Rehabilitation of executive disorders after brain injury: Are interventions effective?

In this paper, the effectiveness of interventions for executive disorders was reviewed. The objective was to evaluate the internal and external validity of intervention studies. A total of 46 papers, describing 54 studies, conducted in the last two decades meeting several preset inclusion criteria, was included in this review. The studies were categorized into three treatment approaches in order to enhance comparability. The overall results show that many interventions yield positive outcomes and seem to be effective in reducing executive problems in brain‐injured subjects. However, several studies have only an explorative intent and are based on less sophisticated experimental designs. The verification of their results is generally more tenuous. The internal validity, or the set‐up of experimental conditions necessary to draw valid conclusions about treatment effectiveness, including the choice of well‐matched control groups, or the randomization of patients over treatment and control conditions, is not always strong. The same conclusion can be drawn for the external validity of a number of the intervention studies; often evidence of generalization to real‐life situations, long‐term follow‐up, and transfer to non‐trained situations, were (partially) lacking in the studies under review. The authors are aware that the design of proper randomized controlled trials for the investigation of the treatment effectiveness of executive disorders is cumbersome and time consuming. Nonetheless, the provisional results of several well‐designed studies described in this review make the effort worthwhile.     

A systematic review and narrative synthesis of occupational therapy-led interventions for individuals with anxiety and stress-related disorders

Anxiety and stress-related disorders are highly prevalent and impede participation in life activities. Occupational therapists work extensively with people diagnosed with these disorders but the effectiveness of their interventions is unclear. A systematic search strategy identified 19 papers describing 13 studies. Studies varied in methodology, intervention type, and theory base. The results show the potential for lifestyle approaches, occupational science-based programs, and skill-building to improve mental health. The variety of interventions and methodologies of many studies means that the effectiveness of occupational therapy interventions for this population is not yet determined. High-quality research is required to replicate interventions with emerging potential for effectiveness.     

A systematic review of interventions to address workplace bias: What we know,what we don't,and lessons learned

Despite the extensive literature about the pervasiveness and impact of microaggressions in the workplace, little is known about what specific workplace interventions have been adopted to mitigate them and, for those adopted, whether the efforts are effective. Given the nature of this special journal issue, we originally sought to answer this call by focusing solely on workplace interventions targeting microaggressions. However, it became clear that the relative paucity of such interventions (as documented in the literature) necessitated that we cast a broader net. We therefore present the results of a systematic review of studies that evaluate the effectiveness of workplace interventions focused on subtle bias and/or its behavioral manifestations. The review identified only six papers that met the inclusion criteria of: 1) reporting a real-world workplace intervention with a goal of reducing subtle bias and/or behavioral manifestations and 2) including a systematic evaluation of attitude, awareness, and/or behavioral change. Multiple themes across the identified studies are summarized. The discussion addresses the dearth of well-documented interventions and examines lessons learned from existing interventions to inform the development of future training focused on microaggressions in order to contribute to long-lasting change.     

What do We Know about Family Interventions for Psychosis at the Process Level? A Systematic Review

The evidence regarding effectiveness of family interventions for psychosis (FIP) is strong and consistent. However, there is a gap in the research on the process of these interventions, and little is known about their active ingredients. This review aims to identify the active ingredients of FIP. We conducted a systematic literature review, focusing on qualitative research, and analyzed 22 papers in total. We found a single study comprehensively exploring the process of FIP. All other studies focused on particular aspects of process‐related variables. The key elements of FIP seem to be the so‐called “common therapeutic factors”, followed by education about the illness and coping skills training. This review supports the value of a stepped model of intervention according to the needs of the families. However, the evidence reviewed also reveals a gap in the research findings based on the limited research available. FIP are complex, psychosocial interventions with multiple components, and more intensive, qualitative research is needed to establish linkages between process and outcome.     

Well-being through learning: a systematic review of learning interventions in the workplace and their impact on well-being

The view that learning is central to well-being is widely held and the workplace is an important setting in which learning takes place. Evaluations of the effectiveness of well-being interventions in work settings are commonplace, but to date, there has been no systematic review of the effectiveness of learning interventions with regard to their impact on well-being. The review synthesizes evidence from 41 intervention studies, and although no studies report a negative impact on well-being, 14 show no effect on well-being, with 27 studies having a positive impact. We classify the studies according to the primary purpose of the learning intervention: to develop personal resources for well-being through learning; to develop professional capabilities through learning; to develop leadership skills through learning; and to improve organizational effectiveness through organizational-level learning. Although there is an abundance of workplace learning interventions, few are evaluated from a well-being perspective despite the commonly held assumption that learning yields positive emotional and psychological outcomes. The evidence indicates an important gap in our evaluation of and design of workplace learning interventions and their impact on well-being, beyond those focusing on personal resources. This raises important theoretical and practical challenges concerning the relationship between learning and well-being in the context of professional capability enhancement, leadership capability and organizational learning.     

Positive Psychology Interventions for Chronic Physical Illnesses: A Systematic Review

Positive health focuses on enhancing health along with curing illness to bring about well-being. Treatment for physical illness generally involves drug therapy, while the psycho-social aspects, specifically the positive psychology perspectives, are largely ignored; nevertheless, a growing number of investigations are now studying the effects of positive psychology interventions on health outcomes. The objective of this paper is to systematically review positive psychology interventions in chronic physical illness. A literature search through the databases of EBSCO, PubMed and PsycINFO, reference lists of significant papers and grey literature was conducted following four criteria set for this review. The number of studies selected finally that acceded to the criteria was 14. These studies were analysed by focusing on the study characteristics, kinds of intervention and outcomes of positive psychology interventions. Overall findings reveal that different intervention programmes have been devised by combining various exercises, writing is the most commonly used method for administration and positive psychology interventions are considered feasible and acceptable by patients, but findings about their usefulness are inconclusive. Suggestions for future research, clinical practice and application in communities have been provided which may be useful for clinicians, practitioners and caregivers.     

Systematic review of the effectiveness of interpersonal coach education interventions on athlete outcomes

ObjectivesTo systematically review and evaluate the literature on the effectiveness of coach education interventions. Specifically, we aimed to: (a) describe the non-formal coach education interventions aimed at coaches' interpersonal knowledge base, (b) highlight underpinning theoretical models, (c) assess the methodological quality of articles evaluating these interventions, (d) identify participant characteristics, and (e) establish the effect of these interventions on athletes' cognitive, affective, and behavioural outcomes.DesignSystematic review of published empirical research.MethodPublished English language articles were identified using electronic databases and manual searches of reference lists. The quality of the identified articles was assessed using the Effective Public Health Practice Project (EPHPP) tool.ResultsFour interventions fulfilled the inclusion criteria and were thus systematically reviewed. Overall, education interventions based on coach effectiveness training and achievement goal theory produced mixed effects on a variety of athlete outcomes, such as anxiety, self-esteem, fear of failure, and motivational orientation.ConclusionsDue to the diversity in athlete outcomes and intervention design, it is difficult to draw firm conclusions around the effectiveness of coach education interventions. The small number of identified interventions highlights the current paucity of empirical data on coach education intervention effectiveness. More research is needed to further our understanding of intervention effectiveness to allow for growth and improvement in coach education. Furthermore, theory-based, rather than “theory inspired” coach education interventions are required.     

Introduction to Multi-Level Community Based Culturally Situated Interventions

This introduction to a special issue of the American Journal of Community Psychiatry is the result of a symposium at the Annual Meeting of the Society for Applied Anthropology, 2006, that brought together anthropologists and psychologists involved in community based collaborative intervention studies to examine critically the assumptions, processes and results of their multilevel interventions in local communities with local partners. The papers were an effort to examine context by offering a theoretical framework for the concept of “level” in intervention science, and advocating for “multi‐level” approaches to social/behavioral change. They presented examples of ways in which interventions targeted social “levels” either simultaneously or sequentially by working together with communities across levels, and drawing on and co‐constructing elements of local culture as components of the intervention. The papers raised a number of important issues, for example: (1) How are levels defined and how should collaborators be chosen; (2) does it matter at which level multilevel interventions begin; (3) do multilevel interventions have a greater effect on desired outcomes than level‐specific interventions; (4) are multilevel interventions more sustainable; (5) are multilevel interventions cost effective to run, and evaluate; (6) how can theories of intervention be generated and adapted to each level of a multilevel intervention; (7) how should intervention activities at each level coordinate to facilitate community resident or target population empowerment? Many of these questions were only partially addressed in the papers presented at that time, and are more fully addressed in the theoretical papers, case studies and approach to evaluation included in this collection.     

Potential Mediators in Parenting and Family Intervention: Quality of Mediation Analyses

Parenting and family interventions have repeatedly shown effectiveness in preventing and treating a range of youth outcomes. Accordingly, investigators in this area have conducted a number of studies using statistical mediation to examine some of the potential mechanisms of action by which these interventions work. This review examined from a methodological perspective in what ways and how well the family-based intervention studies tested statistical mediation. A systematic search identified 73 published outcome studies that tested mediation for family-based interventions across a wide range of child and adolescent outcomes (i.e., externalizing, internalizing, and substance-abuse problems; high-risk sexual activity; and academic achievement), for putative mediators pertaining to positive and negative parenting, family functioning, youth beliefs and coping skills, and peer relationships. Taken as a whole, the studies used designs that adequately addressed temporal precedence. The majority of studies used the product of coefficients approach to mediation, which is preferred, and less limiting than the causal steps approach. Statistical significance testing did not always make use of the most recently developed approaches, which would better accommodate small sample sizes and more complex functions. Specific recommendations are offered for future mediation studies in this area with respect to full longitudinal design, mediation approach, significance testing method, documentation and reporting of statistics, testing of multiple mediators, and control for Type I error.     

A Systematic Scoping Review of the Choice Architecture Movement: Toward Understanding When and Why Nudges Work

In this paper, we provide a domain‐general scoping review of the nudge movement by reviewing 422 choice architecture interventions in 156 empirical studies. We report the distribution of the studies across countries, years, domains, subdomains of applicability, intervention types, and the moderators associated with each intervention category to review the current state of the nudge movement. Furthermore, we highlight certain characteristics of the studies and experimental and reporting practices that can hinder the accumulation of evidence in the field. Specifically, we found that 74% of the studies were mainly motivated to assess the effectiveness of the interventions in one specific setting, while only 24% of the studies focused on the exploration of moderators or underlying processes. We also observed that only 7% of the studies applied power analysis, 2% used guidelines aiming to improve the quality of reporting, no study in our database was preregistered, and the used intervention nomenclatures were non‐exhaustive and often have overlapping categories. Building on our current observations and proposed solutions from other fields, we provide directly applicable recommendations for future research to support the evidence accumulation on why and when nudges work. Copyright © 2017 John Wiley & Sons, Ltd.     

An evaluation of positive psychology intervention effectiveness trials using the re-aim framework: A practice-friendly review

Meta-analyses indicate the efficacy of positive psychology interventions in promoting well-being. But, despite accumulating empirical and anecdotal evidence of these interventions’ implementation in real-world settings, no review of effectiveness research exists. Accordingly, we identified 40 positive psychology intervention effectiveness trials targeting adults, and scored their reporting using the practice-friendly RE-AIM tool which assesses five dimensions of intervention utility: Reach, Efficacy, Adoption, Implementation and Maintenance. Reporting levels varied substantially: reporting on Reach scored 64%; Efficacy scored 73%; Adoption scored 84%; Implementation scored 58%; and Maintenance scored 16%. Within these five dimensions, reporting on participation rates, methods to select delivery agents, differences between participants and non-participants, programme maintenance and costs, was particularly sparse. The studies involved 10,664 participants, approximately half required specialist delivery, and 12 were researcher delivered. To maximize the potential of PPIs for population health promotion, expanded reporting on effectiveness trials is required. Recommendations to assist this process are offered.     

Effectiveness of School-Based Mental Health Services for Children: A 10-Year Research Review

A review of the literature from 1985 to 1995 on school-based mental health services for children was conducted using a computerized data-base search. Of the 5,046 references initially identified, 228 were program evaluations. Three inclusion criteria were applied to those studies: use of random assignment to the intervention; inclusion of a control group; and use of standardized outcome measures. Only 16 studies met these criteria. Three types of interventions were found to have empirical support for their effectiveness, although some of the evidence was mixed: cognitive-behavioral therapy, social skills training, and teacher consultation. The studies are discussed with reference to the sample, targeted problem, implementation, and types of outcomes assessed, using a comprehensive model of outcome domains, called the SFCES model. Future studies of school-based mental health services should (a) investigate the effectiveness of these interventions with a wider range of children's psychiatric disorders; (b) broaden the range of outcomes to include variables related to service placements and family perspectives; (c) examine the combined effectiveness of these empirically-validated interventions; and (d) evaluate the impact of these services when linked to home-based interventions.     

Knowing so much,yet knowing so little: a scoping review of interventions that address the stigma of mental illness in the Canadian context

Stigma can have detrimental effects on the health and wellbeing of individuals living with a mental illness. This scoping review describes the nature, range, and extent of intervention research aimed at reducing public and self-stigma of mental illness in the Canadian context. The review was guided by Arksey and O’Malley’s framework. A search of databases and relevant websites identified 35 primary studies. Most studies used quantitative research methods and included predominantly youth or middle-aged adults, women, and white Canadian-born people. Guided by different conceptualizations of stigma, direct or indirect contact, education, and advocacy-focused interventions, aimed to provide information, and/or develop skills to address self and public stigma. Most studies evaluated interventions’ effectiveness short-term. Of the few studies that followed-up participants long-term, some were able to reduce stigmatizing attitudes post-intervention, however, these targeted only specific groups such as students or health care professionals. Lack of diversity among the samples, and limited evidence of long-term effectiveness of interventions, were some of the studies’ limitations. What is currently known about interventions aimed at reducing the stigma of mental illness in the Canadian context is not informed by research among vulnerable groups, such as people living with a mental illness, older adults, immigrants, and people of diverse ethnic backgrounds. Interventions that are informed by clear conceptualizations of stigma and rigorously evaluated in a range of ethno-cultural groups would create a knowledge base that is useful for policy-makers, community leaders, and agencies serving various ethnic communities in Canada.     

Goal-setting in diabetes self-management: A systematic review and meta-analysis examining content and effectiveness of goal-setting interventions

Background: Goal-setting is recommended and widely used within diabetes self-management programmes. However, empirical evidence around its effectiveness lacks clarity. This review aims to evaluate the effectiveness of goal-setting interventions on diabetes outcomes and to determine which behaviour change techniques (BCTs) are frequently used within these interventions.

Methods: A systematic search identified 14 studies, describing 12 interventions targeting diabetic-control which incorporated goal-setting as the main intervention strategy. Study characteristics, outcome measures and effect sizes of the included studies were extracted and checked by two authors. The BCT taxonomy v1 was used to identify intervention content. Meta-analyses were conducted to assess intervention effects on the primary outcome of average blood glucose levels (HbA1c) and on body-weight. Psycho-social and behavioural outcomes were summarised in narrative syntheses.

Results: Significant post-intervention improvements in HbA1C were found (?.22, 95% CI, ?.40, ?.04) across studies. No other main effects were identified. The BCT ‘goal-setting (behaviour)’ was most frequently implemented and was identified in 84% of the interventions.

Conclusions: Goal-setting interventions appear to be associated with reduced HbA1C levels. However, the low numbers of studies identified and the risk biases across studies suggest more research is needed to further explore goal-setting BCTs in diabetes self-management.     

A systematic review of interventions for anxiety in people with HIV

People with human immunodeficiency virus (HIV) show elevated anxiety levels compared to the general population. Anxiety can predate HIV infection or be triggered by HIV diagnosis and the many stresses that emerge during the course of HIV disease. Many psychological and pharmacological therapies have been shown to treat anxiety in the general population but a systematic understanding of which interventions have been tested in and are effective with HIV-seropositive individuals is needed. This review examines all published intervention studies on anxiety and HIV from 1980 to 2009 covered by the databases MedLine (1980-2009) and PsycINFO (1980-2009) for a definitive account of effectiveness of interventions and an indication of prevalence of HIV-related anxiety and measurement within studies. Standard systematic research methods were used to gather quality published papers on HIV and anxiety, searching published data bases according to quality inclusion criteria. From the search, 492 papers were generated and hand searched resulting in 39 studies meeting adequacy inclusion criteria for analysis. Of these, 30 (76.9%) were implemented in North America (the USA and Canada), with little representation from developing countries. Thirty-three (84.6%) studies recruited only men or mostly men. A total of 50 interventions were investigated by the 39 studies; 13 targeted HIV, symptoms or associated outcomes/conditions, 20 directly targeted anxiety and another 17 indirectly targeted anxiety. Twenty-four (48%) interventions were effective in reducing anxiety (including 11 indirect interventions), 16 (32%) were ineffective and 10 (20%) had an unknown effect on anxiety. Sixty-five percent of interventions directly targeting anxiety were effective. Psychological interventions (especially cognitive behavioural stress management interventions and cognitive behavioural therapy) were generally more effective than pharmacological interventions. Only three studies provided prevalence rates - these ranged from 13% to 80%. Anxiety was measured using 16 different instruments. Our detailed data suggest that interventions are both effective and available, although further research into enhancing efficacy would be valuable. Also, the vast majority of studies were Western-based, no studies looked at children or adolescents and few looked specifically at women. An international effort to harmonise measurement of anxiety is also missing. There is a need to routinely log anxiety in those with HIV infection during the course of their disease, to provide specific data on women, young people and those in diverse geographic areas and incorporate management into care protocols.     

The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review

Previous quantitative reviews of research on psychotherapeutic interventions for bereaved persons have yielded divergent findings and have not included many of the available controlled outcome studies. This meta-analysis summarizes results from 61 controlled studies to offer a more comprehensive integration of this literature. This review examined (a) the absolute effectiveness of bereavement interventions immediately following intervention and at follow-up assessments, (b) several of the clinically and theoretically relevant moderators of outcome, and (c) change over time among recipients of the interventions and individuals in no-intervention control groups. Overall, analyses showed that interventions had a small effect at posttreatment but no statistically significant benefit at follow-up. However, interventions that exclusively targeted grievers displaying marked difficulties adapting to loss had outcomes that compare favorably with psychotherapies for other difficulties. Other evidence suggested that the discouraging results for studies failing to screen for indications of distress could be attributed to a tendency among controls to improve naturally over time. The findings of the review underscore the importance of attending to the targeted population in the practice and study of psychotherapeutic interventions for bereaved persons.     

The intervention selection bias: an underrecognized confound in intervention research

Selection bias can be the most important threat to internal validity in intervention research, but is often insufficiently recognized and controlled. The bias is illustrated in research on parental interventions (punishment, homework assistance); medical interventions (hospitalization); and psychological interventions for suicide risk, sex offending, and juvenile delinquency. The intervention selection bias is most adequately controlled in randomized studies or strong quasi-experimental designs, although recent statistical innovations can enhance weaker designs. The most important points are to increase awareness of the intervention selection bias and to systematically evaluate plausible alternative explanations of data before making causal conclusions.     

Family-based physical activity interventions and family functioning: A systematic review

Family physical activity (PA) can confer multiple health benefits, yet whether PA interventions affect general family functioning has not been appraised. The purpose of this review was to evaluate studies that have examined the effect of family PA interventions, where child PA was the focus of the intervention, on constructs of family functioning. Literature searches were concluded on January 11, 2022 using seven common databases. Eligible studies were in English, utilized a family PA intervention, and assessed a measure of family functioning as a study outcome. The initial search yielded 8413 hits, which was reduced to 20 independent PA interventions of mixed quality after screening for eligibility criteria. There was mixed evidence for whether family PA interventions affected overall family functioning; however, analyses of subdomains indicated that family cohesion is improved by PA interventions when children are in the early school years (aged 5–12). High-quality studies also showed an impact of family PA interventions on family organization. Targeted interventions at specific family subsystems (e.g., father–son, mother–daughter), characteristics (low-income, clinical populations, girls), and broad multibehavioral interventions may have the most reliable effects. Overall, the findings show that family PA interventions can promote family cohesion and organization, particularly among families with children in the early school years. Higher quality research, employing randomized trial designs and targeting specific intervention and sample characteristics (e.g., different clinical conditions, specific parent–child dyads), is recommended in order to better ascertain the effectiveness of these approaches.     

A META‐ANALYTIC REVIEW OF RELATIONSHIP‐BASED INTERVENTIONS FOR LOW‐INCOME FAMILIES WITH INFANTS AND TODDLERS: FACILITATING SUPPORTIVE PARENT–CHILD INTERACTIONS

Relationship‐based intervention programs are increasingly being implemented as a way to enhance parent‐child interaction quality. In this meta‐analytic review, we examined the effectiveness of 19 recent relationship‐based interventions serving socioeconomically disadvantaged families with infants and toddlers (N = 6,807). This review specifically focused on intervention effectiveness in terms of improving supportive parenting behaviors, as measured by observational assessments of dyadic parent–child interactions. Meta‐analytic results indicated significant, yet modest, effectiveness across all interventions (d = .23). Intervention characteristics such as participant randomization, breadth of intervention services offered, duration, child age at the start of the intervention, professional qualifications of the intervenor, and type of play task used during assessment were tested as possible moderators of effectiveness. Significant differences in effectiveness were found between randomized and nonrandomized interventions. Within the subsample of randomized interventions, programs that were shorter in duration, that provided direct services to the parent–child dyad, used intervenors with professional qualifications, and assessed parent‐child interactions with free‐play tasks were the most effective, highlighting important considerations for designing effective intervention protocol tailored to the needs of this high‐risk population.