Promoting walking among older adults living in retirement communities

The authors tested the feasibility and acceptability, and explored the outcomes, of 2 walking interventions based on ecological models among older adults living in retirement communities. An enhanced intervention (EI) was compared with a standard walking intervention (SI) among residents in 4 retirement facilities (N = 87 at baseline; mean age = 84.1 yr). All participants received a walking intervention including pedometers, printed materials, and biweekly group sessions. EI participants also received phone counseling and environmental-awareness components. Measures included pedometer step counts, activities of daily living, environment-related variables, physical function, depression, cognitive function, satisfaction, and adherence. Results indicated improvements among the total sample for step counts, neighborhood barriers, cognitive function, and satisfaction with walking opportunities. Satisfaction and adherence were high. Both walking interventions were feasible to implement among facility-dwelling older adults. Future studies can build on this multilevel approach.     

A process evaluation of an intervention to promote home smoking bans among low income households

Exposure to secondhand smoke occurs primarily in the home due to passage of smoke-free legislation. Creation of a total household smoking ban can reduce associated health conditions such as asthma, lung cancer, heart disease and stroke. This paper describes the results of a randomized control trial of a minimal intervention to create smoke-free homes. 2-1-1 callers were invited to participate in the trial and were randomized to an intervention (mailings and a coaching call) or a control group (no intervention). We assessed reach, dose, fidelity, and receptivity to the intervention through program records and a 3-month follow-up survey with intervention participants. For the intervention materials, materials were mailed to 244 participants (99.2%) and 227 participants (92.3%) received the coaching call intervention. 92.3% received all intervention components. Participants who had full household bans at 3 months were more likely to conduct behaviors leading to a smoke-free home (i.e., making a list of reasons, having a family talk, posting a pledge) than were those with no/partial ban. The intervention materials also were rated higher in relevance and usefulness by non-smokers than smokers. Results demonstrate that this minimal intervention had high fidelity to the delivery of components and relatively high receptivity.     

Healthy eating and physical activity among low-income Hispanic adolescents and a school-based intervention

Hispanic and low-income adolescents have significantly higher overweight and obesity rates than others. This study described the nutrition and physical activity habits of a sample of 122 low-income, Hispanic adolescents and assessed the impact of their environment on their nutrition and physical activity. The study also assessed the outcomes of a pilot of a Farm to Table Chef Demonstration and Blender Bike intervention among a subsample of 16 participants. Family members' influence had a stronger positive correlation to healthy eating while friends' influence had a stronger positive correlation to exercise. The intervention piloted was statistically significantly associated with an increase in vegetable consumption.     

Effects of group therapy on female adolescent survivors of sexual abuse: a pilot study

Treatment interventions for female sexual abuse survivors was explored through a pilot study examining the relationship between group treatment and adolescent self-image. Self-image was defined as body image, self-reliance, self-control, and impulse-control. An experimental pre-post design was utilized. Participants were 13 female adolescent high school drop-outs with a history of sexual abuse who participated in the National Guard Youth Challenge Program at Camp Shelby in Mississippi. Participants completed the Offer Self- Image Questionnaire for Adolescents. The hypothesis that group therapy was an effective intervention for sexual abuse survivors was not supported; however, this is likely due to the small sample size. Because this was a pilot study, mean trends were observed to see directional changes that may assist future researchers. Observation of mean trends revealed that participants who received group therapy increased in levels of impulse control while the group that did not receive group therapy remained the same. Mean trends also revealed that the experimental group had a decrease in self-reliance whereas the control group maintained their levels of self-reliance.     

Intervening with At-risk Mothers: Supporting Infant Language Development

At-risk young mothers and their infants (4–7 months of age) participated in an evaluation of a parenting intervention that focused largely on language stimulation. Participants assigned to the intervention group were matched with a volunteer mentor and were encouraged to attend eleven parenting sessions (five to seven participants per group) across approximately 8 months. Participants in the control group received referrals as needed and were followed across time. Results indicated that babies of the participants in the intervention group experienced more improvement in expressive language from pretest to posttest than did babies of the mothers in the control group.     

Client-centred Case Management: How Much Makes a Difference to Outcomes for Homeless Jobseekers?

Case management has become the predominant model for attempting to improve outcomes for young adults experiencing both homelessness and unemployment. However, there is little evidence-based knowledge about how young adults respond to case management, and how much intervention is needed to be effective. This Australian study utilised quantitative government data to investigate the effects of the amount of case management on key outcomes. With a purposive sample of 224 people aged 18–35, this study compared four different amounts of YP⁴ case management service received over a three-year period. Participants were categorised into four groupings depending on the number of case management contacts they received: 0–5, 6–20, 21–40, and 41–156. The findings show some significant group variations over the course of the trial in the areas of employment and accommodation. Participants who received 20 or more contacts had significantly better accommodation and employment outcomes than those who received fewer contacts.     

Increasing walking in college students using a pedometer intervention: differences according to body mass index

Objective: The researchers assessed the effectiveness of a pedometer intervention and differences in walking behaviors according to body mass index (BMI). Participants: Two hundred ninety college students completed the intervention from January to February 2005. Methods: Participants wore pedometers 5 days per week for 12 weeks and completed questionnaires assessing demographic information. The authors calculated daily step averages for weeks 1, 6, and 12. They then classified students as underweight (UW), normal weight (NW), or overweight/obese, by BMI. The authors analyzed data using repeated-measures analysis of variance. Results: The average number of daily steps increased from week 1 to week 6 (p < .001) and week 12 (p = .002). UW participants reported the fewest steps at each time point, but the difference was significant only when compared with NW participants (p = .03). Conclusions: These results support the effectiveness of a pedometer intervention to increase walking in college students. Health benefits other than weight management should be emphasized to maximize the effects for all students.     

Design of an educational strategy based on Intervention Mapping for nutritional health promotion in Child Care Centers

Early childhood is a critical period for instilling healthy habits to prevent overweight and obesity. This paper describes the development of an educational intervention for the promotion of healthy eating and physical activity among two-to-four-year-old children in public child care centers (CCCs) in Mexico City. Following the Intervention Mapping (IM) protocol, we developed the Bright Futures multidisciplinary intervention. First, a formative research process to identify the personal and environmental determinants of childhood overweight and obesity, behavioral outcomes and performance objectives was conducted. Then, a matrix of change objectives by intersecting the performance objectives with the determinants was integrated. Bright Futures lasted six months and included 24 weekly sessions, each composed of five phases: warm-up, theory, active movements, relaxation, and hydration. Ad hoc interactive teaching materials focused on recreational activities, and formulated plans for the adoption, implementation and process/impact evaluation of the intervention was developed. IM successfully guided the design of a theory-driven and evidence-based intervention for children in CCCs within a socio-ecological and participatory planning framework. This is one of the first studies in Mexico to use IM in the context of CCCs.     

A single-subject design of ergonomic intervention effectiveness for university employees in a new facility

As clinicians are searching for evidence to support their practice interventions, it is sometimes hard to find the "real-world" studies that incorporate the complexities of actual practice. Following calls in the public health, nursing and medical literature for clinicians to participate in practice-based evidence, this pilot study explores the effectiveness of a single-subject design for practice-based evidence. Twenty-five "well" university employees participated in an ergonomic intervention over the course of one academic semester that consisted of a 15 min ergonomic intake session, a 45 min group hands-on ergonomic educational session and a 15 min individual ergonomic consult in their offices. Participants were sent postural comfort surveys weekly and their subjective ratings were analyzed to determine the effectiveness of the intervention to decrease their perceived postural discomfort at a computer work station. Twenty-one of the twenty-five participants reported an improvement in postural comfort over the course of the study. This pilot study suggests that further investigation needs to be conducted to determine the effectiveness of hands-on ergonomic education and consultation for well populations working at computer workstations.     

Use of a mixed-method approach to evaluate the implementation of retention promotion strategies in the New York State WIC program

This research assessed the implementation of strategies piloted at 10 Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinics aimed at increasing retention in the program, by enhancing participants’ shopping experiences. Under WIC Retention Promotion Study: Keep, Reconnect, Thrive (WIC RPS), clinics were recruited and assigned to implement one or a combination of strategies: a standardized Shopping Orientation (SO) curriculum, a Guided Shopping Tour (GST), and a Pictorial Foods Card (PFC) from November 2012 through August 2013. This paper presents results from the process evaluation of the retention strategies, using a mixed-methods comparative case study design employing WIC administrative data, interviews, and focus groups. Qualitative data were inductively coded, analyzed and mapped to the following implementation constructs: organizational capacity, fidelity, allowable adaptations, implementation challenges, and participant responsiveness, while quantitative data were analyzed using SAS to assess reach and dose.Several sites implemented the SO and PFC interventions with the necessary fidelity and dose needed to assess impact on participants’ shopping experiences. Sites that were assigned the GST strategy struggled to implement this strategy. However, use of the standardized SO enabled staff to use a “consistent list of shopping tips” to educate participants about the proper use of checks, while use of the PFC increased participants’ awareness of the variety of WIC-allowable foods. During follow-up telephone calls, 91 percent of participants reported the shopping tips as helpful. Future analyses will assess the impact of enhanced shopping experience on retention at intervention sites.Keywords: Special Supplemental Nutrition Program for Women, Infants and Children (WIC); Mixed-methods; Process evaluation; Shopping with WIC checks; Retention     

Worksite e-mail health promotion trial: Early lessons

In preparation for an electronic mail (e-mail) and web-based health promotion intervention across multiple worksites, secure, regulatory-compliant, user-friendly e-mail and Internet applications were used to recruit potential participants across worksites, to enroll participants, and to collect baseline health assessment data. Specific hardware and software information technology environments were required of the 19 participating worksites. Sequential e-mails introduced the study and invited participation. Twenty-four percent of all employees (1106 of approximately 4600) provided consent. E-mail delivered a web link for the baseline study assessment, and reminder e-mails were sent to prompt completion. Of those who consented, 888 (80%) completed baseline health and behavior data surveys. An HTML-native web survey software was more stable across computing environments. Using e-mail and web assessment, this research recruited, enrolled, and collected data from more than 850 participants. Technical and operational challenges emerged at each step. Solutions and recommendations are discussed. Overall, this experience suggests that the use of e-mail and web software can facilitate recruitment, enrollment, and data acquisition through direct contact with study participants. This experience yields a series of lessons learned for using e-mail and the Internet to support multi-site trials.     

Randomized controlled trial of the Resilience and Coping Intervention (RCI) with undergraduate university students

Objective: The purpose of this pilot study was to evaluate the Resilience and Coping Intervention (RCI) with college students. Participants: College students (aged 18–23) from a large Midwest US university who volunteered for a randomized controlled trial during the 2015 spring semester. Methods: College students were randomly assigned to an intervention (n = 64) or a control (n = 65) group. Intervention participants received three 45-minute RCI sessions over subsequent weeks. All participants completed pre- and post-intervention assessments at the beginning of Week 1 and end of Week 3. Student resilience, coping, hope, stress, depression, and anxiety were assessed. Results. RCI participants reported significantly more hope and less stress and depression from Week 1 to Week 3 compared with control participants. Results for resilience also approached statistical significance. Effect sizes were small to moderate. Conclusions: This study found preliminary evidence that RCI is an effective resilience intervention for use with college students.     

Creating curative communities: feminist group work with women with eating issues

The purpose of this study is to explore the efficacy of feminist group work for women with eating issues. Data for the study is drawn from participants involved in five therapeutic groups at the community based organisation, ISIS Centre for Women's Action on Eating Issues ¹. Participants in this study completed the Eating Disorder Inventory (EDI) before and after group work and also responded to a post-group questionnaire which elicited their experiences of group work. Background information about ISIS and the model of group work at ISIS is provided. Following this, the EDI completed by participants and the post-group questionnaire are examined. The data reveals that feminist group work is a valuable therapeutic intervention for women with eating issues. The key to the effectiveness of group work is that it provides a curative culture.     

An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease

A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.     

Project LIFE: a partnership to increase physical activity in elders with multiple chronic illnesses

The authors describe a medical center-based randomized trial aimed at determining the feasibility and effectiveness of partnering patients and primary-care providers with an exercise health counselor. Study participants included 165 veterans age 70 years and older. The primary end point was change in physical activity at 3 and 6 months comparing patients receiving high-intensity physical activity counseling, attention control counseling, and usual care after receiving standardized clinic-based counseling. We noted a significant Group x Time interaction (p = .041) for physical activity frequency and a similar effect for caloric expenditure (p = .054). Participants receiving high-intensity counseling and usual care increased physical activity over the short term, but those with usual care returned to baseline by the end of the study. The intervention was well received by practitioners and patients. We conclude that partnering primary-care providers with specialized exercise counselors for age- and health-appropriate physical activity counseling is effective.     

Longitudinal Evaluation of a Teenage Pregnancy Case Management Program in Oklahoma

The purpose of this study was to evaluate the efficacy of a school-based case management intervention in reducing teen-pregnancy. A nonrandomized intervention/comparison schools mixed-method evaluation design was employed. Participants included 203 pregnant and parenting teens with annual follow-up over a 3-year period. The results indicated that the time to repeat pregnancy was delayed among pregnant teens, high school drop-out rates were reduced among parenting teens, and pregnant teens were less likely to deliver before 36 weeks in the intervention versus the comparison school. Case management at a school setting is a promising approach to decrease repeat teen pregnancy.     

Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: 3-month follow-up

This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called Michigan Prevention and Alcohol Safety for Students (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students.     

Tai Chi-based exercise for older adults with Parkinson's disease: a pilot-program evaluation

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson's disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p < .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.     

Do Parent Preferences for Child Conduct Problem Interventions Impact Parenting Outcomes? A Pilot Study in Community Children's Mental Health Settings

A pilot, doubly randomized preference trial was conducted to investigate the impact of providing parents preferences on parenting outcomes. Families with children having conduct problems were randomly assigned to a choice group in which they received their preferred treatment among the four intervention options or a no‐choice group in which they were randomized assigned to one of the four options. Results of mixed‐effects models showed that parents in the choice group who selected Parent Management Training‐Oregon Model (PMTO) had better parenting outcomes over time compared to parents in the choice group who selected child therapy. It highlights the importance of incorporating parent preferences in the delivery of evidence‐based treatments.     

Positively Impacting Maternal Stress and Parental Adjustment through Community-Based Relationship Education (RE)

Relationship education (RE) is a brief, strength-based psychoeducational intervention for couples that demonstrates strong outcomes to decrease individual and couple stress. The current study examined changes in relationship and family adjustment for expectant mothers following RE intervention. Participants included 91 pregnant women (64.8% racial or ethnic minorities) who participated in a community-based RE program. In examination of pre and post-intervention relationship assessment scale and parental stress and coping inventory results, RE intervention contributed to increased relationship satisfaction, and reduced parental distress, as well as to improved social support and family-based support scores among participants. In addition, relationship stress is a major contributor to stress during pregnancy that adds vulnerability for the health of low-income and ethnic minority expectant mothers and their children. Findings indicate the effectiveness of RE to significantly reduce stress for expectant mothers. Therefore, the use of RE as a low-cost and accessible intervention to combat stress provides positive implications for this vulnerable population.