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Search Results: 1 - 10 of 103 matches for " Bendtsen Preben "
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Feasibility of a Fully Automated Multiple Session Alcohol Intervention to University Students, Using Different Modes of Electronic Delivery—The TOPHAT 1 Study  [PDF]
Bendtsen Marcus, Bendtsen Preben
Journal of Software Engineering and Applications (JSEA) , 2013, DOI: 10.4236/jsea.2013.610A003

Background: In recent years more and more electronic health behaviour interventions have been developed in order to reach individuals with an unhealthy behaviour such as risky drinking. This is especially relevant in university students who are among those who most frequently are risky drinkers. This study explored the acceptability and feasibility, in an unselected group of university students, of a fully automated multiple session alcohol intervention offering different modes of delivery such as email, SMS and Android. Material and Methods: A total of 11,283 students at Link?ping University in Sweden were invited to perform a single session alcohol intervention and among those accepting this (4916 students) a total of 24.7% accepted to further participate in the extended multiple intervention lasting 3 - 6 weeks. The students could choose mode of delivery, total length of the intervention (between 3 - 6 weeks) and number of messages per week (3, 5, or 7 per week). A follow-up questionnaire was applied after the intervention to which 82.7% responded. Results: most students wanted to receive the messages by email with the shortest intervention length (3 weeks) and as few messages as possible per week (3 messages). However, no major difference was seen regarding satisfaction with the length and frequency of the intervention despite chosen length and

Internet applications for screening and brief interventions for alcohol in primary care settings - implementation and sustainability
Paul G. Wallace,Preben Bendtsen
Frontiers in Psychiatry , 2014, DOI: 10.3389/fpsyt.2014.00129
Abstract: Screening and brief interventions head the list of effective evidence-based interventions for the prevention and treatment of alcohol use disorders in healthcare settings. However, healthcare professionals have been reluctant to engage with this kind of activity both because of the sensitive nature of the subject and because delivery is potentially time-consuming. Digital technologies for behavioural change are becoming increasingly widespread and their low delivery costs make them highly attractive. Internet and mobile technologies have been shown to be effective for the treatment of depression, anxiety and smoking cessation in healthcare settings, and have the potential to add substantial value to the delivery of brief intervention for alcohol. Online alcohol questionnaires have been shown to elicit reliable responses on alcohol consumption and compared with conventional prevention techniques, digital alcohol interventions delivered in various settings have been found to be as effective in preventing alcohol-related harms. The last decade has seen the emergence of a range of approaches to the implementation in health care settings of referral to Internet based applications for screening and brief interventions (eSBI) for alcohol. Research in this area is in its infancy, but there is a small body of evidence providing early indications about implementation and sustainability, and a number of studies are currently underway. This paper examines some of the evidence emerging from these and other studies and assesses the implications for the future of eSBI delivery in primary care settings.
Alcohol email assessment and feedback study dismantling effectiveness for university students (AMADEUS-1): study protocol for a randomized controlled trial
Jim McCambridge, Preben Bendtsen, Marcus Bendtsen, Per Nilsen
Trials , 2012, DOI: 10.1186/1745-6215-13-49
Abstract: The study aim is to evaluate the effectiveness of a brief online intervention, employing a randomized controlled trial (RCT) design that takes account of baseline assessment reactivity, and other possible effects of the research process. Outcomes will be evaluated after 3?months both among student populations as a whole including for a randomized no contact control group and among those who are risky drinkers randomized to brief assessment and feedback (routine practice) or to brief assessment only. A three-arm parallel groups trial will also allow exploration of the magnitude of the feedback and assessment component effects. The trial will be undertaken simultaneously in 2 universities randomizing approximately 15,300 students who will all be blinded to trial participation. All participants will be offered routine practice intervention at the end of the study.This trial informs the development of routine service delivery in Swedish universities and more broadly contributes a new approach to the study of the effectiveness of online interventions in student populations, with relevance to behaviors other than alcohol consumption. The use of blinding and deception in this study raise ethical issues that warrant further attention.ISRCTN28328154Alcohol causes huge problems, both for population health and for society more broadly. It is responsible for approximately 4% of the global burden of disease, similar to tobacco, with a greater impact in high-income countries and among men, for example accounting for 11% of all male deaths in WHO European Region in 2004 [1]. Population-level interventions that seek to influence the price, availability and cultural acceptability of hazardous and harmful drinking may be complemented by individual-level brief interventions delivered in health systems and elsewhere [2]. Brief interventions are typically offered opportunistically by non-specialists in routine contacts with patients attending healthcare services for other reasons and ta
Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory
Siw Carlfjord, Malou Lindberg, Preben Bendtsen, Per Nilsen, Agneta Andersson
BMC Family Practice , 2010, DOI: 10.1186/1471-2296-11-60
Abstract: A qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption.The theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process.When implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the perceived need for the innovation to be implemented, and of its potential compatibility with existing routines. Regarding context, we suggest that implementation concurrent with other major organizational changes should be avoided. The choice of implementation strategy should be given thorough consideration.Improvement in quality of health care has gained interest among policy makers in recent years, and bridging the knowledge-to-practice gap is a major concern in many countries. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process [1], and the factors that play a role in the change process are not yet fully understood [2,3]. Research in the area of implementation emanate
Measuring health-related quality of life in patients with chronic obstructive pulmonary disease in a routine hospital setting: Feasibility and perceived value
Preben Bendtsen, Matti Leijon, Ann Sofie Sommer, Margareta Kristenson
Health and Quality of Life Outcomes , 2003, DOI: 10.1186/1477-7525-1-5
Abstract: Seventy-four patients with chronic pulmonary lung disease were asked to assess their health-related quality of life with a computerised version of the SF-36 questionnaire before a regular the visit to a physician. The results were immediately available for the physician during the consultation for comparison of information given by the patients and the physician's evaluation of the patients overall health status. A focus group interview with the physicians was performed before and after the implementation of routine measurements of health-related quality of life.The systematic assessment concept worked satisfactorily. All patients approached agreed to participate and completed the assessment on the touch screen computer. A weak correlation was found between patients' self-rated health and pulmonary function and between physicians' evaluation and pulmonary function. The physicians appreciated the SF-36 assessments and the value of the patients' perspective although only a few could pinpoint new clinical decisions based upon this new information.Physicians' clinical evaluation and patients' self-rating of health status offer unique and important information that are complementary.Chronic obstructive pulmonary disease (COPD) is major heath problem affecting 8–10 percent of the adult population and constitutes an important cause of death in older adults in Sweden [1]. It is thus well recognised that CODP is a source of significant disability in work life, family roles, socialisation and functions of daily living, thereby leading to decreased health-related quality of life (HRQOL) [2-7]. Previous studies have shown weak relationships between physiological variables related to CODP, such as airflow and pulmonary function, and HRQOL [2,4,5]. A somewhat better relationship has been seen between HRQOL and respiratory symptoms [8]. Still, patients with the same degree of airflow limitation have variable HRQOL scores, mainly due to the variability of coping strategies [7]. The
Implementing training and support, financial reimbursement, and referral to an internet-based brief advice program to improve the early identification of hazardous and harmful alcohol consumption in primary care (ODHIN): study protocol for a cluster randomized factorial trial
Keurhorst Myrna N,Anderson Peter,Spak Fredrik,Bendtsen Preben
Implementation Science , 2013, DOI: 10.1186/1748-5908-8-11
Abstract: Background The European level of alcohol consumption, and the subsequent burden of disease, is high compared to the rest of the world. While screening and brief interventions in primary healthcare are cost-effective, in most countries they have hardly been implemented in routine primary healthcare. In this study, we aim to examine the effectiveness and efficiency of three implementation interventions that have been chosen to address key barriers for improvement: training and support to address lack of knowledge and motivation in healthcare providers; financial reimbursement to compensate the time investment; and internet-based counselling to reduce workload for primary care providers. Methods/design In a cluster randomized factorial trial, data from Catalan, English, Netherlands, Polish, and Swedish primary healthcare units will be collected on screening and brief advice rates for hazardous and harmful alcohol consumption. The three implementation strategies will be provided separately and in combination in a total of seven intervention groups and compared with a treatment as usual control group. Screening and brief intervention activities will be measured at baseline, during 12 weeks and after six months. Process measures include health professionals’ role security and therapeutic commitment of the participating providers (SAAPPQ questionnaire). A total of 120 primary healthcare units will be included, equally distributed over the five countries. Both intention to treat and per protocol analyses are planned to determine intervention effectiveness, using random coefficient regression modelling. Discussion Effective interventions to implement screening and brief interventions for hazardous alcohol use are urgently required. This international multi-centre trial will provide evidence to guide decision makers. Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552
Alcohol use among university students in Sweden measured by an electronic screening instrument
Agneta Andersson, Ann-Britt Wiréhn, Christina ?lvander, Diana Ekman, Preben Bendtsen
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-229
Abstract: In this study an e-SBI project was implemented to assess drinking patterns, and to provide personalised feedback about alcohol consumption and related health problems, to students in a Swedish university. In this study, third semester university students (n = 2858) from all faculties (colleges) at the University were invited to participate in e-SBI screenings. This study employed a randomised controlled trial, with respondents having a equal chance of being assigned to a limited, or full-feedback response.The study shows that high risk drinkers tend to underestimate their own consumption compared to others, and that these high risk drinkers experience more negative consequences after alcohol intake, than other respondents. There was a strong belief, for both high- and low-risk drinkers, that alcohol helped celebrations be more festive. This study also confirms findings from other study locations that while males drank more than females in our study population; females reached the same peak alcohol blood concentrations as males.Obtaining clear and current information on drinking patterns demonstrated by university students can help public health officials, university administration, and local health care providers develop appropriate prevention and treatment strategies.Screening for alcohol intake in university student populations is an important first step to identify risky drinkers, and institute more effective services for this group, as university students represent a group at high risk for excessive alcohol consumption. Excessive alcohol consumption in university student populations has been linked to multiple health problems, including drunk driving, elevated risk for injuries, and development of health problems over time [1-4]. Several recent studies have assessed the drinking patterns of Swedish university students and found that the consumption patterns by some university students in this country are at levels that are likely to cause problems, not only with
Factors associated with patients self-reported adherence to prescribed physical activity in routine primary health care
Matti E Leijon, Preben Bendtsen, Agneta St?hle, Kerstin Ekberg, Karin Festin, Per Nilsen
BMC Family Practice , 2010, DOI: 10.1186/1471-2296-11-38
Abstract: Prospective prescription data were obtained for the general population in 37 of 42 PHC centres in ?sterg?tland County, during 2004. The study population consisted of 3300.The average adherence rate to the prescribed activity was 56% at 3 months and 50% at 12 months. In the multiple logistic regression models, higher adherence was associated with higher activity level at baseline and with prescriptions including home-based activities.Prescription from ordinary PHC staff yielded adherence in half of the patients in this PAR scheme follow-up.Written prescriptions of physical activity, in Sweden commonly referred to as physical activity referral (PAR) schemes [1], have increased in popularity in recent years [1-7]. PAR schemes were initially developed in the UK [4] and were later introduced more broadly in Sweden in 2001 by the National Institute of Public Health in a national campaign called "Sweden on the move" [5,8]. Swedish PAR schemes typically entail primary health care (PHC) providers issuing a formal written physical activity prescription for home-based activities, such as walking, or facility-based activities organized by different physical activity organizations in the community [1,5,8,9].So far PAR schemes have mostly been studied in terms of efficacy, employing randomized controlled trial study designs and researcher-assisted study protocols [6]. Establishing efficacy is usually an important first step before widespread dissemination and implementation of new interventions. The effectiveness of PARs has been questioned by some researchers [4,10,11], although the efficacy has been supported by randomized controlled trials presented in a number of reviews in recent years [6,7,12,13]. However, the enhanced internal validity accomplished in such research is often gained at the expense of external validity since the study conditions tend to be far removed from routine practice. Indeed, interventions in many health fields that have been found to be successful in e
Referral to an Electronic Screening and Brief Alcohol Intervention in Primary Health Care in Sweden: Impact of Staff Referral to the Computer
Preben Bendtsen,Diana Stark Ekman,AnneLie Johansson,Siw Carlfjord,Agneta Andersson,Matti Leijon,Kjell Johansson,Per Nilsen
International Journal of Telemedicine and Applications , 2011, DOI: 10.1155/2011/918763
Abstract: The aim of this paper was to evaluate whether primary health care staff's referral of patients to perform an electronic screening and brief intervention (e-SBI) for alcohol use had a greater impact on change in alcohol consumption after 3 month, compared to patients who performed the test on their own initiative. Staff-referred responders reported reduced weekly alcohol consumption with an average decrease of 8.4 grams. In contrast, self-referred responders reported an average increase in weekly alcohol consumption of 2.4 grams. Staff-referred responders reported a 49% reduction of average number of heavy episodic drinking (HED) occasions per month. The corresponding reduction for self-referred responders was 62%. The differences between staff- and self-referred patient groups in the number who moved from risky drinking to nonrisky drinking at the followup were not statistically significant. Our results indicate that standalone computers with touchscreens that provide e-SBIs for risky drinking have the same effect on drinking behaviour in both staff-referred patients and self-referred patients. 1. Introduction More than two decades ago, the World Health Organisation (WHO) suggested that screening and brief intervention (SBI) for risky alcohol consumption, including hazardous and harmful alcohol consumption but excluding alcohol misuse/dependence, should be integrated in the daily routine of primary health care (PHC) in order to provide early intervention for nontreatment-seeking, nonalcohol-dependent drinkers. Since then, numerous research projects have been carried out in order to establish the scientific evidence for various methods of delivering brief alcohol interventions in PHC and other health care settings [1]. The scientific literature has provided evidence that supports the efficacy of SBI as studied in RCT studies, where mostly research staff has performed the SBI to ensure a consistency in the content of the SBI. Fewer studies have examined the effectiveness of SBI with ordinary staff performing the interventions; however, the distinction between efficacy and effectiveness studies is not always clarified. So far, 15 systematic reviews and meta-analyses of SBI study have been publishing data since 1993, the most recent being a comprehensive 2007 Cochrane review by Kaner et al. [2]. Despite convincing evidence for the efficacy and, to a certain extent, the effectiveness of SBI, the uptake of such interventions in routine health care has been slow. Research has identified several barriers to more widespread implementation and use of these
Is there a demand for physical activity interventions provided by the health care sector? Findings from a population survey
Matti E Leijon, Diana Stark-Ekman, Per Nilsen, Kerstin Ekberg, Lars Walter, Agneta St?hle, Preben Bendtsen
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-34
Abstract: A regional public health survey was mailed to 13 440 adults (aged 18-84 years) living in ?sterg?tland County (Sweden) in 2006. The survey was part of the regular effort by the regional Health Authorities.About 25% of the population was categorised as physically active, 38% as moderately active, 27% as somewhat active, and 11% as low active. More than one-third (37%) had no intentions to increase their physical activity levels, 36% had thought about change, while 27% were determined to change. Lower intention to change was mainly associated with increased age and lower education levels. 28% answered that physical activity was the most important health-related behaviour to change "right now" and 15% of those answered that they wanted or needed support to make this change. Of respondents who might be assumed to be in greatest need of increased activity (i.e. respondents reporting poor general health, BMI>30, and inactivity) more than one-quarter wanted support to make improvements to their health. About half of the respondents who wanted support to increase their physical activity levels listed health care providers as a primary source for support.These findings suggest that there is considerable need for physical activity interventions in this population. Adults feel great responsibility for their own physical activity levels, but also attribute responsibility for promoting increased physical activity to health care practitioners.Health-related behaviours such as physical activity, diet, alcohol use and smoking, contribute substantially to adult health status [1,2]. Numerous approaches have been taken at national and regional levels to influence adults to change their health-related behaviours in order to improve their health and quality of life. In recent years primary health care (PHC) providers have delivered interventions to improve physical activity levels among patients in many countries, including Sweden [3-9]. These interventions are often referred to as exerc
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