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Littérature scientifique sur le sujet « Multicomponent intervention »

Auteur : Grafiati

Publié le 1 février 2025

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Articles de revues sur le sujet "Multicomponent intervention"

León-Salas, Beatriz, Renata Linertová, Javier García-García, Pilar Pérez-Ros, Francisco Rivas-Ruiz, Ana Toledo-Chávarri et María M. Trujillo-Martín. « PP230 Safety, Effectiveness, And Cost Effectiveness Of Interventions For Preventing Delirium In Hospitalized Patients ». International Journal of Technology Assessment in Health Care 37, S1 (décembre 2021) : 29. http://dx.doi.org/10.1017/s0266462321001380.

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IntroductionDelirium is a prevalent syndrome in the hospital setting and the elderly are the most affected. The objective was to assess the safety, clinical effectiveness, and cost effectiveness of interventions for preventing delirium among people aged 65 years or older at hospital admission.MethodsA systematic review of available scientific literature (randomized controlled trials) on the safety, effectiveness, and cost effectiveness of the interventions was conducted. The overall effect size for each type of intervention was estimated through a meta-analysis. A cost-effectiveness study in the context of the Spanish National Healthcare System was performed.ResultsForty-nine studies were included for the effectiveness and safety assessment (25 on pharmacological interventions, 12 on perioperative interventions, 2 on non-pharmacological interventions, and 10 on multicomponent interventions). The following interventions reduced delirium incidence relative to usual care or placebo: hypnotics and sedatives (13 studies; risk ratio [RR] 0.54: 95% confidence interval [CI] 0.36–0.80); perioperative interventions aimed at limiting opioid use (two studies; RR 0.50, 95% CI: 0.29–0.86); controlling the intensity of general anesthesia (three studies; RR 0.77, 95% CI: 0.59–0.99); and multicomponent interventions (10 studies; RR 0.62, 95% CI: 0.54–0.72). In addition, multicomponent interventions reduced the duration (mean difference −1.18, 95% CI: −1.95 - −0.40) and severity of delirium (standardized mean difference −0.98, 95% CI: −1.46 - −0.49), while dexmedetomidine reduced the duration of delirium (mean difference −0.70, 95% CI: −1.03 - −0.37).The economic analysis of a multicomponent preventive intervention estimated an average cost of EUR7,282 per patient, which was EUR140 per patient more expensive than usual care. The incremental cost-effectiveness ratio was EUR21,391 per quality-adjusted life-year, which is below the acceptability threshold used in Spain. The literature review yielded two economic evaluations that estimated the cost effectiveness of a multicomponent intervention in the United Kingdom and found that the multicomponent intervention was a dominant strategy.ConclusionsThis meta-analysis suggests that multicomponent interventions and dexmedetomidine are effective in reducing the incidence of delirium in hospitalized patients and that multicomponent interventions could be a cost-effective strategy in Spain.

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Radley, Keith C., Kate A. Helbig, Stefanie R. Schrieber, Mary E. Ware et Evan H. Dart. « Superheroes Social Skills : A Comparison of Video Only and Full Curriculum on Social Skill Use ». Focus on Autism and Other Developmental Disabilities 36, n^o 2 (9 février 2021) : 95–107. http://dx.doi.org/10.1177/1088357621989260.

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A substantial number of multicomponent interventions have been developed to address social functioning in individuals with autism spectrum disorder (ASD). For multicomponent interventions, identifying critical elements of the intervention related to behavior change is critical and may potentially improve the social validity of interventions. Such an analysis of the Superheroes Social Skills program was conducted. Three participants with ASD and one participant without a diagnosis participated in a 4-week intervention in which three target social skills were taught. Participants were first exposed to only the video-based elements of intervention, followed by participation in the full curriculum. Results of the study indicated that exposure to video elements often resulted in limited increases in skill accuracy, but the largest increases were observed during training with the full curriculum. Limitations and future directions are discussed with respect to multicomponent interventions for individuals with ASD.

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Aké Canul, Didier Francisco, Marco Esteban Morales Rojas, Sheila Mariela Cohuo Cob, Maricela Balam Gómez et Gabriela Montserrat Chi Mex. « Intervención Multicomponente de Enfermería para Promover el Hábito del Lavado de Manos en Escolares. » Notas de Enfermería 25, n^o 44 (27 septembre 2024) : 51–63. http://dx.doi.org/10.59843/2618-3692.v25.n44.46384.

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Diarrheal diseases and respiratory infections represent the main reasons for school absenteeism, which if complicated, will be part of the mortality statistics in children under five years of age. In this sense, it is important to focus on hand washing and multicomponent interventions with theoretical references for behavioral changes to promote sustained and long-term behavior, washing hands with soap and water has been shown to be a life-saving hygiene habit. The Nursing professional, through the Nursing Care Process (PAE), has the necessary skills to design, implement and evaluate multicomponent interventions. Objective: implement a PAE aimed at schoolchildren to promote the habit of handwashing, through a multicomponent intervention and the theory of disruptive behavior. Methodology: community case study with PAE, implemented in a public and rural primary school in Yucatán, Mexico. For the assessment, brainstorming techniques, non-participant observation and social cartography were used. For the diagnostic process, results and interventions, the NANDA 2021-2023 taxonomy, NOC Results Classification and NIC Intervention Classification was used. Results: we worked with a diagnosis, a result and three interventions on health education, community environmental management and behavior modification. Conclusions: through the PAE and the multicomponent intervention, it was possible for the school population to generate a more active and committed practice with handwashing.

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Huynh-Hohnbaum, Anh-Luu T., Valentine M. Villa, Maria P. Aranda et Jorge Lambrinos. « Evaluating a Multicomponent Caregiver Intervention ». Home Health Care Services Quarterly 27, n^o 4 (11 décembre 2008) : 299–325. http://dx.doi.org/10.1080/01621420802589777.

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Dorling, James L., Christoph Höchsmann, Catrine Tudor-Locke, Robbie Beyl et Corby K. Martin. « Effect of an office-based intervention on visceral adipose tissue : the WorkACTIVE-P randomized controlled trial ». Applied Physiology, Nutrition, and Metabolism 46, n^o 2 (février 2021) : 117–25. http://dx.doi.org/10.1139/apnm-2020-0175.

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Office-based activity reduces sedentariness, yet no randomized controlled trials (RCTs) have assessed how such activity influences visceral adipose tissue (VAT). This study examined the effect of an office-based, multicomponent activity intervention on VAT. The WorkACTIVE-P RCT enrolled sedentary office workers (body mass index: 31.4 (standard deviation (SD) 4.4) kg/m2) to an intervention (n = 20) or control (n = 20) group. For 3 months, the intervention group received an office-based pedal desk, further to an intervention promoting its use and increased walking. The control group maintained habitual activity. At baseline and follow-up, VAT, cardiometabolic disease risk markers, physical activity, and food intake were measured. Steps/day were not altered relative to control (P ≥ 0.51), but the pedal desk was utilized for 127 (SD 61) min/day. The intervention reduced VAT relative to control (−0.15 kg; 95% confidence interval (CI) = −0.29 to −0.01; P = 0.04). Moreover, the intervention decreased fasting glucose compared with control (−0.29 mmol/L; 95% CI = −0.51 to −0.06; P = 0.01), but no differences in other cardiometabolic disease markers or food intake were revealed (P ≥ 0.11). A multicomponent intervention decreased VAT in office workers who were overweight or obese. Though longer-term studies are needed, office-based, multicomponent activity regimens may lower cardiometabolic disease risk. Trial registered at ClinicalTrials.gov (NCT02561611). Novelty: In WorkACTIVE-P, a multicomponent activity intervention decreased visceral adipose tissue relative to control in office workers. The intervention also reduced glucose compared with control, though other metabolic risk markers and food intake were not altered. Such multicomponent interventions could help reduce cardiometabolic disease risk, but longer studies are needed.

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Laver, Kate, Rachel Milte, Suzanne Dyer et Maria Crotty. « A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia ». Journal of Aging and Health 29, n^o 8 (25 juillet 2016) : 1308–49. http://dx.doi.org/10.1177/0898264316660414.

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Objective: The aim of this study was to compare the efficacy of two approaches: multicomponent interventions that focus on working with the carer and dyadic interventions that work with both the carer and the person with dementia. Method: A systematic review involving a search of Medline, EMBASE, and PsycINFO in October 2015 was performed. Randomized controlled trials involving carers of people with dementia and comparing multicomponent interventions with usual care were included. Results: Pooling of all studies demonstrated that multicomponent interventions can reduce depressive symptoms, improve quality of life, reduce carer impact, and reduce behavioral and psychological symptoms of dementia as well as caregiver upset with these symptoms. We were unable to find a significant difference in the effects of dyadic interventions in comparison with carer focused interventions for these outcomes. Discussion: Although effect sizes associated with intervention are small, multicomponent interventions are relatively inexpensive to deliver, acceptable, and widely applicable.

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Ayodele, Deborah, et Jennifer Oates. « Effectiveness of interventions to support weight loss in adults taking antipsychotics : a review ». British Journal of Mental Health Nursing 8, n^o 2 (2 mai 2019) : 88–100. http://dx.doi.org/10.12968/bjmh.2019.8.2.88.

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Antipsychotic medication is effective in reducing psychotic symptoms but use is associated with weight gain. Weight gain is associated with an increased risk of a number of life threatening health conditions. Multicomponent lifestyle interventions are the recommended non-pharmacological way of tackling weight gain and its consequences. This literature review summarises the evidence for the effectiveness of multicomponent lifestyle interventions in reducing weight and waist circumference in adults taking antipsychotics. The review of eight studies found that such approaches are effective; however, multiple factors affect success, for example tailoring of information to the cognitive abilities of participants and the use of individual combined with group approaches. There were some unexpected results within studies, where some control groups lost weight or decreased waist circumference as well as intervention groups. Reasons for significant weight change in control groups was attributed to possible access to weight loss activities outside of the intervention programmes. Adherence to intervention programmes was also important for success. Nurses who support patients taking antipsychotics to lose weight should promote multicomponent approaches that are tailored to the specific needs of this group.

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Kim, Myeongshin, Eunyoung Shin, Seyoon Kim et Sohyune Sok. « The Effectiveness of Multicomponent Intervention on Daily Functioning among the Community-Dwelling Elderly : A Systematic Review ». International Journal of Environmental Research and Public Health 19, n^o 12 (18 juin 2022) : 7483. http://dx.doi.org/10.3390/ijerph19127483.

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The deterioration of physical and cognitive functioning in the elderly is an impairment to their independent self-management and to improving their ability to perform daily functions. Nurses should support the elderly to experience a healthy and a successful aging process by preventing dependence on daily functioning and understanding the care assistance that such persons need. This study aimed to gain insight into the evidence on the effectiveness of multicomponent intervention on the activities of daily living (ADL) and instrumental activities of daily living (IADL) among the community-dwelling elderly without cognitive impairment. The design is a systematic review of a randomized controlled trial. The language of the published literature was English, and the search period was from January 2000 to December 2020. Articles were included under the PICO (population, intervention, comparison, and outcome) framework for: (a) community-dwelling elderly without cognitive impairment; (b) multicomponent intervention; (c) comparison group who did not receive the intervention; and (d) measurement of the effect of ADL and IADL. A total of 4413 references were found, 6 studies were included. Most studies (n = 5) reported that the multicomponent intervention exerted a beneficial effect on ADL and IADL. Only one study showed the highest methodology and reporting quality in the Cochrane review. Common components of the programs included: occupational therapy, physical therapy, exercise, memory training, cognitive–behavioral therapy, interdisciplinary intervention, and cognitive training. Multicomponent intervention may be a beneficial way to improve dependence on ADL and IADL as an important area of functional evaluation in the elderly. Considering the physical condition of the elderly, multicomponent interventions, including physical activity, exercise, occupational therapy, and especially individually customized coaching related to ADL and IADL training, may be useful.

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Zhou, Liying, Xinxin Deng, Kangle Guo, Liangying Hou, Xu Hui, Yanan Wu, Meng Xu et al. « Effectiveness of Multicomponent Interventions in Office-Based Workers to Mitigate Occupational Sedentary Behavior : Systematic Review and Meta-Analysis ». JMIR Public Health and Surveillance 9 (26 juillet 2023) : e44745. http://dx.doi.org/10.2196/44745.

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Background Sedentary time in workplaces has been linked to increased risks of chronic occupational diseases, obesity, and overall mortality. Currently, there is a burgeoning research interest in the implementation of multicomponent interventions aimed at decreasing sedentary time among office workers, which encompass a comprehensive amalgamation of individual, organizational, and environmental strategies. Objective This meta-analysis aims at evaluating the effectiveness of multicomponent interventions to mitigate occupational sedentary behavior at work compared with no intervention. Methods PubMed, Web of Science, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from database inception until March 2023 to obtain randomized controlled trials (RCTs) assessing the efficacy of multicomponent interventions on occupational sedentary behavior among office-based workers. Two reviewers independently extracted the data and assessed the risk of bias by using the Cochrane Collaboration’s risk of bias tool. The average intervention effect on sedentary time was calculated using Stata 15.1. Mean differences (MDs) with 95% CIs were used to calculate the continuous variables. Subgroup analyses were performed to determine whether sit-stand workstation, feedback, and prompt elements played an important role in multicomponent interventions. Further, the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system was used to evaluate the certainty of evidence. Results A total of 11 RCTs involving 1894 patients were included in the analysis. Five studies were rated as low risk of bias, 2 as unclear risk of bias, and 4 as high risk. The meta-analysis results showed that compared with no intervention, multicomponent interventions significantly reduced occupational sitting time (MD=–52.25 min/8-h workday, 95% CI –73.06 to –31.44; P<.001) and occupational prolonged sitting time (MD=–32.63 min/8-h workday, 95% CI –51.93 to –13.33; P=.001) and increased occupational standing time (MD=44.30 min/8-h workday, 95% CI 23.11-65.48; P<.001), whereas no significant differences were found in occupational stepping time (P=.06). The results of subgroup analysis showed that compared with multicomponent interventions without installment of sit-stand workstations, multicomponent interventions with sit-stand workstation installment showed better effects for reducing occupational sitting time (MD=–71.95 min/8-h workday, 95% CI –92.94 to –51.15), increasing occupational standing time (MD=66.56 min/8-h workday, 95% CI 43.45-89.67), and reducing occupational prolonged sitting time (MD=–47.05 min/8-h workday, 95% CI –73.66 to –20.43). The GRADE evidence summary showed that all 4 outcomes were rated as moderate certainty. Conclusions Multicomponent interventions, particularly those incorporating sit-stand workstations for all participants, are effective at reducing workplace sedentary time. However, given their cost, further research is needed to understand the effectiveness of low-cost/no-cost multicomponent interventions.

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Van Kann, Dave H. H., Sanne I. de Vries, Jasper Schipperijn, Nanne K. de Vries, Maria W. J. Jansen et Stef P. J. Kremers. « A Multicomponent Schoolyard Intervention Targeting Children’s Recess Physical Activity and Sedentary Behavior : Effects After 1 Year ». Journal of Physical Activity and Health 14, n^o 11 (1 novembre 2017) : 866–75. http://dx.doi.org/10.1123/jpah.2016-0656.

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Background: The aim of the study was to test the 12-month effects of a multicomponent physical activity (PA) intervention at schoolyards on morning recess PA levels of sixth- and seventh-grade children in primary schools, using accelerometry and additional global positioning system data. Methods: A quasi-experimental study design was used with 20 paired intervention and control schools. Global positioning system confirmatory analyses were applied to validate attendance at schoolyards during recess. Accelerometer data from 376 children from 7 pairs of schools were included in the final analyses. Pooled intervention effectiveness was tested by multilevel linear regression analyses, whereas effectiveness of intervention components was tested by multivariate linear regression analyses. Results: Children exposed to the multicomponent intervention increased their time spent in light PA (+5.9%) during recess. No pooled effects on moderate to vigorous PA were found. In-depth analyses of intervention components showed that physical schoolyard interventions particularly predicted a decrease in time spent in sedentary behavior during recess at follow-up. Intervention intensity and the school’s commitment to the project strengthened this effect. Conclusions: The multicomponent schoolyard PA intervention was effective in making children spend a larger proportion of recess time in light PA, which was most likely the result of a shift from sedentary behavior to light PA.

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Thèses sur le sujet "Multicomponent intervention"

Sentelle, Julie A. « A multicomponent behavioral intervention for an urban classroom ». Columbus, Ohio : Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1061358241.

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Thesis (Ph. D.)--Ohio State University, 2003.
Title from first page of PDF file. Document formatted into pages; contains xii, 136 p.; also includes graphics. Includes abstract and vita. Advisor: Antoinette Miranda, College of Education. Includes bibliographical references (p. 117-125).

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Wille, Jessica R. « Reducing disruptive classroom behavior with multicomponent intervention a literature review / ». Online version, 2002. http://www.uwstout.edu/lib/thesis/2002/2002willej.pdf.

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Miller, Carolee. « Effectiveness of a multicomponent intervention for modifying the nutritional practices of college students ». Diss., Virginia Polytechnic Institute and State University, 1987. http://hdl.handle.net/10919/53646.

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Appropriate nutrition is linked to the prevention of several major diseases, yet over 50% of Americans do not eat diets sufficient in the necessary proportions of protein, vitamins, and minerals. Increased interest in health prevention has led to the development of a variety of programs designed to change dietary habits. Most have been only marginally successful. One explanation for their failure is the lack of consideration given to the characteristics of the targeted population in the development of the programs. In this study, a five week multicomponent intervention was designed using marketing and psychological principles to increase the selection of dinner entrees low in fat, calories, and sugar and to improve participants‘ knowledge of and attitude toward appropriate nutrition. Subjects were 8600 students who ate in the dining halls of a large southeastern university. The study investigated the additive effectiveness of three intervention components in three dining halls. One dining hall received availability; the second, availability plus point of choice information; the third, availability‘ plus point of choice information plus an incentive program. The results were derived from three separate sources: cafeteria data, survey data, and individual data. Cafeteria results were not significant. Inspection of daily selection data revealed wide fluctuation in selection across entrees, indicating dramatic changes in student preferences. Inspection of weekly selection means revealed that the incentive program combined with increased availability and point of choice information was initially effective in increasing the selection of the Perfect Balance entree. Prompting was the most effective intervention, yielding an average increase of 31.5% in selection of the Perfect Balance entree. Survey data indicated a minor increase in knowledge in. the information condition. Across all conditions there was a decrease in self-efficacy. Forty-four individuals were involved in a tracking project designed to assess whether the aggregate impact of the interventions reflected consistent change within specific individuals or intermittent change across all individuals. Analyses indicated a significant increase in selection behavior across time ( p <.05). The condition by phase interaction approached significance ( p =.07). The greatest change occurred in the incentive condition with a 16% increase, compared to a .3% increase in the information condition, and a 2.5% increase in the availability condition. The social marketing analysis of the study reveals several important barriers to change: resistance from staff and administration, poor quality entrees, student distrust of the dining hall administration, and limited availability of certain entrees.
Ph. D.

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Hearon, Brittany Valle. « Promoting Happiness in Elementary Schoolchildren : Evaluation of a Multitarget, Multicomponent Classwide Positive Psychology Intervention ». Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6708.

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Youth psychological well-being has become increasingly acknowledged as not merely the absence of psychological distress, but the presence of positive indicators of optimal functioning. Students with complete mental health (i.e., low psychopathology and high well-being) demonstrate the best academic, social, and physical health outcomes. As such, there remains a need to address children’s well-being through a holistic approach emphasizing the prevention of mental health problems and promotion of flourishing. Positive psychology interventions (PPIs) have emerged as a promising method of enhancing students’ complete mental health. Previous investigations support the utility of multitarget PPIs with middle school students and single-target PPIs (e.g., character strengths, hope) with younger elementary students, though the extent to which comprehensive multitarget, multicomponent PPIs enhance classes of elementary students’ outcomes relative to a control has not been examined. This study compared levels of subjective well-being, mental health problems, classroom social support, and classroom engagement between students in 6 classrooms randomly assigned to participate in a 10-week intervention targeting a variety of positive psychological constructs (i.e., positive relationships, gratitude, kindness, character strengths, hope) with parent and teacher components, and students in 7 classrooms randomly assigned to a delayed intervention control group. Follow-up analyses examined levels of outcomes of the immediate intervention group relative to the control group at post-intervention, as well as levels of outcomes in the intervention group three months after program completion. At post-intervention, classes of students participating in the immediate intervention group did not have significantly improved student-reported life satisfaction, positive affect or negative affect, classmate or teacher support, emotional or behavioral engagement, nor teacher-reported relationship satisfaction, instrumental help, and emotional or behavioral engagement relative to the control classes. However, several trends were found: (a) students in the immediate intervention group had lower negative affect relative to the delayed intervention control among students with greater baseline negative affect levels, (b) students in the immediate intervention group had lower teacher-reported levels of instrumental help relative to the control among students with greater baseline instrumental help levels, and (c) students in the immediate intervention group reported lower levels of behavioral engagement relative to the delayed intervention control. Because of the lack of improvement in immediate intervention group outcomes relative to the control group at post-intervention, continuation of those anticipated improvements from post-intervention to 3-month follow-up could not be detected. However, there was a significant increase in teacher-reported internalizing symptoms from post-intervention to follow-up among the immediate intervention group (without comparison to a control). Overall, findings from this study do not provide empirical support for the efficacy of a multitarget, multicomponent PPI when delivered universally to classes of elementary students. Nevertheless, high levels of treatment acceptability and feasibility from students and teachers as well as limitations to the study design support the need for educational scholars and practitioners to continue exploring the impact of multitarget PPIs delivered to students in multiple formats and various age levels in order to promote complete mental health across tiers of support and thus optimize success for all students.

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Sin, Jacqueline Pui Han. « Development and preliminary evaluation of an online multicomponent psychoeducational intervention for siblings of individuals with first episode psychosis ». Thesis, King's College London (University of London), 2015. https://kclpure.kcl.ac.uk/portal/en/theses/development-and-preliminary-evaluation-of-an-online-multicomponent-psychoeducational-intervention-for-siblings-of-individuals-with-first-episode-psychosis(25583c9f-dd5a-4ac5-baf6-b75cee1aafcd).html.

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Ugel, Nicole Suzanne. « The effects of a multicomponent reading intervention on the reading achievement of middle school students with reading disabilities / ». Digital version accessible at:, 1999. http://wwwlib.umi.com/cr/utexas/main.

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Hartzell, Rebecca I. « Evaluating the Contribution of Adult Directed Social Skills Lessons in a Multicomponent Intervention with Children with Autism Spectrum Disorder ». Thesis, The University of Arizona, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10789909.

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This study examined the contribution of adult directed lessons to student social engagement as part of a multicomponent procedure of adult directed lessons and child specific prompting with peer support delivered to four elementary-aged students with Autism Spectrum Disorder. Prior to intervention, each participant exhibited deficits in social engagement compared to same-age peers. The study was conducted in two phases. In Phase One, assessment, interviews, rating scales, and observations were conducted to determine the social skills deficits of each student. During Phase Two, intervention, a individualized intervention plan was implemented using adult directed lessons and child specific prompting with peer support. Using a combined ABC and reversal (A-B-BC-B-BC), a functional relation between the full intervention and immediate increase in social engagement was demonstrated. When the intervention procedures returned to adult directed individualized social skills lessons only, a rapid decrease in social engagement occurred. Reinstatement of the full intervention procedure resulted in high levels of social engagement. Generalization across peers was evident and maintenance data indicated high levels of social engagement for three out of the four participants. Implications, limitations, and directions for future research are presented.

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Golden, Maria Elena. « Academic Achievement among High School Students with ADHD and Internalizing Symptoms and Their Response to a Multicomponent Treatment Intervention ». Thesis, Lehigh University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10814390.

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ADHD is a common disorder in youth, with core deficits that impair important areas of functioning, most notably academic achievement. Existing school-based interventions may not be as effective in improving long-term academic outcomes for adolescents with comorbid ADHD and internalizing disorders. The purpose of this study was to explore the association between ADHD and internalizing symptoms in adolescents and the impact of anxiety and depression symptom severity on their academic outcomes after engaging in a multicomponent school-based intervention (BEST Project). The BEST Project was implemented in several high schools, with 126 participants included in this study. All participants met DSM-5 criteria for ADHD, were 14-18 years old, and attended public high schools.

A multiple multivariate regression analysis was conducted to investigate if internalizing symptom severity predicts pre-treatment academic performance. Female students were found to have more academic problems. To examine whether pre-treatment internalizing symptom severity predicts post-treatment academic performance and moderates the relationship between the effects of the BEST project and academic performance, a second multiple multivariate regression analysis was conducted. Graphed interactions and Johnson-Neyman results suggest that once student’s internalizing symptom scores are above the median, treatment effects on homework problems are stronger for those with anxiety symptoms and weaker for youth with depression symptoms. These findings suggest anxiety may serve as a protective factor in the context of a structured intervention. Limitations and future directions for research and practice are discussed.

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Hall, Jennifer. « Sit-stand desks as a strategy to reduce sitting and increase standing and physical activity in office-based employees : a pilot RCT and process evaluation of a multicomponent workplace intervention intervention ». Thesis, Brunel University, 2017. http://bura.brunel.ac.uk/handle/2438/16227.

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Current UK public health policy and research identifies potential health risks of physical inactivity and high levels of sitting. This is a particularly pertinent issue for office workers, who spend, on average, over two-thirds of the work day sitting. This thesis reports on the design and evaluation of a multicomponent sit-stand desk intervention, delivered within two not-for-profit office-based organisations in London, England. A mixed method study design was employed. A pilot randomised controlled trial examined the efficacy of the intervention on reducing sitting and increasing standing and physical activity, using wearable monitors to measure outcome variables at baseline, and at four additional timepoints up to 12-months following the onset of the intervention. A process evaluation, including in-depth qualitative interviews and participant observation, investigated the processes that influenced the feasibility, acceptability and efficacy of the intervention. Mixed-model ANOVA indicated that the intervention reduced workplace sitting, on average, by 38 minutes, however there was no significant influence on workplace physical activity, or any of the outcome variables across the whole day. The process evaluation revealed that discourses surrounding employee health and organisational effectiveness, and employees' health-focused occupational identities increased the acceptability of sit-stand desk provision, whereas monetary concerns, a centralised organisational structure and incompatibility of the sit-stand desks with the workplace environment negatively influenced implementation feasibility. The sit-stand desk design, expectations and outcomes related to health and productivity, and the organisational culture and interpersonal relationships positively and negatively influenced sit-stand desk experience to differing degrees between participants. Mixed method analyses of outcome and process data illustrated the potential for integrating findings to enhance understanding of 'what works' within behavioural intervention research. Sit-stand desks are not a one-size-fits-all solution to reducing sitting and increasing physical activity, however, they should be available to office-based employees as part of a wider workplace health strategy.

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Dove, Jacqueline Beckham Kreider Richard B. « Effects of a multicomponent school-based intervention on health markers, body composition, physical fitness, and psychological measures in overweight and obese adolescent females ». Waco, Tex. : Baylor University, 2008. http://hdl.handle.net/2104/5253.

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Livres sur le sujet "Multicomponent intervention"

Lawlor, Peter. Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients (DRAFT). Sous la direction de Nathan A. Gray et Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0011.

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This chapter, reports on a prospectively matched controlled trial in which Inouye et al. examined the comparative effectiveness of a targeted multicomponent strategy for reducing the risk of delirium with that of usual standard care. The six targeted baseline risk factors in delirium-free patients admitted to a medical service in a teaching hospital were cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and dehydration. Using standardized interventions for each of these when present, 42/426 (9.9%) of those in the intervention group had a first-incident episode of delirium compared to 64/426 (15%) in the usual care group, representing a statistically significant reduction of approximately 33% in first-incident episodes of delirium. The number of patient-days with delirium (105 vs. 161) and delirium episodes (62 vs. 90) were significantly lower in the intervention group. Primary prevention of delirium was effective.

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Pfiffner, Linda J., et Lauren M. Haack. Nonpharmacologic Treatments for Childhood Attention-Deficit/Hyperactivity Disorder and Their Combination with Medication. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0003.

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Of the nonpharmacological treatments for childhood attention-deficit/hyperactivity disorder (ADHD), behavioral interventions have the largest evidence base. Current behavioral interventions include behavioral parent training, behavioral classroom management, child skills training, behavioral multicomponent interventions, and multimodal treatment, which combines behavioral interventions and medication. This updated review of studies reveals significant behavioral treatment effects from randomized controlled trials on a wide range of child outcomes including ADHD and oppositional defiant disorder symptoms as well as areas of functional impairment such as homework, organizational, and social behaviors. Combined behavioral and medication treatments appear to reduce the needed dose or intensity of each intervention.

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Bedford, Helen, et David Elliman. Integrating immunizations into the programme. Sous la direction de Alan Emond. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198788850.003.0016.

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Immunization is a highly successful public health intervention providing protection against serious infectious diseases. UK vaccine uptake rates are generally high, although pockets of lower uptake and social inequalities remain which compromise herd protection. The child health programme provides health professionals opportunities to introduce immunization to parents, offer ongoing information and advice, and remind them when vaccines are due. Improving and maintaining high vaccine rates depends on multicomponent strategies. In view of their relationship with families, health visitors are the key professionals to work with them to ensure that children are immunized fully and in a timely fashion, although in practice they now do not usually deliver vaccines.

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Burgio, Louis D., et Matthew J. Wynn. The REACH OUT Caregiver Support Program. Oxford University Press, 2021. http://dx.doi.org/10.1093/med-psych/9780190855949.001.0001.

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Our nation increasingly relies on family members or friends (i.e., informal caregivers) for needed care and support as we age. Family caregivers typically assume their caregiving role willingly and reap personal fulfilment from helping a family member, developing new skills, and strengthening family relationships. For these benefits, however, caregivers often sacrifice their own health and well-being. Depression, anxiety, poor physical health, and compromised immune function are more common among family caregivers than in adults not providing such care. The REACH OUT (Resources for Enhancing Alzheimer’s Caregiver Health: Offering Useful Treatments) program is a multicomponent, tailored, and flexible intervention for caregivers of people with dementia focused on the evidence-based therapeutic strategy of problem solving. This work is designed to guide clinicians through the process and provide them the necessary tools to share with caregivers with the goal of enhancing caregiver physical and mental health. Five common risk areas (home safety, caregiver health, social support, challenging behaviors, and emotional well-being) are described in the manual; and interventions are described that respect the nuances of each risk area. By beginning with an individualized risk assessment and being flexible to the needs and issues of the caregiver, the REACH OUT intervention helps clinicians identify risk areas and provide caregivers with tailored action plans to reduce risk and promote well-being.

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Chapitres de livres sur le sujet "Multicomponent intervention"

Khan, Adan Aslam, Andrew Wong, Vahid Pasovic et Esther Akinyemi. « A Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients ». Dans Essential Reviews in Geriatric Psychiatry, 127–31. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94960-0_23.

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Dziak, John J. « Optimizing the Cost-Effectiveness of a Multicomponent Intervention Using Data from a Factorial Experiment : Considerations, Open Questions, and Tradeoffs Among Multiple Outcomes ». Dans Optimization of Behavioral, Biobehavioral, and Biomedical Interventions, 207–67. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-91776-4_7.

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Pasovic, Vahid, Adan Aslam Khan, Andrew Wong et Esther Akinyemi. « Effectiveness of Multicomponent Nonpharmacological Delirium Interventions : A Meta-Analysis ». Dans Essential Reviews in Geriatric Psychiatry, 137–41. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94960-0_25.

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Segkouli, Sofia, Lampros Mpaltadoros, Athanasios T. Patenidis, Vasilis Alepopoulos, Aikaterini Skoumbourdi, Margarita Grammatikopoulou, Ilias Kalamaras et al. « Combined Multicomponent Interventions for Older Adults in a Smart Home Living Lab ». Dans Smart Technologies for a Sustainable Future, 273–84. Cham : Springer Nature Switzerland, 2024. http://dx.doi.org/10.1007/978-3-031-61905-2_27.

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Guastaferro, Kate. « Applying the Multiphase Optimization Strategy (MOST) to the Prevention of Child Maltreatment : A Vision for Future Multicomponent Interventions ». Dans Innovative Methods in Child Maltreatment Research and Practice, 107–33. Cham : Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-33739-0_6.

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« Multicomponent Intervention ». Dans Oppositional Defiant Disorder and Conduct Disorder in Childhood, 183–200. Chichester, UK : John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781118972519.ch11.

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Roberts, Albert R., et Kenneth R. Yeager. « Multicomponent Critical Incident Stress Management ». Dans Pocket Guide to Crisis Intervention, 184–88. Oxford University PressNew York, NY, 2009. http://dx.doi.org/10.1093/oso/9780195382907.003.0031.

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Abstract One only needs to pick up a newspaper to understand the need for effective crisis response capabilities. Crisis situations worldwide are growing, ranging from man-made disasters such as war, fire, building collapse, terrorist bombings, and chemical attacks to seemingly increasing numbers of natural disasters such as tornados, hurricanes, ice storms, blizzards, mudslides, floods, and tsunamis.

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Campbell, Rona, et Chris Bonell. « Development and evaluation of complex multicomponent interventions in public health ». Dans Oxford Textbook of Global Public Health, sous la direction de Roger Detels, Quarraisha Abdool Karim, Fran Baum, Liming Li et Alastair H. Leyland, 351–64. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198816805.003.0048.

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This chapter examines the issues to consider when developing and evaluating complex public health interventions and signposts where more detailed guidance can be found. It starts by considering what complexity means in this context, including the contribution that systems theory has made. When developing complex interventions we suggest: (i) reading quantitative and qualitative research on similar interventions, preferably within systematic reviews; (ii) consulting stakeholders, including those that the intervention is intended to benefit, to help ensure its relevance, acceptability and ownership; (iii) considering using theory to inform the intervention design and hypotheses to assess in evaluations; (iv) assessing whether the intervention could operate at more than one level (from individual through to policy) to increase its chances of success; and (v) reflecting on issues of equity and how the intervention could reduce health inequalities.

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Upreti, Yadu Ram, Krishna Prasad Duwadi, Devi Thapa Magar, Bikash Chandra Aryal, Bhimsen Devkota, Sheri Bastien et Birgitte Bjønness. « Fostering Ownership and Sustainability of School-Based Nutrition Education Intervention ». Dans Implementing Transformative Education With Participatory Action Research, 30–51. IGI Global, 2023. http://dx.doi.org/10.4018/979-8-3693-0607-9.ch003.

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Promoting healthy nutritional behaviors in schoolchildren is still challenging since students' nutritional behaviors are influenced by multilevel determinants. This chapter unpacks a range of contextualized approaches that were the hallmarks of fostering ownership and sustainability of school-based nutrition education intervention (SBNEI) to transform nutritional behaviors in basic-level schoolchildren in a public school in Nepal. The chapter discusses three approaches to fostering the ownership and sustainability of the intervention undergoing a participatory action research (PAR) framework. The first approach is developing the intervention following the five-step bottom-up model. The second approach is considering the multilevel and multicomponent SBNEI. And the third approach is owning transdisciplinary and interdisciplinary collaboration. This chapter offers insightful learning space to the related field's teachers, educators, and researchers to consider contextualized approaches undergoing a PAR framework for fostering the ownership and sustainability of the school-based interventions.

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Agarwal, Shashi K. « Multicomponent Exercise : A Non-pharmaceutical Intervention for a Healthier and Long Life ». Dans Emerging Trends in Disease and Health Research Vol. 7, 31–48. Book Publisher International (a part of SCIENCEDOMAIN International), 2022. http://dx.doi.org/10.9734/bpi/etdhr/v7/15727d.

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Actes de conférences sur le sujet "Multicomponent intervention"

Strong, John. « Development of a Multicomponent Reading Intervention in Upper-Elementary Grades : Findings From a Design Experiment ». Dans AERA 2024. USA : AERA, 2024. http://dx.doi.org/10.3102/ip.24.2107538.

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Strong, John. « Development of a Multicomponent Reading Intervention in Upper-Elementary Grades : Findings From a Design Experiment ». Dans 2024 AERA Annual Meeting. Washington DC : AERA, 2024. http://dx.doi.org/10.3102/2107538.

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Von Visger, T. T., S. Thrane, M. D. Klatt, A. DeVito Dabbs, L. L. Chlan et M. B. Happ. « The Impact of a Multicomponent Integrative Intervention on Symptoms and Health Related Quality of Life for Patients with Pulmonary Hypertension ». Dans American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a2643.

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Serra, Consol, Sergio Vargas-Prada, Mercé Soler, Jose Maria Ramada, Pilar Peña, Anna Amat, Ewan B Macdonald, Antoni Merelles et Ana Maria Garcia. « 0450 Preventing and promoting musculoskeletal health at the workplace through the design and evaluation of an innovative multicomponent intervention : the inteval_spain project ». Dans Eliminating Occupational Disease : Translating Research into Action, EPICOH 2017, EPICOH 2017, 28–31 August 2017, Edinburgh, UK. BMJ Publishing Group Ltd, 2017. http://dx.doi.org/10.1136/oemed-2017-104636.423.

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Zülke, Andrea, Alexander Pabst, Melanie Luppa, David Czock, Thomas Frese, Jochen Gensichen, Walter-Emil Haefeli et al. « Effectiveness of a multicomponent lifestyle intervention against cognitive decline and dementia in an at-risk-population in Germany – Preliminary results from the cluster-randomized AgeWell.de-trial ». Dans Gemeinsame Jahrestagung der Deutschen Gesellschaft für Sozialmedizin und Prävention e.V. (DGSMP)*, des Deutschen Netzwerks Gesundheitskompetenz e. V. (DNGK) und des Nationalen Aktionsplans Gesundheitskompetenz (NAP). Georg Thieme Verlag, 2023. http://dx.doi.org/10.1055/s-0043-1770499.

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Teo, Shyh Poh, et Hjh Noridah Hj Abdul Halim. « Multicomponent interventions to prevent and manage pressure injuries in hospital ». Dans 1st International Electronic Conference on Geriatric Care Models. Basel, Switzerland : MDPI, 2019. http://dx.doi.org/10.3390/iecgcm-1-06169.

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Okasako-Schmucker, Devon, Yinan Peng, Susan Sabatino, Ismaila Ramon, Kristin Tansil Roberts, Shawna L. Mercer et Randy Elder. « Abstract C70 : A community guide systematic review of multicomponent interventions to increase breast, cervical, and colorectal cancer screening : Findings in underserved populations ». Dans Abstracts : Tenth AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved ; September 25-28, 2017 ; Atlanta, GA. American Association for Cancer Research, 2018. http://dx.doi.org/10.1158/1538-7755.disp17-c70.

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Rapports d'organisations sur le sujet "Multicomponent intervention"

Yu, Fang, Nicholas A. Hein et Danstan S. Bagenda. Preventing HIV and HSV-2 through improving knowledge and attitudes : a replication study of a multicomponent intervention in Zimbabwe. International Initiative for Impact Evaluation (3ie), mars 2018. http://dx.doi.org/10.23846/rps0016.

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Treadwell, Jonathan R., Amy Y. Tsou, Benjamin Rouse, Ilya Ivlev, Julie Fricke, Dawn Buse, Scott W. Powers, Mia Minen, Christina L. Szperka et Nikhil K. Mull. Behavioral Interventions for Migraine Prevention. Agency for Healthcare Research and Quality (AHRQ), septembre 2024. http://dx.doi.org/10.23970/ahrqepccer270.

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Objectives. Behavioral interventions for migraine prevention can offer an important alternative or complement to medications. An updated systematic review is needed to support evidencebased guidance for clinicians and identify evidence gaps for future research. Data Sources. MEDLINE, Embase, PsycINFO, PubMed, the Cochrane Database of Systematic Reviews, clinicaltrials.gov, and grey literature sources for randomized trials published from January 1, 1975, to August 24, 2023. Review Methods. A multidisciplinary expert panel including adult and pediatric clinical psychologists, adult and pediatric neurologists, primary care physicians, researchers, funders, children and adults with migraine and their caregivers provided input on scope and methods. We included randomized trials enrolling at least 80% participants with migraine (or outcomes for migraine participants reported separately) and reporting a primary outcome at 4 weeks or more after the start of treatment. Primary outcomes were migraine/headache attack frequency, migraine disability, and migraine-related quality of life. We did not require a formal diagnosis of migraine (i.e., International Classification of Headache Disorders criteria). The review team tabulated information from included trials, rated risk of bias, conducted pairwise meta-analyses, and rated the strength of evidence (SOE). The SOE is a formal rating of the reviewer’s confidence in the estimated effects. Results. For adults, we included 50 trials published since 1978. Most preventive interventions were multicomponent, using one or more of five primary components (cognitive behavioral therapy [CBT], biofeedback, relaxation training, mindfulness-based therapies, and/or education). Most trials were at high risk of bias, primarily due to measurement bias and incomplete data. Given the small amount of evidence on any given intervention/comparator/outcome combination, data were often insufficient to permit conclusions. For adults, we found that any of three components (CBT, relaxation training, mindfulness-based therapies) may reduce migraine/headache attack frequency (SOE: low). Education alone that targets behavior may improve migraine-related disability (SOE: low). For three other interventions (biofeedback, acceptance and commitment therapy, and hypnotherapy), evidence was insufficient to permit conclusions. We also found that mindfulness-based therapy may improve migraine disability more than education, and relaxation + education may improve migraine-related quality of life more than propranolol (SOE: low). For children/adolescents, we included 13 trials published since 1984 (average age 14.5), but the evidence was only sufficient to conclude that CBT + biofeedback + relaxation training may reduce migraine attack frequency and disability more than education alone (SOE: low). Conclusion. Several behavioral interventions appear to reduce migraine/headache attack frequency in adults. Evidence consisted primarily of underpowered trials of multicomponent interventions compared with various types of control groups. Future research should enroll children and adolescents, standardize intervention components to improve reproducibility, use comparison groups that control for expectation confounds, enroll larger samples, consider digital and telehealth modes of care delivery, and improve the completeness of data collection.

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Waldfogel, Julie M., Michael Rosen, Ritu Sharma, Allen Zhang, Eric B. Bass et Sydney M. Dy. Making Healthcare Safer IV : Opioid Stewardship. Agency for Healthcare Research and Quality (AHRQ), décembre 2023. http://dx.doi.org/10.23970/ahrqepc_mhs4opioid.

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Objectives. Opioid stewardship interventions promote the appropriate use of prescribed and ordered opioids to reduce the risk of opioid adverse events. Our main objectives were to determine the effectiveness of these interventions in healthcare settings on opioid prescribing and clinical outcomes (e.g., number of opioid prescriptions, opioid dosage, overdose, emergency department visits, and hospitalizations) including unintended consequences (e.g., changes in patient-reported pain intensity), and ways these interventions can be effectively implemented. Methods. We followed rapid review processes of the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. We searched PubMed and the Cochrane Library to identify eligible systematic reviews from January 2019 to April 2023 and primary studies published from January 2016 to April 2023, supplemented by targeted gray literature searches. We included systematic reviews and studies that addressed opioid stewardship interventions implemented in healthcare settings in the United States and that reported on opioid prescribing and clinical outcomes. Findings. Our search retrieved 6,431 citations, of which 34 articles were eligible (including 1 overview of systematic reviews, 13 additional systematic reviews, 13 randomized controlled trials (RCTs) [reported in 14 articles] and 6 nonrandomized studies). Systematic reviews, mostly summarizing pre-post studies, included a wide variety of opioid stewardship practices that focused on patient and family engagement, healthcare organization policy, or clinician knowledge and behavior interventions, in inpatient, perioperative, emergency department, and ambulatory settings. RCTs addressed multicomponent interventions (typically a combination of prescriber education, care management and facilitated access to resources), and patient education and engagement, mainly in ambulatory chronic pain. Opioid stewardship practices involving clinical decision support or electronic health records, or multicomponent interventions (including for chronic pain) were associated with decreases in opioid prescribing or reduced doses and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence for all outcomes). Patient engagement and education interventions had mixed results for opioid prescribing outcomes (insufficient strength of evidence) and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence). The evidence was insufficient on other types of interventions and on outcomes of opioid refill requests and refills, patient satisfaction, or overdose. Barriers included lack of training, workload, gaps in communication, and inadequate access to nonpharmacological resources. Facilitators included clinician and patient acceptance of intervention components. Conclusions. Selected opioid stewardship interventions may be effective for reducing opioid prescribing and dosing without adversely affecting clinical outcomes overall, although strength of evidence was low. Unintended consequences were often not measured or not measured rigorously. Interventions to reduce opioid use should monitor unintended consequences and include access to nonpharmacological pain management resources with appropriate patient education and engagement.

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Masset, Edoardo. Evaluating complex interventions : What are appropriate methods ? Centre for Excellence and Development Impact and Learning (CEDIL), février 2022. http://dx.doi.org/10.51744/cmb7.

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In this CEDIL Methods Brief, we identify four types of complex development interventions: long causal chain interventions, multicomponent interventions, portfolio interventions, and system-level interventions. These interventions are characterised by multiple activities, multiple outcomes, multiple components, a high level of interconnectedness, and non-linear outcomes. We identify a number of approaches that support the evaluation of different types of complex interventions.

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Dy, Sydney M., Arjun Gupta, Julie M. Waldfogel, Ritu Sharma, Allen Zhang, Josephine L. Feliciano, Ramy Sedhom et al. Interventions for Breathlessness in Patients With Advanced Cancer. Agency for Healthcare Research and Quality (AHRQ), novembre 2020. http://dx.doi.org/10.23970/ahrqepccer232.

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Objectives. To assess benefits and harms of nonpharmacological and pharmacological interventions for breathlessness in adults with advanced cancer. Data sources. We searched PubMed®, Embase®, CINAHL®, ISI Web of Science, and the Cochrane Central Register of Controlled Trials through early May 2020. Review methods. We included randomized controlled trials (RCTs) and observational studies with a comparison group evaluating benefits and/or harms, and cohort studies reporting harms. Two reviewers independently screened search results, serially abstracted data, assessed risk of bias, and graded strength of evidence (SOE) for key outcomes: breathlessness, anxiety, health-related quality of life, and exercise capacity. We performed meta-analyses when possible and calculated standardized mean differences (SMDs). Results. We included 48 RCTs and 2 retrospective cohort studies (4,029 patients). The most commonly reported cancer types were lung cancer and mesothelioma. The baseline level of breathlessness varied in severity. Several nonpharmacological interventions were effective for breathlessness, including fans (SMD -2.09 [95% confidence interval (CI) -3.81 to -0.37]) (SOE: moderate), bilevel ventilation (estimated slope difference -0.58 [95% CI -0.92 to -0.23]), acupressure/reflexology, and multicomponent nonpharmacological interventions (behavioral/psychoeducational combined with activity/rehabilitation and integrative medicine). For pharmacological interventions, opioids were not more effective than placebo (SOE: moderate) for improving breathlessness (SMD -0.14 [95% CI -0.47 to 0.18]) or exercise capacity (SOE: moderate); most studies were of exertional breathlessness. Different doses or routes of administration of opioids did not differ in effectiveness for breathlessness (SOE: low). Anxiolytics were not more effective than placebo for breathlessness (SOE: low). Evidence for other pharmacological interventions was limited. Opioids, bilevel ventilation, and activity/rehabilitation interventions had some harms compared to usual care. Conclusions. Some nonpharmacological interventions, including fans, acupressure/reflexology, multicomponent interventions, and bilevel ventilation, were effective for breathlessness in advanced cancer. Evidence did not support opioids or other pharmacological interventions within the limits of the identified studies. More research is needed on when the benefits of opioids may exceed harms for broader, longer term outcomes related to breathlessness in this population.

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Treadwell, Jonathan R., James T. Reston, Benjamin Rouse, Joann Fontanarosa, Neha Patel et Nikhil K. Mull. Automated-Entry Patient-Generated Health Data for Chronic Conditions : The Evidence on Health Outcomes. Agency for Healthcare Research and Quality (AHRQ), mars 2021. http://dx.doi.org/10.23970/ahrqepctb38.

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Background. Automated-entry consumer devices that collect and transmit patient-generated health data (PGHD) are being evaluated as potential tools to aid in the management of chronic diseases. The need exists to evaluate the evidence regarding consumer PGHD technologies, particularly for devices that have not gone through Food and Drug Administration evaluation. Purpose. To summarize the research related to automated-entry consumer health technologies that provide PGHD for the prevention or management of 11 chronic diseases. Methods. The project scope was determined through discussions with Key Informants. We searched MEDLINE and EMBASE (via EMBASE.com), In-Process MEDLINE and PubMed unique content (via PubMed.gov), and the Cochrane Database of Systematic Reviews for systematic reviews or controlled trials. We also searched ClinicalTrials.gov for ongoing studies. We assessed risk of bias and extracted data on health outcomes, surrogate outcomes, usability, sustainability, cost-effectiveness outcomes (quantifying the tradeoffs between health effects and cost), process outcomes, and other characteristics related to PGHD technologies. For isolated effects on health outcomes, we classified the results in one of four categories: (1) likely no effect, (2) unclear, (3) possible positive effect, or (4) likely positive effect. When we categorized the data as “unclear” based solely on health outcomes, we then examined and classified surrogate outcomes for that particular clinical condition. Findings. We identified 114 unique studies that met inclusion criteria. The largest number of studies addressed patients with hypertension (51 studies) and obesity (43 studies). Eighty-four trials used a single PGHD device, 23 used 2 PGHD devices, and the other 7 used 3 or more PGHD devices. Pedometers, blood pressure (BP) monitors, and scales were commonly used in the same studies. Overall, we found a “possible positive effect” of PGHD interventions on health outcomes for coronary artery disease, heart failure, and asthma. For obesity, we rated the health outcomes as unclear, and the surrogate outcomes (body mass index/weight) as likely no effect. For hypertension, we rated the health outcomes as unclear, and the surrogate outcomes (systolic BP/diastolic BP) as possible positive effect. For cardiac arrhythmias or conduction abnormalities we rated the health outcomes as unclear and the surrogate outcome (time to arrhythmia detection) as likely positive effect. The findings were “unclear” regarding PGHD interventions for diabetes prevention, sleep apnea, stroke, Parkinson’s disease, and chronic obstructive pulmonary disease. Most studies did not report harms related to PGHD interventions; the relatively few harms reported were minor and transient, with event rates usually comparable to harms in the control groups. Few studies reported cost-effectiveness analyses, and only for PGHD interventions for hypertension, coronary artery disease, and chronic obstructive pulmonary disease; the findings were variable across different chronic conditions and devices. Patient adherence to PGHD interventions was highly variable across studies, but patient acceptance/satisfaction and usability was generally fair to good. However, device engineers independently evaluated consumer wearable and handheld BP monitors and considered the user experience to be poor, while their assessment of smartphone-based electrocardiogram monitors found the user experience to be good. Student volunteers involved in device usability testing of the Weight Watchers Online app found it well-designed and relatively easy to use. Implications. Multiple randomized controlled trials (RCTs) have evaluated some PGHD technologies (e.g., pedometers, scales, BP monitors), particularly for obesity and hypertension, but health outcomes were generally underreported. We found evidence suggesting a possible positive effect of PGHD interventions on health outcomes for four chronic conditions. Lack of reporting of health outcomes and insufficient statistical power to assess these outcomes were the main reasons for “unclear” ratings. The majority of studies on PGHD technologies still focus on non-health-related outcomes. Future RCTs should focus on measurement of health outcomes. Furthermore, future RCTs should be designed to isolate the effect of the PGHD intervention from other components in a multicomponent intervention.

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Paynter, Robin A., Celia Fiordalisi, Elizabeth Stoeger, Eileen Erinoff, Robin Featherstone, Christiane Voisin et Gaelen P. Adam. A Prospective Comparison of Evidence Synthesis Search Strategies Developed With and Without Text-Mining Tools. Agency for Healthcare Research and Quality (AHRQ), mars 2021. http://dx.doi.org/10.23970/ahrqepcmethodsprospectivecomparison.

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Background: In an era of explosive growth in biomedical evidence, improving systematic review (SR) search processes is increasingly critical. Text-mining tools (TMTs) are a potentially powerful resource to improve and streamline search strategy development. Two types of TMTs are especially of interest to searchers: word frequency (useful for identifying most used keyword terms, e.g., PubReminer) and clustering (visualizing common themes, e.g., Carrot2). Objectives: The objectives of this study were to compare the benefits and trade-offs of searches with and without the use of TMTs for evidence synthesis products in real world settings. Specific questions included: (1) Do TMTs decrease the time spent developing search strategies? (2) How do TMTs affect the sensitivity and yield of searches? (3) Do TMTs identify groups of records that can be safely excluded in the search evaluation step? (4) Does the complexity of a systematic review topic affect TMT performance? In addition to quantitative data, we collected librarians' comments on their experiences using TMTs to explore when and how these new tools may be useful in systematic review search¬¬ creation. Methods: In this prospective comparative study, we included seven SR projects, and classified them into simple or complex topics. The project librarian used conventional “usual practice” (UP) methods to create the MEDLINE search strategy, while a paired TMT librarian simultaneously and independently created a search strategy using a variety of TMTs. TMT librarians could choose one or more freely available TMTs per category from a pre-selected list in each of three categories: (1) keyword/phrase tools: AntConc, PubReMiner; (2) subject term tools: MeSH on Demand, PubReMiner, Yale MeSH Analyzer; and (3) strategy evaluation tools: Carrot2, VOSviewer. We collected results from both MEDLINE searches (with and without TMTs), coded every citation’s origin (UP or TMT respectively), deduplicated them, and then sent the citation library to the review team for screening. When the draft report was submitted, we used the final list of included citations to calculate the sensitivity, precision, and number-needed-to-read for each search (with and without TMTs). Separately, we tracked the time spent on various aspects of search creation by each librarian. Simple and complex topics were analyzed separately to provide insight into whether TMTs could be more useful for one type of topic or another. Results: Across all reviews, UP searches seemed to perform better than TMT, but because of the small sample size, none of these differences was statistically significant. UP searches were slightly more sensitive (92% [95% confidence intervals (CI) 85–99%]) than TMT searches (84.9% [95% CI 74.4–95.4%]). The mean number-needed-to-read was 83 (SD 34) for UP and 90 (SD 68) for TMT. Keyword and subject term development using TMTs generally took less time than those developed using UP alone. The average total time was 12 hours (SD 8) to create a complete search strategy by UP librarians, and 5 hours (SD 2) for the TMT librarians. TMTs neither affected search evaluation time nor improved identification of exclusion concepts (irrelevant records) that can be safely removed from the search set. Conclusion: Across all reviews but one, TMT searches were less sensitive than UP searches. For simple SR topics (i.e., single indication–single drug), TMT searches were slightly less sensitive, but reduced time spent in search design. For complex SR topics (e.g., multicomponent interventions), TMT searches were less sensitive than UP searches; nevertheless, in complex reviews, they identified unique eligible citations not found by the UP searches. TMT searches also reduced time spent in search strategy development. For all evidence synthesis types, TMT searches may be more efficient in reviews where comprehensiveness is not paramount, or as an adjunct to UP for evidence syntheses, because they can identify unique includable citations. If TMTs were easier to learn and use, their utility would be increased.

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