Training general practitioners in behavior change counseling to improve asthma medication adherence

2005 ◽  
Vol 58 (3) ◽  
pp. 279-287 ◽  
Author(s):  
Sandra Broers ◽  
Ellen Smets ◽  
Patrick Bindels ◽  
Floor Bennebroek Evertsz’ ◽  
Mart Calff ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Behavior Change ◽  
General Practitioners ◽  
Asthma Medication ◽  
Behavior Change Counseling

A Smartphone-Based Self-Management Intervention for Individuals with Bipolar Disorder (LiveWell): User Experiences of the Intervention Change Process (Preprint)

2021 ◽  
Author(s):  
Geneva Kay Jonathan ◽  
Cynthia A Dopke ◽  
Tania Michaels ◽  
Clair R Martin ◽  
Chloe Ryan ◽  
...  
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Medication Adherence ◽  
Behavior Change ◽  
Intervention Development ◽  
Signs And Symptoms ◽  
Self Management ◽  
Health Technologies ◽  
Management Intervention ◽  
Change Framework

BACKGROUND Bipolar disorder is a severe mental illness characterized by recurrent episodes of depressed, elevated and mixed mood states. Pharmacological management combined with adjunctive psychotherapy can decrease symptoms, lower relapse rates and improve quality of life; however, access to psychotherapy is limited. Mental health technologies such as smartphone applications are being studied as a means to increase access to and enhance the effectiveness of adjunctive psychotherapies for bipolar disorder. These studies have demonstrated that individuals with bipolar disorder find this intervention format acceptable, but our understanding of how people utilize and integrate these tools into their behavior change and maintenance processes remains limited. OBJECTIVE The objective of this study was to explore how individuals with bipolar disorder perceive and utilize a smartphone intervention for health behavior change and maintenance. METHODS Individuals with bipolar disorder participated in a pilot study of LiveWell, a smartphone-based self-management intervention. At the end of the study, all participants completed in-depth qualitative exit interviews. The behavior change framework developed to organize the intervention design was used to deductively code behavioral targets and determinants involved in target engagement and inductive coding was used to identify themes not captured by this framework. RESULTS In terms of behavioral targets, participants emphasized the importance of managing mood episode related signs and symptoms. They also discussed the importance of maintaining regular routines, sleep duration, and medication adherence. In addition, participants emphasized that receiving support from a coach as well as seeking and receiving assistance from family, friends and providers was important for managing behavioral targets and staying well. In terms of determinants, participants stressed the important role of monitoring for their behavior change and maintenance efforts. Participants indicated that monitoring facilitated self-awareness and reflection which they felt was valuable for staying well. Some participants also felt that the intervention facilitated learning information necessary for managing bipolar disorder but others felt that the information provided was too basic. CONCLUSIONS In addition to addressing acceptability, satisfaction, and engagement, person-based design of mental health technologies can be used to understand how people experience the impact of these technologies on their behavior change and maintenance efforts. This understanding may then be used to guide ongoing intervention development. In this study, participants discussed their perceptions that managing signs and symptoms and maintaining regular routines, sleep duration, and medication adherence were important for staying well and that monitoring played an important role in these efforts. These perceptions aligned with the intervention's primary behavioral targets and use of a monitoring tool as a core intervention feature. However, participants also highlighted how the intervention encouraged involving family and friends in their change efforts. While content addressing building and engaging supports was included in the intervention, this was not a primary intervention target. Participant feedback thus indicates that developing additional content and tools to address building and engaging social support may be an important avenue for improving LiveWell. Our findings suggest that using a comprehensive behavior change framework to understand participant perceptions of their behavior change and maintenance efforts may help facilitate ongoing intervention development. CLINICALTRIAL NCT02405117

scholarly journals Implementation and Evaluation of a Digitally Enabled Precision Public Health Intervention to Reduce Inappropriate Gabapentinoid Prescription: Cluster Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Andre Q Andrade ◽  
Jean-Pierre Calabretto ◽  
Nicole L Pratt ◽  
Lisa M Kalisch-Ellett ◽  
Gizat M Kassie ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Change ◽  
General Practitioners ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Audit And Feedback ◽  
Professional Behavior ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
Digital Delivery

BACKGROUND Digital technologies can enable rapid targeted delivery of audit and feedback interventions at scale. Few studies have evaluated how mode of delivery affects clinical professional behavior change and none have assessed the feasibility of such an initiative at a national scale. OBJECTIVE The aim of this study was to develop and evaluate the effect of audit and feedback by digital versus postal (letter) mode of delivery on primary care physician behavior. METHODS This study was developed as part of the Veterans’ Medicines Advice and Therapeutics Education Services (MATES) program, an intervention funded by the Australian Government Department of Veterans’ Affairs that provides targeted education and patient-specific audit with feedback to Australian general practitioners, as well as educational material to veterans and other health professionals. We performed a cluster randomized controlled trial of a multifaceted intervention to reduce inappropriate gabapentinoid prescription, comparing digital and postal mode of delivery. All veteran patients targeted also received an educational intervention (postal delivery). Efficacy was measured using a linear mixed-effects model as the average number of gabapentinoid prescriptions standardized by defined daily dose (individual level), and number of veterans visiting a psychologist in the 6 and 12 months following the intervention. RESULTS The trial involved 2552 general practitioners in Australia and took place in March 2020. Both intervention groups had a significant reduction in total gabapentinoid prescription by the end of the study period (digital: mean reduction of 11.2%, <i>P</i>=.004; postal: mean reduction of 11.2%, <i>P</i>=.001). We found no difference between digital and postal mode of delivery in reduction of gabapentinoid prescriptions at 12 months (digital: –0.058, postal: –0.058, <i>P</i>=.98). Digital delivery increased initiations to psychologists at 12 months (digital: 3.8%, postal: 2.0%, <i>P</i>=.02). CONCLUSIONS Our digitally delivered professional behavior change intervention was feasible, had comparable effectiveness to the postal intervention with regard to changes in medicine use, and had increased effectiveness with regard to referrals to a psychologist. Given the logistical benefits of digital delivery in nationwide programs, the results encourage exploration of this mode in future interventions.

Behavior Change Counseling Index

2005 ◽  
Author(s):  
Claire Lane ◽  
Michelle Huws-Thomas ◽  
Kerenza Hood ◽  
Stephen Rollnick ◽  
Karen Edwards ◽  
...  
Keyword(s):  
Behavior Change ◽  
Behavior Change Counseling

scholarly journals Behavior Change Counseling Curricula for Medical Trainees

2012 ◽  
Vol 87 (7) ◽  
pp. 956-968 ◽  
Author(s):  
Karen E. Hauer ◽  
Patricia A. Carney ◽  
Anna Chang ◽  
Jason Satterfield
Keyword(s):  
Behavior Change ◽  
Medical Trainees ◽  
Behavior Change Counseling

Behavior Change Counseling in the Emergency Department to Reduce Injury Risk: A Randomized, Controlled Trial

PEDIATRICS ◽  
2002 ◽  
Vol 110 (2) ◽  
pp. 267-274 ◽  
Author(s):  
B. D. Johnston ◽  
F. P. Rivara ◽  
R. M. Droesch ◽  
C. Dunn ◽  
M. K. Copass
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Injury Risk ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Behavior Change Counseling
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