IU Indianapolis ScholarWorks :: Browsing by Subject "interventions"

Browsing by Subject "interventions"

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Altered Sagittal- and Frontal-Plane Kinematics Following High-Intensity Stepping Training Versus Conventional Interventions in Subacute Stroke
(Oxford, 2016) Mahtani, Gordhan B.; Kinnaird, Catherine R.; Connolly, Mark; Holleran, Carey L.; Hennessy, Patrick W.; Woodward, Jane; Brazg, Gabrielle; Roth, Elliot J.; Hornby, T. George; Physical Medicine and Rehabilitation, School of Medicine
Background Common locomotor deficits observed in people poststroke include decreased speeds and abnormal kinematics, characterized by altered symmetry, reduced sagittal-plane joint excursions, and use of compensatory frontal-plane behaviors during the swing phase of gait. Conventional interventions utilized to mitigate these deficits often incorporate low-intensity, impairment-based or functional exercises focused on normalizing kinematics, although the efficacy of these strategies is unclear. Conversely, higher-intensity training protocols that provide only stepping practice and do not focus on kinematics have demonstrated gains in walking function, although minimal attention toward gait quality may be concerning and has not been assessed. Objective The present study evaluated changes in spatiotemporal and joint kinematics following experimental, high-intensity stepping training compared with conventional interventions. Design Kinematic data were combined from a randomized controlled trial comparing experimental and conventional training and from a pilot experimental training study. Methods Individuals with gait deficits 1 to 6 months poststroke received up to 40 sessions of either high-intensity stepping training in variable contexts or conventional lower-intensity interventions. Analyses focused on kinematic changes during graded treadmill testing before and following training. Results Significant improvements in speed, symmetry, and selected sagittal-plane kinematics favored experimental training over conventional training, although increases in compensatory strategies also were observed. Changes in many kinematic patterns were correlated with speed changes, and increased compensatory behaviors were associated with both stride length gains and baseline impairments. Limitations Limitations include a small sample size and use of multiple statistical comparisons. Conclusions Improved speeds and selected kinematics were observed following high-intensity training, although such training also resulted in increased use of compensatory strategies. Future studies should explore the consequences of utilizing these compensatory strategies despite the observed functional gains.
An Assessment of the Fidelity of Two Different Interventions to Improve Adherence to Glaucoma Treatment in Patients of African Descent
(Office of the Vice Chancellor for Research, 2015-04-17) Idowu, Eniola; Bigatti, Silvia M.; Racette, Lyne
Glaucoma is a chronic eye disease, which is asymptomatic and can slowly lead to blindness if left untreated. Glaucoma is caused by damage to the optic nerve and can lead to irreversible loss of sight. The overall objective of this MURI study was to determine the impact of two different interventions on compliance to glaucoma medication in patients of African descent with open-angle glaucoma. Two types of intervention were used – Education and Motivational Interviewing (MI). The educational intervention involved sharing knowledge with patients about glaucoma, its causes, and its treatments, to help patients better understand glaucoma and the importance of adhering to the daily medication regimen. The MI intervention involved communicating with the patients and encouraging them to identify strategies that would help them better adhere to their medications. These sessions were video-recorded and the content of each video was transcribed verbatim. The transcripts were then scored to assess the fidelity of each session with the intervention type that was given; this was done to ensure that each patient in the MI group received intervention consistent with MI, and that each patient in the Education group received an intervention free of MI. The standard Motivational Interviewing Treatment Integrity 3.0 coding sheet was used to code the MI and Education sessions. Global ratings were given for empathy, direction, collaboration, evocation and autonomy/support on a scale ranging from 1 (Low) to 5 (High). The following behaviors were counted within each transcript: giving information, MI adherent (asking permission, affirm, emphasize control, support), MI Non-adherent (advise, confront, direct), questions (closed questions, open questions), and reflections (simple, complex). We expect that the MI interventions would have significantly higher scores on MI adherent behaviors and significantly lower on MI-non-adherent behaviors compared to the Education session.
Brain volumes as predictors of tDCS effects in primary progressive aphasia
(Elsevier, 2020-01) de Aguiar, Vânia; Zhao, Yi; Faria, Andreia; Ficek, Bronte; Webster, Kimberly T.; Wendt, Haley; Wang, Zeyi; Hillis, Argye E.; Onyike, Chiadi U.; Frangakis, Constantine; Caffo, Brian; Tsapkini, Kyrana; Biostatistics, School of Public Health
The current study aims to determine the brain areas critical for response to anodal transcranial direct current stimulation (tDCS) in PPA. Anodal tDCS and sham were administered over the left inferior frontal gyrus (IFG), combined with written naming/spelling therapy. Thirty people with PPA were included in this study, and assessed immediately, 2 weeks, and 2 months post-therapy. We identified anatomical areas whose volumes significantly predicted the additional tDCS effects. For trained words, the volumes of the left Angular Gyrus and left Posterior Cingulate Cortex predicted the additional tDCS gain. For untrained words, the volumes of the left Middle Frontal Gyrus, left Supramarginal Gyrus, and right Posterior Cingulate Cortex predicted the additional tDCS gain. These findings show that areas involved in language, attention and working memory contribute to the maintenance and generalization of stimulation effects. The findings highlight that tDCS possibly affects areas anatomically or functionally connected to stimulation targets.
Can Hope and Optimism Interventions Be Delivered Online? A Pilot Study in College Students
(2024-08) Ahamadeen, Naheeda; Rand, Kevin L.; Hirsh, Adam; Salyers, Michelle
Hope and optimism are associated with many positive life outcomes, including better physical functioning (Cherry et al., 2017), less psychological dysfunction (Shanahan et al., 2021), and general well-being and better academic achievement in college students (Rand et al., 2020). College students in particular are known to struggle with a variety of issues and could benefit from increased hope and optimism. Interventions have been developed to increase hope and optimism, but these have largely been delivered in person. The purpose of this pilot study was to examine the feasibility and acceptability of delivering hope and optimism interventions in an online format to college students. There was mixed evidence of feasibility, but results did suggest online hope and optimism interventions are acceptable to college students. Although 94.3% of participants were retained, only 23% of participants met the active engagement word count requirement across conditions, and only 52.2% of participants adhered to intervention instructions in the hope condition. Acceptability was met across conditions with most participants reporting engagement (89.6%), vividly imagining their scenario (94.3%), thinking carefully about the prompt (95.4%), and putting effort into the task (93.1%). Examining the preliminary efficacy of these interventions showed no differential changes in state measures across conditions, although there were overall changes for hope and optimism across all conditions. Thus, it may be useful to examine these findings further in a fully powered study to determine the efficacy of these interventions.
The Challenge of Reducing Patient Falls in Hospitals
(ACP, 2020) Schubert, Cathy C.; Medicine, School of Medicine
Effects of diet and exercise on weight-related outcomes for breast cancer survivors and their adult daughters: an analysis of the DAMES trial
(Springer, 2017-08) Tometich, Danielle B.; Mosher, Catherine E.; Winger, Joseph G.; Badr, Hoda J.; Snyder, Denise C.; Sloane, Richard J.; Demark-Wahnefried, Wendy; Department of Psychology, School of Science
Purpose Few trials have aimed to promote diet and exercise behaviors in both cancer survivors and their family members and examine their associations with weight-related outcomes. We conducted a secondary analysis to examine associations between change in diet and exercise behaviors and weight-related outcomes for overweight breast cancer survivors and their overweight adult daughters in the Daughters And MothErS Against Breast Cancer (DAMES) randomized trial. Methods The DAMES trial assessed the impact of two iteratively tailored, mailed print diet and exercise interventions against standard brochures over a 12-month period. This analysis examined change in diet and exercise behaviors and weight-related variables from baseline to post-intervention for the 50 breast cancer survivors and their adult daughters randomized to the intervention arms. To reduce the potential for type II error in this pilot, p values <0.10 were considered statistically significant. Results For mothers, change in diet quality was uniquely related to change in BMI (β = −0.12, p = 0.082), weight (β = −0.12, p = 0.060), and waist circumference (β = −0.38, p = 0.001), whereas change in caloric intake was related to waist circumference (β = 0.21, p = 0.002). For daughters, change in caloric intake was related to change in waist circumference (β = 0.12, p = 0.055). However, change in diet quality was not associated with weight-related outcomes in daughters. Additionally, change in exercise was not associated with weight-related outcomes in mothers or daughters. Conclusions Findings support mail-based and other tailored interventions for weight loss in this population, with an emphasis on diet quality for breast cancer survivors and caloric intake for their adult daughters.
Predictors of Health-related Quality of Life at One Month after Head and Neck Cancer Surgery
(Office of the Vice Chancellor for Research, 2011-04-08) Wang, Hsiao-Lan; Mikesky, Alan; Keck, Juanita F.; Bunnell, Karen; Buelow, Janice; Rawl, Susan M.
Significance: Head and neck cancer (HNC) survivors frequently experience treatment-related complications that may cause decrements in health-related quality of life (HRQOL). Before interventions can be designed to enhance HRQOL in the early postoperative period, descriptive research is needed to determine predictors of HRQOL in this understudied population. Problem and Purpose: The proposed study identified predictors of global HRQOL, and physical, functional, emotional, and social well-being at one month after HNC surgery. Variables examined as potential predictors included shoulder pain, shoulder function, and functional impairments (disfigurement, and eating, speech, and breathing impairments). Theoretical Framework: The University of California, San Francisco School of Nursing Symptom Management Model was modified and used to guide the study. Methods and Analysis: In this exploratory, cross-sectional study, we examined a convenience sample of 29 patients who had undergone HNC surgery with curative intent one month previously. Global HRQOL was measured using the Functional Assessment of Chronic Illness Therapy (FACIT) General Scale, including four well-being subscales. Shoulder pain intensity was measured using the Brief Pain Inventory, shoulder pain distress was measured using a 0-10 numerical rating scale, and functional impairment was measured using the FACIT Head and Neck Subscale. Shoulder function was assessed using a goniometer. Pearson correlations were initially applied to determine correlates (p <0.20) that should be entered in subsequent stepwise regression models. Findings and Implications: The only significant predictor of global HRQOL was eating impairment (B = -0.20, p = 0.02). Predictors of physical well-being were shoulder pain distress (B = -0.10, p = 0.02) and eating impairment (B = 0.27, p = 0.03). Predictors of functional well-being were speech impairment (B = -0.43, p < 0.01) and disfigurement (B = - 0.20, p = 0.02). No significant predictors were found for emotional and social well-being. The findings suggested that patients’ physical and functional well-being can be influenced by eating impairment, shoulder pain distress, speech impairment, or disfigurement at one month after HNC surgery. Nurses need to monitor nutrition intake, provide proper pain management, and collaborate with speech and physical therapists to promote early rehabilitation. A longitudinal study with a larger sample size is warranted to describe needs for multidisciplinary care to improve HQOL after HNC surgery.
Preventing Incident Delirium in Hospitalized Adults: An Integrative Review
(Office of the Vice Chancellor for Research, 2015-04-17) Wassen, Kelly A.; Lasiter, Sue
Incident delirium is an acute confusion state that occurs during hospitalization, has a rapid onset of disturbed consciousness, and requires immediate intervention. Non-modifiable risk factors for incident delirium include preexisting conditions such as advanced age, serious physiological conditions, polypharmacy, and sensory deficits. Exposure to necessary treatments and interventions during hospitalization are known to precipitate delirium. Evidence has suggested that patients who develop delirium are more likely to experience prolonged hospitalization, cognitive impairment with accelerated decline, increased risk of discharge to destinations other than home, and increased mortality. Treatment after the onset of delirium has been shown to be ineffective. Studies testing non-pharmacological interventions have demonstrated effectiveness in preventing incident delirium. The purpose it to identify non-pharmacological interventions that are effective in preventing incident delirium in hospitalized adults. An integrative review was undertaken of 356 published articles found from the following databases: PubMed, Cinahl, MedLine, PsychInfo, Ovid, and Ebsco. After removing duplicates and records that did not meet inclusion criteria, we reviewed 87 abstracts to screen for inclusion criteria. We included systematic reviews, meta-analyses, research reports, and review papers that tested or discussed non-pharmacological interventions used to prevent incident delirium. We excluded 45 papers based on abstract content and 42 full-text examinations led to 13 additional exclusions. The final sample was comprised of 29 articles. Interventions that are in practice today are mostly based on evidence reported in two studies. These interventions take a multi-component approach that includes sensory aids, reduction of environmental stimuli, reorientation, early mobilization, adequate hydration, and cognitively stimulating activities. Music listening as a single intervention has also shown to be effective in preventing incident delirium. Further evidence is needed to support the use of new and existing non-pharmacological interventions in preventing incident delirium in hospitalized adults.
Promoting Recovery from Mental Illness: Tools for Community Programs
(Office of the Vice Chancellor for Research, 2012-04-13) Salyers, Michelle P.
The ACT Center of Indiana is a research and training center devoted to helping promote recovery from severe mental illnesses like schizophrenia and bipolar disorder. We focus on interventions that are based on the best research evidence, and we emphasize ways to translate research into actual practice. One important way to ensure evidence-based practices in community settings is the use of reliable and valid tools to monitor program fidelity, i.e., how well programs are following a specific model of practice. We will describe fidelity monitoring tools and practices at the program level (ACT fidelity in Indiana and in the VA) and at the clinician level (Shared decision making and Illness Management and Recovery-Treatment Integrity). We will describe current research studies implementing these tools, and provide examples of the fidelity measures.
A Randomized Trial to Compare a Tailored Web-Based Intervention and Tailored Phone Counseling to Usual Care for Increasing Colorectal Cancer Screening
(AACR, 2018-12) Champion, Victoria L.; Christy, Shannon M.; Rakowski, William; Gathirua- Mwangi, Wambui G.; Tarver, Will L.; Carter-Harris, Lisa; Cohee, Andrea A.; Marley, Andrew R.; Jessup, Nenette M.; Biederman, Erika; Kettler, Carla D.; Stump, Timothy E.; Monahan, Patrick; Lairson, David R.; Rawl, Susan M.; School of Nursing
Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web + phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23%). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7%, P < 0.0001) and combined Web + phone (35.8%, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1%), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.

Browsing by Subject "interventions"

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