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The study applies the Family Stress Model to examine the impact of an integrated intervention on the mental health of children facing chronic adversity in Burkina Faso. Its primary goal is to enhance understanding of individual and relational factors at the family level as mediators and specific mechanisms through which poverty reduction can impact child well-being. Cross-lagged autoregressive longitudinal mediation analyses tested the intervention effect on child mental health, examining maternal depression, maternal anxiety, harsh parenting, and child exposure to abuse as potential mediators. Longitudinal data were collected over the course of 24 months in a cluster-randomized controlled trial conducted among 360 dyads (children aged 10–15 and their female caregivers) in Burkina Faso. Participants were randomized into a control arm, economic intervention using the Graduation approach (Treatment Arm 1), or a combination of economic strengthening and family coaching (Treatment Arm 2). In Treatment Arm 1, maternal depression fully mediated the intervention effect on child's depression (B = −0.09, 95% confidence interval [CI] from −0.26 to −0.003) and child's self-esteem (B = 0.05, 95% CI from 0.001–0.18). In Treatment Arm 2, violent parenting practices partially mediated the intervention effect on child's depression (B = −0.08, 95% CI from −0.29 to −0.01). Our study underscores the importance of multifaceted interventions merging economic empowerment with family-focused child protection strategies. This approach fosters a supportive family environment, reducing children's vulnerability to mental health issues in resource-poor communities. It enriches our understanding of how parental economic and behavioral interventions impact child mental health outcomes. [ABSTRACT FROM AUTHOR]

The aim of this study is to expand the current knowledge on the relationship between poverty, family functioning, and the mental health of adolescent girls in families affected by poverty and HIV/AIDS in southern Uganda. The study investigates the association between family functioning and mental health and examines whether family functioning moderates the intervention effect on adolescent mental health. Longitudinal data were collected over the course of 24 months in a cluster randomized controlled trial conducted among N=1,260 girls aged 14–17 years in Uganda. Participants were randomized into control group (n=408 girls from n=16 schools), matched youth development accounts treatment, YDA (n=471 girls from n=16 schools), and integrated intervention combining YDA with multiple family group component (n=381 girls from n=15 schools). We found a significant positive association between family functioning and mental health of adolescent girls in our sample. Moderator analyses suggests that effect of the intervention on Beck Hopelessness Scale was significantly moderated by family cohesion (χ2 (4) =21.43; p =.000), frequency of family communication (χ2 (4) =9.65; p =.047), and quality of child-caregiver relationship (χ2 (4) =11.12; p =.025). Additionally, the intervention effect on depression was moderated by the comfort of family communication (χ2 (4) =10.2; p =.037). The study findings highlight the importance of family functioning when examining the link from poverty to adolescent mental health. The study contributes to the scarce evidence suggesting that asset-accumulation opportunities combined with a family strengthening component may improve parenting practices and adolescent mental health in poor households. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? We investigated the effects of a 9-month community-based multidomain intervention of mindfulness meditation, cognitive training, exercise, and nutrition counseling on improving cognition compared to controls for Chinese older adults having risks of cognitive decline. • What is the main finding of this study? Multidomain intervention had immediate benefits on improving cognitive performance measured by objective assessments and subjective cognitive abilities relative to the control, and the benefits on subjective cognitive abilities were retained for 1 year after the completion of the intervention. • What is the meaning of the finding? Multidomain intervention that targeted multiple predictors of cognitive decline can have immediate benefits on improving cognitive performance for older adults at risk of cognitive decline. Long-term effects on cognition and individual differences in response to the intervention deserve further investigation. We sought to assess cognitive benefits of a community-based multidomain intervention for improving cognition among older adults at risk of cognitive decline (COMBAT). A two-armed cluster-randomized controlled trial. Community-dwelling older adults aged 60 years or older and were at risk of cognitive decline (n = 209). In this 9-month intervention study, 10 community hospitals in Beijing, China, were randomized (1:1) to receive either a multidomain intervention of meditation, cognitive training, exercise, and nutrition counseling or usual care. The intervention was delivered with weekly 1-hour group training sessions and weekly home homework. Primary outcome was change in cognition as measured by a composite Z score of seven cognitive tests. Secondary outcomes included subjective cognitive abilities, positive and negative affective experiences, physical activity, and dietary habits. Assessments were administered at baseline, end of the intervention, and 1 year after completing the intervention (1-year follow-up). Immediately after the intervention, the intervention group showed significant enhancement in cognitive performance (p = 0.026). The between-group difference in the Z score of change of cognition was 0.20 (95% CI: 0.053, 0.35), with a Hedges' g of 0.40 (95% CI: 0.29, 0.50). However, this cognitive benefit was not significant at 1-year follow-up. This multidomain intervention was effective to improve cognition for at-risk individuals. Long-term effects on cognitive function and individual differences in response to the intervention deserve further investigation. [ABSTRACT FROM AUTHOR]

Introduction  There is some evidence that homeopathic treatment has been used successfully in previous epidemics, and currently some countries are testing homeoprophylaxis for the coronavirus disease 2019 (COVID-19) pandemic. There is a strong tradition of homeopathic treatment in India: therefore, we decided to compare three different homeopathic medicines against placebo in prevention of COVID-19 infections. Methods  In this double-blind, cluster-randomized, placebo-controlled, four parallel arms, community-based, clinical trial, a 20,000-person sample of the population residing in Ward Number 57 of the Tangra area, Kolkata, was randomized in a 1:1:1:1 ratio of clusters to receive one of three homeopathic medicines (Bryonia alba 30cH, Gelsemium sempervirens 30cH, Phosphorus 30cH) or identical-looking placebo, for 3 (children) or 6 (adults) days. All the participants, who were aged 5 to 75 years, received ascorbic acid (vitamin C) tablets of 500 mg, once per day for 6 days. In addition, instructions on healthy diet and general hygienic measures, including hand washing, social distancing and proper use of mask and gloves, were given to all the participants. Results  No new confirmed COVID-19 cases were diagnosed in the target population during the follow-up timeframe of 1 month—December 20, 2020 to January 19, 2021—thus making the trial inconclusive. The Phosphorus group had the least exposure to COVID-19 compared with the other groups. In comparison with placebo, the occurrence of unconfirmed COVID-19 cases was significantly less in the Phosphorus group (week 1: odds ratio [OR], 0.1; 95% confidence interval [CI], 0.06 to 0.16; week 2: OR, 0.004; 95% CI, 0.0002 to 0.06; week 3: OR, 0.007; 95% CI, 0.0004 to 0.11; week 4: OR, 0.009; 95% CI, 0.0006 to 0.14), but not in the Bryonia or Gelsemium groups. Conclusion  Overall, the trial was inconclusive. The possible effect exerted by Phosphorus necessitates further investigation. Trial registration:  CTRI/2020/11/029265. [ABSTRACT FROM AUTHOR]

Objective: To examine the medium-term effects of a group intervention combining exercise and cognitive-behavioral strategies (EC) on older adults with chronic pain. Method: One hundred and fifty-two Hong Kong Chinese older adults with chronic pain affecting bones, muscles, and joints were randomized by clinic/social center to receive 10 weekly sessions of EC or pain education (control). The primary (pain intensity) and secondary outcomes (pain disability, pain self-efficacy, pain catastrophizing, pain coping, depressive symptoms, health-related quality of life, and hip and knee strength) were collected at baseline (T1), postintervention (T2), and 3- (T3) and 6-month follow-ups (T4). The trajectories of intervention effects were modeled by EC × time and EC × time2 interaction terms in mixed-effects regression. Results: Significant EC × time and/or EC × time2 interactions were found for pain intensity, pain disability, self-efficacy, and catastrophizing, such that the treatment effect leveled off (pain disability) or diminished (pain intensity and catastrophizing) over time, or continued to increase in a linear fashion (self-efficacy). There was also a treatment main effect on hip/knee muscle strength. Group differences in favor of EC were observed up to 3-month follow-up for pain intensity (d = −0.51) and hip/knee muscle strength (d = 0.38), and up to 6-month follow-up for pain disability (d = −0.60) and self-efficacy (d = 0.52). No group difference was found for catastrophizing at any time point. No treatment effects were found for the other outcomes. Conclusion: Older people suffering from chronic pain can benefit from a program incorporating both cognitive-behavioral techniques and physical exercise. What is the public health significance of this article?: Studies on nonpharmacological methods for older people with chronic pain are lacking. This randomized controlled trial provides support for integrating cognitive-behavioral methods with physical exercise in the self-management of chronic pain by older people. The alleviation of pain and its sequelae such as disability through a structured time-limited program that is easy to implement in diverse clinical and service settings can have large public health benefits given the prevalence of chronic pain in aging populations. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effects of the group benefit-finding therapeutic intervention (BFT) for Alzheimer family caregivers up to 10-month follow-up.Methods: This was a cluster-randomized double-blind controlled trial in social centers and clinics. Participants included 129 caregivers. Inclusion criteria were 1) primary caregiver aged 18 years and older and without cognitive impairment, 2) providing 14 or more care hours per week to a relative with mild-to-moderate Alzheimer disease, and 3) scoring 3 or more on the Hamilton Depression Rating Scale. Exclusion criterion was care-recipient having parkinsonism or other forms of dementia. BFT (using cognitive reappraisal to find positive meanings) was evaluated against two forms of psychoeducation as controls-standard and simplified (lectures only) psychoeducation. All interventions had eight weekly sessions of 2 hours each. Primary outcome was depressive symptoms, whereas secondary outcomes were global burden, role overload, and psychological well-being. Measures were collected at baseline, postintervention, and 4- and 10-month follow-up.Results: Mixed-effects regression showed that BFT's effect on depressive symptoms conformed to a curvilinear pattern, in which the strong initial effect leveled out after postintervention and was maintained up to 10-month follow-up; this was true when compared against either control group. The effect on global burden was less impressive but moderate effect sizes were found at the two follow-ups. For psychological well-being, there was an increase in the BFT group at 4-month follow-up and a return to baseline afterward. No effect on role overload was found.Conclusion: Benefit-finding reduces depressive symptoms as well as global burden in the long-term and increases psychological well-being in the medium-term. [ABSTRACT FROM AUTHOR]

Scant research has investigated whether health promotion interventions have sustained effects in increasing physical activity and healthful diet among adolescents in sub-Saharan Africa, which is experiencing an epidemiological transition from infectious diseases to noncommunicable diseases as leading causes of mortality. We examined whether an intervention increased adherence to 5-a-day diet and physical activity guidelines during a 54-month postintervention period among South African adolescents and whether its effects weakened at long-term (42 and 54 months postintervention) compared with short-term (3, 6, and 12 months postintervention) follow-up. We randomized 18 randomly selected schools serving grade 6 learners (mean age = 12.6) in a township and a semirural area in Eastern Cape Province, South Africa, to one of the two 12-hour interventions: health promotion, targeting healthful diet and physical activity; attention-matched control, targeting sexual risk behaviors. We tested the intervention's effects on adherence to 5-a-day diet and physical activity guidelines using generalized estimating equations logistic regression models adjusting for baseline behavior and clustering within schools. Health promotion intervention participants had higher odds of meeting 5-a-day diet and physical activity guidelines than control participants. The effect on 5-a-day diet did not weaken at long-term compared with short-term follow-up, but the effect on physical activity guidelines was weaker at long-term follow-up, mainly because of a reduced effect on muscle-strengthening physical activity. The intervention also increased health promotion attitude and intention and health knowledge and reduced binge drinking compared with the control group. A 12-hour intervention in grade 6 shows promise in increasing self-reported adherence to healthful diet and physical activity guidelines during a 4.5-year postintervention period among South African adolescents. [ABSTRACT FROM AUTHOR]

Objectives: To test the long-term effects of the 12-month Healthy Beat Acupunch (HBA) exercise program on the self-perceived health and sleep quality of older adults in community care centers, and to compare the effects of two delivery methods: instructor-led HBA for the first 6 months and DVD-guided HBA for another 6 months.Design: Cluster-randomized controlled trial.Setting: Eight community care centers.Participants: In total, 232 participants were recruited from eight community care centers, and cluster-randomized to the experimental (4 centers, N = 113) and control (4 centers, N = 119) groups.Intervention: The experimental group received the instructor-led HBA program 3 times weekly for the first 6 months, followed by the DVD-guided HBA program for another 6 months.Measurements: Self-perceived health and sleep quality were assessed using the Short Form Health Survey and the Pittsburgh Sleep Quality Index, respectively, at baseline and every 3 months for 1 year.Results: The experimental group reported more favorable self-perceived physical and mental health, higher subjective sleep quality, and less daytime dysfunction than did the control group. Effect sizes of physical health and sleep quality increased from the instructor-led stage to the DVD-guided stage; the effect size of physical health showed the most significant change, increasing from 0.38 in the instructor-led stage to 0.55 in the DVD-guided stage.Conclusions: The exercise program consisting of the instructor-led class, followed by the DVD-guided class, was an effective and feasible longitudinal program for older adults in community care centers. [ABSTRACT FROM AUTHOR]

The article presents research which found that mental and physical activities such as mahjong and tai chi can delay cognitive decline in some dementia patients. The article notes 110 older nursing home residents participated in the study which used the Mini-Mental State Examination to evaluate primary and secondary outcomes which include immediate/delayed recall and digit span.

Objectives: To examine whether leisure activities can alleviate depressive symptoms among nursing home residents with very mild to mild dementia. Methods: A cluster-randomized open-label controlled design. Thirty-six residents with at least moderate depressive symptoms were randomized by home into three conditions--mahjong (a.k.a. mah-jongg), tai chg and handicrafts (placebo). Activities were conducted three times weekly for 12 weeks. Outcome measure was Geriatric Depression Scale (GDS) administered at baseline, posttreatment, and at 6 months. Results: Repeated-measures analysis of variance showed a group by time interaction on the GDS. Unlike control and tai chi participants whose scores remained relatively unchanged, the mahjong group reported a drop of 3.25 points (95% confidence interval: 1.00-5.50) on the GDS at posttreatment but gained back 2.83 points (95% confidence interval: 1.95-5.47) at 6 months. Activity discontinuation might be the reason for depression to return to baseline. Conclusions: Mahjong can lower depressive symptoms in those with mild dementia, but activity maintenance may be essential for long-term effects. [ABSTRACT FROM AUTHOR]

Background: Research has so far benefited from the use of pedometers in physical activity interventions. However, when public health institutions (eg, insurance companies) implement pedometer-based interventions in practice, people may refrain from participating due to privacy concerns. This might greatly limit the applicability of such interventions. Financial incentives have been successfully used to influence both health behavior and privacy concerns, and may thus have a beneficial effect on the acceptance of pedometer-based interventions. Objective: This paper presents the design and baseline characteristics of a cluster-randomized controlled trial that seeks to examine the effect of financial incentives on the acceptance of and adherence to a pedometer-based physical activity intervention offered by a health insurance company. Methods: More than 18,000 customers of a large Swiss health insurance company were allocated to a financial incentive, a charitable incentive, or a control group and invited to participate in a health prevention program. Participants used a pedometer to track their daily physical activity over the course of 6 months. A Web-based questionnaire was administered at the beginning and at the end of the intervention and additional data was provided by the insurance company. The primary outcome of the study will be the participation rate, secondary outcomes will be adherence to the prevention program, physical activity, and health status of the participants among others. Results: Baseline characteristics indicate that residence of participants, baseline physical activity, and subjective health should be used as covariates in the statistical analysis of the secondary outcomes of the study. Conclusions: This is the first study in western cultures testing the effectiveness of financial incentives with regard to a pedometer-based health intervention offered by a large health insurer to their customers. Given that the incentives prove to be effective, this study provides the basis for powerful health prevention programs of public health institutions that are easy to implement and can reach large numbers of people in need. [ABSTRACT FROM AUTHOR]