Browsing by Subject "Interventions"
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Item Association Between Subjective Cognitive Decline and Twice-Weekly Muscle-Strengthening Activities in Middle-Aged and Older US Adults: An Analysis of the 2019 Behavioral Risk Factor Surveillance System(Sage, 2024) Schroeder, Matthew W.; Waring, Molly E.; Fowler, Nicole R.; Mace, Ryan A.; Pagoto, Sherry L.; Medicine, School of MedicinePurpose: Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD. Design: Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. Sample: 114 164 respondents, representing approximately 59 million US adults aged ≥45. Measures: SCD was indicated if the respondent reported confusion or memory loss during the past 12 months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week). Analysis: Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C. Results: US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0). Conclusion: Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.Item Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue(Springer Nature, 2023) Baldwin, Austin S.; Tiro, Jasmin A.; Zimet, Gregory D.; Pediatrics, School of MedicineThe World Health Organization has designated vaccine hesitancy and vaccine confidence among the most pressing issues in global health. The COVID-19 pandemic has made vaccine hesitancy and vaccine confidence particularly salient and urgent. The purpose of this special issue is to highlight a broad range of perspectives on these critical issues. We have included a total of 30 papers that address issues related to vaccine hesitancy and vaccine confidence across multiple levels of the Socio-Ecological Model. We have organized the empirical papers into the following sections: individual-level beliefs, minority health and health disparities, social media and conspiracy beliefs, and interventions. In addition to the empirical papers, three commentaries are included in this special issue.Item Caregiver Engagement Enhances Outcomes among Randomized Control Trials of Transitional Care Interventions: A Systematic Review and Meta-Analysis(Wolters Kluwer, 2022) Levoy, Kristin; Rivera, Eleanor; McHugh, Molly; Hanlon, Alexandra; Hirschman, Karen B.; Naylor, Mary D.; School of NursingBackground: Fluctuations in health among chronically ill adults result in frequent health care transitions. Some interventions to improve patient outcomes after hospitalization include caregiver engagement as a core component, yet there is unclear evidence of the effects of this component on outcomes. Objective: The objective of this study was to synthesize evidence regarding the attention given to caregiver engagement in randomized control trials of transitional care interventions (TCIs), estimate the overall intervention effects, and assess caregiver engagement as a moderator of intervention effects. Methods: Three databases were systematically searched for randomized control trials of TCIs targeting adults living with physical or emotional chronic diseases. For the meta-analysis, overall effects were computed using the relative risk (RR) effect size and inverse variance weighting. Results: Fifty-four studies met criteria, representing 31,291 participants and 66 rehospitalizations effect sizes. Half (51%) the interventions lacked focus on caregiver engagement. The overall effect of TCIs on all-cause rehospitalizations was nonsignificant at 1 month (P=0.107, k=29), but significant at ≥2 months [RR=0.89; 95% confidence interval (CI): 0.82, 0.97; P=0.007, k=27]. Caregiver engagement moderated intervention effects (P=0.05), where interventions with caregiver engagement reduced rehospitalizations (RR=0.83; 95% CI: 0.75, 0.92; P=0.001), and those without, did not (RR=0.97; 95% CI: 0.87, 1.08; P=0.550). Interventions with and without caregiver engagement did not differ in the average number of components utilized, however, interventions with caregiver engagement more commonly employed baseline needs assessments (P=0.032), discharge planning (P=0.006), and service coordination (P=0.035). Discussion: Future TCIs must consistently incorporate the active participation of caregivers in design, delivery, and evaluation.Item Doctoral Capstone Experiential at Camp Mariposa: Aaron’s Place(2021-04) Huber, Megan H.; Wilburn, Victoria G.; Department of Occupational Therapy, School of Health and Human Sciences; Wilburn, Victoria G.Dependence on alcohol, illicit substances, and opioids impact the parent-child relationship, childhood development, and child behaviors (Romanowicz et al., 2019). There is a strong association between parental substance abuse and subsequent child maltreatment (Opioids and Youth, 2018). Substance use disorder (SUD) can lead to family trauma and significantly impact the child’s life trajectory. However, given the support, knowledge, and tools necessary to intervene, it is possible to mitigate the negative effects of SUD and trauma. Camp Mariposa: Aaron’s Place is a camp for youth ages 9-12 who have been impacted by a family member’s SUD. By applying underutilized approaches to family and group therapy, such as yoga, theatre, and nature-based crafts, this camp promotes resiliency, protective factors, and post-traumatic growth.Item Effectiveness of Occupational Therapy Interventions to Promote Social Participation in Children and Young Adults with Autism Spectrum Disorder(2023-05) Chelmella, Payton; Jackman, Ellie; Negash, Shushan; Richardson, Nicole; Vaccaro, Hannah; Chase, Tony; Sego, Daniel; Department of Occupational Therapy, School of Health and Human SciencesA systematic review of the literature related to effective occupational therapy interventions on socialization for children and adolescents with Autism Spectrum Disorder (ASD). This review provides a comprehensive overview and discussion of 25 studies that addressed the variety of interventions that can be used when targeting social skills including sensory integration, animal-assisted interventions, technology, play, school-based, and caregiver-assisted interventions. The findings reveal that the use of these interventions is clinically significant yet there is limited evidence to support generalizability to the population. This review supports the premise that children and adolescents with ASD who experience socialization challenges as compared to typically developing peers can improve their social skills through these interventions.Item The First 4 Weeks Postpartum: The Mother’s Breastfeeding Concerns and Support(Office of the Vice Chancellor for Research, 2015-04-17) Rosales, Stacy A.; Shieh, Carol; Bakas, Tamilyn; Busby, KatieObjective: The first four weeks postpartum are critical for establishing successful breastfeeding because many women wean or stop exclusive breastfeeding during this time. This study explored the breastfeeding concerns of mothers during the first 4 weeks postpartum and the support sought for those concerns. Design: A qualitative approach was used. Participants: Four mothers, recruited from central Indiana in 2014 through social media or word of mouth participated in the study. Inclusion criteria were women in their first four to six weeks postpartum, delivered full term healthy babies and were discharged from the hospital breastfeeding. Methods: Semi-structured telephone interviews were conducted and data were analyzed using content analysis. Interview transcripts were first coded. Codes with similar meaning were grouped into categories. Categories sharing similar features were again collapsed into common themes. Results: Concerns identified by mothers fell into the themes: Infant breastfeeding difficulties (latch), breast complications related to breastfeeding (pain and nipple trauma), and maternal concerns related to milk production (infant milk intake and milk supply). Four common themes of support were identified that mothers utilized to alleviate concerns: Professional support, informational support, peer support, and family support. Conclusions: Mothers identified concerns related to themselves and their infants with respect to breastfeeding in the first four weeks postpartum. These concerns indicate the women’s struggle with establishing a successful breastfeeding pattern and one that is compromised by infant latch difficulty, nipple pain and inadequate milk production. Support was sought at multiple levels from health care professionals to social media. The findings suggest that support from health care professionals who provide valuable information is important. However, postpartum women also utilize other support methods when encountering breastfeeding concerns in the first four weeks postpartum. When developing interventions to assist postpartum women with establishing breastfeeding outside of the hospital setting, nurses need to consider using social media and social networks as resources for breastfeeding information and support.Item Improving antiretroviral therapy adherence in resource-limited settings at scale: a discussion of interventions and recommendations(Wiley, 2017-03-22) Haberer, Jessica E.; Sabin, Lora; Amico, K. Rivet; Orrell, Catherine; Galárraga, Omar; Tsai, Alexander C.; Vreeman, Rachel C.; Wilson, Ira; Sam-Agudu, Nadia A.; Blaschke, Terrence F.; Vrijens, Bernard; Mellins, Claude A.; Remien, Robert H.; Weiser, Sheri D.; Lowenthal, Elizabeth; Stirratt, Michael J.; Sow, Papa Salif; Thomas, Bruce; Ford, Nathan; Mills, Edward; Lester, Richard; Nachega, Jean B.; Bwana, Bosco Mwebesa; Ssewamala, Fred; Mbuagbaw, Lawrence; Munderi, Paula; Geng, Elvin; Bangsberg, David R.; Pediatrics, School of MedicineIntroduction: Successful population-level antiretroviral therapy (ART) adherence will be necessary to realize both the clinical and prevention benefits of antiretroviral scale-up and, ultimately, the end of AIDS. Although many people living with HIV are adhering well, others struggle and most are likely to experience challenges in adherence that may threaten virologic suppression at some point during lifelong therapy. Despite the importance of ART adherence, supportive interventions have generally not been implemented at scale. The objective of this review is to summarize the recommendations of clinical, research, and public health experts for scalable ART adherence interventions in resource-limited settings. Methods: In July 2015, the Bill and Melinda Gates Foundation convened a meeting to discuss the most promising ART adherence interventions for use at scale in resource-limited settings. This article summarizes that discussion with recent updates. It is not a systematic review, but rather provides practical considerations for programme implementation based on evidence from individual studies, systematic reviews, meta-analyses, and the World Health Organization Consolidated Guidelines for HIV, which include evidence from randomized controlled trials in low- and middle-income countries. Interventions are categorized broadly as education and counselling; information and communication technology-enhanced solutions; healthcare delivery restructuring; and economic incentives and social protection interventions. Each category is discussed, including descriptions of interventions, current evidence for effectiveness, and what appears promising for the near future. Approaches to intervention implementation and impact assessment are then described. Results and discussion: The evidence base is promising for currently available, effective, and scalable ART adherence interventions for resource-limited settings. Numerous interventions build on existing health care infrastructure and leverage available resources. Those most widely studied and implemented to date involve peer counselling, adherence clubs, and short message service (SMS). Many additional interventions could have an important impact on ART adherence with further development, including standardized counselling through multi-media technology, electronic dose monitoring, decentralized and differentiated models of care, and livelihood interventions. Optimal targeting and tailoring of interventions will require improved adherence measurement. Conclusions: The opportunity exists today to address and resolve many of the challenges to effective ART adherence, so that they do not limit the potential of ART to help bring about the end of AIDS.Item Interventions for Family Members of Adolescents With Disruptive Behavior Disorders(Wiley, 2014-08) Oruche, Ukamaka M.; Burke Draucker, Claire; Alkhattab, Halima; Knopf, Amy; Mazurcyk, Jill; IU School of NursingProblem - The family members of adolescents diagnosed with disruptive behavior disorders (DBDs) experience profound stress and burden. Despite the need for empirically supported interventions that address the challenges faced by these family members, few such interventions are available. Methods - In this qualitative descriptive study, we conducted in-depth interviews with 15 families of adolescents diagnosed with DBD. We asked the family members to identify what types of mental health services they needed and to describe the “ideal” program that would best address their concerns. Findings - Family members identified several intervention modalities that would fit their needs, including multifamily groups, family therapy, individual therapy, and community-based hotlines. They indicated that programs should address the following topics: family communication, conflict resolution, education about DBD, and strategies to improve interactions with child service agencies. Conclusions - Clinicians should recognize that all family members may need support to manage the stressors associated with caring for or living with adolescents with DBD. When working with families, clinicians should provide information about the etiology and management of DBD, help navigate interactions with child service agencies, and employ strategies to improve family communication and functioning.Item Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation(BioMed Central, 2016-08-01) Chambers, David; Simpson, Lisa; Hill-Briggs, Felicia; Neta, Gila; Vinson, Cynthia; Beidas, Rinad; Marcus, Steven; Aarons, Gregory; Hoagwood, Kimberly; Schoenwald, Sonja; Evans, Arthur; Hurford, Matthew; Rubin, Ronnie; Hadley, Trevor; Barg, Frances; Walsh, Lucia; Adams, Danielle; Mandell, David; Martin, Lindsey; Mignogna, Joseph; Mott, Juliette; Hundt, Natalie; Kauth, Michael; Kunik, Mark; Naik, Aanand; Cully, Jeffrey; McGuire, Alan; White, Dominique; Bartholomew, Tom; McGrew, John H.; Luther, Lauren; Rollins, Angie; Salyers, Michelle P.; Cooper, Brittany; Funaiole, Angie; Richards, Julie; Lee, Amy; Lapham, Gwen; Caldeiro, Ryan; Lozano, Paula; Gildred, Tory; Achtmeyer, Carol; Ludman, Evette; Addis, Megan; Marx, Larry; Bradley, Katharine; VanDeinse, Tonya; Wilson, Amy Blank; Stacey, Burgin; Powell, Byron; Bunger, Alicia; Cuddeback, Gary; Barnett, Miya; Stadnick, Nicole; Brookman-Frazee, Lauren; Lau, Anna; Dorsey, Shannon; Pullmann, Michael; Mitchell, Shannon; Schwartz, Robert; Kirk, Arethusa; Dusek, Kristi; Oros, Marla; Hosler, Colleen; Gryczynski, Jan; Barbosa, Carolina; Dunlap, Laura; Lounsbury, David; O'Grady, Kevin; Brown, Barry; Damschroder, Laura; Waltz, Thomas; Powell, Byron; Ritchie, Mona; Waltz, Thomas; Atkins, David; Imel, Zac E.; Xiao, Bo; Can, Doğan; Georiou, Panayiotis; Narayanan, Shrikanth; Berkel, Cady; Gallo, Carlos; Sandler, Irwin; Brown, C. Hendricks; Wolcik, Sharlene; Mauricio, Anne Marie; Gallo, Carlos; Mehrota, Sanjay; Chandurkar, Dharmendra; Bora, Siddhartha; Das, Arup; Tripathi, Anand; Saggurti, Nirajan; Raj, Anita; Hughes, Eric; Jacobs, Brian; Kirkendall, Eric; Loeb, Danielle; Trinkley, Katy; Yang, Michael; Sprowell, Andrew; Nease, Donald; Lyon, Aaron; Lewis, Cara; Boyd, Meredith; Melvin, Abigail; Nicodimos, Semret; Liu, Freda; Jungbluth, Nathanial; Lyon, Aaron; Landis-Lewis, Zach; Sales, Anne; Baloh, Jure; Ward, Marcia; Zhu, Xi; Bennett, Ian; Unutzer, Jurgen; Mao, Johnny; Proctor, Enola; Vredevoogd, Mindy; Chan, Ya-Fen; Williams, Nathaniel; Green, Phillip; Bernstein, Steven; Rosner, June-Marie; DeWitt, Michelle; Tetrault, Jeanette; Dziura, James; Hsiao, Allen; Sussman, Scott; O'Connor, Patrick; Toll, Benjamin; Jones, Michael; Gassaway, Julie; Tobin, Jonathan; Zatzick, Douglas; Bradbury, Angela R.; Patrick-Miller, Linda; Egleston, Brian; Olopade, Olufunmilayo I.; Hall, Michael J.; Daly, Mary B.; Fleisher, Linda; Grana, Generosa; Ganschow, Pamela; Fetzer, Dominique; Brandt, Amanda; Farengo-Clark, Dana; Forman, Andrea; Gaber, Rikki S.; Gulden, Cassandra; Horte, Janice; Long, Jessica; Chambers, Rachelle Lorenz; Lucas, Terra; Madaan, Shreshtha; Mattie, Kristin; McKenna, Danielle; Montgomery, Susan; Nielsen, Sarah; Powers, Jacquelyn; Rainey, Kim; Rybak, Christina; Savage, Michelle; Seelaus, Christina; Stoll, Jessica; Stopfer, Jill; Yao, Shirley; Domchek, Susan; Hahn, Erin; Munoz-Plaza, Corrine; Wang, Jianjin; Delgadillo, Jazmine Garcia; Mittman, Brian; Gould, Michael; Liang, Shuting (Lily); Kegler, Michelle C.; Cotter, Megan; Philips, Emily; Hermstad, April; Morton, Rentonia; Beasley, Derrick; Martinez, Jeremy; Riehman, Kara; Gustafson, David; Marsch, Lisa; Mares, Louise; Quanbeck, Andrew; McTavish, Fiona; McDowell, Helene; Brown, Randall; Thomas, Chantelle; Glass, Joseph; Isham, Joseph; Shah, Dhavan; Liebschutz, Jane; Lasser, Karen; Watkins, Katherine; Ober, Allison; Hunter, Sarah; Lamp, Karen; Ewing, Brett; Iwelunmor, Juliet; Gyamfi, Joyce; Blackstone, Sarah; Quakyi, Nana Kofi; Plange-Rhule, Jacob; Ogedegbe, Gbenga; Kumar, Pritika; Devanter, Nancy Van; Nguyen, Nam; Nguyen, Linh; Nguyen, Trang; Phuong, Nguyet; Shelley, Donna; Rudge, Sian; Langlois, Etienne; Tricco, Andrea; Ball, Sherry; Lambert-Kerzner, Anne; Sulc, Christine; Simmons, Carol; Shell-Boyd, Jeneen; Oestreich, Taryn; O'Connor, Ashley; Neely, Emily; McCreight, Marina; Labebue, Amy; DiFiore, Doreen; Brostow, Diana; Ho, P. Michael; Aron, David; Harvey, Jillian; McHugh, Megan; Scanon, Dennis; Lee, Rebecca; Soltero, Erica; Parker, Nathan; McNeill, Lorna; Ledoux, Tracey; McIsaac, Jessie-Lee; MacLeod, Kate; Ata, Nicole; Jarvis, Sherry; Kirk, Sara; Purtle, Jonathan; Dodson, Elizabeth; Brownson, Ross; Mittman, Brian; Curran, Geoffrey; Pyne, Jeffrey; Aarons, Gregory; Ehrhart, Mark; Torres, Elisa; Miech, Edward; Stevens, Kathleen; Hamilton, Alison; Cohen, Deborah; Padgett, Deborah; Morshed, Alexandra; Patel, Rupa; Prusaczyk, Beth; Aron, David C.; Gupta, Divya; Ball, Sherry; Hand, Rosa; Abram, Jenica; Wolfram, Taylor; Hastings, Molly; Moreland-Russell, Sarah; Tabek, Rachel; Ramsey, Alex; Baumann, Ana; Kryzer, Emily; Montgomery, Katherine; Lewis, Ericka; Padek, Margaret; Brownson, Ross; Mamaril, Cezar Brian; Mays, Glen; Branham, Keith; Timsina, Lava; Mays, Glen; Hogg, Rachel; Fagan, Abigail; Shapiro, Valerie; Brown, Eric; Haggerty, Kevin; Hawkins, David; Oesterle, Sabrina; Hawkins, David; Catalano, Richard; McKay, Virginia; Dolcini, M. Margaret; Hoffer, Lee; Moin, Tannaz; Li, Jinnan; Duru, O. Kenrik; Ettner, Susan; Turk, Norman; Chan, Charles; Keckhafer, Abigail; Luchs, Robert; Ho, Sam; Mangione, Carol; Selby, Peter; Zawertailo, Laurie; Minian, Nadia; Balliunas, Dolly; Dragonetti, Rosa; Hussain, Sarwar; Lecce, Julia; Chinman, Matthew; Acosta, Joie; Ebener, Patricia; Malone, Patrick S.; Slaughter, Mary; Freedman, Darcy; Flocke, Susan; Lee, Eunlye; Matlack, Kristen; Trapl, Erika; Ohri-Vachaspati, Punam; Taggart, Morgan; Borawski, Elaine; Parrish, Amanda; Harris, Jeffrey; Kohn, Marlana; Hammerback, Kristen; McMilan, Becca; Hannon, Peggy; Swindle, Taren; Curran, Geoffrey; Whiteside-Mansell, Leanne; Ward, Wendy; Holt, Cheryl; Santos, Sheri Lou; Tagai, Erin; Scheirer, Mary Ann; Carter, Roxanne; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie; Wang, Min Qi; Masica, Andrew; Ogola, Gerald; Berryman, Candice; Richter, Kathleen; Shelton, Rachel; Jandorf, Lina; Erwin, Deborah; Truong, Khoa; Javier, Joyce R.; Coffey, Dean; Schrager, Sheree; Palinkas, Lawrence; Miranda, Jeanne; Johnson, Veda; Hutcherson, Valerie; Ellis, Ruth; Kharmats, Anna; Marshall-King, Sandra; LaPradd, Monica; Fonseca-Becker, Fannie; Kepka, Deanna; Bodson, Julia; Warner, Echo; Fowler, Brynn; Shenkman, Elizabeth; Hogan, William; Odedina, Folakami; Leon, Jessica De; Hooper, Monica; Carrasquillo, Olveen; Reams, Renee; Hurt, Myra; Smit, Steven; Szapocznik, Jose; Nelson, David; Mandal, Prabir; Teufel, James; Department of Psychology, School of ScienceItem Supporting Surgical Teams: Identifying Needs and Barriers for Exoskeleton Implementation in the Operating Room(Sage, 2020) Cha, Jackie S.; Monfared, Sara; Stefanidis, Dimitrios; Nussbaum, Maury A.; Yu, Denny; Surgery, School of MedicineObjective: The objective of this study was to identify potential needs and barriers related to using exoskeletons to decrease musculoskeletal (MS) symptoms for workers in the operating room (OR). Background: MS symptoms and injuries adversely impact worker health and performance in surgical environments. Half of the surgical team members (e.g., surgeons, nurses, trainees) report MS symptoms during and after surgery. Although the ergonomic risks in surgery are well recognized, little has been done to develop and sustain effective interventions. Method: Surgical team members (n = 14) participated in focus groups, performed a 10-min simulated surgical task with a commercial upper-body exoskeleton, and then completed a usability questionnaire. Content analysis was conducted to determine relevant themes. Results: Four themes were identified: (1) characteristics of individuals, (2) perceived benefits, (3) environmental/societal factors, and (4) intervention characteristics. Participants noted that exoskeletons would benefit workers who stand in prolonged, static postures (e.g., holding instruments for visualization) and indicated that they could foresee a long-term decrease in MS symptoms with the intervention. Specifically, raising awareness of exoskeletons for early-career workers and obtaining buy-in from team members may increase future adoption of this technology. Mean participant responses from the System Usability Scale was 81.3 out of 100 (SD = 8.1), which was in the acceptable range of usability. Conclusion: Adoption factors were identified to implement exoskeletons in the OR, such as the indicated need for exoskeletons and usability. Exoskeletons may be beneficial in the OR, but barriers such as maintenance and safety to adoption will need to be addressed. Application: Findings from this work identify facilitators and barriers for sustained implementation of exoskeletons by surgical teams.