scholarly journals A Large Scale, App-Based Behaviour Change Experiment Persuading Sustainable Mobility Patterns: Methods, Results and Lessons Learnt

2019 ◽  
Vol 11 (9) ◽  
pp. 2674 ◽  
Author(s):  
Francesca Cellina ◽  
Dominik Bucher ◽  
Francesca Mangili ◽  
José Veiga Simão ◽  
Roman Rudel ◽  
...  

The present urban transportation system, mostly tailored for cars, has long shown its limitations. In many urban areas, public transportation and soft mobility would be able to effectively satisfy many travel needs. However, they tend to be neglected, due to a deep-rooted car dependency. How can we encourage people to make sustainable mobility choices, reducing car use and the related CO 2 emissions and energy consumption? Taking advantage of the wide availability of smartphone devices, we designed GoEco!, a smartphone application exploiting automatic mobility tracking, eco-feedback, social comparison and gamification elements to persuade individual modal change. We tested the effectiveness of GoEco! in two regions of Switzerland (Cantons Ticino and Zurich), in a large-scale, one year long randomized controlled trial. Notwithstanding a large drop-out rate experienced throughout the experiment, GoEco! was observed to produce a statistically significant impact (a decrease in CO 2 emissions and energy consumption per kilometer) for systematic routes in highly car-dependent urban areas, such as the Canton Ticino. In Zurich, instead, where high quality public transport is already available, no statistically significant effects were found. In this paper we present the GoEco! experiment and discuss its results and the lessons learnt, highlighting practical difficulties in performing randomized controlled trials in the field of mobility and providing recommendations for future research.

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256251
Author(s):  
Teuntje R. Elfrink ◽  
Christina Ullrich ◽  
Miriam Kunz ◽  
Sytse U. Zuidema ◽  
Gerben J. Westerhof

This paper describes a randomized controlled trial on the Online Life Story Book (OLSB), a digital reminiscence intervention for people with (very) mild dementia living at home. The aim of the study was to investigate the effectiveness of the OLSB on (i) neuropsychiatric symptoms (NPS) in persons with dementia and (ii) the distress and quality of life (QOL) of primary informal caregivers. A randomized controlled trial with individual randomization to one of two conditions was conducted: 1) intervention “Online Life Story Book”; 2) wait list control condition. In the intervention OLSB, a trained volunteer guided the participants through the process of creating an OLSB in approximately 5 meetings within a period of 8–10 weeks. Participants in the control condition received care as usual while they waited for 6 months before starting. Outcomes on NPS and distress and QOL of the informal caregiver were assessed at baseline (baseline, T0), 3 months (T1) and 6 months (T2) post baseline. Of the 42 persons with dementia, 23 were female and 19 were male. They had a mean age of 80 years, ranging from 49 to 95. The total drop-out rate was 14.3 percent. Small but insignificant effects on NPS, caregiver distress and QOL of caregivers were found with the exception of self-rated caregiver distress that reduced significantly during the intervention. One reason to explain the results might be that the included participants were in relatively good health. Practical challenges during the intervention could have affected the results as well. It might also be that the intervention caused effects on other outcomes than NPS and caregiver distress. In future research, it is important to study the effects in persons with more complaints and higher distress and to be careful in the selection of outcome variables in relation to the reminiscence functions served by the intervention.


2020 ◽  
Author(s):  
Thi Thuy Duong Doan ◽  
Chuyen Trung Tran ◽  
Minh Ngoc Pham ◽  
Yun Zhao ◽  
Hoa Thi Phuong Dinh ◽  
...  

BACKGROUND Breastfeeding has substantial benefits for both mothers and children. The World Health Organization and the Vietnam Ministry of Health recommend exclusive breastfeeding for 6 months. However, this target was reached by fewer than 17% of Vietnamese infants and in urban areas such as Hanoi, was only about 12.6%. Many factors influence breastfeeding, but mothers are the most influential in achieving breastfeeding success. The high rate of use of smart mobile phones among mothers in urban areas offers unique opportunities to promote breastfeeding OBJECTIVE This study is to document the process of designing, developing, and evaluating a mobile app that is tailored to Vietnamese culture and aims to increase breastfeeding rates, particularly exclusive breastfeeding, and duration in Vietnamese women METHODS To design and develop the mobile app we used a 4-step mixed methods approach. We firstly reviewed studies on using mHealth and mobile apps for improving breastfeeding as well as barriers and facilitators of breastfeeding in Vietnam. We then conducted 22 in-depth interviews with mothers about key barriers, facilitators, and ideas about the apps. Self-administered online questionnaires were responded to by 49 mothers and fathers about the main features and contents of the apps. After that, we identified and developed the app among the research team to have two versions of the app (intervention vs. control version) and a mechanism that ensured a triple-blinded, randomized controlled trial study. In the next step, we tested the app messages with mothers of 3 focus groups and invited external experts for reviewing the library content. Finally, team members tested and adjusted the prototype before conducting a large-scale test of its effectiveness RESULTS Participants were most interested in information on the mental health and wellbeing of mothers during pregnancy and after delivery, preparation for delivery, and avoiding food and beverages. Regarding breastfeeding, mothers were most concerned about nutrition for mothers during breastfeeding, preventing and reducing difficulties on breastfeeding, and initiation of breastfeeding. Three key features to be included in the prototype app were identified from the formative research: (1) notifications; (2) an information library; and (3) searching function. The app should be installed during pregnancy rather than after delivery. Push notifications that convey the main messages should be sent 2 – 3 times per week to remind mothers of using the app. CONCLUSIONS The development of the app, called BeBo followed a best practice approach, including the involvement of related stakeholders and grounding in behavior change theory. To the best of our knowledge, it is the first mobile app that enables us to evaluate the effectiveness of mHealth interventions in a well-conducted randomised controlled trial. CLINICALTRIAL ACTRN12619000531112


2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.


2019 ◽  
Vol 15 (1) ◽  
pp. 54-56
Author(s):  
Stelina Alkagiet ◽  
Konstantinos Tziomalos

Primary aldosteronism (PA) is not only a leading cause of secondary and resistant hypertension, but is also quite frequent in unselected hypertensive patients. Moreover, PA is associated with increased cardiovascular risk, which is disproportionate to BP levels. In addition, timely diagnosis of PA and prompt initiation of treatment attenuate this increased risk. On the other hand, there are limited data regarding the usefulness of screening for PA in all asymptomatic or normokalemic hypertensive patients. More importantly, until now, no well-organized, large-scale, prospective, randomized controlled trial has proved the effectiveness of screening for PA for improving clinical outcome. Accordingly, until more relevant data are available, screening for PA should be considered in hypertensive patients with spontaneous or diuretic-induced hypokalemia as well as in those with resistant hypertension. However, screening for PA in all hypertensive patients cannot be currently recommended.


Author(s):  
Tomasz Kuligowski ◽  
Anna Skrzek ◽  
Błażej Cieślik

The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research.


2021 ◽  
pp. 089826432110150
Author(s):  
Janet M. Boekhout ◽  
Esmee Volders ◽  
Catherine A. W. Bolman ◽  
Renate H. M. de Groot ◽  
Lilian Lechner

Objectives: This study explores the effects of the Active Plus intervention aiming to decrease loneliness among older adults (>65 years) with chronic diseases. Methods: A randomized controlled trial (RCT) was performed (N = 585; age: M = 74.5 years, SD = 6.4), assessing loneliness at baseline, 6 months and 12 months. Outcome measures in the multilevel linear regression analyses were total, social and emotional loneliness. Results: At 12 months, significant decreases in total ( B = −.37, p = .01) and social loneliness ( B = −.24, p = .02) were found. Age was a significant moderator for total and social loneliness; however, the intervention was effective only for participants aged 80 years and older. Discussion: The Active Plus intervention showed a significant decrease in total and social loneliness and was especially beneficial for the vulnerable age group of 80 years and older. A more comprehensive tool for measuring social activity and mobility impairments, and using a longer time frame to detect loneliness changes, may form interesting future research.


Aerospace ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 38
Author(s):  
Malik Doole ◽  
Joost Ellerbroek ◽  
Victor L. Knoop ◽  
Jacco M. Hoekstra

Large-scale adoption of drone-based delivery in urban areas promise societal benefits with respect to emissions and on-ground traffic congestion, as well as potential cost savings for drone-based logistic companies. However, for this to materialise, the ability of accommodating high volumes of drone traffic in an urban airspace is one of the biggest challenges. For unconstrained airspace, it has been shown that traffic alignment and segmentation can be used to mitigate conflict probability. The current study investigates the application of these principles to a highly constrained airspace. We propose two urban airspace concepts, applying road-based analogies of two-way and one-way streets by imposing horizontal structure. Both of the airspace concepts employ heading-altitude rules to vertically segment cruising traffic according to their travel direction. These airspace configurations also feature transition altitudes to accommodate turning flights that need to decrease the flight speed in order to make safe turns at intersections. While using fast-time simulation experiments, the performance of these airspace concepts is compared and evaluated for multiple traffic demand densities in terms of safety, stability, and efficiency. The results reveal that an effective way to structure drone traffic in a constrained urban area is to have vertically segmented altitude layers with respect to travel direction as well as horizontal constraints imposed to the flow of traffic. The study also makes recommendations for areas of future research, which are aimed at supporting dynamic traffic demand patterns.


2021 ◽  
pp. 1-7
Author(s):  
Alastair J. Flint ◽  
Kathleen S. Bingham ◽  
Nicholas H. Neufeld ◽  
George S. Alexopoulos ◽  
Benoit H. Mulsant ◽  
...  

Abstract Background Little is known about the relationship between psychomotor disturbance (PMD) and treatment outcome of psychotic depression. This study examined the association between PMD and subsequent remission and relapse of treated psychotic depression. Methods Two hundred and sixty-nine men and women aged 18–85 years with an episode of psychotic depression were treated with open-label sertraline plus olanzapine for up to 12 weeks. Participants who remained in remission or near-remission following an 8-week stabilization phase were eligible to participate in a 36-week randomized controlled trial (RCT) that compared the efficacy and tolerability of sertraline plus olanzapine (n = 64) with sertraline plus placebo (n = 62). PMD was measured with the psychiatrist-rated sign-based CORE at acute phase baseline and at RCT baseline. Spearman's correlations and logistic regression analyses were used to analyze the association between CORE total score at acute phase baseline and remission/near-remission and CORE total score at RCT baseline and relapse. Results Higher CORE total score at acute phase baseline was associated with lower frequency of remission/near-remission. Higher CORE total score at RCT baseline was associated with higher frequency of relapse, in the RCT sample as a whole, as well as in each of the two randomized groups. Conclusions PMD is associated with poorer outcome of psychotic depression treated with sertraline plus olanzapine. Future research needs to examine the neurobiology of PMD in psychotic depression in relation to treatment outcome.


2018 ◽  
Vol 42 (3) ◽  
pp. 358-385 ◽  
Author(s):  
Natalie Todak ◽  
Michael D. White ◽  
Lisa M. Dario ◽  
Andrea R. Borrego

Objective: To provide guidance to criminologists for conducting experiments in light of two common discouraging factors: the belief that they are overly time-consuming and the belief that they can compromise the ethical principles of human subjects’ research. Method: A case study approach is used, based on a large-scale randomized controlled trial experiment in which we exposed participants to a 5-s TASER shock, to describe how the authors overcame ethical, methodological, and logistical difficulties. Results: We derive four pieces of advice from our experiences carrying out this experimental trial: (1) know your limitations, (2) employ pilot testing, (3) remain flexible and patient, and (4) “hold the line” to maintain the integrity of the research and the safety of human subjects. Conclusions: Criminologists have an obligation to provide the best possible evidence regarding the impact and consequences of criminal justice practices and programs. Experiments, considered by many to be the gold standard of empirical research methodologies, should be used whenever possible in order to fulfill this obligation.


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