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PubMed2026

BRAIN-Diabetes: Acceptability of an adapted FINGER multidomain intervention among adults living with type 2 diabetes in rural border regions across the island of Ireland.

BackgroundIndividuals with type 2 diabetes mellitus (T2DM) face increased risk of cognitive decline and dementia. Multidomain lifestyle interventions offer a non-pharmacological strategy to support brain health in this high-risk group.ObjectiveThis study examined the acceptability of a culturally adapted FINGER-based intervention among adults living with T2DM in rural border regions of Ireland (BRAIN-Diabetes Trial).MethodsA 6-month pilot randomized controlled trial was conducted. The intervention group received a multidomain program targeting diet, physical activity, and computerized cognitive training (CCT). The control group received standard care. Acceptability was assessed using questionnaires (all participants) and semi-structured interviews (intervention participants). Quantitative data were analyzed descriptively and qualitative data using template analysis, guided by four a-priori themes: trial participation and engagement, dietary behavior change, exercise behavior change, and CCT behavior change.ResultsQuestionnaire data (intervention: n = 28; control: n = 36) indicated high overall acceptability. Dietary and exercise components were rated most positively, while CCT component was less well received. Interviews (n = 25) highlighted facilitators to trial engagement, including perceived health improvements, and social connection, with time constraints and limited personalization as barriers. Dietary change was supported by tailored guidance but hindered by cost and availability. Facilitators for exercise included accessible resources and perceived benefits, with barriers including competing priorities. CCT engagement was mixed, with challenges including digital access and repetitiveness.ConclusionsThe Brain-Diabetes intervention was acceptable and feasible among adults with T2DM. Personalized support and accessible resources were key to engagement. Future work should refine delivery to enhance scalability and long-term adherence among high-risk groups.

Humans↗
PubMed2026

Effect of a digitally augmented general health promotion intervention on abstinence from health-risk behaviors among emergency department discharge patients: A randomized controlled trial.

BACKGROUND: Noncommunicable diseases (NCDs) are the leading global cause of death and are driven by modifiable behaviors, such as tobacco use, harmful alcohol consumption, unhealthy diet, and physical inactivity. Recognizing that emergency department (ED) visits represent a unique opportunity to promote behavior change, this trial evaluated a digitally augmented, theory based general health promotion approach, combining a brief telephone-based intervention with mobile instant messaging support, to help discharged ED patients abstain from health risk behaviors. METHODS AND FINDINGS: This assessor-blinded randomized controlled trial was conducted in a major public hospital ED in Hong Kong. Adults (18-65 years) triaged as semi-urgent or non-urgent and with &#x2265;1 health-risk behavior and smartphone access were randomized to receive a digitally augmented, theory&#x2011;based general health&#x2011;promotion intervention consisting of a brief telephone&#x2011;based AWARD&#x2011;model intervention (Ask, Warn, Advise, Refer, and Do-it-again) followed by weekly WhatsApp or WeChat messages for 6 months, or to a control group receiving brief telephone advice only. The primary outcome was self-report abstinence from &#x2265;1 health-risk behavior at 6 months; secondary outcomes included the proportion of participants who achieved self-reported abstinence from &#x2265;1 health-risk behavior at 12 months and reduction in the number of behaviors at 6 and 12 months. Of the 2,134 screened patients, 572 were enrolled (286 per group). At 6 months, 30.1% of the intervention participants versus 19.9% of the controls achieved self-reported abstinence (RR&#x2009;=&#x2009;1.51; 95% CI, 1.13-2.02; P&#x2009;=&#x2009;0.006). The intervention also significantly increased the likelihood of fewer risky behaviors at 6 (RR&#x2009;=&#x2009;1.54; P&#x2009;=&#x2009;0.01) and 12 (RR&#x2009;=&#x2009;1.48; P&#x2009;=&#x2009;0.02) months. Physical inactivity showed the greatest improvement at 6 months (31.7% versus 16.2%; P&#x2009;<&#x2009;0.001). The effects attenuated after cessation of booster messaging. Limitations include reliance on self-reported outcomes, the single-center study design, and loss to follow-up, which may have affected the generalizability of the results. CONCLUSIONS: A digitally augmented, theory-based general health promotion strategy delivered at ED discharge through brief telephone intervention and mobile instant messaging support demonstrated short-term benefits in promoting self-reported abstinence and reducing health-risk behaviors at 6 months. However, the absence of a sustained effect at 12 months suggests that extended support or maintenance strategies may be required to maintain these improvements over time. Multicenter trials with longer follow-up are warranted to evaluate long-term effectiveness. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (Registration No: NCT06077565).

Humans↗
PubMed1989

Risk reduction among intravenous drug users in Amsterdam under the influence of AIDS.

We evaluated the impact of a needle/syringe exchange program among 263 drug users in the period December 1985 to April 1988. Participants in this study were asked about their risk-behavior at three different visits. We found no increase in the proportion injecting drugs or in the frequency of intravenous drug use. A strong decrease in borrowing and lending of used needle/syringes was found and this behavioral change was not dependent on learning human immunodeficiency virus (HIV) serostatus. Although use of the exchange program increased over time, reduction in needle sharing was mainly an effect of the study with only a limited impact of the exchange program. We conclude that ample provision of needles and syringes is an important starting point but in itself not enough to produce the necessary drastic change in risk behavior. Intensive counseling of the drug user is also needed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Stress reduction training changed number of sexual partners but not immune function in men with HIV.

We tested the impact of stress management training on sexual behavior and immune functioning in 64 gay men infected with human immunodeficiency virus (HIV). Subjects randomized to the stress management group met for eight two-hour sessions and one all day retreat to learn systematic relaxation, health behavior change, and stress management skills. Compared to those randomized to a wait list control, treatment subjects reported significantly fewer sexual partners in the prior month at post-test (1.10 vs 2.29 for controls). There were no differences between groups in lymphocyte numbers and function.

Adult↗
PubMed1990

Maintenance of safer sexual behaviors and predictors of risky sex: the San Francisco Men's Health Study.

This paper describes the sexual behavior changes made by 686 gay and bisexual men in San Francisco between 1984 and 1988, focusing on the individual maintenance of this behavior change over time. There were drastic reductions in insertive and receptive unprotective anal intercourse over time and the vast majority of subjects were able to maintain these changes for at least 12 months prior to the last interview. A total of 12 percent of participants admitted to relapsing to unprotected receptive anal intercourse following initial behavior change; 10 percent reported engaging in unprotected receptive anal sex during every year of the study period. Men were more likely to practice unprotected anal intercourse in 1988 if at baseline they were younger, practiced unprotected anal intercourse, reported more sex partners, did not have a close friend or lover with AIDS, and engaged in fewer other health-related behaviors.

Adult↗
PubMed1989

The weight loss profile: a biopsychosocial approach to weight loss.

Obesity is a common complicating condition in a variety of medical problems. Often effective consultation liaison involves recommendations to overweight patients involving lifestyle and health risk modification. Factors that need to be addressed include exercise, nutritional counseling/caloric restriction, and attitude and behavioral change regarding eating. Patients requiring weight loss typically seek various commercial programs that are readily accessible. One major problem associated with such programs is the high attrition rate within the first six weeks of initiation. Therefore, attempts to facilitate longer-term retention and associated weight loss are warranted. One approach is the identification of factors associated with problems in short-term retention and weight loss followed by the implementation of brief interventions to potentially reverse the influence of these factors on retention and weight loss. The present investigation was conducted to determine the effects of such a strategy on short-term retention and weight loss in a commercial weight loss program. Two groups (n = 66 per group) of female participants with a mean age of thirty-eight years, mean initial weight of 184.6 lbs, mean height of 64.3 inches, mean goal weight of 147.3 lbs, mean Body Mass Index of 31.4 kg/m2 were recruited for the study. Groups were matched for age, initial weight, height, goal weight, and body mass index. One group (controls) received a standard thirteen-week group cognitive-behavioral intervention that emphasized the teaching of self-management strategies for weight reduction. The second group (personalized intervention) received the same thirteen-week cognitive-behavioral intervention. This group also completed a questionnaire (Weight Loss Profile) that identifies factors associated with poor retention and minimal weight loss. Targeted interventions were implemented to modify specific problem areas identified on the Weight Loss Profile. The problem areas were based upon previous research which identified predictors of retention and weight loss. The problem areas included job stress, social comfort, self-consciousness regarding weight and eating behaviors, concern with physical appearance, Type A behavior pattern, social support, motivation, and expectation of success. Both groups also received 1,000 calorie/day prepackaged foods, instruction in mild exercise, and nutritional counseling. Weekly weights and attendance were recorded across the thirteen consecutive week period. The group receiving the personalized intervention lost significantly more weight than the control group (30 lbs vs. 11 lbs, respectively).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1991

University students and AIDS: knowledge, attitudes and behavioral adjustment.

This study addresses the relations between AIDS-related knowledge, attitudes, and behavior change among university students. A questionnaire covering such issues and personal background variables was administered to 750 students at the University of Zagreb. Over-all, 62.7% of the knowledge items were answered correctly, while functional, self-protective aspects of knowledge proved to be much better than general knowledge. On the average, attitudinal responses were moderately liberal. Both self-reported change in risk-reduction behavior and personal concern due to the appearance of AIDS were very small. Correlations of risk-reducing behavior with permissive (.15) and restrictive (.14) attitude orientations and with general and functional knowledge (.08) were modest. The level of personal concern correlated neither with permissive attitudes nor with functional knowledge, while it correlated negatively with restrictive attitudes (-.20) and with general knowledge (-.08). Substantial association was only established between functional knowledge and permissive (.51) and restrictive attitude orientations (-.23). It is concluded that, in addition to knowledge and attitudes, a number of factors which restrain desired behavioral adjustment should be considered in anti-AIDS campaigns, such as perceived level of exposure to HIV in a particular environment, young age-specific illusion of invulnerability, peer norms, and others.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Weight reduction interventions for persons with a chronic illness: findings and factors for consideration.

Obesity in persons with a concomitant chronic illness poses complex issues relating to the choice of appropriate interventions. More recent emphasis on modification of risk factors has resulted in the need to prescribe complex therapeutic regimens with multiple treatment goals. The traditional approach to weight reduction in such persons has been nutrition education. Studies have shown, however, that knowledge alone does not translate into self-care behaviors that in turn result in weight loss and weight maintenance. Although the latter outcomes continue to be primary goals of therapy in obese individuals with a chronic illness, improvement in the physiologic parameters associated with the illness is also a desired outcome. Behavior therapy and group support appear to be enabling factors that go beyond knowledge to facilitate behavior change and subsequent changes in health-related indexes. This article describes various approaches to the problem of combined interventions for patients education and weight reduction. Findings and factors are discussed about whether the primary goal of weight reduction interventions for persons with a chronic illness should focus on pounds lost or improvement in metabolic or physiologic status.

Behavior Therapy↗
PubMedDate not supplied

Sexual self-defense versus the liaison dangereuse: a strategy for AIDS prevention in the '90s.

The present public health strategy to encourage the adoption of "safe sex" practices to contain the AIDS epidemic in America is incomplete. Current policy is responsive to and appropriate for control of homosexual, but not heterosexual transmission. Powerful societal forces restrict a woman's perception of risk. Consequently, the adoption of safe sex (condom use/insistence on use) by women at risk has not matched safe sex practice by homosexual men. Predictably, pattern two (heterosexual, maternal-fetal) HIV transmission is now rapidly increasing in the United States, particularly among minority women. In anticipation of an intensified pattern two subepidemic, AIDS containment policy should be reoriented to develop the role of women in AIDS prevention. An initiative, termed "sexual self-defense" (SSD), combines the technology of double-barrier (female irrespective of male) protection with a "universal precautions" approach to long-term sexual risk management. The initiative addresses both per-contact infectiousness and new partner acquisition, the principal determinants of HIV spread. As a female-targeted strategy, SSD is a timely supplement to existing programs, consistent with the direction of contemporary women's movements in the United States. A "street smart" approach, SSD bridges ethnic and socioeconomic individual differences. As a unifying philosophy of risk management in health promotion, SSD may avert the threatened fragmentation of AIDS control from existing programs of sexually transmitted disease control and teenage pregnancy prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Heart healthy education. Effectiveness of teaching methods in the workplace.

One fourth to one third of employed workers in this country have at least one of three major risk factors for coronary heart disease. This pilot study examined differences between educational methods used in an occupational setting. The specific aims of the quasi-experimental study were: to determine differences between two groups of subjects who received either group support and instruction or only written instruction; and to determine the association between the practice of heart healthy behaviors and decreased blood cholesterol levels. No significant differences were found between the two groups in cholesterol and behavior changes. However, there was a significant difference between pre- and post-instruction for all subjects. The study documented significant changes in cholesterol levels, cholesterol and fat intake, and weight reduction.

Adult↗
PubMedDate not supplied

Patient reactions to nutrition education for cholesterol reduction.

The purpose of this study was to assess the perceptions of patients with elevated cholesterol who participated in a physicians' office-based cholesterol management program and to compare patient reports with clinic counseling records. We conducted telephone interviews with 94 patients from five family practice clinics participating in the Physician-Based Nutrition Program (PBNP) between January and March 1988. Within two weeks after a cholesterol counseling visit, interviewers asked patients what happened during the cholesterol management process, queried their understanding of their health risk and recommended dietary changes, and assessed their attitudes toward the educational process and recommended nutrition behavior changes. Results indicate that a large majority of patients understood the problem of high cholesterol and the needed behavior changes and were highly satisfied with the cholesterol management process. However, patients' memory of specific facts, such as their cholesterol levels and behavioral goals, was often incorrect. We discuss the implications of these findings for developing and providing patient cholesterol education.

Adult↗
PubMed1990

Promoting AIDS risk reduction via behavioral training.

The present study employed behavioral techniques to teach assertive strategies designed to reduce the risk of contracting AIDS and to promote "safer-sex" behaviors. A total of 79 university students (38 male and 41 female) were included in the final data analysis. Subjects participated in three one-hour training sessions which included live modeling of assertive interactions, role-playing, behavior shaping, corrective feedback, verbal reinforcement, assertiveness training, and an AIDS educational lecture. Dependent measures included ratings of the key components of assertive behavior from videotaped role-plays at pre- and posttests. Behavioral training had a positive effect on participants' assertive behavior. On the role-play ratings, experimental subjects were rated higher on overall assertiveness than the controls. Even brief behaviorally based educational interventions can produce increases in assertive behaviors known to be related to AIDS prevention, for example, insisting on condom use and requesting information about a prospective partner's sexual and drug use histories. Behavior changes extended to in vivo situations, of course, remain less assured.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The AIDS dilemma: worry and concern over AIDS.

Information was collected from 148 homosexual men to examine their current sexual practices, knowledge of acquired immunodeficiency syndrome (AIDS), perception of risk for this disease and change in sexual behaviour. The data were analyzed to investigate the relationship of these variables to the degree of worry and concern about AIDS expressed by most respondents. Overall, a decline in high-risk sexual behaviour was reported. Measures of worry and concern were significantly related to the subjects' perception of risk for AIDS and reduction in risk behaviours. However, the measures of Health Locus of Control, knowledge about AIDS and sociodemographic characteristics did not significantly predict the degree of worry and concern. The data are discussed in light of the current AIDS epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A skills-training group intervention model to assist persons in reducing risk behaviors for HIV infection.

Fifteen gay men with a history of recent high-risk sexual activities attended seven group sessions that provided risk education, training in self-management skills pertinent to risk reduction, sexual assertiveness training, and problem solving with respect to health consciousness, social supports, and efficacy of risk-reduction change. Before and after intervention, subjects completed measures of AIDS risk knowledge, sexual practices occurring over 4-month retrospective periods, and self-monitored records of ongoing sexual activities and participated in role plays assessing behavioral assertiveness skill for resisting high-risk coercions. Eight-month follow-up data were also collected. Subjects exhibited substantial and well-maintained change following intervention in behaviors relevant to HIV infection risk, including frequency of unprotected anal intercourse (which decreased to near-zero levels), condom use (which increased to almost 90% of intercourse occasions), and in an index that reflects the multiplicative function of risk behaviors frequency by the number of partners with whom high-risk behaviors occurs. This demonstration provides further evidence that skills-training approaches can assist individuals in implementing behavior changes to reduce risk for AIDS and identifies a model relevant to counseling efforts in AIDS prevention programs, HIV counseling and testing programs, drug abuse and STD clinics, and other applied settings.

Adolescent↗
PubMed1989

AIDS prevention in homosexual and bisexual men: results of a randomized trial evaluating two risk reduction interventions.

This study evaluates two AIDS risk-reduction interventions targeted at homosexual and bisexual men. Participants were randomized into two peer-led interventions: both involved a lecture on 'safer sex', and one provided a skills-training component during which men could discuss and rehearse the negotiation of safer sexual encounters. Follow-up data collection assessed self-reported changes in sexual behavior at 6 and 12 months. Skills training increased condom use for insertive anal intercourse. In sessions providing skills training, condom use increased, on average, by 44% between pre-test and second follow-up compared with only 11% on average in sessions which did not provide such training.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Differences in gay men's AIDS risk knowledge and behavior patterns in high and low AIDS prevalence cities.

Several studies have found reductions in acquired immunodeficiency syndrome (AIDS) risk practices among gay men in high AIDS-prevalence cities since the start of the AIDS crisis. Much less is known about risk behavior patterns among gay men in smaller cities, where AIDS cases are less common and the prevalence of human immunodeficiency virus infection is relatively lower. In the study, men entering gay bars in three cities, one large and two small, completed anonymous surveys of sexual practices and AIDS risk knowledge. Men in high AIDS-prevalence areas were found to have had a greater number of sexual partners, were more knowledgeable about AIDS, were much more likely to engage in low-risk practices (such as mutual masturbation or body rubbing), and had unprotected anal intercourse less frequently than gay men in smaller cities. The most common sexual activity among gay men in the larger city was mutual masturbation, a low-risk practice. The most common sexual activity among gay men in the smaller cities was unprotected anal intercourse. Increased efforts are needed to educate gay men and to promote risk behavior changes among those living in smaller cities and in communities outside the prominent AIDS epicenters.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Evaluation of needle exchange in central London: behaviour change and anti-HIV status over one year.

From November 1987 to October 1988, numbers of clients, visits made and syringes dispensed and returned were monitored at the needle exchange of the Middlesex Hospital, London, UK. A sample of clients were interviewed 1 month after entry to the scheme and again 3 months later to evaluate changes in injecting and sexual risk behaviours for HIV infection. Clients were asked to donate saliva for anti-HIV immunoglobulin G (IgG) antibody capture radioimmunoassay (GACRIA). The rate of lending and borrowing used injecting equipment fell, both compared with rates prior to entry to the scheme and during the period of study. Frequency of injecting did not increase and there was reduced incidence of abscesses. There was a highly significant correlation between multiple sexual partners and condom use and a reduction in the proportion of clients with multiple partners. On entry to the study, seven out of 121 (6%) clients were anti-HIV positive; after 3 months, a further two clients tested were found to be anti-HIV positive. Anti-HIV positivity prevalence for the year of study was nine out of 121 (7%). The scheme attracts clients, reduces injecting-related risk for HIV infection and has high equipment return rates. Saliva testing is acceptable to clients. Continued monitoring of anti-HIV in saliva is indicated.

Acquired Immunodeficiency Syndrome↗