Subject(s)
Attention Deficit Disorder with Hyperactivity/therapy , Behavioral Medicine/methods , Pediatricians/statistics & numerical data , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Behavior Therapy/methods , Behavior Therapy/trends , Behavioral Medicine/statistics & numerical data , Child, Preschool , Female , Humans , Infant , Male , Pediatricians/psychologyABSTRACT
Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.
Subject(s)
Behavior Therapy/trends , Diet, Healthy/psychology , Nutrition Therapy/trends , Nutritionists/statistics & numerical data , Psychological Theory , Behavior Therapy/methods , Behavior Therapy/statistics & numerical data , Humans , Nutrition Therapy/methods , Nutrition Therapy/statistics & numerical dataABSTRACT
BACKGROUND: Most research evaluating telehealth psychiatric treatment has been conducted in outpatient settings. There is a great lack of research assessing the efficacy of telehealth treatment in more acute, intensive treatment settings such as a partial hospital. In the face of the COVID-19 pandemic, much of behavioral health treatment has transitioned to a virtual format. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined the effectiveness of our partial hospital program (PHP). METHOD: The sample included 207 patients who were treated virtually from May 2020 to September 2020 and a comparison group of 207 patients who were treated in the in-person partial program a year earlier. Patients completed self-administered measures of patient satisfaction, symptoms, coping ability, functioning, and general well-being. RESULTS: For both the in-person and telehealth methods of delivering partial hospital level of care, patients were highly satisfied with treatment and reported a significant reduction in symptoms and suicidality from admission to discharge. On the modified Remission from Depression Questionnaire, the primary outcome measure, both groups reported a significant (P < .01) improvement in functioning, coping ability, positive mental health, and general well-being. A large effect size of treatment (Cohen d > 0.8) was found in both treatment groups. The only significant difference in outcome between the patients treated in the different formats was a greater length of stay (mean ± SD of 13.5 ± 8.1 vs 8.5 ± 5.0 days, t = 7.61, P < .001) and greater likelihood of staying in treatment until completion (72.9% vs 62.3%, χ2 = 5.34, P < .05) in the virtually treated patients. CONCLUSIONS: Telehealth partial hospital treatment was as effective as in-person treatment in terms of patient satisfaction, symptom reduction, suicidal ideation reduction, and improved functioning and well-being. The treatment completion rate was higher in the telehealth cohort, and several patients who were treated virtually commented that they never would have presented for in-person treatment even if there was no pandemic. Telehealth PHPs should be considered a viable treatment option even after the pandemic has resolved.
Subject(s)
Behavior Therapy , COVID-19 , Emergency Services, Psychiatric , Mental Disorders , Telemedicine , Adult , Behavior Therapy/methods , Behavior Therapy/trends , COVID-19/epidemiology , COVID-19/prevention & control , Emergency Service, Hospital/statistics & numerical data , Emergency Services, Psychiatric/methods , Emergency Services, Psychiatric/trends , Female , Hospitalization/statistics & numerical data , Humans , Infection Control/methods , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health/trends , Patient Safety , Patient Satisfaction , SARS-CoV-2 , Telemedicine/methods , Telemedicine/organization & administration , United States/epidemiologyABSTRACT
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
Subject(s)
Pediatric Obesity/therapy , Weight Reduction Programs/methods , Behavior Therapy/methods , Behavior Therapy/organization & administration , Behavior Therapy/trends , Child , Community Networks/organization & administration , Community Networks/trends , Humans , Nutrition Therapy/methods , Nutrition Therapy/trends , Patient Education as Topic/methods , Patient Education as Topic/organization & administration , Patient Education as Topic/trends , Pediatric Obesity/epidemiology , Pediatric Obesity/etiology , Physical Therapy Modalities/organization & administration , Physical Therapy Modalities/trends , Prevalence , School Health Services/organization & administration , School Health Services/trends , Weight Reduction Programs/organization & administration , Weight Reduction Programs/trendsABSTRACT
Increased prevalence of autism spectrum disorder (ASD) has underscored the need for early intervention services. Early Intensive Behavioral Intervention (EIBI) is among the most common evidence-based approaches, however, stakeholders report significant waitlists. The effects of these delays to intervention are unknown. The purpose of this study was to evaluate the effects of delay to EIBI for preschool aged children with ASD on later educational outcomes. Medicaid records from Minnesota (2008-2010) were used to evaluate a cohort diagnosed with ASD and their later educational outcomes from 2010 to 2014 (n = 667) using generalized estimating equations. Approximately 70% of children experienced a delay to EIBI and children that experienced less delay and started EIBI at a younger age had better educational outcomes.
Subject(s)
Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/therapy , Behavior Therapy/trends , Early Intervention, Educational/trends , Early Medical Intervention/trends , Medicaid/trends , Autism Spectrum Disorder/epidemiology , Behavior Therapy/methods , Child , Child, Preschool , Cohort Studies , Early Intervention, Educational/methods , Early Medical Intervention/methods , Educational Status , Female , Humans , Male , Minnesota/epidemiology , United States/epidemiologyABSTRACT
When individuals with autism and intellectual and developmental disabilities exhibit severe problem behavior, assessment and treatment are often warranted. Parents of such individuals are at high risk for developing parenting stress. In this study, 194 parents completed the Parenting Stress Index-Short Form at their child's time of admission to and discharge from inpatient or outpatient treatment for severe problem behavior. Parent stress was examined in relation to rate and function of child problem behavior as determined via functional analysis. Repeated measures analyses of variance were conducted, and differential effects were observed when child participants exhibited an attention, automatic, or mands function for problem behavior. These findings highlight the importance of considering function of problem behavior in relation to parenting stress.
Subject(s)
Behavior Therapy/methods , Caregivers/psychology , Parents/psychology , Problem Behavior/psychology , Stress, Psychological/psychology , Adolescent , Adult , Behavior Therapy/trends , Child , Child, Preschool , Female , Humans , Infant , Male , Parenting/psychology , Patient Admission/trends , Stress, Psychological/therapy , Treatment Outcome , Young AdultABSTRACT
Services for children with autism spectrum disorder (ASD) and their families have evolved with the advent of the Medicaid waiver, leading to more family-based coordination of care. Evaluating family involvement, the current investigation compared 230 families of children with ASD receiving Medicaid waiver services to a propensity-score matched group of 230 families who were waiting for such services (i.e., registry families). Compared to the registry, waiver families reported more involvement in service planning tasks, but not activities related to future-planning, managing crisis situations, or searching for and securing funding. Additional analyses characterize waiver families as engaging in high levels of coordinating and delivering behavioral interventions for their child. Implications for family burden and future programming for waiver programs are discussed.
Subject(s)
Autism Spectrum Disorder/economics , Behavior Therapy/economics , Caregivers/economics , Family , Home Care Services/economics , Medicaid/economics , Adolescent , Autism Spectrum Disorder/epidemiology , Autism Spectrum Disorder/therapy , Behavior Therapy/trends , Caregivers/trends , Child , Cross-Sectional Studies , Female , Home Care Services/trends , Humans , Male , Medicaid/trends , United States/epidemiologySubject(s)
Autism Spectrum Disorder/therapy , Behavior Therapy/methods , Early Intervention, Educational/methods , Behavior Therapy/trends , Child , Child, Preschool , Early Intervention, Educational/trends , Evidence-Based Practice , Humans , Infant , Patient Care Team , Pediatrics/methods , Professional-Family Relations , Referral and Consultation , Treatment OutcomeABSTRACT
Continuing professional development (CPD) is a widely used and evolving set of complex interventions that seeks to update and improve the knowledge, skills, and performance of health care professionals to ultimately improve patient care and outcomes. While synthesized evidence shows CPD in general to be effective, effects vary, in part due to variation in CPD interventions and limited understanding of CPD mechanisms of action. We introduce two behavioral science tools-the Behavior Change Technique Taxonomy version 1 and the Theoretical Domains Framework-that can be used to characterize the content of CPD interventions and the determinants of behaviour potentially targeted by the interventions, respectively. We provide a worked example of the use of these tools in coding the educational content of 43 diabetes quality improvement trials containing clinician education as part of their multicomponent intervention. Fourteen (of a possible 93; 15%) behavior change techniques were identified in the clinician education content of the quality improvement trials, suggesting a focus of addressing the behavioral determinants beliefs about consequences, knowledge, skills, and social influences, of diabetes care providers' behavior. We believe that the Behavior Change Technique Taxonomy version 1 and Theoretical Domains Framework offer a novel lens to analyze the CPD content of existing evidence and inform the design and evaluation of future CPD interventions.
Subject(s)
Behavior Therapy/methods , Education, Continuing/methods , Staff Development/methods , Behavior Therapy/trends , Education, Continuing/trends , Humans , Quality Improvement , Staff Development/trends , Surveys and QuestionnairesABSTRACT
PURPOSE OF REVIEW: Technological advancement has led to the development of novel treatment approaches for attention deficit hyperactivity disorder (ADHD). This review aims to review recent studies which employ the use of technology to treat ADHD, with particular focus on studies published during a 1-year period from February 2019 to February 2020. RECENT FINDINGS: Most recent studies involved children aged 12 years and below. Interventions included cognitive training through games, neurofeedback and a combination of several approaches. More novel approaches included trigeminal nerve stimulation and brain-computer interface, and studies had utilized technology such as X-box Kinect and eye tracker. There was a shift towards delivering intervention at home and in school, enabled by technology. The study outcomes were variable and mainly included executive functioning measures and clinical ratings. These interventions were generally safe with few reported adverse events. SUMMARY: Technology has enabled interventions to be delivered outside of the clinic setting and presented an opportunity for increased access to care and early intervention. Better quality studies are needed to inform on the efficacy of these interventions.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Behavior Therapy , Cognitive Behavioral Therapy , Computing Methodologies , Technology Assessment, Biomedical , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit Disorder with Hyperactivity/therapy , Behavior Rating Scale , Behavior Therapy/instrumentation , Behavior Therapy/methods , Behavior Therapy/trends , Child , Cognitive Behavioral Therapy/instrumentation , Cognitive Behavioral Therapy/methods , HumansSubject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pain Management/standards , Pain/epidemiology , Pneumonia, Viral/epidemiology , Telemedicine/standards , Behavior Therapy/standards , Behavior Therapy/trends , COVID-19 , Coronavirus Infections/diagnosis , Humans , Pain/diagnosis , Pain Management/trends , Pandemics , Physical Therapy Modalities/standards , Physical Therapy Modalities/trends , Pneumonia, Viral/diagnosis , SARS-CoV-2 , Telemedicine/trendsABSTRACT
Objectives: Smartphone applications ("apps") can be used to promote health behavior change and expand the reach of behavioral interventions. To date, only a few existing apps have been developed for health promotion among adolescent survivors of childhood cancer. To address this gap, we developed an app-based intervention, using game design characteristics, theory-based behavioral strategies, and assistance from a health coach to motivate health behavior change for adolescent survivors of childhood cancer. This article describes the development and initial feasibility evaluation of the intervention. Methods: Using a theoretical framework and an extensive formative process, we developed an app-based game ("Mila Blooms") that promotes healthy eating and physical activity among adolescent survivors of childhood cancer. A single-arm 8-week intervention, using this app-based game, with assistance from a health coach, was conducted among a sample of pediatric cancer survivors (n = 15) to evaluate its initial feasibility for promoting health behavior change. Results: Results from the feasibility evaluation were encouraging. The majority of enrolled participants were retained throughout the 8-week intervention (93.8%). Participant satisfaction feedback indicated positive experiences, related to ease of use and enjoyment of the app. Although there was little evidence for behavior change attributable to the app in this first stage of development, there was a solid demonstration of the viability and appeal of the game features, and there were no adverse side effects. Conclusions: Results provide insights into how gamification can be used to promote health behaviors through an app-based intervention. Mila Blooms holds promise for promoting health behavior change. Lessons learned from our experiences could be useful for the future development and implementation of app-based adolescent health interventions.
Subject(s)
Behavior Therapy/instrumentation , Cancer Survivors/psychology , Diet, Healthy/psychology , Exercise/psychology , Mobile Applications/trends , Adolescent , Behavior Therapy/trends , Cancer Survivors/statistics & numerical data , Child , Diet, Healthy/statistics & numerical data , Female , Health Promotion/methods , Health Promotion/statistics & numerical data , Humans , Male , Neoplasms/complications , Neoplasms/psychology , Video Games/standards , Video Games/trendsABSTRACT
Avoidant/restrictive food intake disorder (ARFID) was recently introduced to psychiatric nosology to describe a group of patients who have avoidant or restrictive eating behaviours that are not motivated by a body image disturbance or a desire to be thinner. This scoping review aimed to systematically assess the extent and nature of the ARFID literature, to identify gaps in current understanding, and to make recommendations for further study. Following an extensive database search, 291 unique references were identified. When matched against pre-determined eligibility criteria, 78 full-text publications from 14 countries were found to report primary, empirical data relating to ARFID. This literature was synthesised and categorised into five subject areas according to the central area of focus: diagnosis and assessment, clinical characteristics, treatment interventions, clinical outcomes, and prevalence. The current evidence base supports ARFID as a distinct clinical entity, but there is a limited understanding in all areas. Several possible avenues for further study are indicated, with an emphasis placed on first parsing this disorder's heterogeneous presentation. A better understanding of the varied mechanisms which drive food avoidance and/or restriction will inform the development of targeted treatment interventions, refine screening tools and impact clinical outcomes.
Subject(s)
Avoidant Restrictive Food Intake Disorder , Feeding Behavior/psychology , Motivation , Behavior Therapy/methods , Behavior Therapy/trends , Feeding Behavior/physiology , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/psychology , Female , Humans , Male , Motivation/physiology , PrevalenceABSTRACT
BACKGROUND: Women of childbearing age are vulnerable to weight gain. This scoping review examines the extent and range of research undertaken to evaluate behavioral interventions to support women of childbearing age to prevent and treat overweight and obesity. METHODS: Eight electronic databases were searched for randomized controlled trials (RCT) or systematic reviews of RCTs until 31st January 2018. Eligible studies included women of childbearing age (aged 15-44 years), evaluated interventions promoting behavior change related to diet or physical activity to achieve weight gain prevention, weight loss or maintenance and reported weight-related outcomes. RESULTS: Ninety studies met the inclusion criteria (87 RCTs, 3 systematic reviews). Included studies were published from 1998 to 2018. The studies primarily focused on preventing excessive gestational weight gain (n = 46 RCTs, n = 2 systematic reviews), preventing postpartum weight retention (n = 18 RCTs) or a combination of the two (n = 14 RCTs, n = 1 systematic review). The RCTs predominantly evaluated interventions that aimed to change both diet and physical activity behaviors (n = 84) and were delivered in-person (n = 85). CONCLUSIONS: This scoping review identified an increasing volume of research over time undertaken to support women of childbearing age to prevent and treat overweight and obesity. It highlights, however, that little research is being undertaken to support the young adult female population unrelated to pregnancy or preconception.
Subject(s)
Behavior Therapy/trends , Obesity/prevention & control , Obesity/therapy , Overweight/prevention & control , Overweight/therapy , Weight Reduction Programs/trends , Adolescent , Adult , Female , Humans , Outcome Assessment, Health Care , Pregnancy , Randomized Controlled Trials as Topic , Young AdultABSTRACT
The purpose of this descriptive qualitative study was to understand the processes women used to change osteoporosis prevention health behaviors. Twenty healthy, predominately white, middle-aged women engaged in an osteoporosis prevention program shared behavior change stories. Results indicated that behavior change was a highly personalized process influenced by a myriad of factors that are unique to the individual. Approaches to behavior change varied across individuals over time and were shaped by personal preferences, capacity, and past experiences. Rather than relying on a systematic approach to health behavior change, women selected and restructured aspects of research-based recommendations to match their personal needs and preferences. We identified four person-initiated behavior change processes: (a) picking and choosing, (b) doing it my way, (c) recognizing how I am doing, and (d) using prompts and feedback. Understanding the process people use to change behaviors might uniquely contribute to increasing the effectiveness of theory, research, intervention development, and clinical care.
Subject(s)
Behavior Therapy/methods , Self-Management/methods , Behavior Therapy/trends , Feedback , Female , Humans , Interviews as Topic/methods , Middle Aged , Qualitative Research , Self-Management/trendsABSTRACT
Previous research showed that the disposition to react with disproportionate aggression in adults is influenced by an interaction between a variant in the X-chromosomal monoamine oxidase A gene (MAOA) and early traumatic events. Such studies have often focused on a single type of trauma, whereas we know that experiencing multiple trauma types is associated with more detrimental consequences. The differential susceptibility hypothesis suggests that individuals who are most susceptible to adversity, are also most likely to benefit from supportive experiences in childhood. Differences in susceptibility are thought to be partly genetically driven. In the present study we explored whether a genotype of MAOA linked to lower expression of the gene (MAOA-L) modified the effect of multiple types of trauma on aggression and/or altered responsiveness to treatment among adults with severe aggression. Forensic psychiatric outpatients (FPOs) (N=150) receiving treatment for aggression regulation problems were recruited. Traumatic events and aggression were measured using self-report. FPOs with multiple trauma types and those with the MAOA-L allele reported more severe levels of aggression. No interaction effects between MAOA genotype and trauma emerged. There were no differences in response to the intervention between FPOs with and without the MAOA-L variant, whereas FPOs with a single type of trauma showed the slowest reduction of aggression. FPOs with multiple types of trauma reported the highest levels of aggression over the course of treatment. Future research is needed to elucidate this association in further detail. The current study emphasized the importance of early recognition of early traumatic events.
Subject(s)
Adverse Childhood Experiences/psychology , Aggression/psychology , Forensic Psychiatry/methods , Mental Disorders/genetics , Mental Disorders/psychology , Monoamine Oxidase/genetics , Adult , Adverse Childhood Experiences/trends , Aggression/physiology , Behavior Therapy/methods , Behavior Therapy/trends , Female , Forensic Psychiatry/trends , Gene-Environment Interaction , Humans , Male , Mental Disorders/therapy , Middle Aged , Treatment OutcomeABSTRACT
Sudden cardiac death (SCD) is relatively uncommon, yet it is a deadly consequence of some antipsychotic medications in patients with psychiatric disorders. The widespread concerns about the adverse cardiac effects associated with antipsychotics and their unpredictable nature have led to a restriction on the use of some antipsychotic medications. Recent progress has been made in the identification of important genetic factors that may contribute to the adverse complication of antipsychotic drugs, suggesting that high-risk individuals can be identified prior to initiating therapy. In addition, some high-tech smart wearable medical devices have recently been developed, allowing users to record and analyze the electrocardiogram (ECG) in couple with artificial intelligence (AI) technologies, and notifying of irregular heart rhythms or arrhythmias, a medical condition well documented in most SCD cases. In this literature review, we summarize recent advances in understanding the link between SCD and antipsychotic drug usage, as well as in utilizing wearable medical devices for monitoring of cardiac arrhythmias. New strategies for improving the care of patients receiving antipsychotic medications are proposed. As it is now possible to evaluate the risk of SCD in patients on antipsychotic medications, preventative measures and close monitoring may be used to detect the early signs of adverse cardiac events and SCD.
Subject(s)
Antipsychotic Agents/therapeutic use , Arrhythmias, Cardiac/chemically induced , Arrhythmias, Cardiac/epidemiology , Death, Sudden, Cardiac/epidemiology , Disease Management , Antipsychotic Agents/adverse effects , Arrhythmias, Cardiac/prevention & control , Behavior Therapy/trends , Death, Sudden, Cardiac/prevention & control , Electrocardiography/drug effects , Electrocardiography/methods , Forecasting , Humans , Mental Disorders/drug therapy , Predictive Value of Tests , Risk FactorsABSTRACT
BACKGROUND: The health care sector has one of the highest rates of workplace violence, putting staff at risk and impeding care. To deliver quality health care, staff need targeted resources. This article describes a program to improve staff safety and reduce barriers to care for patients with behavioral disturbances. PROGRAM DESCRIPTION: A nurse-led behavioral response team was created to identify high-risk patients and offer prompt targeted interventions. The Behavioral Optimization and Outcomes Support Team (BOOST) was implemented in November 2012, in conjunction with a proactive model of care, enabling psychiatric intervention. Advanced practice nurses in psychiatry respond to requests from staff on medical/surgical units to assist with management of behavioral disturbances. METHODS: Consultation and intervention data were reviewed, and staff satisfaction surveys were completed to evaluate the program. RESULTS: The program has contributed to staff feeling more supported and safer at work. There has also been a reduction in staff's experience of perceived burden in the care of patients with behavioral disturbances although they are caring for more of these patients. CONCLUSIONS: Although violence risk in health care continues to be a significant issue, programs to intervene early can be effective in supporting staff to minimize these risks.