Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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Decreasing Caregiver Stress

Stress is both critical and personal experience and has significant effects on caregivers’ physical, mental, and social well-being. The nature of caregiving and the responsibility to work and serve individuals at their illness conditions are very personal encounters that often result in adverse effects on the health and well-being of caregivers (Frederick, 2016). A decrease in stress experience can lead to the satisfaction of caregiver roles and improvement of patient’s quality of life (Choi, Jisun & Boyle, Diane, 2013; Yada, Nagata, & Inagaki, 2014). This scholarly project determined that evidence-based stress management interventions have decreased the perceived stress in caregivers. The scholarly project identified low levels of stress among research participants, and how evidence-based interventions decreased caregiver stress by increasing their knowledge and awareness of evidence-based stress management interventions. The results of this scholarly project agree with the literature that caregiver stress experience can be decreased through the implementation of evidence-based stress management interventions (Blom, Zarit, Groot Zwaaftink, Cuijpers, & Pot, 2013). It is significant to implement evidence-based stress management interventions to decrease perceived stress among caregivers

Mental Disorders and Medical Comorbidity

Presents findings on factors behind the prevalence of patients with both mental and medical conditions; mortality, quality of care, and cost burdens; and evidence-based treatment approaches, including self-management support. Outlines policy implications

Effects of post-abortion family planning services on contraceptive practices in China : protocol for a clustered randomized controlled trial

Study objectives: To determine whether integrating post-abortion services in hospital settings in China will increase the contraceptive use and decrease repeat abortion rates. Study design: Three-arms cluster randomised controlled trial in which the unit of randomisation is hospital. Participants: Women seeking induced abortion within 12 weeks of gestation age. Sites: Ninety hospitals from 30 provinces in China will be randomised to the three arms of the study stratified by province. In each province, eligible hospitals will be matched on the characteristics of abortion departments, especially the volume of abortions in the 2 months in the situation survey. Length of follow up: Six months. Intervention: Multiple interventions that aim to increase the use of more effective contraceptive methods, improve user adherence to reduce the unintended pregnancies and repeat induced abortions. Data collection: Data will be collected at four time points, one at baseline(month 0 at the time of enrolment) and twice during intervention (1st 3rd and 6th month after enrolment, respectively). Primary outcome: Unintended pregnancies or repeated induced abortions; immediate contraceptive uptake and the use of modern effective contraceptive methods

Integration of substance use disorder services with primary care: health center surveys and qualitative interviews.

BackgroundEach year, nearly 20 million Americans with alcohol or illicit drug dependence do not receive treatment. The Affordable Care Act and parity laws are expected to result in increased access to treatment through integration of substance use disorder (SUD) services with primary care. However, relatively little research exists on the integration of SUD services into primary care settings. Our goal was to assess SUD service integration in California primary care settings and to identify the practice and policy facilitators and barriers encountered by providers who have attempted to integrate these services.MethodsPrimary survey and qualitative interview data were collected from the population of federally qualified health centers (FQHCs) in five California counties known to be engaged in SUD integration efforts was surveyed. From among the organizations that responded to the survey (78% response rate), four were purposively sampled based on their level of integration. Interviews were conducted with management, staff, and patients (n=18) from these organizations to collect further qualitative information on the barriers and facilitators of integration.ResultsCompared to mental health services, there was a trend for SUD services to be less integrated with primary care, and SUD services were rated significantly less effective. The perceived difference in effectiveness appeared to be due to provider training. Policy suggestions included expanding the SUD workforce that can bill Medicaid, allowing same-day billing of two services, facilitating easier reimbursement for medications, developing the workforce, and increasing community SUD specialty care capacity.ConclusionsEfforts to integrate SUD services with primary care face significant barriers, many of which arise at the policy level and are addressable

Addressing the Health Needs of an Aging America: New Opportunities for Evidence-Based Policy Solutions

This report systematically maps research findings to policy proposals intended to improve the health of the elderly. The study identified promising evidence-based policies, like those supporting prevention and care coordination, as well as areas where the research evidence is strong but policy activity is low, such as patient self-management and palliative care. Future work of the Stern Center will focus on these topics as well as long-term care financing, the health care workforce, and the role of family caregivers

Evaluating the impact of physical activity apps and wearables: interdisciplinary review

Background: Although many smartphone apps and wearables have been designed to improve physical activity, their rapidly evolving nature and complexity present challenges for evaluating their impact. Traditional methodologies, such as randomized controlled trials (RCTs), can be slow. To keep pace with rapid technological development, evaluations of mobile health technologies must be efficient. Rapid alternative research designs have been proposed, and efficient in-app data collection methods, including in-device sensors and device-generated logs, are available. Along with effectiveness, it is important to measure engagement (ie, users’ interaction and usage behavior) and acceptability (ie, users’ subjective perceptions and experiences) to help explain how and why apps and wearables work. Objectives: This study aimed to (1) explore the extent to which evaluations of physical activity apps and wearables: employ rapid research designs; assess engagement, acceptability, as well as effectiveness; use efficient data collection methods; and (2) describe which dimensions of engagement and acceptability are assessed. Method: An interdisciplinary scoping review using 8 databases from health and computing sciences. Included studies measured physical activity, and evaluated physical activity apps or wearables that provided sensor-based feedback. Results were analyzed using descriptive numerical summaries, chi-square testing, and qualitative thematic analysis. Results: A total of 1829 abstracts were screened, and 858 articles read in full. Of 111 included studies, 61 (55.0%) were published between 2015 and 2017. Most (55.0%, 61/111) were RCTs, and only 2 studies (1.8%) used rapid research designs: 1 single-case design and 1 multiphase optimization strategy. Other research designs included 23 (22.5%) repeated measures designs, 11 (9.9%) nonrandomized group designs, 10 (9.0%) case studies, and 4 (3.6%) observational studies. Less than one-third of the studies (32.0%, 35/111) investigated effectiveness, engagement, and acceptability together. To measure physical activity, most studies (90.1%, 101/111) employed sensors (either in-device [67.6%, 75/111] or external [23.4%, 26/111]). RCTs were more likely to employ external sensors (accelerometers: P=.005). Studies that assessed engagement (52.3%, 58/111) mostly used device-generated logs (91%, 53/58) to measure the frequency, depth, and length of engagement. Studies that assessed acceptability (57.7%, 64/111) most often used questionnaires (64%, 42/64) and/or qualitative methods (53%, 34/64) to explore appreciation, perceived effectiveness and usefulness, satisfaction, intention to continue use, and social acceptability. Some studies (14.4%, 16/111) assessed dimensions more closely related to usability (ie, burden of sensor wear and use, interface complexity, and perceived technical performance). Conclusions: The rapid increase of research into the impact of physical activity apps and wearables means that evaluation guidelines are urgently needed to promote efficiency through the use of rapid research designs, in-device sensors and user-logs to assess effectiveness, engagement, and acceptability. Screening articles was time-consuming because reporting across health and computing sciences lacked standardization. Reporting guidelines are therefore needed to facilitate the synthesis of evidence across disciplines

A systematic review of school-based alcohol and other drug prevention programs

Background: Alcohol use in adolescents constitutes a major public health concern. Europe is the heaviest drinking region of the world. Several school-based alcohol prevention programs have been developed but it is not clear whether they are really effective. The present study was aimed at identifying the typology with the best evidence of effectiveness in European studies. Methods: A systematic search of meta-analyses and/or randomized controlled trials (RCTs) on interventions school-based prevention programs aimed at preventing alcohol consumption or changing the attitudes to consume alcohol. Results: A meta-analysis published in 2011 and 12 RCTs more recently published were identified. The meta-analysis evaluated 53 RCTs but only 11.3% of them were conducted in Europe. Globally, 23 RCTs (43.4%) showed some evidence of effectiveness, and 30 RCTs (56.6%) did not find significant difference between the groups. According to the conclusions of the meta-analysis, the Unplugged program should be considered as a practice option in Europe. Among the other 12 RCTs, 42% were conducted in Europe. Globally, 7 studies (58.3%) achieved positive results, and 5 studies (41.7%) did not find significant differences or produced a mixed pattern of results. Three of the 5 European trials (60%) used the Unplugged program with positive results. Conclusion: Even if further studies should be conducted to confirm these results, Unplugged appears to be the prevention project with the best evidence of effectiveness in European studies