Online randomised factorial trial of electronic Screening and Brief Intervention for alcohol use in pregnancy: a study protocol

INTRODUCTION: Approximately 1 in 7 pregnant women in the USA report past-month alcohol use. Strong evidence connects prenatal alcohol exposure with a range of adverse perinatal outcomes, including the spectrum of conditions known as fetal alcohol spectrum disorders. Screening and Brief Intervention (SBI) has been recommended for pregnant women but has proven difficult to implement. This study will test the efficacy of single-session technology-delivered SBI (electronic SBI) for alcohol use in pregnancy, while simultaneously evaluating the possible additional benefit of tailored text messages and/or booster sessions in a 3×2 factorial trial. METHOD AND ANALYSIS: This full factorial trial will use online advertising and clinic-based flyers to recruit pregnant women meeting criteria for unhealthy alcohol use, and randomly assign them to one of six conditions crossing three levels of brief intervention (none, single 120-minute session and single session plus two 5-minute boosters) with two levels of tailored text messaging (none vs twice weekly messages). The primary analysis will test for dose-response effects of the brief intervention on alcohol abstinence, defined as no self-report of alcohol use in the 90 days prior to 34 weeks\u27 gestation, and negative results for ethyl glucuronide analysis of fingernail samples. Secondary analyses will examine main and interaction effects of tailored text messaging as well as intervention effects on birth outcomes. ETHICS AND DISSEMINATION: Ethical approval was provided by the Michigan State University Biomedical and Health Institutional Review Board (STUDY00005298). Results will be presented at conferences and community forums, in addition to being published in a peer-reviewed journal. Intervention content demonstrating sufficient efficacy and safety will be made publicly available. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04332172)

Screening, Brief Intervention, and Referral to Treatment for Pain Management for Veterans Seeking Service-Connection Payments for Musculoskeletal Disorders: SBIRT-PM Study Protocol

BACKGROUND: Veterans with significant chronic pain from musculoskeletal disorders are at risk of substance misuse. Veterans whose condition is the result of military service may be eligible for a disability pension. Department of Veterans Affairs compensation examinations, which determine the degree of disability and whether it was connected to military service, represent an opportunity to engage Veterans in pain management and substance use treatments. A multisite randomized clinical trial is testing the effectiveness and cost-effectiveness of Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT-PM) for Veterans seeking compensation for musculoskeletal disorders. This telephone-based intervention is delivered through a hub-and-spoke configuration. DESIGN: This study is a two-arm, parallel-group, 36-week, multisite randomized controlled single-blind trial. It will randomize 1,100 Veterans experiencing pain and seeking service-connection for musculoskeletal disorders to either SBIRT-PM or usual care across eight New England VA medical centers. The study balances pragmatic with explanatory methodological features. Primary outcomes are pain severity and number of substances misused. Nonpharmacological pain management and substance use services utilization are tracked in the trial. SUMMARY: Early trial enrollment targets were met across sites. SBIRT-PM could help Veterans, at the time of their compensation claims, use multimodal pain treatments and reduce existing substance misuse. Strategies to address COVID-19 pandemic impacts on the SBIRT-PM protocol have been developed to maintain its pragmatic and exploratory integrity

Late Winter Biogeochemical Conditions Under Sea Ice in the Canadian High Arctic

With the Arctic summer sea-ice extent in decline, questions are arising as to how changes in sea-ice dynamics might affect biogeochemical cycling and phenomena such as carbon dioxide (CO2) uptake and ocean acidification. Recent field research in these areas has concentrated on biogeochemical and CO2 measurements during spring, summer or autumn, but there are few data for the winter or winter–spring transition, particularly in the High Arctic. Here, we present carbon and nutrient data within and under sea ice measured during the Catlin Arctic Survey, over 40 days in March and April 2010, off Ellef Ringnes Island (78° 43.11′ N, 104° 47.44′ W) in the Canadian High Arctic. Results show relatively low surface water (1–10 m) nitrate (<1.3 µM) and total inorganic carbon concentrations (mean±SD=2015±5.83 µmol kg−1), total alkalinity (mean±SD=2134±11.09 µmol kg−1) and under-ice pCO2sw (mean±SD=286±17 µatm). These surprisingly low wintertime carbon and nutrient conditions suggest that the outer Canadian Arctic Archipelago region is nitrate-limited on account of sluggish mixing among the multi-year ice regions of the High Arctic, which could temper the potential of widespread under-ice and open-water phytoplankton blooms later in the season

Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study

A41 Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study In: Addiction Science & Clinical Practice 2017, 12(Suppl 1): A4

Multi-Frequency Eddy Current Testing of Ferromagnetic Welds

Single frequency phase analysis eddy current techniques have limited potential for inspections for surface cracking in inhomogeneous ferromagnetic welded surfaces [1). Signals from these cracks are masked in noise produced by lift-off, probe wobble and local changes of the permeability of the weld, the most troublesome noise source. Surface cracks and changes in magnetic permeability create signals with phase angles that are too close to be discriminated from each other. Another method, in addition to phase discrimination, must be used to distinguish crack signals from signals created by changes in magnetic permeability. This paper explores the use of the comparison of phase and amplitude data from two probe frequencies to distinguish cracks from changes in local magnetic permeability.</p

Comparing Satisfaction, Alliance and Intervention Components in Electronically Delivered and In-person Brief Interventions for Substance Use Among Childbearing-Aged Women

Electronic delivery of Screening, Brief Intervention, and Referral to Treatment (e-SBIRT) may be a low-cost and high-reach method for screening and brief intervention in health care settings. However, its relative acceptability, ability to build a therapeutic alliance, and delivery of key intervention components compared to in-person SBIRT (SBIRT) is unclear. The association of these factors with intervention outcomes is also not known. We compared SBIRT and e-SBIRT on satisfaction, alliance, and receipt of intervention components, and evaluated the extent to which these intervention dimensions were related to later substance use. Data were collected as part of a randomized clinical trial (N = 439) examining SBIRT, e-SBIRT, and enhanced usual care for childbearing-aged women in two reproductive healthcare clinics (see Martino et al. (2018) for main trial findings). Participants receiving SBIRT or e-SBIRT (N = 270) rated satisfaction and alliance following a single-session, brief intervention, based on motivational interviewing that targeted hazardous substance use (tobacco, alcohol, illicit drugs and prescribed medications). Trained raters coded audio-recorded SBIRT sessions for the presence of six major intervention components, and evaluated the occurrence of these components in the e-SBIRT software. Overall, participants in both groups reported strong satisfaction (on average, “considerably” to “extremely” satisfied) and perceived working alliance (on average, “very often” to “always” allied). SBIRT participants provided higher overall alliance ratings, felt more encouraged to make their own decisions, and rated the intervention\u27s likely helpfulness to other women higher. Fewer e-SBIRT participants received intervention components focusing on personalized feedback, developing importance of and confidence in making changes to substance use, and developing a plan to change, compared to SBIRT participants. However, e-SBIRT participants were equally or more likely to receive components seeking to help them understand their use, discussing reasons for use, and summarizing and supporting what the patients elected to do. Notably, satisfaction, alliance, and number of intervention components received were not associated with total days of substance use. Although we found no evidence that the intervention characteristics evaluated in this study were associated with outcomes, acceptability and alliance may have other important implications. Findings suggest areas for improvement with respect to e-SBIRT satisfaction and alliance formation. ClinicalTrials.gov registration number: NCT0153952

Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: the role of built, socioeconomic, and social environments

Obesity prevalence among US children and adolescents has tripled in the past three decades. Consequently, dramatic increases in chronic disease incidence are expected, particularly among populations already experiencing health disparities. Recent evidence identifies characteristics of obesogenic neighborhood environments that affect weight and weight-related behaviors. This study aimed to examine associations between built, socioeconomic, and social characteristics of a child\u27s residential environment on body mass index (BMI), diet, and physical activity. We focused on pre-adolescent children living in New Haven, Connecticut to better understand neighborhood environments\u27 contribution to persistent health disparities. Participants were 1048 fifth and sixth grade students who completed school-based health surveys and physical measures in fall 2009. Student data were linked to US Census, parks, retailer, and crime data. Analyses were conducted using multilevel modeling. Property crimes and living further from a grocery store were associated with higher BMI. Students living within a 5-min walk of a fast food outlet had higher BMI, and those living in a tract with higher density of fast food outlets reported less frequent healthy eating and more frequent unhealthy eating. Students\u27 reported perceptions of access to parks, playgrounds, and gyms were associated with more frequent healthy eating and exercise. Students living in more affluent neighborhoods reported more frequent healthy eating, less unhealthy eating, and less screen time. Neighborhood social ties were positively associated with frequency of exercise. In conclusion, distinct domains of neighborhood environment characteristics were independently related to children\u27s BMI and health behaviors. Findings link healthy behaviors with built, social, and socioeconomic environment assets (access to parks, social ties, affluence), and unhealthy behaviors with built environment inhibitors (access to fast food outlets), suggesting neighborhood environments are an important level at which to intervene to prevent childhood obesity and its adverse consequences

eHealth literacy research:quo vadis?

Abstract The concept of electronic health (eHealth) literacy evolved from the social and information sciences and describes competencies necessary to use electronic health services. As it is a rather new topic, and as there is no current overview of the state of the art in research, it is not possible to identify research gaps. Therefore, the objective of this viewpoint article is to increase knowledge on the current state of the art of research in eHealth literacy and to identify gaps in scientific research which should be focused on by the research community in the future. The article provides a current viewpoint of the concept of eHealth literacy and related research. Gaps can be found in terms of a missing “gold standard” regarding both the definition and the measurement of eHealth literacy. Furthermore, there is a need for identifying the implications on eHealth developers, which evolve from the measurement of eHealth literacy in eHealth users. Finally, a stronger inclusion of health professionals, both in the evolving concept and in the measurement of eHealth literacy, is needed in the future

Feasibility and acceptability of a novel intervention to improve hand hygiene behavior in rural Liberian health facilities

Hand hygiene is central to the prevention of healthcare-associated infection. In low-income settings, barriers to health worker hand hygiene may include inconsistent availability of hand hygiene supplies at the point of care. However, there is a lack of knowledge of interventions to improve and sustain health worker hand hygiene in these settings. This pilot study evaluates acceptability and feasibility of a personally-worn hand hygiene holster device for improving point-of-care access to alcohol-based handrub (ABHR). Holsters were distributed to clinical staff at a hospital in Liberia in July–September 2021. Data collection included 2,066 structured observations of hand hygiene behavior, six spot checks of supply availability, and focus group discussions with 13 clinical staff. The Integrated Behavioral Model for Water, Sanitation, and Hygiene (IBM-WASH) provided a framework for study design and qualitative analysis. Acceptability of the intervention was high, with users reporting that holsters were comfortable, easy to use, and aligned with their professional identities. Feasibility depended on consistent ABHR availability, which may diminish sustainability of this intervention. The hand hygiene holster is a promising tool for improving health worker hand hygiene behavior, but solutions to ABHR supply chain and distribution constraints are necessary to support sustainability of this intervention. HIGHLIGHTS This pilot study evaluated the feasibility and acceptability of a hand hygiene holster device to improve access to point-of-care hand hygiene in Liberian health facilities.; Users reported satisfaction with holsters and many felt that this intervention made hand hygiene more accessible during patient care.; Further research should explore the impact of the holster intervention on health worker hand hygiene behavior.