Effectiveness of mHealth Interventions in Medication Adherence among Patients with Cardiovascular Diseases: A Systematic Review.

mHealth interventions have been reported to improve adherence to long-term therapies in chronic conditions. Therefore, this study aimed at determining the effectiveness of mHealth interventions in medication adherence among patients with cardiovascular diseases (CVDs), a leading cause of mortality globally. Relying on our inclusion criteria and the PRISMA recommendations, a literature search was carried out in the PubMed, Medline, and ProQuest databases for primary studies that investigated the impact of mHealth on medication adherence for cardiovascular disease (CVD) between 2000-2021. A total of 23 randomized controlled trials with 34,915 participants matched the selection criteria. The mHealth interventions used included text messages, mobile phone applications, and voice calls, which were used either as a single intervention or combined. Additionally, studies on enhancing drug adherence had contradictory findings: most of the studies elaborated positive results; however, six studies were unable to reveal any significant effect. Finally, a risk bias analysis revealed varying outcomes across all studies. This review, as a whole, supported the notion that mHealth interventions can be effective in improving adherence to CVD medication even though they could not improve adherence to all CVD medications when compared with controls. Further trials with more refined designs integrated with comprehensive interventions are needed to produce better health outcomes.

Coping Mechanism among Parents of Children with Autism Spectrum Disorder: A Review.

This review presented the current literature on coping mechanisms among parents of children with autism spectrum disorder (ASD), focusing on types of coping mechanisms among parents and different coping mechanisms between mothers and fathers of children with ASD. A search of published literature in English was conducted using Google Scholar, PsycINFO, Medline, Scopus, CINAHL, EBSCO, Springer, Ovid, PubMed, and Cochrane Library up to February 2020. Overall, 18 articles were relevant to the review. The review included thirteen studies for types of coping mechanisms among parents of children with ASD and five studies for different coping mechanisms between mothers and fathers. Coping mechanisms demonstrated by parents when caring for their child include problem-focused and emotion-focused coping. A comparison between fathers and mothers in our review showed that mothers used emotion-focused coping more than fathers, while fathers used problem-focused coping more frequently than mothers. The review provides an exciting opportunity to advance our knowledge on types of coping mechanisms and gender difference in using coping mechanisms among parents of children with ASD. The review also sheds new light on developing supportive interventions by healthcare providers to improve coping mechanisms among parents of children with ASD.

Changes in Prosocial Behaviors Among Children With Behavioral Problems Following Incredible Years Parenting Program.

Parenting programs often train parents in improving their parenting practices and parent-child relationship to reduce behavioral problems in children. However, the children's prosocial behaviors are less examined as an intervention outcome in these programs. This study aimed to evaluate the effectiveness of the Incredible Years parenting program (IYPP) for Malaysian parents of school-going children and its sustainability in improving the children's prosocial behaviors. This randomized controlled study involved pre- and post-intervention assessments at 2 and 14 weeks. Mothers of children aged 6-12 years (n = 70) recruited through the pediatrics and the child and adolescent psychiatric clinics were randomly assigned to the parenting program or a waitlist control condition. The mothers rated their children's prosocial behaviors using a self-administered questionnaire. The program ran two to three hours weekly for 14 weeks. Several modifications were made to the program to accommodate public health control during the pandemic. Children in the intervention group showed a notable but non-significant increase in prosocial skills. However, subsequent score decline at follow-up may suggest a lack of evidence that the program is potentially effective in improving prosocial behaviors among school children who are at risk of or already having behavioral problems.

Knowledge, Attitude, and Practice of Adolescent Girls towards Reducing Malnutrition in Maiduguri Metropolitan Council, Borno State, Nigeria: Cross-Sectional Study.

Addressing the gap in knowledge, attitude, and practice among adolescent girls are important as malnutrition has a negative effect on their future generation. This study aimed to determine the knowledge, attitude, and practice of adolescent girls towards reducing malnutrition in Maiduguri Metropolitan Council, Borno State, Nigeria. This was a school-based cross-sectional study conducted among 612 adolescent girls (10 to 19 years old). KoBo collect toolbox was used for the data collection between 3 June and 31 July 2019. Multivariable logistic regression was used to identify predictors of knowledge, attitude, and practice towards reducing malnutrition. The majority of respondents (451, 80.2%; 322, 57.3%) had poor knowledge and attitude towards reducing malnutrition respectively, 278 (49.5%) had poor practice towards reducing malnutrition. Schooling (GGSS; p = 0.022; Shehu Garbai; p = 0.003) was a significant predictor of knowledge. Religion (p = 0.023), information (p < 0.001) and motivation (p < 0.001) were significant predictors of attitude. School (GGSS; p < 0.001; GGC; p < 0.001; Shehu garbai; p < 0.001; Bulabulin; p = 0.030; Zajeri day; p = 0.049), education of father (p = 0.001), information (p = 0.026) and behavioral skill (p = 0.019) were significant predictors of practice. There is a need to focus on both school-based and community-based health education intervention to address the poor knowledge, attitude, and practice among adolescent girls for a healthier future.

Effectiveness of an Educational Intervention in Reducing New International Postgraduates' Acculturative Stress in Malaysian Public Universities: Protocol for a Cluster Randomized Controlled Trial.

BACKGROUND: Universities around the world, including Malaysia, have attracted many international students from different countries. Research has reported that acculturative stress resulting from international students' attempts to adjust to the cultures of host countries is one of the most challenging issues that affects their lives in general and academic lives in particular. OBJECTIVE: This study aims to examine the effectiveness of an educational intervention on acculturative stress among new postgraduate international students joining Malaysian public universities. METHODS: A cluster randomized controlled trial design with Malaysian public universities as the unit of randomization will be used in this study. Public universities will be randomized in a 1:1 ratio to be either in the intervention (educational program) or control group (waiting list). Participants in the intervention group will receive 7 sessions in 9 hours delivered by an expert in psychology and the researcher. The control group will receive the intervention once the 3-month follow-up evaluation is completed. RESULTS: The data will be analyzed using the generalized estimation equation with a confidence interval value of 95%; significant differences between and within groups are determined as P<.05. The results of the study underlie the effectiveness of educational program in decreasing acculturative stress of new international students and enabling them to cope with a new environment. The results of this study will contribute to previous knowledge of acculturative stress, acculturation, and adjustment of international students. Furthermore, such results are expected to play a role in raising university policy makers' awareness of their postgraduate international students' acculturative stress issues and how they can help them avoid such stress and perform well in their academic life. CONCLUSIONS: We expect that the intervention group will score significantly lower than the wait-list group on the immediate and 3-month postintervention evaluation of acculturative stress and achieve a higher level of adjustment. Results will have implications for international students, policy makers at universities, the Malaysian Ministry of Higher Education, and future research. TRIAL REGISTRATION: Clinical Trials Registry India CTRI/2018/01/011223; http://ctri.nic.in/Clinicaltrials/showallp.php?mid1= 21978&EncHid=&userName=Muhamad%20Hanafiah%20Juni. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/12950.