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Bu araştırmanın amacı, Etkileşimli Kitap Okuma Programı’nın etkililiğini belirlemektir. Araştırmada üç haftalık müdahale programının hem okuma oturumları sırasındaki ebeveyn davranışları hem de gün içerisindeki ebeveyn-çocuk etkileşimi üzerindeki etkisi incelenmiştir. Araştırmada karma desenlerden biri olan eşzamanlı üçgenleme kullanılmıştır. Araştırmaya Ankara ilinin düşük sosyoekonomik bölgesinde ikamet eden sekiz ebeveyn ve bu ebeveynlerin çocukları dâhil edilmiştir. Ebeveynlerin okuma oturumları sırasında sergilemiş olduğu etkileşimsel davranışlar, araştırmacı tarafından hazırlanmış olan kontrol listesi aracılığıyla ön test ve son test olarak değerlendirilmiştir. Ebeveynler ve çocukları arasında gerçekleşen gün içerisindeki etkileşim ise araştırma sonunda ebeveynlerle yapılmış olan yarı-yapılandırılmış görüşmeler aracılığıyla belirlenmeye çalışılmıştır. Nitel verilerin analizinde betimsel analiz, nicel verilerin analizinde Wilcoxon İşaretli Sıralar Testi kullanılmıştır. Bulgular, programın hem ebeveynlerin çocuklarıyla kitap okuma oturumları esnasında sergilemiş oldukları etkileşimli davranışlar hem de gün içerisinde çocuk ve ebeveyn arasında gerçekleşen etkileşimin üzerinde etkili olduğunu göstermiştir. Bulgular, alandaki diğer çalışmalar göz önünde bulundurularak tartışılmış, sınırlılıklara değinilmiş ve gelecekteki araştırmalara yönelik öneriler sunulmuştur.

Background: Previous studies have suggested that changes in the composition of intestinal microbiota may be influenced by dietary quality. Objective: This study aimed to assess the impact of a hypocaloric diet on the relationship between microbiota and clinical/dietary variables. Methods: This was a longitudinal study. Ten women with obesity (Obese Group, ObG) participated in an 8-week home-based hypocaloric diet intervention. Anthropometric, dietary intake, biochemical, and gut microbiota assessments were conducted before and after the intervention. Microbiota relative abundance was determined using real-time PCR in triplicate. Results: In the ObG, the hypocaloric diet intervention led to significant weight loss (before: 119.5 ± 10.3 kg; after: 114.9 ± 10.2 kg; p = 0.003). Following the intervention, positive correlations were observed between nutrient intake and phyla composition: Actinobacteria phylum with fibers (r = 0.787; p = 0.012), Firmicutes phylum with proteins (r = 0.736; p = 0.024), and Proteobacteria phylum with lipids (r = 0.669; p = 0.049). Conclusions: The hypocaloric diet intervention improved health parameters associated with obesity and its comorbidities, demonstrating associations between nutrient intake and specific phyla. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Mother Tongue Education / Ana Dili Egitim Dergisi is the property of Journal of Mother Tongue Education / Ana Dili Egitim Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background A Phase I study showed that it is feasible to implement a home-based self-management program aimed at increasing physical activity in individuals after stroke with mild walking disability in Brazil. The next step is to test this program against a control group in order to provide a power analysis for a fully-powered Phase III clinical trial. Methods A Phase II pilot randomised clinical trial with concealed allocation, blinded measurement, and intention-to-treat analyses will be carried out. The inclusion criteria will be individuals diagnosed with stroke, in the acute or subacute phase, with mild walking disability, sedentary, and no significant language impairment. The participants will be randomly allocated to the experimental or control group. The experimental group will receive six sessions of a home-based self-management program based on behaviour change techniques through the Social-Cognitive Theory and Control Theory over 11 weeks. The control group will receive one session of education about stroke (regarding the importance of practising physical activity after a stroke) and usual care. A total of 24 participants will be recruited. The primary outcome will be physical activity, measured through steps taken per day by an activity monitor (Actigraph wGT3X-BT, Pensacola, FL, USA). The mean of daily steps will be analysed to compare groups after intervention. Secondary outcomes will be cardiovascular risk (body mass index, waist circumference, and blood pressure), depressive symptoms (Geriatric Depression Scale), walking ability (6-Minute Walk Test and 10-Meter Walk Test), exercise self-efficacy (Self-Efficacy for Exercise scale), social participation (Stroke Impact Scale) and quality of life (EuroQual-5D). Two-way analyses of variance will be implemented for all parametric outcomes, and the Kruskal–Wallis test for non-parametric outcomes will be used to determine the statistical significance of the between-group differences and reported as mean differences between groups (95% CI). All analyses will be conducted intention-to-treat. All outcomes will be measured at baseline (Week 0), post-intervention (Week 12), and follow-up (Week 24). This pilot clinical trial was registered online at Clinical Trials under number NCT05461976 on 4th April 2022. Discussion If beneficial, this Phase II pilot randomised trial will provide data to plan a fully powered future Phase III clinical trial aimed at verifying the efficacy of this program to promote physical activity after stroke. Trial registration Clinical Trials NCT05461976 on 4th April 2022.

BackgroundHome-based intervention occupies a prominent place in the treatment of autism spectrum disorder （ASD） in children， whereas previous studies on the effect of home-based early intensive behavioral intervention on verbal ability of children with ASD are somewhat inadequate.ObjectiveTo study the effects of intensive family behavioral of intervention based on Verbal Behavior Milestones Assessment and Placement Program （VB-MAPP） on the language ability of children with ASD， so as to provide references for the development of family intervention strategies for children with ASD.MethodsChildren aged 2 to 3 years old who attended the Children's Rehabilitation Department of the Second Affiliated Hospital of Shantou University Medical College from September 2020 to December 2021 and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for ASD were selected as the study objects. A non-randomized concurrent control trial was conducted to compare a study group （n=24） receiving home-based early intensive behavioral intervention using VB-MAPP with a control group （n=14） receiving training from other special institutions or early childhood education institutions. The intervention lasted for 6 months in both groups. Before and after the intervention， the VB-MAPP milestone assessment was performed in the two groups， and the VB-MAPP milestone score， mand， trac and listener responds were selected as the study indicators. Then the intervention effect was compared between two groups， and the multiple linear regression was performed to screen the related influencing factors.ResultsAfter intervention， the total milestone assessment score， mand， tact and listener responds scores of study group were higher than those of control group， with statistical difference （Z=-4.339~-2.195， P

Aging is characterized by substantial changes in sleep architecture that negatively impact fitness, quality of life, mood, and cognitive functioning. Older adults often fail to reach the recommended level of physical activity to prevent the age-related decline in sleep function, partly because of geographical barriers. Implementing home-based interventions could surmount these obstacles, thereby encouraging older adults to stay active, with videoconference administration emerging as a promising solution. Increasing the availability of biological rhythms synchronizers, such as physical activity, light exposure, or vestibular stimulation, represents a viable non-pharmacological strategy for entraining circadian rhythms and potentially fortifying the sleep–wake cycle, thereby enhancing sleep in aging. This study aims to (1) assess the impact of remote physical exercise training and its combination with bright light exposure, and (2) investigate the specific contribution of galvanic vestibular stimulation, to sleep quality among healthy older adults with sleep complaints. One hundred healthy older adults aged 60–70 years with sleep complaints will be randomly allocated to one of four groups: a physical exercise training group (n = 25), a physical exercise training combined with bright light exposure group (n = 25), a galvanic vestibular stimulation group (n = 25) or a control group (i.e., health education) (n = 25). While physical exercise training and health education will be supervised via videoconference at home, bright light exposure (for the physical exercise training combined with bright light exposure group) and vestibular stimulation will be self-administered at home. Pre-and post-tests will be conducted to evaluate various parameters, including sleep (polysomnography, subjective questionnaires), circadian rhythms (actigraphy, temperature), fitness (physical: VO2 peak, muscular function; and motor: balance, and functional mobility), cognition (executive function, long-term memory), quality of life and mood (anxiety and depression). The findings will be anticipated to inform the development of recommendations and non-pharmaceutical preventive strategies for enhancing sleep quality in older adults, potentially leading to improvements in fitness, cognition, quality of life, and mood throughout aging.

To evaluate the effectiveness of home-based interventions in improving loneliness and social connectedness (primary outcomes), and depressive symptoms (secondary outcome) among older adults. Eight electronic databases were searched from inception dates to February 2022. Meta-analyses were conducted using a random-effect model. Heterogeneity was assessed using I2 statistics and Cochran's Q chi-squared test. The Cochrane risk of bias tool and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to appraise the included studies. Fourteen randomized controlled trials were included. Home-based interventions were found to significantly increase older adults' social connectedness (social support and social engagement) and reduce their loneliness and depressive symptoms. Subgroup analyses suggested that interventions which lasted more than three months and were delivered using mixed platforms were more favorable. Both professional-led and volunteer-led interventions showed favorable results. Future studies could be conducted in varied geographical regions and consider carrying out follow-up assessments. Home-based interventions could be improved by being more than months, delivered by mixed personnel, and using mixed platforms. Considering the low-quality rating by the GRADE approach, future research is needed to confirm current findings. Older adults can be at higher risk for loneliness and home-based interventions may help to address this issue. This review consolidated the available evidence regarding the effectiveness of home-based interventions in improving loneliness, social connectedness, and depressive symptoms among older adults. Home-based interventions could significantly increase older adults' social connectedness (social support and social engagement), and reduce their loneliness and depressive symptoms. Future research would be needed to ascertain the sustainability of home-based programs' effect on older adults. [ABSTRACT FROM AUTHOR]

Background: Digital health interventions (DHIs) have been used to improve postoperative functional ability in older patients with hip fractures. However, there is limited information on the characteristics of home-based DHIs, and controversy exists regarding their impact on functional outcomes in this population. Objective: This study aims to provide an overview of the characteristics and effects of home-based DHIs on functional outcomes in older patients with hip fractures after surgery. Methods: We conducted a systematic review and meta-analysis following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Five electronic medical databases (PubMed, Embase, Cochrane, ProQuest, and CINAHL) were searched up until January 3, 2023. We included clinical trials or randomized controlled trials (RCTs) in English involving home-based DHIs for postoperative care among older patients with hip fractures. Excluded studies involved patients not hospitalized, not discharged to home, not directly using DHIs, or with inaccessible full text. The PROSPERO registration number is CRD42022370550. Two independent reviewers screened and extracted data (SP and NB). Disagreements were resolved through discussion and agreement with the third author (KP). Home-based DHIs were characterized in terms of purpose and content, mode of delivery, and health care provider. Functional outcomes assessed included Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and Functional Independence Measure (FIM). Summary measures were calculated using mean differences with 95% CIs. Risk of bias was assessed using the Risk-of-Bias 2 assessment tool for RCTs and ROBINS-I for non-RCTs. The quality of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Results: Of 2125 identified studies, 16 were included in the systematic review, involving 1467 participants. Six studies were included in the meta-analysis (4 for TUG, 4 for SPPB, and 2 for FIM). Home-based DHIs predominantly involved communication and feedback, education, and telerehabilitation. Telephone calls were the most common mode of delivery, followed by web-based software and mobile apps. Physical therapists were the main health care providers. The meta-analysis showed that home-based DHIs improved functional outcomes compared with usual care, with decreased TUG scores (mean difference=–7.89; 95% CI –10.34 to –5.45; P <.001), significantly increased SPPB scores (mean difference=1.11; 95% CI 0.51-1.72; P <.001), and increased FIM scores (mean difference=7.98; 95% CI 5.73-10.24; P <.001). Conclusions: Home-based DHIs that integrate communication and feedback, education, and telerehabilitation have demonstrated effectiveness in enhancing functional outcomes among older patients recovering from hip fractures after surgery. These interventions are commonly administered by physical therapists, who play a crucial role in facilitating and guiding the rehabilitation process. However, while the existing evidence supports the efficacy of such interventions, further research is needed to enhance our understanding and optimize the implementation of home-based DHIs for this specific population. [ABSTRACT FROM AUTHOR]

Background: A Phase I study showed that it is feasible to implement a home-based self-management program aimed at increasing physical activity in individuals after stroke with mild walking disability in Brazil. The next step is to test this program against a control group in order to provide a power analysis for a fully-powered Phase III clinical trial. Methods: A Phase II pilot randomised clinical trial with concealed allocation, blinded measurement, and intention-to-treat analyses will be carried out. The inclusion criteria will be individuals diagnosed with stroke, in the acute or subacute phase, with mild walking disability, sedentary, and no significant language impairment. The participants will be randomly allocated to the experimental or control group. The experimental group will receive six sessions of a home-based self-management program based on behaviour change techniques through the Social-Cognitive Theory and Control Theory over 11 weeks. The control group will receive one session of education about stroke (regarding the importance of practising physical activity after a stroke) and usual care. A total of 24 participants will be recruited. The primary outcome will be physical activity, measured through steps taken per day by an activity monitor (Actigraph wGT3X-BT, Pensacola, FL, USA). The mean of daily steps will be analysed to compare groups after intervention. Secondary outcomes will be cardiovascular risk (body mass index, waist circumference, and blood pressure), depressive symptoms (Geriatric Depression Scale), walking ability (6-Minute Walk Test and 10-Meter Walk Test), exercise self-efficacy (Self-Efficacy for Exercise scale), social participation (Stroke Impact Scale) and quality of life (EuroQual-5D). Two-way analyses of variance will be implemented for all parametric outcomes, and the Kruskal–Wallis test for non-parametric outcomes will be used to determine the statistical significance of the between-group differences and reported as mean differences between groups (95% CI). All analyses will be conducted intention-to-treat. All outcomes will be measured at baseline (Week 0), post-intervention (Week 12), and follow-up (Week 24). This pilot clinical trial was registered online at Clinical Trials under number NCT05461976 on 4th April 2022. Discussion: If beneficial, this Phase II pilot randomised trial will provide data to plan a fully powered future Phase III clinical trial aimed at verifying the efficacy of this program to promote physical activity after stroke. Trial registration: Clinical Trials NCT05461976 on 4th April 2022. [ABSTRACT FROM AUTHOR]

Objective: Living the final days of life being cared for at home is a preference expressed by many. The data on the effectiveness of home-based end-of-life care (EoLC) intervention to improve the holistic conditions of terminally ill patients are scanty. This study sought to evaluate a psychosocial home-based EoLC intervention for terminally ill patients in Hong Kong. Methods: A prospective cohort study was conducted, applying the Integrated Palliative Care Outcome Scale (IPOS) at 3 timepoints (service intake, 1-month, and 3-months after enrollment). A total of 485 eligible, consenting terminally ill people (mean age = 75.48, SD = 11.39) were enrolled, with 40.21% (n = 195) providing data at all 3 timepoints for this study. Results: Decreasing symptom severity scores were observed for all IPOS psychosocial symptoms, and most physical symptoms, over the 3 timepoints. Improvements in depression and practical concerns had the highest omnibus time effects (F > 31.92, P <.01) and T0 to T2 paired comparison effects (Cohen's d > 0.54, P <.01). Physical symptoms of weakness/lack of energy, poor mobility, and poor appetite also showed significant improvements at T1 and T2 (Cohen's d : 0.22-0.46, P <.05). Bivariate regression analyses showed that improvements in anxiety, depression, and family anxiety were associated with improvements in physical symptoms of pain, shortness of breath, weakness/lack of energy, nausea, poor appetite, and poor mobility. Patients' demographic and clinical characteristics were not associated with changes in symptoms. Conclusions: The psychosocial home-based EoLC intervention effectively improved the psychosocial and physical status of terminally ill patients, irrespective of their clinical characteristics or demographics. [ABSTRACT FROM AUTHOR]

Using wearable technologies in the home setting is an emerging option for self-directed rehabilitation. A comprehensive review of its application as a treatment in home-based stroke rehabilitation is lacking. This review aimed to 1) map the interventions that have used wearable technologies in home-based physical rehabilitation for stroke, and 2) provide a synthesis of the effectiveness of wearable technologies as a treatment choice. Electronic databases of the Cochrane Library, MEDLINE, CINAHL, and Web of Science were systematically searched for work published from their inception to February 2022. This scoping review adopted Arksey and O’Malley’s framework in the study procedure. Two independent reviewers screened and selected the studies. Twenty-seven were selected in this review. These studies were summarized descriptively, and the level of evidence was assessed. This review identified that most research focused on improving the hemiparetic upper limb (UL) function and a lack of studies applying wearable technologies in home-based lower limb (LL) rehabilitation. Virtual reality (VR), stimulation-based training, robotic therapy, and activity trackers are the interventions identified that apply wearable technologies. Among the UL interventions, “strong” evidence was found to support stimulation-based training, “moderate” evidence for activity trackers, “limited” evidence for VR, and “inconsistent evidence” for robotic training. Due to the lack of studies, understanding the effects of LL wearable technologies remains “very limited.” With newer technologies like soft wearable robotics, research in this area will grow exponentially. Future research can focus on identifying components of LL rehabilitation that can be effectively addressed using wearable technologies.

The study aims to describe the development and validation of an intervention module based on home-based care training for patients with filarial lymphedema. Qualitative and quantitative approaches were followed for the development of the intervention module. Initial steps involved the framing of the intervention module. Direct observation, interviews with patients, suggestions from five experts in community medicine, community health nursing, and plastic surgery department were conducted. The experts and patients for the discussion were chosen with the help of convenient sampling. The experts rated the usefulness and feasibility of the components on a scale of 1–5 (5 extremely helpful). The ingredients derived for the intervention module included washing and drying of limb, prevention, care of entry lesions, light oil massage, the exercise of limb, the elevation of the stem, wearing of appropriate footwear, and management of adenolymphangitis (ADL). The intervention included individual sessions with demonstration and return demonstration. The final version of the module was pilot tested among five patients and had been found to improve the quality of life. Home-based care training with low-cost interventions can improve patients’ quality of life.

Copyright of Sichuan Mental Health is the property of Sichuan Mental Health Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The strong association between perinatal HIV infection and poor performance in academic learning is further challenged by various barriers to learning in the South African context of basic education. This study investigated the efficacy of a novel play-informed, caregiver-implemented, home-based intervention (PICIHBI) for improving academic learning in HIV-positive children. Methodology: A single-blinded, randomised comparison group design was selected to compare PICHIBI with conventional one-on-one occupational therapy interventions. Children with HIV aged 5 to 8 years old on ART and their primary caregiver (N=23) were randomly allocated to an intervention group. The primary outcome of academic learning was measured using the Griffiths Mental Developmental Scales-Extended Revised and the short form Beery-Buktenica Visual Motor Integration test, 5th edition at baseline, mid (5 months) and post-intervention (after 10 months). Results: At baseline, the total sample (n=23) presented with below-average performance in all assessed academic learning outcomes. Between-group differences for all academic learning outcomes were not significant at mid or post-test assessment points. A statistically significant within-group change in visual motor integration was noted in the PICIHBI from baseline to mid-test (p=.019). In the conventional group, there were statistically significant changes in visual perception from baseline to mid (p=.001) and baseline to post-test (p=.009). The sub scale Performance in the conventional group improved significantly from baseline to mid-test (p=.027). Conclusion: While improvements were noted, children in both groups continued to present with academic learning concerns at post-test. These concerns motivate the need for continued monitoring and further investigation into the feasibility and effectiveness of occupational therapy interventions targeting the academic learning challenges of this population. [ABSTRACT FROM AUTHOR]

Using wearable technologies in the home setting is an emerging option for self-directed rehabilitation. A comprehensive review of its application as a treatment in home-based stroke rehabilitation is lacking. This review aimed to 1) map the interventions that have used wearable technologies in home-based physical rehabilitation for stroke, and 2) provide a synthesis of the effectiveness of wearable technologies as a treatment choice. Electronic databases of the Cochrane Library, MEDLINE, CINAHL, and Web of Science were systematically searched for work published from their inception to February 2022. This scoping review adopted Arksey and O’Malley’s framework in the study procedure. Two independent reviewers screened and selected the studies. Twenty-seven were selected in this review. These studies were summarized descriptively, and the level of evidence was assessed. This review identified that most research focused on improving the hemiparetic upper limb (UL) function and a lack of studies applying wearable technologies in home-based lower limb (LL) rehabilitation. Virtual reality (VR), stimulation-based training, robotic therapy, and activity trackers are the interventions identified that apply wearable technologies. Among the UL interventions, “strong” evidence was found to support stimulation-based training, “moderate” evidence for activity trackers, “limited” evidence for VR, and “inconsistent evidence” for robotic training. Due to the lack of studies, understanding the effects of LL wearable technologies remains “very limited.” With newer technologies like soft wearable robotics, research in this area will grow exponentially. Future research can focus on identifying components of LL rehabilitation that can be effectively addressed using wearable technologies. [ABSTRACT FROM AUTHOR]

This study investigated the changes that occur in mothers' language and interactions with their preschool-aged children who have language difficulties when a Spanish language-based intervention was provided within their homes. The intervention was provided using toys and routines that existed within their homes. Three Spanish speaking mothers of Mexican descent participated alongside their preschool children in a language-based intervention. The mothers were interviewed before and after the intervention to understand their experiences and perceptions. They were video recorded interacting with their children during play-based events to document language events between the mothers and their child. Study findings demonstrated that mothers changed in their use of language strategies and had positive opinions about the intervention. To build on culturally responsive interventions, specific factors were identified to promote a positive experience when working with Mexican immigrant mothers. [ABSTRACT FROM AUTHOR]

Background: This short term structured, multimodal, home-based, self-help program was designed to reduce frailty of elderly type 2 diabetes mellitus (T2DM) patients, and detect the major predictors of frailty status improvement. Method: This study recruited T2DM patients aged 65 years and older from the DM shared care center in a regional hospital who were frail or prefrail according to Fried Frailty Phenotype. Short term (12 weeks) home-based intervention including an elastic band low resistance exercise, a smart bracelet monitored walking exercise, and nutrition consultation was conducted. Change of frailty status, functional outcomes, body composition and metabolic indices after intervention were analyzed. A logistic regression was applied to determine the predictive factors associated with frailty status improvement. Results: 81 participants were enrolled after they were fully consented. After 12 weeks' intervention, 60 participants completed the program. Since two participants with incomplete data were excluded, there were 58 remaining in the analysis. They were on average 71.7 ± 4.9 years old and 22 persons (36.7%) were male. 46 (79.3%) of them were prefrail and 12 (20.7%) were frail. The average duration between the pre-test and the post-test was 107.1 ± 25.6 days. The average incidence of home-based exercise was 1.4 ± 1.1 times a week. Fried Frailty Phenotype, handgrip strength, muscle quality, HbA1c, and symptomatic hypoglycemic episodes significantly improved. Initial poorer frailty status was the major predictor (OR = 104.446, 95% CI = 7.551-1444.726, p = 0.001) of frailty status improvement. Conclusions: Short term structured, multimodal, interdisciplinary, home-based, self-help program is effective in reducing frailty status among elderly T2DM patients. [ABSTRACT FROM AUTHOR]

Introduction: One of the treatments with the greater scientific support for children with cerebral palsy (CP) are home programmes (HP). However, its implementation may be complex in some cases. A systematic review was conducted to explore the existing literature on the following question: What are the barriers and facilitators to implementing HP for children with CP?, Material and Methods: The articles were extracted from the Web of Science (WoS), Scopus, ERIC, PubMed and CINAHL databases., Inclusion Criteria: articles based on therapies conducted at home, for children with CP aged 0-8 years and their families, published in English and Spanish., Exclusion Criteria: reviews, studies of cases and controls and one-case studies. The risk of bias was assessed through Cochrane tools Risk of Bias (RoB) I, RoB 2 and RoB E., Results: Twenty-one articles were selected from a total of 1.336, with 523 families and professionals. A qualitative research was carried out through content analysis using inductive coding and subsequent analytical categorization within an interpretative paradigm. Six themes were obtained: participation, personal cost and social support, family impact, training, professional role and efficacy. The quantitative results were analysed descriptively. They address HP research in a superficial manner., Conclusions: Barriers: lack of time or availability to attend to the children one by one, poor economic and social support networks and sensitive emotional situation. Facilitators: training, adapted treatment objectives, activities within the daily routine and fluid family-professional communication., Limitation: Only one article could be found that analysed family variables, considering the possible confounding variables. There is no funding source for this review. Registered in PROSPERO with code number: CRD42023477735., (© 2025 John Wiley & Sons Ltd.)

Physical literacy (PL) is increasingly being implemented as a means for holistic development for children and youth. Despite this, children experiencing disabilities and their families continue to face barriers that impede participation in physical activities and subsequent PL development. To empower families to actively engage in their PL development, this study sought to provide an accessible, home- and play-based, parent-facilitated intervention, namely, PLayTubs. The purpose was to explore parents' subjective understanding, involvement, and attitudes toward facilitating physical activity opportunities contributing to PL development through this intervention. Four parents with a child (<12 years old) diagnosed with a developmental impairment participated in a 10-week PLayTub experience. Data were collected via semistructured interviews with parents and their children. Making use of an interpretive description methodology and an ecological-dynamics conceptual framework, this study resulted in three themes: (a) a catalyst for autonomy, (b) more than just movement, and (c) an accessible alternative. Parents found that PLayTubs fostered autonomous participation and individual agency, enhanced connections and togetherness, and allowed for the creation of meaningful experiences with physical activity. These positive insights demonstrate the benefit of home-based interventions for this population and highlight the need for larger studies in the future.

The purpose of this study, that took place in Lebanon, is to investigate the effectiveness of Portage, a home-based early intervention program for children with special needs. The sample consisted of 16 children (eight male and eight female) whose ages ranged between 1 and 3 years. Participants were provided with home-based services by a Portage home-visitor for a period of six months. Data were collected before and after the intervention. Participants' progress was evaluated in five developmental areas: communication, social-emotional, exploration, purposeful-motor activity, and sensory organization. Parents' satisfaction with the program's provisions was also examined. The results revealed significant differences in the participants' pre and post ratings, indicating improvement in the children's functional skills in all developmental areas. Also, parents' interviews revealed satisfaction with the program's services. In sum, Portage seems to be a promising home-based intervention, but further research is needed before making any claims about its wider potential. [ABSTRACT FROM AUTHOR]

Background: Despite significant prevalence of specific learning disorder (SLD) in India, insufficient efforts have been taken to deal with its burden. Currently, the workforce is limited and resources are expensive and difficult for families to access. Consequently, developing an alternative remedial program in the form of a home-based intervention (HBI) is imperative. This article describes the development phase of a manualized HBI program for 7 to 12-year-old children with SLD. Methods: Extensive literature search, 7 focus group discussions with parents of children with and without SLD and teachers/counselors (n = 44), and 22 in-depth interviews with SLD children (n = 9) and professionals (n = 13) were conducted. A thematic analysis was done. Intervention strategies were identified based on themes. Experts' feedback about the content and structure of HBI was also taken. Results: The design and application of the HBI program integrate several intervention areas, including psychoeducation, learning strategies, cognitive, social, and behavioral techniques, and therapy for parents. HBI comprised 14 parent training sessions, the duration being 45 to 60 min per session, over six months. Parent training consisted of four steps. (a) The researcher/clinician describes the steps of reading, writing, or math strategies to the parents/caregivers; (b) the researcher/clinician implements the strategies with or without the presence of the child and observation by the parent; (c) the parent practices the strategies in front of the researcher/clinician; and (d) the researcher/clinician observes parents' practice and corrects them if required. Conclusion: HBI manual for children with SLD-mixed type has been developed, keeping with all stakeholders' perspectives. Further study is on the way to assess its acceptability, feasibility, and effectiveness. [ABSTRACT FROM AUTHOR]

Research has shown that the initial few years of children’s lives are the best times for language to develop at a rapid pace, the first language (L1) or a foreign language (FL) may be acquired these times. Researches on preschoolers FL acquisition with home-based intervention (HBI) have not been studied extensively under the L1 environment. This study aims to examine the results of HBI on the development of the acquisition of Indonesian preschoolers’ English as a Foreign Language (EFL) sentences. This research is a case study with naturalistic observation design, where data were obtained from logbooks and interview. The research subjects were 2 preschoolers about 36 months. The study’s duration was 24 months from the 13th until the 36th month with HBI, namely parents-based and authentic/semi authentic-media intervention. The data were the children’s English sentences taken at 24th to 36th months at their own homes. The Owens’ acquisition of sentence forms measured the English sentences’ development of in the respondents’ conversation and self-narration. This research found that at about 36th month, these Indonesian preschoolers were able to communicate in English in various sentences such as declarative, negative, interrogative, imperative, embedded and conjoining. HIGHLIGHTS: • Simultaneous foreign language learning and first language acquisition for children is tangible advantage. • Authentic input and active interaction act as the language environment substitute in foreign language learning. • Intensive learning makes preschoolers speak a foreign language earlier.

• Both home-based aerobic and resistance exercise programs were feasible. • Two-month exercise intervention tended to improve physical function. • Two-month exercise intervention might be not enough to exert effects on cognitive function. To examine the feasibility and efficacy of home-based aerobic and resistance exercise interventions for geriatric individuals with cognitive impairment. Fourteen participants with cognitive impairment were allocated to either the aerobic group (n = 8) or the resistance group (n = 6), after which they implemented a two-month home-based training program. Feasibility and efficacy outcomes were evaluated. A semi-structured interview was performed after the intervention. All fourteen participants completed the two-month training program. The adherence rate was 0.94 for the aerobic group and 0.96 for the resistance group. No adverse events occurred. The results revealed a trend of group×time interaction effect on delayed recall. Significant group×time interaction effects were revealed on simple physical performance and body composition. Semi-structured interviews identified four motivators for participating in this program, four facilitators for and three barriers to keeping exercising, and some perceived benefits. Home-based aerobic and resistance exercise programs are feasible for geriatric individuals with cognitive impairment. The efficacy needs to be further examined. [ABSTRACT FROM AUTHOR]

Older adults with visual impairments face many barriers to being physically active in their communities, which include their risk of suffering serious falls due to poor balance. Thus, the purpose of this study was to examine the effectiveness of a home-based intervention upon gait, balance, and well-being with older adults with visual impairments. A total of 17 adults with visual impairments above the age of 55 participated and were placed into either the experimental or the control group. All participants were assessed on well-being, balance, and gait. Experimental group participants attended balance workshops and received exercise equipment and a balance intervention manual. Following eight weeks, both groups were tested, and the experimental group was reassessed five months following the intervention. Four separate 2 × 2 mixed model analyses of variance (ANOVAs) were used to test for significant main effects and interactions related to their baseline and posttest scores for the four tests completed. Both groups improved their gait (p =.006). Although not significant, the experimental group improved across the tests, and maintained their balance abilities scores 5 months after the intervention was delivered. A home-based exercise program can be an effective means for improving balance and gait in older adults with visual impairments. [ABSTRACT FROM AUTHOR]

Consumption of vegetables is low among preschoolers and does not meet WHO recommendations. We conducted a systematic review of home-based interventions aimed at increasing vegetable consumption and liking among preschoolers. The main aim was to synthesize existing studies and to identify relevant features of successful interventions, especially looking at those with long-lasting effects. A comprehensive search strategy was performed using Psychinfo, PsychArticles, Psyndex, Medline and ERIC databases. Articles published until February 2020, regarding evaluation of vegetable intake and/or liking following an intervention, were included. Fourteen articles were selected, encompassing seven intervention strategies: familiarization with vegetable, tasting of the vegetable, intake of the vegetable, reward, information to parents about healthy eating, how-to-do tips to parents to improve healthy eating, intervention tailored to the characteristics of the family. Successful interventions on vegetable intake did not present systematic similarities in terms of type of intervention, but were characterized by an intense intervention (high frequency/length ratio). Successful interventions on vegetable liking mainly included a small reward. Interestingly, the few studies including a long-term follow-up found persistent positive effects. Despite interesting and promising outcomes, the present review highlighted a number of methodological issues that limited the generalisability of findings. Such limitations are discussed, together with outlets for future directions concerning this research topic. [ABSTRACT FROM AUTHOR]

Previous evidence suggests physical activity interventions effectively produce short-term improvements in physical function for older adults. The present study examined whether improvements in physical function after a DVD-delivered exercise intervention were maintained 18 months postintervention. Older adults (n = 153) randomized to a 6-month DVD-delivered exercise intervention or an attentional control condition were contacted 18 months postintervention. Participants completed the Short Physical Performance Battery (SPPB) and measures of flexibility, strength, and functional limitations were taken. Analyses of variance were conducted to determine if improvements in physical function as a result of the intervention were maintained at follow-up. Improvements in the SPPB, F (1,125) = 3.70, p = .06, η2 = .03, and upper body strength, F (1,121) = 3.04, p = .08, η2 = .03 were maintained for the intervention condition. Home-based DVD exercise training interventions may hold promise for long-term maintenance of physical function in older adults. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is a worldwide cause of disability in older age, especially during the covid pandemic. Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has shown encouraging efficacy for treatment of depression. Here, we investigate the feasibility of an innovative protocol where tDCS is administered within the homes of older adults with MDD (patient participants) with the help of a study companion (i.e. caregiver). We further analyze the feasibility of a remotely-hosted training program that provides the knowledge and skills to administer tDCS at home, without requiring them to visit the lab. We also employed a newly developed multi-channel tDCS system with real-time monitoring designed to guarantee the safety and efficacy of home-based tDCS. Patient participants underwent a total of 37 home-based tDCS sessions distributed over 12 weeks. The protocol consisted of three phases each lasting four weeks: an acute phase, containing 28 home-based tDCS sessions, a taper phase containing nine home-based tDCS sessions, and a follow up phase, with no stimulation sessions. We found that the home-based, remotely-supervised, study companion administered, multi-channel tDCS protocol for older adults with MDD was feasible and safe. Further, the study introduces a novel training program for remote instruction of study companions in the administration of tDCS. Future research is required to determine the translatability of these findings to a larger sample.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT04799405?term=NCT04799405&draw=2&rank=1, identifier NCT04799405.

Major depressive disorder (MDD) is a worldwide cause of disability in older age, especially during the covid pandemic. Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has shown encouraging efficacy for treatment of depression. Here, we investigate the feasibility of an innovative protocol where tDCS is administered within the homes of older adults with MDD (patient participants) with the help of a study companion (i.e. caregiver). We further analyze the feasibility of a remotely-hosted training program that provides the knowledge and skills to administer tDCS at home, without requiring them to visit the lab. We also employed a newly developed multi-channel tDCS system with real-time monitoring designed to guarantee the safety and efficacy of home-based tDCS. Patient participants underwent a total of 37 home-based tDCS sessions distributed over 12 weeks. The protocol consisted of three phases each lasting four weeks: an acute phase, containing 28 home-based tDCS sessions, a taper phase containing nine home-based tDCS sessions, and a follow up phase, with no stimulation sessions. We found that the home-based, remotely-supervised, study companion administered, multi-channel tDCS protocol for older adults with MDD was feasible and safe. Further, the study introduces a novel training program for remote instruction of study companions in the administration of tDCS. Future research is required to determine the translatability of these findings to a larger sample. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04799405?term=NCT04799405&draw=2&rank=1, identifier NCT04799405. [ABSTRACT FROM AUTHOR]

Background: One of the most effective interventions to prevent falls is exercise. A commonly used program that prevents falls is the Otago Exercise Programme (OEP). Despite this, user-based knowledge of its applicability in real-world settings for older adults who are dependent on formal care in their homes is lacking. Purposes: To explore how physical therapists (PTs) experience the applicability of the OEP in clinical practice for home-dwelling older adults who are dependent on formal home care and to determine their beliefs regarding the benefits of the OEP for living longer at home. Methods: Semi-structured interviews were conducted with 17 physical therapists. Data were analyzed using qualitative thematic analysis. Results: The OEP was described by PTs to be applicable in clinical practice. Their experience was that the OEP seemed to be meaningful and to have a strong relationship with everyday activities. The OEP improved physical function, mood, self-efficacy, and participation in social activities in older adults, as well as provided faith in the future. Conclusion: The OEP is suitable for use in a primary care setting, and according to the perceptions of physical therapists, the OEP contributes to older adults' capability to live longer at home. [ABSTRACT FROM AUTHOR]

Home-based psychosocial care has the potential to improving outcomes in patients with schizophrenia and related disorders (SCZ). There is lack of India data for such care in early psychosis. We developed the " Saksham " programme, a bespoke self-managed home-based psychosocial care model, available in two formats: manual-based and mobile-application based. With the anticipated success of recruitment of early psychosis cases in our setting, we plan to test the such intervention in this population in future trials. To assess the feasibility of the Saksham programme intervention in people with SCZ and its clinical efficacy as an adjunct to treatment as usual. Seventy-five patient-caregiver pairs (total n=150) were recruited. Patients received either: treatment-as-usual (TAU) (n=25), manual-based Saksham intervention+TAU (n=25), or app-based Saksham intervention+TAU (n=25). Feasibility (i.e. acceptability, practicality, demand, implementation and integration) was assessed at three-months. Participants were assessed for psychopathology, illness-severity, cognition, functioning, disability, and caregiver-coping at baseline, one-month, and three-month. The percentage changes over time were compared across three groups. More found the mobile application-based intervention acceptable and easy-to-use than the manual-based intervention (92 % vs 68 %, and 76 % vs 68 %, respectively). Psychopathology and caregiver-burden improved significantly in all three groups (p<0.05). Cognition, disability, functioning, and caregiver burden improved significantly in the two Saksham intervention groups, with greater improvement in the Saksham app group (p<0.05). Home-based intervention is feasible and acceptable in a low-resource setting, with preliminary evidence for effectiveness. These findings need corroboration with randomised controlled trials in early psychosis to ameliorate course of illness. [ABSTRACT FROM AUTHOR]

Infant massage (IM) can be considered an early intervention program that leads to the environmental enrichment framework. The effectiveness of IM to promote neurodevelopment in preterm infants has been proved, but studies on infants with early brain damage are still lacking. The main aim of this study was to assess the feasibility, acceptability and usability of IM, carried out by parents at home, on infants at high risk for Cerebral Palsy. An IM daily diary and an ad hoc questionnaire, called Infant Massage Questionnaire Parent-Infant Experiences (IMQPE), were developed. IMQPE consisted of a total of 30 questions, divided into 5 areas. The parents were trained to carry out the IM with a home-based course, conducted by an expert therapist. The intensive IM program was set according to a defined daily length of at least 20 min, with a frequency of at least 5 days per week for a total of 8 weeks. Data collection consisted in the selection of the variables around the characteristics, both of the infants and the mothers, IM dosage and frequency, different body parts of the infants involved and IMQPE scores. Variable selection was carried out by minimizing the Bayesian Information Criteria (BIC) over all possible variable subsets. Nineteen high-risk infants, aged 4.83 ± 1.22 months, received IM at home for 8 weeks. The massage was given by the infants' mothers with a mean daily session dose of 27.79 ± 7.88 min and a total of 21.04 ± 8.49 h. 89.74% and 100% of mothers performed the IM for the minimum daily dosage and the frequency recommended, respectively. All the families filled in the IMQPE, with a Total mean score of 79.59% and of 82.22% in General Information on IM, 76.30% in Infant's intervention-related changes, 76.85% in IM Suitability, 79.07% in Infant's acceptance and 83.52% in Time required for the training. Different best predictors in mothers and in infants have been found. These data provide evidence of the feasibility of performing IM at home on infants at high risk for CP. Study registration: www.clinicaltrial.com (NCT03211533 and NCT03234959).

Background: Inadequate glycemic control usually leads to peripheral neuropathy, vasculopathy, and foot deformities that leads to diabetic foot ulcer (DFU), and a 10-years history of diabetes and inadequate self-management increases the risk of reoccurring DFU. A home-based intervention program, which includes Diabetes Self-Management Education (DSME) and wound care is the most likely approach, to engage families and overcoming the barriers in self-care management. The aim of this study is to provide an overview on the effectiveness of home-based nursing intervention in the elderly patients with reoccurring diabetic foot ulcers. Design and method: In this study, a case study approach was used that presented a case related to self-management and wound care in elderly patients with reoccurring DFU. The intervention was carried out by the community health nurses for eight weeks with home visit. Results: Significant changes were reported in diabetes self-management practices, blood glucose level, and wound healing. The Diabetes Self-Management Questionnaire (DSMQ) score increased from 5,62 to 8,54 and the Summary of Diabetes Self-Care Activities (SDSCA) score increased from 3,2 to 6. The Bates Jansen Examination score decreased from 24 and 26 to 17 and 14 in six weeks. Conclusions: The results confirm that family-based interventions program are effective in improving glycemic control and wound healing. Community nursing is believed to prevent an increase in self-management behavior to prevent recurring DFU and maintain a healthy life-style about diabetes self-management education.

The aim of this study is to investigate whether a home-based physical activity and dietary awareness intervention program could improve on body composition, VO2max and vital capacity among sedentary females leaving in an unstable country. The intervention program was conducted for 12-weeks and consisted of two groups which were experimental and control groups. Total subjects selected in this study were 44 and was equally distributed for both groups. Body Composition was measured using the equation of BMI and skinfold thickness. While VO2max and Vital Capacity were measured using step test and Jaeger Spirometer, respectively. Data was collected three times i.e. baseline pre-test, post-test1, and post-test2, but only the experimental group participants received the intervention program. Results reported that there were significant improvements in body mass index, body fat, VO2max and vital capacity as compared to controls group. The reported t values were, respectively. As the conclusion, home-based physical activity and dietary intervention program can positively influence sedentary undergraduate female students' physiological variables especially in term of improving the VO2max capability. [ABSTRACT FROM AUTHOR]

Background: Inadequate glycemic control usually leads to peripheral neuropathy, vasculopathy, and foot deformities that leads to diabetic foot ulcer (DFU), and a 10-years history of diabetes and inadequate self-management increases the risk of reoccurring DFU. A home-based intervention program, which includes Diabetes Self-Management Education (DSME) and wound care is the most likely approach, to engage families and overcoming the barriers in self-care management. The aim of this study is to provide an overview on the effectiveness of home-based nursing intervention in the elderly patients with reoccurring diabetic foot ulcers. Design and method: In this study, a case study approach was used that presented a case related to self-management and wound care in elderly patients with reoccurring DFU. The intervention was carried out by the community health nurses for eight weeks with home visit. Results: Significant changes were reported in diabetes selfmanagement practices, blood glucose level, and wound healing. The Diabetes Self-Management Questionnaire (DSMQ) score increased from 5.62 to 8.,54 and the Summary of Diabetes Self- Care Activities (SDSCA) score increased from 3.2 to 6. The Bates Jansen Examination score decreased from 24 and 26 to 17 and 14 in six weeks. Conclusions: The results confirm that family-based interventions program are effective in improving glycemic control and wound healing. Community nursing is believed to prevent an increase in self-management behavior to prevent recurring DFU and maintain a healthy life-style about diabetes self-management education. [ABSTRACT FROM AUTHOR]

Objective: This study was aimed to evaluate the effectiveness of a home-based physical exercise program on participants' mental health: psychological symptoms, depression, and burden of female informal caregivers.Design and Participants: In a randomized controlled trial, a sample of 48 female informal primary caregivers completed the entire study, 25 were randomly allocated to the intervention group (IG), and 23 participants to the control group (CG).Intervention: Participants in the IG performed two 60-minute-long physical exercise sessions per week (36 weeks) that were supervised by a personal trainer at caregivers' home during 9 months. The CG continued their habitual leisure-time activities.Measurements: Subjective burden was assessed by the Zarit Burden Interview. The risk of depression was measured by the Geriatric Depression Scale Short Form 15-item version, and psychological symptoms were evaluated by the Symptom Check List-90-Revised (SCL-90-R). All participants were evaluated at baseline and at the end of the intervention.Results: A promising positive impact of the intervention on caregivers' subjective burden and risk of depression was found in the IG. In addition, no significant between-group differences were found in any of nine subscales scores of the SCL-90-R. Finally, care recipients' level of functional independence and area of residence were found to be predictors of the promising positive impact on caregivers' subjective burden and risk of depression.Conclusions: The present home-based physical exercise intervention that was individually implemented has shown promising results to reduce subjective burden and risk of depression in female caregivers of relatives with dementia. However, future research efforts should elucidate both the particular dose of physical exercise and the particular duration of the intervention that are required to obtain the expected significant positive impact. Finally, future inclusion of psychological approaches, besides physical exercise, might help reduce female caregivers' psychological symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Wearables have emerged as a transformative rehabilitation tool to provide self-directed training in the home. Objective. In this study, we examined the efficacy of a novel wearable device, "Smart Reminder" (SR), to provide home-based telerehabilitation for hemiparetic upper limb (UL) training in persons with stroke., Methods: Forty stroke survivors from community support groups were randomized (stratified by the period after stroke onset and impairment severity) to either the SR group or the sham device group. Participants received either 20 hours of telerehabilitation using the SR device or training with pictorial handouts and a sham device over 4 weeks. In addition, all participants wore a standard accelerometer for 3 hours each day, 5 times a week, outside the prescribed training. Participants were assessed by a masked assessor at baseline, post-intervention (week 4), and follow-up (week 8). The outcome measures included Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test, Motor Activity Log, muscle strength, active range of motion and amount of movement of the UL, and compliance rate of training., Results: The SR group improved substantially in their FMA-UE scores after treatment (mean difference = 2.05, P   =   .036 ) compared to the sham group. Also, adherence to the training using the SR device was significantly higher, 97%, than the sham group, 82.3% ( P   =   .038)., Conclusion: The 4-week telerehabilitation program using a "SR" device demonstrated potential efficacy in improving FMA-UE scores of the hemiparetic upper limb. However, it did not significantly enhance the performance of the affected limb in daily activities. The trial was registered on ClinicalTrial.gov (URL: http://www.clinicaltrials.gov) with the identifier NCT05877183., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Research indicates that parent involvement in their child’s education is positively related to academic achievement. The purpose of this manuscript is two-fold. First, we describe a home-based intervention designed to support parents’ involvement with their children in mathematics. The intervention was implemented with parents of children in Grades 1 and 2 in two rural parishes in Jamaica. Key components of the intervention included (a) six sets of mathematics learning materials, each covering foundational early mathematics concepts, and (b) educator-led workshops to implement the mathematics learning materials intended to support parents’ conceptual understanding of the mathematics concepts. Second, we describe the iterative development process used to create the sets of mathematics learning materials. Research and development activities included focus groups conducted with parents, teachers, members from the Ministry of Education, and community members; an external review for mathematical accuracy and cultural relevancy; and a feasibility study implemented with a small group of Jamaican parents. We detail the process used to refine the materials after each of these research activities to improve their usability, accessibility, and cultural relevancy. We hypothesize that parents’ involvement with their children will increase if they have access to accessible and culturally relevant mathematics learning materials.

Background: There is evidence that interventions based on a behavioral medicine approach to physical therapy (BMPI) are beneficial for older adults living with chronic pain; however, knowledge of the perceptions of older people regarding their participation in BMPI is lacking. Aim: The aim of this study was to describe the perceptions of older people about being participants in a home-based BMPI. Methods: Semi-structured interviews were conducted with 12 older adults living with chronic pain and participating in a BMPI. Data were analyzed using qualitative content analysis. Results: The respondents highlighted the importance of the home-based and individualized nature of the intervention. They perceived the support from the physical therapist (PT) as significant for their motivation and goal attainment. The benefits of the intervention were described in physical, psychological, social, and functional terms and as enabling participants to live at home for longer. Conclusion: The results show that participation in a BMPI was perceived as a positive and meaningful experience. Support from a PT is crucial to encouraging behavioral changes. Finally, participation in a BMPI may contribute to the ability of participants to "age in place" for longer. [ABSTRACT FROM AUTHOR]

Pregnancy is a time of heightened HIV risk, but also a phase when a couple can prioritize family health. We conducted secondary analysis of a home-based intervention in rural Kenya to explore couple-level adherence to HIV prevention behaviors. The intervention included health education, relationship-building skills, and Couples HIV Testing and Counseling. Pregnant women were randomized to the intervention (n = 64) or standard care (n = 63) along with male partners. Of 96 couples, 82 (85.0%) were followed to 3 months postpartum, when 31.0% of couples reported perfect adherence to HIV prevention. In logistic regression, intervention condition couples had three-fold higher odds of perfect adherence (AOR = 3.07, 95% CI = 1.01–9.32). A structural equation model found the intervention had moderate effects on couple communication, large effects on couple efficacy to take action around HIV, which in turn improved HIV prevention behaviors (CFI = 0.969; TLI = 0.955; RMSEA = 0.049). Strengthening couple communication and efficacy may help prevent the spread of HIV to infants or partners around the time of pregnancy. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess the feasibility and acceptability of a home‐based intervention—Amagugu Asakhula—to promote nurturing interactions and healthy behaviours with the caregivers of preschool children. Amagugu Asakhula means "treasures that are still growing" and focuses on children's cognitive development, physical activity, screen time, diet and sleep while also promoting the caregiver–child relationship. Methods: This study took place in a low‐income setting in Cape Town, South Africa. The 6‐week intervention was implemented by community health workers (CHWs) with 20 caregivers of preschool children. CHWs provided written feedback on intervention sessions, and two focus groups were conducted, one with the CHWs involved (n = 4) and another with caregivers (n = 6), to obtain their feedback on the intervention and its implementation. Data were collated according to themes relating to implementation. In this pilot study, training and recruitment proved feasible and were facilitated by partnership with a community‐based organization. Results: The intervention was generally implemented as intended, in terms of dose and delivery. Family support and active engagement of caregivers' preschool children in intervention activities were reported by CHWs and caregivers, and CHWs also reported mostly positive interactions with caregivers. CHWs and caregivers perceived the intervention to have benefits relating to the following: caregivers' awareness and knowledge of health behaviours, awareness of their role, changes in behaviours, and connection between the caregiver and child. The only change to the intervention suggested was the inclusion of some group sessions to promote support amongst intervention participants and sustain engagement in the intervention. Conclusions: The findings of this pilot study indicate that Amagugu Asakhula was both feasible and acceptable with caregivers of preschool children in a low‐income urban setting. Further research is needed to assess the extent to which this intervention has an objective and measurable effect on intended outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To determine the comparative impact of the standard Parents as Teachers (PAT) to the nutrition and physical activity enhanced version (PATE) of the perinatal educational curriculum on compliance with infant feeding recommendations and changes in maternal infant feeding knowledge and beliefs.Methods: Women at least 18 years of age, <19 weeks pregnant, and residing in three Mississippi counties were randomized to the standard PAT or the PATE version of the perinatal educational curriculum. Infant diets were assessed via 24-hour diet recall at postnatal months 1 to 12. Maternal knowledge and beliefs about infant feeding were assessed via survey at baseline and postnatal month 12. Compliance with infant feeding recommendations and differences in compliance between treatment arms were assessed using Kaplan-Meier survival curves. Longitudinal changes in maternal knowledge and beliefs were assessed with McNemar tests of symmetry.Results: Postnatal retention for the PAT and PATE arms were 83% (25/30) and 88% (21/24). Compliance with feeding recommendations for PAT and PATE participants, respectively, was 40% and 63% for no solid food before 6 months; 23% and 21% for no sugar-sweetened beverages before 12 months; 100% (both) for no fruit juice before 6 months; and 43% and 46% for no snack chips, French fries, and other fried food and candy before 12 months. Median times to feeding sugar-sweetened beverages were 10.1 and 9.6 months in PAT and PATE arms. Significant differences in compliance between arms were not found (P > 0.05). Participants' knowledge and beliefs about infant feeding were generally in agreement with expert recommendations at baseline, with few changes over time or between arms.Conclusions: Findings suggest the need for further intervention focused on translating knowledge into action to improve diets of weaning infants in this region of the United States. [ABSTRACT FROM AUTHOR]

The purpose of this study was to elucidate whether implementation of a parent-led physical activity (PA) curriculum improved health parameters in youth with obesity. This prospective study included 45 youth with Prader-Willi syndrome (PWS) and 66 youth classified as obese without PWS. Participants were quasi-randomly assigned to an intervention (I) group which completed PA sessions (25–45+ minutes long) 4 days/week for 24 weeks or to a control (C) group. Generalized estimating equations analyzed differences in body composition, PA, and health-related quality of life (HRQL) by youth group, time, and treatment group. A secondary analysis in the I-group compared outcomes based on whether youth showed increases (n = 12) or decreases (n = 19) of ≥2 minutes of moderate-to-vigorous PA (MVPA). Body mass index increased from baseline to 24 weeks in youth with obesity (p =.032) but not in youth with PWS. There were no changes in MVPA, total PA, or body fat indicators over time. The I-group demonstrated an increase of 7.2% and 7.6% in social and school HRQL, respectively, and a 3.3% improvement in total HRQL. Youth in the I-group who increased MVPA demonstrated decreased body mass (p =.010), body mass index z-score (p =.018), and body fat mass (p =.011); these changes were not observed in those who decreased MVPA over time. Participation in a parent-led PA intervention at home can positively influence HRQL in youth with obesity and/or PWS. Increases in MVPA ≥2 minutes above baseline led to decreases in body mass and fat, while maintaining lean mass. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to develop a theoretical account of the behavioural pattern of adherence to home-based inspiratory muscle training (IMT) in people with chronic obstructive pulmonary disease (COPD), performed as two daily sessions of 30 breaths with mechanical threshold loading. Methods: This was a qualitative study based on the classic grounded theory method. We conducted interviews with people living with COPD recruited after completion of 6 weeks of outpatient pulmonary rehabilitation program in 2015. Concurrently, we generated data and performed analyses by means of constant comparative analysis and theoretical sampling that focused on the behavioural characteristics of adherence to IMT. Results: We achieved theoretical saturation of substantive codes with 33 interviews, nine of which were with men. The participants' mean age and forced expired volume in the first second were 65 (SD 8) years and 59.1 (SD 13.9) percent of predicted, respectively. Seventeen participated in face-to-face interviews, and 16 participated in telephone interviews. The core category "Preserving Integrity" emerged as representative of the primary pattern of behaviour related to the inspiratory muscle-training regimen. Through this pattern, the participants resolved the main concern of losing integrity. Preserving Integrity involved three behavioural modes of adherence to home-based IMT: evading, misgiving, and involving modes. Conclusions: The participants' behavioural modes regarding adherence revealed patterns of both intended and unintended nonadherence. In particular, support offered by healthcare professionals should target people with unintended nonadherence and scepticism about the effects of IMT to maximise the possibility of adherence. When implementing inspiratory muscle training, healthcare professionals should be prepared to spend considerable time providing attention and support to participants who feel challenged during the execution of inspiratory muscle training. Support offered by healthcare professionals should target people with scepticism about the effects of inspiratory muscle training to maximise the possibility of adherence. Intended adherence to inspiratory muscle training appeared to be firmly rooted, which means that healthcare professionals can pay less attention to patients with strong intentions to ensure adherence. [ABSTRACT FROM AUTHOR]

Abstract Objective To examine whether a healthy weight intervention embedded in the Parents as Teachers (PAT) home visiting program, which was previously found to improve mothers' body mass index (BMI) and obesity-related behaviors, changed the BMI of preschool children or maternal feeding practices. Methods This stratified randomized trial included preschool-aged children at risk for overweight whose mothers were overweight or had obesity (n = 179). The Healthy Eating and Active Living Taught at Home (HEALTH) intervention was based on the Diabetes Prevention Program. Differences were examined using repeated-measures mixed-ANOVA models. Results Compared with PAT usual care, the HEALTH intervention had no effect on children's BMI or maternal feeding practices. However, combined analyses showed that children's BMI percentile decreased (P =.007), BMI z-scores were maintained (P =.19), and 3 of 8 feeding practices improved over time (P <.05). Conclusions and Implications Additional research is needed to assess the effectiveness of PAT to prevent preschool-age obesity using rigorous designs (eg, group-randomized trials) and to identify its active components. HEALTH is ready to be scaled up to prevent maternal weight gain through embedding within the national PAT program. [ABSTRACT FROM AUTHOR]

The Smiley Activation Programme (SAP) is a home-based intervention that is targeted to reduce depressive symptoms in elderly Hong Kong Chinese. The SAP includes eight social worker's home visits and two volunteer visits over 19 weeks and a three-month follow-up, integrating problem-solving treatment and behavioural activation. This study aims to evaluate the feasibility of the SAP in reducing depressive symptoms for elderly depression in Hong Kong, by comparing the outcomes at pre-test, post-test and three-month follow-up. Two hundred and nineteen old adults aged 60 or above with depressive symptoms were recruited. Significant improvements in depression (t = 12.79, p < .01) and an effect size of 0.96 were reported. Other benefits include improvements in perceived general health, physical and social activeness and pleasant activity level. The low attrition rate and high participant satisfactory level supported the feasibility of the programme. Implications of social work research and practice are discussed. [ABSTRACT FROM AUTHOR]

Policy Points: The Pay for Success (PFS) financing approach has potential for scaling the implementation of evidence‐based prevention interventions in Medicaid populations, including a range of multicomponent interventions for childhood asthma that combine home environment risk mitigation with medical case management. Even though this type of intervention is efficacious and cost‐saving among high‐risk children with asthma, the main challenges for implementation in a PFS context include legal and regulatory barriers to capturing federal Medicaid savings and using them as a source of private investor repayment. Federal‐level policy change and guidance are needed to support PFS financing of evidence‐based interventions that would reduce expensive acute care among Medicaid enrollees. Context: Pay for Success has emerged as a potential financing mechanism for innovative and cost‐effective prevention programs. In the PFS model, interventions that provide value to the public sector are implemented with financing from private investors who receive a payout from the government only if the metrics identified in a performance‐based contract are met. In this nascent field, little has been written about the potential for and challenges of PFS initiatives that produce savings and/or value for Medicaid. Methods: In order to elucidate the basic economics of a PFS intervention in a Medicaid population, we modeled the potential impact of an evidence‐based multicomponent childhood asthma intervention among low‐income children enrolled in Medicaid in Detroit. We modeled outcomes and a comparative benefit‐cost analysis in 3 risk‐based target groups: (1) all children with an asthma diagnosis; (2) children with an asthma‐related emergency department visit in the past year; and (3) children with an asthma‐related hospitalization in the past year. Modeling scenarios for each group produced estimates of potential state and federal Medicaid savings for different types or levels of investment, the time frames for savings, and some overarching challenges. Findings: The PFS economics of a home‐based asthma intervention are most viable if it targets children who have already experienced an expensive episode of asthma‐related care. In a 7‐year demonstration, the overall (undiscounted) modeled potential savings for Group 2 were $1.4 million for the federal Medicaid and $634,000 for the state Medicaid programs, respectively. Targeting children with at least 1 hospitalization in the past year (Group 3) produced estimated potential savings of $2.8 million to federal Medicaid and $1.3 million to state Medicaid. However, current Medicaid rules and regulations pose significant challenges for capturing federal Medicaid savings for PFS payouts. Conclusions: A multicomponent intervention that provides home remediation and medical case management to high‐risk children with asthma has significant potential for PFS financing in urban Medicaid populations. However, there are significant administrative and payment challenges, including the limited ability to capture federal Medicaid savings and to use them as a source of investor repayment. Without some policy reform and clear guidance from the federal government, the financing burden of PFS outcome payments will be on the state Medicaid program or some other state‐level funding source. [ABSTRACT FROM AUTHOR]