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PubMed2025

Examining Behavioral Interventions for Infancy and Early Toddlerhood: A Systematic Review of Intervention Effects, Parameters, and Participants.

Rapid advancement is paving the way to identify children who would likely benefit from early intervention during the first years of life, prior to the onset of significant delays in development. With the widely acknowledged benefits of early intervention, key questions arise: Does behavioral intervention targeted to infancy and early toddlerhood improve developmental outcomes? What procedures might be used, and under what circumstances? Who do these interventions work for? The current review comprehensively examined the literature on behavioral interventions based in operant learning, focused on key developmental areas with children in the first two years of life. We located and synthesized 69 studies with unique participant cohorts that included 1735 children. The search revealed many studies focused on the first year of life, of which a large proportion investigated approaches to increase communication. We provide implications, limitations, and future directions on how behavioral interventions for infants and young toddlers can inform current practice and future intervention research this population.

Humans↗

PubMed2006

The impact of an educational intervention for elderly care nurses on care recipients' and family relatives' ratings of quality of care: a prospective, controlled intervention study.

BACKGROUND: Low competence levels among nursing staff have been associated with lower quality of elderly care. However, interventions aimed at improving nursing staff competence have not always been evaluated for their possible impact on the quality of elderly care. An educational intervention in the form of a workplace "toolbox" was shown to have positive effects on nursing staff competence and work satisfaction. It was therefore of interest to investigate whether the intervention had any effect on residents' and/or their family members' ratings of the quality of elderly care. OBJECTIVES: The aim of this study was to evaluate the possible effects of an educational intervention for nursing staff on care recipients' and their relatives' ratings of the quality of elderly care. DESIGN: The study was a prospective, non-randomized, controlled intervention. PARTICIPANTS AND SETTINGS: Care recipients and their relatives in two elderly care organisations in Sweden. METHODS: Practical instruments and educational materials for improving staff competence and work practices were collated in a workplace "toolbox", which was introduced in the intervention organisation in February of 2003. Care recipients and their relatives' ratings of the quality of care were measured pre and post-intervention by questionnaire and compared to quality ratings in a reference organisation, where no toolbox was introduced. RESULTS: Neither care recipients' nor relatives' ratings of the quality of care changed significantly over time in the intervention organisation. Furthermore, there were no significant interaction effects over time between organisations for quality of care ratings. Methodological weaknesses, such as low response rates, may have influenced results. CONCLUSIONS: The results of this study raise questions regarding the alleged positive association between staff competence and work satisfaction and care recipients' perceptions of the quality of care.

Aged↗

PubMed2004

Intervention after PSA failure: examination of intervention time and subsequent outcomes from a prospective patient database.

PURPOSE: To investigate timing of intervention for solitary biochemical relapse following external beam radiation therapy (EBRT) for localized prostate cancer, and to assess the impact on survival. METHODS AND MATERIALS: Of 1499 men treated with EBRT from 1994 to 2000, 544 men had prostate-specific antigen (PSA) relapse by the Vancouver Criteria. Patients with near-simultaneous clinical relapse (n = 79) were excluded, leaving 465 for analysis. Pretreatment prognostic factors, the time that biochemical relapse was realized (trigger PSA time), and postrelapse doubling time (PSAdt) were examined for effect on the timing of intervention and cause-specific survival (CSS). RESULTS: Median actuarial time from trigger-PSA time to intervention was 30 months. The only factor associated with early intervention on multivariate analysis (MVA) was faster PSAdt (p < 0.0001). Not significant were initial PSA, Gleason score, T stage, or adjuvant androgen ablation use or duration. Seventy-five percent of interventions occurred with PSAdt faster than 12 months. The 5-year CSS was 89%. Faster PSAdt (p = 0.0007), higher Gleason score (p = 0.018), and earlier intervention (p = 0.0006) were significantly associated with increased prostate cancer death on MVA. The 5-year CSS is 19% where the PSAdt was <3 months, 84% where 3-6 months, 93% where 6-12 months, and 98% where >12 months (p < 0.0001). CONCLUSIONS: Men with a biochemical relapse post-EBRT with PSAdt >1 year had excellent 5-year CSS (98%). Rapid PSAdt is associated with increased mortality on MVA. The association of earlier intervention with increased mortality may be due to the selection of those with occult metastasis for early intervention.

Aged↗

PubMed2006

Maintenance of a low-sodium, high-carotene and -vitamin C diet after a 1-year dietary intervention: the Hiraka dietary intervention follow-up study.

BACKGROUND: The importance of dietary modification for disease prevention is widely accepted. The difficulty of implementing and sustaining long-term changes is also well documented. Nevertheless, a few studies have attempted to achieve significant dietary change for extended periods. METHODS: The Hiraka Dietary Intervention Study was a community-based randomized cross-over trial designed to develop an effective dietary modification tool and system in an area with high mortality for stomach cancer and stroke in 1998-2000. The main study subjects were 550 healthy volunteers, who were randomized into two groups and given tailored dietary education aimed at decreasing the intake of sodium and increasing that of carotene and vitamin C in either the first or second year. Four (first intervention group) and three (second intervention group) years after the intervention ended, 308 subjects were selected for this follow-up dietary survey. RESULTS: The low-sodium, high-vitamin C and -carotene diet was maintained with only a small, nonsignificant reversal from post-intervention to follow-up (P = 0.082-0.824). Significant changes from pre-intervention to follow-up were also maintained (P < 0.01). CONCLUSION: This dietary intervention program was maintained well over 4 years after the termination of the intervention sessions.

Ascorbic Acid↗

PubMed1999

Heparin after percutaneous intervention (HAPI): a prospective multicenter randomized trial of three heparin regimens after successful coronary intervention.

OBJECTIVES: The purpose of this study was to determine the incidence of bleeding, vascular, and ischemic complications using three different heparin regimens after successful intervention. BACKGROUND: The ideal dose and duration of heparin infusion after successful coronary intervention is unknown. METHODS: Patients were randomized to one of three heparin strategies after coronary intervention: Group 1 (n = 157 patients) received prolonged (12 to 24 h) heparin infusion followed by sheath removal; Group 2 (n = 120 patients) underwent early removal of sheaths, followed by reinstitution of heparin infusion for 12 to 18 h; Group 3 (n = 137 patients) did not receive any further heparin after intervention with early sheath removal. The primary end point of the study was the combined incidence of in-hospital bleeding and vascular events. Secondary end points included in-hospital ischemic events, length of stay, cost and one-month outcome. RESULTS: After successful coronary intervention, 414 patients were randomized. Unstable angina or postinfarction angina was present in 83% of patients before intervention. The combined incidence of bleeding and vascular events was 21% in Group 1, 14% in Group 2 and 8% in Group 3 (p = 0.01). The overall incidence of in-hospital ischemic complications was 2.2%; there were no differences between groups. Length of hospital stay was shorter (p = 0.033) and adjusted hospital cost was lower (p < 0.001) for Group 3. At 30 days, the incidence of delayed cardiac and vascular events was similar for all three groups. CONCLUSIONS: Heparin infusion after successful coronary intervention is associated with more minor bleeding and vascular injury, prolonged length of stay and increased cost. In-hospital and one-month ischemic events rarely occur after successful intervention, irrespective of heparin use. Routine postprocedure heparin is not recommended, even in patients who present with unstable ischemic syndromes.

Angioplasty, Balloon, Coronary↗

PubMed1998

Development of an intervention map for a parent education intervention to prevent violence among Hispanic middle school students.

This paper describes development of Padres Trabajando por la Paz, a violence prevention intervention for Hispanic parents to increase parental monitoring. The intervention was developed using an innovative new program planning process: intervention mapping. Theory and empirical evidence broadly defined performance objectives and determinants of parental monitoring. These objectives were further refined through group and individual interviews with the target parent group. Learning objectives for the intervention guided the content of the intervention that used modeling as the primary method and role model stories as a strategy delivered through newsletters. Stage-matching members of the target population for their readiness to implement the parental monitoring behaviors further refined the social cognitive message design strategies. Intervention mapping provides an explicit theory- and data-driven guide for intervention development that maximizes intervention impact for a specific target population.

Adolescent↗

PubMed2006

Reducing sick leave by minimal postal intervention: a randomised, controlled intervention study.

BACKGROUND: The lack of efficient medical interventions for combating increasing sickness absence rates has lead to the introduction of alternative measures initiated by the Norwegian National Insurance Service or at workplaces. AIM: To determine whether minimal postal intervention had any effect on the length of sick leave. METHODS: Randomised, controlled trial with a one year follow up in Northern Norway in 1997 and 1998; 990 consecutive newly sick-listed persons with musculoskeletal or mental disorders were studied. Within the intervention group, 495 eligible sick-listed persons received a general information letter and a questionnaire as their sick leave passed 14 days. Possible intervention effects were analysed by survival analysis of the probability of returning to work within one year, and logistic regressions with benefits at one year as the dependent variable. RESULTS: The overall reduction of 8.3 (95% CI -22.5 to 6.0) calendar days in mean length of sick leaves in the intervention group compared to controls, was not statistically significant. However, intervention significantly reduced length of sick leaves in subgroups with mental disorders, and with rheumatic disorders and arthritis, and overall for sick leaves lasting 12 weeks or more. Young people with low back pain showed an adverse effect to intervention. The overall relative risk of receiving benefits due to sickness after one year in the intervention group was 0.69 (95% CI 0.51 to 0.93) compared to controls. CONCLUSION: The results should encourage employers, insurance institutions, and authorities to initiate challenges as questions on the length of sick leave and possible modified work measures, during the first few weeks of sick leave, for at least some groups of sick-listed persons.

Absenteeism↗

PubMed2006

Effectiveness of a low-intensity intra-worksite intervention on smoking cessation in Japanese employees: a three-year intervention trial.

To test the effectiveness of a low-intensity intervention program for smoking cessation targeting the worksite environment in employees who had a low readiness to quit, we conducted an intervention trial at six intervention and six control worksites in Japan. A total of 2,307 smokers at baseline who remained at their worksite throughout the three-year study period were analyzed (1,017 in intervention and 1,290 in control groups). The multi-component program at the worksites consisted of (1) presenting information on the harms of tobacco smoking and the benefits of cessation by posters, websites, and newsletters; (2) smoking cessation campaigns for smokers; (3) advice on designation of smoking areas; and (4) periodic site-visits of the designated smoking areas by an expert researcher. At baseline, the intervention and control groups each had high prevalence of immotive or precontemplation, that reflected low readiness to quit (71.5% and 73.2%, respectively). The smoking cessation rate, as not having smoked for the preceding six months or longer, assessed at 36 months after the baseline survey by a self-administered questionnaire was significantly higher in the intervention group than the control group (12.1%, vs. 9.4%, p=0.021). The intervention program still had a significant effect on the smoking cessation rate after multiple logistic regression analysis adjusted for sex, age, type of occupation, age of starting smoking, quit attempts in the past, number of cigarettes per day, and readiness to quit (odds ratio: 1.38, 95% confidence interval: 1.05-1.81, p=0.02). The cost per additional quitter due to the intervention was calculated to be Yen 70,080. These findings indicate that this program is effective and can be implemented in similar workplaces where the prevalence of smoking is high and smokers' readiness to cease smoking is low.

Adult↗

PubMed1999

Early communication intervention within a community-based intervention model in South Africa.

Infants and toddlers with special needs within the developing context in South Africa are not currently receiving adequate early communication intervention services. The development of a model for service delivery to this population is imperative for the successful implementation of early communication intervention in the developing context in South Africa. The basic model of early intervention service delivery provides a theoretical basis for early intervention service delivery but has certain limitations when applied to the developing context in South Africa. Community-based intervention is proposed as an avenue for the delivery of health care services within primary health care although constraints in the application of community-based intervention exist. An integrated model of early communication intervention service delivery within community-based intervention is proposed and illustrated by presenting a case example.

Child, Preschool↗

PubMed2026

Intervention Without Borders - an Automated Self-Guided AI-Enhanced Psychoeducation Intervention for Dementia Caregivers: Parallel-Group Randomized Waitlist-Controlled Trial.

OBJECTIVE: To examine whether a fully automated, self-guided intervention (PDC30) could improve caregiver well-being over a 1-month waitlist control in an international sample. DESIGN: Randomized waitlist-controlled trial. SETTING: Web-based platform accessible globally. PARTICIPANTS: 441 individuals responded to study promotion on the internet, of whom 274 from 43 countries met the study criteria and were randomized. Eligible participants were adults providing ≥10 care hours weekly to community-dwelling relatives with dementia, scoring ≥5 on Patient Health Questionnaire-9 (PHQ-9), and without recent caregiver intervention. INTERVENTION: Available 24/7, PDC30 is a self-guided, automated intervention consisting of a Guidebook, an AI-powered counseling chatbot, and interactive applications for cognitive-behavioral techniques, relaxation, and caregiver-recipient bonding. MEASUREMENTS: At baseline and follow-ups at 1, 2, and 3 months, depression was assessed by PHQ-9. Secondary outcomes were measured with validated brief versions of anxiety, burden, and positive gains. RESULTS: Intent-to-treat analysis using mixed-effects regression showed treatment x time2 effects on all outcomes except anxiety. At 1-month follow-up, coinciding with exclusive access to PDC30, intervention caregivers showed significant improvements in depression (d = -0.37), burden (d = -0.34), and positive gains (d = 0.42). The differences mostly disappeared after control participants received the intervention, while improvements in both groups were sustained thereafter. Participants reported using the website several times weekly, were generally satisfied with it, and found the chatbot most helpful. CONCLUSIONS: The effects on depression and other outcomes were consistent with those observed for in-person programs, suggesting the viability of well-designed automated intervention. The study demonstrates the feasibility, acceptability, and potential global health impact of PDC30.

Humans↗

PubMed2002

Interventional versus conservative treatment for patients with unstable angina or non-ST-elevation myocardial infarction: the British Heart Foundation RITA 3 randomised trial. Randomized Intervention Trial of unstable Angina.

BACKGROUND: Current guidelines suggest that, for patients at moderate risk of death from unstable coronary-artery disease, either an interventional strategy (angiography followed by revascularisation) or a conservative strategy (ischaemia-driven or symptom-driven angiography) is appropriate. We aimed to test the hypothesis that an interventional strategy is better than a conservative strategy in such patients. METHODS: We did a randomised multicentre trial of 1810 patients with non-ST-elevation acute coronary syndromes (mean age 62 years, 38% women). Patients were assigned an early intervention or conservative strategy. The antithrombin agent in both groups was enoxaparin. The co-primary endpoints were a combined rate of death, non-fatal myocardial infarction, or refractory angina at 4 months; and a combined rate of death or non-fatal myocardial infarction at 1 year. Analysis was by intention to treat. FINDINGS: At 4 months, 86 (9.6%) of 895 patients in the intervention group had died or had a myocardial infarction or refractory angina, compared with 133 (14.5%) of 915 patients in the conservative group (risk ratio 0.66, 95% CI 0.51-0.85, p=0.001). This difference was mainly due to a halving of refractory angina in the intervention group. Death or myocardial infarction was similar in both treatment groups at 1 year (68 [7.6%] vs 76 [8.3%], respectively; risk ratio 0.91, 95% CI 0.67-1.25, p=0.58). Symptoms of angina were improved and use of antianginal medications significantly reduced with the interventional strategy (p<0.0001). INTERPRETATION: In patients presenting with unstable coronary-artery disease, an interventional strategy is preferable to a conservative strategy, mainly because of the halving of refractory or severe angina, and with no increased risk of death or myocardial infarction.

Angina Pectoris↗

PubMed2003

Clinical services in interventional radiology: results from the national Medicare database and a Society of Interventional Radiology membership survey.

PURPOSE: To evaluate trends in evaluation and management (E & M) services performed by interventional radiologists. MATERIALS AND METHODS: Recent national Medicare physician utilization data (1997-2000) were analyzed for trends in E & M services provided by interventional radiologists. The results were evaluated in conjunction with a recent Society of Interventional Radiology (SIR) membership survey in which 165 interventional radiology (IR) practices answered questions about clinical service issues. RESULTS: Despite the perception of frequent clinical services by interventional radiologists, paid Medicare claims for E & M services have increased only minimally, from 9,472 to 9,662 (+2.0%), and have lagged behind non-E & M procedural services, which have increased from 2,283,111 to 2,527,323 (+10.7%). The relative value unit (RVU) impact of E & M encounters has increased from 14,422 to 14,893 (+3.2%) while the RVU impact of procedural services has increased from 2,262,991 to 3,723,486 (+64.5%). E & M services account for only 0.39% of all Medicare claims, 0.49% of service RVUs, and 0.68% of all reimbursable time spent by interventionalists. However, when surveyed, interventional radiologists perceived that E & M services are much more frequent: 92% provide clinical services and indicate that 6.6% +/- 5.4 of physician time is spent providing E & M services. CONCLUSION: Despite perceptions by interventional radiologists that E & M services are common, Medicare claims for such services are infrequent and growth lags behind that of IR services overall. These discrepancies may be explained in part by practice and billing infrastructures that do not effectively translate actual clinical services into successful claims.

Data Collection↗

PubMed2004

[Spanish Registry of Cardiac Catheterization and Coronary Interventions. Thirteenth Official Report of the Working Group on Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology (1990-2003)].

The results of the Registry of the Working Group on Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology for 2003 are presented. Data were obtained from 112 centers representing nearly all cardiac catheterization laboratories in Spain; 104 centers performed mainly adult catheterization and 8 carried out pediatric procedures only. In 2003, 105,939 diagnostic catheterization procedures were performed, including 90 939 coronary angiograms, representing a total increase of 8.5% in comparison to 2002. The population-adjusted rate was 2171 coronary angiograms per 106 inhabitants. Coronary interventions increased by 14.4% in comparison to 2002, with a total of 40,584 procedures and a rate of coronary interventions of 969 per 106 inhabitants. Coronary stents were used in 92.5% of the procedures (47,249 units implanted, for a total increase of 22% in comparison to 2002). About one fifth (20.2%) of the implanted stents were drug-eluting stents (11,699 units). A total of 6080 percutaneous coronary interventions were done in patients with acute myocardial infarction, representing an increase of 27.5% in comparison to 2002, and accounting for 14.9% of all interventional procedures. Of the noncoronary interventions recorded, we note the increase in percutaneous mitral valvuloplasties (21.6%) and atrial septal defect closures (86%), and also the increase in pediatric interventions (13.3%). In conclusion, we emphasize the high rate of reporting by laboratories, which allows the Registry to compile data that are highly representative of the activity at cardiac catheterization laboratories in Spain.

Angioplasty, Balloon, Coronary↗

PubMed2005

Current issues of interventional radiology in Canada: a national survey by the Canadian Interventional Radiology Association.

OBJECTIVE: To determine current issues facing the field of interventional radiology (IR) in Canada. METHODS: An anonymous online survey was emailed to all members of the Canadian Interventional Radiology Association. The survey was open for 1 month. RESULTS: A total of 83 survey responses were received (of an estimated possible 233). Responses regarding demographics, aspects of practice, research, and IR trainee education were collected. CONCLUSIONS: Several issues were identified as pertinent to Canadian interventional radiologists, including a current and future drought of interventional radiologists, a lack of women in the profession, inadequate protected research time for those in academic practice, a lack of protected clinical time, concern regarding turf issues with other specialties, division between interventional and diagnostic radiology, and the ideal profile of the future interventional radiologist. The field of interventional radiology (IR) continues to develop, expand, and mature at a rapid pace. As the field is still relatively young, several issues are bound to arise. It is important therefore to stay abreast of the current trends and opinions of practitioners within the field.

Canada↗

PubMed2004

A randomized intervention since infancy to reduce intake of saturated fat: calorie (energy) and nutrient intakes up to the age of 10 years in the Special Turku Coronary Risk Factor Intervention Project.

OBJECTIVE: To evaluate the longitudinal impact of dietary counseling on children's nutrient intake. DESIGN: A prospective, randomized, clinical trial. PARTICIPANTS: Children were recruited to the study between December 1, 1989, and May 30, 1992. At the age of 7 months, children were randomized to the intervention group (n = 540) or the control group (n = 522) and were followed up until the age of 10 years. Intervention Families in the intervention group have, since randomization, received regularly individualized counseling about how to modify the quality and quantity of fat in the child's diet, the goal being an unsaturated-saturated fat ratio of 2:1. MAIN OUTCOME MEASURES: Nutrient intakes between the ages of 4 and 10 years based on annual 4-day food records. RESULTS: The fat intake of the intervention children was constantly around 30% of the calorie (energy) intake, while that of the control children was 2 to 3 calorie percentage units higher (P<.001). The intervention children received 2 to 3 calorie percentage units less saturated fats and 0.5 to 1.0 calorie percentage unit more polyunsaturated fats than the control children (P<.001 for both). However, neither group reached the 2:1 goal set for the unsaturated-saturated fatty acid ratio. The vitamin and mineral intakes of the intervention and control children closely resembled each other despite the marked differences in fat intake. CONCLUSION: Individualized, biannually given, fat intake-focused dietary counseling that began at the child's age of 8 months continued to influence favorably the diet of 4- to 10-year-old intervention children without disadvantageous dietary effects, but the 2:1 goal for unsaturated-saturated fat ratio was not reached.

Age Factors↗

PubMed1996

Policy implications of intervention research: research on the social context for intervention.

Intervention research is of significance because the failure or success of particular interventions may have influence on policy and practice. Poorly designed interventions may impede progress in health and safety. Frequently, interventions are based on scientific/ technical definitions of occupational health and safety problems but involve intrusion into complex sociotechnical work environments. Intervention research must be built on a solid foundation of social science research. An example of research useful to health and safety intervention is the Gray Institute study of management practices in the chemical industry that was commissioned by OSHA a few years ago. It focused on safety management in chemical manufacturing firms and their contractors, including a survey of managers and contractors and nine intensive case studies of particular plants. The study describes safety management practices in the best firms in the industry. Such research can provide the groundwork for effective safety interventions in the industry, including training and training requirements, experimentation with redefined managerial responsibilities, regulation of contractors, and others. It also suggests the kinds of useful data that might be collected by NIOSH in the normal course of health and safety studies. Finally, it suggests that the interdisciplinary teams currently investigating occupational health and safety should be expanded to include social scientists.

Chemical Industry↗

PubMed2007

Innovative interventions for disordered eating: evaluating dissonance-based and yoga interventions.

OBJECTIVE: Eating-disordered behavior is prevalent among college women. Few interventions have successfully reduced risk factors for these behaviors, however. The most promising interventions are both selective and interactive. This study compared two newer types of interventions that meet these criteria: cognitive dissonance and yoga programs. METHOD: This study advertised programs for women who were dissatisfied with their bodies. Participants (N = 93) were randomly assigned to dissonance, yoga, or control groups. RESULTS: Hierarchical regression analyses revealed that there were no significant post-intervention differences between the yoga and control groups. Dissonance group participants had significantly lower scores than the scores of both other groups on measures of disordered eating, drive for thinness, body dissatisfaction, alexithymia, and anxiety. CONCLUSION: These findings have important implications for interventions on college campuses. In particular, dissonance interventions appear to be an efficient and inexpensive approach to reducing eating disorder risk factors. Additional research regarding the value of yoga interventions is needed.

Adaptation, Psychological↗

PubMed1999

[A dialectic view of the efficacy of nursing interventions. Connections between nursing interventions and effects of psychotherapy].

The following essay deals with the question whether there are psychotherapeutic effects within nursing interventions. The first part describes the framework for nursing interventions according to the nursing theories of I. King considering particularly the process of goal-achievement. Humanistic thoughts and views of Patterson, Zderad and Watson have also been taken into consideration. In order to look at the question concerning the effectiveness of psychotherapeutic intervention the scientific studies of K. Grawe, R. Donati und F. Bernauer as well as those of V. Tschuschke und D. Czogalik are discussed. Particular attention has been paid to the so-called non-specific factors with regard to the effectiveness of the interventions which was the basis for the formulation of the question. The second part combines the non-specific factors relating to the effectiveness of psychotherapy and the way in which nursing interventions work which is the basis for a model relevant to the different levels of nursing intervention. From this synthesis it can be said that nursing interventions do process psychotherapeutic effectiveness. To come to a conclusion the necessary consequences regarding training and continuing education in nursing management are discussed.

Goals↗