Psychological intervention

About: Psychological intervention is a research topic. Over the lifetime, 82654 publications have been published within this topic receiving 2608356 citations.

Local opinion leaders: effects on professional practice and health care outcomes

Abstract: Background Clinical practice is not always evidence-based and, therefore, may not optimise patient outcomes. Opinion leaders disseminating and implementing 'best evidence' is one method that holds promise as a strategy to bridge evidence-practice gaps. Objectives To assess the effectiveness of the use of local opinion leaders in improving professional practice and patient outcomes. Search methods We searched Cochrane EPOC Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, HMIC, Science Citation Index, Social Science Citation Index, ISI Conference Proceedings and World Cat Dissertations up to 5 May 2009. In addition, we searched reference lists of included articles. Selection criteria Studies eligible for inclusion were randomised controlled trials investigating the effectiveness of using opinion leaders to disseminate evidence-based practice and reporting objective measures of professional performance and/or health outcomes. Data collection and analysis Two review authors independently extracted data from each study and assessed its risk of bias. For each trial, we calculated the median risk difference (RD) for compliance with desired practice, adjusting for baseline where data were available. We reported the median adjusted RD for each of the main comparisons. Main results We included 18 studies involving more than 296 hospitals and 318 PCPs. Fifteen studies (18 comparisons) contributed to the calculations of the median adjusted RD for the main comparisons. The effects of interventions varied across the 63 outcomes from 15% decrease in compliance to 72% increase in compliance with desired practice. The median adjusted RD for the main comparisons were: i) Opinion leaders compared to no intervention, +0.09; ii) Opinion leaders alone compared to a single intervention, +0.14; iii) Opinion leaders with one or more additional intervention(s) compared to the one or more additional intervention(s), +0.10; iv) Opinion leaders as part of multiple interventions compared to no intervention, +0.10. Overall, across all 18 studies the median adjusted RD was +0.12 representing a 12% absolute increase in compliance in the intervention group. Authors' conclusions Opinion leaders alone or in combination with other interventions may successfully promote evidence-based practice, but effectiveness varies both within and between studies. These results are based on heterogeneous studies differing in terms of type of intervention, setting, and outcomes measured. In most of the studies the role of the opinion leader was not clearly described, and it is therefore not possible to say what the best way is to optimise the effectiveness of opinion leaders.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18.

Abstract: Background The World Health Organization estimates that 19 million deaths worldwide are attributable to physical inactivity Chronic diseases associated with physical inactivity include cancer, diabetes and coronary heart disease Objectives The purpose of this systematic review is to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents Search strategy The search strategy included searching several databases In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews Primary authors of included studies were contacted as needed for additional information Selection criteria To be included, the intervention had to be relevant to public health practice, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, report on outcomes for children and adolescents (aged 6 to 18 years), and use a prospective design with a control group Data collection and analysis Standardized tools were used by two independent reviewers to rate each studyﾒs methodological quality and for data extraction Where discrepancies existed discussion occurred until consensus was reached The results were summarized narratively due to wide variations in the populations, interventions evaluated and outcomes measured Main results 13,841 titles were identified and screened and 482 articles were retrieved Multiple publications on the same project were combined and counted as one project, resulting in 395 distinct project accounts (studies) Of the 395 studies 104 were deemed relevant and of those, four were assessed as having strong methodological quality, 22 were of moderate quality and 78 were considered weak In total 26 studies were included in the review There is good evidence that school-based physical activity interventions have a positive impact on four of the nine outcome measures Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol Generally school-based interventions had no effect on leisure time physical activity rates, systolic and diastolic blood pressure, body mass index, and pulse rate At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity result in positive effects Authors' conclusions Given that there are no harmful effects and that there is some evidence of positive effects on lifestyle behaviours and physical health status measures, ongoing physical activity promotion in schools is recommended at this time

Interventions to Break and Create Consumer Habits

Abstract: Interventions to change everyday behaviors often attempt to change people's beliefs and intentions. As the authors explain, these interventions are unlikely to be an effective means to change behaviors that people have repeated into habits. Successful habit change interventions involve disrupting the environmental factors that automatically cue habit performance. The authors propose two potential habit change interventions. “Downstream-plus” interventions provide informational input at points when habits are vulnerable to change, such as when people are undergoing naturally occurring changes in performance environments for many everyday actions (e.g., moving households, changing jobs). “Upstream” interventions occur before habit performance and disrupt old environmental cues and establish new ones. Policy interventions can be oriented not only to the change of established habits but also to the acquisition and maintenance of new behaviors through the formation of new habits.

interventions to improve antibiotic prescribing practices for hospital inpatients (updated protocol)

Abstract: This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: Aim: To systematically review the literature to identify interventions that alone, or in combination, are effective in improving antibiotic prescribing to hospital inpatients. Research questions: What is the evidence that exposure of hospital inpatients to antibiotics can be reduced safely, without compromising clinical outcomes? What is the evidence that changing the antibiotic choice, dose or route can be achieved without compromising clinical outcomes? Are interventions that include goal setting, feedback and action planning more effective than interventions that only include one or two of these components? Do interventions that include behaviour change techniques to enhance capability have greater initial effect (Michie 2011)? Do interventions that include behaviour change techniques to enhance capability have more sustained effectiveness (Michie 2011)? What is the relationship between change in antibiotic use or choice and microbial outcomes? Withdrawal from publication: this protocol was written with the express purpose of updating the methodology for the review, and has now been superseded by the updated review (Davey 2017).