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Using Multivariate Statistics

Background: The Internet is increasingly used as a medium for the delivery of interventions designed to promote health behavior change. However, reviews of these interventions to date have not systematically identified intervention characteristics and linked these to effectiveness. Objectives: The present review sought to capitalize on recently published coding frames for assessing use of theory and behavior change techniques to investigate which characteristics of Internet-based interventions best promote health behavior change. In addition, we wanted to develop a novel coding scheme for assessing mode of delivery in Internet-based interventions and also to link different modes to effect sizes. Methods: We conducted a computerized search of the databases indexed by ISI Web of Knowledge (including BIOSIS Previews and Medline) between 2000 and 2008. Studies were included if (1) the primary components of the intervention were delivered via the Internet, (2) participants were randomly assigned to conditions, and (3) a measure of behavior related to health was taken after the intervention. Results: We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d+ = 0.16, 95% CI 0.09-0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d+ = 0.36, 95% CI 0.15-0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages. Conclusions: The review provides a framework for the development of a science of Internet-based interventions, and our findings provide a rationale for investing in more intensive theory-based interventions that incorporate multiple behavior change techniques and modes of delivery. [J Med Internet Res 2010;12(1):e4]

Using the Internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy

Childhood obesity affects both the physical and psychosocial health of children and may put them at risk of ill health as adults. More information is needed about the best way to treat obesity in children and adolescents. In this review, 64 studies were examined including 54 studies on lifestyle treatments (with a focus on diet, physical activity or behaviour change) and 10 studies on drug treatment to help overweight and obese children and their families with weight control. No surgical treatment studies were suitable to include in this review. This review showed that lifestyle programs can reduce the level of overweight in child and adolescent obesity 6 and 12 months after the beginning of the program. In moderate to severely obese adolescents, a reduction in overweight was found when either the drug orlistat, or the drug sibutramine were given in addition to a lifestyle program, although a range of adverse effects was also noted. Information on the long-term outcome of obesity treatment in children and adolescents was limited and needs to be examined in some high quality studies.

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Interventions for treating obesity in children

Home PURPOSE OF THE CENTER: To develop the center to address state-of-the-art research, create innovating educational programs, and support technology transfers using commercially viable results to assist the Army Research Laboratory to develop the next generation Future Combat System in the telecommunications sector that assures prevention of perceived threats, and Non Line of Sight/Beyond Line of Sight lethal support.

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Traditional engineering instruction is deductive, beginning with theories and progressing to the applications of those theories Alternative teaching approaches are more inductive Topics are introduced by presenting specific observations, case studies or problems, and theories are taught or the students are helped to discover them only after the need to know them has been established This study reviews several of the most commonly used inductive teaching methods, including inquiry learning, problem-based learning, project-based learning, case-based teaching, discovery learning, and just-in-time teaching The paper defines each method, highlights commonalities and specific differences, and reviews research on the effectiveness of the methods While the strength of the evidence varies from one method to another, inductive methods are consistently found to be at least equal to, and in general more effective than, traditional deductive methods for achieving a broad range of learning outcomes

Inductive Teaching and Learning Methods: Definitions, Comparisons, and Research Bases

Aims To identify, from the perspectives of nurses, occupational stressors and ways in which they may be reduced. Background Nurses commonly experience high levels of occupational stress, with negative consequences for their physical and psychological health, health-care organisations and community. There is minimal research on reducing occupational stress. Method Six focus groups were conducted with 38 registered nurses using a qualitative exploratory approach. Participants were asked to identify sources of occupational stress and possible workplace initiatives to reduce stress. Findings Sources of occupational stress were: high workloads, unavailability of doctors, unsupportive management, human resource issues, interpersonal issues, patients' relatives, shift work, car parking, handover procedures, no common area for nurses, not progressing at work and patient mental health. Suggestions for reduction included: workload modification, non-ward-based initiatives, changing shift hours, forwarding suggestions for change, music, special events, organisational development, ensuring nurses get breaks, massage therapists, acknowledgement from management and leadership within wards. Conclusion The findings highlight the need to understand local perspectives and the importance of involving nurses in identifying initiatives to reduce occupational stress. Implications for nursing management Health-care environments can be enhanced through local understanding of the occupational stressors and productively engaging nurses in developing stress reduction initiatives. Nurse managers must facilitate such processes.

Trudy Dwyer

Papers

Nurses and stress: recognizing causes and seeking solutions.

Accurate respiratory rates count: So should you!

Supporting bachelor of nursing students within the clinical environment: perspectives of preceptors.

Facilitator versus preceptor: Which offers the best support to undergraduate nursing students?

Nurses' behaviour regarding CPR and the theories of reasoned action and planned behaviour.