scholarly journals Feasibility of the Web-Based IDEAL CGM Training and Follow-Up Support Intervention: A Randomized Controlled Pilot Study (Preprint)

2019 ◽  
Author(s):  
Madison Brick Smith ◽  
Anastasia Albanese-O'Neill ◽  
Yingwei Yao ◽  
Diana J. Wilkie ◽  
Michael J. Haller ◽  
...  

BACKGROUND Proper training and follow-up for patients new to continuous glucose monitor (CGM) use are required to maintain adherence and achieve diabetes-related outcomes. However, CGM training is hampered by a lack of evidence-based standards and poor reimbursement. We hypothesized that web-based CGM training and education would be effective and could be provided with minimal burden to the healthcare team. OBJECTIVE To perform a pilot feasibility study testing a theory-driven, web-based intervention designed to provide extended training and follow-up support to adolescents and young adults newly implementing CGM, and to describe CGM adherence, glycemic control and CGM-specific psychosocial measures pre- and post-intervention. METHODS The “Intervention Designed to Educate and improve Adherence through Learning to use CGM”, (IDEAL CGM) web-based training intervention was based on supporting literature and theoretical concepts adapted from the Health Belief Model and Social Cognitive Theory. Patients new to CGM aged 15-24 with type 1 diabetes for more than 6 months were recruited from within a public university’s endocrinology clinics. Participants were randomized to enhanced standard care or enhanced standard care plus the IDEAL CGM intervention using a 1:3 randomization scheme. HbA1c and psychosocial measures were assessed at baseline and 3 months after start of the intervention. RESULTS 10 eligible subjects were approached for recruitment and eight were randomized. Within the IDEAL CGM group 4 of the 6 participants received exposure to the web-based training. Half of the participants completed at least 5 of the 7 modules, however dosage of the intervention and level of engagement varied widely among participants. This study provided proof of concept for use of a web-based intervention to deliver follow-up CGM training and support. However, revisions to the intervention are needed in order to improve engagement and determine feasibility. CONCLUSIONS This pilot study underscores the importance of continued research efforts to optimimize the use of web-based intervention tools for their potential to improve adherence, glycemic control and the psychosocial impact of the use of diabetes technologies without adding significant burden to the healthcare team. Enhancements should be made to the intervention to increase engagement, maximize responsiveness, and ensure attainment of the skills necessary to achieve consistent use and improvements in glycemic control prior to the design of a larger well-powered clinical trial to establish feasibility. CLINICALTRIAL ClinicalTrials.gov NCT03367351, https://clinicaltrials.gov/ct2/show/NCT03367351.

2020 ◽  
Author(s):  
Mariana Brussoni ◽  
Christina S Han ◽  
Yingyi Lin ◽  
John Jacob ◽  
Ian Pike ◽  
...  

BACKGROUND Outdoor risky play, such as climbing, racing and independent exploration, is an important part of childhood and is associated with various positive physical, mental and developmental outcomes for children. Parental attitudes and fears, particularly mothers’, are a major deterrent to children’s opportunities for outdoor risky play. OBJECTIVE To evaluate the efficacy of two versions of an intervention to reframe mothers’ perceptions of risk and change parenting behaviours: web-based intervention or an in-person workshop, compared to the control condition. METHODS The Go Play Outside! randomized controlled trial was conducted in Canada in 2017 to 2018. Participants were recruited through social media, snowball sampling, and community notices. Mothers of children aged 6-12 years were self-assessed through eligibility questions, and those eligible and consented to participate in the study were randomized into a fully automated web-based intervention, the in-person workshop or the control condition. The intervention was underpinned by social cognitive theory, incorporating behaviour change techniques. Participants progressed through a series of self-reflection exercises and developed a goal for change. Control participants received the Position Statement on Active Outdoor Play. The primary outcome was increase in tolerance of risky play and the secondary outcome was goal attainment. Data were collected online via REDCap at baseline, 1-week and 3-months post-intervention. Randomization was conducted using sealedenvelope.com. Allocations were concealed to researchers at assignment and data analysis. We conducted mediation analyses to examine whether the intervention influenced elements of social cognitive theory, as hypothesized. RESULTS A total of 451 mothers were randomized and completed baseline socio-demographic assessments: 150 in the web-based intervention, 153 in the in-person workshop, and 148 in the control condition; of which a total of 351 mothers completed the intervention. At 1-week post-intervention, 121, 85, and 135 mothers completed assessments for each condition, respectively, and at 3-months post-intervention, 105, 84 and 123 completed the assessments, respectively. Compared to mothers in the control condition, mothers in the web-based intervention had significantly higher tolerance of risky play at 1-week, and 3-months post-intervention; and mothers in the in-person workshop had significantly higher tolerance of risky play at 1-week post-intervention. No other significant outcomes were found. None of the potential mediators were found to significantly mediate the outcomes. CONCLUSIONS The trial demonstrates that the web-based intervention was effective in increasing mothers’ tolerance for risk in play. CLINICALTRIAL ClinicalTrials.gov, NCT03374683. Retrospectively registered on December 15, 2017. INTERNATIONAL REGISTERED REPORT RR2-10.1186/s13063-018-2552-4


JMIR Diabetes ◽  
10.2196/15410 ◽  
2019 ◽  
Author(s):  
Madison Brick Smith ◽  
Anastasia Albanese-O'Neill ◽  
Yingwei Yao ◽  
Diana J. Wilkie ◽  
Michael J. Haller ◽  
...  

2014 ◽  
Vol 48 (3) ◽  
pp. 492-499 ◽  
Author(s):  
Juliana Rizzo Gnatta ◽  
Patricia Petrone Piason ◽  
Cristiane de Lion Botero Couto Lopes ◽  
Noemi Marisa Brunet Rogenski ◽  
Maria Júlia Paes da Silva

Objective: To verify if the use of ylang ylang essential oil by cutaneous application or inhalation alters the anxiety and self-esteem perception and physiological parameters as blood pressure and temperature. Method : A pilot study with 34 professionals from a nursing group randomized in three groups: one received the ylang ylang essential oil by cutaneous application, the second received through inhalation and the third (placebo) received the ylang ylang essence through cutaneous application. The assessment was done by an Anxiety Inventory (IDATE) and the Dela Coleta self-esteem scale, applied on baseline, after 30, 60 and 90 days and after 15 days post-intervention (follow up). Results : In the pre and post-intervention intergroup analysis, there was a significant difference in self-esteem for the three groups (p values: G1=0.014; G2=0.016; G3=0.038). There were no differences in the analysis between groups for anxiety or for physiological parameters. Conclusion : It was found significant alterations only to the intergroup perception of self-esteem for the three groups.



2020 ◽  
Author(s):  
Matthew Louis Mauriello ◽  
Nantanick Tantivasadakarn ◽  
Marco Antonio Mora-Mendoza ◽  
Emmanuel Thierry Lincoln ◽  
Grace Hon ◽  
...  

BACKGROUND Approximately 60%-80% of the primary care visits have a psychological stress component, but only 3% of patients receive stress management advice during these visits. Given recent advances in natural language processing, there is renewed interest in mental health chatbots. Conversational agents that can understand a user’s problems and deliver advice that mitigates the effects of daily stress could be an effective public health tool. However, such systems are complex to build and costly to develop. OBJECTIVE To address these challenges, our aim is to develop and evaluate a fully automated mobile suite of shallow chatbots—we call them Popbots—that may serve as a new species of chatbots and further complement human assistance in an ecosystem of stress management support. METHODS After conducting an exploratory Wizard of Oz study (N=14) to evaluate the feasibility of a suite of multiple chatbots, we conducted a web-based study (N=47) to evaluate the implementation of our prototype. Each participant was randomly assigned to a different chatbot designed on the basis of a proven cognitive or behavioral intervention method. To measure the effectiveness of the chatbots, the participants’ stress levels were determined using self-reported psychometric evaluations (eg, web-based daily surveys and Patient Health Questionnaire-4). The participants in these studies were recruited through email and enrolled on the web, and some of them participated in follow-up interviews that were conducted in person or on the web (as necessary). RESULTS Of the 47 participants, 31 (66%) completed the main study. The findings suggest that the users viewed the conversations with our chatbots as helpful or at least neutral and came away with increasingly positive sentiment toward the use of chatbots for proactive stress management. Moreover, those users who used the system more often (ie, they had more than or equal to the median number of conversations) noted a decrease in depression symptoms compared with those who used the system less often based on a Wilcoxon signed-rank test (W=91.50; Z=−2.54; <i>P</i>=.01; <i>r</i>=0.47). The follow-up interviews with a subset of the participants indicated that half of the common daily stressors could be discussed with chatbots, potentially reducing the burden on human coping resources. CONCLUSIONS Our work suggests that suites of shallow chatbots may offer benefits for both users and designers. As a result, this study’s contributions include the design and evaluation of a novel suite of shallow chatbots for daily stress management, a summary of benefits and challenges associated with random delivery of multiple conversational interventions, and design guidelines and directions for future research into similar systems, including authoring chatbot systems and artificial intelligence–enabled recommendation algorithms.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021249 ◽  
Author(s):  
Ilse van Beusekom ◽  
Ferishta Bakhshi-Raiez ◽  
Nicolette F de Keizer ◽  
Dave A Dongelmans ◽  
Marike van der Schaaf

ObjectivesScreening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires.DesignA mixed-methods study.SettingNine Dutch ICU follow-up clinics.Participants221 ICU survivors and 14 health professionals.InterventionsA web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge.Primary outcomesOutcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires.Results221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals’ interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7).ConclusionsWeb-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.


2004 ◽  
Vol 43 (03) ◽  
pp. 268-272 ◽  
Author(s):  
S. Morita ◽  
T. Fukui ◽  
J. Sakamoto ◽  
M. Rahman

Summary Objective: To examine the physicians’ preference between Web and fax-based remote data entry (RDE) system for an ongoing randomized controlled trial (RCT) in Japan. Methods: We conducted a survey among all the collaborating physicians (n = 512) of the CASE-J (Candesartan Antihypertensive Survival Evaluation in Japan) trial, who have been recruiting patients and sending follow-up data using the Web or a fax-based RDE system. The survey instrument assessed physicians’ choice between Web and fax-based RDE systems, their practice pattern, and attitudes towards these two modalities. Results: A total of 448 (87.5%) responses were received. The proportions of physicians who used Web, fax, and the combination of these two were 45.9%, 33.3% and 20.8%, respectively. Multivariate logistic regression analyses revealed that physicians 55 years or younger [odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.1-3.3] and regular users of computers (OR = 4.2, 95% CI = 2.1-8.2) were more likely to use the Web-based RDE system. Conclusions: This information would be useful in designing an RCT with a Web-based RDE system in Japan and abroad.


2020 ◽  
Vol 15 (3) ◽  
pp. 21-35
Author(s):  
Rick Stoddart ◽  
Bruce Godfrey

Abstract Objective –This article reports on a pilot research project that gathered usage statistics in specifically designated library learning spaces using a Web-based Geographic Information System (GIS). These learning spaces were then mapped to expected learning activities that would occur in these areas based on its intention or design. In this way, the library could begin to associate the usage of a space with different types of learning. The researchers then mapped these learning activities to campus learning outcomes to create learning impact statements. Methods – The researchers used observation data gathered with a Web GIS tool to examine space usage within the library’s curriculum center. Results – The pilot study found that student usage of the curriculum center was mainly associated with two campus learning outcomes: (1) Communicate and (2) Learning and Integrate. The evidence also indicated possible design improvements that may make the curriculum centers spaces more functional for students. Conclusions – The Web GIS tool proved to be a useful tool to gather evidence of student space usage within the library environment. The mapping of individual spaces to learning activities further enhanced the usefulness in interpreting how students are using library spaces. Leveraging the space usage data within learning outcomes statements created another means for the library to communicate its learning impact with campus stakeholders.


2021 ◽  
Vol 2 ◽  
Author(s):  
Ritu Sharma ◽  
Amy E. Latimer-Cheung ◽  
John Cairney ◽  
Kelly P. Arbour-Nicitopoulos

Background: Physical activity (PA) interventions are limited in number and reach for youth with physical disabilities (YPD) who experience systemic barriers that may preclude their in-person participation. Further, a lack of theory in the development and evaluation of PA interventions impedes our understanding and replication of active components of behavior change. These limitations pose challenges in the effective promotion of PA in YPD. Theory-based and more inclusive methods of PA intervention delivery must be explored in our efforts to promote PA and overall health in YPD.Methods: A pilot study was conducted to evaluate the feasibility and outcomes of an online, 4-week social cognitive theory-based PA intervention for YPD. Intervention feasibility (implementation fidelity, intervention compliance, and intervention acceptability) was evaluated through manual documentation, weekly feedback questionnaires, and open-ended feedback at 1-month post-intervention. Targeted social cognitive (outcome expectations, self-efficacy [task, self-regulatory, barrier] and self-regulation) and PA behavior outcomes were self-reported at baseline and 1-week and 1-month post-intervention.Results: Sixteen YPD (Mage = 17.4 ± 2.7 years, 69% female) completed the study. Intervention feasibility was supported by high implementation fidelity (100%), high intervention compliance (&gt;90%), and positive ratings on indicators of acceptability for all weeks of the intervention (weekly feedback questionnaire means ranging from 5.74 to 6.19 out of 7). Through open-ended feedback, participants indicated the intervention was easy to use and understand, favorably shifted their self-awareness and personal meaning of PA, and provided value and potential for future use pertaining to the learned self-regulation skills and strategies. Participants also provided formatting and content recommendations for intervention improvement. Repeated measures ANOVAs showed significant and large effect sizes for changes in participants' task (p = 0.01, n2p = 0.28) and barrier (p = 0.02, n2p = 0.24) self-efficacy, goal-setting and planning and scheduling behaviors (ps &lt; 0.001, n2ps = 0.42), and self-reported PA behavior (p = 0.02, n2p = 0.26).Conclusions: An online PA intervention for YPD is feasible and may offer potential benefit through the enhancement of self-efficacy, self-regulation, and PA behavior. Continued research is necessary to understand the efficacy and longer-term outcomes of online, theory-based interventions for YPD as a PA promotion strategy.


2019 ◽  
Author(s):  
Jessica Lee Schleider ◽  
Michael C Mullarkey ◽  
John R Weisz

BACKGROUND Depression is the leading cause of disability in youth, with a global economic burden of US >$210 billion annually. However, up to 70% of youth with depression do not receive services. Even among those who do access treatment, 30% to 65% fail to respond and many dropout prematurely, demonstrating a need for more potent, accessible interventions. In a previous trial, a single-session Web-based growth mindset (GM) intervention significantly reduced depressive symptoms in high-symptom adolescents; however, this intervention did not benefit adolescents uniformly. For instance, the intervention reduced depression in adolescents who reported post intervention increases in perceived control, but it did not lead to significant depression reductions in adolescents who reported no significant post intervention increases in perceived control. OBJECTIVE The goal of this project is to test the acceptability and efficacy of a novel, single-session, virtual reality (VR) depression intervention—the VR Personality Project—teaching GM, the belief that personal attributes are malleable rather than fixed. The VR Personality Project was designed to systematically target and increase adolescents’ perceived control by offering a more immersive, engaging, user-directed intervention experience than the Web-based intervention can provide. By targeting an identified predictor of intervention response, the VR Personality Project may lead to larger reductions in depressive symptoms than existing Web-based mindset interventions. METHODS Adolescents with elevated depressive symptoms or a recent history of depression (N=159; ages 12 to 16 years) will be randomized to one of 3 intervention conditions: the VR Personality Project; the Web-based GM intervention tested previously; or an active, Web-based control. Adolescents and their parents will report on the adolescents’ depression symptoms, perceived control, and related domains of functioning at preintervention, postintervention, and at 3- and 9-month follow-up assessments. RESULTS We predict that the VR and Web-based mindset interventions will both lead to larger reductions in adolescent symptoms than the control intervention. Additionally, we predict that the VR-based single session intervention will lead to larger reductions in depression than the online mindset intervention and that these symptom reductions will be mediated by increases in adolescents’ perceived control from pre- to postintervention. CONCLUSIONS The results may suggest an efficient strategy for reducing adolescent depressive symptoms: One that is mechanism-targeted, relatively affordable (less than US $200 for a commercially available VR headset, a fraction of the cost of long-term psychotherapy) and potentially engaging to adolescents experiencing mood-related distress. CLINICALTRIAL ClinicalTrials.gov NCT0385881; https://clinicaltrials.gov/ct2/show/NCT03858881 (Archived by WebCite at http://www.webcitation.org/78C3roDgA). INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13368


2019 ◽  
Vol 127 (1) ◽  
pp. 5-7 ◽  
Author(s):  
Henri Tilga ◽  
Hanna Kalajas-Tilga ◽  
Vello Hein ◽  
Lennart Raudsepp ◽  
Andre Koka

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