Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity. In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the “black box” of Web-based intervention development and to support future Web-based intervention development.
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Abstract Background Smoking among people with severe mental illness (SMI) is highly prevalent and strongly associated with poor physical health. Currently, evidence-based smoking cessation interventions are scarce and need to be integrated into current mental health care treatment guidelines and clinical practice. Therefore, the present study aims to evaluate the implementation and effectiveness of a smoking cessation intervention in comparison with usual care in people with SMI treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. Methods A pragmatic, cluster-randomised controlled trial with embedded process evaluation will be conducted. Randomisation will be performed at the level of FACT teams, which will be assigned to the KISMET intervention or a control group (care as usual). The intervention will include pharmacological treatment combined with behavioural counselling and peer support provided by trained mental health care professionals. The intervention was developed using a Delphi study, through which a consensus was reached on the core elements of the intervention. We aim to include a total of 318 people with SMI (aged 18–65 years) who smoke and desire to quit smoking. The primary outcome is smoking status, as verified by carbon monoxide measurements and self-report. The secondary outcomes are depression and anxiety, psychotic symptoms, physical fitness, cardiovascular risks, substance use, quality of life, and health-related self-efficacy at 12 months. Alongside the trial, a qualitative process evaluation will be conducted to evaluate the barriers to and facilitators of its implementation as well as the satisfaction and experiences of both patients and mental health care professionals. Discussion The results of the KISMET trial will contribute to the evidence gap of effective smoking cessation interventions for people treated by FACT teams. Moreover, insights will be obtained regarding the implementation process of the intervention in current mental health care. The outcomes should advance the understanding of the interdependence of physical and mental health and the gradual integration of both within the mental health care system. Trial registration Netherlands Trial Register, NTR9783. Registered on 18 October 2021.
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Abstract Background Smoking among people with severe mental illness (SMI) is highly prevalent and strongly associated with poor physical health. Currently, evidence-based smoking cessation interventions are scarce and need to be integrated into current mental health care treatment guidelines and clinical practice. Therefore, the present study aims to evaluate the implementation and efectiveness of a smoking cessation intervention in comparison with usual care in people with SMI treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. Methods A pragmatic, cluster-randomised controlled trial with embedded process evaluation will be conducted. Randomisation will be performed at the level of FACT teams, which will be assigned to the KISMET intervention or a control group (care as usual). The intervention will include pharmacological treatment combined with behavioural counselling and peer support provided by trained mental health care professionals. The intervention was developed using a Delphi study, through which a consensus was reached on the core elements of the intervention. We aim to include a total of 318 people with SMI (aged 18–65 years) who smoke and desire to quit smoking. The primary outcome is smoking status, as verifed by carbon monoxide measurements and self-report. The secondary outcomes are depression and anxiety, psychotic symptoms, physical ftness, cardiovascular risks, substance use, quality of life, and health-related self-efcacy at 12months. Alongside the trial, a qualitative process evaluation will be conducted to evaluate the barriers to and facilitators of its implementation as well as the satisfaction and experiences of both patients and mental health care professionals. Discussion The results of the KISMET trial will contribute to the evidence gap of efective smoking cessation interventions for people treated by FACT teams. Moreover, insights will be obtained regarding the implementation process of the intervention in current mental health care. The outcomes should advance the understanding of the interdependence of physical and mental health and the gradual integration of both within the mental health care system. Trial registration Netherlands Trial Register, NTR9783. Registered on 18 October 2021.
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In de openbare geestelijke gezondheidszorg is bemoeizorg al een tijdje bekend. Hulpverleners proberen daarbij in contact te komen met ‘zorgwekkende zorgmijders’; een risicogroep van mensen met vaak complexe en meervoudige problematiek die zelf niet om hulp vragen.
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Abstract Background Clients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5–17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the imple‑ mentation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the efectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth. Methods The GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth inter‑ vention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants’ reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efcacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth. Discussion The GILL eHealth intervention is expected to be more efective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven efective, GILL eHealth ofers a clinically useful tool to improve physical health and lifestyle behaviours.
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BACKGROUND: Advanced interventions to enhance the mental health literacy (MHL) of educational professionals are now available, though their effectiveness varies, likely due to contextual differences. To adapt these interventions for use in other countries, a systematic and tailored approach is required to maintain the logical framework. This study describes the systematic process of selecting and adapting an intervention to improve MHL of Dutch secondary school educational professionals, using Intervention Mapping (IM) Adapt.METHODS: IM Adapt regards six steps: (1) assess needs and organizational capacity; (2) find evidence-based interventions; (3) plan adaptations; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation.RESULTS: The outcomes of a needs assessment were used to develop a logic model of the problem and of change, leading to the intervention goal of increasing mental health awareness, knowledge, attitudes, and self-efficacy among end-users. A logic model of the problem and of change visually outlines the relationship between a specific issue, its root causes, and the intended intervention to drive change. The existing evidence-based digital intervention, named LEARN, was identified as the most suitable for addressing these needs. This was done through reviewing the literature and existing intervention databases. Four main content adaptations were made to align with the distinct needs of the Dutch context and the evolving trends within the field of mental health, resulting in LEARN-NL, a digital mental health literacy intervention for Dutch educational professionals. Finally, implementers were identified, and a mixed methods feasibility study was set up.CONCLUSIONS: Our findings show that some content adaptations to LEARN were needed to address the needs and (learning) preferences of educational professionals in the Dutch education context, but that the majority of the existing intervention could be upheld. Existing evidence-based MHL interventions for educational professionals are useful as a basis for the adaptation and transfer to other countries. IM Adapt is a valuable framework for the systematic planning of adaptations to a new context while retaining its essential elements.
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Worldwide, an increasing number of students in higher education have mental health problems. Talking about these problems at the university is often not that easy. Students fear to be stigmatised if they disclose their problems to others. However, if they do not disclose their problems, they may not get the support they often need. Existing interventions to help people with this disclosure-dilemma are not specifically aimed at students, and lack certain important aspects. Therefore, we developed an intervention to help students with making a personal, well-informed decision regarding whether or not to disclose their problems. We examined the experiences of students and professionals with the new intervention. Moreover, we studied whether the students were less concerned about disclosure and experienced less decisional conflicts after using the intervention. Students with mental health problems from three universities of applied sciences in the Netherlands completed questionnaires prior to the intervention, directly after and three months after. In addition, the educational professionals reported their experiences with applying the intervention. Both students and professionals appreciated the contents and structure of the intervention and students’ level of concern about disclosure and level of decisional conflicts were lower after using the intervention.
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Depression is a highly prevalent and seriously impairing disorder. Evidence suggests that music therapy can decrease depression, though the music therapy that is offered is often not clearly described in studies. The purpose of this study was to develop an improvisational music therapy intervention based on insights from theory, evidence and clinical practice for young adults with depressive symptoms. The Intervention Mapping method was used and resulted in (1) a model to explain how emotion dysregulation may affect depressive symptoms using the Component Process Model (CPM) as a theoretical framework; (2) a model to clarify as to how improvisational music therapy may change depressive symptoms using synchronisation and emotional resonance; (3) a prototype Emotion-regulating Improvisational Music Therapy for Preventing Depressive symptoms (EIMT-PD); (4) a ten-session improvisational music therapy manual aimed at improving emotion regulation and reducing depressive symptoms; (5) a program implementation plan; and (6) a summary of a multiple baseline study protocol to evaluate the effectiveness and principles of EIMT-PD. EIMT-PD, using synchronisation and emotional resonance may be a promising music therapy to improve emotion regulation and, in line with our expectations, reduce depressive symptoms. More research is needed to assess its effectiveness and principles.
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Mental health problems in adolescence can have a profound influence on school functioning, educational attainment and thus future societal participation. Supported education (SEd) is a potentially useful method for educational professionals to help adolescents with mental health problems in secondary school improve their functioning by stimulating collaboration, ownership, and participation. In this study, we examined the feasibility of SEd in secondary education by examining its acceptability, implementation, and preliminary effectiveness. We performed a mixed-methods study using quantitative data (questionnaires) and qualitative data (interviews) from educational professionals (EP) and adolescents, aged 13–17, about their experiences with a SEd intervention. Regarding the acceptability of the intervention, three main themes emerged: (a) structure, (b) autonomy, and (c) applicability of the intervention. Themes regarding the implementation were: (a) lack of time, (b) personal attitude, (c) mastery, and (d) complexity of the school environment. The findings show that, for those that followed the intervention, SEd is a promising approach to support adolescents with mental health problems to improve their functioning and participation in school. Further research is needed on the effectiveness of the intervention.This article belongs to the Special Issue Children and Young People’s Participation in Health and Well-Being.
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Exhaust emissions from motorized vehicles are not only harmful to the environment but also to human health. However, motorists are not necessarily aware of the adverse health effects resulting from their emissions. In this work, we use the health aspect as a primary motivation factor in the design of an intervention targeted at reducing exhaust emissions. Based on research into the problem domain and the target group, we propose a design for a behavior-change intervention, consisting of an infrastructure of large public displays and a mobile application. In a design prototype, we incorporate two approaches, shaming and empowerment, designed to engage motorists with the intervention. An experimental evaluation of the prototype suggests that shaming can have a lot of potential in providing motivation for change, while empowerment is also needed inside the application for helping the drivers reduce their emissions by means of more efficient traveling. Based on the findings, we discuss the role of personal data in the intervention and outline possibilities for realizing the design as part of the built environment.
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