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BACKGROUND: Family dynamics play an important role in determining the glycemic outcomes of type 1 diabetes (T1D) in children. The time interval immediately following T1D diagnosis is particularly stressful for families, and interventions to support families in adjusting their family practices to support adjustment to and management of T1D in the months following diagnosis may improve glycemic outcomes. Self-guided digital interventions offer a sustainable model for interventions to support caregivers in learning evidence-based family management skills for adjustment to and management of T1D. OBJECTIVE: We hypothesized that a self-guided, web-based, family skills management program (addressing caregiver social support as well as family problem-solving, communication, and supportive behavior change strategies) initiated at the time of T1D diagnosis would improve glycemic outcomes in children with T1D. In this study, we report on the feasibility and acceptability of this program. METHODS: We prospectively evaluated a sample of 37 children newly diagnosed with T1D recruited from a pediatric endocrinology clinic. Parent participants were asked to complete web-based modules addressing social support, family problem-solving, communication, and supportive behavior change strategies. Module completion was analyzed for percentage completion, patterns of completion, and differences in completion rates by coparenting status. Qualitative open-ended feedback was collected at the completion of each module. RESULTS: A total of 31 (84%) of the 37 participants initiated the web-based program. Of those 31 participants, 25 (81%) completed some content and 15 (48%) completed all 5 modules. Completion rates were higher when coparenting partners engaged in the intervention together (P=.04). Of the 18 participants given a choice about the spacing of content delivery, 15 (83%) chose to have all sessions delivered at once and 3 (17%) chose to space sessions out at 2-week intervals. Qualitative feedback supported the acceptability of the program for delivery soon after T1D diagnosis. Families reported on positive benefits, including requesting future access to the program and describing helpful changes in personal or family processes for managing T1D. CONCLUSIONS: In this study, we found that a self-guided digital family support intervention initiated at the time of a childs T1D diagnosis was largely feasible and acceptable. Overall, rates of participation and module completion were similar to or higher than other self-guided digital prevention interventions for mental and physical health outcomes. Self-guided digital programs addressing family management skills may help prevent challenges common with T1D management and can decrease cost, increase access, and add flexibility compared to traditional interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT03720912; https://clinicaltrials.gov/study/NCT03720912.

BACKGROUND: Self-guided web-based interventions have the potential of addressing help-seeking barriers and symptoms common among university students, such as depression and anxiety. Unfortunately, self-guided interventions are also associated with less adherence, implicating motivation as a potential moderator for adherence and improvement for such interventions. Previous studies examining motivation as a moderator or predictor of improvement on web-based interventions have defined and measured motivation variably, producing conflicting results. OBJECTIVE: This secondary analysis of data from a randomized controlled trial aimed to examine constructs of motivation as moderators of improvement for a self-guided 8-week web-based intervention in university students (N=1607). METHODS: Tested moderators included internal motivation, external motivation, and confidence in treatment derived from the Treatment Motivation Questionnaire. The primary outcome was an improvement in depression and anxiety measured by the Depression Anxiety Stress Scale-21. RESULTS: Piecewise linear mixed effects models showed that internal motivation significantly moderated symptom change for the intervention group (t1504=-2.94; P=.003) at average and high (+1 SD) motivation levels (t1507=-2.28; P=.02 and t1507=-4.05; P

Background/Objectives: Early childhood development is profoundly influenced by parent–child interactions, with recent research emphasizing the crucial role fathers play alongside mothers. Paternal involvement, especially in caregiving activities like feeding, positively impacts children's cognitive, emotional, and social development. However, paternal depressive symptoms can hinder the quality of these interactions, potentially leading to long-term behavioral and emotional difficulties in children. Despite this, interventions to enhance caregiving quality that target fathers remain limited. This study aimed to evaluate the effectiveness of a web-based video feedback intervention in improving father–child feeding interactions and reducing psychopathological symptoms in both fathers and their 12- to 24-month-old children. Methods: A longitudinal study was conducted with 244 fathers and their young children. Participants were assessed at two time points (T1 and T2) four weeks apart. Fathers engaged in remote one-hour intervention sessions twice a week, based on the Video Intervention Therapy (VIT) approach. The Symptom Checklist-90-Revised (SCL-90-R) assessed the fathers' psychopathological symptoms, while the Child Behavior Checklist (CBCL 1½–5) evaluated the children's emotional and behavioral functioning. Father–child feeding interactions were video-recorded and analyzed using the Scala di Valutazione delle Interazioni Alimentari (SVIA). Results: Post-intervention analyses showed significant improvements in father–child feeding interactions, with reductions in maladaptive behaviors and interactive conflicts. Fathers exhibited significant decreases in psychopathological symptoms, particularly in depression, anxiety, and obsessive–compulsive tendencies. Children demonstrated significant reductions in internalizing and externalizing problems. Conclusions: The web-based video feedback intervention effectively enhanced the quality of father–child feeding interactions and reduced psychopathological symptoms in both fathers and children. These findings highlight the importance of supporting fathers in their caregiving roles to promote positive developmental outcomes during critical early childhood periods. Further research is warranted to explore the long-term effects of such interventions and their applicability across diverse populations. [ABSTRACT FROM AUTHOR]

The possibility of inducing value change has attracted interest among scholars and practitioners in developmental and social psychology. This study proposes a new web-based intervention aimed at enhancing the importance adolescents ascribe to social-focused values (i.e., self-transcendence and conservation), which was implemented and evaluated in the context of online schooling during the COVID-19 pandemic. Social-focused values primarily regulate how one relates to others and preserve cooperative relations. These values were found to predict positive outcomes, such as adolescents' well-being, school performance, prosocial behavior, and, most recently, COVID-19 preventive behaviors. The intervention was carried out with a group of 140 high school students (Age: M = 16.53, SD = 0.95) living in Italy during the pandemic. The intervention group (N = 84) completed four tasks, which were based on the value-changing mechanisms of priming, consistency maintenance (raising awareness and knowledge of prosociality), or direct persuasion (trying to convince another person to act prosocially). The intervention significantly increased the importance of conservation values (i.e., tradition, conformity, security) but not of self-transcendence values (i.e., universalism, benevolence) in the intervention group in comparison to the control group (N = 56). This result reflects the reality during the pandemic, where prosociality was more easily expressed through behaviors consistent with conservation values instead of self-transcendence values, which emphasize (physical) proximity to others. The effectiveness of the intervention was further supported by a qualitative analysis of adolescents' writings while completing the tasks. Limitations of the study, future research developments, and practical implications for values education in secondary schools are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Dietary intervention is the cornerstone in the management of disorders of amino acid metabolism (AAMDs). Therefore, a MyProteinGuideTM web-based application was developed to assist the caregivers of AAMDs in self-monitoring their nutritional status especially the dietary intake. Materials and methods: A cross-sectional study was conducted to evaluate the usability of the MyProteinGuideTM web-based application among caregivers of patients diagnosed with AAMDs including aminoacidopathies (AA), Organic Aciduria (OA) and Urea Cycle Disorders (UCD) aged between 6 months to 18-year-old who are receiving treatment in the genetic clinic, Hospital Kuala Lumpur (HKL) and Hospital Pulau Pinang (HPP). A total of 30 caregivers participated in this study, out of most of the caregivers had children with AA (43.3%), followed by OA (30.0%) and UCD (26.7%). The Malay version of mHealth application usability questionnaire (MAUQ) and System Usability Scale (SUS) were used as the assessment tools to assess the application usability. Results: An overall usability mean (SD) score of 5.88 (0.76) out of a maximum score of seven as rated by MAUQ while SUS score was 78.17 (15.70), indicating good usability. In term of domain breakdown, the highest scoring domain being Domain 3: Usefulness 5.99 (0.79) followed by Domain 2: User Interface and Satisfaction 5.94 (0.73) and Domain 1: Ease of Use 5.69 (0.91). Suggestions to improve the application include to make it into a responsive web application or mobile application which are user-friendly to both mobile phone user. Conclusion: In conclusion, the usability results showed that MyProteinGuideTM had a good usability. [ABSTRACT FROM AUTHOR]

Web-based interventions can be effective in treating depressive symptoms. Patients with risk not responding to treatment have been identified by early change patterns. This study aims to examine whether early changes are superior to baseline parameters in predicting long-term outcome. In a randomized clinical trial with 409 individuals experiencing mild to moderate depressive symptoms using the web-based intervention deprexis, three latent classes were identified (early response after registration, early response after screening and early deterioration) based on early change in the first four weeks of the intervention. Baseline variables and these classes were included in a Stepwise Cox Proportional Hazard Multiple Regression to identify predictors associated with the onset of remission over 36-months. Early change class was a significant predictor of remission over 36 months. Compared to early deterioration after screening, both early response after registration and after screening were associated with a higher likelihood of remission. In sensitivity and secondary analyses, only change class consistently emerged as a predictor of long-term outcome. Early improvement in depression symptoms predicted long-term outcome and those showing early improvement had a higher likelihood of long-term remission. These findings suggest that early changes might be a robust predictor for long-term outcome beyond baseline parameters. [ABSTRACT FROM AUTHOR]

Reading comprehension is an essential skill for academic success in K-12 settings and professional success beyond schooling. Unfortunately, approximately 33% of students fail to master this essential skill in elementary grades. Students attending high-poverty schools are at a bigger disadvantage due to high teacher turnover and lack of high-quality instruction. Recent efficacy studies with upper elementary-grade students attending rural and suburban schools have revealed that the text structure strategy focused on generating main ideas and summarization and delivered by a web-based intelligent tutor for structure strategy (ITSS) had a positive impact on reading comprehension measured by standardized and researcher-designed measures. The current study focused on replicating these findings with fifth-grade students attending high-poverty schools. A cluster randomized controlled trial with 33 elementary schools was conducted with 2-day teacher practice-based professional development, pretests at the beginning of the academic year, followed by a year-long implementation of the ITSS with coaching and modeling for teachers to provide consistent instruction, and posttests administered at the end of the academic year. Multilevel analysis of data revealed large effects on researcher-designed measures related to writing the main idea and recall (effect sizes ranged from 0.97 to 1.32). A small, yet not statistically significant, effect (effect size = 0.23) was found that favored the intervention classrooms on the standardized Gray silent reading test. These results replicate findings from previous studies on the ITSS. The positive results provide additional evidence of the impact of ITSS on reading comprehension for students attending high-poverty schools who need support the most. Educational Impact and Implications Statement: In this replication study, fifth-grade students attending high-poverty schools were provided a reading intervention focused on teaching them to identify and use text structures to generate main ideas and summaries. Students used the intelligent tutoring system for the structure strategy, a computer-delivered instructional platform, and teachers provided additional text structure-focused main idea and summarization instruction using guides aligned with the textbook passages. Students who received the text structure-based main idea and summarization instruction showed significant progress on measures related to writing main idea statements and recalling important text information. Teaching students to identify and use text structures to generate main ideas and summaries is beneficial for their reading comprehension. [ABSTRACT FROM AUTHOR]

Abstract Background Returning to work after long-term sick leave can be challenging, particularly in small- and medium-sized enterprises (SMEs) where support may be limited. Recognizing the responsibilities and challenges of SME employers, a web-based intervention (hereafter the SME tool) has been developed. The SME tool aims to enhance the employer’s intention and ability to support the sick-listed employee. Based on the Self-Determination Theory, it is hypothesized that this intention is enhanced by intervening in the employer’s autonomy, competences, and relatedness targeted at, e.g., communication with sick-listed employee, involvement of other stakeholders, and practical support. This is achieved by means of providing templates, communication videos, and information on legislation. This article describes the design of an effect and process evaluation of the SME tool. Methods A randomized controlled trial (RCT) with a 6-month follow-up will be conducted with a parallel-group design with two arms: an intervention group and a control group. Sick-listed employees (≤ 8 weeks) of SMEs (≤ 250 employees) at risk of long-term sick leave and their employers will be recruited and randomly allocated as a dyad (1:1). Employers randomized to the intervention group receive unlimited access to the SME tool, while those in the control group will receive care as usual. The primary outcome is the satisfaction of the employee with the return to work (RTW) support provided by their employer. Secondary outcomes include social support, work performance, and quality of work life at the employee level and self-efficacy in providing RTW support at the employer level. Outcomes will be assessed using questionnaires at baseline and 1, 3, and 6 months of follow-up. Process evaluation measures include, e.g., recruitment and use of and perceived usefulness of the SME tool. Additionally, semi-structured interviews with employers, employees, and occupational physicians will explore the interpretation of the RCT results and strategies for the national implementation of the SME tool. Discussion The SME tool is hypothesized to be valuable in addition to usual care helping employers to effectively support the RTW of their long-term sick-listed employees, by improving the employers’ intention and ability to support. Trial registration ClinicalTrials.gov, NCT06330415. Registered on February 14, 2024.

Diabetes mellitus is called as the "pandemic of the era" due to its rising prevalence. Since it is a disease that affects all spheres of life, it has an impact on the quality of life of individuals. This systematic review aims to examine the effect of web-based diabetes training programmes prepared for individuals with type 2 diabetes mellitus on their quality of life. The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta Analysis Protocols) flowchart was used in the literature search stage. A comprehensive search was performed through the [MeSH] keywords (Web-based Intervention, Randomised Controlled Trial, HRQOL, Type 2 Diabetes) until May 8, 2024 in databases of PubMed, Web of Science, Science Direct, Medline, CINAHL, EBSCO host, Cochrane Library, and Google Scholar. Zotero software program was used to identify duplications of the obtained studies. Seven randomised controlled studies were included in the review. It was found that, most of the studies that were included in review showed that quality of life did not cause any significant difference in the level of quality of life; whereas, improvement was observed in quality-of-life levels in all of the experimental groups. Also, studies conducted for 1.5 to 3 months showed that web-based training was effective in improving the quality of life. Consequently, it is recommended that web-based trainings be long enough to prevent patients from dropping out of training, with possibility of an online individual interview, and follow-up periods of 1.5 to 3 months in order to achieve effective results. PROSPERO Number: CRD42024530777. [ABSTRACT FROM AUTHOR]

Background: Legacy building is a priority for pediatric oncology. Storytelling is one strategy to help children document their legacies. Understanding story content would advance knowledge of how children want to be remembered but this has yet to be explored. This study explored content of digital stories created by children with advanced cancer. Method: Facebook advertisements were used to recruit families of children (7–17) with relapsed/refractory cancer to participate in a randomized controlled trial testing a legacy intervention through storytelling. Parent–child dyads (N = 150) were randomly assigned to an intervention or usual care group. A web program guided children to answer legacy questions and upload photographs, movies, and music. Families received the final digital stories. Experienced qualitative coders developed a hierarchical coding system to identify major categories/subcategories within 78 stories. Results: Stories included 1,516 unique story entries, including text, photographs, and movies. Two major categories emerged from the data: (a) story entry medium and (b) story content. Photographs frequently reflected people, objects, pets, and places while text often described personal preferences, goals, dreams, and other people. The story content overall included references to (a) people, (b) setting/location, (c) cancer, (d) objects/activities, and (e) expression of emotions/beliefs. Exemplar quotes, counts, and frequencies for each category are reported. Discussion: Children documented their legacies through stories that emphasized the value of family relationships and children's desires to be known for personal traits/preferences. Children chose to include cancer in their stories, indicating that cancer is a part of how children perceive their legacies. Registration Number : ClinicalTrials.gov NCT04059393. [ABSTRACT FROM AUTHOR]

Background: Returning to work after long-term sick leave can be challenging, particularly in small- and medium-sized enterprises (SMEs) where support may be limited. Recognizing the responsibilities and challenges of SME employers, a web-based intervention (hereafter the SME tool) has been developed. The SME tool aims to enhance the employer's intention and ability to support the sick-listed employee. Based on the Self-Determination Theory, it is hypothesized that this intention is enhanced by intervening in the employer's autonomy, competences, and relatedness targeted at, e.g., communication with sick-listed employee, involvement of other stakeholders, and practical support. This is achieved by means of providing templates, communication videos, and information on legislation. This article describes the design of an effect and process evaluation of the SME tool. Methods: A randomized controlled trial (RCT) with a 6-month follow-up will be conducted with a parallel-group design with two arms: an intervention group and a control group. Sick-listed employees (≤ 8 weeks) of SMEs (≤ 250 employees) at risk of long-term sick leave and their employers will be recruited and randomly allocated as a dyad (1:1). Employers randomized to the intervention group receive unlimited access to the SME tool, while those in the control group will receive care as usual. The primary outcome is the satisfaction of the employee with the return to work (RTW) support provided by their employer. Secondary outcomes include social support, work performance, and quality of work life at the employee level and self-efficacy in providing RTW support at the employer level. Outcomes will be assessed using questionnaires at baseline and 1, 3, and 6 months of follow-up. Process evaluation measures include, e.g., recruitment and use of and perceived usefulness of the SME tool. Additionally, semi-structured interviews with employers, employees, and occupational physicians will explore the interpretation of the RCT results and strategies for the national implementation of the SME tool. Discussion: The SME tool is hypothesized to be valuable in addition to usual care helping employers to effectively support the RTW of their long-term sick-listed employees, by improving the employers' intention and ability to support. Trial registration: ClinicalTrials.gov, NCT06330415. Registered on February 14, 2024. [ABSTRACT FROM AUTHOR]

The present study examined young adults' completion of the Web-based intervention content in a randomized trial that tested two Personalized Feedback Interventions (PFIs) for alcohol use and risky sex behavior (RSB). Data are from a study that evaluated efficacy of two Web-delivered PFIs (combined PFI and integrated PFI) among 269 sexually active young adults between the ages of 18 and 25. We described the view patterns of the Web-based intervention and examined if baseline sociodemographic and alcohol- and sex-related behavioral factors were associated with the completion of PFI. Many participants viewed the intervention more than one time, and the majority finished all intervention pages in at least one session. Older participants and participants who drink more frequently prior to or during sex were more likely to complete. Most participants, especially the young adults who were at higher risk, utilized the intervention contents as intended. [ABSTRACT FROM AUTHOR]

Abstract Background Structural and behavioral interventions to manage work-related stress are effective in employees. Nonetheless, they have been implemented insufficiently, particularly in micro- and small-sized enterprises (MSE). Main barriers include a lack of knowledge and limited resources, which could potentially be overcome with simplified web-based alternatives for occupational stress prevention. However, there is a lack of implementation research about web-based prevention in realistic settings of MSE. Objective The aim of this study is to evaluate the implementation process and success of an integrated web-based platform for occupational stress prevention (“System P”) and to identify potential barriers for its uptake and use in MSE in Germany. Methods This study with a mixed-methods approach investigates eight process-related outcomes in a quantitative part I (adoption, reach, penetration, fidelity/dose, costs, acceptability) and a qualitative part II (acceptability, appropriateness and feasibility). Part I has a pre-post design with two measurements (6 months apart) with 98 individual participants and part II consists of 12 semi-structured interviews with managers and intercorporate stakeholders. Results Part I revealed shortcomings in the implementation process. Adoption/Reach: Despite extensive marketing efforts, less than 1% of the contacted MSE responded to the offer of System P. A total of 40 MSE registered, 24 of which, characterized by good psychosocial safety climate, adopted System P. Penetration: Within these 24 MSE, 15% of the employees used the system. Fidelity/Dose: 11 MSE started a psychosocial risk-assessment (PRA), and no MSE finished it. The stress-management training (SMT) was started by 25 users and completed by 8. Costs: The use of System P was free of charge, but the time required to engage with was an indirect cost. Part II added insights on the perception of the web-based intervention: Acceptance of System P by users and stakeholders was good and it was assessed as appropriate for MSE. Results for feasibility were mixed. Conclusions Although System P was generally perceived as useful and appropriate, only a small number of contacted MSE implemented it as intended. Prior experience and sensitivity for occupational (stress) prevention were mentioned as key facilitators, while (perceived) indirect costs were a key barrier. Enabling MSE to independently manage stress prevention online did not result in successful implementation. Increasing external support could be a solution. ⁺ Full project name “PragmatiKK – Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben” (= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises). Trial registration German Register of Clinical Studies (DRKS) DRKS00026154, date of registration 2021-09-16.

INTRODUCTION: Online interventions have emerged as innovative solutions to address health issues, notably obesity, while minimizing the necessity for in-person interactions during the recent COVID-19 pandemic. There is urgency in designing and developing an appropriate online intervention module within a web-based application. This study aims to describe the design process and usability of the online Canteen Operators, Parents, and Teachers (CoPT Nutri Trail) module for an upcoming school-based obesity intervention. MATERIALS AND METHODS: The design methodology consists of four phases: content development, design, web app development, and usability testing. The web application was designed to personalize usage for teachers, parents, and canteen operators to foster healthy environments for children. Thirteen experts, including teachers, nutritionists, and IT professionals, participated in the usability testing. RESULTS: All experts agreed that the design of the web application met the requirements of target users, requiring slight improvements in graphic design, language, and information elements. The web application tool was found acceptable, as the usability of alpha scores for all interface elements ranged from 68.2% to 86.6%, falling between good and very good scores. The content validation indices indicate good levels of validity (ranging from 0.83 to 1.00). CONCLUSION: The CoPT Nutri Trail web application is ready to be launched as a school-based intervention for obesity. [ABSTRACT FROM AUTHOR]

This study aimed to assess the effect of web-based reproductive health education provided to university students in Turkey on their belief in sexual myths and risky behaviours. A randomised controlled trial was conducted in a state university between March-October 2021 with 96 students. The web-based health education was developed using the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model, and was delivered by means of a special platform. An intervention group of 48 students received 5 modules of education, while a control group of 48 students received none. Performance on two scales measuring information gained and risk behaviours, and sexual myths, respectively, was assessed at the beginning of the study and 5 weeks following the intervention. A statistically significant difference was observed between the two groups on both scales at the final evaluation. Additionally, a significant difference was observed in final sexual myths evaluation scores between the intervention and control groups for sexual orientation, age and sexuality, masturbation, sexual violence, sexual intercourse, and sexual satisfaction, as subdimensions of the sexual myths scale. Our findings suggest that web-based reproductive health education can be effective in reducing sexual myths and increasing knowledge about risky behaviours among university students relevant to sexual and reproductive health in young adults. [ABSTRACT FROM AUTHOR]

This study examined factors anticipating adolescents' (N=232) adherence and dropout in an online acceptance and commitment therapy (ACT) intervention targeted at promoting well-being during the COVID-19 pandemic. First, results showed that adolescents with high academic achievement and educational expectations were more likely to participate in the induction meeting and start the program. Second, adolescents in the human-supported model fulfilled the adherence criteria more often than adolescents supported by virtual coach only. Finally, though male participants were less likely to participate in the study, participants who started the online program were likely to adhere to it regardless of gender. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has caused many countries to turn to web-based solutions. The Home Assessment Tool (HAT) is a web-based system using the MySejahtera application developed by the government. It serves as a communication platform for patients with COVID-19 to self-monitor their clinical symptoms and enables authorised healthcare personnel to access and manage collected data for clinical monitoring. Our study aimed to examine the utilisation of this internet-based tool among patients with COVID-19 in Selangor. Methods: This observational study analysed secondary data from the self-reported HAT within MySejahtera. It included all patients who were diagnosed with COVID-19 through molecular assays such as RT-PCR or RTK-Ag on 1-21 February 2021, aged =18 years and residing in Selangor. Patients who had documented their symptoms at least once in the HAT during the prescribed 10-day isolation period were classified as HAT users. Results: A total of 4438 patients were included, of whom 39.4% were HAT users, while 60.6% were non-HAT users. Logistic regression analysis revealed three significant factors associated with low utilisation of the HAT: absence of medical condition (odds ratio [OR]: 9.4; 95% confidence interval [CI]: 7.49-12.01), advanced age (OR: 1.35; 95% CI: 1.20-1.52) and non-Malaysian citizenship (OR: 3.4; 95% CI: 2.50-4.72). Conclusion: The utilisation of the HAT is low, which is associated with advanced age (=65 years), absence of medical conditions and foreign nationality. It is imperative to develop inventive strategies tailored to address the unique needs of these particular demographics. [ABSTRACT FROM AUTHOR]

Passive psychoeducation is an easily accessible and cost-effective self-guided intervention that does not use elements of active psychotherapies or require homework. The present study aimed to investigate the acceptability and efficacy of a 7-week app-based passive psychoeducation stress management program to promote adaptive emotion regulation and coping skills in university students (i.e., 80% psychology students). Participants were tested via Lime-Survey® at pre- and post-test with the Depression Anxiety Stress Scale-21 (DASS-21), the Response Styles Questionnaire (RSQ), and the Emotion Regulation Questionnaire (ERQ). A stratified permutation block randomization by age, gender, and the DASS-21 stress subscale was performed. Each week, the psychoeducation group (n = 123) received different psychoeducation modules. At the end of each module, participants answered questions about their satisfaction with each module and adherence to psychoeducation. The control group (n = 130) received no intervention. The psychoeducation program led to a significant improvement in the adaptive emotion regulation strategy: "reappraisal" (p = 0.004) and a significant reduction in the dysfunctional coping style: "symptom-related rumination" (p = 0.01) but not to a significant reduction in depression, anxiety, and stress scores compared to the control group. Thus, the present study might demonstrate a preventive effect of an app-based passive psychoeducation program in students with low clinically relevant psychopathological symptoms. [ABSTRACT FROM AUTHOR]

Background We investigated the effects of a 12-week home-based exercise program delivered with virtual or minimal supervision on the physical and cognitive function of community-dwelling older adults in the context of the COVID-19 pandemic in Brazil. Methods The study was registered on the Brazilian Registry of Clinical Trials platform (code: RBR-8qby2wt). Thirty-eight older adults (81% female and 68±7 years old), non-disabled, and without cognitive impairment or dementia, were randomly assigned to a 12-week home-based exercise program: 1) virtual supervision (classes remotely delivered through video conference by trained staff), or 2) minimal supervision (once-weekly contact to touch base through standardized text messages). The participants initially performed two sets of 10 repetitions three times a week, with a 60-second interval. The volume and complexity of the exercises were progressively increased. (e.g., the number of sets increased to 3 and later to 4). At baseline and follow-up, we collected remote measurements of physical function (muscle strength and power, functional muscular fitness) and cognition (processing speed, inhibitory control, verbal fluency). Results Participants in the minimal supervision home-based exercise group significantly improved the Stroop test (-1.6 sec, 95% CI = -3.20; -0.09). No significant between-group differences were observed for physical and cognitive outcomes. Conclusion A home-based exercise program delivered with virtual or minimal supervision can produce similar effects, and may help to maintain physical and cognitive capabilities among healthy, high-functioning older adults who experienced mobility restrictions due to the COVID-19 pandemic in Brazil. [ABSTRACT FROM AUTHOR]

Background: The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults. Methods: A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV). Results: Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of 'agoraphobia' (0.947; 95%CI [0.934, 0.960]), 'anxiety' (0.959; 95%CI [0.946, 0.970]), and 'panic disorder' (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the 'obsessive-compulsive' dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for 'depression' (0.716; 95%CI [642, 798]) and 'alcohol abuse' (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions. Conclusions: The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ screening result. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the efficacy of a web-based health information intervention on knowledge, care burden and attitudes of family caregivers of patients with dementia. This study is a unblinded randomised controlled trial. The study population consisted of family caregivers of patients with dementia (n = 50) which were randomly allocated to the intervention group (access to the web-based health information) or control group (access to information as usual). The participants completed knowledge, care burden and attitude questionnaire at baseline and at two months follow-up. A total of 50 caregivers participated in this study. Before the intervention, there was no statistically significant difference between the knowledge, care burden and attitude score between the two groups. In comparison to the control group after the intervention, participants in the intervention group showed significant improvements in all outcomes. These findings provide further evidence that web-based information interventions helped caregivers feel more confident, empathetic and concerned about dementia care with less care burden. [ABSTRACT FROM AUTHOR]

Background: No web-based interventions addressing sexual problems are available for young adult survivors of childhood cancer. Aim: This study aimed to test the efficacy of a web-based psychoeducational intervention, Fex-Can Sex, to alleviate sexual problems in young adults treated for cancer during childhood. Method: This randomized controlled trial tested the effects of a 12-week, self-help, web-based intervention. Young adults (aged 19–40) reporting sexual dysfunction were drawn from a population-based national cohort of childhood cancer survivors and randomized to either an intervention group (IG, n = 142) or a wait-list control group (CG, n = 136). The primary outcome was ‘Satisfaction with sex life’ assessed by the PROMIS® SexFS v 2.0. Secondary outcomes included other SexFS domains, body image (BIS), emotional distress (HADS), health-related quality of life (EORTC QLQ-C30), and sex-related self-efficacy. Surveys were completed at baseline (T0), directly after the intervention (T1), and three months later (T2). The effects of the intervention were tested using t-test and linear mixed models, including intention-to-treat (ITT) and subgroups analysis. Adherence was based on log data extracted from the website system. The intervention included an open-ended question about perceived sexual problems. Results: No effect of the intervention was found in the primary outcome. Regarding secondary outcomes, the IG reported less vaginal dryness (Lubrication subscale) than the CG at T1 (p = 0.048) and T2 (p = 0.023). Furthermore, at T1, the IG reported less emotional distress than the CG (p = 0.047). Subgroup analyses showed that those with greater sexual problems at T0 improved over time (T1 and T2), regardless of group allocation. Overall, adherence to the intervention was low and participants' activity levels did not change the results. Additionally, some members of the IG reported increased understanding and acceptance of their sexual problems. Conclusion: The Fex-Can Sex intervention shows potential to improve sexual function, especially among those with greater dysfunction. To increase adherence and effect, we recommend the intervention to be further developed including more tailored content. Clinical trial registration: ISRCTN Registry, trial number: 33081791 (registered on November 27, 2019).

Background Families, friends and support networks are key to managing bereavement. COVID-19 social restrictions prevented families and friends from being with the dying and participating in usual rituals to honour the dead. This resulted in social disconnection, feelings of guilt, and difficulty in making sense of the death and reconstructing relationships. In response to this context a theoretically informed, co-produced web-resource to facilitate meaning-making, which situates bereavement in the context of family and friends, was developed. This paper describes the development of the web-based intervention. Study aims To co-produce a web-based intervention theoretically informed by the family level extension Dual Process Model and Family Sense of Coherence, and pilot the intervention gaining user feedback to inform refinements in readiness for adoption and implementation. Methods Following a scoping review, a mixed methods study was undertaken using an online survey via questionnaire and virtual co-production workshop with bereaved people and bereavement professionals. Results Survey respondents (n=32) reported the pandemic negatively affected bereavement (guilt, isolation, inability to bear witness) but also presented new opportunities to celebrate the deceased and support the bereaved (new funeral rituals, technology, remote contact, social acknowledgement of grief). Sense-making and managing bereavement were helped through information-giving, support networks, and relocating the person within the family context. A web-resource to facilitate collective grief was viewed positively and endorsed. Key content including family activities to stimulate support, information regarding the range of grief experience and dealing with the practicalities, along with other sources of support was agreed by workshop participants (n=5) to form the basis of the intervention. Conclusion The publicly accessible Families and Friends in Bereavement intervention encourages consideration of bereavement in the context of close social networks. It enables grief to be understood and managed within a shared experience by promoting communication and meaning-making.

Abstract Background Health education is one of the main items to enable health promotion to patients with fibromyalgia. The objective of the study “Amigos de Fibro (Fibro Friends)” is to evaluate the impact of an educational intervention associated with physical exercise based on the web in promoting health and quality of life of patients with fibromyalgia in Brazil. Methods A study with a randomized controlled trial approach will be carried out. The sample will consist of 24 participants, divided into two groups, with 12 individuals each. The experimental group will participate in meetings with lectures, debates, conversation rounds and exercises by a multidisciplinary team. Physical exercises will also be performed in an online environment. On the other hand, the control group will receive an e-book of education and self-care. Primary outcomes will be quality of life. The secondary outcomes will be sociodemographic and health profile, pain intensity, sleep quality, self-care agency, usage and costs of health and social care services, viability of the program and program participation. In addition, a qualitative evaluation process will be carried out with the participants. After the intervention, the data of both groups will be collected again, as well as after 3, 6, and 12 months to verify the effect and the maintenance of the intervention. Discussion The results will provide data for studies to consider the use of this tool in the future by professionals working in the field of rheumatology. Trial registration The protocol was registered in the Brazilian Registry of Clinical Trials RBR-3rh759 ( https://trialsearch.who.int/Trial2.aspx?TrialID=RBR-3rh759 ). Date of registration: 07/02/2020].

Abstract Background To address the challenges in nursing education brought about by the pandemic, this study aimed to evaluate the use of a web-based standardized patient practice in the development of nursing students’ anamnesis taking skills and their views about its application. Method We conducted a descriptive intervention study with 39 s-year nursing students. The students completed anamnesis using the standardized patient practice in line with a scenario with real standardized patients in a web-based environment with audio and video. Results The total scores of students’ anamnesis skills were low. The agreement between the total scores, scores obtained from the health patterns, and each item in the control list was statistically significant (p

Suicide is a serious public health problem; however, suicides are preventable with evidence-based and often low-cost interventions. This study analyzes the online content of suicide prevention and helps websites in the context of preventive psychiatry. The universe and sample of the research consisted of 147 web pages whose links can be found on the most widely used international social media platforms and websites dedicated to suicide prevention. To conduct the content analysis, the crisis hotline guide prepared by the World Health Organization for suicide prevention and the guide prepared for media professionals were used in the data collection form created by the researchers. The majority of the websites were of European origin and were prepared by mental health and suicide prevention associations for suicide prevention and crisis intervention. Telephone helplines were the most common means of communicating with consultants via the web page. On the basis of the research findings, suggestions were generated regarding the scope, content, and sustainability of web pages for crisis intervention and suicide prevention prepared at the national and international levels. [ABSTRACT FROM AUTHOR]

Completing a thesis is one of the crucial stages that determine the length of a student’s study. Therefore, various previous studies have attempted to reveal the factors that influence the thesis writing process as well as the effectiveness of various interventions to overcome existing obstacles. Meanwhile, this study aims to determine the effectiveness of the intervention of web-based diaries, web-based comics, and web-based diaries+comics on the self-regulated learning of students working on theses. The intervention was designed as a modification of previous research in order to test different application methods and more comprehensive evaluations of independent learning. This study involved 35 undergraduate students who could follow the research process from start to finish for 25 days. Sampling from the population used a purposive sampling technique. The measurement of self-regulated learning was carried out using the results of the shortened version of the MSLQ adaptation, in which the measurements were carried out on each component that composes self-regulated learning, referring to Pintrich’s theory of self-regulated learning. The results of the mixed between-within subject ANOVA analysis using IBM SPSS Statistics 23 on each self-regulated learning indicator in each group showed that the three forms of intervention are only effective in increasing scores on the self-efficacy for learning and performance, organization, critical thinking, and metacognitive subscales. This finding becomes an evaluation for the preparation of further interventions that target the self-regulated learning of students who are working on their thesis. [ABSTRACT FROM AUTHOR]

Background: Digital health interventions are a promising method for delivering timely support to underresourced family caregivers. The uptake of digital health interventions among caregivers may be improved by engaging caregivers in participatory design (PD). In recent years, there has been a shift toward conducting PD remotely, which may enable participation by previously hard-to-reach groups. However, little is known regarding how best to facilitate engagement in remote PD among family caregivers. Objective: This study aims to (1) understand the context, quality, and outcomes of family caregivers' engagement experiences in remote PD and (2) learn which aspects of the observed PD approach facilitated engagement or need to be improved. Methods: We analyzed qualitative and quantitative data from evaluation and reflection surveys and interviews completed by research and community partners (family caregivers) across 4 remote PD studies. Studies focused on building digital health interventions for family caregivers. For each study, community partners met with research partners for 4 to 5 design sessions across 6 months. After each session, partners completed an evaluation survey. In 1 of the 4 studies, research and community partners completed a reflection survey and interview. Descriptive statistics were used to summarize quantitative evaluation and reflection survey data, while reflexive thematic analysis was used to understand qualitative data. Results: In 62.9% (83/132) of evaluations across projects 1-3, participants described the session as "very effective." In 74% (28/38) of evaluations for project 4, participants described feeling "extremely satisfied" with the session. Qualitative data relating to the engagement context identified that the identities of partners, the technological context of remote PD, and partners' understanding of the project and their role all influenced engagement. Within the domain of engagement quality, relationship-building and co-learning; satisfaction with prework, design activities, time allotted, and the final prototype; and inclusivity and the distribution of influence contributed to partners' experience of engagement. Outcomes of engagement included partners feeling an ongoing interest in the project after its conclusion, gratitude for participation, and a sense of meaning and self-esteem. Conclusions: These results indicate high satisfaction with remote PD processes and few losses specific to remote PD. The results also demonstrate specific ways in which processes can be changed to improve partner engagement and outcomes. Community partners should be involved from study inception in defining the problem to be solved, the approach used, and their roles within the project. Throughout the design process, online tools may be used to check partners' satisfaction with design processes and perceptions of inclusivity and power-sharing. Emphasis should be placed on increasing the psychosocial benefits of engagement (eg, sense of community and purpose) and increasing opportunities to participate in disseminating findings and in future studies. [ABSTRACT FROM AUTHOR]

Background: Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Many would benefit from support programs, but the figures reveal that only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children. Research on digital interventions aimed at this target group is scarce. We have developed a novel digital therapist-assisted self-management intervention targeting adolescents whose parents had alcohol use problems. This program aims to strengthen coping behaviors, improve mental health, and decrease alcohol consumption in adolescents. Objective: This study aims to examine the effectiveness of a novel web-based therapist-assisted self-management intervention for adolescents whose parents have alcohol use problems. Methods: Participants were recruited on the internet from social media and websites containing health-related information about adolescents. Possible participants were screened using the short version of the Children of Alcoholics Screening Test-6. Eligible participants were randomly allocated to either the intervention group (n=101) or the waitlist control group (n=103), and they were unblinded to the condition. The assessments, all self-assessed, consisted of a baseline and 2 follow-ups after 2 and 6 months. The primary outcome was the Coping With Parents Abuse Questionnaire (CPAQ), and secondary outcomes were the Center for Epidemiological Studies Depression Scale, Alcohol Use Disorders Identification Test (AUDIT-C), and Ladder of Life (LoL). Results: For the primary outcome, CPAQ, a small but inconclusive treatment effect was observed (Cohen d =–0.05 at both follow-up time points). The intervention group scored 38% and 46% lower than the control group on the continuous part of the AUDIT-C at the 2- and 6-month follow-up, respectively. All other between-group comparisons were inconclusive at either follow-up time point. Adherence was low, as only 24% (24/101) of the participants in the intervention group completed the intervention. Conclusions: The findings were inconclusive for the primary outcome but demonstrate that a digital therapist-assisted self-management intervention may contribute to a reduction in alcohol consumption. These results highlight the potential for digital interventions to reach a vulnerable, hard-to-reach group of adolescents but underscore the need to develop more engaging support interventions to increase adherence. Trial Registration: ISRCTN Registry ISRCTN41545712; https://www.isrctn.com/ISRCTN41545712?q=ISRCTN41545712 International Registered Report Identifier (IRRID): RR2-10.1186/1471-2458-12-35 [ABSTRACT FROM AUTHOR]

Background: More than half (55%) of Latina women do not meet aerobic physical activity (PA) guidelines, and frequently cite time, childcare, and transportation as barriers to PA. In addition to linguistic adaptations for this population, successful PA interventions for Latina women addressed these barriers through remote intervention delivery approaches (eg, mail, phone, or web delivery). Objective: We aimed to evaluate 6-month outcomes of a randomized trial comparing a Spanish-language, individually tailored, web-delivered PA intervention (original) to an enhanced version with text messages and additional features (enhanced). Further, we evaluated if increases in PA at 6 months were moderated by baseline activity status. Methods: In total, 195 Latina women aged 18-65 years participated in a trial comparing the efficacy of the enhanced versus original interventions at initiating PA behavior change. We examined minutes per week of accelerometer-measured PA in the enhanced versus original arms, and the proportion of each arm meeting aerobic PA guidelines (150 min/wk at 6 mo). For moderator analyses, participants were classified as inactive (0 min/wk) or low active (1-90 min/wk) at baseline, measured via the 7 Day Physical Activity Recall interview. Results: PA increased from 19.7 (SD 47.9) minutes per week at baseline to 46.9 (SD 66.2) minutes per week at 6 months in the enhanced arm versus 20.6 (SD 42.7) minutes per week to 42.9 (SD 78.2) minutes per week in the original arm (P =.78). Overall, 30% (31/103) of the enhanced group met aerobic PA guidelines at 6 months, compared to 21% (19/92) of the original group (odds ratio [OR] 1.75, 95% CI 0.87-3.55). Baseline PA (inactive vs low active) moderated treatment effects on PA. For inactive participants, there were no group differences at 6 months (b=7.1; SE 22.8; P =.75), while low-active participants increased more in enhanced than original (b=72.5; SE 27.9; P =.01). For low-active participants, 45% (46/103) of the enhanced group met PA guidelines at 6 months, versus 20% (18/92) of the original arm (OR 3.29, 95% CI 1.05-11.31). For inactive participants, there were no group differences (25/103, 24% vs n=19/92, 21% for enhanced vs original, respectively; OR 1.28, 95% CI 0.54-3.06). Conclusions: Intervention effects were conditional on baseline PA. For low-active Latina women, the enhanced intervention was more effective at increasing PA. Additional tailored intervention enhancements may be necessary to increase PA for inactive Latina women. Trial Registration: ClinicalTrials.gov NCT03491592; https://www.clinicaltrials.gov/study/NCT03491592 International Registered Report Identifier (IRRID): RR2-10.1186/s13063-022-06575-4 [ABSTRACT FROM AUTHOR]

Background: Cancer has emerged as a considerable global health concern, contributing substantially to both morbidity and mortality. Recognizing the urgent need to enhance the overall well-being and quality of life (QOL) of cancer patients, a growing number of researchers have started using online mindfulness-based interventions (MBIs) in oncology. However, the effectiveness and optimal implementation methods of these interventions remain unknown. Objective: This study evaluates the effectiveness of online MBIs, encompassing both app- and website-based MBIs, for patients with cancer and provides insights into the potential implementation and sustainability of these interventions in real-world settings. Methods: Searches were conducted across 8 electronic databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CINAHL Complete, Scopus, and PsycINFO, until December 30, 2022. Randomized controlled trials involving cancer patients aged ≥18 years and using app- and website-based MBIs compared to standard care were included. Nonrandomized studies, interventions targeting health professionals or caregivers, and studies lacking sufficient data were excluded. Two independent authors screened articles, extracted data using standardized forms, and assessed the risk of bias in the studies using the Cochrane Bias Risk Assessment Tool. Meta-analyses were performed using Review Manager (version 5.4; The Cochrane Collaboration) and the meta package in R (R Foundation for Statistical Computing). Standardized mean differences (SMDs) were used to determine the effects of interventions. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to assess the potential implementation and sustainability of these interventions in real-world settings. Results: Among 4349 articles screened, 15 (0.34%) were included. The total population comprised 1613 participants, of which 870 (53.9%) were in the experimental conditions and 743 (46.1%) were in the control conditions. The results of the meta-analysis showed that compared with the control group, the QOL (SMD 0.37, 95% CI 0.18-0.57; P <.001), sleep (SMD −0.36, 95% CI −0.71 to −0.01; P =.04), anxiety (SMD −0.48, 95% CI −0.75 to −0.20; P <.001), depression (SMD −0.36, 95% CI −0.61 to −0.11; P =.005), distress (SMD −0.50, 95% CI −0.75 to −0.26; P <.001), and perceived stress (SMD −0.89, 95% CI −1.33 to −0.45; P =.003) of the app- and website-based MBIs group in patients with cancer was significantly alleviated after the intervention. However, no significant differences were found in the fear of cancer recurrence (SMD −0.30, 95% CI −1.04 to 0.44; P =.39) and posttraumatic growth (SMD 0.08, 95% CI −0.26 to 0.42; P =.66). Most interventions were multicomponent, website-based health self-management programs, widely used by international and multilingual patients with cancer. Conclusions: App- and website-based MBIs show promise for improving mental health and QOL outcomes in patients with cancer, and further research is needed to optimize and customize these interventions for individual physical and mental symptoms. Trial Registration: PROSPERO CRD42022382219; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382219 [ABSTRACT FROM AUTHOR]

Background: Workplace mental health is an important global health concern. Objectives: This unblinded, phase-III, wait-listed cluster randomized controlled trial aimed to examine the effectiveness of a mobile health (mHealth) psychoeducation program using a spaced education approach on mental health literacy (MHL) in the workplace. The main interest of this paper was the immediate and 3-month medium-term effect of the program on the MHL of workers. The purposely built mHealth platform was also evaluated as a health-related app. Methods: The mHealth platform was designed using the principle of spaced education as a psychoeducation intervention program, with various modules of web-based and mobile materials presented to the participant in a progressive manner. Short quizzes at the end of each module ensured adequate learning, and successful completion qualified the learner to progress to the next level. The trial recruited 456 employees of specific industries with high levels of work-related stress. Participants who were nested in different offices or units were allocated into the intervention and wait-listed control groups using a block randomization process, with the office or unit as the cluster. A separate sample of 70 individual raters were used for the evaluation of the mHealth platform. The Australian National MHL and Stigma Survey and the Mobile Apps Rating Scale were completed through a web-based self-reported survey to assess MHL and evaluate the app. The trial and follow-up data were analyzed by a generalized linear latent and mixed model with adjustments for the clustering effect of work sites and repeated measures. Results: Of the 456 participants in the trial, 236 (51.8%) responded to the follow-up survey. Most MHL outcomes obtained significant results immediately after the intervention and across time. After adjusting for the clustering effect, the postintervention weighted mean scores were significantly higher in the intervention group than the control group for correct recognition of a mental health problem, help seeking, and stigmatization by 0.2 (SE 0.1; P =.003), 0.9 (SE 0.2; P <.001), and 1.8 (SE 0.4; P <.001), respectively. After adjusting for the clustering effect, significant differences across time were found in help-seeking intention (P =.01), stigmatization (P <.001), and social distancing (P <.001). The evaluation of the mHealth program resulted in average scores of the 4 major domains ranging from 3.8 to 4.2, with engagement having the lowest score. Conclusions: The mHealth psychoeducation intervention program using this platform had immediate and 3-month medium-term effects of retaining and improving MHL. The platform was evaluated to have satisfactory performance in terms of functionality, aesthetics, information content, and utility in enhancing MHL. It is anticipated that ongoing development in digital health will provide great benefits in improving the mental health of the global population. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12619000464167; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377176 International Registered Report Identifier (IRRID): RR2-10.1186/s13063-019-3748-y [ABSTRACT FROM AUTHOR]

Background: Compromised well-being and mental health problems pose a significant threat to individuals and societies worldwide. Resource-intensive psychological treatments alone cannot alleviate this burden. There is a need for low-cost, evidence-based interventions aimed at preventing illness and promoting well-being. Five activity domains appear to be linked with well-being promotion across populations: connecting with others, being active, taking notice, learning, and being generous/giving. The activities mentioned are part of the Five Ways to Wellbeing framework and the web-based intervention Five Ways to Wellbeing for All (5waysA). Objective: This randomized controlled trial aims to test the effects of the 5waysA intervention, a web-based, low-cost, well-being--promoting measure targeting the general population. To date, the Five Ways to Wellbeing framework has not been tested in this specific format. The 5waysA intervention comprises 2 webinars and SMS text message reminders delivered over a 10-week period. Methods: In 2021, a total of 969 study participants from various regions across Norway were openly recruited through a web page. They were then randomly assigned to either an intervention group or 1 of 2 waiting list control groups, namely, active or passive. Self-reported life satisfaction (Satisfaction With Life Scale [SWLS]), flourishing (Flourishing Scale [FS]), positive emotions, anxiety, and depression symptoms (Hopkins Symptom Checklist-8 [HSCL-8]) were assessed before the intervention, at 4 weeks into the intervention, and 1-2 weeks after the intervention (over 10 weeks). Data analysis was conducted using linear mixed (multilevel) models. Results: After 10 weeks, 453 participants (171 in the intervention group and 282 in the waiting list control group) were assessed on outcome variables, with a dropout rate of 53.2% (516/969). Results revealed a significantly greater increase in the intervention group compared with the controls for SWLS (b=0.13, 95% CI 0.03-0.23; P=.001), FS (b=0.19, 95% CI 0.08-0.30; P=.001), positive emotions (b=0.43, 95% CI 0.27-0.60; P<.001), and these factors combined into a global well-being measure (b=0.28, CI 0.16-0.39; P<.001). Effect sizes (Cohen d) for the well-being outcomes ranged from 0.30 to 0.49. In addition, a significant decrease in anxiety and depressive symptoms was observed (b=-0.17, 95% CI -0.30 to -0.04; P=.001) with an effect size (Cohen d) of -0.20. Conclusions: The findings suggest that the web-based 5waysA intervention could serve as an effective approach for enhancing well-being and mental health within the general population. This study offers individuals, policy makers, and local stakeholders an accessible and potentially cost-effective well-being intervention that could be easily implemented. [ABSTRACT FROM AUTHOR]

A web-based clinical simulation program, known as FIRST2ACT (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends), was designed to increase the efficacy of clinicians' actions in the recognition and immediate response to a patient's deterioration. This study, which was nested in a larger mixed method project, used ten focus groups (n = 65) of graduate, enrolled, registered nurses, associate nurse unit managers, and general managers/educators/coordinators from four different institutions to investigate whether nurses felt their practice was influenced by participating in either a face-to-face or web-based simulation educational programme about patient deterioration. The results indicate that individuals who were less "tech-savvy" appreciated the flexibility of web-based learning, which increased their confidence. Face-to-face students appreciated self-reflection through performance evaluation. While face-to-face simulations were unable to completely duplicate symptoms, they showed nurses' adaptability. Both interventions enhanced clinical practice by improving documentation and replies while also boosting confidence and competence. Web learners initially experienced tech-related anxiety, which gradually subsided, demonstrating healthcare professionals' resilience to new learning approaches. Overall, the study highlighted the advantages and challenges of web-based and face-to-face education in clinical practice, emphasising the importance of adaptability and reflective learning for healthcare professionals. Further exploration of specific topics is required to improve practice, encourage knowledge sharing among colleagues, and improve early detection of patient deterioration. [ABSTRACT FROM AUTHOR]

Intrinsic values and priorities influence decision-making and are, therefore, important to consider explicitly in intervention development. Although health is generally considered an important value, individuals often make unhealthy choices, indicating a values disconnect. To investigate how becoming aware of a disconnect between the value assigned to health and the effort devoted to health is related to intentions and commitment for behavioural change and physical activity among inactive adults. We performed a secondary exploratory analysis on previously collected data. The intervention included a values exercise based on the Disconnected Values Model (DVM) that made disconnected values explicit to participants in two study arms. We compared participants with a disconnect (n = 138) with participants without a disconnect (n = 101) regarding intentions and commitment for behavioural change and physical activity and sitting time 2–4 weeks follow-up. Logistic and linear regression analyses were performed to analyse the data. Between-group differences were found for the intention to devote more effort to health (OR = 3.75; 95%CI: 2.05; 6.86) and for the intention to become more physically active (OR = 2.21; 95%CI: 1.10; 4.46), indicating that significantly more participants with a disconnect were motivated to change, compared to participants without a disconnect. No between-group differences were found for commitment, intention strength, follow-up physical activity and sitting time. Making explicit a disconnect regarding health in an active choice intervention was associated with intentions to become more physically active. Still, it did not translate in significant behaviour change at 2–4 weeks follow-up. ClinicalTrials.gov: NCT04973813. Retrospectively registered. ClinicalTrials.gov identifier: NCT04973813.. [ABSTRACT FROM AUTHOR]

Aims Modern clinical management of patients with an implantable cardioverter defibrillator (ICD) largely consists of remote device monitoring, although a subset is at risk of mental health issues post-implantation. We compared a 12-month web-based intervention consisting of goal setting, monitoring of patients' mental health—with a psychological intervention if needed—psychoeducational support from a nurse, and an online patient forum, with usual care on participants' device acceptance 12 months after implantation. Methods and results This national, multi-site, two-arm, non-blinded, randomized, controlled, superiority trial enrolled 478 first-time ICD recipients from all 6 implantation centres in Denmark. The primary endpoint was patient device acceptance measured by the Florida Patient Acceptance Survey (FPAS; general score range = 0–100, with higher scores indicating higher device acceptance) 12 months after implantation. Secondary endpoints included symptoms of depression and anxiety. The primary endpoint of device acceptance was not different between groups at 12 months [ B = −2.67, 95% confidence interval (CI) (−5.62, 0.29), P = 0.08]. Furthermore, the secondary endpoint analyses showed no significant treatment effect on either depressive [ B = −0.49, 95% CI (−1.19; 0.21), P = 0.17] or anxiety symptoms [ B = −0.39, 95% CI (−0.96; 0.18), P = 0.18]. Conclusion The web-based intervention as supplement to usual care did not improve patient device acceptance nor symptoms of anxiety and depression compared with usual care. This specific web-based intervention thus cannot be recommended as a standardized intervention in ICD patients. [ABSTRACT FROM AUTHOR]

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Objective: This study determined the characteristics of engagement and whether engagement in an adaptive preventive intervention (API) was associated with reduced binge drinking and alcohol-related consequences. Method: Incoming students were recruited for a sequential multiple assignment randomized trial (SMART; N = 891, 62.4% female, 76.8% non-Hispanic White) with an assessment-only control group. The API occurred during the first semester of college, with outcomes assessed at the end of the semester. The API involved two stages. Stage 1 included universal intervention components (personalized normative feedback [PNF] and self-monitoring). Stage 2 bridged heavy drinkers to access additional resources. We estimated the effect of engagement in Stage 1 only and in the whole API (Stages 1 and 2) among the intervention group, and the effect of the API versus control had all students assigned an API engaged, on alcohol-related outcomes. Results: Precollege binge drinking, intention to pledge a fraternity/sorority, and higher conformity motives were most associated with lower odds of Stage 1 engagement. Action (readiness to change) and PNF engagement were associated with Stage 2 engagement. API engagement was associated with significant reductions in alcohol-related consequences among heavy drinkers. Compared to the control, we estimated the API would reduce the relative increase in alcohol-related consequences from baseline to follow-up by 25%, had all API students engaged. Conclusions: Even partial engagement in each component of the "light-touch" API rendered benefits. Analyses suggested that had all students in the intervention group engaged, the API would significantly reduce the change in alcohol-related consequences over the first semester in college. What is the public health significance of this article?: This study focuses on the characteristics associated with engaging in a brief adaptive preventive intervention and concludes that engagement is associated with reduced alcohol-related consequences among first-year college students. Identifying characteristics associated with intervention engagement (e.g., intending to pledge into a fraternity/sorority, precollege drinking motives and behaviors, readiness to change) can inform efforts to improve intervention implementation and thereby improve outcomes. [ABSTRACT FROM AUTHOR]

Objective: Personalized normative feedback (PNF) interventions are effective at reducing hazardous drinking in college. However, little is known about who is most receptive to PNF. College women with a history of alcohol-related incapacitated rape (IR) are at elevated risk for hazardous drinking, but it is unclear what impact intervention messaging may have on this group and how their outcomes compare to those without past IR. To address this gap, this study involved secondary data analysis of a large web-based clinical trial. Method: Heavy drinking college women (N = 1,188) were randomized into PNF (n = 895) or control conditions (n = 293). Postintervention, women reported their reactions to intervention messaging. Hazardous drinking outcomes (typical drinking, heavy episodic drinking [HED], peak estimated blood alcohol content [eBAC], blackout frequency) were assessed at baseline and 12 months. Results: Past IR was reported by 16.3% (n = 194) of women. Womenwith a history of IR reportedmore baseline hazardous drinking and greater readiness to change than women without IR. For those who received PNF, history of IR related to greater perceived impact of the intervention, but no difference in satisfaction with the message. After controlling for baseline drinking, regressions revealed the effect of PNF was moderated by IR for frequency of HED at 12 months. Simple main effects revealed PNF was associated with lower levels of hazardous drinking at follow-up among women with past IR. Conclusions: This initial investigation suggests PNF is a low resource and easily disseminated intervention that can have a positive impact on college women with past IR. [ABSTRACT FROM AUTHOR]

Lymphomas are characterized by a relatively favorable prognosis and a good five-year survival rate, but they are associated with increased psychosocial distress. There is insufficient evidence on the efficacy of psychological interventions for lymphoma patients. This review aimed to present the research findings on currently used psychological interventions for (non-) Hodgkin lymphoma patients and survivors. A literature search on English language peer-reviewed original publications on psychological interventions for lymphoma patients published prior to December 2021 was performed in PubMed, Medline, Web of Science, Scopus and ResearchGate. Titles and abstracts were screened for the relevant terms including psychological intervention and psychological management along with (non-) Hodgkin lymphoma. The retrieved articles were evaluated by independent reviewers, the lists of eligible publications were compared, and disagreements were resolved by discussion. Of the 50 publications sought for retrieval, 8 articles were shortlisted based on their content. The papers were classified according to their content and the methodology employed. Research themes including "promoting resilience in lymphoma survivors", "web-based self-management interventions for patients with lymphoma", "addressing unmet needs whilst undergoing chemotherapy", and "mind-body interactive exercise" were identified and presented in this review. As the number of lymphoma survivors is increasing, future research on evidence-based interventions addressing patients' and survivors' unmet psychological needs is warranted. [ABSTRACT FROM AUTHOR]

Background During the containment of COVID-19, the traditional face-to-face interventions conducted at the rehabilitation center were plagued by many limitations, while internet-based interventions can overcome the limitations of geographic location, working hours and transportation, with less medical costs. Objective To examine the effects of internet-based interventions on knowledge, attitude/belief and practice (KAP) toward rehabilitation exercises, physical activity (PA) level, and exercise compliance inpatients after PCI. Methods The subjects were 76 patients who received their first PCI in Department of Cardiology, Tangshan Gongren Hospital from November 2021 to June 2022. They were randomly and equally divided into two groups to receive either internet-based intervention with routine nursing (experimental group) or routine nursing (control group) . Before and three months after the intervention, the Rehabilitation Exercise Knowledge-Belief-Practice Scale for Patients with Coronary Heart Disease (REKBPCHD) , the International Physical Activity Questionnaire-Short Form (IPAQ-SF) , and Patients' Exercise Log were used to assess the KAP level, PA level, and exercise adherence, respectively. The impact of network intervention on exercise adherence in patients after PCI by univariate Logistic regression analysis. Results After 3 months of intervention, a significant increase was found in the average total score of REKBPCHD, and the average scores of the knowledge dimension, attitude dimension and practice dimension of the scale in the experimental group (P

Objective Chronic obstructive pulmonary disease is one of the most common causes of death in the world, which affects the functional level of patients due to its progressive nature. disabilities caused by the disease lead to the dependence of these patients on family caregivers. Following the changes in caregivers’ lives, most family caregivers are exposed to psychological distress. Involving caregivers in pulmonary rehabilitation training for patients is one of the ways to reduce psychological distress. Considering the emergence of the digital age and the limitations of face-to-face training such as time and cost, mobile phone-based applications are available as one of the new methods for providing educational support to caregivers. Therefore, this study was conducted with the aim of determining the effect of the pulmonary rehabilitation application on the psychological distress of caregivers of people with chronic obstructive pulmonary disease. Materials & Methods This study is a field trial conducted on 70 family caregivers of people with chronic obstructive pulmonary disease. The samples were selected as available from the Sun Breathing Comprehensive Clinic and after checking the inclusion criteria, they were randomly assigned to intervention and control groups by minimization software. The intervention group used mobile phone-based pulmonary rehabilitation training application for 6 weeks. For the control group, face-to-face pulmonary rehabilitation training (routine) was provided in the form of 12 sessions during 6 weeks. The data collection tool included Kessler’s demographic information and psychological distress questionnaires, which were completed by caregivers before and after the intervention. Data analysis was done using SPSS version 24 software and Mann-Whitney, Chi-square and independent and paired t tests. Results According to the findings, the two groups were homogeneous in terms of demographic characteristics. The average age of caregivers in the intervention and control groups was (44.1±14.8), (47.7±13.8) years, respectively. In the intervention group, 71.4% were female caregivers and in the control group, 82.9% were female caregivers (P>0/05). Before the intervention, there was no significant difference in terms of psychological distress between the test and control groups (P

Abstract Background Poor maternal mental well-being and a lack of secure parent-infant attachment, have been identified as important factors associated with adverse mental health outcomes later in a child’s life. Interventions designed to care for maternal mental well-being during pregnancy and early parenthood, are therefore likely to support healthy child development. Mentalization is a skill parents can practice, improving the emotional bond to the child, offering insights into their own and the child’s mental states and potentially improving parental mental well-being. Most pregnant women in Denmark schedule antenatal consultations in general practice, potentially offering a solid platform to promote web-based interventions aiming to enhance mentalization skills. Signposting towards online resources has several advantages including high accessibility, ease of distribution and cost-effectiveness. We aimed to explore the attitudes and experiences of clinicians in general practice in signposting women towards a web-intervention to increase parental mentalization skills. Methods The intervention was offered to pregnant women at their primary preventive antenatal consultation in Danish general practice around week eight of pregnancy, and was designed to be incorporated into the following antenatal- and pediatric consultations until the child’s second birthday. Semi-structured interviews about clinicians’ experiences with signposting the intervention were conducted with 11 general practitioners (GP), three practice midwives (MW) and one practice nurse (NR). Results Clinicians wanted to enhance the focus on mental well-being in pregnancy and early childhood during preventive consultations. The main barriers to signposting the web-program were decreasing motivation over time, lack of financial viability and time limitations. Utilizing a psychoeducational web-intervention was generally accepted by clinicians, but ideally not carried out solely in general practice. Conclusion Signposting web-programs to improve parental mentalization skills can be welcomed by clinicians in general practice but need to be more tailored to suit the everyday workflow of the clinics. Addressing parental mentalization remains largely unchartered territory for pregnant women and clinicians alike, therefore training clinicians on the subject and its presentation should be offered. Trial registration The study is part of a larger project that has been approved by the Research Ethics Committee at the University of Copenhagen, Nov. 2019 (reference number 504–0111/19–5000).

ABSTRACTBackground Intrinsic values and priorities influence decision-making and are, therefore, important to consider explicitly in intervention development. Although health is generally considered an important value, individuals often make unhealthy choices, indicating a values disconnect.Study aim To investigate how becoming aware of a disconnect between the value assigned to health and the effort devoted to health is related to intentions and commitment for behavioural change and physical activity among inactive adults.Methods We performed a secondary exploratory analysis on previously collected data. The intervention included a values exercise based on the Disconnected Values Model (DVM) that made disconnected values explicit to participants in two study arms. We compared participants with a disconnect (n = 138) with participants without a disconnect (n = 101) regarding intentions and commitment for behavioural change and physical activity and sitting time 2–4 weeks follow-up. Logistic and linear regression analyses were performed to analyse the data.Results Between-group differences were found for the intention to devote more effort to health (OR = 3.75; 95%CI: 2.05; 6.86) and for the intention to become more physically active (OR = 2.21; 95%CI: 1.10; 4.46), indicating that significantly more participants with a disconnect were motivated to change, compared to participants without a disconnect. No between-group differences were found for commitment, intention strength, follow-up physical activity and sitting time.Conclusion Making explicit a disconnect regarding health in an active choice intervention was associated with intentions to become more physically active. Still, it did not translate in significant behaviour change at 2–4 weeks follow-up.Trial registration ClinicalTrials.gov: NCT04973813. Retrospectively registered.Trial registration: ClinicalTrials.gov identifier: NCT04973813..

Background: Health education is one of the main items to enable health promotion to patients with fibromyalgia. The objective of the study "Amigos de Fibro (Fibro Friends)" is to evaluate the impact of an educational intervention associated with physical exercise based on the web in promoting health and quality of life of patients with fibromyalgia in Brazil. Methods: A study with a randomized controlled trial approach will be carried out. The sample will consist of 24 participants, divided into two groups, with 12 individuals each. The experimental group will participate in meetings with lectures, debates, conversation rounds and exercises by a multidisciplinary team. Physical exercises will also be performed in an online environment. On the other hand, the control group will receive an e-book of education and self-care. Primary outcomes will be quality of life. The secondary outcomes will be sociodemographic and health profile, pain intensity, sleep quality, self-care agency, usage and costs of health and social care services, viability of the program and program participation. In addition, a qualitative evaluation process will be carried out with the participants. After the intervention, the data of both groups will be collected again, as well as after 3, 6, and 12 months to verify the effect and the maintenance of the intervention. Discussion: The results will provide data for studies to consider the use of this tool in the future by professionals working in the field of rheumatology. Trial registration: The protocol was registered in the Brazilian Registry of Clinical Trials RBR-3rh759 (https://trialsearch.who.int/Trial2.aspx?TrialID=RBR-3rh759). Date of registration: 07/02/2020]. [ABSTRACT FROM AUTHOR]

Background: To address the challenges in nursing education brought about by the pandemic, this study aimed to evaluate the use of a web-based standardized patient practice in the development of nursing students' anamnesis taking skills and their views about its application. Method: We conducted a descriptive intervention study with 39 s-year nursing students. The students completed anamnesis using the standardized patient practice in line with a scenario with real standardized patients in a web-based environment with audio and video. Results: The total scores of students' anamnesis skills were low. The agreement between the total scores, scores obtained from the health patterns, and each item in the control list was statistically significant (p < 0.05). Conclusion: Web-based standardized patient practice is an alternative for clinical practice facilitating the gaining of competencies in making holistic nursing diagnoses under conditions that limit face-to-face interactions, such as pandemics. [ABSTRACT FROM AUTHOR]

With the current increase in web-based interventions, the question of how to measure, and consequently improve engagement in such interventions is gaining more importance. Modern day web analytics tools make it easy to monitor use of web-based interventions. However, in this article, we propose that it would be more meaningful to first examine how the developers envisioned the use of the intervention to establish behavior change (i.e. intended use), before looking into how the intervention is ultimately used with web analytics (i.e. actual use). Such an approach responds to the regularly expressed concern that behavioral interventions are often poorly described, leading to less meaningful evaluations as it is not clear what exactly is being evaluated. Using a page on chlamydia prevention (104 557 pageviews in 2020) from a Dutch sexual health intervention (Sense), we demonstrate the value of acyclic behavior change diagrams (ABCDs) as a method to visualize intended use of an intervention. ABCDs show at a glance how behavior change principles are applied in an intervention and target determinants of behavior. Based on this ABCD, we investigate actual use of the intervention, using web analytics tool Matomo. Despite being intended to stimulate STI-testing, only 14% of the 35 347 transfers from this page led to the STI-testing page and a high bounce rate (79%) and relatively high exit rate were reported (69%). Recommendations to further interpret the data are given. This real-life example demonstrates the potential of combining ABCDs and Matomo as methods to gain insight into use of web-based interventions. [ABSTRACT FROM AUTHOR]