Challenges and opportunities in the science of research to practice: lessons learned from a randomized controlled trial of a sexual risk-reduction intervention for psychiatric patients in a public mental health system

Objective: Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap has become a focus of implementation science. This paper describes the first and only HIV Prevention intervention trial for psychiatric patients conducted in real-world outpatient psychiatric settings facilitated by trained clinic-based providers. Methods: The HIV Prevention intervention, which uses the Information-Motivation-Behavioral Skills model to achieve sexual risk-reduction, was rigorously adapted to the local context and clinic services' needs. Participants from eight clinics were randomized to HIV Prevention or Health Promotion conditions. Results: HIV Prevention participants showed significant improvement in Information-Motivation-Behavioral domains; in this group, behavioral intentions were associated with significantly fewer unprotected sex occasions, but reduction of unprotected sex occasions was similar in both conditions. Conclusion: Our trial was conducted before implementation studies became widely funded. Transporting an intervention to a new culture or into real-world practice settings may require adaptations. Our results demonstrate that clear guidelines are needed regarding whether to conduct efficacy, effectiveness, and/or implementation research as the most appropriate next step. Clinical trial registration: NCT00881699

Educação parental: estudo exploratório em um grupo de dança inclusiva / Parent education: exploratory study in an inclusive dance group / Educación parental: estudio exploratorio en un grupo de danza inclusiva

Neste trabalho avaliamos a eficácia do programa de educação parental Grupo Laços de Inclusão, implementado numa associação de arte inclusiva. Participaram no estudo 11 pais (três pais e oito mães) de crianças/jovens (nove com necessidades especiais e dois sem necessidades especiais) que frequentavam um grupo de dança inclusiva na Região Autónoma da Madeira (Portugal). Realizou-se uma avaliação pré-teste e pós-teste, cujos resultados parecem apontar para uma diminuição das perceções do stress global dos participantes, da exigência associada à interação com a criança e do nível de saúde dos pais que poderá interferir na relação com os filhos. Apesar de os resultados serem promissores nestas dimensões, são apresentadas algumas reflexões e limitações a ter em conta em futuras intervenções de educação parental.

This paper evaluates the effectiveness of a parent training program, Grupo Laços de Inclusão (Bonds of Inclusion Group), implemented in an association of inclusive art. In this study participated 11 parents (three fathers and eight mothers) of children/youngsters (nine with special needs and two without disabilities) attending an inclusive dance group in Madeira Island (Portugal). It was carried out a pre-test and a post-test evaluation. The results show a decrease in the parents' perceptions of global stress, demand associated with the interaction with the child, and parents' health that could interfere with the relationship with the children. Despite the promising results, we present some reflections and limitations to take into consideration in future parent education interventions.

El trabajo evalúa la eficacia del programa de educación parental Grupo Laços de Inclusão (Grupo Lazos de Inclusión), aplicado en una asociación de arte inclusiva, de la Región Autónoma de Madeira. Han participado en el estudio 11 padres (ocho madres y tres padres) de nueve niños/jóvenes con necesidades especiales y de tres niños/jóvenes sin ninguna necesidad especial. Se ha realizado una evaluación pre-test y post-test y los resultados previos indican para una disminución de la percepción: del estrés global de los participantes; de exigencias de como relacionarse con el niño; del nivel de la salud de los padres, que pueden interferir na relación con el niño. Aunque los resultados parecen ser positivos, todavia se destacan algunas limitaciones y se sacan reflexiones para futuras intervenciones de educación parental.

Effects of a Clonorchiasis Prevention Education Program for Clonorchiasis Prevention Lecturers

PURPOSE: The study was conducted to clarify effects of a clonorchiasis prevention education program for clonorchiasis prevention lecturers. METHODS: The research adopted a single group pretest-posttest design to see effects of the educational program to prevent Clonorchis sinensis infection. The subjects of this study were 74 clonorchiasis prevention lecturers from primary health care facilities. The pretest was conducted before the clonorchiasis prevention education program and the post test was done after the 2-day program in August, 2011. Descriptive statistics, t-test, and ANOVA were conducted to analyze the data. RESULTS: The confidence level in Clonorchiasis management activities was improved significantly from 4.1+/-0.53 points before the education to 4.4+/-0.46 points after the education (t=-5.117, p<.001). The knowledge level about prevention of Clonorchis sinensis was improved significantly from 16.1+/-2.72 points before the education to 18.3+/-1.14 points after the education (t=-6.629, p<.001). CONCLUSION: The results suggest that the education program was effective in improving the confidence and knowledge levels in Clonorchiasis management activities for the clonorchiasis prevention lecturers. Based on the results of this study, continuous research on how the increased knowledge and confidence levels of Clonorchis sinensis prevention affect the prevalence of Clonorchis sinensis infection.

Effectiveness of PLISSIT Model Sexual Program on Female Sexual Function for Women with Gynecologic Cancer

PURPOSE: The purpose of this study was to evaluate the effectiveness of the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model sexual program on female sexual function for women with gynecologic cancer. METHODS: The integrative 6-hr (two hours per session) program reflecting physical and psychosocial aspects of women's sexuality was developed based on Annon's PLISSIT model. Participants were 61 women with cervical, ovarian, or endometrial cancer. Of them, 29 were assigned to the experimental group and 32 to the control group. The women completed the Female Sexual Function Index (FSFI) including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. Independent t-test and repeated measured ANOVA were used to test the effectiveness of the program. RESULTS: Significant group differences were found on FSFI sub-domain scores including sexual desire, arousal, lubrication, orgasm, and satisfaction but not pain. Significant time differences were found on all domains except for pain in the experimental group repeated measured ANOVA. CONCLUSION: The results indicate that the three-week PLISSIT model sexual program is effective in increasing sexual function for women with gynecologic cancer. Nurses may contribute to improving women's sexual function by utilizing the program. Strategies to relieve sexual pain need to be considered for greater effectiveness of the program.

Effects of a Health Education Program for Elementary School Children in Gyeonggi-do Rural Area / 대한지역사회영양학회지

The purpose of this study was to implement and evaluate the health education program for elementary school children. The program consisted of nutritional education and physical exercise. The subjects composed of 89 school children, first through sixth grade (n = 100), who had completed ten weeks of health education program from April through July 2010. Pre-post intervention design was used to evaluate the program effectiveness. After completing health education program, the number of overweight subjects decreased (boys 13 to 11 and girls 11 to 9) and the number of obese subjects decreased from 5 to 4 for boys and 4 to 2 for girls The number of sit-ups significantly increased in both 1-2 grade girls and 3-4 grade girls. Backward trunk extension of 1-2 grade girls also significantly increased (p < 0.05). The level of serum total cholesterol decreased from 171.8 mg/dL to 153.5 mg/dL (p < 0.001). Hypercholesterolemia (above 239 mg/dL), hyperLDLcholesterolemia (above 175 mg/dL) and low level hemoglobin subjects changed to normal levels. Total score of nutrition knowledge increased from 5.9 to 6.1 (p < 0.05), percentage of perception answers increased significantly in 5 out of 10 items and percentage of correct answers increased significantly in 6 out of 10 items (p < 0.05). Three food habits improved, including, "having breakfast", "having diverse foods" and "having vegetables per meal" (p < 0.05). Two self-efficacy items improved significantly, including, "having meals slowly", "having exercise instead of watching TV or computer" (p < 0.05). These results suggest that health education program for elementary school children including nutritional education and physical exercise may be effective to improve their anthropometric characteristics, physical fitness, hyperlipidemia, nutrition knowledge, food habits and self-efficacy.

The Development and Effectiveness of a Program to Prevent Ventilator Associated Pneumonia in the ICU / 성인간호학회지

PURPOSE: This study developed and evaluated a systematic intervention among medical ICU nurses for preventing ventilator-associated pneumonia (hereafter VAP). METHODS: A VAP prevention program was proposed based on a literature review, revised to fit the target situation, and validated. It was composed of one-time interventions including education, pamphlets, hand cultures, and a quiz event, as well as repeated interventions such as posters, reminders, posting hand culture results, and performance feedback. A simulated control group pretest-posttest design was used to verify the effectiveness of the VAP control program. The incidence of VAP among ICU patients was measured both during 3 months before (n = 80) and during 3 months after (n = 75) intervention. RESULTS: The VAP prevention program's effectiveness, with a pre-intervention VAP rate of 17.38 and post-intervention rate of 11.04 per 1,000 ventilator days, showed a clinical tendency to decrease, but the difference was not statistically significant (p = .750). CONCLUSION: A VAP prevention program of multiple interventions can be useful in decreasing the VAP rate. Given that the monthly decrease in the VAP rate was not considered statistically significant, long-term research needs to be done. Additionally, since this study targeted only nurses, it is suggested that future research targets other health care workers who can influence VAP rates.

The Effect of a Simulated Disability Exercise Program on Attitude and Stereotyping toward People with Disabilities by Nursing Students / 성인간호학회지

PURPOSE: The purpose of this study was to identify the effect of a simulated disability program on attitude and stereotyping by nursing students toward people with disabilities. METHODS: A total of 107 undergraduate nursing students attended and completed pre-and post-questionnaires on attitude and stereotyping. The experimental group participated in a simulation exercise program which was composed of wheel-chair mobility and vision modification in Nam-won Rehabilitation Center. The data were analyzed by the SPSS 12.0 program including frequency, percentage, chi-square test and t-test. RESULTS: There was no significant difference in attitude toward people with disabilities between the two groups (t=-.743, p=.459). But there was a significant difference in stereotyping between the experimental and the control group(t=-4.097, p=.000). CONCLUSION: As the result of this study, we can conclude that the program was effective to improve stereotyping toward people with disabilities.