ORCID Profile
0000-0002-4252-5572
Current Organisation
University of Newcastle Centre for Brain and Mental Health Research
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Psychiatry | Nanomaterials | Mental Health | Health Care Administration | Medical Devices | Public Health and Health Services | Nanotechnology | Sensor Technology (Chemical aspects)
ANZSRC Socio-Economic Objective (SEO)
Diagnostic Methods | Mental health | Health Status (e.g. Indicators of Well-Being) |
Related Links
Publications
Smartphone Apps About Crystal Methamphetamine (“Ice”): Systematic Search in App Stores and Assessment of Composition and Quality (Preprint)
Publisher: JMIR Publications Inc.
Date: 19-03-2018
Abstract: mid considerable community concern about the prevalence and harms associated with the use of crystal meth hetamine (“ice”), the increased use of smartphones to access health information and a growing number of available smartphone apps related to crystal meth hetamine, no previous reviews have examined the content and quality of these apps. his study aims to systematically review existing apps in the iTunes and Google Play Stores to determine the existence, composition, and quality of educational smartphone apps about meth hetamines, including ice. he iTunes and Google Play Stores were systematically searched in April 2017 for iOS Apple and Android apps, respectively. English-language apps that provided educational content or information about meth hetamine were eligible for inclusion. Eligible apps were downloaded and independently evaluated for quality by 2 reviewers using the Mobile Application Rating Scale (MARS). total of 2205 apps were initially identified, of which 18 were eligible and rated using the MARS. The mean MARS quality total score for all rated apps was 3.0 (SD 0.6), indicating poor to acceptable quality. Overall, mean scores were the highest for functionality (mean 4.0, SD 0.5) and lowest for engagement (mean 2.3, SD 0.7). his study demonstrates a shortage of high-quality educational and engaging smartphone apps specifically related to meth hetamine. The findings from this review highlight a need for further development of engaging and evidence-based apps that provide educational information about crystal meth hetamine.
Feasibility of internet-delivered mental health treatments for rural populations
Publisher: Springer Science and Business Media LLC
Date: 21-05-2013
DOI: 10.1007/S00127-013-0708-9
Abstract: Rural populations face numerous barriers to mental health care. Although internet-delivered mental health treatments may offer an accessible and cost-effective answer to these barriers, there has been little evaluation of the feasibility of this approach among rural communities. Data were obtained from a random rural community s le through the third wave of the Australian Rural Mental Health Study. Attitudes towards internet-delivered mental health treatments and availability of internet access were explored. Data were analysed to identify sub-groups in whom internet-delivered treatments may be usefully targeted. Twelve hundred and forty-six participants completed the survey (mean age 59 years, 61% females, 22% from remote areas). Overall, 75% had internet access and 20% would consider using internet-based interventions, with 18% meeting both of these feasibility criteria. Logistic regression revealed feasibility for internet-delivered mental health treatment was associated with younger age, male gender, being a carer, and a 12-month mental health problem. Participants who had used internet-delivered services in the past were significantly more likely to endorse these treatments as acceptable. There is considerable potential for internet-delivered treatments to increase service accessibility to some sub-groups, particularly among people with mental health problems who are not currently seeking help. Resistance to internet treatments appears to be largely attitudinal, suggesting that enhancing community education and familiarity with such programs may be effective in improving perceptions and ultimately access.
Predictors of Suicidal Ideation in Older People: A Decision Tree Analysis
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.JAGP.2013.05.009
Abstract: Suicide among older adults is a major public health issue worldwide. Although studies have identified psychological, physical, and social contributors to suicidal thoughts in older adults, few have explored the specific interactions between these factors. This article used a novel statistical approach to explore predictors of suicidal ideation in a community-based s le of older adults. Prospective cohort study. Participants aged 55-85 years were randomly selected from the Hunter Region, a large regional center in New South Wales, Australia. Baseline psychological, physical, and social factors, including psychological distress, physical functioning, and social support, were used to predict suicidal ideation at the 5-year follow-up. Classification and regression tree modeling was used to determine specific risk profiles for participants depending on their in idual well-being in each of these key areas. Psychological distress was the strongest predictor, with 25% of people with high distress reporting suicidal ideation. Within high psychological distress, lower physical functioning significantly increased the likelihood of suicidal ideation, with high distress and low functioning being associated with ideation in 50% of cases. A substantial subgroup reported suicidal ideation in the absence of psychological distress dissatisfaction with social support was the most important predictor among this group. The performance of the model was high (area under the curve: 0.81). Decision tree modeling enabled in idualized "risk" profiles for suicidal ideation to be determined. Although psychological factors are important for predicting suicidal ideation, both physical and social factors significantly improved the predictive ability of the model. Assessing these factors may enhance identification of older people at risk of suicidal ideation.
Effectiveness of the Hunter Way Back Support Service: An historical controlled trial of a brief non‐clinical after‐care program for hospital‐treated deliberate self‐poisoning
Publisher: Wiley
Date: 05-02-2022
DOI: 10.1111/SLTB.12840
Abstract: Active contact and follow‐up interventions have been shown to be effective in reducing repetition of hospital‐treated self‐harm. The Way Back Support Service (WBSS) is a new service funded by the Australian government to provide three months of non‐clinical after‐care following a hospital‐treated suicide attempt. The aim of this study was to investigate the effectiveness of WBSS in reducing deliberate self‐poisoning (DSP) and psychiatric hospital admissions over a 12‐month follow‐up period for a population of DSP patients within the Hunter (Australia) region. A non‐randomized, historical controlled (two periods) trial design with intention‐to‐treat analyses. Outcome data were drawn from hospital records. There were a total of 2770 participants across study periods. There were no significant differences between cohorts for proportion with any, or number of, re‐admissions for DSP in the follow‐up period. For psychiatric admissions, the intervention cohort had a non‐significantly greater proportion with any psychiatric admission and significantly more admissions compared to one of the control cohorts. The WBSS model of care should be modified to strengthen treatment engagement and retention and to include established, clinical, evidence‐based treatments shown to reduce DSP repetition. Any modified WBSS model should be subject to further evaluation.
Assessment of function and clinical utility of alcohol and other drug web sites : an observational, qualitative study
Publisher: Springer Science and Business Media LLC
Date: 05-05-2011
Measuring the hospital experiences of junior doctors
Publisher: Wiley
Date: 05-1998
DOI: 10.1046/J.1365-2923.1998.00206.X
Abstract: The development of an appraisal questionnaire which measures junior doctors' opinions about their hospital experiences is described. The first section of the questionnaire consists of seven reliable subscales which measure opinions about teaching and learning, registrar teaching, consultant teaching, staff support, workload, administration and overall experiences during a period of attachment or term. The second part of the survey contains 11 reliable questions about the hours spent on service and education during the term. The responses to this measure of 257 randomly selected Australian junior doctors are described. The questionnaire may be used to contrast the experiences of junior doctors in different types of terms, different hospitals or varying levels of training. The data generated from the instrument can provide useful information about hospitals, such as the work practices of junior staff and the effectiveness of educational programs.
How do Australian Doctors with Different Pre-medical School Backgrounds Perform as Interns?
Publisher: Informa UK Limited
Date: 03-2001
Factors Influencing Community Participation in Internet Interventions Compared With Research Trials: Observational Study in a Nationally Representative Adult Cohort
Publisher: JMIR Publications Inc.
Date: 02-02-2023
DOI: 10.2196/41663
Abstract: Digital mental health (DMH) programs can be effective in treating and preventing mental health problems. However, community engagement with these programs can be poor. Understanding the barriers and enablers of DMH program use may assist in identifying ways to increase the uptake of these programs, which have the potential to provide broad-scale prevention and treatment in the community. In this study, we aimed to identify and compare factors that may influence participation in DMH programs in practice and research trials, identify any respondent characteristics that are associated with these factors, and assess the relationship between intentions to use DMH programs and actual uptake. Australian adults aged ≥18 years were recruited from market research panels to participate in the study. The s le was representative of the Australian adult population based on age, gender, and location. Participants completed a cross-sectional web-based survey assessing demographic characteristics, mental health symptom measures, attitudes and use of DMH programs in practice and in research studies, and the factors influencing their use in both settings. Across both research and practice, trust in the organization delivering the service or trial was the top-ranked factor influencing participation, followed by anonymity or privacy and adequate information. There was little variation in rankings across demographic groups, including intentions to use DMH programs or mental health status. Intentions to use DMH programs were a strong predictor of both current (odds ratio 2.50, 99% CI 1.41-4.43 P .001) and past (odds ratio 2.98, 99% CI 1.71-5.19 P .001) use behaviors. Efforts to increase the uptake of DMH programs or participation in research trials should focus on clearly communicating the following to users: the legitimacy of the organization delivering the program, security and use of participant data, and effectiveness of DMH programs.
Coronary Heart Disease Risk Reduction Intervention Among Overweight Smokers with a Psychotic Disorder: Pilot Trial
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670802607147
Abstract: Objective: The aim of the present pilot study was to test the feasibility and short-term impact of a multi-component risk factor intervention for reducing (i) coronary heart disease (CHD) risk (ii) smoking and (iii) weight among smokers with psychosis. Secondary dependent variables included physical activity, unhealthy eating, substance use, psychiatric symptomatology, treatment retention, general functioning, and quality of life. Method: This was a feasibility study utilizing a pre–post-treatment design with no control group (n=43). All participants provided written informed consent and were assessed before treatment and again a mean of 19.6weeks later. The treatment consisted of nine in idual 1h sessions of motivational interviewing and cognitive behaviour therapy plus nicotine replacement therapy, in addition to treatment as usual. Research assistants who had not been involved in the delivery of the treatment programme conducted post-treatment assessments. Results: The intervention was associated with significant reductions in CHD risk scores, smoking and weight. A significant improvement was also reported in level of moderate physical activity, and a small change in the unhealthy eating index was reported. No improvement in biological measures (cholesterol and blood pressure) was evident. Conclusions: A multi-component CHD risk factor intervention among smokers with psychosis appears to be feasible and effective in the short-term. A randomized controlled trial replicating and extending these findings is warranted.
The influence of admissions variables on first year medical school performance: a study from Newcastle University, Australia
Publisher: Wiley
Date: 02-2002
DOI: 10.1046/J.1365-2923.2002.01071.X
Abstract: This study examined the relationship between the performance of first year medical students at the University of Newcastle, Australia, and admission variables: previous educational experience, and entry classification (standard -- academic or composite, Aboriginal and Torres Strait Islander, or overseas), age and gender. Admission and demographic information was obtained for students who entered first year medicine at Newcastle between the years 1994 and 1997 inclusive. Academic performance was measured according to results of first assessment ('satisfactory' vs. 'not satisfactory') and the final assessment of the first year ('satisfactory' vs. 'not satisfactory'). Logistic regression was used to examine the relationship between predictor variables and outcomes. Assessment and admissions information was obtained for 278 students, 98% of all students who entered the medical course between 1994 and 1997. Regression analysis of first assessment indicated that Aboriginal and Torres Strait Islander and overseas students were significantly more likely to be 'not satisfactory' than all other students (RR=3.1,95% CI: 1.4. - 6 7 and RR=1.5, 95% CI: 1.2-1.8, respectively). Analysis of final assessment indicated these two student groups were also significantly more likely to be 'not satisfactory' than all other students (RR=4.5, 95% CI: 1.4-13.5 and RR=3.5, 95% CI: 1.2-10.8, respectively). At first assessment, students entering via the standard academic pathway and older students were less likely to be 'not satisfactory' (RR=0.6, 95% CI: 0.5-0.7 and RR=0.8, 95% CI: 0.7-0.9, respectively). However both these differences were not evident at final assessment. There were no significant relationships between performance in first year and the remaining variables. Aboriginal and Torres Strait Islander, and overseas medical students had academic difficulties in the first year of the course, suggesting the need for extra course support. The result may reflect the educational and other obstacles these students must overcome in order to enter and progress through their medical degree. More research is warranted to explore the extent to which these differences persist throughout the medical degree.
Screening and intervention for mental health problems in alcohol and other drug settings: Can training change practitioner behaviour?
Publisher: Informa UK Limited
Date: 28-09-2011
Are health behaviors associated with academic performance among tertiary education students? A systematic review of cohort studies
Publisher: Informa UK Limited
Date: 12-05-2022
Contributors to suicidality in rural communities: beyond the effects of depression
Publisher: Springer Science and Business Media LLC
Date: 08-08-2012
Integrating and extending cohort studies: Lessons from the eXtending Treatments, Education and Networks in Depression (xTEND) study
Publisher: Springer Science and Business Media LLC
Date: 05-10-2013
Optimizing Engagement in an Online Dietary Intervention for Depression (My Food & Mood Version 3.0): Cohort Study
Publisher: JMIR Publications Inc.
Date: 31-03-2021
DOI: 10.2196/24871
Abstract: Online interventions can be a cost-effective and efficient way to deliver programs to large numbers of people regardless of geographic location. However, attrition in web-based interventions is often an issue. Developing ways to keep participants engaged is important for ensuring validity and limiting potential biases. We developed a web-based dietary intervention as part of The My Food & Mood study which aimed to optimize ways to engage participants with low mood or depressive symptoms to promote dietary behavior change. Different versions of the My Food & Mood program were tested during optimization. Iterations were developed based on user feedback and usage analysis. The purpose of this study was to compare engagement and nonusage attrition across 4 program iterations—which differed by platform format, delivery mode, and activity type—to create an optimized version. Each program version contained modular videos with key activities with respect to implementing behavior change techniques of equivalent levels of required participation and length: version 1.0, desktop program and smartphone app version 2.1, desktop or smartphone program version 2.2, desktop program and version 3.0, smartphone app. Adults with PHQ-8 scores of 5 or greater were recruited online and assigned to 1 of the 4 versions. Participants were asked to use the program for 8 weeks and complete measures at weeks 4 and 8. Engagement data were collected from the web-based platform system logs and customized reports. Cox regression survival analysis examined nonusage attrition and Kruskal-Wallis tests compared engagement across each cohort. A total of 614 adults participated. Kruskal-Wallis tests showed significant differences across the 4 cohorts in all engagement measures. The smartphone app (version 3.0) had the greatest engagement as measured by weeks engaged, total usage time, total time key activities, number of active sessions, percentage of activities completed against protocol, goals completed, and percentage of videos watched. Cox regression multivariate survival analysis showed referral from a health practitioner (hazard ratio [HR] 0.344, P=.001) and greater proficiency with computers (HR 0.796, P=.049) reduced the risk of nonusage attrition. Computer confidence was associated with an increased risk of nonusage attrition. My Food & Mood version 3.0, a dietary intervention delivered via smartphone app with self-monitoring tools for diet quality and mood monitoring, was the version with greatest engagement in a population with low mood or depression. The iterative design techniques employed and analysis of feedback from participants resulted in a program that achieved lower rates of nonusage attrition and higher rates of intensity of use.
The 'co-morbidity roundabout': A framework to guide assessment and intervention strategies and engineer change among people with co-morbid problems
Publisher: Wiley
Date: 12-2004
DOI: 10.1080/09595230412331324536
Abstract: This paper describes the nature and consequences of co-morbidity, as applied to co-occurring mental health and alcohol/other drug (AOD) use problems. The 'co-morbidity roundabout' is introduced as a useful metaphor for conceptualizing the current experiences of people with co-occurring mental health and AOD use problems. In order to successfully negotiate the 'roundabout', the 'drivers' (people with co-morbid mental health and AOD use problems) must consider a range of internal and external conditions (knowledge about services, support from family, friends, health providers, motivation to change, etc.), account for their vehicle's characteristics (other conditions and demands, including social/legal/financial issues), keep their travel itinerary in mind (plans for change including treatment) and navigate through the many detours and dead-ends that they may confront (eligibility for services, accessibility of treatments, etc.). Co-morbidity is a major contributing factor in 'drivers' failing to successfully negotiate, or even becoming 'stuck' on, the 'roundabout'. A summary of relevant treatment research is also presented, including descriptions of brief interventions and more intensive treatment approaches. Finally, the 'co-morbidity roundabout' metaphor is expanded to assist clinicians to translate the findings from this treatment research into clinical practice. Further suggestions are made for improved navigation through and exit from the 'roundabout', including recommendations for the use of a stepped-care approach to the assessment and treatment of clients with co-morbid mental health and AOD use problems.
Physical, Mental, and Cognitive Function in a Convenience Sample of Centenarians in Australia
Publisher: Wiley
Date: 03-05-2011
DOI: 10.1111/J.1532-5415.2011.03404.X
Abstract: To examine the physical, mental, and cognitive function of centenarians. Descriptive study using a structured questionnaire and convenience s ling. Residential care facilities and private dwellings in Australia. A convenience s le of 188 centenarians. The Hospital Anxiety and Depression Scale (HADS) screened for anxiety and depression. The Katz Index of Independence in Activities of Daily Living (Katz ADL) was used to assess functional status. The Quality of Life Scale was used to assess quality of life. The Mini-Mental State Examination (MMSE) was used to screen for dementia. Structured responses were obtained for living arrangement, marital status, social relationships, and supports. Centenarians had regular contact with friends (59%), neighbors (62%), and families (72%) 54% were religious and 43.5% had received social supports. Average MMSE and Katz ADL scores were 21.5 and 3.7, respectively 45% had scores on the MMSE indicative of dementia, 10% indicated anxiety and 14% depression on the HADS. Participants with poor ratings of health experienced higher rates of anxiety and depression than their healthier counterparts. In this convenience s le of Australian centenarians, anxiety and depression was relatively nonexistent, and most reported a high quality of life. This was despite objective deterioration in functional status, paralleling the aging process, and high dependence on others for everyday tasks. Potentially, this is suggestive of a unique ability within the s le to adapt to aging and its limitations.
Feasibility and Acceptability of a Novel Online Program for Mental Health Carers
Publisher: Universidad de San Buenaventura
Date: 28-04-2023
Abstract: Objective: To evaluate the feasibility and acceptability of a new online program (Minds Together ) for carers of a person with depressive or anxiety symptoms. Methods: Using a two-arm randomised controlled trial design, 108 carers of a person with depressive or anxiety symptomology aged 16 years or over (89% female mean age 50 years) received immediate or delayed access to the Minds Together program. Feasibility was measured using program activation and survey completion rates. Acceptability was measured using a project-specific satisfaction scale, semi-structured interviews, and program completion metadata. The study used intention-to-treat (ITT) analysis for participant-reported outcomes (carer burden, coping self-efficacy) across groups. Results: Feasibility and acceptability thresholds were consistent with similar studies: 59% activated their program account, 47% met the program completion threshold, and almost all reported satisfaction with the program. The ITT indicated trends in increased coping self-efficacy and reduced carer burden for the Intervention group, compared to the Waitlist control. Conclusions: The Minds Together program is a feasible and acceptable program for carers supporting a person with depressive or anxiety symptomology. Results support exploration of the program’s efficacy in a full-scale RCT.
Cognitive-behavioural therapy for substance use disorders in people with psychotic disorders: Randomised controlled trial
Publisher: Royal College of Psychiatrists
Date: 05-2006
Abstract: Few randomised controlled trials have been aimed specifically at substance use reduction among people with psychotic disorders. To investigate whether a 10-session intervention consisting of motivational interviewing and cognitive-behavioural therapy (CBT) was more efficacious than routine treatment in reducing substance use and improving symptomatology and general functioning. A community s le of people with a psychotic disorder and who reported hazardous alcohol, cannabis and/or hetamine use during the preceding month was recruited. Participants were randomly allocated to motivational interviewing/CBT ( n =65) or treatment as usual ( n =65), and were assessed on multiple outcomes at baseline, 15 weeks, 6 months and 12 months. There was a short-term improvement in depression and a similar trend with regard to cannabis use among participants who received the motivational interviewing/CBT intervention, together with effects on general functioning at 12 months. There was no differential benefit of the intervention on substance use at 12 months, except for a potentially clinically important effect on hetamine use. The motivational interviewing/CBT intervention was associated with modest improvements.
Lifestyle risks for chronic disease among Australian adolescents: a cross-sectional survey
Publisher: Wiley
Date: 07-11-2022
DOI: 10.5694/MJA2.51333
Technology and innovation in the psychosocial treatment of methamphetamine use, risk and dependence
Publisher: Wiley
Date: 05-2008
DOI: 10.1080/09595230801914768
Abstract: The dramatic increase in meth hetamine use has led to the urgent need for high-quality, effective treatments and management strategies for meth hetamine use problems to be developed and disseminated. Although some evidence exists for the use of psychological, pharmacological and other approaches to treatment for problematic meth hetamine use, other evidence suggests that many meth hetamine users do not access these treatment options due to a range of in idual and service-level barriers. A review of available research literature was undertaken to identify treatment strategies for meth hetamine users, which overcome the problems associated with treatment access for this important target group and involve technological and other innovative approaches. Several approaches to addressing problematic meth hetamine use have been suggested, including assertive engagement strategies, flexibility in the provision of treatment and retention strategies and use of a multi-focused intervention package, such as stepped care, perhaps including new technologies as alternatives or supplements to face-to-face-delivered treatments. No research currently exists to examine the possible benefit of these strategies for people with meth hetamine use problems. The use of stepped-care intervention packages has the potential to address many of the current challenges faced by both clinicians and clients in treating meth hetamine use problems. Although promising, these approaches require further attention and research effort, particularly among the specific group of meth hetamine users.
Predictors of antenatal alcohol use among Australian women: a prospective cohort study
Publisher: Wiley
Date: 17-07-2013
Abstract: To identify predictors of antenatal alcohol consumption among women who usually consume alcohol. Prospective cohort study. Australian Longitudinal Study on Women's Health (ALSWH). A total of 1969 women s led from the ALSWH 1973-78 cohort. Women were included if they were pregnant in 2000, 2003, 2006 or 2009. The relationship between antenatal alcohol consumption and sociodemographics, reproductive health, mental health, physical health, health behaviours, alcohol guidelines and healthcare factors was investigated using a multivariate logistic regression model. Alcohol use during pregnancy. Most (82.0%) women continued to drink alcohol during pregnancy. Women were more likely to drink alcohol during pregnancy if they had consumed alcohol on a weekly basis before pregnancy (odds ratio [OR] 1.47 95% confidence interval [95% CI] 1.13-1.90), binge drank before pregnancy (OR 2.28 95% CI 1.76-2.94), or if they were pregnant while alcohol guidelines recommended low alcohol versus abstinence (OR 1.60 95% CI 1.26-2.03). Drinking during pregnancy was less likely if women had a Health Care Card (OR 0.63 95% CI 0.45-0.88) or if they had ever had fertility problems (OR 0.64 95% CI 0.48-0.86). Most Australian women who drank alcohol continued to do so during pregnancy. Prepregnancy alcohol consumption was one of the main predictors of antenatal alcohol use. Alcohol guidelines, fertility problems and Health Care Card status also impacted antenatal alcohol consumption.
Incidental treatment effects of CBT on suicidal ideation and hopelessness
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.JAD.2013.06.005
Abstract: Depression and alcohol misuse are among the most prevalent diagnoses in suicide fatalities. The risk posed by these disorders is exacerbated when they co-occur. Limited research has evaluated the effectiveness of common depression and alcohol treatments for the reduction of suicide vulnerability in in iduals experiencing comorbidity. Participants with depressive symptoms and hazardous alcohol use were selected from two randomised controlled trials. They had received either a brief (1 session) intervention, or depression-focused cognitive behaviour therapy (CBT), alcohol-focused CBT, therapist-delivered integrated CBT, computer-delivered integrated CBT or person-centred therapy (PCT) over a 10-week period. Suicidal ideation, hopelessness, depression severity and alcohol consumption were assessed at baseline and 12-month follow-up. Three hundred three participants were assessed at baseline and 12 months. Both suicidal ideation and hopelessness were associated with higher severity of depressive symptoms, but not with alcohol consumption. Suicidal ideation did not improve significantly at follow-up, with no differences between treatment conditions. Improvements in hopelessness differed between treatment conditions hopelessness improved more in the CBT conditions compared to PCT and in single-focused CBT compared to integrated CBT. Low retention rates may have impacted on the reliability of our findings. Combining data from two studies may have resulted in heterogeneity of s les between conditions. CBT appears to be associated with reductions in hopelessness in people with co-occurring depression and alcohol misuse, even when it is not the focus of treatment. Less consistent results were observed for suicidal ideation. Establishing specific procedures or therapeutic content for clinicians to monitor these outcomes may result in better management of in iduals with higher vulnerability for suicide.
Factors Predicting Trial Engagement, Treatment Satisfaction, and Health-Related Quality of Life During a Web-Based Treatment and Social Networking Trial for Binge Drinking and Depression in Young Adul
Publisher: JMIR Publications Inc.
Date: 31-08-2020
Abstract: ental health and alcohol use problems are among the most common causes of disease burden in young Australians, frequently co-occur (comorbidity), and lead to significant lifetime burden. However, comorbidities remain significantly underdetected and undertreated in health settings. Digital mental health tools designed to identify at-risk in iduals, encourage help-seeking, or deliver treatment for comorbidity have the potential to address this service gap. However, despite a strong body of evidence that digital mental health programs provide an effective treatment option for a range of mental health and alcohol use problems in young adults, research shows that uptake rates can be low. Thus, it is important to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e–mental health interventions for comorbidity. n this study, we seek to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e–mental health interventions for comorbid alcohol and mood disorders. The aim is to determine the importance of personality (ie, Big Five personality traits and intervention attitudes), affective factors (ie, depression, anxiety, and stress levels), and baseline alcohol consumption in predicting intervention trial engagement at sign-up, satisfaction with the online tool, and quality of life at the end of the iTreAD (Internet Treatment for Alcohol and Depression) trial. ustralian adults (N=411) aged between 18 and 30 years who screened positive for depression and alcohol use problems signed up for the iTreAD project between August 2014 and October 2015. During registration, participants provided information about their personality, current affective state, alcohol use, treatment expectations, and basic demographic information. Subsequent follow-up surveys were used to gauge the ongoing trial engagement. The last follow-up questionnaire, completed at 64 weeks, assessed participants’ satisfaction with web-based treatment and quality-of-life outcomes. ultiple linear regression analyses were used to assess the relative influence of predictor variables on trial engagement, treatment satisfaction, and quality-of-life outcomes. The analyses revealed that the overall predictive effects of personality and affective factors were 20% or lower. Neuroticism constituted a unique predictor of engagement with the iTreAD study in that neuroticism facilitated the return of web-based self-assessments during the study. The return of incentivized follow-up assessments predicted treatment satisfaction, and state-based depression predicted variance in quality-of-life reports at study completion. ur findings suggest that traditional predictors of engagement observed in face-to-face research may not be easily transferable to digital health interventions, particularly those aimed at comorbid mental health concerns and alcohol misuse among young adults. More research is needed to identify what determines engagement in this population to optimally design and execute digital intervention studies with multiple treatment aims. ustralian New Zealand Clinical Trials Registry (ACTRN): 12614000310662 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365137& isReview=true. R2-10.1186/s12889-015-2365-2
Young People’s Support Needs During the Military–Civilian Transition: “I Would Have Been a Very Different Person if There was More Support Available”
Publisher: Informa UK Limited
Date: 17-07-2022
Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: Outcomes to 36-months
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.JSAT.2013.10.001
Abstract: Integrated psychological treatment addressing co-existing alcohol misuse and depression has not been compared with single-focused treatment. This trial evaluates changes over 36 months following randomization of 284 outpatients to one of four motivational interviewing and cognitive-behavior therapy (MICBT) based interventions: (1) brief integrated intervention (BI) or BI plus 9 further sessions with (2) an integrated-, (3) alcohol-, or (4) depression-focus. Outcome measures included changes in alcohol consumption, depression (BDI-II: Beck Depression Inventory) and functioning (GAF: Global Assessment of Functioning), with average improvements from baseline of 21.8 drinks per week, 12.6 BDI-II units and 8.2 GAF units. Longer interventions tended to be more effective in reducing depression and improving functioning in the long-term, and in improving alcohol consumption in the short-term. Integrated treatment was at least as good as single-focused MICBT. Alcohol-focused treatment was as effective as depression-focused treatment at reducing depression and more effective in reducing alcohol misuse. The best approach seems to be an initial focus on both conditions followed by additional integrated- or alcohol-focused sessions.
Feasibility and outcomes of an innovative cognitive-behavioural skill training programme for co-occurring disorders in the youth alcohol and other drug (AOD) sector
Publisher: Wiley
Date: 09-2007
DOI: 10.1080/09595230701499134
Abstract: There are limited treatment options available for young drug users with comorbid mental health problems who present to alcohol and other drug (AOD) services within Australia. While there is some evidence for the use of cognitive-behaviour therapy (CBT) in the treatment of co-occurring disorders, CBT is rarely used to address comorbidity in the AOD sector. This paper describes the development, implementation and evaluation of a brief cognitive-behavioural skills (BCBS) training programme for addressing comorbidity within two youth AOD services in Australia. Ten youth AOD workers completed a 2-day training programme in the BCBS. Training was evaluated using measures of trainees' cognitive-behavioural knowledge, attitudes towards mental health interventions and level of skills and confidence in each of the BCBS pre- and 6 months post-training. The BCBS training had a positive impact on the knowledge, skills and confidence of trainees and was perceived to be highly relevant and appropriate. These findings provide preliminary support for the feasibility and effectiveness of the BCBS training programme for workers within the youth AOD sector.
A Brief Intervention to Increase Uptake and Adherence of an Internet-Based Program for Depression and Anxiety (Enhancing Engagement With Psychosocial Interventions): Randomized Controlled Trial
Publisher: JMIR Publications Inc.
Date: 27-07-2021
DOI: 10.2196/23029
Abstract: Psychosocial, self-guided, internet-based programs are effective in treating depression and anxiety. However, the community uptake of these programs is poor. Recent approaches to increasing engagement (defined as both uptake and adherence) in internet-based programs include brief engagement facilitation interventions (EFIs). However, these programs require evaluation to assess their efficacy. The aims of this hybrid implementation effectiveness trial are to examine the effects of a brief internet-based EFI presented before an internet-based cognitive behavioral therapy self-help program (myCompass 2) in improving engagement (uptake and adherence) with that program (primary aim), assess the relative efficacy of the myCompass 2 program, and determine whether greater engagement was associated with improved efficacy (greater reduction in depression or anxiety symptoms) relative to the control (secondary aim). A 3-arm randomized controlled trial (N=849 recruited via social media) assessed the independent efficacy of the EFI and myCompass 2. The myCompass 2 program was delivered with or without the EFI both conditions were compared with an attention control condition. The EFI comprised brief (5 minutes), tailored audio-visual content on a series of click-through linear webpages. Uptake was high in all groups 82.8% (703/849) of participants clicked through the intervention following the pretest survey. However, the difference in uptake between the EFI + myCompass 2 condition (234/280, 83.6%) and the myCompass 2 alone condition (222/285, 77.9%) was not significant (n=565 χ21=29.2 P=.09). In addition, there was no significant difference in the proportion of participants who started any number of modules (1-14 modules) versus those who started none between the EFI + myCompass 2 (214/565, 37.9%) and the myCompass 2 alone (210/565, 37.2%) conditions (n=565 χ21 .1 P=.87). Finally, there was no significant difference between the EFI + myCompass 2 and the myCompass 2 alone conditions in the number of modules started (U=39366.50 z=−0.32 P=.75) or completed (U=39494.0 z=−0.29 P=.77). The myCompass 2 program was not found to be efficacious over time for symptoms of depression (F4,349.97=1.16 P=.33) or anxiety (F4,445.99=0.12 P=.98). However, planned contrasts suggested that myCompass 2 may have been effective for participants with elevated generalized anxiety disorder symptoms (F4,332.80=3.50 P=.01). This brief internet-based EFI did not increase the uptake of or adherence to an existing internet-based program for depression and anxiety. In iduals’ motivation to initiate and complete internet-based self-guided interventions is complex and remains a significant challenge for self-guided interventions. Australian New Zealand Clinical Trials Registry ACTRN12618001565235 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375839
Assessment of Brain Electrical Activity in Relation to Memory and Complex Behavior
Publisher: Elsevier
Date: 1993
Reasons for substance use among people with psychotic disorders: method triangulation approach.
Publisher: American Psychological Association (APA)
Date: 06-2011
DOI: 10.1037/A0026469
Abstract: Substance use disorders (SUD) are common among people with psychotic disorders and are associated with many negative consequences. Understanding the reasons for substance use in this population may allow for the development of more effective prevention and intervention strategies. We examined reasons for tobacco, alcohol, or cannabis use among people with psychotic disorders. Sixty-four participants with a diagnosed psychotic disorder completed a self-report reasons for use questionnaire. A subset of eight participants completed semi-structured qualitative interviews. Both the qualitative and quantitative data indicated that reasons for use of tobacco, alcohol, and cannabis differed considerably. Tobacco was primarily used for coping motives, alcohol for social motives, and cannabis for pleasure enhancement motives. Prevention and intervention strategies targeting coexisting psychotic disorders and SUD may improve in effectiveness if they address the perceived beneficial effects of tobacco use, the strong social pressures influencing alcohol use and if they encourage cannabis users to seek alternative pleasurable activities.
A Web-Based Toolkit to Provide Evidence-Based Resources About Crystal Methamphetamine for the Australian Community: Collaborative Development of Cracks in the Ice (Preprint)
Publisher: JMIR Publications Inc.
Date: 06-09-2017
Abstract: he use of crystal meth hetamine (ice) and the associated harms for in iduals, families, and communities across Australia has been the subject of growing concern in recent years. The provision of easily accessible, evidence-based, and up-to-date information and resources about crystal meth hetamine for the community is a critical component of an effective public health response. his paper aims to describe the codevelopment process of the Web-based Cracks in the Ice Community Toolkit, which was developed to improve access to evidence-based information and resources about crystal meth hetamine for the Australian community. evelopment of the Cracks in the Ice Community Toolkit was conducted in collaboration with community members across Australia and with experts working in the addiction field. The iterative process involved the following: (1) consultation with end users, including community members, crystal meth hetamine users, families and friends of someone using crystal meth hetamine, health professionals, and teachers (n=451) via a cross-sectional Web-based survey to understand information needs (2) content and Web development and (3) user testing of a beta version of the Web-based toolkit among end users (n=41) and experts (n=10) to evaluate the toolkit’s acceptability, relevance, and appeal. nitial end user consultation indicated that the most commonly endorsed reasons for visiting a website about crystal meth hetamine were “to get information for myself” (185/451, 41.0%) and “to find out how to help a friend or a family member” (136/451, 30.2%). Community consultation also revealed the need for simple information about crystal meth hetamine, including what it is, its effects, and when and where to seek help or support. Feedback on a beta version of the toolkit was positive in terms of content, readability, layout, look, and feel. Commonly identified areas for improvement related to increasing the level of engagement and personal connection, improving the ease of navigation, and balancing a “low prevalence of use, yet high impact” message. A total of 9138 users visited the website in the 3 months immediately post launch, and over 25,000 hard-copy Cracks in the Ice booklets and flyers were distributed across Australia. Of these resources, 60.93% (15,525/25,480) were distributed to relevant organizations and mailing list subscribers, and 39.07% (9955/25,480) were ordered directly by in iduals, services, and community groups via the Cracks in the Ice website. he codevelopment process resulted in an engaging Web-based resource for the Australian community to access up-to-date and evidence-based resources about crystal meth hetamine. The Cracks in the Ice Community Toolkit provides much-needed information and support for in iduals, families, and communities.
Perceptions of anti-smoking public health campaigns among people with psychotic disorders
Publisher: Informa UK Limited
Date: 05-2011
A Mobile App to Provide Evidence-Based Information About Crystal Methamphetamine (Ice) to the Community (Cracks in the Ice): Co-Design and Beta Testing
Publisher: JMIR Publications Inc.
Date: 20-12-2018
DOI: 10.2196/11107
Content and functionality of alcohol and other drug websites: Results of an online survey
Publisher: JMIR Publications Inc.
Date: 19-12-2010
DOI: 10.2196/JMIR.1449
Theories Informing eHealth Implementation: Systematic Review and Typology Classification (Preprint)
Publisher: JMIR Publications Inc.
Date: 03-2020
Abstract: heory-guided approaches to implementation science have informed translation efforts and the acceptance of eHealth (digital health) interventions in clinical care. However, there is scarce evidence on which theories are best suited to addressing the inherent complexity of eHealth implementation. he objectives of this systematic review are to identify theories that inform and explain eHealth implementation and to classify these theories using the typology by Sovacool and Hess for theories of sociotechnical change. n electronic search was conducted in the PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Sociological Source Ultimate, Web of Science, ABI/INFORM, EBSCO, and ProQuest databases in June 2019. Studies were included if they were published between 2009 and June 2019 were written in English reported on empirical research, regardless of study or publication type reported on one or more theories in the context of eHealth implementation and were published in a peer-reviewed journal. A total of 2 reviewers independently assessed the titles, abstracts, and full texts. Theories identified were classified using a typology for theories of sociotechnical change, which was considered a useful tool for ordering and analyzing the erse theoretical approaches as a basis for future theory building. f the 13,101 potentially relevant titles, 119 studies were included. The review identified 36 theories used to explain implementation approaches in eHealth. The most commonly used approaches were the Technology Acceptance Model (TAM) (n=33) and the Unified Theory of Acceptance and Use of Technology (UTAUT) (n=32). These theories were primarily concerned with in idual and interpersonal elements of eHealth acceptance. Less common were theories that reflect the various disorderly social processes and structural dimensions of implementation, such as the normalization process theory (n=17) and the structuration theory (n=6). heories currently informing the implementation of eHealth interventions predominantly focus on predicting or explaining end-user acceptance. Theoretical perspectives that capture the dense and intricate relationships and structures required to enact sustainable change are less well represented in the eHealth literature. Given the growing acknowledgment of the inherent complexity of eHealth implementation, future research should develop and test models that recognize and reflect the multidimensional, dynamic, and relational nature of this process. >
Disclosure of suicidal thoughts during an e-mental health intervention: relational ethics meets actor-network theory
Publisher: Informa UK Limited
Date: 12-2019
Stepping through treatment: Reflections on an adaptive treatment strategy among methamphetamine users with depression
Publisher: Wiley
Date: 09-2010
DOI: 10.1111/J.1465-3362.2010.00203.X
Abstract: Stepped-care has been recommended in the alcohol and other drug field and adopted in a number of service settings, but few research projects have examined this approach. This article aims to describe a pilot trial of stepped-care methods in the treatment of meth hetamine use and depression comorbidity. An adaptive treatment strategy was developed based on recommendations for stepped-care among meth hetamine users, and incorporating cognitive behaviour therapy/motivational intervention for meth hetamine use and depression. The adaptive treatment strategy was compared with a fixed treatment, comprising an extended integrated cognitive behaviour therapy/motivational intervention treatment. Eighteen participants across two study sites were involved in the trial, and were current users of meth hetamines (at least once weekly) exhibiting at least moderate symptoms of depression (score of 17 or greater on the Beck Depression Inventory II). Treatment delivered via the adaptive treatment (stepped-care) model was associated with improvement in depression and meth hetamine use, however, was not associated with more efficient delivery of psychological treatment to this population relative to the comparison treatment. This pilot trial attests to the potential for adaptive treatment strategies to increase the evidence base for stepped-care approaches within the alcohol and other drug field. However, in order for stepped-care treatment in this trial to be delivered efficiently, specific training in the delivery and philosophy of the model is required.
Identifying pregnant women at risk of poor birth outcomes
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/01443610902753713
Abstract: Pregnancy is a vulnerable period in women's lives, with a range of maternal and environmental factors impacting upon pregnancy outcome. This study sought to explore the clustering of health risks among pregnant women, and compare the characteristics of women exhibiting clustered risks. A cross-sectional study was undertaken at a large public hospital in Queensland, Australia. Cluster analysis grouped women who had similar levels of risk based on health and lifestyle factors demonstrated to be associated with adverse maternal and infant outcomes. Interviews were conducted with 437 women. The results highlight the interconnectedness of demographic and health risks, and high concentration of risks among Indigenous women. Vulnerable women can be identified and targeted for public health interventions focussing on clustered risk factors, such as alcohol, smoking and sexually transmitted infections. Opportunity exists for screening in routine primary care to identify the in iduals who are at risk, rather than identifying specific risks.
A comparison of practice outcomes of graduates from traditional and non-traditional medical schools in Australia
Publisher: Wiley
Date: 10-2002
DOI: 10.1046/J.1365-2923.2002.01281.X
Abstract: The primary aim of the study was to compare the practice outcomes of doctors who graduated from a non-traditional, problem-based medical school (University of Newcastle) with those of graduates from a traditional programme (University of Sydney), matched randomly on the background characteristics of graduation year, age, gender, and rural primary and secondary school education. Our secondary aim was to differentiate admission from curricular influences by comparing the outcomes of Newcastle and Sydney graduates who entered medical school under similar admission criteria ('traditional academic' entry). Nested case-control analysis in a retrospective cohort study. A validated mail-out survey was distributed to all Newcastle and Sydney graduates registered to practise in the state of New South Wales, Australia. Current main occupation (clinician or other), clinical career choice (family medicine and psychiatry or other specialties), practice location (urban or rural) and employment sector (public or private). A total of 513 Newcastle respondents (68% of the original, eligible Newcastle s le) were each matched randomly with a Sydney respondent according to the four background characteristics. Medical school background was not related to main occupation over 90% of all graduates were employed in clinician positions. A greater proportion of Newcastle than Sydney graduates were either training or qualified in family medicine or psychiatry rather than in other specialties. The school of graduation was not related to practice environment fewer than 20% of all graduates were working in rural locations and around 25% were employed in the public sector. There were no differences in outcome between Newcastle and Sydney graduates who had entered medical school under similar academic criteria. Our study suggests that initial selection procedures of medical school candidates with particular background characteristics and attributes may influence practice outcomes. Further research is required to confirm these findings.
MyHealthPA: Development and Pilot Testing of a Mobile-Based Monitoring Tool to Reduce Cardio-Vascular Disease Risk in People with Mental Health Problems (Preprint)
Publisher: JMIR Publications Inc.
Date: 26-02-2018
Abstract: ackground: People with mental health disorders live on average 20 years less than those without, often due to poor physical health including cardio-vascular disease (CVD). Evidence-based interventions are required to reduce this lifespan gap. bjective: This study aimed to develop, trial, and evaluate a mobile-based lifestyle program (MyHealthPA) to help people with mental health problems improve key health risk behaviors and reduce their risk of CVD. ethods: The development of MyHealthPA occurred in three stages: (1) a review of the literature (2) a scoping survey (n=251) among people with and without experience of mental health problems and (3) program development informed by stages (1) and (2). A small pilot trial among young people with and without mental health (MH) disorders was also conducted. Participants completed a baseline assessment and given access to the MyHealthPA program for a period of eight weeks. They were then asked to complete an end-of-treatment assessment and a follow-up assessment one month later. esults: Twenty-eight young people aged 19 to 25 years were recruited to the pilot trial. Of these, 12 (43%) had been previously diagnosed with a MI. Twelve participants (43%) completed the end-of-treatment assessment and six (21%) completed the follow-up assessment. Small improvements in fruit and vegetable consumption, level of physical activity, alcohol use, and mood were found between baseline and end-of-treatment and follow-up, particularly among people with experience of MH issues. Most participants (57-60%) reported the program had above average usability, however only 29-40% of participants reported that they would like to use the program frequently and would recommend it to other young people. Participants also identified a number of ways in which the program could be improved. onclusions: This article describes the formative research and process of planning that formed the development of MyHealthPA and the evidence base underpinning the approach. The MyHealthPA program represents an innovative approach to CVD risk reduction among people with mental health problems. MyHealthPA appears to be an acceptable, easy to use, and potentially effective mHealth intervention to assist young people with mental illness to monitor risk factors for CVD. However, ways in which the program could be improved for future testing and dissemination were identified and are discussed.
Consumer-Guided Development of an Engagement-Facilitation Intervention for Increasing Uptake and Adherence for Self-Guided Web-Based Mental Health Programs: Focus Groups and Online Evaluation Survey
Publisher: JMIR Publications Inc.
Date: 29-10-2020
DOI: 10.2196/22528
Abstract: Self-guided web-based mental health programs are effective in treating and preventing mental health problems. However, current engagement with these programs in the community is suboptimal, and there is limited evidence indicating how to increase the use of existing evidence-based programs. This study aims to investigate the views of people with lived experience of depression and anxiety on factors influencing their engagement with self-guided web-based mental health (e–mental health) programs and to use these perspectives to develop an engagement-facilitation intervention (EFI) to increase engagement (defined as both uptake and adherence) with these programs. A total of 24 community members (female=21 male=3) with lived experience of depression and anxiety or depression or anxiety alone participated in 1 of 4 focus groups discussing the factors influencing their engagement with self-guided e–mental health programs and the appearance, delivery mode, and functionality of content for the proposed EFI. A subsequent evaluation survey of the focus group participants (n=14) was conducted to evaluate the resultant draft EFI. Data were thematically analyzed using both inductive and deductive qualitative methods. Participants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement, including receiving personalized symptom feedback, information regarding the program’s content or effectiveness and data security, and normalization of using e–mental health programs (eg, testimonials). Reminders, rewards, feedback about progress, and coaching were all mentioned as facilitating adherence. EFIs have the potential to improve community uptake of e–mental health programs. They should focus on providing information on the content and effectiveness of e–mental health programs and normalizing their use. Given that the s le comprised predominantly young females, this study may not be generalizable to other population groups. There is a strong value in involving people with a lived experience in the design and development of EFIs to maximize their effectiveness.
It's the thought that counts: Craving metacognitions and their role in abstinence from methamphetamine use
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.JSAT.2009.12.006
Abstract: Craving is frequently reported as a trigger for relapse by those trying to remain abstinent from psychoactive substances. Metacognitive beliefs about managing craving may play an important role in determining further cognition and behavior. They are, therefore, important to measure in treatment and may serve as target cognitions to be modified in support of behavioral change. As part of the assessment battery of a randomized controlled trial among 214 meth hetamine users, we included the Craving Beliefs Questionnaire (CBQ), a measure designed to assess an in idual's perception of the potential negative impact of craving, at baseline. Changes in abstinence rates were significantly related to CBQ score, suggesting that craving beliefs are associated with changes in meth hetamine use. Further validation of the CBQ is warranted. Future clinical research among meth hetamine users could focus on directly manipulating craving beliefs through cognitive therapy to affect abstinence.
Mental health care needs in cystic fibrosis: A scoping review
Publisher: Informa UK Limited
Date: 07-02-2022
DOI: 10.1080/00981389.2022.2060422
Abstract: People with cystic fibrosis experience rates of anxiety and depression that are considerably higher than those of the general population. Research suggests low mental health functioning can lead to poor health outcomes and quality of life for this population. Consequently, recognition of the need for routine mental health screening and referral in cystic fibrosis care is increasing. Yet to date, less is known about the actual mental health care needs of people with cystic fibrosis. This scoping review sought to address this gap by examining the mental health care needs of adults and adolescents living with cystic fibrosis, and how are these needs are (or are not) being met. Findings suggest current efforts at mental health care provision do not adequately meet the needs of people with cystic fibrosis, highlighting the urgency of conducting high quality intervention research to support effective mental health care for this population.
A Multiple Health Behavior Change, Self-Monitoring Mobile App for Adolescents: Development and Usability Study of the Health4Life App
Publisher: JMIR Publications Inc.
Date: 12-04-2021
DOI: 10.2196/25513
Abstract: The link between chronic diseases and the Big 6 lifestyle risk behaviors (ie, poor diet, physical inactivity, smoking, alcohol use, sedentary recreational screen time, and poor sleep) is well established. It is critical to target these lifestyle risk behaviors, as they often co-occur and emerge in adolescence. Smartphones have become an integral part of everyday life, and many adolescents already use mobile apps to monitor their lifestyle behaviors and improve their health. Smartphones may be a valuable platform for engaging adolescents with interventions to prevent key chronic disease risk behaviors. The aim of this paper is to describe the development, usability, and acceptability of the Health4Life app, a self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors. The development of the Health4Life app was an iterative process conducted in collaboration with adolescents and experts. The development process consisted of three stages: scoping the literature end user consultations, which included a web-based survey (N=815 mean age 13.89, SD 0.89 years) and a focus group (N=12) among adolescents and app development and beta testing. Following this development work, 232 adolescents were asked to rate the usability and acceptability of the app. The process resulted in a self-monitoring smartphone app that allows adolescent users to track and set goals for the Big 6 health behaviors, using in-app rewards and notifications to enhance engagement. The overall adolescent feedback was positive in terms of user-friendly design, content, relevance, and helpfulness. Commonly identified areas for improvement were to increase interactive features and display recorded health behaviors differently to improve interpretability. The Health4Life app is a co-designed, self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors. Adolescents rated the app as highly acceptable and usable. The app has the potential to efficiently and effectively modify important risk factors for chronic disease among young people and is currently being evaluated in a world-first trial of 6640 secondary school students in 71 schools across Australia.
Higher Blood Pressure Associated With Higher Cognition and Functionality Among Centenarians in Australia
Publisher: Oxford University Press (OUP)
Date: 03-2011
DOI: 10.1038/AJH.2010.236
Abstract: The objective of this study was to examine blood pressure (BP) and cholesterol levels among centenarians in Australia, and to compare the relationship between these biological parameters with cognitive and functional status. We performed BP (n = 142) and cholesterol (n = 67) measurements using the Omron automated sphygmomanometer (Omron Healthcare, Melbourne, Australia) and the LDX Cholestech Analyzer (Inverness Medical, San Diego, CA), respectively. A medical history was also obtained. Cognitive and functional statuses were assessed using the Mini-Mental State Examination (MMSE) and Katz Index of Independence in Activities of Daily Living (Katz ADL), respectively. Average age of participants was 101.1 years. Hypertension was demonstrated in 1% according to the WHO criterion (≥140/90 mm Hg). However, 38% of centenarians were hypertensive, defined as having a medical diagnosis of hypertension, and/or being on antihypertensive medications, and/or having a BP measurement ≥ 140/90 mm Hg. Mean values were: systolic = 130 mm Hg (90-182 mm Hg), diastolic = 70 mm Hg (44-98 mm Hg), and pulse pressure (PP) = 60 mm Hg (20-130 mm Hg). Hypercholesterolaemia was only detected in 8% of participants. Hypertension was not associated with increased risk of hypercholesterolaemia. Low systolic BP (SBP) and narrower PP was associated with lower MMSE scores. High SBP and wider PP was associated with better functional status. Centenarians have a very low prevalence of high BP and high cholesterol compared with the general population. There seems to be an inverse relationship between the risk factors for cardiovascular disease vs. the risk factors for dementia in our s le. There appears to be a complex interaction between BP and health in old age.
Evaluation of a Digital Health Initiative in Illicit Substance Use: Cross-sectional Survey Study
Publisher: JMIR Publications Inc.
Date: 10-08-2021
DOI: 10.2196/29026
Abstract: The Cracks in the Ice (CITI) community toolkit was developed to provide evidence-based, up-to-date information and resources about crystal meth hetamine to Australians. Given the high rates of internet use in the community and the potential for misinformation, CITI has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal meth hetamine. This study aims to determine (1) whether the CITI toolkit is achieving its aim of disseminating evidence-based information and resources to people who use crystal meth hetamine, their family and friends, health professionals, and the general community and (2) examine the association between the use of CITI and the knowledge and attitudes about crystal meth hetamine. A cross-sectional web-based survey, open to Australian residents (aged ≥18 years), was conducted from November 2018 to March 2019. People who had previously visited the website (referred to as “website visitors” in this study) and those who had not (“naïve”) were recruited. At baseline, knowledge, attitudes, and demographics were assessed. CITI website visitors then completed a series of site evaluation questions, including the System Usability Scale (SUS), and naïve participants were asked to undertake a guided site tour of a replicated version of the site before completing the evaluation questions and repeating knowledge and attitude scales. Of a total 2108 participants, 564 (26.7%) reported lifetime use of crystal meth hetamine, 434 (20.6%) were family/friends, 288 (13.7%) were health professionals, and 822 (38.9%) were community members. The average SUS score was 73.49 (SD 13.30), indicating good site usability. Health professionals reported significantly higher SUS scores than community members (P=.02) and people who used crystal meth hetamine (P .001). Website visitors had significantly higher baseline knowledge than naïve participants (P .001). Among naïve participants, knowledge scores increased following exposure to the website (mean 15.2, SE 0.05) compared to baseline (mean 14.4, SE 0.05 P .001). The largest shifts in knowledge were observed for items related to prevalence, legal issues, and the effects of the drug. Stigmatizing attitude scores among the naïve group were significantly lower following exposure to CITI (mean 41.97, SE 0.21) compared to baseline (mean 44.3, SE 0.21 P .001). This study provides an innovative evaluation of a national eHealth resource. CITI is achieving its aim of disseminating evidence-based, nonstigmatizing, and useful information and resources about crystal meth hetamine to key end user groups and has received good usability scores across its target groups. Interaction with CITI led to immediate improvements in knowledge about crystal meth hetamine and a decrease in stigmatizing attitudes. CITI demonstrates the important role of digital information and support platforms for translating evidence into practice and improving knowledge and reducing stigma.
Where there's smoke, there's fire: high prevalence of smoking among some sub-populations and recommendations for intervention
Publisher: Wiley
Date: 2006
DOI: 10.1080/09595230500459552
Abstract: In Australia, the prevalence of smoking is higher among certain sub-populations compared to the general population. These sub-populations include Aboriginal and Torres Strait Islander people, people from culturally and linguistically erse backgrounds, as well as people with mental and substance use disorders and prisoners. The aims of this paper are to: describe the high prevalence of smoking among these particular sub-populations and harms associated with smoking explore possible reasons for such high prevalence of smoking review the evidence regarding the efficacy of existing smoking cessation interventions and make recommendations for smoking interventions and further research among these groups. In addition to low socio-economic status, limited education and other factors, there are social, systems and psychobiological features associated with the high prevalence of smoking in these sub-groups. General population-based approaches to reducing smoking prevalence have been pursued for decades with great success and should be continued with further developments that aim specifically to affect Aboriginal and Torres Strait Islander people and some cultural groups. However, increasing attention, more specific targeting and flexible goals and interventions are also required for these and other distinct sub-populations with high smoking prevalence. Recommendations include: more funding and increased resources to examine the most appropriate education and treatment strategies to promote smoking cessation among people from Aboriginal and Torres Strait Islander and some culturally and linguistically erse backgrounds larger and better-designed studies evaluating smoking cessation/reduction interventions among distinct sub-groups and system-wide interventions requiring strong leadership among clients and staff within mental health, drug and alcohol and prison settings.
A Web-Based Toolkit to Provide Evidence-Based Resources About Crystal Methamphetamine for the Australian Community: Collaborative Development of Cracks in the Ice
Publisher: JMIR Publications Inc.
Date: 20-03-2018
DOI: 10.2196/MENTAL.8891
Abstract: The use of crystal meth hetamine (ice) and the associated harms for in iduals, families, and communities across Australia has been the subject of growing concern in recent years. The provision of easily accessible, evidence-based, and up-to-date information and resources about crystal meth hetamine for the community is a critical component of an effective public health response. This paper aims to describe the codevelopment process of the Web-based Cracks in the Ice Community Toolkit, which was developed to improve access to evidence-based information and resources about crystal meth hetamine for the Australian community. Development of the Cracks in the Ice Community Toolkit was conducted in collaboration with community members across Australia and with experts working in the addiction field. The iterative process involved the following: (1) consultation with end users, including community members, crystal meth hetamine users, families and friends of someone using crystal meth hetamine, health professionals, and teachers (n=451) via a cross-sectional Web-based survey to understand information needs (2) content and Web development and (3) user testing of a beta version of the Web-based toolkit among end users (n=41) and experts (n=10) to evaluate the toolkit’s acceptability, relevance, and appeal. Initial end user consultation indicated that the most commonly endorsed reasons for visiting a website about crystal meth hetamine were “to get information for myself” (185/451, 41.0%) and “to find out how to help a friend or a family member” (136/451, 30.2%). Community consultation also revealed the need for simple information about crystal meth hetamine, including what it is, its effects, and when and where to seek help or support. Feedback on a beta version of the toolkit was positive in terms of content, readability, layout, look, and feel. Commonly identified areas for improvement related to increasing the level of engagement and personal connection, improving the ease of navigation, and balancing a “low prevalence of use, yet high impact” message. A total of 9138 users visited the website in the 3 months immediately post launch, and over 25,000 hard-copy Cracks in the Ice booklets and flyers were distributed across Australia. Of these resources, 60.93% (15,525/25,480) were distributed to relevant organizations and mailing list subscribers, and 39.07% (9955/25,480) were ordered directly by in iduals, services, and community groups via the Cracks in the Ice website. The codevelopment process resulted in an engaging Web-based resource for the Australian community to access up-to-date and evidence-based resources about crystal meth hetamine. The Cracks in the Ice Community Toolkit provides much-needed information and support for in iduals, families, and communities.
“Another tool in our toolbox”: a scoping review of the use of eHealth technologies in health social work practice
Publisher: Informa UK Limited
Date: 2023
Brief cognitive behavioural interventions for regular amphetamine users: A step in the right direction
Publisher: Wiley
Date: 03-2005
DOI: 10.1111/J.1360-0443.2005.01002.X
Abstract: The present study sought to replicate and extend a small pilot study conducted by Baker, Boggs & Lewin (2001) which demonstrated that brief interventions consisting of motivational interviewing and cognitive-behaviour therapy (CBT) were feasible and associated with better outcomes compared with a control condition. Randomized controlled trial (RCT). Greater Brisbane Region of Queensland and Newcastle, NSW, Australia. The study was conducted among 214 regular hetamine users. Demographic characteristics, past and present alcohol and other drug use and mental health, treatment, hetamine-related harms and severity of dependence. The main finding of this study was that there was a significant increase in the likelihood of abstinence from hetamines among those receiving two or more treatment sessions. In addition, the number of treatment sessions attended had a significant short-term beneficial effect on level of depression. There were no intervention effects on any other variables (HIV risk-taking, crime, social functioning and health). Overall, there was a marked reduction in hetamine use among this s le over time and, apart from abstinence rates and short-term effects on depression level, this was not differential by treatment group. Reduction in hetamine use was accompanied by significant improvements in stage of change, benzodiazepine use, tobacco smoking, polydrug use, injecting risk-taking behaviour, criminal activity level, and psychiatric distress and depression level. A stepped-care approach is recommended. The first step in providing an effective intervention among many regular hetamine users, particularly those attending non-treatment settings, may include provision of: a structured assessment of hetamine use and related problems self-help material and regular monitoring of hetamine use and related harms. Regular hetamine users who present to treatment settings could be offered two sessions of CBT, while people with moderate to severe levels of depression may best be offered four sessions of CBT for hetamine use from the outset, with further treatment for hetamine use and/or depression depending on response. Pharmacotherapy and/or longer-term psychotherapy may be suitable for non-responders. An RCT of a stepped-care approach among regular hetamine users is suggested.
Randomized controlled trial of cognitive-behavioural therapy for coexisting depression and alcohol problems: Short-term outcome
Publisher: Wiley
Date: 14-12-2010
DOI: 10.1111/J.1360-0443.2009.02757.X
Abstract: Alcohol use disorders and depression co-occur frequently and are associated with poorer outcomes than when either condition occurs alone. The present study (Depression and Alcohol Integrated and Single-focused Interventions DAISI) aimed to compare the effectiveness of brief intervention, single-focused and integrated psychological interventions for treatment of coexisting depression and alcohol use problems. Participants (n = 284) with current depressive symptoms and hazardous alcohol use were assessed and randomly allocated to one of four in idually delivered interventions: (i) a brief intervention only (single 90-minute session) with an integrated focus on depression and alcohol, or followed by a further nine 1-hour sessions with (ii) an alcohol focus (iii) a depression focus or (iv) an integrated focus. Follow-up assessments occurred 18 weeks after baseline. Compared with the brief intervention, 10 sessions were associated with greater reductions in average drinks per week, average drinking days per week and maximum consumption on 1 day. No difference in duration of treatment was found for depression outcomes. Compared with single-focused interventions, integrated treatment was associated with a greater reduction in drinking days and level of depression. For men, the alcohol-focused rather than depression-focused intervention was associated with a greater reduction in average drinks per day and drinks per week and an increased level of general functioning. Women showed greater improvements on each of these variables when they received depression-focused rather than alcohol-focused treatment. Integrated treatment may be superior to single-focused treatment for coexisting depression and alcohol problems, at least in the short term. Gender differences between single-focused depression and alcohol treatments warrant further study.
Internet-Delivered Tobacco Treatment for People Using Cannabis: A Randomized Trial in Two Australian Cannabis Clinics
Publisher: JMIR Publications Inc.
Date: 07-12-2020
DOI: 10.2196/14344
Abstract: Tobacco use is disproportionately higher in people who smoke cannabis than in the general population, increasing the severity of dependence for cannabis use, decreasing the likelihood of successful quit attempts for both cannabis and tobacco, and increasing the risk of relapse for both substances. Opportunities to address tobacco use in people using cannabis are being missed. This study aims to investigate the feasibility of engaging tobacco smokers who were accessing treatment for cannabis, with a tobacco-focused internet-based Healthy Lifestyle Program (iHeLP 4 modules). It was hypothesized that iHeLP completion would be associated with decreases in tobacco use and improved quality of life (QoL) and psychological health. It was also hypothesized that iHeLP completion would be higher in those who additionally received telephone support. Given that iHeLP aimed to improve healthy lifestyle behaviors, it was also hypothesized that there would be reductions in cannabis use. A total of 13 smokers seeking treatment for cannabis use were randomly allocated to iHeLP alone or iHeLP plus telephone support. Participants were engaged in iHeLP over 8 weeks and completed a 12-week follow-up assessment. Results from 10 participants who completed the follow-up indicated that the acceptability of iHeLP was high-very high in terms of general satisfaction, appropriateness of services, effectiveness, and met need. Additional telephone support increased modal module completion rates for iHeLP from 0 to 2 but did not provide any other significant advantages over iHeLP alone in terms of cannabis use, tobacco use, QoL, or psychological health. Participants in the iHeLP-alone condition (n=4) reported a mean reduction of 5.5 (SD 9.00) tobacco cigarettes per day between baseline and follow-up, with a concomitant mean reduction in expired carbon monoxide (CO) of 5.5 parts per million (ppm, SD 6.91). The iHeLP plus telephone support group (n=6) reported a mean reduction of 1.13 (SD 4.88) tobacco cigarettes per day and a mean reduction of 9.337 ppm of expired CO (SD 5.65). A urinalysis indicated that abstinence from cannabis was achieved by 2 participants in the iHeLP-alone group and three participants in the iHeLP plus telephone support group. Between baseline and follow-up assessments, iHeLP-alone participants reported a mean reduction in days of use of cannabis in the prior month of 6.17 days (SD 13.30). The average reduction in the number of days of cannabis use for the iHeLP plus telephone support group was also 6.17 days (SD 13.59). Despite the small s le size, this study provides preliminary support for the use of internet-delivered, tobacco-focused interventions in tobacco smokers seeking treatment for cannabis use.
Self-Compassion Amongst Clients with Problematic Alcohol Use
Publisher: Springer Science and Business Media LLC
Date: 27-04-2012
Hardware-efficient signal generation of layered/enhanced ACO-OFDM for short-haul fiber-optic links
Publisher: The Optical Society
Date: 02-06-2017
DOI: 10.1364/OE.25.013359
It's worth a try: The treatment experiences of rural and Urban participants in a randomized controlled trial of computerized psychological treatment for comorbid depression and alcohol/other drug use
Publisher: Informa UK Limited
Date: 11-2012
A system for maintaining the educational and training standards of junior doctors
Publisher: Wiley
Date: 07-1998
DOI: 10.1046/J.1365-2923.1998.00211.X
Abstract: The development of junior doctors' competence is complex because the hospital environment in which doctors work places many demands on them. The need for quality education and training and personal development may be in direct conflict with the service commitments required from hospitals. This paper describes the methods by which the Postgraduate Medical. Council of New South Wales, Australia, addresses the needs of junior doctors in the state in order to improve the quality of their education. Key elements of the Council's function include the provision of hospital clinical supervisors who oversee junior doctor education and training, and central involvement in supplying the junior doctor workforce to all state hospitals who must meet defined accreditation standards. This paper also provides data on evaluation of those methods and some educational outcomes.
‘I no longer know that person’: Grief and loss in families living with someone using crystal methamphetamine
Publisher: Research Square Platform LLC
Date: 02-10-2020
DOI: 10.21203/RS.3.RS-84158/V1
Abstract: Background: Although crystal meth hetamine (‘ice’) use is a large and growing worldwide problem, few research studies have explored the impact of crystal meth hetamine use on affected friends and family members. In order to inform the development of a Family and Friend Support Program for those affected by someone else’s use of ice, the experiences and narratives of family members and friends were explored. Methods: This paper reports on a subset of findings from a mixed method study, which sought to better understand the experiences of affected friends and family members of people using ice. Participants were recruited via a Facebook ad and asked to complete a survey outlining their experiences. At the end of the survey, participants were invited to be interviewed by the clinical psychologist on the research team, to discuss their experiences in greater depth. Seventeen people (out of the 39 who completed the survey) agreed to be interviewed. This paper is based on a qualitative thematic analysis of those seventeen interviews conducted with family members and friends of people using ice. Results: The thematic analysis highlighted common areas of concern and experience. Key themes emerged from the thematic analysis, namely loss, stigma, support (or lack thereof), ways of coping, and the value in sharing personal experiences. The pre-eminent theme was that of grief and loss. Concepts of ambiguous loss, disenfranchised grief, and narrative constructivist approaches to understanding loss were applied to the analysis of results. Loss was often compounded by social constructions and stigma attached to ice usage, which extended to the people caring for friends and family members as well. Conclusion: The experiences of the people interviewed in relation to a person in their life who was using ice, were complicated by social constructions of the drug itself. It emerged that this resulted in grief processes which were made more complex because of the stigma attached to the use of ice. These results warrant further clinical consideration and research.
Urban-rural influences on suicidality: Gaps in the existing literature and recommendations for future research
Publisher: Wiley
Date: 21-11-2011
DOI: 10.1111/J.1440-1584.2011.01235.X
Abstract: Suicide is a major public health issue of particular concern among rural populations, which experience a consistently higher suicide rate than urban areas. Although extensive research efforts have been directed towards understanding suicidality and related factors, there is a continued lack of clinically useful factors to target preventive measures, particularly among some regional and demographic groups. This suggests limitations in the conceptualisation of this important construct. A review of the literature was undertaken, using a snowballing and saturation approach. Literature was considered relevant if it addressed the research question 'what are the current limitations in research on urban/rural influences on suicidality?' Findings were used to develop a set of guidelines to inform future research. A number of gaps in existing research relevant to limitations in rural suicide research were identified: inconsistencies in terminology a focus on high-end suicidal behaviours a disproportionate focus on urban populations a dominance of cross-sectional research and a high use of clinical s les. These limitations are discussed in terms of their implications for rural suicidality, and are used to support the development of recommendations for future research, with a focus on encouraging consistency and standardisation. A number of limitations can be identified in existing research on suicide. Targeting these specific areas can be an important step in addressing the current gaps in knowledge relating to rural suicide prevention.
‘Speaking with them, not about them’: engaging undergraduate social work students in research with young people
Publisher: Informa UK Limited
Date: 30-07-2019
Longitudinal course and predictors of suicidal ideation in a rural community sample
Publisher: SAGE Publications
Date: 24-06-2013
Abstract: Suicide rates in rural Australia are higher than in urban areas. No existing research has explored the long-term patterns and predictors of change in suicidal ideation within rural areas. This report uses longitudinal data and multiple time points to determine predictors of the trajectory of suicidal ideation in rural Australia. Participants in the Australian Rural Mental Health Study (ARMHS) completed self-report surveys at baseline, 12 and 36 months, reporting their psychological and social well-being, and suicidal ideation. Generalised linear mixed models explored these factors as correlates and predictors of suicidal ideation across 3 years using multiple data points. A total of 2135 participants completed at least one wave of ARMHS, and hence were included in the current analysis. Overall, 8.1% reported suicidal ideation during at least one study wave, 76% of whom reported suicidal ideation intermittently rather than consistently across waves. Across the three time points, suicidal ideation was significantly associated with higher psychological distress (OR 1.30, 95% CI 1.23 to 1.37), neuroticism (OR 1.15, 95% CI 1.04 to 1.27), and availability of support (OR 0.80, 95% CI 0.69 to 0.92), with a non-significant association with unemployment (OR 1.73, 95% CI 0.93 to 3.24) even after controlling for the effects of perceived financial hardship. Future suicidal ideation was significantly predicted by distress (OR 1.16, 95% CI 1.09 to 1.23) and neuroticism (OR 1.17, 95% CI 1.03 to 1.32), with a non-significant association with unemployment (OR 2.11, 95% CI 0.41 to 2.27). Predictive effects for marital status, social networks, sense of community and availability of support did not remain significant in the full multivariate analysis. Fluctuations in suicidal ideation are common, and may be associated with changes in psychological and social well-being. Public health strategies, focusing on encouraging help-seeking among those with higher psychological distress, lower social support, and unstable or absent employment opportunities, may be a useful long-term initiative to reduce the prevalence of suicidal ideation in the general rural community.
A Systematic Literature Review and Narrative Synthesis of Effective Interventions for Family and Caregivers of People who use Methamphetamine
Publisher: SAGE Publications
Date: 26-05-2022
Health behaviour risk factors for coronary heart disease (CHD) in smokers with a psychotic disorder: baseline results
Publisher: Informa UK Limited
Date: 05-2011
Reasons for substance use among people with mental disorders.
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.ADDBEH.2011.11.039
Abstract: Comorbidity of mental disorders and substance use continues to be a major problem. To inform the development of more effective interventions for these co-existing disorders, this paper aimed to determine if there are clear variations in the reasons for tobacco, alcohol or cannabis use across people with different mental disorders. Data from five randomized controlled trials on co-existing disorders that measured reasons for tobacco, alcohol or cannabis use using the Drug Use Motives Questionnaire, Reasons for Smoking Questionnaire or via free response are reported and combined. Two studies involved participants with depression, two involved participants with a psychotic disorder and one involved participants with a range of mental disorders. A series of logistic regressions were conducted to examine differences in reasons for tobacco, alcohol or cannabis use and to compare these reasons between people with psychotic disorders or depression. Participants had a mean age of 38 (SD=12) and just over half (60%) were male. Forty-six percent of participants had a psychotic disorder and 54% experienced depression. Data from 976 participants across the five studies were included in the analyses. Tobacco and alcohol were primarily used to cope, while cannabis was primarily used for pleasure. People with psychotic disorders were more likely than people with depression to use tobacco for coping, pleasure and illness motives. People with depression, in contrast, were more likely to use alcohol for these reasons and social reasons. It may be important to tailor interventions for co-existing mental disorders and substance use by substance type and type of mental disorder. For ex le, interventions might be improved by including alternative coping strategies to tobacco and/or alcohol use, by addressing the social role of alcohol and by helping people with mental disorders using cannabis to gain pleasure from their lives in other ways.
An engagement-facilitation intervention (EFI) for increasing uptake and engagement for self-guided online mental health interventions: Consumer-guided development (Preprint)
Publisher: JMIR Publications Inc.
Date: 03-09-2019
Abstract: elf-guided online mental health programs are effective in treating and preventing mental health problems. However, both the uptake and engagement with these programs in the community is suboptimal, and there is limited current evidence indicating how to increase the use of existing evidence-based programs. he current study aims to investigate the views of people with lived experience of depression and anxiety on the barriers and facilitators to using e-mental health interventions and to use these perspectives to help develop an engagement-facilitation intervention (EFI) to increase uptake and engagement with self-guided online mental health programs. total of 24 community members (female = 21 male = 3) with lived experience of depression and/or anxiety participated in four focus groups that discussed: 1) barriers and facilitators to self-guided e-mental health programs, 2) specific details needed to help them decide to use an online program, and 3) the appearance, delivery mode, and functionality of content for the proposed EFI. A total of 14 of the focus group attendees participated in a subsequent follow-up survey to evaluate the resultant draft EFI. Data were thematically analysed using both inductive and deductive methods. articipants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement with psychosocial interventions. These were providing personalised feedback about symptoms, information about the content and effectiveness of the e-mental health program, normalisation of participation in e-mental health programs including testimonials, and brief information on data security. Reminders, rewards, feedback about their progress, and coaching were all mentioned as being useful in assisting people to continue to engage with a program once they had started. Feedback on the developed EFI was positive with participants reporting satisfaction with the content of the EFI and that it would likely positively affect their use of an e-mental health program. FIs have the potential to improve the uptake of e-mental health programs in the community and should focus on providing information on the content and effectiveness of e-mental health programs, as well as normalising their use. There is strong value in involving people with a lived experience in the design and development of EFIs to maximise their effectiveness.
Craving as a predictor of treatment outcomes in heavy drinkers with comorbid depressed mood
Publisher: Elsevier BV
Date: 02-2013
DOI: 10.1016/J.ADDBEH.2012.06.003
Abstract: Alcohol and depression comorbidity is high and is associated with poorer outcomes following treatment. The ability to predict likely treatment response would be advantageous for treatment planning. Craving has been widely studied as a potential predictor, but has performed inconsistently. The effect of comorbid depression on craving's predictive performance however, has been largely neglected, despite demonstrated associations between negative affect and craving. The current study examined the performance of craving, measured pre-treatment using the Obsessive subscale of the Obsessive Compulsive Drinking Scale, in predicting 18-week and 12-month post-treatment alcohol use outcomes in a s le of depressed drinkers. Data for the current study were collected during a randomized controlled trial (Baker, Kavanagh, Kay-Lambkin, Hunt, Lewin, Carr, & Connolly, 2010) comparing treatments for comorbid alcohol and depression. A subset of 260 participants from that trial with a Timeline Followback measure of alcohol consumption was analyzed. Pre-treatment craving was a significant predictor of average weekly alcohol consumption at 18 weeks and of frequency of alcohol binges at 18 weeks and 12 months, but pre-treatment depressive mood was not predictive, and effects of Baseline craving were independent of depressive mood. Results suggest a greater ongoing risk from craving than from depressive mood at Baseline.
A Systematic Review of Diffusion Tensor Imaging Findings in Sports-Related Concussion
Publisher: Mary Ann Liebert Inc
Date: 11-2012
Abstract: Sports-related concussion (SRC) is typically associated with functional, as opposed to structural, injury. The results of traditional structural neuroimaging techniques used to assess SRC tend to be normal in many athletes, and are only clinically helpful in ruling out a more serious injury. Diffusion tensor imaging (DTI) has increasingly been touted as a method offering greater clinical potential in mild traumatic brain injury (mTBI). Despite this, the utility of DTI as a clinical tool for diagnosing and managing SRC has received considerably less attention than it has in the general TBI research literature. The aim of this article is to conduct a systematic review of DTI in SRC, and to provide a focus and overview of research findings using this MRI technique in SRC. A systematic review of articles published in the English language, up to February 2012, was retrieved via PsycINFO(®), MEDLINE(®), EMBASE, SPORTDiscus(™), Scopus, Web of Science, and Informit using the key search terms: diffusion tensor imaging, diffusion magnetic resonance imaging, diffusion weighted MRI, diffusion MRI, fractional anisotropy, tractography, apparent diffusion coefficient, magnetic resonance imaging, mild traumatic brain injury, mTBI, traumatic brain injury, concussion, sport, athletic and athlete. Observational, cohort, correlation, cross-sectional and longitudinal studies were all included in the current review. Results of the review found eight articles that met inclusion criteria, which included data on 214 athletes and 96 controls. Seven of eight studies reported some type of DTI abnormality, although the neuroanatomical sites involved varied. Although considerable methodological variations exist across studies, the current review suggests that DTI may possess adequate diagnostic sensitivity to detect SRC in affected athletes. Further longitudinal studies are required to demonstrate its discriminate validity and prognostic capacity within this field.
Breakingtheice: A protocol for a randomised controlled trial of an internet-based intervention addressing amphetamine-type stimulant use
Publisher: Springer Science and Business Media LLC
Date: 25-06-2012
Avoiding Emotional Bonds: An Examination of the Dimensions of Therapeutic Alliance Among Cannabis Users
Publisher: Frontiers Media SA
Date: 2013
Drug use patterns and mental health of regular amphetamine users during a reported 'heroin drought'
Publisher: Wiley
Date: 27-04-2004
Study protocol of the Health4Life initiative: a cluster randomised controlled trial of an eHealth school-based program targeting multiple lifestyle risk behaviours among young Australians
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2019-035662
Abstract: Lifestyle risk behaviours, including alcohol use, smoking, poor diet, physical inactivity, poor sleep (duration and/or quality) and sedentary recreational screen time (‘the Big 6’), are strong determinants of chronic disease. These behaviours often emerge during adolescence and co-occur. School-based interventions have the potential to address risk factors prior to the onset of disease, yet few eHealth school-based interventions target multiple behaviours concurrently. This paper describes the protocol of the Health4Life Initiative , an eHealth school-based intervention that concurrently addresses the Big 6 risk behaviours among secondary school students. A multisite cluster randomised controlled trial will be conducted among year 7 students (11–13 years old) from 72 Australian schools. Stratified block randomisation will be used to assign schools to either the Health4Life intervention or an active control (health education as usual). Health4Life consists of (1) six web-based cartoon modules and accompanying activities delivered during health education (once per week for 6 weeks), and a smartphone application (universal prevention), and (2) additional app content, for students engaging in two or more risk behaviours when they are in years 8 and 9 (selective prevention). Students will complete online self-report questionnaires at baseline, post intervention, and 12, 24 and 36 months after baseline. Primary outcomes are consumption of sugar-sweetened beverages, moderate-to-vigorous physical activity, sleep duration, sedentary recreational screen time and uptake of alcohol and tobacco use. This study has been approved by the University of Sydney (2018/882), NSW Department of Education (SERAP no. 2019006), University of Queensland (2019000037), Curtin University (HRE2019-0083) and relevant Catholic school committees. Results will be presented to schools and findings disseminated via peer-reviewed journals and scientific conferences. This will be the first evaluation of an eHealth intervention, spanning both universal and selective prevention, to simultaneously target six key lifestyle risk factors among adolescents. Australian New Zealand Clinical Trials Registry (ACTRN12619000431123), 18 March 2019.
When does change begin following screening and brief intervention among depressed problem drinkers?
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.JSAT.2012.07.009
Abstract: Brief interventions are effective for problem drinking and reductions are known to occur in association with screening and assessment. The present study sought to assess, among participants (N=202) in a clinical trial, how much change occurred between baseline assessment and a one-session brief intervention (S1), and the predictors of early change. The primary focus was on changes in the Beck Depression Inventory Fast Screen scores and alcohol consumption (standard drinks per week) prior to random allocation to nine further sessions addressing either depression, alcohol, or both problems. There were large and clinically significant reductions between baseline and S1, with the strongest predictors being baseline scores in the relevant domain and change in the other domain. Client engagement was also predictive of early depression changes. Monitoring progress in both domains from first contact, and provision of empathic care, followed by brief intervention appear to be useful for this high prevalence comorbidity.
You’ve got to have friends: the predictive value of social integration and support in suicidal ideation among rural communities
Publisher: Springer Science and Business Media LLC
Date: 12-10-2011
DOI: 10.1007/S00127-011-0436-Y
Abstract: To explore the role of social integration and support in the longitudinal course of suicidal ideation (SI) in a rural population. Baseline and 12-month data were obtained from participants within the Australian Rural Mental Health Study, a longitudinal study of community residents within rural and remote New South Wales, Australia. SI was assessed using the Patient Health Questionnaire. In idual psychological factors, family and community characteristics were examined alongside personal social networks (Berkman Syme Social Network Index), availability of social support (Interview Schedule for Social Interaction) and perception of local community (Sense of Community Index). Thirteen hundred and fifty-six participants were included in the analysis (39% male, mean age 56.5 years). Sixty-one participants reported recent SI at baseline, while 57 reported SI at follow-up. Baseline SI was a strong predictor of SI at 12 months [odds ratio (OR) 19.0, 95% confidence interval (CI) 8.6-42.3) significant effects were also observed for baseline values of psychological distress (OR 1.4, 95% CI 1.0-1.9) and availability of social support (OR 0.76, 95% 0.58-1.0) on 12-month SI. The emergence of SI at 12-month follow-up was predicted by higher psychological distress (OR 1.8, 95% CI 1.3-2.4) there was a marginal effect of lower availability of support (OR 0.74, 95% CI 0.55-1.0) neither of these variables predicted SI resolution. This study investigated factors associated with SI over a 12-month period in a rural cohort. After controlling for known risk factors for SI, low availability of social support at baseline was associated with greater likelihood of SI at 12-month follow-up.
The Impact of Tobacco Smoking on Treatment for Comorbid Depression and Alcohol Misuse
Publisher: Springer Science and Business Media LLC
Date: 26-04-2013
Therapeutic Alliance, Client Need for Approval, and Perfectionism as Differential Moderators of Response to eHealth and Traditionally Delivered Treatments for Comorbid Depression and Substance Use Problems
Publisher: Springer Science and Business Media LLC
Date: 17-08-2017
DOI: 10.1007/S12529-017-9676-X
Abstract: This study sought to undertake an exploratory analysis of the impact of therapeutic alliance and dysfunctional attitudes (perfectionism and need for approval) on outcomes for participants receiving therapist-delivered and eHealth interventions for comorbid depression and alcohol/cannabis use problems. These factors have been shown in previous research to moderate response to psychological treatment for depression and related disorders. Participants (N = 274) with concurrent depression and alcohol/cannabis misuse were randomized to 10 sessions of therapist-delivered cognitive behavior therapy/motivational interviewing (CBT/MI), computer-delivered CBT/MI with brief therapist assistance (SHADE CBT/MI), or supportive counseling (PCT). Follow-up occurred at 3, 6, and 12 months post-baseline. Exploratory moderator analyses examined changes in depression, alcohol use, and cannabis use over the 3-12-month follow-up timepoints, adjusting for baseline, as a function of treatment allocation, and the hypothesized moderators of therapeutic alliance, perfectionism, and need for approval. The s le size and number of comparisons in the analysis mean that the results are considered preliminary and need replication in larger trials. The analysis revealed that "client initiative," a subscale of therapeutic alliance, moderated change in depression scores between 3- and 12-month follow-up for the PCT group, with higher scores associated with decreases in depression over time. Higher therapeutic "bond" early in treatment for SHADE CBT/MI participants was associated with reduced cannabis use over time. Participants with higher "perfectionism" scores at baseline who received therapist CBT/MI reported increases in depression over the follow-up period, but reductions in depression if they received SHADE CBT/MI. Therapist CBT/MI participants high on "need for approval" at baseline reported better alcohol use outcomes over time. The preliminary nature of these results do not justify firm conclusions. However, the specific variables of perfectionism, need for approval, and client initiative show promise as moderators of treatment efficacy for comorbid depression and alcohol/cannabis use problems. Further research is justified to determine whether these factors can assist in tailoring the modality and strategies offered in the delivery of psychotherapy to this population.
Prevalence of the Long-Allele Genotype of the Serotonin Transporter-Linked Gene in Female Centenarians
Publisher: Wiley
Date: 09-2012
Smartphone Apps About Crystal Methamphetamine (“Ice”): Systematic Search in App Stores and Assessment of Composition and Quality
Publisher: JMIR Publications Inc.
Date: 21-11-2018
DOI: 10.2196/10442
A Brief Intervention to Increase Uptake and Adherence of an Internet-Based Program for Depression and Anxiety (Enhancing Engagement With Psychosocial Interventions): Randomized Controlled Trial (Prepr
Publisher: JMIR Publications Inc.
Date: 30-07-2020
Abstract: sychosocial, self-guided, internet-based programs are effective in treating depression and anxiety. However, the community uptake of these programs is poor. Recent approaches to increasing engagement (defined as both uptake and adherence) in internet-based programs include brief engagement facilitation interventions (EFIs). However, these programs require evaluation to assess their efficacy. he aims of this hybrid implementation effectiveness trial are to examine the effects of a brief internet-based EFI presented before an internet-based cognitive behavioral therapy self-help program ( i myCompass 2 /i ) in improving engagement (uptake and adherence) with that program (primary aim), assess the relative efficacy of the i myCompass 2 /i program, and determine whether greater engagement was associated with improved efficacy (greater reduction in depression or anxiety symptoms) relative to the control (secondary aim). 3-arm randomized controlled trial (N=849 recruited via social media) assessed the independent efficacy of the EFI and i myCompass 2 /i . The i myCompass 2 /i program was delivered with or without the EFI both conditions were compared with an attention control condition. The EFI comprised brief (5 minutes), tailored audio-visual content on a series of click-through linear webpages. ptake was high in all groups 82.8% (703/849) of participants clicked through the intervention following the pretest survey. However, the difference in uptake between the EFI + i myCompass 2 /i condition (234/280, 83.6%) and the i myCompass 2 /i alone condition (222/285, 77.9%) was not significant (n=565 i χ /i sup /sup sub /sub =29.2 i P= /i .09). In addition, there was no significant difference in the proportion of participants who started any number of modules (1-14 modules) versus those who started none between the EFI + i myCompass 2 /i (214/565, 37.9%) and the i myCompass 2 /i alone (210/565, 37.2%) conditions (n=565 i χ /i sup /sup sub /sub .1 i P= /i .87). Finally, there was no significant difference between the EFI + i myCompass 2 /i and the i myCompass 2 /i alone conditions in the number of modules started ( i U /i =39366.50 i z /i =−0.32 i P= /i .75) or completed ( i U /i =39494.0 i z /i =−0.29 i P= /i .77). The i myCompass 2 /i program was not found to be efficacious over time for symptoms of depression ( i F /i sub ,349.97 /sub =1.16 i P= /i .33) or anxiety ( i F /i sub ,445.99 /sub =0.12 i P= /i .98). However, planned contrasts suggested that i myCompass 2 /i may have been effective for participants with elevated generalized anxiety disorder symptoms ( i F /i sub ,332.80 /sub =3.50 i P= /i .01). his brief internet-based EFI did not increase the uptake of or adherence to an existing internet-based program for depression and anxiety. In iduals’ motivation to initiate and complete internet-based self-guided interventions is complex and remains a significant challenge for self-guided interventions. ustralian New Zealand Clinical Trials Registry ACTRN12618001565235 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375839
Study protocol: a dissemination trial of computerized psychological treatment for depression and alcohol/other drug use comorbidity in an Australian clinical service
Publisher: Springer Science and Business Media LLC
Date: 07-07-2012
Risky Drinking Patterns Are Being Continued into Pregnancy: A Prospective Cohort Study
Publisher: Public Library of Science (PLoS)
Date: 15-01-2014
Healthy lifestyle intervention for people with severe mental disorders
Publisher: Informa UK Limited
Date: 05-2011
To enforce or engage: The relationship between coercion, treatment motivation and therapeutic alliance within community-based drug and alcohol clients
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.ADDBEH.2013.01.017
Abstract: Three fundamental clinical issues are consistently associated with treatment engagement and outcomes in substance using populations coercion, motivation and therapeutic alliance. It is accepted that these factors play an integral role in the success of substance use treatment and particularly that higher motivation and therapeutic alliance are advantageous to treatment outcomes. The impact of coercion on engagement and treatment outcome, on the other hand, is less clear, and the relationship between these three issues has not been adequately explored. The current study aimed to address this gap, by examining the presenting characteristics of clients attending a community drug and alcohol counselling service in relation to coercion, motivation, therapeutic alliance and substance use, as well as the effect that these variables had on treatment outcomes 15 weeks later. A total of 77 clients recruited from the Central Coast Drug and Alcohol Service participated in the study, completing a phone assessment upon treatment entry and 15 weeks post-baseline. Results indicated that facets of motivation and therapeutic alliance played a significant role in client's substance use upon presentation for treatment, although coercion did not. Coercion was not associated with substance use outcomes at 15 week follow up. However, due to a relatively small s le completing post-baseline assessments (n=33), further research is needed to examine the predictive effects of these variables in community drug and alcohol clients.
Determinants of pregnant women's compliance with alcohol guidelines: a prospective cohort study
Publisher: Springer Science and Business Media LLC
Date: 13-09-2012
Supporting friends and family of adults with a primary brain tumour: A systematic review
Publisher: Hindawi Limited
Date: 11-10-2022
DOI: 10.1111/HSC.13586
Impact of a self-guided, eHealth program targeting weight loss and depression in men: A randomized trial.
Publisher: American Psychological Association (APA)
Date: 08-2021
DOI: 10.1037/CCP0000671
Optimizing Engagement in an Online Dietary Intervention for Depression (My Food & Mood Version 3.0): Cohort Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 08-10-2020
Abstract: nline interventions can be a cost-effective and efficient way to deliver programs to large numbers of people regardless of geographic location. However, attrition in web-based interventions is often an issue. Developing ways to keep participants engaged is important for ensuring validity and limiting potential biases. We developed a web-based dietary intervention as part of The My Food & Mood study which aimed to optimize ways to engage participants with low mood or depressive symptoms to promote dietary behavior change. Different versions of the My Food & Mood program were tested during optimization. Iterations were developed based on user feedback and usage analysis. he purpose of this study was to compare engagement and nonusage attrition across 4 program iterations—which differed by platform format, delivery mode, and activity type—to create an optimized version. ach program version contained modular videos with key activities with respect to implementing behavior change techniques of equivalent levels of required participation and length: version 1.0, desktop program and smartphone app version 2.1, desktop or smartphone program version 2.2, desktop program and version 3.0, smartphone app. Adults with PHQ-8 scores of 5 or greater were recruited online and assigned to 1 of the 4 versions. Participants were asked to use the program for 8 weeks and complete measures at weeks 4 and 8. Engagement data were collected from the web-based platform system logs and customized reports. Cox regression survival analysis examined nonusage attrition and Kruskal-Wallis tests compared engagement across each cohort. total of 614 adults participated. Kruskal-Wallis tests showed significant differences across the 4 cohorts in all engagement measures. The smartphone app (version 3.0) had the greatest engagement as measured by weeks engaged, total usage time, total time key activities, number of active sessions, percentage of activities completed against protocol, goals completed, and percentage of videos watched. Cox regression multivariate survival analysis showed referral from a health practitioner (hazard ratio [HR] 0.344, i P /i =.001) and greater proficiency with computers (HR 0.796, i P /i =.049) reduced the risk of nonusage attrition. Computer confidence was associated with an increased risk of nonusage attrition. y Food & Mood version 3.0, a dietary intervention delivered via smartphone app with self-monitoring tools for diet quality and mood monitoring, was the version with greatest engagement in a population with low mood or depression. The iterative design techniques employed and analysis of feedback from participants resulted in a program that achieved lower rates of nonusage attrition and higher rates of intensity of use.
Factors Predicting Trial Engagement, Treatment Satisfaction, and Health-Related Quality of Life During a Web-Based Treatment and Social Networking Trial for Binge Drinking and Depression in Young Adul
Publisher: JMIR Publications Inc.
Date: 07-06-2021
DOI: 10.2196/23986
Abstract: Mental health and alcohol use problems are among the most common causes of disease burden in young Australians, frequently co-occur (comorbidity), and lead to significant lifetime burden. However, comorbidities remain significantly underdetected and undertreated in health settings. Digital mental health tools designed to identify at-risk in iduals, encourage help-seeking, or deliver treatment for comorbidity have the potential to address this service gap. However, despite a strong body of evidence that digital mental health programs provide an effective treatment option for a range of mental health and alcohol use problems in young adults, research shows that uptake rates can be low. Thus, it is important to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e–mental health interventions for comorbidity. In this study, we seek to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e–mental health interventions for comorbid alcohol and mood disorders. The aim is to determine the importance of personality (ie, Big Five personality traits and intervention attitudes), affective factors (ie, depression, anxiety, and stress levels), and baseline alcohol consumption in predicting intervention trial engagement at sign-up, satisfaction with the online tool, and quality of life at the end of the iTreAD (Internet Treatment for Alcohol and Depression) trial. Australian adults (N=411) aged between 18 and 30 years who screened positive for depression and alcohol use problems signed up for the iTreAD project between August 2014 and October 2015. During registration, participants provided information about their personality, current affective state, alcohol use, treatment expectations, and basic demographic information. Subsequent follow-up surveys were used to gauge the ongoing trial engagement. The last follow-up questionnaire, completed at 64 weeks, assessed participants’ satisfaction with web-based treatment and quality-of-life outcomes. Multiple linear regression analyses were used to assess the relative influence of predictor variables on trial engagement, treatment satisfaction, and quality-of-life outcomes. The analyses revealed that the overall predictive effects of personality and affective factors were 20% or lower. Neuroticism constituted a unique predictor of engagement with the iTreAD study in that neuroticism facilitated the return of web-based self-assessments during the study. The return of incentivized follow-up assessments predicted treatment satisfaction, and state-based depression predicted variance in quality-of-life reports at study completion. Our findings suggest that traditional predictors of engagement observed in face-to-face research may not be easily transferable to digital health interventions, particularly those aimed at comorbid mental health concerns and alcohol misuse among young adults. More research is needed to identify what determines engagement in this population to optimally design and execute digital intervention studies with multiple treatment aims. Australian New Zealand Clinical Trials Registry (ACTRN): 12614000310662 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365137& isReview=true. RR2-10.1186/s12889-015-2365-2
Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: A randomized controlled trial of clinical efficacy
Publisher: Wiley
Date: 06-02-2009
DOI: 10.1111/J.1360-0443.2008.02444.X
Abstract: To evaluate computer- versus therapist-delivered psychological treatment for people with comorbid depression and alcohol/cannabis use problems. Randomized controlled trial. Community-based participants in the Hunter Region of New South Wales, Australia. Ninety-seven people with comorbid major depression and alcohol/cannabis misuse. All participants received a brief intervention (BI) for depressive symptoms and substance misuse, followed by random assignment to: no further treatment (BI alone) or nine sessions of motivational interviewing and cognitive behaviour therapy (intensive MI/CBT). Participants allocated to the intensive MI/CBT condition were selected at random to receive their treatment 'live' (i.e. delivered by a psychologist) or via a computer-based program (with brief weekly input from a psychologist). Depression, alcohol/cannabis use and hazardous substance use index scores measured at baseline, and 3, 6 and 12 months post-baseline assessment. (i) Depression responded better to intensive MI/CBT compared to BI alone, with 'live' treatment demonstrating a strong short-term beneficial effect which was matched by computer-based treatment at 12-month follow-up (ii) problematic alcohol use responded well to BI alone and even better to the intensive MI/CBT intervention (iii) intensive MI/CBT was significantly better than BI alone in reducing cannabis use and hazardous substance use, with computer-based therapy showing the largest treatment effect. Computer-based treatment, targeting both depression and substance use simultaneously, results in at least equivalent 12-month outcomes relative to a 'live' intervention. For clinicians treating people with comorbid depression and alcohol problems, BIs addressing both issues appear to be an appropriate and efficacious treatment option. Primary care of those with comorbid depression and cannabis use problems could involve computer-based integrated interventions for depression and cannabis use, with brief regular contact with the clinician to check on progress.
Theories Informing eHealth Implementation: Systematic Review and Typology Classification
Publisher: JMIR Publications Inc.
Date: 31-05-2021
DOI: 10.2196/18500
Abstract: Theory-guided approaches to implementation science have informed translation efforts and the acceptance of eHealth (digital health) interventions in clinical care. However, there is scarce evidence on which theories are best suited to addressing the inherent complexity of eHealth implementation. The objectives of this systematic review are to identify theories that inform and explain eHealth implementation and to classify these theories using the typology by Sovacool and Hess for theories of sociotechnical change. An electronic search was conducted in the PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Sociological Source Ultimate, Web of Science, ABI/INFORM, EBSCO, and ProQuest databases in June 2019. Studies were included if they were published between 2009 and June 2019 were written in English reported on empirical research, regardless of study or publication type reported on one or more theories in the context of eHealth implementation and were published in a peer-reviewed journal. A total of 2 reviewers independently assessed the titles, abstracts, and full texts. Theories identified were classified using a typology for theories of sociotechnical change, which was considered a useful tool for ordering and analyzing the erse theoretical approaches as a basis for future theory building. Of the 13,101 potentially relevant titles, 119 studies were included. The review identified 36 theories used to explain implementation approaches in eHealth. The most commonly used approaches were the Technology Acceptance Model (TAM) (n=33) and the Unified Theory of Acceptance and Use of Technology (UTAUT) (n=32). These theories were primarily concerned with in idual and interpersonal elements of eHealth acceptance. Less common were theories that reflect the various disorderly social processes and structural dimensions of implementation, such as the normalization process theory (n=17) and the structuration theory (n=6). Theories currently informing the implementation of eHealth interventions predominantly focus on predicting or explaining end-user acceptance. Theoretical perspectives that capture the dense and intricate relationships and structures required to enact sustainable change are less well represented in the eHealth literature. Given the growing acknowledgment of the inherent complexity of eHealth implementation, future research should develop and test models that recognize and reflect the multidimensional, dynamic, and relational nature of this process.
Internet-Delivered Tobacco Treatment for People Using Cannabis: A Randomized Trial in Two Australian Cannabis Clinics (Preprint)
Publisher: JMIR Publications Inc.
Date: 11-04-2019
Abstract: obacco use is disproportionately higher in people who smoke cannabis than in the general population, increasing the severity of dependence for cannabis use, decreasing the likelihood of successful quit attempts for both cannabis and tobacco, and increasing the risk of relapse for both substances. Opportunities to address tobacco use in people using cannabis are being missed. his study aims to investigate the feasibility of engaging tobacco smokers who were accessing treatment for cannabis, with a tobacco-focused i i /i nternet-based i He /i althy i L /i ifestyle i P /i rogram (iHeLP 4 modules). It was hypothesized that iHeLP completion would be associated with decreases in tobacco use and improved quality of life (QoL) and psychological health. It was also hypothesized that iHeLP completion would be higher in those who additionally received telephone support. Given that iHeLP aimed to improve healthy lifestyle behaviors, it was also hypothesized that there would be reductions in cannabis use. total of 13 smokers seeking treatment for cannabis use were randomly allocated to iHeLP alone or iHeLP plus telephone support. Participants were engaged in iHeLP over 8 weeks and completed a 12-week follow-up assessment. esults from 10 participants who completed the follow-up indicated that the acceptability of iHeLP was high-very high in terms of general satisfaction, appropriateness of services, effectiveness, and met need. Additional telephone support increased modal module completion rates for iHeLP from 0 to 2 but did not provide any other significant advantages over iHeLP alone in terms of cannabis use, tobacco use, QoL, or psychological health. Participants in the iHeLP-alone condition (n=4) reported a mean reduction of 5.5 (SD 9.00) tobacco cigarettes per day between baseline and follow-up, with a concomitant mean reduction in expired carbon monoxide (CO) of 5.5 parts per million (ppm, SD 6.91). The iHeLP plus telephone support group (n=6) reported a mean reduction of 1.13 (SD 4.88) tobacco cigarettes per day and a mean reduction of 9.337 ppm of expired CO (SD 5.65). A urinalysis indicated that abstinence from cannabis was achieved by 2 participants in the iHeLP-alone group and three participants in the iHeLP plus telephone support group. Between baseline and follow-up assessments, iHeLP-alone participants reported a mean reduction in days of use of cannabis in the prior month of 6.17 days (SD 13.30). The average reduction in the number of days of cannabis use for the iHeLP plus telephone support group was also 6.17 days (SD 13.59). espite the small s le size, this study provides preliminary support for the use of internet-delivered, tobacco-focused interventions in tobacco smokers seeking treatment for cannabis use.
Consumer-Guided Development of an Engagement-Facilitation Intervention for Increasing Uptake and Adherence for Self-Guided Web-Based Mental Health Programs: Focus Groups and Online Evaluation Survey (
Publisher: JMIR Publications Inc.
Date: 15-07-2020
Abstract: elf-guided web-based mental health programs are effective in treating and preventing mental health problems. However, current engagement with these programs in the community is suboptimal, and there is limited evidence indicating how to increase the use of existing evidence-based programs. his study aims to investigate the views of people with lived experience of depression and anxiety on factors influencing their engagement with self-guided web-based mental health (e–mental health) programs and to use these perspectives to develop an engagement-facilitation intervention (EFI) to increase engagement (defined as both uptake and adherence) with these programs. total of 24 community members (female=21 male=3) with lived experience of depression and anxiety or depression or anxiety alone participated in 1 of 4 focus groups discussing the factors influencing their engagement with self-guided e–mental health programs and the appearance, delivery mode, and functionality of content for the proposed EFI. A subsequent evaluation survey of the focus group participants (n=14) was conducted to evaluate the resultant draft EFI. Data were thematically analyzed using both inductive and deductive qualitative methods. articipants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement, including receiving personalized symptom feedback, information regarding the program’s content or effectiveness and data security, and normalization of using e–mental health programs (eg, testimonials). Reminders, rewards, feedback about progress, and coaching were all mentioned as facilitating adherence. FIs have the potential to improve community uptake of e–mental health programs. They should focus on providing information on the content and effectiveness of e–mental health programs and normalizing their use. Given that the s le comprised predominantly young females, this study may not be generalizable to other population groups. There is a strong value in involving people with a lived experience in the design and development of EFIs to maximize their effectiveness.
Study protocol: a randomised controlled trial investigating the effect of a healthy lifestyle intervention for people with severe mental disorders
Publisher: Springer Science and Business Media LLC
Date: 05-01-2011
Acceptability of a clinician-assisted computerized psychological intervention for comorbid mental health and substance use problems: Treatment adherence data from a randomized controlled trial
Publisher: JMIR Publications Inc.
Date: 27-01-2011
DOI: 10.2196/JMIR.1522
A Multiple Health Behavior Change, Self-Monitoring Mobile App for Adolescents: Development and Usability Study of the Health4Life App (Preprint)
Publisher: JMIR Publications Inc.
Date: 04-11-2020
Abstract: he link between chronic diseases and the Big 6 lifestyle risk behaviors (ie, poor diet, physical inactivity, smoking, alcohol use, sedentary recreational screen time, and poor sleep) is well established. It is critical to target these lifestyle risk behaviors, as they often co-occur and emerge in adolescence. Smartphones have become an integral part of everyday life, and many adolescents already use mobile apps to monitor their lifestyle behaviors and improve their health. Smartphones may be a valuable platform for engaging adolescents with interventions to prevent key chronic disease risk behaviors. he aim of this paper is to describe the development, usability, and acceptability of the Health4Life app, a self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors. he development of the Health4Life app was an iterative process conducted in collaboration with adolescents and experts. The development process consisted of three stages: scoping the literature end user consultations, which included a web-based survey (N=815 mean age 13.89, SD 0.89 years) and a focus group (N=12) among adolescents and app development and beta testing. Following this development work, 232 adolescents were asked to rate the usability and acceptability of the app. he process resulted in a self-monitoring smartphone app that allows adolescent users to track and set goals for the Big 6 health behaviors, using in-app rewards and notifications to enhance engagement. The overall adolescent feedback was positive in terms of user-friendly design, content, relevance, and helpfulness. Commonly identified areas for improvement were to increase interactive features and display recorded health behaviors differently to improve interpretability. he Health4Life app is a co-designed, self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors. Adolescents rated the app as highly acceptable and usable. The app has the potential to efficiently and effectively modify important risk factors for chronic disease among young people and is currently being evaluated in a world-first trial of 6640 secondary school students in 71 schools across Australia. >
An Online Intervention for Co-Occurring Depression and Problematic Alcohol Use in Young People: Primary Outcomes From a Randomized Controlled Trial
Publisher: JMIR Publications Inc.
Date: 23-03-2016
DOI: 10.2196/JMIR.5178
Understanding ambivalence in help-seeking for suicidal people with comorbid depression and alcohol misuse
Publisher: Public Library of Science (PLoS)
Date: 17-04-2020
An Evaluation of a SVA Retrotransposon in the FUS Promoter as a Transcriptional Regulator and Its Association to ALS
Publisher: Public Library of Science (PLoS)
Date: 07-03-2014
Men’s Perceptions of a Gender-Tailored eHealth Program Targeting Physical and Mental Health: Qualitative Findings from the SHED-IT Recharge Trial
Publisher: MDPI AG
Date: 07-12-2021
Abstract: Despite increasing rates of co-morbid depression and obesity, few interventions target both conditions simultaneously, particularly in men. The SHED-IT: Recharge trial, conducted in 125 men with depressive symptoms and overweight or obesity, tested the efficacy of a gender-tailored eHealth program with integrated mental health support. The aims of this study were to examine the perceptions of men who received the SHED-IT: Recharge intervention in relation to recruitment, satisfaction with the program, and suggestions to improve the program. In idual semi-structured interviews were conducted in a random sub-s le, stratified by baseline depression and weight status (n = 19, mean (SD) age 49.6 years (11.6), PHQ−9 score 9.0 (3.7), BMI 32.5 kg/m2 (4.6)). Transcripts were analyzed using an inductive process by an independent qualitative researcher. Four themes emerged, namely, (i) specific circumstances determined men’s motivation to enroll, (ii) unique opportunity to implement sustained physical and mental health changes compared to previous experiences, (iii) salience of the program elements, and (iv) further opportunities that build accountability could help maintain focus. Gender-tailored, self-directed lifestyle interventions incorporating mental health support are acceptable and satisfying for men experiencing depressive symptoms. These findings provide important insights for future self-guided lifestyle interventions for men with poor physical and mental health.
The feasibility and acceptability of a brief intervention for clients of substance use services experiencing symptoms of post traumatic stress disorder
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.ADDBEH.2014.03.013
Abstract: Trauma exposure and post traumatic stress disorder (PTSD) are common among clients of substance use services. Existing treatments for these co-occurring conditions tend to be lengthy, treatment retention is relatively poor, and they require extensive training and clinical supervision. The aim of the present study was to conduct a preliminary examination of the feasibility and acceptability of a brief intervention for PTSD symptoms among in iduals seeking substance use treatment. An uncontrolled open-label pilot study was conducted among 29 inpatients of a medicated detoxification unit in Sydney, Australia. All participants completed a baseline interview followed by the brief intervention. The intervention consists of a single, one-hour manualised session providing psychoeducation pertaining to common trauma reactions and symptom management. PTSD and substance use outcomes were assessed at 1-week, 1-month and 3-month post-intervention. PTSD symptom severity (assessed using the Clinicians Administered PTSD Scale) decreased significantly from baseline to 1-week follow up (β -10.87, 95%CI: -19.75 to -1.99) and again between the 1-week and 3-month follow-ups (β -15.38, 95%CI: -23.20 to -7.57). Despite these reductions, the majority of participants continued to meet criteria for a diagnosis of PTSD and there was no change in participants' negative post-traumatic cognitions. Participants expressed high levels of satisfaction with the intervention. Brief psychoeducation for traumatised clients attending substance use services appears to be feasible, acceptable, and may be of some benefit in reducing PTSD symptoms. However, participants continued to experience symptoms at severe levels thus, brief intervention may best be conceptualised as a "stepping stone" to further trauma treatment.
When less is more: Addressing symptoms of mental health problems in drug and alcohol treatment settings
Publisher: Informa UK Limited
Date: 06-2009
A Mobile App to Provide Evidence-Based Information About Crystal Methamphetamine (Ice) to the Community (Cracks in the Ice): Co-Design and Beta Testing (Preprint)
Publisher: JMIR Publications Inc.
Date: 21-05-2018
Abstract: espite evidence of increasing harms and community concern related to the drug crystal meth hetamine (“ice”), there is a lack of easily accessible, evidence-based information for community members affected by its use, and to date, no evidence-based mobile apps have specifically focused on crystal meth hetamine. his study aims to describe the co-design and beta testing of a mobile app to provide evidence-based, up-to-date information about crystal meth hetamine to the general community. mobile app about crystal meth hetamine was developed in 2017. The development process involved multiple stakeholders (n=12), including technology and drug and alcohol experts, researchers, app developers, a consumer expert with lived experience, and community members. Beta testing was conducted with Australian general community members (n=34), largely recruited by the Web through Facebook advertising. Participants were invited to use a beta version of the app and provide feedback about the content, visual appeal, usability, engagement, features, and functions. In addition, participants were asked about their perceptions of the app’s influence on awareness, understanding, and help-seeking behavior related to crystal meth hetamine, and about their knowledge about crystal meth hetamine before and after using the app. he vast majority of participants reported the app was likely to increase awareness and understanding and encourage help-seeking. The app received positive ratings overall and was well received. Specifically, participants responded positively to the high-quality information provided, usability, and visual appeal. Areas suggested for improvement included reducing the amount of text, increasing engagement, removing a profile picture, and improving navigation through the addition of a “back” button. Suggested improvements were incorporated prior to the app’s public release. App use was associated with an increase in perceived knowledge about crystal meth hetamine however, this result was not statistically significant. he Cracks in the Ice mobile app provides evidence-based information about the drug crystal meth hetamine for the general community. The app is regularly updated, available via the Web and offline, and was developed in collaboration with experts and end users. Initial results indicate that it is easy to use and acceptable to the target group.
The long and the short of treatments for alcohol or cannabis misuse among people with severe mental disorders
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.ADDBEH.2009.02.002
Abstract: Substance misuse among people with severe mental disorders is very common and has been associated with a number of adverse outcomes. Most trials among people with severe mental disorders have reported general substance misuse outcomes and have argued that longer treatments are likely to be more effective. Such studies have not specifically compared intervention effectiveness for alcohol vs. cannabis misuse. The present paper reports findings from a synthesis of datasets from three randomized controlled trials (N=248) comparing brief (1-session advice or motivational interviewing, MI) and extended (10 sessions MI/cognitive-behaviour therapy CBT) interventions for substance misuse among people with psychosis or major depression and outcomes are reported separately for alcohol and cannabis use. Whilst there were comparable rates of reduction in alcohol consumption for the BI and intensive MI/CBT, BI tended to be associated with less reduction in cannabis use. A stepped care approach for substance misuse in people with severe mental disorders may help to improve cannabis outcomes, including monitoring of both mental health and substance misuse domains, with interventions stepped up or down according to treatment response. Future studies should evaluate the effectiveness of stepped care approaches.
A Mobile Phone–Based Healthy Lifestyle Monitoring Tool for People With Mental Health Problems (MyHealthPA): Development and Pilot Testing
Publisher: JMIR Publications Inc.
Date: 04-10-2018
DOI: 10.2196/10228
An improved brief measure of cannabis misuse: the Cannabis Use Disorders Identification Test-Revised (CUDIT-R).
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.DRUGALCDEP.2010.02.017
Abstract: Cannabis is widely used and significant problems are associated with heavier consumption. When a cannabis misuse screening tool, the CUDIT, was originally published it was noted that although it performed well there was concern about in idual items. 144 patients enrolled in a clinical trial for concurrent depression and substance misuse were administered an expanded CUDIT, containing the original 10 items and 11 candidate replacement items. All patients were assessed for a current cannabis use disorder with the SCID. A revised CUDIT-R was developed containing 8 items, two each from the domains of consumption, cannabis problems (abuse), dependence, and psychological features. Although the psychometric adequacy of the original CUDIT was confirmed, the CUDIT-R was shorter and had equivalent or superior psychometric properties. High sensitivity (91%) and specificity (90%) were achieved. The 8-item CUDIT-R has improved performance over the original scale and appears well suited to the task of screening for problematic cannabis use. It may also have potential as a brief routine outcome measure.
Substance Use and Mood Disorders
Publisher: Elsevier
Date: 2013
Prevalence of smoking and other health risk factors in people attending residential substance abuse treatment
Publisher: Wiley
Date: 30-05-2012
DOI: 10.1111/J.1465-3362.2012.00465.X
Abstract: People attending substance abuse treatment have an elevated risk of developing cardiovascular disease (CVD) and cancer. Consequently, there have been increasing calls for substance abuse treatment services to address smoking. The current study examined smoking behaviours of people attending residential substance abuse treatment. Additionally, the study examined rates of other potentially modifiable health risk factors for the development of CVD and cancer. A cross-sectional survey was completed by participants attending Australian Salvation Army residential substance abuse treatment services (n = 228). Rates of smoking, exercise, dietary fat intake, body mass index and depression were identified and compared with representative community populations. The relationship between length of treatment and changes in these variables was also examined. When compared with the Australian population, participants were much more likely to be current smokers. They also showed higher rates of dietary fat intake, and having had a previous diagnosis of a depressive disorder. Encouragingly, participants were more likely to be engaging in regular exercise. Over a third of all smokers reported having increased their smoking since attending the residential program, with correlational analysis suggesting that nicotine dependence was increasing the longer participants were in treatment. People attending substance abuse treatment show extremely high rates of smoking (77%). With the large majority of participants showing multiple risk factors for CVD, it is important that residential services consider strategies to address smoking and the other potentially modifiable health risk factors in an integrated fashion.
Evaluating a Brief, Internet-Based Intervention for Co-Occurring Depression and Problematic Alcohol Use in Young People: Protocol for a Randomized Controlled Trial
Publisher: JMIR Publications Inc.
Date: 27-02-2014
DOI: 10.2196/RESPROT.3192
Online alcohol interventions: A systematic review
Publisher: JMIR Publications Inc.
Date: 19-12-2010
DOI: 10.2196/JMIR.1479
A systematic review of concussion in rugby league
Publisher: BMJ
Date: 10-04-2014
DOI: 10.1136/BJSPORTS-2013-093102
Abstract: Concussion remains one of the inherent risks of participation in rugby league. While other injuries incurred by rugby league players have been well studied, less focus and attention has been directed towards concussion. The current review examined all articles published in English from 1900 up to June 2013 pertaining to concussion in rugby league players. Publications were retrieved via six databases using the key search terms: rugby league, league, football in combination with injury terms: athletic injuries, concussion, sports concussion, sports-related concussion, brain concussion, brain injury, brain injuries, mild traumatic brain injury, mTBI, traumatic brain injury, TBI, craniocerebral trauma, head injury and brain damage. Observational, cohort, correlational, cross-sectional and longitudinal studies were all included. 199 rugby league injury publications were identified. 39 (20%) were related in some way to concussion. Of the 39 identified articles, 6 (15%) had the main aim of evaluating concussion, while the other 33 reported on concussion incidence as part of overall injury data analyses. Rugby league concussion incidence rates vary widely from 0.0 to 40.0/1000 playing hours, depending on the definition of injury (time loss vs no time loss). The incidence rates vary across match play versus training session, seasons (winter vs summer) and playing position (forwards vs backs). The ball carrier has been found to be at greater risk for injury than tacklers. Concussion accounts for 29% of all injuries associated with illegal play, but only 9% of injuries sustained in legal play. In comparison with other collision sports, research evaluating concussion in rugby league is limited. With such limited published rugby league data, there are many aspects of concussion that require attention, and future research may be directed towards these unanswered questions.
A Web-Based Intervention for Users of Amphetamine-Type Stimulants: 3-Month Outcomes of a Randomized Controlled Trial
Publisher: JMIR Publications Inc.
Date: 11-09-2014
DOI: 10.2196/MENTAL.3278
Abstract: Among illicit drugs, the prevalence of hetamine-type stimulant (ATS) use is second only to cannabis. Currently, there are no approved pharmacotherapies for ATS problems, but some face-to-face psychotherapies are effective. Web-based interventions have proven to be effective for some substance use problems, but none has specifically targeted ATS users. The objective of the study was to evaluate the effectiveness of a Web-based intervention for ATS problems on a free-to-access site compared with a waitlist control group. We used a randomized controlled trial design. The primary outcome measure was self-reported ATS use in the past three months assessed using the Alcohol, Smoking, Substance Involvement Screening Test (ASSIST). Other measures included quality of life (EUROHIS score), psychological distress (K-10 score), days out of role, poly-drug use, general help-seeking intentions, actual help-seeking, and “readiness to change”. The intervention consisted of three fully automated, self-guided modules based on cognitive behavioral therapy and motivation enhancement. The analysis was an intention-to-treat analysis using generalized estimating equation models, with a group by time interaction as the critical assessment. We randomized 160 people (intervention n=81, control n=79). At three months, 35/81 (43%) intervention and 45/79 (57%) control participants provided follow-up data. In the intervention group, 51/81 (63%) completed at least one module. The only significant group by time interaction was for days out of role. The pre ost change effect sizes showed small changes (range d=0.14 to 0.40) favoring the intervention group for poly-drug use, distress, actual help-seeking, and days out of role. In contrast, the control group was favored by reductions in ATS use, improvements in quality of life, and increases in help-seeking intentions (range d=0.09 to 0.16). This Web-based intervention for ATS use produced few significant changes in outcome measures. There were moderate, but nonsignificant reductions in poly-drug use, distress, days partially out of role, and increases in help-seeking. However, high levels of participant attrition, plus low levels of engagement with the modules, preclude firm conclusions being drawn on the efficacy of the intervention and emphasize the problems of engaging this group of clients in a fully automated program. Australian and New Zealand Clinical Trials Registry: ACTRN 12611000947909 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000947909 (Archived by WebCite at SHTxEnzP).
“You need someone steering the ship for you”: Australian brain tumour care coordination needs, practices, and opportunities.
Publisher: Research Square Platform LLC
Date: 22-11-2022
DOI: 10.21203/RS.3.RS-2298960/V1
Abstract: Objective In Australia, care coordination has not been widely adopted in neuro-oncology services and there is a dearth of empirical evidence about routine care coordinator practices with brain tumour (BT) patients and their caregivers. In this study, we explored how neuro-oncology service models can best promote personalised, flexible interventions, and how BT care coordination can be effectively integrated within Australian health care services. Methods We used a qualitative approach, conducting semi-structured interviews with 21 informal brain tumour caregivers and 11 multidisciplinary health and social care professionals. Results Three main themes were developed: i) “No-one’s really on your team”: Need for patient-and family-centred care, partnership, and support ii) “You need someone steering the ship for you”: Navigating complexity and guiding the whole family and iii) “Good, shared decision-making communication improves patient outcomes every time”: Future opportunities and modifiable factors. Conclusion Care coordination can improve the responsiveness of BT care and increase the accessibility of already-existing services. However, many families do not have access to a central coordinating figure. Since BT care coordination is an emerging subspecialty in Australia, it is critical that neuro-oncology services review and evaluate these positions to ensure that they are adequately integrated and supported.
Cigarette smoking and psychosis: Naturalistic follow up 4 years after an intervention trial
Publisher: SAGE Publications
Date: 04-2010
DOI: 10.3109/00048670903489841
Abstract: Objective: Cigarette smoking is very common among people with a psychotic disorder and is often not addressed by clinicians. Additionally, few studies have evaluated smoking interventions among this group. The present study reports findings from a naturalistic follow up 4 years after a smoking intervention trial. Method: Longer-term smoking, symptomatology and functioning were examined among 247 participants (recruited in Sydney and Newcastle, Australia) who initially attended a 1 year follow up of an eight-session in idually administered trial for regular smokers with a psychotic disorder. Variables profiled included continuous and point prevalence abstinence rates, smoking reduction status (no reduction, %, ≥50%, or abstinence) and changes in anxiety, depression and current functioning. Results: Two-thirds of those who completed the 1 year assessment were followed up at 4 years (164/247, 66.4%), of whom 79.2% reported maintenance or improvement in their smoking reduction status relative to 1 year. Abstinence at 1 year was significantly associated with 4 year point prevalence abstinence. Lengthy periods of abstinence were also evident among those reporting 4 year point prevalence abstinence or at least a 50% reduction. No baseline or intervention status variables predicted smoking status at 4 years. Symptomatology and functioning also improved between baseline and 4 years. Conclusions: Smokers with a psychotic disorder are capable of long-term change. It is recommended that clinicians address and monitor smoking during treatment of people with psychosis, emphasizing potential lifestyle and harm reduction benefits, with a view to eventual smoking cessation.
Evaluation of a Digital Health Initiative in Illicit Substance Use: Cross-sectional Survey Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 23-03-2021
Abstract: he i Cracks in the Ice /i (CITI) community toolkit was developed to provide evidence-based, up-to-date information and resources about crystal meth hetamine to Australians. Given the high rates of internet use in the community and the potential for misinformation, CITI has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal meth hetamine. his study aims to determine (1) whether the CITI toolkit is achieving its aim of disseminating evidence-based information and resources to people who use crystal meth hetamine, their family and friends, health professionals, and the general community and (2) examine the association between the use of CITI and the knowledge and attitudes about crystal meth hetamine. cross-sectional web-based survey, open to Australian residents (aged ≥18 years), was conducted from November 2018 to March 2019. People who had previously visited the website (referred to as “website visitors” in this study) and those who had not (“naïve”) were recruited. At baseline, knowledge, attitudes, and demographics were assessed. CITI website visitors then completed a series of site evaluation questions, including the System Usability Scale (SUS), and naïve participants were asked to undertake a guided site tour of a replicated version of the site before completing the evaluation questions and repeating knowledge and attitude scales. f a total 2108 participants, 564 (26.7%) reported lifetime use of crystal meth hetamine, 434 (20.6%) were family/friends, 288 (13.7%) were health professionals, and 822 (38.9%) were community members. The average SUS score was 73.49 (SD 13.30), indicating good site usability. Health professionals reported significantly higher SUS scores than community members ( i P /i =.02) and people who used crystal meth hetamine ( i P /i & .001). Website visitors had significantly higher baseline knowledge than naïve participants ( i P /i & .001). Among naïve participants, knowledge scores increased following exposure to the website (mean 15.2, SE 0.05) compared to baseline (mean 14.4, SE 0.05 i P /i & .001). The largest shifts in knowledge were observed for items related to prevalence, legal issues, and the effects of the drug. Stigmatizing attitude scores among the naïve group were significantly lower following exposure to CITI (mean 41.97, SE 0.21) compared to baseline (mean 44.3, SE 0.21 i P /i & .001). his study provides an innovative evaluation of a national eHealth resource. CITI is achieving its aim of disseminating evidence-based, nonstigmatizing, and useful information and resources about crystal meth hetamine to key end user groups and has received good usability scores across its target groups. Interaction with CITI led to immediate improvements in knowledge about crystal meth hetamine and a decrease in stigmatizing attitudes. CITI demonstrates the important role of digital information and support platforms for translating evidence into practice and improving knowledge and reducing stigma.
Study protocol: A randomized controlled trial of a computer-based depression and substance abuse intervention for people attending residential substance abuse treatment
Publisher: Springer Science and Business Media LLC
Date: 10-02-2012
Related Organisations
University Of Newcastle Centre For Brain And Mental Health Research
Location: Australia
Priority Research Centre For Translational Neuroscience And Mental Health
Location: Australia
Related Funding Activities
Special Research Initiatives - Grant ID: SR0354823
Start Date: 01-2004
End Date: 12-2003
Amount: $10,000.00
Funder: Australian Research Council
View Funded ActivityIndustrial Transformation Research Hubs - Grant ID: IH210100040
Start Date: 08-2022
End Date: 07-2027
Amount: $5,000,000.00
Funder: Australian Research Council
View Funded Activity