Peer-delivered motivational interviewing intervention for post-intensive care syndrome: A pilot of peer mentor training feasibility (original) (raw)
Related papers
Comparative Effectiveness Research, 2012
Smoking cessation among patients with chronic medical illnesses substantially decreases morbidity and mortality. Chronically ill veteran smokers may benefit from interventions that assist them in harnessing social support from family and friends. Methods: We proactively recruited veteran smokers who had cancer, cardiovascular disease, or other chronic illnesses (diabetes, chronic obstructive pulmonary disease, hypertension) and randomized them to either standard telephone counseling or family-supported telephone counseling focused on increasing support for smoking cessation from family and friends. Participants each received a letter from a Veterans Affairs physician encouraging them to quit smoking, a self-help cessation kit, five telephone counseling sessions, and nicotine replacement therapy, if not contraindicated. The main outcome was 7-day point prevalent abstinence at 5 months. Results: We enrolled 471 participants with mean age of 59.2 (standard deviation [SD] = 7.9) years. 53.0% were white, 8.5% were female, and 55.4% were married/living as married. Overall, 42.9% had cardiovascular disease, 34.2% had cancer, and 22.9% had other chronic illnesses. At baseline, participants were moderately dependent on cigarettes as measured by the Heaviness of Smoking Index (mean = 2.8, SD = 1.6), expressed significant depressive symptoms as measured by the Center for Epidemiological Studies Depression scale (54.8% . 10), and reported high self-efficacy for quitting (mean = 5.7; SD = 1.5). At 5-months follow-up, we found no differences in smoking cessation by arm: 19.8% in the family-supported intervention and 22.0% in the standard arm. The following factors were associated with smoking cessation at 5 months: having cardiovascular disease or other diagnosis compared to cancer, lower nicotine dependence, older age, and higher self-efficacy. Conclusions: This comparative effectiveness trial among chronically ill veterans did not find differences in smoking cessation by type of intervention. Future studies should expand upon our findings and consider tailoring proactive telephone-based interventions based on age and type of disease.
Implementation Science, 2016
Background Many cancer survivors with anxiety and depression symptoms are treated in oncology care settings that lack systems to recognize such symptoms or offer behavioral interventions. Materials and methods Over the past four years we have fostered a collaboration with the administrators, providers, and patients at a 21-office community oncology care network to address this challenge. We initially targeted a network office site and provider team that championed external collaborations, to establish screening procedures and conduct a pilot study. Results We aligned our goal to implement a screener for anxiety and depression symptoms among cancer survivors with the site's goal to implement a distress screener at survivorship appointments (N > 200 screened to date). Upon establishing a successful screening system, we partnered with an onsite social worker champion (J.L.M.) to develop and evaluate a behavioral intervention for positively screened patients (N = 51), in a format and length adapted to the needs of the site, with content iteratively refined in response to patient feedback. The intervention showed large effects on anxiety and depression outcomes. We communicated these findings to much of the network, thus building support from network administrative, physician, and social work teams to identify anxious and depressed patients, implement the intervention, and recently, to conduct a funded clinical trial in the network, using patient screening and recruitment strategies tailored to the needs and capacities of each site. Conclusions Our work demonstrates one approach to partnering with a communitybased cancer care network to implement a behavioral intervention that addresses anxiety and depression among cancer survivors. A8 Tailoring a Cognitive Behavioral Therapy implementation protocol using mixed methods, conjoint analysis, and implementation teams
Clinical and Translational Science, 2014
Peer education offers a novel strategy for the translation of health promotion interventions in hard-to-reach communities. We describe the development, implementation, and evaluation of a program where research participants from a cardiovascular risk reduction intervention were invited to be trained as peer educators. The goal of the "Heart-to-Heart" intervention was to promote healthy behaviors among peers to reduce cardiovascular disease risk. We recruited and trained 32 peer educators from a rural, Midwestern community to implement the program, and 18 educators reached 175 women and men. A mixed-method analysis revealed that those who opted to become peer educators were more likely to be African American than participants of the study population from which they were recruited. Peer educators reported positive assessments of their encounters with respect to preparation and confidence, as well as reinforced personal health behaviors. Peer educators' success was evident in reports from the individuals they reached, who reported learning new concepts and intention to change behavior. Interviews with peer educators revealed their motivations, peer education barriers, and recommendations. The Heart-to-Heart model for training research participants to serve as peer educators to disseminate behavior change messages warrants further investigation as a strategy for the translation of research to communities.
Implementation Research and Practice, 2020
Background: Substance use disorders (SUDs) among people with HIV are both prevalent and problematic. The Substance Abuse Treatment to HIV care project was funded to test the Implementation and Sustainment Facilitation (ISF) strategy as an adjunct to the Addiction Technology Transfer Center (ATTC) strategy for integrating a motivational interviewing-based brief intervention (MIBI) for SUDs within HIV community-based organizations. Methods: Using a cluster-randomized, type 2 hybrid trial design, 39 HIV organizations were randomized to either (1) ATTC ( n = 19) or (2) ATTC + ISF ( n = 20). Each HIV organization identified two staff members to be prepared to implement the MIBI ( N = 78). Subsequently, during the implementation phase, HIV organizations in each condition randomized client participants ( N = 824) to one of the two intervention conditions: usual care (UC; n = 415) or UC + MIBI ( n = 409). Both staff-level outcomes and client-level outcomes were examined. Results: The ISF st...
Implementation Science, 2015
Background: General medical hospitals provide care for a disproportionate share of patients who abuse or are dependent upon substances. This group is among the most costly to treat and has the poorest medical and addiction recovery outcomes. Hospitalization provides a unique opportunity to identify and motivate patients to address their substance use problems in that patients are accessible, have time for an intervention, and are often admitted for complications related to substance use that renders hospitalization a "teachable moment." Methods/Design: This randomized controlled trial will examine the effectiveness of three different strategies for integrating motivational interviewing (MI) into the practice of providers working within a general medical inpatient hospitalist service: (1) a continuing medical education workshop that provides background and "shows" providers how to conduct MI (See One); (2) an apprenticeship model involving workshop training plus live supervision of bedside practice (Do One); and (3) ordering MI from the psychiatry consultation-liaison (CL) service after learning about it in a workshop (Order One). Thirty providers (physicians, physician assistants, nurses) will be randomized to conditions and then assessed for their provision of MI to 40 study-eligible inpatients. The primary aims of the study are to assess (1) the utilization of MI in each condition; (2) the integrity of MI when providers use it on the medical units; and (3) the relative costs and cost-effectiveness of the three different implementation strategies. Discussion: If implementation of Do One and Order One is successful, the field will have two alternative strategies for supporting medical providers' proficient use of brief behavioral interventions, such as MI, for medical inpatients who use substances problematically. Trial registration: Clinical Trials.gov (NCT01825057)
Health marketing quarterly
The purpose of this review was to better understand how to market the Chronic Disease Self-Management Program to new audiences. Eight databases were searched for peer-reviewed studies of the CDSMP. A total of 39 articles were analyzed to describe the theoretical basis of recruitment strategies and their effectiveness while engaging diverse populations. Findings included that female, Caucasian, and elderly groups are overrepresented in CDSMP literature and recruitment efforts have not been explicitly grounded in theory. This review provides insight into trends in CDSMP recruitment and identifies the need for further research regarding the application of marketing theory to future enrollment efforts.