Reliabilities of Intra-Individual Mean and Intra-Individual Variability of Self-Reported Pain Derived From Ecological Momentary Assessments: Results From the Einstein Aging Study
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Pain catastrophizing
Multilevel interventions, implemented at the individual, physician, clinic, health-care organization, and/or community level, increasingly are proposed and used in the belief that they will lead to more substantial and sustained changes in behaviors related to cancer prevention, detection, and treatment than would single-level interventions. It is important to understand how intervention components are related to patient outcomes and identify barriers to implementation. Designs that permit such assessments are uncommon, however. Thus, an important way of expanding our knowledge about multilevel interventions would be to assess the impact of interventions at different levels on patients as well as the independent and synergistic effects of influences from different levels. It also would be useful to assess the impact of interventions on outcomes at different levels. Multilevel interventions are much more expensive and complicated to implement and evaluate than are single-level interventions. Given how little evidence there is about the value of multilevel interventions, however, it is incumbent upon those arguing for this approach to do multilevel research that explicates the contributions that interventions at different levels make to the desired outcomes. Only then will we know whether multilevel interventions are better than more focused interventions and gain greater insights into the kinds of interventions that can be implemented effectively and efficiently to improve health and health care for individuals with cancer. This chapter reviews designs for assessing multilevel interventions and analytic ways of controlling for potentially confounding variables that can account for the complex structure of multilevel data.
Multilevel modelling
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Summary The purpose of this study was to review existing behavioural interventions for preventing and treating obesity in adult population that were published between 2000 and September 2006. A total of 23 interventions were found. Most of these interventions targeted both physical activity and nutrition behaviours. Majority of the interventions were not based on any explicit behavioural theory. In terms of duration, the interventions ranged from 3 weeks to 9 years. Approximately half of the interventions were less than 6 months in duration. Most of the interventions were implemented by the researchers themselves. However, some interventions were implemented by nurse educators, nutritionists, trained public health nurses, dietitians, healthcare providers, fitness workers and certified diabetic educators. Most of the interventions used group sessions as the predominant method to deliver the programme. Three of the interventions used media. Majority of the interventions were implemented in patient care settings with some in community settings. The most common determinant for measuring impact of the interventions has been body mass index. Fifteen interventions showed positive change in adiposity indices while six showed no change in adiposity indices. Recommendations for enhancing the effectiveness of behavioural interventions for prevention of obesity are presented.
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This systematic review was conducted to provide an overview of effective interventions targeting stress at the workplace. The literature search was performed in the database ISI Web of Knowledge and Embase between January 2005 and July 2012. Study characteristics, types of interventions and outcome measures, work settings, the effectiveness of the interventions, and the quality of the studies were extracted, evaluated, and synthesized. A total of 114 studies reported 192 interventions and were identified for analyses. The overwhelming majority of these studies was conducted in high-income countries or regions. These interventions were categorized into seven types: training or learning interventions, social-support interventions, occupational interventions, organizational-structural interventions, physiological interventions, psychological interventions, and interventions combining physiological and psychological aspects. Results showed that training and learning interventions, social-support interventions and interventions combining physiological and psychological aspects were mainly conducted in both the public and the private sectors, while occupational interventions were specifically performed in the public sector. The effectiveness of stress interventions was especially investigated in health, education, and public-administration agencies in the public sector and in manufacturing enterprises in the private sector. Of the 114 studies, 36 studies rated as excellent or good quality reported 66 significantly or partly-significantly effective interventions. Training and learning interventions and social-support interventions were frequently used in both the public and the private sectors, while interventions combining physiological and psychological aspects were mainly applied in the public sector. Furthermore, specific stress interventions extracted from included studies were associated with work settings: Group meetings were most frequently applied in the administrative and health agencies, while fitness exercise was most commonly applied in financial and insurance companies. Our review revealed the great diversity in stress interventions at the workplace, which reflects the difficulties in conducting effective stress interventions there. Further studies that identify the factors that have the most impact on presenteeism are required. This review can serve as a guide for effective interventions targeting stress and the improvement of stress interventions at the workplace.
Occupational Stress
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Cyberbullying intervention resources can be classified into school-based and stand-alone interventions.
The difference between both interventions will be described, but the focus of the presentation will be on the recently developed and theoretically based stand-alone interventions to combat and prevent cyberbullying. Five stand-alone interventions will be described that are based on theory and tested on effectivity. They are all tailored on personality characteristics, coping strategies and needs and have common core themes, but differ in their development and procedures.
Several lessons can be learned from research on the effectiveness of these five interventions regarding the usefulness of interventions and implementation pitfalls. In the presentation the necessity of tailored advice in interventions and important aspects of the content and the structure of interventions will be discussed, as well as the necessity of guidance. Several recommendations for future interventions will be provided.
Presentation (obstetrics)
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Objectives: This study aims to describe what adults with chronic pain experience in their role as parents, utilizing quantitative and qualitative methods. The first aim was to compare parents with chronic pain to parents without chronic pain on perceptions of their adolescent’s pain, parental response to pain, and catastrophizing beliefs about pain. The study also examined predictors of parental protective behaviors, and examined whether these associations differed by study group. Materials and Methods: Parents with chronic pain (n=58) and parents without chronic pain (n=72) participated, and completed questionnaire measures of pain characteristics and pain interference, as well as measures of parental catastrophizing and protective pain responses. Parents with chronic pain also completed a structured interview about their experience of being a parent. Interview responses were videotaped and subsequently coded for content. Results: Compared with controls, parents with chronic pain endorsed more pain in their adolescents, and were more likely to catastrophize about their adolescent’s pain and respond with protective behaviors. Parent’s own pain interference and the perception of higher pain in their adolescent was associated with increased protective parenting in the chronic pain group. Qualitative coding revealed a number of areas of common impact of chronic pain on parenting. Discussion: Chronic pain impacts everyday parenting activities and emotions, and impacts pain-specific parent responses that are known to be related to increased pain and pain catastrophizing in children and adolescents. Parents with chronic pain might benefit from interventions that address potential parenting difficulties, and might improve outcomes for their children.
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70% of medication errors occurring in the hospitals are preventable. The study was aimed to document, classify and examine interventions and examine reasons as to why pharmacists initiate changes in drug therapy and the outcomes of interventions, also examine the acceptability of interventions to analyze if intervention study can be a reliable learning process and to identify the areas of weakness in case of ineffective interventions. Interventions were broadly classified into Reactive interventions and Passive interventions. The study was conducted for six months. A total of 470 interventions were recorded in this study. Out of these 470 interventions, 104 were reactive interventions and 366 were passive interventions. Out of 92 outcome assessed interventions, the outcomes were beneficial in (91.30%) and had no effect in (8.70%). Active involvement of clinical pharmacists in the wards helps physicians in taking better therapeutic decisions which highlights areas where clinical pharmacists could prove their skill and knowledge to achieve better patient outcomes.
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Although theoretical and empirical writings on habits and routines are a promising body of science to guide interventions, little is known about such interventions among emerging adults with type 1 diabetes. Thus, an integrative review was conducted to describe interventions in relation to habits and routines, their influence on outcomes, and users’ perspectives. A medical librarian conducted a search. Teams screened titles, abstracts, and articles based upon predefined criteria. Evidence from the final 11 articles was synthesized. A minority of investigators explicitly articulated habits and routines theoretical underpinnings as part of the interventions. However, text messaging or feedback via technology used in other interventions could be implicitly linked to habits and routines. For the most part, these interventions positively influenced diabetes self-management-related behaviors and health outcomes. In general, the interventions were perceived positively by users. Future research is advocated using habit and routine theoretical underpinnings to guide interventions.
Habit
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Summary The purpose of this article was to review physical activity interventions done with Hispanic American girls and women that were published between 1994 and 2007, and suggest ways of enhancing these interventions. A total of 12 such interventions were found. Majority of the interventions focused on both physical activity and nutrition behaviours. Only half of the interventions were based on a behavioural theory. Social cognitive theory was the most popular theory, which was operationalized by four interventions. The interventions ranged from 3 weeks to 2 years in duration. The impact was not necessarily linked to the length of the intervention. The most popular physical activity that was promoted was walking, which was utilized by four interventions. Most of the interventions utilized a classroom format for imparting instruction in being physically active. All the interventions utilized individual‐level behaviour change as an approach, and none tried to address broader policy and environmental‐level changes. Process evaluation was done by very few interventions and must be done more systematically. In terms of the impact, half of the interventions were successful in influencing the outcomes. Recommendations for enhancing the effectiveness of physical activity interventions in Hispanic American girls and women are presented.
Social Cognitive Theory
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Summary The purpose of this article was to review international (excluding the United States) school‐based interventions for preventing obesity in children published between 1999 and 2005. A total of 21 such interventions were found from Australia (1), Austria (1), Canada (1), Chile (1), France (1), Germany (3), Greece (1), New Zealand (1), Norway (1), Singapore (1) and the United Kingdom (9). The grade range of these interventions was from pre‐school to high school with the majority (17) from elementary schools. Nine of these interventions targeted nutrition behaviours followed by seven aiming to modify both physical activity and nutrition behaviours. Only five interventions in international settings were based on any explicit behavioural theory which is different than the interventions developed in the United States. Majority of the interventions (9) were one academic year long. It can be speculated that if the interventions are behavioural theory‐based, then the intervention length can be shortened. All interventions that documented parental involvement successfully influenced obesity indices. Most interventions (16) focused on individual‐level behaviour change approaches. Most published interventions (16) used experimental designs with at least 1‐year follow‐up. Recommendations from international settings for enhancing the effectiveness of school‐based childhood obesity interventions are presented.
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