An RCT of a decision aid to support informed choices about taking aspirin to prevent colorectal cancer and other chronic diseases: a study protocol for the SITA (Should I Take Aspirin?) trial.

BACKGROUND: Australian guidelines recommend that all people aged 50-70 years old actively consider taking daily low-dose aspirin (100-300 mg per day) for 2.5 to 5 years to reduce their risk of colorectal cancer (CRC). Despite the change of national CRC prevention guidelines, there has been no active implementation of the guidelines into clinical practice. We aim to test the efficacy of a health consultation and decision aid, using a novel expected frequency tree (EFT) to present the benefits and harms of low dose aspirin prior to a general practice consultation with patients aged 50-70 years, on informed decision-making and uptake of aspirin. METHODS: Approximately five to seven general practices in Victoria, Australia, will be recruited to participate. Patients 50-70 years old, attending an appointment with their general practitioner (GP) for any reason, will be invited to participate in the trial. Two hundred fifty-eight eligible participants will be randomly allocated 1:1 to intervention or active control arms using a computer-generated allocation sequence stratified by general practice, sex, and mode of trial delivery (face-to-face or teletrial). There are two co-primary outcomes: informed decision-making at 1-month post randomisation, measured by the Multi-dimensional Measure of Informed Choice (MMIC), and self-reported daily use of aspirin at 6 months. Secondary outcomes include decisional conflict at 1-month and other behavioural changes to reduce CRC risk at both time points. DISCUSSION: This trial will test the efficacy of novel methods for implementing national guidelines to support informed decision-making about taking aspirin in 50-70-year-olds to reduce the risk of CRC and other chronic diseases. TRIAL REGISTRATION: The Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001003965 . Registered on 10 October 2020

Mindfulness and Mantra Training for Disaster Mental Health Workers in the Philippines

Disaster mental health training programs have begun to include mindfulness instruction, though better understanding of providers’ mindfulness training expectancies and the differences that disaster exposure might make in their personal practice and clinical utilization of mindfulness is needed to support the feasibility and acceptability of this training in challenging disaster settings. This study examined training expectancies and utilization of a manualized mindfulness meditation and mantra program (Inner Resources for Stress) among N = 68 counselors and psychologists living in the Philippines beginning 12 weeks after Typhoon Haiyan. They attended a 4-h workshop conducted in Manila, Philippines, followed by an 8-week home study program. Following the workshop, a majority had high expectancies that the training would help with survivor and self-care. Higher disaster exposure (β = 0.32) and training expectancies (β = 0.25), but not baseline stress symptoms, were associated with higher perceived usefulness of the training for disaster work. Growth curve analyses demonstrated significantly different trajectories of weekly mindfulness practice for disaster-exposed versus nonexposed participants, with a flatter slope for disaster-exposed participants, though both groups had significant increases in practice time across the 8 weeks (d = 1.71). Higher total number of minutes of mindfulness practice was associated with lower depression severity (β = − 0.34), but not anxiety, at 8 weeks post-training. Participants perceived the training as credible and useful for disaster work and self-care and reported active personal and professional use of the techniques, suggesting that mindfulness training shows promise as a disaster intervention component