The Efficacy and Usability of an Unguided Web-Based Grief Intervention for Adults Who Lost a Loved One During the COVID-19 Pandemic: Randomized Controlled Trial.

BACKGROUND: The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed. OBJECTIVE: The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system. METHODS: We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention. RESULTS: A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P<.001 to P=.006), with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at 3 months after the intervention. The results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist (P<.001), but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, the results indicated a high level of satisfaction with the Grief COVID. CONCLUSIONS: The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide risk, posttraumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional web-based psychological tools to help reduce clinical symptoms in people experiencing grief because of the loss of a loved one during a pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04638842; https://clinicaltrials.gov/ct2/show/NCT04638842.

Internet-based self-administered intervention to reduce anxiety and depression symptomatology and improve well-being in 7 countries: protocol of a randomized control trial.

Background: Online psychological interventions have emerged as a treatment alternative because they are accessible, flexible, personalized, and available to large populations. The number of Internet interventions in Latin America is limited, as are Randomized Controlled Trials (RCTs) of their effectiveness and a few studies comparing their effectiveness in multiple countries at the same time. We have developed an online intervention, Well-being Online, which will be available to the public free of charge in 7 countries: Mexico, Ecuador, Peru, Chile, Brazil, Spain, and the Netherlands. We expect a reduction in depression and anxiety symptoms and an increase in well-being of the participants. Methods: A multi-country, randomized controlled trial will be conducted. The intervention is multicomponent (Cognitive Behavioral Therapy, Behavioral Activation Therapy, Mindfulness, Acceptance and Commitment Therapy, and Positive Psychology), with 10 sessions. In each country, eligible participants will be randomized to one of three groups: Enriched Intervention (interactive web design with videos, infographics, text, audio, and forum), Text Intervention (text on the website), and Wait List (control group). Repeated measures will be obtained at 5-time points. Our primary outcomes will be anxiety symptomatology, depressive symptomatology, and mental well-being. MANOVA analysis will be used for our main analysis. Discussion: This protocol describes the design of a randomized trial to evaluate the efficacy of a web-based intervention to reduce anxiety and depression symptomatology and increase subjective well-being. The intervention will be made available in four languages (Spanish, Portuguese, Dutch, and English). Its results will contribute to the evidence of effectiveness in terms of randomized trials and Internet interventions, mainly in Latin America and Europe.

Sex Differences in Mental Status and Coping Strategies among Adult Mexican Population: A Cross-Sectional Study.

We performed a cross-sectional study in order to determine the association between stress coping strategies and stress, depression, and anxiety, in which the Mexican population was invited to answer these variables by an electronic questionnaire. A total of 1283 people were included, of which 64.8% were women. Women presented higher levels of stress, depression, and anxiety than men; likewise, women showed a higher frequency of some maladaptive coping strategies (behavioral disengagement and denial) and lower levels of some adaptive ones (active coping and planning); additionally, maladaptive coping strategies were positively correlated with stress and depression in both sexes: self-blame, behavioral disengagement, denial, substance use, and self-distraction. Likewise, there were negative correlations between stress and depression and the adaptive strategies: planning, active coping, acceptance, and positive reframing. For women, religion presented negative correlations with stress, depression, and anxiety, and humor showed low positive correlations with stress, anxiety, and depression. In conclusion, most adaptive and maladaptive coping strategies are common in both sexes with the exception of religion, which seems to be adaptive in women and neutral in men, and humor, which seems to be adaptive in men and maladaptive in women. In addition, emotional and instrumental support seem to be neutral in both sexes.

Brief COPE Short Version (Mini-COPE): A Proposal of Item and Factorial Reduction in Mexican Population.

The factorial reduction of Brief COPE has not been successfully replicated by independent studies, and few have been performed in Spanish-speaking populations; therefore, the objective of this study was to perform a factorial reduction of the instrument in a large sample of the Mexican population and perform a convergent and divergent validity of the factors obtained. We distributed a questionnaire via social networks with sociodemographic and psychological variables, including the Brief COPE and the scales of the CPSS, GAD-7, and CES-D to measure stress, anxiety, and depression. A total of 1283 persons were included, most of whom (64.8%) were women and had a bachelor's degree (55.2%). After performing the exploratory factorial analysis, we did not find a model with an adequate fit and a reduced number of factors; therefore, we decided to reduce the number of items according to the most representative ones of adaptive, maladaptive, and emotional coping strategies. The resulting model with three factors showed good fit parameters and good internal consistency of the factors. In addition, the nature and naming of the factors were confirmed by convergent and divergent validity, with significant negative correlations between factor 1 (active/adaptive) and stress, depression, and anxiety, significant positive correlations between factor 2 (avoidant/maladaptive) and these three variables, and no significant correlation between factor 3 (emotional/neutral) and stress or depression. This shortened version of the brief COPE (Mini-COPE) is a good option to evaluate adaptive and maladaptive coping strategies in Spanish-speaking populations.

Measurement scales of mental health related to climate change: a scoping review protocol using artificial intelligence.

INTRODUCTION: Human actions have influenced climate changes around the globe, causing extreme weather phenomena and impacting communities worldwide. Climate change has caused, directly or indirectly, health effects such as injury and physical injuries, which impact morbidity and mortality. Similarly, there is evidence that exposure to climatic catastrophes has serious repercussions on psychological well-being, and rising temperatures and drought have detrimental effects on mental health.Despite the recent effort of researchers to develop specific instruments to assess the effects of climate change on mental health, the evidence on measures of its impact is still scarce, and the constructs are heterogeneous. The aim of this scoping review is to describe the instruments developed and validated to assess the impact of mental health related to climate change. METHODS AND ANALYSIS: This review is registered at Open Science Framework (https://osf.io/zdmbk). This scoping review will follow the reporting elements chosen for systematic review and meta-analysis (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We proposed a PO question, as it places no restrictions on the participants (P), and the outcome (O) are measurement instruments on mental health related to climate change. A search will be conducted in different databases (PubMed, Scopus, Web of Science, PsycINFO). We will use an open-source artificial intelligence screening tool (ASReview LAB) for the title and abstract review. The full-text review will be performed by three researchers. If there is a disagreement between two independent reviewers, a third reviewer will take the final decision. We will use the COnsensus-based Standards for the selection of health Measurement INstruments tool to assess the risk of bias for each included study. The review will be conducted starting in September 2023. ETHICS AND DISSEMINATION: The planned scoping review does not require ethical approval since it will not involve an ethical risk to the participants. The results obtained from this study will be presented at conferences, congresses and scientific publications.

Psychological capital and its relationship with lifestyle of Mexican university students / Capital psicológico y su relación con el estilo de vida de universitarios mexicanos

Background: University students don't have a healthy lifestyle so it is necessary to identify psychosocial variables that can increase it. Objective: To determine the relationship between the psychological capital (CapPsi) and lifestyle (EV) of Mexican university students. Method: A cross-sectional and correlational study was carried out among 320 students of a public university. The sample was non probabilistic by quotas. To assess the factors of CapPsi were used the General Scale of Self-efficacy, the Scale of Hope for Adults, Questionnaire of Resilience, the Life Orientation Test and; to assess the lifestyle was used the Fantastic questionnaire. Results: The variables of the CapPsi correlated with the healthy lifestyle; resilience (r = 0.505, p < 0.01); hope (r = 0.432, p < 0.01); optimism (r = 0.412, p < 0.01); and self-efficacy (r = 0.400, p < 0.01). The 33.3 of the total variance of the lifestyle was explained by the CapPsi (R2 = 0.333). Conclusions: Based on the results, it is assumed that the CapPsi improve lifestyle; however, further research is necessary to determine if the influence of CapPsi is in the adoption and / or maintenance of healthy lifestyle and identify how each one of its factors infl uences it particularly. The CapPsi has a representative percentage of prediction of healthy lifestyle. It is necessary that health promotion and prevention programs incorporate the approach of CapPsi to achieve a healthy lifestyle in the university students.

Introducción: en algunos estudios se ha reportado que los universitarios no tienen un estilo de vida saludable (EVS) por lo que es necesario identificar no solo las variables psicosociales negativas, sino también las variables de Psicología Positiva que pueden favorecerlo. Objetivo: Determinar la relación entre el capital psicológico (CapPsi) y el estilo de vida (EV) de estudiantes universitarios mexicanos. Método: se realizó un estudio transversal y correlacional con 320 estudiantes de una universidad pública. La muestra fue no probabilística por cuotas. Para evaluar los factores del CapPsi se utilizaron los instrumentos Escala General de Autoeficacia, Escala de Esperanza para Adultos, Cuestionario de Resiliencia y Test de Orientación en la Vida (optimismo); para evaluar el EV se usó el Cuestionario Fantástico. Resultados: las variables del CapPsi mostraron una correlación estadísticamente significativa con el EV; resiliencia (r = 0,505, p < 0,01); esperanza (r = 0,432, p < 0,01); optimismo (r = 0,412, p < 0,01); autoeficacia (r = 0,400, p < 0,01). El 33,3 de la varianza total del EV es explicado por el CapPsi (R2 = 0,333). Conclusiones: con base en los resultados, se asume que el CapPsi favorece el EVS; no obstante, es necesario que futuras investigaciones detallen si la influencia es en la adopción y/o mantenimiento del EVS, así como identificar cómo influye particularmente en cada factor del EV. El CapPsi tiene un porcentaje representativo de predicción del EV saludable. Es necesario que los programas de promoción y prevención en salud incorporen el abordaje del CapPsi para lograr un EV saludable en los universitarios.

Relationship between lifestyle and positive psychological functioning in university administrative staff / Relación entre el estilo de vida y el funcionamiento psicológico positivo en personal administrativo universitario

Abstract In Mexico, healthy lifestyle has a low prevalence. The importance of a healthy lifestyle lies in avoiding the emergence of a chronic non-communicable disease. Thus, university administrative personnel are a vulnerable population due to working conditions that prevent them from having a healthy lifestyle, so it is necessary to analyze psychological variables that can explain how to promote and develop a healthy lifestyle. The purposes of this study were to identify relationships among lifestyle (LS) and positive psychological functioning (PPF) and their differences by gender in the administrative staff; a cross-sectional and correlational study was conducted. University administrative staff (n = 102), were recruited using the snowball sampling method, forming a non-probabilistic sample, completed the Fantastic Lifestyle Questionnaire and the Positive Psychological Functioning Scale. LS has a statistically significant correlation with PPF (r = .355, p = .001); in addition, it is worth pointing out that showing a low level of PPF implies a lower probability of having a healthy LS (Ψ = 28.333, 4.965 - 161.675). Results suggest the relevance of interventions to develop psychological resources in people seeking the adoption of a healthy LS.

Resumen En México, el estilo de vida saludable tiene una baja prevalencia. La importancia de un estilo de vida saludable radica en evitar la aparición de una enfermedad crónica no transmisible. Así, el personal administrativo universitario es una población vulnerable debido a las condiciones laborales que les impiden tener un estilo de vida saludable, por lo que es necesario analizar las variables psicológicas que pueden explicar cómo promoverlo y desarrollarlo. Los propósitos de este estudio fueron identificar las relaciones entre el estilo de vida (EV) y el funcionamiento psicológico positivo (FPP) y sus diferencias por sexo en personal administrativo universitario para lo cual se realizó un estudio transversal y correlacional. El personal administrativo universitario (n = 102) reclutado mediante el método de muestreo de bola de nieve, completó el Cuestionario de Estilo de Vida Fantástico y la Escala de Funcionamiento Psicológico Positivo. El EV presentó una correlación estadísticamente significativa con el FPP (r = .355, p = .001); además, vale la pena señalar que tener un bajo nivel de FPP implica una menor probabilidad de tener un EV saludable (Ψ = 28.333, 4.965 - 161.675). Los resultados sugieren la relevancia de las intervenciones para desarrollar recursos psicológicos en personas que buscan la adopción de un EV saludable.

Locus de control de la salud, actitud religiosa y espiritualidad en adultos mayores / Health locus of control, religious attitude and spirituality in older adults

Objetivo: valorar la relación del locus de control de la salud con la actitud religiosa y la espiritualidad en adultos mayores mexicanos. Materiales y métodos: estudio correlacional de corte transversal en una muestra de 101 adultos mayores de centros gubernamentales de asistencia social en México. Para evaluar las variables de estudio se utilizó la Escala de Locus de Control en Salud, el Índice de Espiritualidad y la Escala de Actitud Religiosa, además de un cuestionario para las variables sociodemográficas. La recolección de datos fue realizada por psicólogas previa firma del consentimiento informado. Se realizaron análisis descriptivos para las variables de estudio, y para evaluar la relación entre el locus de control de la salud con la actitud religiosa y la espiritualidad se realizaron dos análisis: una correlación de Pearson y la razón de momios. Resultados: la correlación del locus de control de la salud en su dimensión otros poderosos tiene una correlación baja pero estadísticamente significativa con la actitud religiosa (r = ,278, p < ,01) y no tiene una correlación con la espiritualidad, así, un nivel alto de actitud religiosa hace más probable que los adultos mayores tengan un locus de control de la salud otros poderosos a un nivel alto (Ψ = 2,71, 1,154 - 6,394). Conclusión: a medida que la actitud religiosa tiene un nivel más alto, el empoderamiento de la salud en los adultos mayores mexicanos tiene mayor probabilidad de ser menor.. (au)

Objective: to assess the relationship of health locus of control with religious attitude and spirituality in a group of Mexican elders. Materials and methods: cross-sectional correlational study in a sample of 101 older adults from government social assistance centers in Mexico. To evaluate the study variables, the Locus of Control in Health Scale, the Spirituality Index and the Religious Attitude Scale were used; in addition to a questionnaire for sociodemographic variables. Data collection was carried out by psychologists after signing the informed consent. Descriptive analyzes were carried out for the study variables and to evaluate the relationship between health locus of control with religious attitude and spirituality, two analyzes were carried out: a Pearson correlation and the odds ratio. Results: the correlation of health locus of control in its dimension powerful others has a low but statistically significant correlation with religious attitude (r = ,278, p <,01) and does not have a correlation with spirituality, thus, a high level of religious attitude makes it more likely that older adults have a powerful others health locus of control at a high level (Ψ = 2,71, 1,154 ­ 6,394). Conclusion: as religious attitude has a higher level, health empowerment in Mexican older adults is more likely to be lower..(Au)

Intervención cognitivo-conductual para el control metabólico de la diabetes mellitus tipo 2: un estudio piloto / Cognitive-behavioral intervention for the metabolic control of type 2 diabetes mellitus: a pilot study

Resumen En México, una de cada cuatro personas con diabetes mellitus tipo 2 (DM2) tiene un control aceptable de la enfermedad. Consecuentemente, el propósito de este estudio fue determinar el cambio clínico de una intervención cognitivo-conductual en el control metabólico (CM) de la DM2 y variables psicológicas asociadas (malestar emocional asociado a diabetes mellitus [MEADM], sintomatología depresiva y bienestar psicológico). Se utilizó un diseño cuasiexperimental pretest-postest con seguimiento a los tres meses. Los resultados muestran un efecto muy alto de la intervención en el MEADM del pretest al postest (g = 1.399) y al seguimiento (g = 1.478); un efecto moderado del pretest al postest (g = 0.461) y alto del pretest al postest (g = 1.036) en el bienestar psicológico. Se necesita más tiempo para que la HbA1c y la sintomatología depresiva lleguen a rangos de control.

Abstract In Mexico, one of four people with type 2 diabetes mellitus has an acceptable control. Thus, the purpose of this study was to determine the clinical change of a cognitive-behavioral intervention on metabolic control and associated psychological variables (emotional distress, depressive symptomatology and psychological well-being) in people with this disease. A quasi-experimental pretest posttest design with a follow-up of one and three months was used. Results show a very high effect on the emotional distress to the pretest to posttest (g = 1.399) and to the follow-up (g = 1.478); a moderate effect from pretest to posttest (g = 0.461) and high from pretest to posttest (g = 1.036) in psychological well-being. More time is needed for the HbA1c and depressive symptomatology reach ranges of control.

Gaudiebility and health status perception in a Mexican sample / Gaudibilidade e percepção do estado de saúde em uma amostra mexicana / Gaudibilidad y percepción de estado de salud en una muestra mexicana

Abstract The current approach to the health-illness process requires, in addition to disease control, the preservation of the person's quality of life. This study has the purpose of identifying the relationship between gaudiebility and the perception of health status in a Mexican sample, as well as comparing these variables by gender. A cross-sectional and correlational study was conducted for such purposes. Gaudiebility was measured with the Gaudiebility Scale and the perception of health status with the MOS 36-Item Short-Form Health Survey (SF-36). The sample consisted of 285 people between the ages of 14 and 78 (M = 32.13, SD = 13.38), who were recruited with the snowball sampling method, forming a non-probability sample. Results indicate a statistically significant positive and moderate relationship between gaudiebility and the General Health of people (p = .433, p < .001). Thus, people with high gaudiebility perceive less risks to their General Health compared with people who have low and moderate gaudiebility (RM = 4.527, 2.434 - 8.419). Furthermore, a statistically significant difference was identified by gender regarding Physical Functioning (z = -2.293, p = .022) and Mental Health (z = -2.243, p = .025) on the SF-36, where men reported a higher level in both cases. It was concluded that gaudiebility has a relevant influence on the perception of health status.

Resumo Na atualidade, para a abordagem do processo saúde-doença requer-se, além de controlar a doença, preservar, na medida do possível, a qualidade de vida da pessoa. Nesse sentido, o objetivo do presente trabalho foi identificar a relação entre a gaudibilidade e a percepção do estado de saúde em uma amostra de mexicanos e comparar tais variáveis de acordo com o gênero dos participantes. Para isso, utilizou-se um desenho transversal e correlacional com a aplicação da Escala de Gaudibilidade e a versão curta do Questionário de Saúde (SF-36). No total, participaram 285 pessoas com idades entre 14 e 78 anos (M = 32.13, DP = 13.38) recrutados por meio da técnica de bola de neve, com quem se formou uma amostra não probabilística. Os resultados indicaram uma relação estatisticamente significativa, positiva e moderada entre a gaudibilidade e a saúde geral dos participantes (p = .407, p < .001), devido ao fato de que as pessoas com alta gaudibilidade perceberam menos riscos em saúde geral em comparação com as pessoas com gaudibilidade baixa e moderada (RM = 4.527, 2.434 - 8.419). Igualmente, identificou-se uma diferença estatisticamente significativa com respeito ao gênero nos fatores funcionamento físico (z = -2.293, p = .022) e saúde mental (z = -2.243, p = .025) do SF-36, já que os homens indicaram um maior nível em ambos os casos. Conclui-se que a gaudibilidade tem uma influência relevante sobre a percepção do estado de saúde.

Resumen En la actualidad, para el abordaje del proceso salud-enfermedad se requiere, además de controlar la enfermedad, preservar en lo posible la calidad de vida de la persona. En este sentido, el objetivo del presente trabajo fue identificar la relación entre la gaudibilidad y la percepción del estado de salud en una muestra de mexicanos, y comparar dichas variables según el género de los participantes. Para esto, se utilizó un diseño transversal y correlacional con la aplicación de la Escala de Gaudibilidad y la versión corta del Cuestionario de Salud (SF-36). En total, participaron 285 personas de entre 14 y 78 años (M = 32.13, DE = 13.38), reclutados por medio de la técnica de bola de nieve, con quienes se formó una muestra no probabilística. Los resultados indicaron una relación estadísticamente significativa, positiva y moderada entre la gaudibilidad y la salud general de los participantes (p = .407, p < .001), debido a que las personas con alta gaudibilidad percibieron menos riesgos en salud general en comparación con las personas con baja y moderada gaudibilidad (RM = 4.527, 2.434 - 8.419). Asimismo, se identificó una diferencia estadísticamente significativa en cuanto al género en los factores funcionamiento físico (z = -2.293, p = .022) y salud mental (z = -2.243, p = .025) del SF-36, ya que los hombres refirieron un nivel mayor en ambos casos. Se concluye que la gaudibilidad tiene una influencia relevante sobre la percepción del estado de salud.

Intervenciones cognitivo conductuales para diabéticos en México / Cognitive behavioral interventions for diabetics in Mexico

RESUMEN: Antecedentes: La diabetes mellitus (DM) tiene una alta prevalencia en México. Se estima que sólo una cuarta parte de los casos está metabólicamente controlada. Se requiere de intervenciones eficaces que coadyuven a controlarla, como las cognitivo conductuales. Objetivo: Realizar una revisión por temas de las intervenciones cognitivo conductuales utilizadas en México para mejorar el control de la DM. Método: Las intervenciones cognitivo conductuales para la revisión se obtuvieron de bases de datos (Redalyc, Dialnet, SciELO), el Catálogo TESIUNAM, centros de documentación especializados, libros, referencias de los estudios analizados y consulta a expertos. Se incluyeron trabajos realizados entre 1990 y 2014. Se analizaron variables relacionadas con la intervención y para evaluar las características metodológicas se utilizaron los criterios del CONSORT (Consolidated Standards of Reporting Trials / Estándares Consolidados de Reporte de Ensayos). Resultados: Fueron incluidos diecinueve estudios que cumplían con los criterios necesarios. 11 intervenciones buscaban mejorar la adherencia al tratamiento y/o al autocuidado; 11 mejorar el estado de ánimo y 10 buscaban aumentar la calidad de vida y/o bienestar psicológico. De los 19 estudios, 18 reportaron resultados favorables para el control de la DM. Sólo dos estudios cumplieron con más del 50% de los criterios sugeridos por el CONSORT. Discusión y conclusión: Los alcances de las intervenciones son cortos, ya que las muestras de los estudios apenas promedian 26.21 participantes y los periodos de seguimiento promedian 2.15 meses. La mayoría de los estudios no cumple (o solo parcialmente) con los criterios del CONSORT, lo cual pone en discusión los efectos alcanzados en las intervenciones.

ABSTRACT: Background: Diabetes mellitus (DM) is highly prevalent in Mexico. It is estimated that only a quarter of such cases are metabolically controlled. Control of DM requires effective interventions, such as cognitive behavioral therapy. Objective: To conduct a subject review of cognitive behavioral interventions used in Mexico to improve the control of DM. Method: Cognitive behavioral interventions for the review were obtained from databases (Redalyc, Dialnet, SciELO), the TESIUNAM Catalog, specialist libraries, books, references of the analyzed studies, and consultations with experts. Studies carried out between 1990 and 2014 were included. Certain variables related to the intervention were analyzed; to evaluate the methodological characteristics, the criteria set by the CONSORT (Consolidated Standards of Reporting Trials) was used. Results: Nineteen studies that met the inclusion criteria were included. Eleven interventions were looking for improved adherence to treatment and/or self-care, 11 were looking for improved mood, and 10 were looking for better quality of life and/or psychological well-being. Of the 19 studies, 18 reported favorable results for control of DM. Only two studies met with more than 50% of the criteria suggested by the CONSORT. Discussion and conclusion: The scope of the interventions is short because study samples averaged just 26.21 participants and follow-up periods averaged 2.15 months. Most of the studies do not or only partially meet with CONSORT criteria, putting into question the effects achieved in the interventions.