37 resultados para Social intervention

em QUB Research Portal - Research Directory and Institutional Repository for Queen's University Belfast


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Social and psychological interventions are often complex. Understanding randomized controlled trials (RCTs) of these complex interventions requires a detailed description of the interventions tested and the methods used to evaluate them; however, RCT reports often omit, or inadequately report, this information. Incomplete and inaccurate reporting hinders the optimal use of research, wastes resources, and fails to meet ethical obligations to research participants and consumers. In this article, we explain how reporting guidelines have improved the quality of reports in medicine and describe the ongoing development of a new reporting guideline for RCTs: Consolidated Standards of Reporting Trials-SPI (an extension for social and psychological interventions). We invite readers to participate in the project by visiting our website, in order to help us reach the best-informed consensus on these guidelines (http://tinyurl.com/CONSORT-study).

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This paper details a researcher's experience of gaining access to three statutory social work agencies in order to conduct a study examining how social workers respond to family support cases and how parents and carers experience the intervention of social workers in these cases. The stages in gaining access are outlined, the gate-keepers involved at each stage are identified and some of the difficulties encountered are highlighted and discussed. The paper concludes that researchers need to give greater priority to access considerations and that social work agencies need to give greater priority to co-operation with researchers.

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Objective: To apply the UK Medical Research Council (MRC) framework for development and evaluation of trials of complex interventions to a primary healthcare intervention to promote secondary prevention of coronary heart disease. Study Design: Case report of intervention development. Methods: First, literature relating to secondary prevention and lifestyle change was reviewed. Second, a preliminary intervention was modeled, based on literature findings and focus group interviews with patients (n = 23) and staff (n = 29) from 4 general practices. Participants’ experiences of and attitudes toward key intervention components were explored. Third, the preliminary intervention was pilot-tested in 4 general practices. After delivery of the pilot intervention, practitioners evaluated the training sessions, and qualitative data relating to experiences of the intervention were collected using semistructured interviews with staff (n = 10) and patient focus groups (n = 17). Results: Literature review identified 3 intervention components: a structured recall system, practitioner training, and patient information. Initial qualitative data identified variations in recall system design, training requirements (medication prescribing, facilitating behavior change), and information appropriate to the prospective study participants. Identifying detailed structures within intervention components clarified how the intervention could be tailored to individual practice, practitioner, and patient needs while preserving the theoretical functions of the components. Findings from the pilot phase informed further modeling of the intervention, reducing administrative time, increasing practical content of training, and omitting unhelpful patient information. Conclusion: Application of the MRC framework helped to determine the feasibility and development of a complex intervention for primary care research.

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Selected biochemical evidence suggests a potential role for n-3 long-chain PUFA (n-3PUFA) in the regulation of mood and behaviour. The present paper reviews the relevant evidence, to date, from epidemiological studies, clinical studies and intervention trials. Most evidence is available investigating a role for n-3PUFA in depression, depressive illness and suicidal behaviour, but work is also available on anxiety and anxiety-related disorders, fatigue and fatigue-related disorders, aggression, hostility and anti-social behaviour, inattention, impulsivity and attention deficit hyperactivity disorder and schizophrenic disorders. For all these aspects of mood and behaviour, the evidence available is currently limited and highly inconsistent, both in terms of study methodology and study findings. There is a clear need for further work in this area.

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Background: Smoking cessation is the primary disease modifying intervention for chronic obstructive pulmonary disease (COPD).

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Implementation of maternity reform agendas remains limited by the dominance of a medical rather than social model of health. This article considers group prenatal care as a complex health intervention and explores its potential in the socially divided, postconflict communities of Northern Ireland. Using qualitative inquiry strategies, we sought key informants’ views on existing prenatal care provision and on an innovative group care model (CenteringPregnancy®) as a social health initiative. We argue that taking account of the locally specific context is critical to introducing maternity care interventions to improve the health of women and their families and to contribute to community development.

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Methadone maintenance treatment (MMT) is an intervention used to treat opioid (heroin) dependence. Several investigators have found that MMT is effective in reducing heroin use and other behaviors; however, a disproportionate number of MMT clients leave treatment prematurely. Moreover, MMT outcome variables are often limited in terms of their measurement. Utilizing an integrated theoretical framework of social control and stigma, we focused on the experiences of methadone maintenance from the perspective of clients. We pooled interview data from four qualitative studies in two jurisdictions and found linkages between social control and institutional stigma that serve to reinforce "addict" identities, expose undeserving customers to the public gaze, and encourage clients to be passive recipients of treatment. We discuss the implications for recovery and suggest recommendations for change.

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The purpose of this article is to critically examine the literature to provide a rationale for including systemic family therapy (SFT) in the psycho-social treatment of people suffering the impact of post-traumatic stress (PTS). Attention is drawn to the relatively underdeveloped academic literature on PTS and the family. The impact of PTS is conceptualized within a psycho-social framework and the current evidence base for psycho-social interventions for PTS responses is described, highlighting the opportunity and need to undergird this area of daily practice. The impact of PTS on the family at multiple levels is identified, emphasizing its recursive nature. The case for SFT is articulated and a range of models of family intervention for PTS briefly reviewed, concluding with an emphasis on Walsh's key processes in family resilience as a framework for practice.

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Building on a body of previous research by the author and colleagues in relation to multiple adverse childhood experiences (MACE), this paper addresses the question of ‘why multiples matter’ in relation to issues of cumulative adversity. Illustrative evidence is drawn from three research domains, epidemiology, multiple services use and child maltreatment to demonstrate the collective weight of evidence to suggest a targeting of those children and families experiencing multiple adversities to diminish the effects of such adversities realised across the life-course. Whilst the history of previous largely unsuccessful attempts to widen the range of children prioritised for intervention by child and family social workers might lead to pessimism in relation to their ability to respond to a MACE informed public health agenda, there are clear possibilities for developing agency structures, assessment tools and social work practices directed toward meeting the needs of those sub populations already prioritised by social workers: namely Children in Need, Children in need of Protection and Looked after Children.

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We evaluated the impact of the Friendship Project, a program designed to improve elementary school children's attitudes toward refugees. Participants either received 4 weekly lessons based on the program, or they received no lessons. All participants completed attitude measures before and after implementation of the program. Half completed the post-test 1 week after completion of the program, while the other half completed the post-test 7 weeks after its completion. The program led to more positive attitudes toward refugees in the short term, but not in the long term. Moreover, although it did not increase empathy, the program increased the proportion of participants who preferred an acculturation strategy of integration and reduced the number of participants who had conflictual acculturative fit.

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Family caregivers of patients requiring palliative care commonly experience physical, social, and psychological burdens. Although family caregivers are acknowledged as valid service recipients of palliative care, many have unmet needs, and systematic reviews have shown there are limited evidence-based supportive interventions.

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Aims: This study assessed the efficacy of a school-based healthy lifestyle intervention (Sport for LIFE) for increasing physical activity, decreasing sedentary behaviour, reducing screen time behaviour, encouraging healthy attitudes and behaviour to nutrition, and reducing body mass index (BMI) in 8–9-year-old primary school children from lower socioeconomic backgrounds in Northern Ireland.

Methods: A non-randomised controlled trial of 416 children from 24 schools took part. Schools were randomly assigned to one of two groups, an intervention or control group with 12 schools in each group. The intervention group received a 12-week school-based programme based on social cognitive theory. At baseline and follow-up, groups completed questionnaires assessing physical activity, screen time behaviour and dietary patterns. On each occasion anthropometric assessments of height and weight were taken. Physical activity and sedentary behaviour were measured by accelerometry.

Results Significant effects were observed for vigorous, moderate and light activity for the intervention group at follow-up. Sedentary behaviour was significantly reduced for the intervention group but not for the control group. No significant effects of the intervention on BMI, screen time behaviour or attitudes to nutrition, with the exception of non-core foods, were shown.

Conclusions: The programme was effective in increasing physical activity and reducing sedentary behaviour, however no significant changes in screen time behaviour and attitude to nutrition, with the exception of non-core foods, were observed. Future research ideas are offered for tackling low levels of physical activity in children.