Correspondence between practitioners’ self-assessment and independent motivational interviewing treatment integrity ratings

As evaluation of practitioners’ competence is largely based on self-report, accuracy in practitioners’ self-assessment is essential for ensuring high quality treatment-delivery. The aim of this study was to assess the relationship between independent observers’ ratings and practitioners’ self-reported treatment integrity ratings of Motivational interviewing (MI). Practitioners (N = 134) were randomized to two types of supervision [i.e., regular institutional group supervision, or individual telephone supervision based on the MI Treatment Integrity (MITI) code]. The mean age was 43.2 years (SD = 10.2), and 62.7 percent were females. All sessions were recorded and evaluated with the MITI, and the MI skills were self-assessed with a questionnaire over a period of 12 months. The associations between self-reported and objectively assessed MI skills were overall weak, but increased slightly from baseline to the 12-months assessment. However, the self-ratings from the group that received monthly objective feedback were not more accurate than those participating in regular group supervision. These results expand findings from previous studies and have important implications for assessment of practitioners’ treatment fidelity: Practitioners may learn to improve the accuracy of self-assessment of competence, but to ensure that patients receive intended care, adherence and competence should be assessed objectively

Cognitive behavior therapy for obsessive-compulsive disorder in routine clinical care: A systematic review and meta-analysis

Cognitive behavioral therapy (CBT) has strong research support for obsessive-compulsive disorder (OCD). However, less is known about how CBT performs when delivered in routine clinical care. A systematic review and meta-analysis was conducted of CBT for OCD in adults treated in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were systematically searched for studies published until July 2021. The effectiveness of CBT, methodological quality, and moderators of treatment outcome were examined, and benchmarked by meta-analytically comparing with efficacy studies for OCD. Twenty-nine studies (8 randomized controlled trials) were included, comprising 1669 participants. Very large within-group effect sizes (ES) were obtained for OCD-severity at post-treatment (2.12), and follow-up (2.30), on average 15 months post-treatment. Remission rates were 59.2% post-treatment and 57.0% at follow-up. Attrition rate was 15.2%. Risk of bias was considerable in the majority of studies. The benchmarking analysis showed that effectiveness studies had almost exactly the same ES as efficacy studies at post-treatment and somewhat higher at follow-up. Furthermore, effectiveness studies had significantly higher remission rates than efficacy studies, both at post- and follow-up assessment. CBT for OCD is an effective treatment when delivered in routine clinical care, with ES comparable to those found in efficacy studies. However, the evidence needs to be interpreted with caution because of the risk of bias in a high proportion of studies.publishedVersio

Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol.

INTRODUCTION: Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity. METHODS AND ANALYSIS: Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the Transforming Obesity in CHILDren Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components. ETHICS AND DISSEMINATION: The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study's findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with key stakeholders. PROSPERO REGISTRATION NUMBER: CRD42020177408

Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity.

INTRODUCTION: Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of individual and trial-level subgroups. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups. METHODS AND ANALYSIS: Systematic searches of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo and trial registries for all ongoing and completed randomised controlled trials evaluating behavioural interventions for the prevention of early childhood obesity have been completed up to March 2021 and will be updated annually to include additional trials. Eligible trialists will be asked to share their IPD; if unavailable, aggregate data will be used where possible. An IPD meta-analysis and a nested prospective meta-analysis will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome will be body mass index z-score at age 24±6 months using WHO Growth Standards, and effect differences will be explored among prespecified individual and trial-level subgroups. Secondary outcomes include other child weight-related measures, infant feeding, dietary intake, physical activity, sedentary behaviours, sleep, parenting measures and adverse events. ETHICS AND DISSEMINATION: Approved by The University of Sydney Human Research Ethics Committee (2020/273) and Flinders University Social and Behavioural Research Ethics Committee (HREC CIA2133-1). Results will be relevant to clinicians, child health services, researchers, policy-makers and families, and will be disseminated via publications, presentations and media releases. PROSPERO REGISTRATION NUMBER: CRD42020177408

Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity

Introduction Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of intervention-covariate interactions. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups

Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol

Introduction Little is known about how early (e.g., commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to 1) characterise early obesity prevention interventions in terms of target behaviours, delivery features, and behaviour change techniques (BCTs), 2) explore similarities and differences in BCTs used to target behaviours, and 3) explore effectiveness of intervention components in preventing childhood obesity

Eating Disorders and Nutritional Beliefs, Trends or Practices

This Special Issue of Nutrients on “Eating disorders and nutritional beliefs, trends or practices” contains ten empirical papers that cover various aspects of the topic [...

Upplevelser av att leva med KOL

Bakgrund: Sjukdomen KOL är den tredje största sjukdomen i hela världen som ökar globalt. Sjukdomens förlopp, svårighetsgrader och begränsningar på grund av sjukdomen hos personer med KOL påverkar personens liv fysiskt, psykiskt och socialt. Syfte: Syftet med studien var att beskriva upplevelser av att leva med kroniskt obstruktiv lungsjukdom. Metod: Metoden som användes var en litteraturstudie med kvalitativ ansats som grundades på sex vetenskapliga artiklar. Artiklarna analyserades med hjälp av en innehållsanalys inspirerad av Forsberg och Wengström (2013). Resultat: Resultatet visade att upplevelser av att leva med KOL var starkt förknippade med andnöden som orsakade dödsångest och rädsla. Personerna med KOL upplevde även att de var begränsade i sin vardag till följd av sjukdomen samt att deras sociala liv förändrades. Slutsats. Personer som lever med KOL upplever ett stort lidande i sitt liv orsakat av sjukdomen. De känner ständig försämring och är medvetna om att sjukdomen kommer att progrediera. Genom att öka vårdpersonalens medvetenhet och förståelse för vad det innebär att leva med KOL kan det förbättra det vårdande mötet och ge personerna med KOL trygghet och stöd

Upplevelser av att leva med KOL

Bakgrund: Sjukdomen KOL är den tredje största sjukdomen i hela världen som ökar globalt. Sjukdomens förlopp, svårighetsgrader och begränsningar på grund av sjukdomen hos personer med KOL påverkar personens liv fysiskt, psykiskt och socialt. Syfte: Syftet med studien var att beskriva upplevelser av att leva med kroniskt obstruktiv lungsjukdom. Metod: Metoden som användes var en litteraturstudie med kvalitativ ansats som grundades på sex vetenskapliga artiklar. Artiklarna analyserades med hjälp av en innehållsanalys inspirerad av Forsberg och Wengström (2013). Resultat: Resultatet visade att upplevelser av att leva med KOL var starkt förknippade med andnöden som orsakade dödsångest och rädsla. Personerna med KOL upplevde även att de var begränsade i sin vardag till följd av sjukdomen samt att deras sociala liv förändrades. Slutsats. Personer som lever med KOL upplever ett stort lidande i sitt liv orsakat av sjukdomen. De känner ständig försämring och är medvetna om att sjukdomen kommer att progrediera. Genom att öka vårdpersonalens medvetenhet och förståelse för vad det innebär att leva med KOL kan det förbättra det vårdande mötet och ge personerna med KOL trygghet och stöd