An argument for using participatory approaches for the design of online health interventions targeted at young women

The Internet is becoming an increasingly important portal to health information and means for promoting health in user populations. As the most frequent users of online health information, young women are an important target population for e-health promotion interventions. Health-related websites have traditionally been generic in design, resulting in poor user engagement and affecting limited impacts on health behaviour change. Mounting evidence suggests that the most effective health promotion communication strategies are collaborative in nature, fully engaging target users throughout the development process. Participatory design approaches to interface development enable researchers to better identify the needs and expectations of users, thus increasing user engagement in, and promoting behaviour change via, online health interventions. This article introduces participatory design methods applicable to online health intervention design and presents an argument for the use of such methods in the development of e-Health applications targeted at young women.

Randomisation before consent : Avoiding delay to time-critical intervention and ensuring informed consent

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An evaluation of an online peer support forum for university students with depressive symptoms

Background: Depression is the most common mental health problem among young people, particularly university students, with prevalence rates as high as 48% reported. This population however, is reluctant to seek professional help. Online interventions may be particularly appealing to students, with evidence suggesting that they use the Internet for mental health support. While there are many mental health resources on the Internet few focus specifically on the needs of young people and few have been evaluated. This research aimed to develop and pilot test an online peer support intervention for students experiencing depressive symptoms. Methods: A depression support Web site (www.losetheblues.ie) was designed specifically for 18-24. year old students. The study used a mixed method, involving quantitative descriptive, pre- and post-test and qualitative descriptive designs. Data were collected using the Centre for Epidemiological Studies Depression Scale (CES-D), a background questionnaire and online forum posts. Results: The sample consisted of 117 university students with self-reported depressive symptoms. Results from participants in the pre- and post-test element of the study, showed no statistical significance. The forum posts revealed that the participants' main difficulties were loneliness and perceived lack of socialization skills. The Web site provided a place for sharing, offering and receiving emotional and informational support. Conclusion: Developing health care interventions in an online environment presents unique challenges to the research process, however they have the potential to provide mental health care that is accessible and affordable.

HomeBank: An Online Repository of Daylong Child-Centered Audio Recordings.

HomeBank is introduced here. It is a public, permanent, extensible, online database of daylong audio recorded in naturalistic environments. HomeBank serves two primary purposes. First, it is a repository for raw audio and associated files: one database requires special permissions, and another redacted database allows unrestricted public access. Associated files include metadata such as participant demographics and clinical diagnostics, automated annotations, and human-generated transcriptions and annotations. Many recordings use the child-perspective LENA recorders (LENA Research Foundation, Boulder, Colorado, United States), but various recordings and metadata can be accommodated. The HomeBank database can have both vetted and unvetted recordings, with different levels of accessibility. Additionally, HomeBank is an open repository for processing and analysis tools for HomeBank or similar data sets. HomeBank is flexible for users and contributors, making primary data available to researchers, especially those in child development, linguistics, and audio engineering. HomeBank facilitates researchers' access to large-scale data and tools, linking the acoustic, auditory, and linguistic characteristics of children's environments with a variety of variables including socioeconomic status, family characteristics, language trajectories, and disorders. Automated processing applied to daylong home audio recordings is now becoming widely used in early intervention initiatives, helping parents to provide richer speech input to at-risk children.

Social-Cognitive Determinants of Success in Online Communities for Weight Management

Background: Online communities may be an effective, convenient, and relatively inexpensive intervention platform for individuals seeking assistance with weight management. Recent research suggests that these communities may be as effective as in-person treatments for weight management; however, very little is known about the characteristics that predict weight loss amongst those using an online community. Methods: Within a social-cognitive framework, we sought to identify the psychosocial characteristics that are associated with successful weight management for users of MyFitnessPal, a popular online community for weight management. We recruited participants who were new to the online community and asked them to complete 2 surveys (one at baseline and one 3 months later) that assessed various psychosocial constructs as well as self-reported height and weight. Results: Participants in our sample reported losing, on average, 4.55 kg during the 3-month time period. We found that engaging in weight control behaviors (e.g., monitoring food intake, weighing oneself, etc.) fully mediated the relationship between several of our variables of interest (i.e., baseline self-efficacy and perceived social support within the community) and weight loss. We also found that participants who expected to lose more weight at baseline were significantly more likely to have lost more weight at follow-up. Conclusions: On average, participants in our study lost a clinically meaningful amount of weight. Predictors of weight loss within this community included perceived support within the community (mediated by weight control behaviors), baseline self-efficacy (mediated by weight control behaviors), and baseline outcome expectations. Results of this study can ultimately serve to inform the design of future eHealth interventions for weight management.

The Efficacy of a Novel Video Game Intervention (MindLight) in Reducing Children's Anxiety

Anxiety disorders are the most prevalent form of psychopathology among children and adolescents. Because demand for treatment far exceeds availability, there is a need for alternative approaches that are engaging, accessible, cost-effective, and incorporate practice to reach as many youth as possible. One novel approach is a video game intervention called MindLight that uses two evidence-based strategies to target childhood anxiety problems. Using neurofeedback mechanics to train players to: (1) attend to positive rather than threatening stimuli and (2) down-regulate arousal during stressful situations, MindLight teaches children how to practice overcoming anxious thoughts and arousal in a fun and engaging context. The present study examined the effectiveness of MindLight versus online cognitive-behavioural therapy (CBT) based psychoeducation sessions as a comparison in reducing anxiety in a sample of 144 anxious children, which was measured in three ways: (1) anxiety symptoms, (2) state anxiety in response to stress, and (3) psychophysiological arousal in response to stress. Children between the ages of 8.05–17.78 years (M=13.61, SD=1.79) were randomly assigned to play MindLight or complete psychoeducation for five hours over three weeks. State anxiety and psychophysiological arousal were assessed in response to two stress tasks before and after exposure to MindLight or psychoeducation. Anxiety symptoms were also measured via a questionnaire. Overall, participants showed significant reductions in anxiety symptoms and state anxiety in response to stress, but not psychophysiological arousal in response to stress. Moreover, the magnitude of reductions in anxiety did not differ between interventions but by age and sex. Specifically, older participants showed a greater decrease in severity of state anxiety in response to a social stressor than younger participants and girls showed a greater decrease in severity of state anxiety in response to a cognitive stressor than boys. The present study suggests that playing MindLight results in similar reductions in anxiety as one of the more common means of delivering CBT principles to youth.

Identity Text: an educational intervention to foster cultural interaction

Background: Sociocultural theories state that learning results from people participating in contexts where social interaction is facilitated. There is a need to create such facilitated pedagogical spaces where participants share their ways of knowing and doing. The aim of this exploratory study was to introduce pedagogical space for sociocultural interaction using ‘Identity Text’.
Methods: Identity texts are sociocultural artifacts produced by participants, which can be written, spoken, visual, musical, or multimodal. In 2013, participants of an international medical education fellowship program were asked to create their own Identity Texts to promote discussion about participants’ cultural backgrounds. Thematic analysis was used to make the analysis relevant to studying the pedagogical utility of the intervention.
Result: The Identity Text intervention created two spaces: a ‘reflective space’ helped
participants reflect on sensitive topics like institutional environments, roles in
interdisciplinary teams, and gender discrimination. A ‘narrative space’ allowed
participants to tell powerful stories that provided cultural insights and challenged cultural hegemony; they described the conscious and subconscious transformation in identity that evolved secondary to struggles with local power dynamics and social demands involving the impact of family, peers and country of origin.
Conclusion: Whilst the impact of providing pedagogical space using Identity Text on
cognitive engagement and enhanced learning requires further research, the findings of
this study suggest that it is a useful pedagogical strategy to support cross-cultural
education.

Evaluation of a Brief Intervention to Assist Health Visitors and Community Practitioners to Engage with Fathers as Part of the Healthy Child Initiative

Aims: To improve engagement of Health Visitors and Community Practitioners delivering the Healthy Child Programme with fathers. To evaluate a one-day, father-focused workshop with a supporting handbook for Practitioners. To identify institutional and organisational barriers to engagement with fathers. Background: The UK government policy encourages health professionals to engage with fathers. This derives from robust evidence that fathers’ early involvement with their children impacts positively on emotional, behavioural and educational development. Yet, there is little evidence that the importance of engaging fathers is reflected in Health Visitor training or that primary-care services are wholly embracing father-inclusive practice. The Fatherhood Institute (FI), a UK charity, has developed a workshop for Practitioners delivering the Healthy Child Programme. Method: A ‘before and after’ evaluation study, comprising a survey followed by telephone interviews, evaluated the impact of the FI workshop on Health Visitors’ and Community Practitioners’ knowledge, attitudes and behaviour in practice. A total of 134 Health Visitors and Community Practitioners from eight NHS Trusts in England attended the workshop from November 2011 to January 2014 at 12 sites. A specially constructed survey, incorporating a validated questionnaire, was administered before the workshop, immediately afterwards and three months later. Telephone interviews further explored participants’ responses. Findings: Analysis of the questionnaire data showed that the workshop and handbook improved participants’ knowledge, attitudes and behaviour in practice. This was sustained over a three-month period. In telephone interviews, most participants said that the workshop had raised their awareness of engaging fathers and offered them helpful strategies. However, they also spoke of barriers to engagement with fathers. NHS Trusts need to review the training and education of Health Visitors and Community Practitioners and take a more strategic approach towards father-inclusive practice and extend services to meet the needs of fathers.

Layers of Listening: Qualitative Analysis of the Impact of Early Intervention Services for First-episode Psychosis on Carers' Experiences

Background Early intervention services (EIS) comprise low-stigma, youth-friendly mental health teams for young people undergoing first-episode psychosis (FEP). Engaging with the family of the young person is central to EIS policy and practice. Aims By analysing carers' accounts of their daily lives and affective challenges during a relative's FEP against the background of wider research into EIS, this paper explores relationships between carers' experiences and EIS. Method Semi-structured longitudinal interviews with 80 carers of young people with FEP treated through English EIS. Results Our data suggest that EIS successfully aid carers to support their relatives, particularly through the provision of knowledge about psychosis and medications. However, paradoxical ramifications of these user-focused engagements also emerge; they risk leaving carers' emotions unacknowledged and compounding an existing lack of help-seeking. Conclusions By focusing on EIS's engagements with carers, this paper draws attention to an urgent broader question: as a continuing emphasis on care outside the clinic space places family members at the heart of the care of those with severe mental illness, we ask: who can, and should, support carers, and in what ways?

Effects of a 12-week aerobic exercise intervention on eating behaviour, food cravings and 7-day energy intake and energy expenditure in inactive men

This study examined effects of 12 weeks of moderate-intensity aerobic exercise on eating behaviour, food cravings and weekly energy intake and expenditure in inactive men. Eleven healthy men (mean ± SD: age, 26 ± 5 years; body mass index, 24.6 ± 3.8 kg/m2; maximum oxygen uptake, 43.1 ± 7.4 mL/kg/min) completed the 12-week supervised exercise programme. Body composition, health markers (e.g. blood pressure), eating behaviour, food cravings and weekly energy intake and expenditure were assessed before and after the exercise intervention. There were no intervention effects on weekly free-living energy intake (p=0.326, d=-0.12) and expenditure (p=0.799, d=0.04), or uncontrolled eating and emotional eating scores (p>0.05). However, there was a trend with a medium effect size (p=0.058, d=0.68) for cognitive restraint to be greater after the exercise intervention. Total food cravings (p=0.009, d=-1.19) and specific cravings of high-fat foods (p=0.023, d=-0.90), fast-food fats (p=0.009, d=-0.71) and carbohydrates/starches (p=0.009, d=-0.56) decreased from baseline to 12 weeks. Moreover, there was a trend with a large effect size for cravings of sweets (p=0.052, d=-0.86) to be lower after the exercise intervention. In summary, 12 weeks of moderate-intensity aerobic exercise reduced food cravings and increased cognitive restraint, however, these were not accompanied by changes in other eating behaviours and weekly energy intake and expenditure. The results indicate the importance of exercising for health improvements even when reductions in body mass are modest.

Active Data Collection Techniques to Understand Online Scammers and Cybercriminals

Nigerian scam, also known as advance fee fraud or 419 scam, is a prevalent form of online fraudulent activity that causes financial loss to individuals and businesses. Nigerian scam has evolved from simple non-targeted email messages to more sophisticated scams targeted at users of classifieds, dating and other websites. Even though such scams are observed and reported by users frequently, the community’s understanding of Nigerian scams is limited since the scammers operate “underground”. To better understand the underground Nigerian scam ecosystem and seek effective methods to deter Nigerian scam and cybercrime in general, we conduct a series of active and passive measurement studies. Relying upon the analysis and insight gained from the measurement studies, we make four contributions: (1) we analyze the taxonomy of Nigerian scam and derive long-term trends in scams; (2) we provide an insight on Nigerian scam and cybercrime ecosystems and their underground operation; (3) we propose a payment intervention as a potential deterrent to cybercrime operation in general and evaluate its effectiveness; and (4) we offer active and passive measurement tools and techniques that enable in-depth analysis of cybercrime ecosystems and deterrence on them. We first created and analyze a repository of more than two hundred thousand user-reported scam emails, stretching from 2006 to 2014, from four major scam reporting websites. We select ten most commonly observed scam categories and tag 2,000 scam emails randomly selected from our repository. Based upon the manually tagged dataset, we train a machine learning classifier and cluster all scam emails in the repository. From the clustering result, we find a strong and sustained upward trend for targeted scams and downward trend for non-targeted scams. We then focus on two types of targeted scams: sales scams and rental scams targeted users on Craigslist. We built an automated scam data collection system and gathered large-scale sales scam emails. Using the system we posted honeypot ads on Craigslist and conversed automatically with the scammers. Through the email conversation, the system obtained additional confirmation of likely scam activities and collected additional information such as IP addresses and shipping addresses. Our analysis revealed that around 10 groups were responsible for nearly half of the over 13,000 total scam attempts we received. These groups used IP addresses and shipping addresses in both Nigeria and the U.S. We also crawled rental ads on Craigslist, identified rental scam ads amongst the large number of benign ads and conversed with the potential scammers. Through in-depth analysis of the rental scams, we found seven major scam campaigns employing various operations and monetization methods. We also found that unlike sales scammers, most rental scammers were in the U.S. The large-scale scam data and in-depth analysis provide useful insights on how to design effective deterrence techniques against cybercrime in general. We study underground DDoS-for-hire services, also known as booters, and measure the effectiveness of undermining a payment system of DDoS Services. Our analysis shows that the payment intervention can have the desired effect of limiting cybercriminals’ ability and increasing the risk of accepting payments.

The Spanish online program "Educar en Positivo" ("The Positive Parent"): whom does it benefit the most?

This study evaluated the Spanish online program 'Educar en Positivo' ("The Positive Parent") (http://educarenpositivo.es). Eighty-five users were surveyed to examine changes in views of online parenting support and satisfaction with the module completed, as a function of their sociodemographic profile, their level of experience with the Internet, and their general and educational use of Internet resources. Results showed that parents changed their views of online support, the benefits thereof, and their parenting skills. Participants reported high satisfaction with the program's usability, the module content, and their perception of parental self-efficacy. These findings are moderated by level of Internet experience and educational use of web-based resources, suggesting that improving parents' digital literacy and promoting Internet use may be an effective avenue for improving access to prevention resources. In sum, this program offers a space for Spanish-speaking parents to learn and exchange experiences, thereby filling a gap in ensuring the promotion of positive parenting in this large community of potential users.

Aider sans nuire: intervention de groupe destinée aux proches de victimes d'actes criminels

Rapport de stage présenté en vue de l’obtention du grade Maître ès sciences (M.Sc.) en criminologie option stage en intervention clinique.

Using alcohol unit-marked glasses enhances capacity to monitor intake:evidence from a mixed-method intervention trial

AIMS: In the UK, people tend to have poor knowledge of government guidelines for alcohol use, and lack the motivation and skills required to use them to monitor their drinking. The study aim was to determine whether using glasses marked with such guidelines would improve knowledge and attitudes, increase frequency of counting units and lower alcohol intake. METHODS: A total of 450 adults in the UK participated in an intervention vs control study with 1-month follow-up. The intervention group was encouraged to use glasses supplied by the researchers that indicated the unit content of drinks of different strengths and volumes, and stated the intake guidelines. Data were collected online. A further more in-depth interview with 13 intervention group participants enquired into their experiences of using the glasses. RESULTS: Analyses adjusted for baseline variables showed that the intervention improved the following: knowledge of unit-based guidelines, ability to estimate the unit content of drinks, attitudes toward the guidelines and frequency of counting unit intake. However, there was no significant difference in alcohol consumption between the groups at follow-up. Interviews suggested that the glasses encouraged people to think about their drinking and to discuss alcohol with other people. The design of the glasses was not appealing to all, and their initial impact did not always persist. CONCLUSION: Use of unit-marked glasses led to changes in people's reported use of unit-based guidelines to monitor their drinking but, in the short term, no change in consumption. Qualitative data suggested that the glasses could have an impact at the individual level (on knowledge and attitudes) and at a broader level (by prompting discussion of alcohol use).

Aider sans nuire: intervention de groupe destinée aux proches de victimes d'actes criminels

Rapport de stage présenté en vue de l’obtention du grade Maître ès sciences (M.Sc.) en criminologie option stage en intervention clinique.