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- Ahlgren, Christina, et al.
(författare)
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Engagement in New Dietary Habits : Obese Women's Experiences from Participating in a 2-Year Diet Intervention
- 2016
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Ingår i: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 23:1, s. 84-93
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time.PURPOSE: The purpose of this paper is to explore overweight and obese middle-aged women's experiences of the dietary change processes when participating in a 2-year-long diet intervention.METHODS: Qualitative semi-structured interviews with 12 overweight and obese women (54-71 years) were made after their participation in a diet intervention programme. The programme was designed as a RCT study comparing a diet according to the Nordic nutrition recommendations (NNR diet) and a Palaeolithic diet (PD). Interviews were analysed according to Grounded Theory principles.RESULTS: A core category "Engagement phases in the process of a diet intervention" concluded the analysis. Four categories included the informants' experiences during different stages of the process of dietary change: "Honeymoon phase", "Everyday life phase", "It's up to you phase" and "Crossroads phase". The early part of the intervention period was called "Honeymoon phase" and was characterised by positive experiences, including perceived weight loss and extensive support. The next phases, the "Everyday life phase" and "It's up to you phase", contained the largest obstacles to change. The home environment appeared as a crucial factor, which could be decisive for maintenance of the new dietary habits or relapse into old habits in the last phase called "Crossroads phase".CONCLUSION: We identified various phases of engagement in the process of a long-term dietary intervention among middle-aged women. A clear personal goal and support from family and friends seem to be of major importance for long-term maintenance of new dietary habits. Gender relations within the household must be considered as a possible obstacle for women engaging in diet intervention.
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- Andersson, Claes, et al.
(författare)
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Interactive voice response with feedback intervention in out-patient treatment of substance use problems in adolescents: a randomized controlled trial on substance use, stress and psychiatric symptoms.
- 2017
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 24:5, s. 789-797
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Substance use disorders and problematic substance use are common problems in adolescence and young adulthood. Brief personalized feedback has been suggested for treatment of alcohol and drug problems and poor mental health. This repeated measurement randomized controlled trial examines the effect of an interactive voice response (IVR) system for assessing stress, depression, anxiety and substance use. Methods: The IVR system was used twice weekly over 3 months after treatment initiation, with or without addition of a personalized feedback intervention on stress and mental health symptoms. Both IVR assessment only (control group) and IVR assessment including feedback (intervention group) were provided as an add-on to treatment-as-usual procedures (TAU) in outpatient treatment of substance use problems in adolescents and young adults (N = 73). Results: By using a mixed models approach, differences in change scores were analyzed over the three-month assessment period. Compared to the control group, the intervention group demonstrated significantly greater improvement in the Arnetz and Hasson stress score (AHSS, p = 0.019), the total Symptoms Checklist 8 score (SCL-8D, p = 0.037), the SCL-8D anxiety sub-score (p = 0.017), and on a summarized feedback score (p = 0.026), but not on the depression subscale. There were no differences in global substance use scores between the intervention group (feedback on mental health symptoms) and the control group. Conclusion: In conclusion, IVR may be useful for follow-up and repeated interventions as an add-on to regular treatment, and personalized feedback could potentially improve mental health in adolescents and young adults with problematic substance use.
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- Andersson, Claes, et al.
(författare)
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Interactive Voice Response with Feedback Intervention in Outpatient Treatment of Substance Use Problems in Adolescents and Young Adults : A Randomized Controlled Trial
- 2017
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Ingår i: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 24:5, s. 789-797
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Tidskriftsartikel (refereegranskat)abstract
- Substance use disorders and problematic substance use are common problems in adolescence and young adulthood. Brief personalized feedback has been suggested for treatment of alcohol and drug problems and poor mental health. This repeated measurement randomized controlled trial examines the effect of an Interactive Voice Response (IVR) system for assessing stress, depression, anxiety and substance use. The IVR system was used twice weekly over three months after treatment initiation, with or without addition of a personalized feedback intervention on stress and mental health symptoms. Both IVR assessment only (control group) and IVR assessment including feedback (intervention group) were provided as an add-on to treatment-as-usual procedures (TAU) in outpatient treatment of substance use problems in adolescents and young adults (N=73). By using a mixed models approach, differences in change scores were analyzed over the three-month assessment period. Compared to the control group, the intervention group demonstrated significantly greater improvement in the Arnetz and Hasson stress score (AHSS, p=0.019), the total Symptoms Checklist 8 score (SCL-8D, p=0.037), the SCL-8D anxiety sub-score (p=0.017), and on a summarized feedback score (p=0.026), but not on the depression subscale. There were no differences in global substance use scores between the intervention group (feedback on mental health symptoms) and the control group. In conclusion, IVR may be useful for follow-up and repeated interventions as an add-on to regular treatment, and personalized feedback could potentially improve mental health in adolescents and young adults with problematic substance use.
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- Augustsson, Hanna, et al.
(författare)
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Investigating Variations in Implementation Fidelity of an Organizational-Level Occupational Health Intervention
- 2015
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 22:3, s. 345-355
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Tidskriftsartikel (refereegranskat)abstract
- The workplace has been suggested as an important arena for health promotion, but little is known about how the organizational setting influences the implementation of interventions. The aims of this study are to evaluate implementation fidelity in an organizational-level occupational health intervention and to investigate possible explanations for variations in fidelity between intervention units. The intervention consisted of an integration of health promotion, occupational health and safety, and a system for continuous improvements (Kaizen) and was conducted in a quasi-experimental design at a Swedish hospital. Implementation fidelity was evaluated with the Conceptual Framework for Implementation Fidelity and implementation factors used to investigate variations in fidelity with the Framework for Evaluating Organizational-level Interventions. A multi-method approach including interviews, Kaizen notes, and questionnaires was applied. Implementation fidelity differed between units even though the intervention was introduced and supported in the same way. Important differences in all elements proposed in the model for evaluating organizational-level interventions, i.e., context, intervention, and mental models, were found to explain the differences in fidelity. Implementation strategies may need to be adapted depending on the local context. Implementation fidelity, as well as pre-intervention implementation elements, is likely to affect the implementation success and needs to be assessed in intervention research. The high variation in fidelity across the units indicates the need for adjustments to the type of designs used to assess the effects of interventions. Thus, rather than using designs that aim to control variation, it may be necessary to use those that aim at exploring and explaining variation, such as adapted study designs.
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- Berman, Anne H., et al.
(författare)
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Digital Paths to Changing Problematic alcohol Use : Effectiveness of Unguided and Guided Interventions in a Stepped Care Model
- 2018
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Ingår i: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 25:Supplement 1, s. S43-S44
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction & Purpose: Digital interventions for changing problematic alcohol use have shown small effect sizes in relation to control groups. A meta-analysis (Riper et al., 2014) found an overall effect size of 0.20, with slightly higher effect sizes of 0.23 for interventions with a human guide, compared to 0.20 for unguided interventions. This presentation describes five different interventions, from unguided low-intensity to high-intensity guided interventions, evaluated in separate randomized controlled trials (RCT). Methods: Target groups included internet help-seekers and university students, with hazardous drinking according to the Alcohol Use Disorders Identification Test (AUDIT), excessive drinking based on national public health guidelines, or diagnosed alcohol use disorder (AUD). Study 1 evaluated eScreen.se, offering minimal screening and personal feedback, and alkoholhjalpen.se, a self-help program, with 633 internetbased participants reporting hazardous drinking. Study 2 evaluated the PartyPlanner and Promillekoll smartphone apps with 1932 university students reporting hazardous drinking. Study 3 evaluated the TeleCoach skills-based app with 186 university students who drank excessively. For studies 1-3 assessment-only controls were comparison groups. Study 4 compared the unguided eChange 10-week program to a guided version with 80 internet-based participants having at least hazardous use. Study 5 with 166 participants compared the high-intensity ePlus 13-week program to the unguided eChange program in a 13-week version, and a small wait-list control group. Results: Studies 1-5 are compared with one another in terms of baseline characteristics and results. Although inclusion criteria varied, baseline AUDIT levels out of a maximum of 40 points for studies 1-5 respectively were 20.82 (SD 6.93), 10.55 (3.90); 13.46 (4.69); 21.00 (4.90) and 23.70 (1.40). Within-group and between-group results are compared, showing greater effects for more intensive interventions. Conclusions: Effects vary by target groups, severity levels and interventions, but it is clear that digital interventions contribute to reduced problematic alcohol use.
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