scholarly journals Patient experience and predictors of improvement in a group behavioral and educational intervention for individuals with diabetes and serious mental illness: a mixed methods case study (Preprint)

Author(s):  
Kristina Schnitzer ◽  
Corrine Cather ◽  
Vanya Zvonar ◽  
Alyson Dechert ◽  
Rachel Plummer ◽  
...  
2020 ◽  
Author(s):  
Kristina Schnitzer ◽  
Corrine Cather ◽  
Vanya Zvonar ◽  
Alyson Dechert ◽  
Rachel Plummer ◽  
...  

BACKGROUND In a prior study, participation in a 16-week, reverse integrated care, group behavioral and educational intervention for individuals with diabetes and serious mental illness was associated with improved glycemic control (HbA1C) and body mass index (BMI). In order to inform future implementation efforts, more information about the effective components of the intervention is needed. OBJECTIVE The goal of this study was to identify aspects of the intervention participants reported were helpful and to evaluate predictors of outcome. METHODS This study involved qualitative evaluation and post-hoc quantitative analysis of a prior intervention. Qualitative data were collected using semi-structured interviews with 24 of 35 individuals (69%) who attended one or more group sessions and 9 of 26 individuals (35%) who consented but attended no sessions. Quantitative mixed effects modeling was performed to test whether improved diabetes knowledge, diet and exercise, or higher group attendance predicted improved HbA1C and BMI. These interview and modeling outcomes were combined using a mixed methods case study framework and integrated thematically. RESULTS In qualitative interviews, participants identified application of health-related knowledge gained to real world situations, accountability for goals, positive reinforcement and group support, and increased confidence to prioritize health goals as factors contributing to success of the behavioral intervention. Improved diabetes knowledge was associated with reduced BMI (=-1.27, SD=0.40, P=0.003). No quantitative variables examined were significantly associated with improved HbA1C. CONCLUSIONS In this mixed methods analysis of predictors of success in a behavioral diabetes management program, group participants highlighted the value of positive reinforcement and group support, accountability for goals set, and real-world application of health-related knowledge gained. Improved diabetes knowledge was associated with weight loss. CLINICALTRIAL


BMJ Open ◽  
2018 ◽  
Vol 8 (6) ◽  
pp. e021931 ◽  
Author(s):  
Vari M Drennan ◽  
Melania Calestani ◽  
Fiona Ross ◽  
Mary Saunders ◽  
Peter West

Seizure ◽  
2021 ◽  
Author(s):  
G. Locatelli ◽  
D. Ausili ◽  
V. Stubbings ◽  
S. Di Mauro ◽  
M. Luciani

2018 ◽  
Vol 8 (2) ◽  
pp. 1
Author(s):  
Dino M. Minoli

Globally there are around 34,000 golf facilities including very many small golf clubs that collectively generate significant economic, social and environmental impacts. Thus, small golf clubs have an important role to play in the greening of golf in support of sustainability. Environmental programmes (EPs) were developed to improve the environmental performance of all types and sizes of golf facilities. However, EPs are rarely employed in small golf clubs and no research until now has explored the reasons for this. Data from an in-depth mixed methods case study found several internal and external influences on the level of implementation of EPs in small golf clubs. Interventions are suggested to stimulate the uptake of EPs in smaller golf clubs. The study is of value to the golf sector, government policy and organisations concerned with the greening of small businesses in the greening of an industry sector for sustainability. The study also provides a conceptual/empirical framework for further studies in this under-researched yet noteworthy field.


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