Relationship of the Japanese Old Stories Cognitive Scale With the Revised Hasegawa Cognitive Scale and Mini-Mental State Examination.

The Revised Hasegawa Dementia Scale (HDS-R) is the most widely used instrument to screen for dementia in Japan and is similar to the Mini-Mental State Examination (MMSE). The development of a quicker and simpler screening tool, the Japanese Old Stories Cognitive Scale (JOSS), was previously reported. A total of 953 new outpatients from 8 memory clinics in Japan completed the JOSS, HDS-R, and MMSE at first visit. We investigated the relationship of JOSS score with both the total and individual domain scores on the HDS-R and MMSE. We found a significant relation between JOSS score and total HDS-R and MMSE scores. In addition, JOSS score was significantly related to scores on 8 of the 9 HDS-R domains and 7 of the 11 MMSE domains. We obtained regression lines for JOSS score versus HDS-R and MMSE scores. JOSS score could be useful for predicting HDS-R and MMSE scores and thus in estimating cognitive functioning.

Supporting autistic communities through parent-led and child/young person-led digital social story interventions: an exploratory study.

Introduction: Social Stories (SS) is a socially-valid intervention for autistic children and young people (CYP) which is used widely by professionals and parents. Research suggests that whilst parents are in an ideal position to deliver interventions for their autistic CYP, a lack of procedural integrity can result in a great deal of variability in parent-mediated intervention outcomes. Methods: This exploratory study investigated the extent to which SS can be effectively developed and delivered, through digital mediation, by parents with little to no researcher input (n = 17, sample 1) and the factors that impact effectiveness. Furthermore, the study also investigated the extent to which digitally-mediated SS can support autistic CYP to develop and deliver their own stories, thereby utilising the intervention as a means for self-support and self-management (n = 5, sample 2). Results: The outcomes of the study indicate that digital mediation can effectively support parent-led SS intervention. Findings also indicate that receptive/expressive language skills of autistic CYP, their level of systemizing, as well as the practice of consulting with the autistic CYP whilst identifying goals and developing stories, are individual and procedural characteristics which positively influence the effectiveness of the parent-led intervention. The study also found that digitally-mediated SS can be utilised as a self-support tool by autistic CYP themselves. Discussion: The results inform the developing literature on digital interventions and support tools that aim to engage with, and involve further, the autistic community in the setting and authoring of interventions and research.

Instagram Stories Unveiled: Exploring Links with Psychological Distress, Personality, and Gender.

Instagram is one of the most used platforms, and ephemeral stories are proving to be the most used medium for users to share content on the platform. However, there have been few studies examining this type of content in relation to emotional well-being. This study examined the association between the number of published Instagram stories, psychological well-being, personality traits, and gender in a sample of 734 Instagram users from Italy, including 281 men and 453 women, with a mean age of 25.19 years (SD = 7.08). Participants were recruited online and asked to complete an online questionnaire. Differences were found between genders in terms of time spent on Instagram, but not in terms of the number of stories posted in the past week. In the overall sample, a small positive correlation was found between the number of Instagram stories posted and extraversion. When considering gender differences, small effect sizes were observed for emotional dysregulation, agreeableness, and neuroticism, indicating a stronger association with Instagram stories in the female group, and for openness, indicating a stronger association in the male group. Results of multiple regression analyses suggest that among females, psychological variables, including personality and emotional distress, may have a stronger association with Instagram stories. To our knowledge, this is the first study to report these differences. The findings help to clarify how certain characteristics of social media platforms relate to psychological well-being and personality differently in men and women in their journey to using social media.

Life story templates in dementia care: Ambiguous direction and purpose.

BACKGROUND: The use of life stories in dementia care has been described as a way of seeing every person as an individual, looking beyond their dementia. Life stories have become synonymous with high-quality care, while in Sweden their mere existence in dementia care settings is taken to indicate quality in national comparisons. Such life stories are often standardised, generated by a family member answering predetermined questions in a template. AIM AND METHODS: Using a constructionist approach, this study will (1) chart what versions of a person's life story the templates produce, and (2) establish the intended purpose of such life stories, as communicated by the templates. This study departs from the assumption that life story templates communicate something about the conceptions of people living with dementia. The thematic analysis used data comprising 30 blank templates, totalling about 1,700 questions. FINDINGS: The life story templates were found to generate two very different versions of the individual: (1) a person before symptoms of dementia or (2) a patient with dementia. We also found contradictions about what information should be included, whose life story it was, and the intended use. DISCUSSION: Despite strong pressure on dementia care providers to collect life stories from residents, the life story templates they use are without clear direction, ideology, or purpose. The lack of direction is key given that life stories can be considered actants that shape assumptions about people with dementia and construct realities in dementia care settings. We highlight the need to develop ethical guidelines for life story template design, matched with guidelines for their intended use.

On the role of personality in successful aging: A scoping review.

BACKGROUND AND OBJECTIVES: This study aimed to critically examine current knowledge on the role of personality in successful aging, considering McAdams' (Hooker & McAdams, 2003; McAdams, 2015) three-level, six-foci model of personality. The aim was also to pinpoint knowledge gaps that research should address in the future. RESEARCH DESIGN AND METHODS: We carried out a scoping review on the literature on successful aging and personality, following the five-step framework proposed by Arksey and O'Malley (2005) and further expanded by Levac et al. (2010). RESULTS: Research into the role of personality in successful aging has grown significantly over the last 20 years. However, the increasing number of publications on the topic was primarily accounted for by studies focused on layer 1 and particularly layer 2 of McAdams' model of personality, with layer 3 being scarcely addressed. Research that included more than one layer of personality was rare. DISCUSSION AND IMPLICATIONS: Our study pinpointed gaps that should be considered in future research in this area. These gaps were related to advancing towards agreed-upon definitions of successful aging and personality, broadening the scope of research on this topic, and integrating personality dimensions on research on successful aging.

'I had to Educate Myself': A thematic analysis of online stillbirth stories to improve obstetric care.

OBJECTIVE: To examine which met and unmet needs are discussed in stillbirth stories shared on YouTube with the aim to improve obstetric care. DESIGN: Inductive thematic analysis of 19 English-language stillbirth stories uploaded to YouTube. SETTING: Online setting, YouTube video content. SAMPLE: Women who experienced stillbirth and shared a video on YouTube talking about their experience. METHODS: We conducted a thorough textual reading of the transcripts following Braun and Clarke's guidelines for thematic analysis. MAIN OUTCOME MEASURES: Codes were developed and grouped into themes. RESULTS: Although some women actively used their birth videos to call out shortcomings in their care, most others used their platform for other purposes such as destigmatisation, awareness and support, and rather unintentionally provided insight into their met and unmet needs. When analysing their birth stories, three major themes emerged: choice and decision-making, education and information, and behaviour of healthcare providers. CONCLUSIONS: This study demonstrates the value of birth stories in research. We identified three major opportunities for improvement of obstetric care: being provided with options and being able to make choices in the decision-making process are clearly valued, but there are some caveats: women and other childbearing individuals need timely and continuous information, and more attention is needed for emotional intelligence training of healthcare providers.

The impact of storytelling on building resilience in children: A systematic review.

WHAT IS KNOWN ON THE SUBJECT?: Storytelling is an effective tool for communication, is universally comprehensible and transcends linguistic barriers, adapting to cultures easily. Storytelling has a strong influence on children and has been used for knowledge retention and for developing imagination, creativity and prosocial behaviours. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The systematic review offers essential insights into the effects of storytelling interventions on the development of resilience in children. It indicates the various forms of storytelling interventions implemented and also the specific measures of resilience employed in the studies. The review has demonstrated that storytelling plays a crucial role in the development of protective factors in children including resilience. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric and mental health nurses working in community, hospital or mental health units play an important role in mental health interventions, particularly when it comes to children and young adults. Employing storytelling techniques can help psychiatric and mental health nurses provide timely and consistent support to children while helping them explore support systems, mechanisms and coping strategies helping build resilience. This holds particular importance for low- and middle-income countries where limited resources pose challenges in providing adequate support for mental health programmes for children. Methods such as storytelling are simple and adaptable to the specific challenges faced in the mental health setting. ABSTRACT: INTRODUCTION: Resilience is a crucial aspect of mental health and coping that enables individuals to effectively recover from challenges. Fostering resilience in children becomes a significant objective. Storytelling is known to positively affect resilience, providing opportunities to share and develop narratives that help make sense of difficult experiences, find meaning in them, and building beliefs around our capacity to adapt well to challenging experiences. AIM: The aim of this review is to synthesize peer-reviewed studies on the impact of storytelling interventions in developing resilience in children. METHOD: The review adhered to the updated PRISMA 2020 guidelines and was registered with PROSPERO (CRD42022365474). We conducted searches in 12 databases with search strings comprising of concepts regarding storytelling, resilience and children. RESULTS: The review included 11 studies published between 2012 and 2022. The narrative synthesis of the studies indicates that storytelling interventions enhanced psychological resilience in children. DISCUSSION: Storytelling-based interventions in school settings with participatory approaches using cultural stories, and positive psychology-based interventions were effective and feasible. IMPLICATIONS FOR PRACTICE: This review has scope for informing future interventions with children, especially those who live in marginalized communities in low- and middle-income countries (LMICs).

Perceptions of client stories in internet-delivered cognitive behaviour therapy: A mixed-methods evaluation.

Internet-delivered Cognitive-Behavioural Therapy (ICBT) aims to support people with mental health concerns using online treatment materials. Client stories (either real or a composite based on many clients) are often used in ICBT to facilitate learning. However, these stories remain understudied in terms of how they are perceived by clients, as well as their relationship to ICBT engagement, satisfaction, and outcomes. Among a sample of 324 clients enrolled in transdiagnostic ICBT targeting symptoms of depression and anxiety, we examined client perceptions of stories through mixed-method qualitative (open-ended) and quantitative (closed-ended) data collection. Specifically, 234 (72.22 %) clients responded to questions about stories at 4 weeks and 221 (68.21 %) responded to questions at 8 weeks. Most clients who responded to questions endorsed reviewing at least some stories (79.06 % at 4 weeks, 71.95 % at 8 weeks). Moreover, they rated stories positively in terms of being relatable, making clients feel less alone, increasing knowledge, providing ideas for how to use skills, and motivating clients to use skills. These perceptions of stories remained stable over the course of treatment. Stories were perceived more positively among those with lower symptom severity at 8 weeks as well as those who were more satisfied with ICBT at 8 weeks. Story perceptions at 4 weeks were predictive of decreased post-treatment anxiety symptom severity but not depression while controlling for baseline scores, age, and education. 26.49 % of clients at 4 weeks who reviewed stories and 33.33 % at 8 weeks provided suggestions about how to improve stories. In a qualitative analysis, we found 5 categories of suggestions including increasing the variety of issues and relatability of stories, ensuring the stories are realistic, refining the formatting, and making the stories shorter. Overall, this study provides insights into how client stories could be improved to play a more significant role in future ICBT programs.

Western life courses challenged in life stories collected in contemporary China.

Introduction: The life course describes the progression of life as a social role, from birth to death. Traditional Western life-history studies of the life course usually describe a continuous lifeline with occasional interruptions in between. The extraordinary temporal events of the Anti-Japanese War (AJW), Civil War (CW), Great Famine (GF), Cultural Revolution (CR), and the Reform and Opening-up of China in just few decades mean that the life history of contemporary Chinese older adults may be quite different from those of their western peers. Methods: The study used qualitative research methods to conduct in-depth interviews with 16 older adults and collect their life stories through a standardized list of questions. Grounded theory was employed to condense, compare, conceptualize, and synthesize patterns within the collected data, approaching the investigation with a "naturalistic" perspective. Results: Based on a generalized analysis of the Interview transcripts, we can find that Chinese old adults' life stories were shaped by recurring exceptional and rapidly changing environmental conditions. The themes and sub-themes of Chinese old adults' life stories were focus on (1) violence, loss of family member, escape and unstable life in their early life which are related to AJW and CW; (2) poverty and starvation in daily life when they were adolescents and young adults which are related to GF; (3) discontinuity, timed opportunities, categorizations in order to split the social relationships and networks in CR. The data also suggest that education is an important part of the life story and that its value changes over time. Discussion: The discontinuity and instability of the life stories of the Chinese old adults are unexpected according to the dominant Western-influenced life course theories, which enriches life course theory and provides a new perspective for studying the individual life course in a society of constant and rapid change.

'Bringing forth' skills and knowledge of newly qualified midwives in free-standing birth centres: A hermeneutic phenomenological study.

AIM: To understand and interpret the lived experience of newly qualified midwives (NQMs) as they acquire skills to work in free-standing birth centres (FSBCs), as well as the lived experience of experienced midwives in FSBCs in Germany who work with NQMs. BACKGROUND: In many high-, middle- and low-income countries, the scope of practice of midwives includes autonomous care of labouring women in all settings, including hospitals, home and FSBCs. There has been to date no research detailing the skills acquired when midwives who have trained in hospitals offer care in out-of-hospital settings. METHODS: This study was underpinned by hermeneutic phenomenology. Fifteen NQMs in their orientation period in a FSBC were interviewed three times in their first year. In addition to this, focus groups were conducted in 13 FSBCs. Data were collected between 2021 and 2023. FINDINGS: Using Heidegger's theory of technology as the philosophical underpinning, the results illustrate that the NQMs were facilitated to bring forth competencies to interpret women's unique variations of physiological labour, comprehending when they could enact intervention-free care, when the women necessitated a gentle intervention, and when acceleration of labour or transfer to hospital was necessary. CONCLUSION: NQMs learned to effectively integrate medical knowledge with midwifery skills and knowledge, creating a bridge between the medical and midwifery approaches to care. IMPLICATIONS: This paper showed the positive effects that an orientation and familiarization period with an experienced team of midwives have on the skill development of novice practitioners in FSBCs. IMPACT: The findings of this study will have an impact on training and orientation for nurse-midwives and direct-entry midwives when they begin to practice in out-of-hospital settings after training and working in hospital labour wards. PATIENT AND PUBLIC CONTRIBUTION: This research study has four cooperating partners: MotherHood, Network of Birth Centres, the Association for Quality at Out-of-Hospital Birth and the German Association of Midwifery Science. The cooperating partners met six times in a period of 2 ½ years to hear reports on the preliminary research findings and discuss these from the point of view of each organization. In addition, at each meeting, three midwives from various FSBCs were present to discuss the results and implications. The cooperating partners also helped disseminate study information that facilitated recruitment.

How Do You Move? Everyday stories of physical activity.

Stories can be a powerful method of exploring complexity, and the factors affecting everyday physical activity within a modern urban setting are nothing if not complex. The first part of our How Do You Move? study focused on the communication of physical activity guidelines to under-served communities. A key finding was that adults especially wanted physical activity messages to come from 'everyday people, people like us'. This finding also reflects a wider move to use more relatable imagery in health promotion campaigns. Using a portrait vignette approach to create monologues, we set out to explore the experiences of people from diverse backgrounds living in Bristol, all of whom took part in varied leisure time physical activities but would also be considered to lead 'normal' lives. We aim to demonstrate that stories of such 'experts by experience' can contribute to how physical activity is perceived and elucidate the complex interplay of barriers and enablers in everyday experiences of physical activity.

The UK government has guidelines about how much physical activity people should do to stay healthy. However, many people don't manage to do as much physical activity as the government recommends. There are many reasons why people don't do enough physical activity. Reasons include where people live, what work they do or how much spare time they have. In the How Do You Move? project, we explored the messaging about physical activity guidelines. Many people told us that they wanted to hear physical activity advice from 'people like me'. We set out to find people who managed to stay active, despite how difficult that can sometimes be in modern life. We interviewed them about their physical activity. We then worked with them to write their experiences as personal stories. These stories are presented in this paper.

The lived experience of physical exertion for persons with advanced multiple sclerosis: making connections with the world.

PURPOSE: To explore the lived experience of physical exertion for persons living with advanced multiple sclerosis (MS). METHOD: An interpretive (hermeneutic) phenomenological approach was undertaken with 8 persons living with advanced MS. Interviews were conducted with exploratory questions that explored participants' experiences of physical exertion. Data was analysed using phenomenological methods and the findings presented as hermeneutic stories. RESULTS: Participants conveyed physical exertion as a means of influencing their connection with the world. Interpretation identified four subthemes; Lived Body, Sense of Self, Purpose of exertion, and Attributes of the World and an overarching superordinate theme Body-World engagement. Hermeneutic stories illuminated the intertwined relationship between the themes and the idiographic nature of physical exertion. CONCLUSION: The experience of physical exertion was meaningfully related to participants' sense of self, agency, and 'being in the world'.

For persons living with advanced MS:Physical exertion has the potential to enhance sense of self through regaining a lost, or creating a new identity.Physical exertion can enhance bodily consciousness and cause individuals to dwell on inability, consequently health care professionals should consider how their language and therapy focus may intensify this.Attempting to meet societally accepted standards of normal had a shaping influence on the exertional experience.The meaning of physical exertion is influenced by an individual's preconceptions and healthcare professionals should take time to understanding these, in order to optimise engagement in physical exertion.

How do women talk about self-funded breast cancer genetic testing?: Small stories and stance-taking strategies.

Genetic testing for breast cancer genes is an experience which is inextricably linked with health communication practices and the broader social context in which it occurs. Linguistic approaches can provide perspective on how women seeking self-funded BRCA1/2 gene testing represent their experiences, knowledge, roles, choices and emotions through the way they talk. A discursive constructionist epistemology and narrative theoretical framework informed the applied linguistics methodology. Analysis of 'small stories' and stance-taking was performed on eight transcripts of audio-recorded telephone interviews with women at low to moderate risk of carrying BRCA1/2 pathogenic variants who self-funded genetic testing. We found a high prevalence of 'small stories' including accounts of events, hypotheticals, habitual narratives, and stories which combined multiple genres. Stance-taking was a means by which participants constructed personal identities in the conversational context, such as that of a responsible person. Via stance-taking strategies, participants also actively negotiated the conversational agenda, for example expressing different degrees of alignment with the interviewer's orientation towards emotions. This study provides a basis for recognizing linguistic markers in genetic counseling interactions about genetic testing for breast cancer genes. Enhanced awareness of client language choice, and the ways in which small stories and stance can signify the client's evaluation of experience and choices, alignment with the genetic counselor's questions/statements, and investment in the conversation, has potential to improve the therapeutic interaction.

Perspectives on creative well-being of older adults.

The growing aging population has become a significant global issue in recent years, increasing the need for research that examines aging-related phenomena such as personal growth and development in later life. A major challenge in achieving this aim is the prevailing deficit perspective on aging, which is so pervasive that it often overshadows older adults' contributions to society and diminishes the opportunities encountered in older adulthood. Although perspectives on the nature of aging are gradually changing in a positive way, and the developments in medicine are improving health-related aspects of aging, it is still a worldwide challenge to eradicate negative stereotypes around aging. This article explores empirical perspectives on aging by analyzing diverse narratives gathered from open-ended interviews we conducted in Finland from 2019 to 2021. Focusing on their aging experiences and the value of a broad range of creative engagements and interventions that older adults have joined voluntarily, the study aims to provide a better understanding of personal perspectives of aging, the creative well-being of older adults, and the growing diversity of experiences within the older age group. Based on the findings of this study, we highlight the importance of promoting older adults' engagement in art-based interventions to enhance their creativity and well-being in later life, as well as fostering aging-friendly co-creative approaches in such interventions by involving the older adults themselves in the process.

Protecting Parents, Idealizing the Past, Blaming Friends: Life Stories of Men Imprisoned for Violence.

Life-stories emerge from a wide variety of facts and events in individual lives and weave a selected few of these together to make meaning in the present. They are crucial for constructing identity and influence action by establishing worldviews and a persona that narrators will seek to confirm. In this study we describe three main themes in the life-stories of six incarcerated men in Argentina: a) Protecting family, especially parents; b) reconstructing an ideal past, and contrasting it with a more cynical present; and c) blaming criminal neighborhoods, friends, and girlfriends for their crimes. We discuss how these themes are intertwined, what function they fulfill, and the identities and masculinities they produce. Combining research on life-stories with narrative and psychosocial criminology the analysis reveals how life-stories of incarcerated men can be seen as attempts at countering stigma and defending a self that is under attack. The life-stories portray a believable, 'good', and multifaceted image of the self, but most importantly, create coherence and unity in otherwise chaotic lives.

Follow Your Heart: Trials and Tribulations of Sir Terence English and the First Successful Heart Transplant in the United Kingdom.

The journey of heart transplantation in the United Kingdom (UK) has been marked by challenges and triumphs. Following a series of unsuccessful transplant attempts in 1968, a moratorium was imposed on the procedure. However, in 1979, Sir Terence English broke the national ban, by performing the UK's first successful heart transplant at Papworth Hospital. This achievement opened doors for advancements in heart and lung transplantation and established the Papworth programme as a world leader in the field. Sir Terence's legacy stands as a testament to the transformative power of determination, perseverance and teamwork in overcoming the moratorium, lack of financial support, difficult colleagues and the failure of his first transplant attempt. Through a comprehensive review of the literature, qualitative interviews and Sir Terence's personal contributions, this article provides an account of his trials and tribulations, aiming to inspire and encourage physicians, surgeons and scientists in their pursuit of innovation in the field of medicine.

A comparative evaluation of video modeling and social stories for improving oral hygiene in children with autism spectrum disorder: A pilot study.

INTRODUCTION: The purpose of this pilot study was to compare video modeling (VM) to a toothbrushing social story (TSS) for improving oral hygiene in children with autism spectrum disorder (ASD). METHODS: Four to 17-year-old children and adolescents with ASD were evaluated at a pre-intervention visit for quality of oral hygiene using plaque and gingival indices. A pre-intervention survey assessed caregivers' perceptions of their children's daily oral hygiene practices. Participants were randomized into VM or TSS groups and caregivers received daily emails to access a VM or TSS presentation when completing toothbrushing for their child for 30 days. At the one-month visit, oral hygiene was re-evaluated, and post-intervention surveys were completed. RESULTS: There were significant improvements in plaque and gingival scores for VM (0.68 ± 0.20; 0.59 ± 0.15) and TSS (0.50 ± 0.11; 0.40 ± 0.10) groups at post-intervention compared to pre-intervention visits. No significant improvements in plaque or gingival scores were noted between the VM and TSS groups. Caregivers' perceptions regarding oral hygiene acceptance by their children was promising for the VM group. CONCLUSIONS: VM and TSS interventions improved oral hygiene in subjects with ASD. There was greater acceptance of daily oral hygiene in the VM compared to the TSS group.

Eye Movements Decrease during Effortful Speech Listening.

Hearing impairment affects many older adults but is often diagnosed decades after speech comprehension in noisy situations has become effortful. Accurate assessment of listening effort may thus help diagnose hearing impairment earlier. However, pupillometry-the most used approach to assess listening effort-has limitations that hinder its use in practice. The current study explores a novel way to assess listening effort through eye movements. Building on cognitive and neurophysiological work, we examine the hypothesis that eye movements decrease when speech listening becomes challenging. In three experiments with human participants from both sexes, we demonstrate, consistent with this hypothesis, that fixation duration increases and spatial gaze dispersion decreases with increasing speech masking. Eye movements decreased during effortful speech listening for different visual scenes (free viewing, object tracking) and speech materials (simple sentences, naturalistic stories). In contrast, pupillometry was less sensitive to speech masking during story listening, suggesting pupillometric measures may not be as effective for the assessments of listening effort in naturalistic speech-listening paradigms. Our results reveal a critical link between eye movements and cognitive load, suggesting that neural activity in the brain regions that support the regulation of eye movements, such as frontal eye field and superior colliculus, are modulated when listening is effortful.SIGNIFICANCE STATEMENT Assessment of listening effort is critical for early diagnosis of age-related hearing loss. Pupillometry is most used but has several disadvantages. The current study explores a novel way to assess listening effort through eye movements. We examine the hypothesis that eye movements decrease when speech listening becomes effortful. We demonstrate, consistent with this hypothesis, that fixation duration increases and gaze dispersion decreases with increasing speech masking. Eye movements decreased during effortful speech listening for different visual scenes (free viewing, object tracking) and speech materials (sentences, naturalistic stories). Our results reveal a critical link between eye movements and cognitive load, suggesting that neural activity in brain regions that support the regulation of eye movements are modulated when listening is effortful.

Does knowledge of liver fibrosis affect high-risk drinking behaviour (KLIFAD): an open-label pragmatic feasibility randomised controlled trial.

Background: Early identification followed by effective behaviour interventions is pivotal to changing the natural history of alcohol-related liver disease. We examined the feasibility of using transient elastography based advice and alcohol recovery video stories (ARVS) to change drinking behaviour in community alcohol services. Methods: A feasibility randomised control trial (RCT) was conducted in three community alcohol services. Adults 18+ years presenting with a primary alcohol problem were randomised (1:1) to receive either usual care (control group) or usual care and the KLIFAD Intervention, consisting of advice tailored to liver stiffness measure and access to ARVS (intervention group). Data were collected at baseline and six months. To establish definitive trial feasibility, recruitment and retention rates, study procedure safety and extent of effectiveness were measured (Start date: 02.10.2019, End date: 30.11.2022, ISRCTN.com: 16922410). Findings: 382 service users were screened, 184 were randomised (intervention: 93, control: 91), and baseline data were collected for 128 (intervention: 71, control: 59). Six months follow-up data were available in 87 (intervention: 53, control: 34). Intervention compared to the control group had a longer duration of engagement with services (mean difference 8.6 days SD = 18.4), was more likely to complete the allocated treatment program and reduced or stop drinking (54.9% vs 43.9%) and reduce AUDIT category (71.7% vs 61.8%). There were no reported serious adverse reactions, one intervention group participant reported an increase in AUDIT category. Interpretation: Integration of transient elastography in community alcohol services is feasible. It may improve engagement with services, retention in clinical trials and supplement the reduction in self-reported alcohol consumption. A definitive RCT is supported. Funding: National Institute for Health and Care Research (NIHR201146).