Attitudes to Evidence-Based Interventions and Individual Readiness to Change in Maternity and Child Health Care: A Cross-Sectional Study Among Midwives and Public Health Nurses

ABSTRACT Background Integrating evidence-based interventions in services by midwives and public health nurses (PHNs) has the potential to improve public health. Attitudes and individual readiness to change can influence the implementation of evidence-based interventions, but there is limited research in community nursing and maternity and child health care services (MCHCs). Aims To examine attitudes toward evidence-based practice and readiness to change in midwives and PHNs in MCHCs before implementing the “Mamma Mia” intervention (an evidence-based intervention to improve maternal mental health). Methods A survey-based, multisite cross-sectional study following the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guideline. Data were collected from 190 midwives and PHNs from 42 MCHCs across 33 municipalities in Norway (2021–2022). Six subscales of the Evidence-Based Practice Attitude Scale (EBPAS) assessed attitudes toward evidence-based practice, and the Brief Individual Readiness for Change Scale (BIRCS) measured individual readiness. Descriptive and inferential statistics using frequency tables, Pearson correlation coefficient, and linear regression were used for data analysis. Open-ended responses were analyzed using content analysis. Results Sixty-five midwives and 125 PHNs completed the baseline survey (mean age 46.8, all female). Mean EBPAS subscales scores were 2.99 to 3.58 (SD = 0.46–0.77) mean BIRCS score was 3.16 (SD = 0.49) (possible range 0–4). Scores were slightly higher than typically reported in clinical settings, with no significant differences based on demographics (all p-values ≥ 0.166). EBPAS subscores and the BIRCS score showed a moderate positive association. The most frequently reported positive factors influencing readiness were “enhanced care and positive gain” (42.6%), “organizational support” (26.3%), and “receiving training and implementation support” (23.2%). Negative factors included “time constraints and workload” (58.4%), and “research participation and implementation demands” (27.9%). Linking Evidence to Action Midwives and PHNs showed positive attitudes toward EBP and a high degree of individual readiness. Our findings align with previous research highlighting barriers such as time constraints and workload, offering insights to inform strategies for more effective EBP adoption and implementation. These results can guide nurse managers, administrators, policymakers, professional associations, implementers, and intervention developers in enhancing EBP integration into practice

‘Devoted Despite It All’: Norwegian Child Welfare Workers' Experiences of Implementing a Therapeutic Model for Adolescents With Co-Occurring Problems

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School children’s mental health during the COVID-19 pandemic

Introduction: The COVID-19 pandemic significantly impacted the daily routines of children, with social distancing and quarantine leading to reduced social interactions and potential increased conflicts within families. These factors can increase the risk for anxiety and depression while reducing overall quality of life. Methods: Our study included 1843 school children aged 8 to 12 from 56 schools over a 2.5-year period before and during the pandemic. This multi-wave cross-sectional study utilized baseline data from an optimization trial of an indicated preventive intervention. The main outcomes were self-reported symptoms of anxiety and depression, and quality of life was the secondary outcome measure. Furthermore, responses to COVID-relevant questions were measured using a self-composed scale. Our objectives were to compare anxiety and depression symptom levels between cohorts of children who participated in the study before and during the pandemic, to examine if anxiety or depression predicted the COVID response, and whether anxiety and depression and subtypes of anxiety had an impact on quality of life during the pandemic. Linear regression and interaction models were used to examine relevant associations. Results: Levels of anxiety and depression were higher in all waves compared to pre-pandemic levels. Quality of life was lower during the pandemic than before the pandemic, particularly among children with generalized anxiety symptoms. Quality of life was negatively associated with loneliness. Discussion: Our study revealed that children reported higher anxious and depressive symptoms during the pandemic compared to pre-pandemic levels, as well as reduced quality of life. Lockdowns and restrictions may have contributed to this burden. Additionally, self-reported loneliness was a significant possible consequence of the restrictive measures imposed on children during the pandemic. Additional research is needed to investigate the long-term effects of the pandemic on children, particularly regarding the stability of elevated levels of anxiety and depression. Such studies could examine whether these conditions are indicative of a trajectory toward more severe internalizing disorders.School children’s mental health during the COVID-19 pandemicpublishedVersio

Optimizing indicated cognitive behavioral therapy to prevent child anxiety and depression: A cluster-randomized factorial trial

Identifying effective components can lead to interventions that are less resource-intensive and better suited for real-world needs. In this 2×2×2 cluster-randomized factorial trial (clinicaltrials.gov NCT04263558), we investigated the effects of three components of an indicated, transdiagnostic CBT intervention for children: 1) Intervention Delivery Format (child group format versus a blended format with group sessions and automated web-based sessions), 2) Parental Involvement in the intervention (group-based versus psychoeducational brochure), and 3) a Measurement Feedback System (MFS; on versus off). The intervention was delivered at schools in a group-based format. The participants (N = 701 children) were school children (age 8–12 years) with elevated symptoms of anxiety or depression, and their parents. The main outcomes were self-reported (N = 633) and parent-reported (N = 725) symptoms of child anxiety and depression post-intervention. The secondary outcome was children's user satisfaction with the intervention. We did not find significant main or interaction effects of Delivery Format, Parental Involvement, or MFS on children's symptom levels. There were no significant effects on children's user satisfaction. Results were compatible with retaining the least resource intensive combination (i.e., blended format, parental brochure, no MFS) in an optimized intervention.Optimizing indicated cognitive behavioral therapy to prevent child anxiety and depression: A cluster-randomized factorial trialpublishedVersio

Måleegenskaper ved den norske versjonen av Assessment, Intervention and Moving On (AIM3); utredningsmodellen

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Effect of Psychosocial Interventions on Children and Youth Emotion Regulation: A Meta-Analysis

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Kunnskapsoppsummering og klassifisering av tiltaket: Flyt

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Process and Implementation Elements of Measurement Feedback Systems: A Systematic Review

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Dropout or Drop-In Experiences in an Internet-Delivered Intervention to Prevent Depression and Enhance Subjective Well-Being During the Perinatal Period: Qualitative Study

Background: The perinatal period is a vulnerable time when women are at increased risk of depression. “Mamma Mia” is a universal preventive internet-delivered intervention offered to pregnant women, with the primary goals of preventing the onset or worsening of depression and enhancing subjective well-being during the perinatal period. However, treatment dropout from internet-delivered interventions is often reported. Objective: The study aim was to acquire an understanding of the different experiences among participants who dropped out of the Mamma Mia intervention during pregnancy, compared to participants who dropped out during the postpartum follow-up phase. Methods: A total of 16 women from a larger randomized controlled trial (Mamma Mia) participated in individual semistructured interviews following a strengths, weaknesses, opportunities, and threats format. Of the 16 participants included, 8 (50%) women dropped out early from the intervention during pregnancy (pregnancy group), whereas 8 (50%) women dropped out later, after giving birth (postpartum follow-up group). Data were analyzed using the framework approach. Results: The results showed that there were differences between the groups. In general, more participants in the postpartum follow-up group reported that the program was user-friendly. They became more aware of their own thoughts and feelings and perceived that the program had provided them with more new knowledge and practical information than participants in the pregnancy group. Participants in both groups suggested several opportunities for improving the program. Conclusions: There were differences between women who dropped out of the intervention during pregnancy and the postpartum follow-up phase. The reported differences between groups should be further examined.Dropout or Drop-In Experiences in an Internet-Delivered Intervention to Prevent Depression and Enhance Subjective Well-Being During the Perinatal Period: Qualitative StudypublishedVersio

Måleegenskaper ved den norske versjonen av Autism Spectrum Screening Questionnaire (ASSQ)

Autism Spectrum Screening Questionnaire (ASSQ) ble publisert i 1999 av Ehlers, Gillberg og Wing. og er oversatt til norsk av Anita Eriksson og Anne Mari Sund. Testen er utviklet for å være et screeningverktøy for å identifisere barn med mulig autismespekterforstyrrelse, beregnet på utfylling fra voksne informanter som kjenner barnet godt. ASSQ har en enkelt hovedskala og anbefalte grenseverdier (indikasjon på mulig autisme) for lærere og foreldre. Testen består av 27 ledd og det er ingen formelle kompetansekrav for bruk eller tolkning. Litteratursøk resulterte i 121 treff, hvorav 21 norske og 9 svenske eller danske artikler ble inkludert. Disse inneholdt dokumentasjon på interraterreliabilitet, begrepsvaliditet, kriterievaliditet, diskriminant validitet og normer for en avgrenset aldersgruppe. Det ble funnet middelverdier for ulike kliniske grupper (autisme, cerebral parese, nevrologiske tilstander, premature barn, barn av mødre med rusmisbruk eller røyking i svangerskapet). ASSQ har utmerket test-retest reliabilitet. Testens begrepsvaliditet synes å være tilfredsstillende, selv om det er behov for mer forskning på testens konvergerende og diskriminerende validitet. ASSQ synes å ha gode egenskaper som klinisk screeningverktøy i den forstand at lærer- eller foreldrerapporterte skårer over grenseverdi indikerer mulig autismespekterforstyrrelse som bør utredes nærmere av en kliniker. Ved bruk i forskningsprosjekter er det usikkert hvor treffsikkert det er å bruke skåre over klinisk grenseverdi som proxy for diagnostisert autisme da det blir mange falske positive uten at testresultatene suppleres med en grundig diagnostisk vurdering. Validiteten til det å bruke totalskåren som et kontinuerlig mål på hvor en befinner seg på autismespekteret er også usikkert.publishedVersio