Browsing by Subject "Intervention"
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Item Achieving ADL Independence Post-Stroke Through Occupational Therapy Interventions(2024-04-24) Wonnell, Cassie; Gulyas, Belle; DeGeorge, August; Knoy, Morgan; Warrick, Emilee; Fowler, Avery; Chase, Anthony; Lee, Chang Dae; Department of Occupational Therapy, School of Health and Human SciencesThis rapid systematic review evaluates the current literature on occupational therapy interventions aimed at improving ADL independence in post-stroke individuals. 28 studies were evaluated and 6 categories (task-oriented training, virtual reality and video games, technology, constraint-induced movement therapy, electrical stimulation, and other) of interventions were identified. The 28 articles used in this rapid systematic review were retrieved from PubMed and CINAHL using Covidence. Literature included are publications from the past 10 years, studies with participants 60+ years of age that have experienced a stroke, and studies with interventions focused on ADL independence. Level IV and V studies were excluded. TOT, CIMT/mCIMT, technology, E-stim, VR and virtual reality, sensory interventions, ankle-foot orthoses, and strategy training are evidence-based stroke interventions that have been showing improvement in ADL participation when compared to the standard of care. Findings reveal overall moderately strong evidence for the impact of the identified occupational therapy interventions on ADL performance for adults 60+ post-stroke. The current review supports six categories of interventions that improve ADL independence, which informs occupational therapy practice for older adult stroke patients.Item AN ACTION SCIENCE APPROACH TO CREATING AND SUSTAINING PROFESSIONAL LEARNING COMMUNITIES AS A VEHICLE FOR COMPREHENSIVE SOCIAL REFORM(2005-11-21T18:22:55Z) Folkman, Daniel VPublic education in the United States is in crisis. Far too many children are failing to achieve minimal standards in reading, writing and mathematics. New federal legislation seeks to correct this situation by legislative fiat that is backed with severe sanctions for schools and districts that fail to improve. This situation offers a unique opportunity for adult educators to play a critical role in helping public schools meet this challenge. The strategy is to focus on the learning and professional development of the adults within the system—principals, teachers, staff, parents and community partners. This paper summarizes an action research/intervention project with several Milwaukee public schools that are attempting comprehensive school reform. The research strategy employs action science theory and tools of inquiry to document interpersonal dynamics at the individual, group and organizational level that either inhibit or promote the creation of a learning culture within the school. The intervention strategy is to organize and facilitate a series of participatory action research (PAR) initiatives aimed at implementing the components of the school’s reform initiative. The combined action research/intervention project explores whether action learning technologies like PAR coupled with action science inquiry can make a significant contribution to transforming schools into learning organizations that are capable of embracing all children.Item Adolescent Substance Use and Occupational Therapy Interventions: A Rapid Systematic Review(2021-05-05) Byrn, Hannah; Davila, Danielle; Green, Samantha; Kendall, Mary; Larson, Sydney; Prentice, Alexandra; Chase, Anthony; Petrenchik, Terry; Department of Occupational Therapy, School of Health and Human SciencesThis rapid systematic review analyzes the evidence for substance use reduction through therapeutic interventions and activities in adolescents between the ages of 13-25, along with the potential for implementation in the field of occupational therapy. Adolescents with substance use disorders (SUDs) often have specific challenges regarding their family interactions, cultural beliefs, school engagement, and community support. It can be difficult for adolescents with SUDs to successfully navigate their ever changing lives, as they may also present with comorbid psychiatric conditions. It is noted that throughout this review, many interventions were the first of their kind and focused on targeting adolescents within the contexts of their environment. Many studies utilized specific techniques aimed at improving adolescents’ intrinsic beliefs regarding their substance use. Overall, low to moderate evidence was found for the effectiveness of various interventions to reduce adolescent substance use. More exhaustive research is needed to evaluate the usefulness of these interventions, as many were done in very specific settings with very individualized populations. Moreover, occupational therapists should be cautious before implementation into practice, as none of the studies evaluated explicitly examined the role of occupational therapy. More investigation is required to determine how these interventions can be applied to the field of occupational therapy.Item Breast cancer survivors’ perceptions of their partners’ interest in cancer-focused psychosocial interventions(LWW, 2021) Cohee, Andrea A.; Krueger, Ellen F.; Vachon, Eric A.; Cottingham, Ann H.; Stutz, Patrick V.; Alwine, Jennifer S.; Johns, Shelley A.Background: Despite that partners of breast cancer survivors (BCS) often experience long-term consequences from the cancer experience, including fear of recurrence and depression, there are rarely psychosocial interventions aimed at mitigating these consequences. Because partners are usually recruited to research studies through BCS, it is important to understand the views of BCS regarding their partners’ involvement in interventions. The aim of this study was to explore perceptions of BCS regarding the advisability of offering a psychosocial intervention to their partners. Methods: BCS (N = 22) enrolled in 1 of 3 interventions (acceptance and commitment therapy [ACT], survivorship education [SE], or enhanced usual care [EUC]) were queried about whether they believed their partner would be interested in a psychosocial intervention similar to what they had just completed and asked to provide their opinions about how a partner intervention should be structured and what it should address. Twenty-two BCS (ACT group [n = 5], SE [n = 11], and EUC [n = 6]) completed the interviews. Results: The participants identified 3 unmet partner needs that they thought could be addressed by a psychosocial intervention: problems with coping, communication breakdowns, and lack of information. They also provided 3 recommendations regarding the development of a partner intervention: the use of a group format, the provision of separate sessions for partners and BCS, and the inclusion of intervention components that provide practical or factual information related to breast cancer. Conclusions: BCS can provide valuable insights that can inform the development of psychosocial interventions for partners of survivors. The development of such partner interventions is critical to address the negative and often hidden health and social effects experienced by partners of BCS.Item Diet and exercise intervention adherence and health-related outcomes among older long-term breast, prostate, and colorectal cancer survivors(Springer, 2014-10) Winger, Joseph G.; Mosher, Catherine E.; Rand, Kevin L.; Morey, Miriam C.; Snyder, Denise C.; Demark-Wahnefried, Wendy; Department of Psychology, School of ScienceBACKGROUND: Diet and exercise interventions for cancer survivors result in health benefits; however, few studies have examined health outcomes in relation to adherence. PURPOSE: We examined associations between adherence to components of a diet-exercise intervention and survivors' physical and mental health. METHODS: A randomized controlled trial tested a telephone and mailed print intervention among 641 older, overweight, long-term survivors of breast, prostate, and colorectal cancer. Dietary and exercise behaviors were assessed at 14 time points throughout the year-long intervention; health outcomes were examined postintervention. RESULTS: Telephone session attendance had significant indirect relationships with health outcomes through intervention-period exercise and dietary behavior. Attendance showed positive indirect relationships with physical function (β = 0.11, p < 0.05), basic and advanced lower extremity function (β = 0.10, p < 0.05/β = 0.09, p < 0.05), and mental health (β = 0.05, p < 0.05), and a negative indirect relationship with body mass index (β = -0.06, p < 0.05). CONCLUSIONS: Session attendance is vital in facilitating improvement in health behaviors and attendant outcomes (Clinicaltrials.gov number NCT00303875).Item Examining an In-Home Behavioral Parent Training Protocol Among Parents Who Use Substances Involved Child Welfare: Effectiveness of SafeCare(Sage, 2022) Moreland, Angela; Crum, Kathleen; Rostad, Whitney L.; Stefanescu, Andrei; Whitaker, Daniel; Psychiatry, School of MedicineGiven the detrimental impact of substance use (SU) on both parent and child outcomes including child maltreatment, research and service efforts have focused on incorporating parenting resources into integrated SU treatment programs. While promising, it is imperative to examine and test parenting programs in a variety of settings. This study examined whether SU moderated the relationship between treatment condition and parenting outcomes among parents who participated in SafeCare, and parent ratings of engagement, service satisfaction, and perceived cultural competency of services. Results indicated that SU did not moderate the relationship between treatment condition and abuse potential, but did moderate this relationship for depression and parental distress such that parents with higher levels of SU reported less improvement in depression and parental distress. Results underscore that SU problems may impact the effectiveness of SC on specific risk factors, such as depression and parental distress, potentially indicating unique treatment needs and the need to adapt interventions to ensure treatment success. In addition, this study found that SafeCare was not found to be beneficial for parents with SU problems above and beyond the treatment as usual condition. Finally, results indicated that parents with SU concerns and without SU concerns engaged very similarly in SafeCare.Item Gender Differences in Risk Factors for Adolescent Binge Drinking and Implications for Intervention and Prevention(Frontiers Media, 2017-12-22) Dir, Allyson L.; Bell, Richard L.; Adams, Zachary W.; Hulvershorn, Leslie A.; Pediatrics, School of MedicineAlcohol use, particularly binge drinking (BD), is a major public health concern among adolescents. Recent national data show that the gender gap in alcohol use is lessening, and BD among girls is rising. Considering the increase in BD among adolescent girls, as well as females' increased risk of experiencing more severe biopsychosocial negative effects and consequences from BD, the current review sought to examine gender differences in risk factors for BD. The review highlights gender differences in (1) developmental-related neurobiological vulnerability to BD, (2) psychiatric comorbidity and risk phenotypes for BD, and (3) social-related risk factors for BD among adolescents, as well as considerations for BD prevention and intervention. Most of the information gleaned thus far has come from preclinical research. However, it is expected that, with recent advances in clinical imaging technology, neurobiological effects observed in lower mammals will be confirmed in humans and vice versa. A synthesis of the literature highlights that males and females experience unique neurobiological paths of development, and although there is debate regarding the specific nature of these differences, literature suggests that these differences in turn influence gender differences in psychiatric comorbidity and risk for BD. For one, girls are more susceptible to stress, depression, and other internalizing behaviors and, in turn, these symptoms contribute to their risk for BD. On the other hand, males, given gender differences across the lifespan as well as gender differences in development, are driven by an externalizing phenotype for risk of BD, in part, due to unique paths of neurobiological development that occur across adolescence. With respect to social domains, although social and peer influences are important for both adolescent males and females, there are gender differences. For example, girls may be more sensitive to pressure from peers to fit in and impress others, while male gender role stereotypes regarding BD may be more of a risk factor for boys. Given these unique differences in male and female risk for BD, further research exploring risk factors, as well as tailoring intervention and prevention, is necessary. Although recent research has tailored substance use intervention to target males and females, more literature on gender considerations in treatment for prevention and intervention of BD in particular is warranted.Item Implementation of a Brief Dialectical Behavioral Therapy Skills Group in High Schools for At-Risk Youth: Protocol for a Mixed Methods Study(JMIR, 2022-05-12) Zapolski, Tamika; Whitener, MacKenzie; Khazvand, Shirin; Crichlow, Queenisha; Revilla, Rebecca; Salgado, Eduardo F.; Aalsma, Matthew; Cyders, Melissa; Salyers, Michelle; Wu, Wei; Psychology, School of ScienceBackground: Adolescence is a developmental period marked by engagement in risk-taking behaviors, especially among impulsive or emotionally dysregulated youth. Thus, interventions that teach skills to reduce the risk of negative outcomes associated with emotional dysregulation are required. Social and emotional learning (SEL) programs have been developed to address both adolescent emotional dysregulation and risk-taking behaviors; however, current programs have mostly been implemented among younger youth and are used as a tier 1 universal intervention rather than a targeted tier 2 intervention for youth identified with emotional regulation difficulties. Objective: This study aimed to address the need for SEL programming that can be delivered in schools, particularly for older youth who have difficulties with emotional or behavioral dysregulation, to reduce the risk of health-risk behaviors among this population. Methods: Here, we outline the implementation of an SEL intervention titled Going 4 Goals, a 9-session adaptation of the Dialectical Behavioral Therapy for Adolescents (DBT-A) program delivered to at-risk high school students in a school setting. The primary objectives of the study are to test whether participating in the skills group intervention produces significant increases in the core DBT-A skills of mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness, while also producing significant decreases in substance use and risky behaviors. These primary outcomes are based on changes in participant scores between baseline and after the intervention and follow-ups at 1, 3, and 6 months compared with a control group of youth participating in the school's health curriculum at the same time points. Qualitative interviews will also be conducted with intervention participants and school staff to examine acceptability and facilitators of and barriers to the intervention. Results: A total of 171 participants across 13 groups had been enrolled in the intervention, with data collection ending December 2021. Data analysis will begin in the spring of 2022, with expected results to be published in the spring of 2023. Conclusions: This paper describes the protocol of the 9-session school-based adaptation of the DBT-A intervention and discusses the strengths and limitations of the study and future directions.Item Intervention Delivery Matters: What Mothers at High Risk for Type 2 Diabetes Want in a Diabetes Prevention Program—Results from a Comparative Effectiveness Trial(Springer Nature, 2020-08-08) Palmer, Kelly N. B.; Garr Barry, Valene E.; Marrero, David G.; McKinney, Brett M.; Graves, Anne N.; Winters, Chelsy K.; Hannon, Tamara S.; Medicine, School of MedicineParticipants in the ENCOURAGE Healthy Families Study, a family-focused, modified Diabetes Prevention Program, reported challenges to and preferences for engaging in a diabetes prevention program. Challenges with flexible intervention delivery, accessibility, the traditional group-based format, and Coronavirus Disease 2019 (COVID-19) exposure risk can be mitigated by participant preferences for one-on-one, virtual/online intervention delivery.Item Interventions for Developmental Delays in Children Born to HIV-infected Mothers: A Systematic Review(Taylor & Francis, 2019-03) Song McHenry, Megan; Ian McAteer, Carole; Oyungu, Eren; Deathe, Andrew Roland; Vreeman, Rachel Christine; Pediatrics, School of MedicineChildren born to HIV-infected mothers have worse developmental outcomes compared to HIV-unexposed children. However, little is known about interventions to improve developmental outcomes in this population. This study systematically reviews the literature on interventions to improve development in children born to HIV-infected mothers. We systematically searched the following electronic bibliographic databases: Ovid MEDLINE, Embase, PsycINFO, Education Resources Information Center, and the Cochrane Database of Systematic Reviews. Studies were selected on the basis of defined inclusion criteria and excluded if antiretroviral medication was the only intervention. Titles, abstracts, and full texts were assessed by 2 independent reviewers. Data were collected on characteristics of the study design, intervention, and developmental outcomes measured. Risk of bias and strength of evidence were assessed on all included articles. Our search resulted in 11,218 records. After our initial review, 43 records were appraised in their entirety and 9 studies met all inclusion criteria. Six were performed in sub-Saharan Africa, while the remaining 3 were performed in the United States. Eight were randomized-controlled trials and one was a retrospective chart review. Four studies focused on caregiver-training, 2 studied massage therapy, and the remaining studies focused on maternal vitamin supplementation, video-based cognitive therapy, or center-based interventions. Massage therapy had the most consistent improvements in the domains measured, while caregiver training and cognitive therapy interventions had limited benefits. The center-based intervention showed no benefit. Only 3 studies had a low risk of bias, and 4 studies had good strength of evidence. Most studies found some benefit. However, these findings are limited by the quality of the study designs, small sample size, and heterogeneity of the interventions and assessments used to measure outcomes. There is a critical need for the creation of evidence-based interventions to promote development in this vulnerable population.