Peer coaching through mHealth targeting physical activity in people with Parkinson disease: feasibility study

BACKGROUND: Long-term engagement in exercise and physical activity mitigates the progression of disability and increases quality of life in people with Parkinson disease (PD). Despite this, the vast majority of individuals with PD are sedentary. There is a critical need for a feasible, safe, acceptable, and effective method to assist those with PD to engage in active lifestyles. Peer coaching through mobile health (mHealth) may be a viable approach. OBJECTIVE: The purpose of this study was to develop a PD-specific peer coach training program and a remote peer-mentored walking program using mHealth technology with the goal of increasing physical activity in persons with PD. We set out to examine the feasibility, safety, and acceptability of the programs along with preliminary evidence of individual-level changes in walking activity, self-efficacy, and disability in the peer mentees. METHODS: A peer coach training program and a remote peer-mentored walking program using mHealth was developed and tested in 10 individuals with PD. We matched physically active persons with PD (peer coaches) with sedentary persons with PD (peer mentees), resulting in 5 dyads. Using both Web-based and in-person delivery methods, we trained the peer coaches in basic knowledge of PD, exercise, active listening, and motivational interviewing. Peer coaches and mentees wore FitBit Zip activity trackers and participated in daily walking over 8 weeks. Peer dyads interacted daily via the FitBit friends mobile app and weekly via telephone calls. Feasibility was determined by examining recruitment, participation, and retention rates. Safety was assessed by monitoring adverse events during the study period. Acceptability was assessed via satisfaction surveys. Individual-level changes in physical activity were examined relative to clinically important differences. RESULTS: Four out of the 5 peer pairs used the FitBit activity tracker and friends function without difficulty. A total of 4 of the 5 pairs completed the 8 weekly phone conversations. There were no adverse events over the course of the study. All peer coaches were "satisfied" or "very satisfied" with the training program, and all participants were "satisfied" or "very satisfied" with the peer-mentored walking program. All participants would recommend this program to others with PD. Increases in average steps per day exceeding the clinically important difference occurred in 4 out of the 5 mentees. CONCLUSIONS: Remote peer coaching using mHealth is feasible, safe, and acceptable for persons with PD. Peer coaching using mHealth technology may be a viable method to increase physical activity in individuals with PD. Larger controlled trials are necessary to examine the effectiveness of this approach.This study is supported by Boston Roybal Center for Active Lifestyle Interventions (RALI Boston), Grant #P30 AG048785, and the American Parkinson Disease Association, Massachusetts chapter. The authors would like to thank Nicole Sullivan, SOT, for her assistance with data management and data collection and Nick Wendel, DPT, for his assistance with data collection. Additionally, the authors would like to thank the participants in this study for their time, effort, and insights. (P30 AG048785 - Boston Roybal Center for Active Lifestyle Interventions (RALI Boston); American Parkinson Disease Association, Massachusetts chapter)Accepted manuscrip

The 45th Australasian Universities Building Education Association Conference: Global Challenges in a Disrupted World: Smart, Sustainable and Resilient Approaches in the Built Environment, Book of Abstracts, 23 - 25 November 2022

This is the book of abstract of the 45th Australasian Universities Building Education Association (AUBEA) conference, which will be hosted by Western Sydney University in November 2022. The conference is organised by the School of Engineering, Design, and Built Environment in collaboration with the Centre for Smart Modern Construction, Western Sydney University. This year’s conference theme is “Global Challenges in a Disrupted World: Smart, Sustainable and Resilient Approaches in the Built Environment”, and expects to publish over a hundred double-blind peer review papers under the proceedings

Waiting Room Health Promotion for Older Adults in Rural Primary Care

Background: Advances in health care technology have lead to adults living longer than in previous decades. Longer life expectancy in combination with the aging of the Baby Boomer generation is predicted to result in rapid and exponential growth among the older adult population. Adults in the U.S. over the age of 65 have on average five or more chronic illnesses, many of which are often poorly managed. Older adults who experience chronic diseases often report decreased quality of life, limitations in functional ability, loss of independence, and periods of decline and increasing disability. Health promotion efforts can help in delaying the onset of disability and preventing rapid decline associated with many chronic conditions. Purpose: The purpose of this project was to assess the effectiveness of the implementation of a brief waiting room health promotion activity that informs older adults about the benefits of walking, such as reducing the risk of chronic disease, improving mood, and maintaining weight, physical and cognitive function. This project took place at a federally qualified health center in Plainfield, Vermont. Methods: The target population for this educational intervention included patients, as well as family members and visitors to the primary care practice who were age 55 and older. All age-eligible participants were encouraged to participate regardless of health status or the presence of comorbid health conditions. The activity comprised of participants viewing a brief audiovisual educational activity explaining the health benefits of walking, supplemented with paper materials to support the health messages; the intervention was then followed by completion of a brief paper survey evaluation. Results: During the two-month period the health promotion activity was available, 56 individuals participated and completed the survey. Of the 56 participants, 87% indicated they either “strongly agreed” or “agreed” that watching the video increased knowledge about health-related benefits of walking. In total, approximately 73% of participants who participated in this health promotion activity agreed that they paid attention to educational materials in the waiting room setting. Approximately 57% of participants shared a health related goal that they created as a result of the health promotion activity. Conclusion: This project has suggested that implementation of waiting room health promotion activities, specifically for older adults, is a simple and cost-effective way to promote good health practices and provide patients with in-depth health care information that may not be addressed during the health care visit. Activities in the waiting room can help to supplement information provided during the clinical encounter, leaving patients more satisfied with their visits, and promoting positive behavior change

Playing it safe : A literature review and research agenda on motivational technologies in transportation safety

While motivation affects safety-related decision-making and human reliability, technologies to promote it are scarcely used. We have only recently witnessed how motivational technologies, including serious games, gamification, and persuasive technologies have emerged on the palette of methods for enhancing transportation safety. However, the research on these technologies for transportation safety is fragmented, preventing future studies and practical efforts. This paper describes the state-of-the-art through a systematic review to address this issue. Analyzing 62 studies, we perceive that motivational technologies focus on reducing the accident likelihood and mitigating their consequences. While these technologies can induce positive psychological change and improve learning, the evidence of behavioral change is mainly limited to simulation settings, lacking examination of the long-term benefits and potential adverse effects. Our results highlight the importance of aligning motivational design with the cognitive demand of the transportation task and the means for improving safety. Future research should explore how motivational technologies can enhance safety from the system design perspective, cover a broader scope of transportation modes, compare their effects to conventional approaches while considering social aspects in their design and evaluation. Beside providing an overview of the area and future directions, this paper also introduces design recommendations to guide practitioners.publishedVersionPeer reviewe

Serious Gaming for Behaviour Change: A Systematic Review

Over the years, there has been a significant increase in the adoption of game-based interventions for behaviour change associated with many fields such as health, education, and psychology. This is due to the significance of the players’ intrinsic motivation that is naturally generated to play games and the substantial impact they can have on players. Many review papers measure the effectiveness of the use of gaming on changing behaviours; however, these studies neglect the game features involved in the game design process, which have an impact of stimulating behaviour change. Therefore, this paper aimed to identify game design mechanics and features that are reported to commonly influence behaviour change during and/or after the interventions. This paper identified key theories of behaviour change that inform the game design process, providing insights that can be adopted by game designers for informing considerations on the use of game features for moderating behaviour in their own games

Innovations that Address Socioeconomic, Cultural, and Geographic Barriers to Preventive Oral Health Care

This report focuses on nine oral health innovations that integrate service delivery and workforce models in order to reduce or eliminate socioeconomic, geographic, and cultural barriers to care. Two additional reports in this series describe the remaining programs that provide care in non-dental settings and care to young children. Although the programs are diverse in their approaches as well as in the specific characteristics of the communities they serve, a common factor among them is the implementation of multiple strategies to increase the number of children from low-income families who access preventive care, and also to engage families and communities in investing in and prioritizing oral health. For low-income children and their families, the barriers that must be addressed to increase access to preventive oral health care are numerous. For example, even children covered by public insurance programs face a shortage of dentists that accept Medicaid and who specialize in pediatric dentistry.(Guay, 2004).The effects of poverty intersect with other barriers such as living in remote geographic areas and community-wide history of poor access to dental care in populations such as recent immigrants . Overcoming these barriers requires creative strategies that address transportation barriers; establish welcoming environments for oral health care; and are linguistically and culturally relevant. Each of these nine programs is based on such strategies, including:-Expanding the dental workforce through training new types of providers or adding new providers to their workforce to increase reach and community presence;-Implementing new strategies to increase the cost-effectiveness of care so that more oral health care services are available and accessible;-Providing training and technical assistance that increase opportunities for and competence in delivering oral health education and care to children;-Developing creative service delivery models that address transportation and cultural barriers as well as the fear and stigma associated with dental care that may arise in communities with historically poor access.The findings from the EAs of these programs are synthesized to highlight diverse and innovative strategies for overcoming barriers to access that have potential for rigorous evaluation that could emerge as best practices. If proven effective, these innovative program elements could then be disseminated and replicated to increase access for populations in need of preventive oral health care

Improving School Improvement

PREFACEIn opening this volume, you might be thinking:Is another book on school improvement really needed?Clearly our answer is yes. Our analyses of prevailing school improvement legislation, planning, and literature indicates fundamental deficiencies, especially with respect to enhancing equity of opportunity and closing the achievement gap.Here is what our work uniquely brings to policy and planning tables:(1) An expanded framework for school improvement – We highlight that moving from a two- to a three-component policy and practice framework is essential for closing the opportunity and achievement gaps. (That is, expanding from focusing primarily on instruction and management/government concerns by establishing a third primary component to improve how schools address barriers to learning and teaching.)(2) An emphasis on integrating a deep understanding of motivation – We underscore that concerns about engagement, management of behavior, school climate, equity of opportunity, and student outcomes require an up-to-date grasp of motivation and especially intrinsic motivation.(3) Clarification of the nature and scope of personalized teaching – We define personalization as the process of matching learner motivation and capabilities and stress that it is the learner's perception that determines whether the match is a good one.(4) A reframing of remediation and special education – We formulate these processes as personalized special assistance that is applied in and out of classrooms and practiced in a sequential and hierarchical manner.(5) A prototype for transforming student and learning supports – We provide a framework for a unified, comprehensive, and equitable system designed to address barriers to learning and teaching and re-engage disconnected students and families.(6) A reworking of the leadership structure for whole school improvement --We outline how the operational infrastructure can and must be realigned in keeping with a three component school improvement framework.(7) A systemic approach to enhancing school-community collaboration – We delineate a leadership role for schools in outreaching to communities in order to work on shared concerns through a formal collaborative operational infrastructure that enables weaving together resources to advance the work.(8) An expanded framework for school accountability – We reframe school accountability to ensure a balanced approach that accounts for a shift to a three component school improvement policy.(9) Guidance for substantive, scalable, and sustainable systemic changes –We frame mechanisms and discuss lessons learned related to facilitating fundamental systemic changes and replicating and sustaining them across a district.The frameworks and practices presented are based on our many years of work in schools and from efforts to enhance school-community collaboration. We incorporate insights from various theories and the large body of relevant research and from lessons learned and shared by many school leaders and staff who strive everyday to do their best for children.Our emphasis on new directions in no way is meant to demean current efforts. We know that the demands placed on those working in schools go well beyond what anyone should be asked to do. Given the current working conditions in many schools, our intent is to help make the hard work generate better results. To this end, we highlight new directions and systemic pathways for improving school outcomes.Some of what we propose is difficult to accomplish. Hopefully, the fact that there are schools, districts, and state agencies already trailblazing the way will engender a sense of hope and encouragement to those committed to innovation.It will be obvious that our work owes much to many. We are especially grateful to those who are pioneering major systemic changes across the country. These leaders and so many in the field have generously offered their insights and wisdom. And, of course, we are indebted to hundreds of scholars whose research and writing is a shared treasure. As always, we take this opportunity to thank Perry Nelson and the host of graduate and undergraduate students at UCLA who contribute so much to our work each day, and to the many young people and their families who continue to teach us all.Respectfully submitted for your consideration,Howard Adelman & Linda Taylo