of the low density lipoprotein (LDL) receptor gene, plasma concentrations of LDL cholesterol (LDL-C) are elevated[1]. In the Netherlands, approximately one in 300 people is affected with the heterozygous type of FH[2]. In 2003, the Ministry of Health, Welfare, and Sports introduced a national cascade screening program to detect people with FH. The
Design of the muscles in motion study: a randomized controlled trial to evaluate the efficacy and feasibility of an individually tailored home-based exercise training program for children and adolescents with juvenile dermatomyositis
G. Esther A. Habers, Marco van Brussel, Anneli C Langbroek-Amersfoort, Annet van Royen, Tim Takken
BMC Musculoskeletal Disorders , 2012, DOI: 10.1186/1471-2474-13-108
Abstract: Subjects (n?=?30) will include 8–18?year olds diagnosed with JDM. The intervention consists of an individually tailored 12-weeks home-based exercise training program in which interval training on a treadmill is alternated with strength training during each session. The program is based on previous literature and designed with a defined frequency, intensity, time, and type of exercise (FITT principles). Primary outcome measures include aerobic exercise capacity, isometric muscle strength, and perception of fatigue. The study methodology has been conceived according to the standards of the CONSORT guidelines. The current study will be a multi-center (4 Dutch University Medical Centers) RCT, with the control group also entering the training arm directly after completion of the initial protocol. Randomization is stratified according to age and gender.The current study will provide evidence on the efficacy and feasibility of an individually tailored 12-week home-based exercise training program in youth with JDM.Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands: 11–336; Netherlands Trial Register (NTR): NTR 3184.
Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care
Sabine N van der Veer, Maartje LG de Vos, Kitty J Jager, Peter HJ van der Voort, Niels Peek, Gert P Westert, Wilco C Graafmans, Nicolette F de Keizer
Implementation Science , 2011, DOI: 10.1186/1748-5908-6-119
Abstract: We will conduct a cluster randomized controlled trial with intensive care units (ICUs) in the Netherlands. We will include ICUs that submit indicator data to the Dutch National Intensive Care Evaluation (NICE) quality registry and that agree to allocate at least one intensivist and one ICU nurse for implementation of the intervention. Eligible ICUs (clusters) will be randomized to receive basic NICE registry feedback (control arm) or to participate in the InFoQI program (intervention arm). The InFoQI program consists of comprehensive feedback, establishing a local, multidisciplinary QI team, and educational outreach visits. The primary outcome measures will be length of ICU stay and the proportion of shifts with a bed occupancy rate above 80%. We will also conduct a process evaluation involving ICUs in the intervention arm to investigate their actual exposure to and experiences with the InFoQI program.The results of this study will inform those involved in providing ICU care on the feasibility of a tailored multifaceted performance feedback intervention and its ability to accelerate systematic and local quality improvement. Although our study will be conducted within the domain of intensive care, we believe our conclusions will be generalizable to other settings that have a quality registry including an indicator set available.Current Controlled Trials ISRCTN50542146To systematically monitor the quality of care and develop and evaluate successful improvement interventions, data on clinical performance are essential [1,2]. These performance data are often based on a set of quality indicators, ideally combining measures of structure, process, and outcomes of care [3,4].Also within the domain of intensive care, several indicator sets have been developed [5-9], and numerous quality registries have been established worldwide to routinely have indicator data available on the performance of intensive care units (ICUs) [10-13]. In the Netherlands, the National Intensive Car
Feasibility Study of Stochastic Streaming with 4K UHD Video Traces  [PDF]
Joongheon Kim,Eun-Seok Ryu
Computer Science , 2015,
Abstract: This paper performs the feasibility study of stochastic video streaming algorithms with up-to-date 4K ultra-high-definition (UHD) video traces. In previous work, various stochastic video streaming algorithms were proposed which maximize time-average video streaming quality subject to queue stability based on the information of queue-backlog length. The performance improvements with the stochastic video streaming algorithms were verified with traditional MPEG test sequences; but there is no study how much the proposed stochastic algorithm is better when we consider up-to-date 4K UHD video traces. Therefore, this paper evaluates the stochastic streaming algorithms with 4K UHD video traces; and verifies that the stochastic algorithms perform better than queue-independent algorithms, as desired.
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