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An interactive digital behaviour change intervention to decrease incidence of sexually transmitted infections among users of STI self-sampling websites: a feasibility RCT. 一项互动式数字行为改变干预以降低性传播感染在性传播感染自我抽样网站用户中的发病率：可行性随机对照试验。
Public health research (Southampton, England)
Pub Date : 2025-10-01 DOI: 10.3310/LKOT7404
Katie Newby, Kayleigh Kwah, Lauren Schumacher, Rik Crutzen, Julia V Bailey, Louise J Jackson, Stephen Bremner, Katherine E Brown
<p><strong>Background: </strong>Sexually transmitted infections such as chlamydia are common among young people. If left untreated, they can have serious health consequences. Condoms are recommended for prevention, but young people report often not using them for penetrative sex. Use of web-based sexually transmitted infection testing is increasing rapidly, but these services provide little support or advice on how to prevent future infections. 'Wrapped' is a web-based intervention that aims to support young users of web-based sexually transmitted infection testing to use condoms correctly every time they have penetrative sex, thus reducing future sexually transmitted infection incidence.</p><p><strong>Objective: </strong>To assess whether and how it is possible to carry out a future randomised controlled trial of Wrapped.</p><p><strong>Design: </strong>A two-arm, parallel-group feasibility randomised controlled trial, with nested qualitative study, in which Wrapped in addition to usual care is tested against usual care alone.</p><p><strong>Setting: </strong>Participants were recruited from five English local authority areas through one web-based sexually transmitted infection testing service.</p><p><strong>Participants: </strong>Young people aged 16-24 years with internet access and who were likely to have penetrative sex during the study.</p><p><strong>Intervention: </strong>Wrapped interactive multimedia intervention. Control: Non-interactive web page with standard information on sexually transmitted infections and details about how to access condoms.</p><p><strong>Main outcome measures: </strong>Proportion of sampling pool recruited and return of valid chlamydia self-sample at month (M)12. Other outcome measures: return of valid chlamydia self-sample at M3; completion of surveys at baseline, M3, M6 and M12; follow-up by demographic characteristics; and acceptability of intervention and measures.</p><p><strong>Results: </strong>In total, 230 participants were recruited and randomised to the feasibility randomised controlled trial: 115 to the intervention group and 115 to the control. Of these, 173 (75.2%) self-reported the result of their first sexually transmitted infection test. This sub-sample ('restricted sample') best represents the true nature of the sample at full trial for which the baseline sexually transmitted infection test result is needed. Results which follow are therefore for this sample. Of the sampling pool, 1.5% were recruited. A valid chlamydia self-sample was returned by 75.7% at M12. Based on this information, 3574 participants, derived from a sampling pool of 238,266 service users, were estimated to be necessary to power a future full trial. Return of other follow-up measures was as follows: valid M3 chlamydia self-sample 75.1%, M3 survey 91.3%, M6 survey 90.8% and M12 survey 91.8%. Participants at M12 appeared to broadly represent individuals in the sampling pool with some limited exceptions: a tendency for over-represen
背景：衣原体等性传播感染在年轻人中很常见。如果不及时治疗，它们可能会造成严重的健康后果。人们建议使用避孕套进行预防，但据报道，年轻人在进行插入性行为时往往不使用避孕套。基于网络的性传播感染检测的使用正在迅速增加，但这些服务在如何预防未来感染方面提供的支持或建议很少。“包裹”是一项基于网络的干预措施，旨在支持基于网络的性传播感染检测的年轻用户在每次进行插入性行为时正确使用避孕套，从而减少未来的性传播感染发生率。目的：评估是否以及如何可能在未来开展wrap的随机对照试验。设计：一项双臂，平行组可行性随机对照试验，嵌套定性研究，其中常规护理与常规护理相比较。环境：参与者通过一个基于网络的性传播感染检测服务从五个英国地方当局地区招募。参与者：年龄在16-24岁之间，可以上网，并且在研究期间可能发生插入性行为的年轻人。干预：包装交互式多媒体干预。对照：非交互式网页，提供关于性传播感染的标准信息和如何获得避孕套的详细信息。主要观察指标：抽样池的招募比例和有效衣原体自样本在第12个月的返回。其他结果测量：在M3时返回有效衣原体自样本；完成基线、M3、M6及M12的测量；按人口特征进行随访；干预措施的可接受性。结果：总共招募了230名参与者，并随机分配到可行性随机对照试验中：干预组115名，对照组115名。其中，173人（75.2%）自我报告了第一次性传播感染检测结果。该子样本（“限制性样本”）最能代表需要基线性传播感染检测结果的完整试验中样本的真实性质。因此，下面的结果是针对这个样本的。在抽样池中，1.5%被招募。在M12时，有效衣原体自检回收率为75.7%。根据这一信息，估计从238 266名服务用户的抽样池中需要3574名参与者才能为未来的全面试验提供动力。其他随访指标的回收率为：M3有效衣原体自检75.1%，M3调查91.3%，M6调查90.8%，M12调查91.8%。M12的参与者似乎广泛地代表了抽样池中的个人，但有一些有限的例外：年龄较大（20-24岁）、黑人和最贫困的五分之一的参与者有过度代表的趋势；年轻（16-19岁）、白人和贫困五分之一的参与者代表性不足。没有证据表明干预组之间存在差异损耗。与会者报告说，试验过程和程序是可以接受的。限制：研究广告可能对大多数符合条件的参与者不可见，导致招募率低。质性研究样本缺乏种族和性别多样性。结论：全面试验是可行的。尽管招募率很低，但有足够多的年轻人使用基于网络的性传播感染检测（根据最新数据，每年585,000人）来获得所需的样本。应执行建议的战略，以解决M12中某些人口分组人数可能不足或过多的问题。未来的工作：一个完全确定的随机对照试验，从这项研究中学习。研究注册：本研究注册号为当前对照试验ISRCTN17478654。资助：该奖项由美国国家卫生与保健研究所（NIHR）公共卫生研究计划（NIHR奖号：NIHR128148）资助，全文发表在《公共卫生研究》上；第13卷，第9号有关进一步的奖励信息，请参阅美国国立卫生研究院资助和奖励网站。
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引用次数: 0
Gathering baseline data to assess household energy interventions' impact on indoor air quality, occupant health, and wellbeing: In2Air a non-randomized experiment. 收集基线数据以评估家庭能源干预对室内空气质量、居住者健康和福祉的影响：In2Air非随机实验。
Public health research (Southampton, England)
Pub Date : 2025-09-03 DOI: 10.3310/SOSO8851
Jane Entwistle, Tarek Ahmed, Lindsay Bramwell, Graham Coulby, Michael E Deary, Olivia Mansell, Anil Namdeo, Richard McNally, Luke Vale, Adam Vaughan, Colin White

Background: Tackling climate change, together with improving indoor air quality, offers a significant opportunity to improve residents' health and well-being. This requires the evidence base to inform an energy-efficient retrofit design.

Objectives: (i) To develop a protocol that could be implemented by local authorities across a range of housing typologies and (ii) to deploy this protocol to establish baseline conditions in n = 30 homes ahead of energy-efficient retrofitting.

Methods: Working with the local council and the community, this baseline study (In2Air) developed and deployed a protocol across 30 single-storey one- and two-bedroom properties owned by Newcastle City Council, United Kingdom, and occupied by tenants (> 55 years). The following data were collected before homes underwent a fabric-first intervention: indoor and outdoor air quality (for ~3 weeks); energy consumption (for ~12 months); occupant behaviour and home-specific details; self-reported general health and well-being.

Results: The collected baseline data indicated that the mean PM2.5 (particulate matter < 2.5 µm in diameter) concentrations ranged from 3 to 24 µg/m3 (excluding three homes where smoking occurred indoors). No homes had monitoring period means above the current United Kingdom (2019) outdoor annual mean limit (25 µg/m3); however, 21 homes had monitoring period means above the current World Health Organization (2021) annual mean guidance value (5 µg/m3). Strong correlations were observed between indoor PM2.5 and indoor PM10 (particulate matter < 10 µm in diameter), suggesting similar sources, while no-to-weak correlations were observed between indoor carbon dioxide and indoor PM2.5. Moderate-to-good ventilation was suggested by indoor concentrations of carbon dioxide across all the study homes. The lack of correlation between carbon dioxide and particulate matter highlights the need for housing professionals to add particulate matter to their usual indoor air quality assessment suite of carbon dioxide, temperature and humidity. Most homes had mean humidity levels within the range considered healthy (i.e. between 40% and 60%), with only three homes above this range. With respect to the baseline health and well-being scores, compared to the comparison population, data for this initial time point indicated most participants (83%) had a physical health score below the norm, which likely reflects the age (> 55 years) of the cohort. In comparison, the mental health score for most participants (74%) was at or above average. Here, the physical layout of the estate with communal amenities may well be engendering a positive sense of belonging. The mean/median ICEpop CAPability score suggests a high level of capability across the cohort.

Limitations: Our study focused on changes

背景：应对气候变化，同时改善室内空气质量，为改善居民的健康和福祉提供了重要机会。这就需要证据基础来为节能改造设计提供信息。目标：(i)制定一项可由地方当局在一系列住房类型中实施的协议；（ii）部署该协议，在n = 30个家庭中建立节能改造前的基线条件。方法：与当地议会和社区合作，这项基线研究（In2Air）开发并部署了一项协议，该协议涉及英国纽卡斯尔市议会拥有的30套单层一卧室和两卧室房产，这些房产由租户（bbbb55年）居住。在家庭进行织物优先干预之前收集以下数据：室内和室外空气质量（持续约3周）；能源消耗（约12个月）；住户行为及家居细节；自我报告的总体健康和幸福感。结果：收集的基线数据表明，PM2.5（直径< 2.5µm的颗粒物）的平均浓度范围为3至24µg/m3（不包括室内吸烟的三个家庭）。没有家庭的监测期平均值高于当前英国（2019年）室外年平均限值（25微克/立方米）；然而，有21个家庭的监测期均值高于世界卫生组织（2021年）现行的年平均指导值（5微克/立方米）。室内PM2.5和室内PM10（直径< 10µm的颗粒物）之间存在强相关性，表明来源相似，而室内二氧化碳和室内PM2.5之间没有到弱相关性。所有研究家庭的室内二氧化碳浓度表明，通风条件中等至良好。二氧化碳和颗粒物之间缺乏相关性，这凸显了住房专业人员需要将颗粒物添加到他们通常的室内空气质量评估套件中，包括二氧化碳、温度和湿度。大多数家庭的平均湿度水平在被认为是健康的范围内（即在40%到60%之间），只有三个家庭高于这个范围。关于基线健康和幸福得分，与比较人群相比，该初始时间点的数据表明，大多数参与者（83%）的身体健康得分低于标准，这可能反映了队列的年龄（bb0 - 55岁）。相比之下，大多数参与者（74%）的心理健康得分达到或高于平均水平。在这里，带有公共设施的房产的物理布局可能会产生一种积极的归属感。ICEpop能力得分的平均值/中位数表明整个队列的能力水平很高。局限性：我们的研究侧重于在有限数量的建筑类型和参数中改变建筑围护结构，并在室内和室外监测地点使用固定的低成本传感器，而不是个人空气质量监测仪。结论和未来的工作：本文中报告的基线条件提供了基础，作为未来研究的一部分，可以告知和评估整个社会住房存量的节能翻新效果。制定的协议和研究结果提供了支持和告知英国各地议会改造团队正在进行的脱碳计划的决策的潜力。资助：本文介绍了由国家卫生与保健研究所（NIHR）公共卫生研究计划资助的独立研究，奖励号为NIHR153617。
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引用次数: 0
Effectiveness of Safe and Well Visits in reducing falls and improving quality of life among older people: The FIREFLI RCT. 安全健康访视在减少老年人跌倒和提高生活质量方面的有效性：firefi随机对照试验
Public health research (Southampton, England)
Pub Date : 2025-09-01 DOI: 10.3310/DJHF6633
Sarah Cockayne, Caroline Fairhurst, Rachel Cunningham-Burley, Jo Mann, Richard Stanford-Beale, Sarah Hampton, Sarah Wilkinson, Joy Adamson, Shelley Crossland, Avril Drummond, Catherine E Hewitt, Alison Pighills, Gareth Roberts, Sarah Ronaldson, Arabella Scantlebury, David J Torgerson
<p><strong>Background: </strong>Fire and rescue services in England routinely carry out Home Fire Safety Visits which aim to reduce risk of fire, support independent living and improve quality of life. The visits include a person-centred assessment and providing general advice on health-related topics such as preventing falls.</p><p><strong>Planned objective: </strong>To assess the effectiveness and cost-effectiveness of Home Fire Safety Visits (also known as Safe and Well Visits) to reduce falls and improve quality of life in older adults living in the community.</p><p><strong>Design, setting and participants: </strong>We designed a multicentre, randomised controlled trial with economic and qualitative evaluations, involving two fire and rescue services in England, to recruit 1156 community-dwelling adults aged 65 years and over.</p><p><strong>Interventions: </strong>All participants could continue to access routine care from healthcare professionals and were provided with a falls prevention leaflet as part of the trial. The intervention group were additionally offered a Home Fire Safety Visit. The usual care group were offered a visit after they had completed the trial. Blinding was not possible. Participants were randomised 1 : 1 using a secure web-based system.</p><p><strong>Main outcomes measures: </strong>The primary outcomes were (1) the number of falls per participant and (2) health-related quality of life (EuroQol-5 Dimensions, five-level version) over 12 months from randomisation. Secondary outcomes included fire risk-taking behaviours, loneliness, fear of falling and time to first fall. The planned economic evaluation comprised cost-utility and cost-effectiveness analyses. The qualitative study was designed to examine intervention fidelity and acceptability.</p><p><strong>Results: </strong>It proved impossible to conduct the trial as planned in the current research landscape. We faced significant delays in setting up and starting recruitment, in large part due to this coinciding with the start of the COVID-19 pandemic. Obtaining regulatory approval took longer than anticipated. Additionally, we were unable to access general practitioner registration data to identify participants as planned and so we had to use Consumer Classification Platform data to identify potential households to send study invitations to. This resulted in a less targeted and non-personalised mail-out as this is not patient-level data so the householder names were unavailable. Ultimately, recruitment was much lower than expected. In total, 237 participants were assessed for eligibility and 63 randomised (intervention, <i>n</i> = 32; usual care, <i>n</i> = 31). The Home Fire Safety Visits were delivered as planned to both groups; however, the planned statistical and health economic analyses could not be conducted due to the limited data. Data from the qualitative evaluation indicated the intervention was largely acceptable to staff and service users.</p><p><strong>Co
背景：英格兰的消防和救援服务部门定期开展家庭消防安全访问，旨在减少火灾风险，支持独立生活和提高生活质量。这些访问包括以人为中心的评估，并就预防跌倒等与健康有关的主题提供一般性咨询意见。计划目标：评估家庭消防安全访问（也称为安全健康访问）的有效性和成本效益，以减少跌倒和提高生活在社区的老年人的生活质量。设计、环境和参与者：我们设计了一项多中心、随机对照试验，进行了经济和定性评估，涉及英格兰的两个消防和救援服务，招募了1156名65岁及以上的社区居民。干预措施：所有参与者都可以继续获得医疗保健专业人员的常规护理，并作为试验的一部分提供预防跌倒的传单。干预组还接受了家庭消防安全访问。常规护理组在完成试验后进行了一次访问。失明是不可能的。参与者使用安全的基于网络的系统进行1:1的随机分配。主要结局指标：主要结局指标为(1)每位参与者跌倒次数和(2)随机化后12个月内与健康相关的生活质量（EuroQol-5维度，五个水平版本）。次要结果包括冒险行为、孤独、害怕跌倒和第一次跌倒的时间。计划的经济评价包括成本效用和成本效益分析。质性研究旨在检验干预的保真度和可接受性。结果：在目前的研究环境下，不可能按计划进行试验。我们在设立和开始招聘方面面临严重延误，这在很大程度上是由于这与COVID-19大流行的开始相吻合。获得监管部门批准的时间比预期的要长。此外，我们无法访问全科医生注册数据来确定参与者，因此我们不得不使用消费者分类平台数据来确定可能发送研究邀请的家庭。由于这不是患者级别的数据，因此无法获得户主的姓名，因此这导致了不那么有针对性和非个性化的邮件发送。最终，招聘人数远低于预期。共有237名受试者被评估为合格，63名受试者被随机分组（干预组，n = 32；常规治疗组，n = 31）。家庭消防安全探访计划如期向两组进行；但是，由于数据有限，无法进行计划的统计和卫生经济分析。定性评价的数据表明，工作人员和服务使用者基本上可以接受干预措施。结论：目前在这种情况下进行试验极具挑战性。为了促进未来的研究，我们建议紧急审查与可以访问和用于研究的个人数据类型相关的研究治理问题。这篇综述的目的应该是为这一领域的研究提供支持，避免造成额外的障碍。未来的工作：家庭消防安全访问的有效性和成本效益的证据仍然没有定论。地方当局的研究治理需要紧急审查。试验注册：本试验注册为当前对照试验NCT04717258。资助：该奖项由美国国家卫生与保健研究所（NIHR）公共卫生研究项目（NIHR奖励编号：NIHR128341）资助，全文发表在《公共卫生研究》上；第13卷第7期有关进一步的奖励信息，请参阅美国国立卫生研究院资助和奖励网站。
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引用次数: 0
Public preferences for health and non-health outcomes of Universal Basic Income and alternative income-based policies: A mixed-method feasibility study. 公众对全民基本收入和替代性收入政策的健康和非健康结果的偏好：一项混合方法可行性研究。
Public health research (Southampton, England)
Pub Date : 2025-07-30 DOI: 10.3310/ALDS8846
Neil McHugh, David Bomark, Rachel Baker, Verity Watson, Neil Craig, Ruth Lightbody, Clare Bambra, Victoria McGowan, Cam Donaldson
<p><strong>Background: </strong>The United Kingdom is experiencing worrying trends in population health. Policy needs to shift 'upstream' to address fundamental causes. Universal Basic Income has emerged as one response to tackling these health issues. A Universal Basic Income would provide a new form of societal safety net through a regular, unconditional cash payment to all individuals in society. However, with scarce public resources and competing upstream income-based policies, such as a Minimum Income Guarantee, implementing transformative initiatives, such as Universal Basic Income, without a public mandate is unlikely. Currently, we do not know the extent to which the general public value different income-based policies, including when wider impacts, such as health outcomes, are explicitly stated.</p><p><strong>Objective: </strong>This feasibility study had two broad aims. First, to determine which income-based policies to select for valuation, based on their importance to stakeholders and coverage of a range of characteristics and outcomes; second, to design and test a framework, and associated methods, for stated preference elicitation.</p><p><strong>Design and methods: </strong>Six income-based policy scenarios - Universal Basic Income, Minimum Income Guarantee, Negative Income Tax, Participation Income, Targeted Basic Income and Universal Credit - were identified and developed through literature searches, stakeholder interviews (<i>n</i> = 13) and consultation with our General Public Panel. Policy scenarios were described in terms of five policy characteristics and impact described qualitatively based on three outcomes - overall population health, health inequality and income inequality. Three trade-off-based stated preference methods - choice, ranking and willingness to pay - were used to elicit preferences. All methods adopted a socially inclusive perspective. Think-aloud and open-ended interview questions were asked to explore respondents' understanding of the survey methods and explore the reasons for respondents' decisions.</p><p><strong>Participants: </strong>For the main survey, 50 members of the general public were sampled across Glasgow and Newcastle using recruitment targets for age, gender, education, income, employment status, ethnicity, benefits, voting preferences and health status.</p><p><strong>Results: </strong>Respondents understood the policy scenarios, the perspective they were asked to adopt when constructing their values and the task they were asked to complete in each of the survey methods. Relatively few respondents had fully inconsistent preferences, there was no evidence of a labelling effect and introducing information on outcomes did not impact preferences. The type of policy seems to matter, with respondents making trade-offs between policy type and the outcomes of improving overall health, health inequalities and/or income inequalities; there is also evidence of preference heterogeneity.</p><p><strong>Limi
背景：联合王国正在经历令人担忧的人口健康趋势。政策需要向“上游”转移，以解决根本原因。全民基本收入作为解决这些健康问题的一种回应而出现。全民基本收入将通过向社会中所有个人提供定期、无条件的现金支付，提供一种新型的社会安全网。然而，由于公共资源稀缺和上游收入政策（如最低收入保障）的竞争，在没有公共授权的情况下实施全民基本收入等变革性举措是不可能的。目前，我们不知道公众在多大程度上重视不同的基于收入的政策，包括在明确说明健康结果等更广泛影响的情况下。目的：本可行性研究有两个主要目的。首先，根据对利益相关者的重要性以及一系列特征和结果的覆盖范围，确定选择哪些基于收入的政策进行评估；其次，设计和测试一个框架，以及相关的方法，以说明偏好的启发。设计和方法：通过文献检索、利益相关者访谈（n = 13）和咨询公众小组，确定并制定了六种基于收入的政策方案——全民基本收入、最低收入保障、负所得税、参与性收入、目标基本收入和全民信贷。根据五个政策特征描述了政策情景，并根据三个结果————总体人口健康、健康不平等和收入不平等————定性地描述了影响。三种基于权衡的陈述偏好方法——选择、排名和支付意愿——被用来引出偏好。所有方法都采用了社会包容的观点。通过“出声思考”和开放式访谈等问题，探讨受访者对调查方法的理解，并探讨受访者做出决定的原因。参与者：在主要调查中，根据年龄、性别、教育程度、收入、就业状况、种族、福利、投票偏好和健康状况等招聘目标，从格拉斯哥和纽卡斯尔抽取了50名普通公众。结果：受访者理解政策情景，他们被要求在构建他们的价值观时采用的观点，以及他们被要求在每种调查方法中完成的任务。相对较少的受访者有完全不一致的偏好，没有证据表明标签效应和介绍结果的信息不会影响偏好。政策类型似乎很重要，答复者在政策类型与改善总体健康、保健不平等和/或收入不平等的结果之间作出权衡；也有证据表明偏好异质性。局限性：我们的小样本排除了对研究结果的普遍性的主张。我们关注的是政策特征的一个子集，结果在三个层面上进行了定性描述，政策的货币支付规模没有明确说明。结论：总体而言，结果表明，当健康和非健康结果明确时，使用基于权衡的陈述偏好问题，可以引起公众对具有不同政策特征的基于收入的政策的偏好。未来工作：这项可行性研究为一项更大规模的、具有全国代表性的研究奠定了基础，该研究可以提供急需的新见解，为政策制定提供信息，以实施解决卫生不平等问题的变革性政策。资助：本文介绍了由国家卫生与保健研究所（NIHR）公共卫生研究计划资助的独立研究，奖励号为NIHR153096。
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引用次数: 0
Group-based interventions to reduce gambling involvement among male football fans: a synopsis of findings from a feasibility study. 以群体为基础的干预措施，以减少男性足球迷的赌博参与：一项可行性研究的结果摘要。
Public health research (Southampton, England)
Pub Date : 2025-07-01 DOI: 10.3310/SWWP9393
Gerda Reith, Blair Biggar, Chris Bunn, Manuela Deidda, Craig Donnachie, Frankie Graham, Cindy Gray, Nicola Greenlaw, Kate Hunt, Matthew Philpott, Neil Platt, Robert D Rogers, John Rooksby, Sally Wyke, Heather Wardle

Background: Gambling is associated with serious social and health harms, including suicidal ideation and suicide attempts. The risk of these adverse effects increases with consumption and imposes a substantial economic burden to the National Health Service and wider society, beyond the negative impacts on individuals and their families. Sports betting is a major growth area for the gambling industry. Sports bettors are disproportionately male and younger, two risk factors for gambling harms. It is important to develop and implement preventative interventions that limit the escalation of gambling harms among this group. We report on the feasibility of an intervention delivered within and by professional football clubs, a setting which has proved highly successful in attracting men to other behaviour change interventions (e.g. weight loss).

Methods: In what was originally designed as a three-phase study, a face-to-face group-based intervention (Football Fans and Betting) was refined in Phase 1, for delivery by trained community coaches at professional football club stadia. Eight 90-minute weekly sessions included interactive 'classroom-based' education around gambling behaviours, the industry and impacts, and group-based physical activity to promote social connectivity. Phase 2 assessed the feasibility of approaches to recruitment and retention and the acceptability of Football Fans and Betting to both coaches and participants. Phase 3 was intended to comprise a pragmatic, two-arm pilot randomised controlled trial of the Football Fans and Betting intervention at four professional football clubs in England.

Results: Data collected from participants and coaches via one-to-one interviews, observations and focus groups revealed significant barriers to recruitment, despite considerable iterative efforts to optimise 'branding' and strategies. Many of our target population did not perceive themselves as needing support. Instead, Football Fans and Betting was attractive to those with more severe gambling symptomology but who were ineligible as they required more specialist safeguarding support than Football Fans and Betting offered. It proved problematic to promote Football Fans and Betting as a programme to prevent progression to more serious gambling harms to men who were embedded in social networks where gambling was perceived as normal. The irony that many professional football clubs partner with gambling companies was noted by participants and some expressed scepticism around club intentions for delivering Football Fans and Betting. Despite considerable efforts to run Football Fans and Betting at six English professional football clubs during 2022 and 2023, insufficient numbers were recruited and retained. Phase 3 did not take place as progression to a pilot trial was unviable. Despite low numbers participating in Football Fans and Betting, those who undertook the programme found

背景：赌博与严重的社会和健康危害有关，包括自杀意念和自杀企图。这些不利影响的风险随着消费的增加而增加，除了对个人及其家庭产生负面影响外，还给国民保健服务和更广泛的社会带来了沉重的经济负担。体育博彩是博彩业的一个主要增长领域。体育投注者中男性和年轻人的比例过高，这是赌博危害的两个风险因素。重要的是制定和实施预防性干预措施，限制赌博危害在这一群体中的升级。我们报告了在职业足球俱乐部内部和由职业足球俱乐部提供的干预的可行性，这种设置在吸引男性进行其他行为改变干预（例如减肥）方面非常成功。方法：在最初设计为三个阶段的研究中，在第一阶段改进了面对面的基于群体的干预（足球迷和博彩），由专业足球俱乐部体育场训练有素的社区教练提供。每周8次90分钟的课程包括围绕赌博行为、行业和影响的互动式“课堂”教育，以及以团体为基础的体育活动，以促进社会联系。第二阶段评估招募和保留方法的可行性，以及球迷和博彩对教练和参与者的可接受性。第三阶段旨在包括一个实用的，双臂试点随机对照试验，对英格兰四家职业足球俱乐部的球迷和投注干预进行研究。结果：通过一对一访谈、观察和焦点小组从参与者和教练那里收集的数据显示，尽管不断努力优化“品牌”和战略，但招聘存在重大障碍。我们的许多目标人群并不认为自己需要支持。相反，足球迷和博彩对那些有更严重赌博症状但不符合条件的人有吸引力，因为他们需要比足球迷和博彩提供更多的专业保障支持。事实证明，将“足球迷和赌博”推广为一种防止发展成更严重的赌博伤害的计划，对那些被嵌入赌博被视为正常的社交网络的男性来说，是有问题的。与会者注意到许多职业足球俱乐部与博彩公司合作的讽刺意味，一些人对俱乐部提供球迷和博彩的意图表示怀疑。尽管在2022年和2023年期间，六家英国职业足球俱乐部在运营球迷和博彩方面做出了相当大的努力，但招募和保留的人数不足。第三阶段没有进行，因为进展到试点试验是不可行的。尽管参与球迷和博彩的人数很少，但参与该计划的人发现，它在支持行为改变和提供对行业策略的更深入了解方面很有用。当它在基层和当地社区环境中交付时，足球迷和博彩在可行性交付方面最为成功。结论：在当前博彩业渗透到职业足球的大环境下，促进预防赌博危害的干预被证明是一个不可逾越的挑战。局限性：该研究未能吸引足够的人数进行干预。未来的工作：应该考虑在不受商业赌博安排阻碍的足球社区中嵌入足球迷和博彩或类似的干预措施，同时强调早期干预的重要性，以防止赌博发展到严重危害。资助：本摘要介绍了由国家卫生和保健研究所（NIHR）公共卫生研究方案资助的独立研究，奖励号为NIHR127665。
{"title":"Group-based interventions to reduce gambling involvement among male football fans: a synopsis of findings from a feasibility study.","authors":"Gerda Reith, Blair Biggar, Chris Bunn, Manuela Deidda, Craig Donnachie, Frankie Graham, Cindy Gray, Nicola Greenlaw, Kate Hunt, Matthew Philpott, Neil Platt, Robert D Rogers, John Rooksby, Sally Wyke, Heather Wardle","doi":"10.3310/SWWP9393","DOIUrl":"https://doi.org/10.3310/SWWP9393","url":null,"abstract":"<p><strong>Background: </strong>Gambling is associated with serious social and health harms, including suicidal ideation and suicide attempts. The risk of these adverse effects increases with consumption and imposes a substantial economic burden to the National Health Service and wider society, beyond the negative impacts on individuals and their families. Sports betting is a major growth area for the gambling industry. Sports bettors are disproportionately male and younger, two risk factors for gambling harms. It is important to develop and implement preventative interventions that limit the escalation of gambling harms among this group. We report on the feasibility of an intervention delivered within and by professional football clubs, a setting which has proved highly successful in attracting men to other behaviour change interventions (e.g. weight loss).</p><p><strong>Methods: </strong>In what was originally designed as a three-phase study, a face-to-face group-based intervention (Football Fans and Betting) was refined in Phase 1, for delivery by trained community coaches at professional football club stadia. Eight 90-minute weekly sessions included interactive 'classroom-based' education around gambling behaviours, the industry and impacts, and group-based physical activity to promote social connectivity. Phase 2 assessed the feasibility of approaches to recruitment and retention and the acceptability of Football Fans and Betting to both coaches and participants. Phase 3 was intended to comprise a pragmatic, two-arm pilot randomised controlled trial of the Football Fans and Betting intervention at four professional football clubs in England.</p><p><strong>Results: </strong>Data collected from participants and coaches via one-to-one interviews, observations and focus groups revealed significant barriers to recruitment, despite considerable iterative efforts to optimise 'branding' and strategies. Many of our target population did not perceive themselves as needing support. Instead, Football Fans and Betting was attractive to those with more severe gambling symptomology but who were ineligible as they required more specialist safeguarding support than Football Fans and Betting offered. It proved problematic to promote Football Fans and Betting as a programme to <i>prevent</i> progression to more serious gambling harms to men who were embedded in social networks where gambling was perceived as normal. The irony that many professional football clubs partner with gambling companies was noted by participants and some expressed scepticism around club intentions for delivering Football Fans and Betting. Despite considerable efforts to run Football Fans and Betting at six English professional football clubs during 2022 and 2023, insufficient numbers were recruited and retained. Phase 3 did not take place as progression to a pilot trial was unviable. Despite low numbers participating in Football Fans and Betting, those who undertook the programme found","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 6","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility study of Learning Together for Mental Health: fidelity, reach and acceptability of a whole-school intervention aiming to promote health and wellbeing in secondary schools. 共同学习促进心理健康的可行性研究：旨在促进中学健康和福祉的全校干预的保真度、可及性和可接受性。
Public health research (Southampton, England)
Pub Date : 2025-06-01 DOI: 10.3310/RTRT0202
Neisha Sundaram, Oliver Lloyd-Houldey, Joanna Sturgess, Elizabeth Allen, Semina Michalopoulou, Steven Hope, Rosa Legood, Stephen Scott, Lee D Hudson, Dasha Nicholls, Deborah Christie, Russell M Viner, Chris Bonell
<p><strong>Background: </strong>Despite high rates of adolescent mental health problems, there are few effective school-based interventions to address this. Whole-school interventions offer a feasible and sustainable means of promoting mental health, but to date, few have been evaluated. Previously we trialled the Learning Together intervention comprising local needs assessment, student and staff participation in decision-making, restorative practice, and a social and emotional skills curriculum. This was effective not only in preventing bullying (primary outcome) but also in promoting mental well-being and psychological functioning (secondary outcomes). We adapted Learning Together to develop Learning Together for Mental Health, focused on promoting mental health.</p><p><strong>Objective: </strong>This paper reports on quantitative data on intervention implementation fidelity, reach and acceptability to assess progression to a Phase III trial.</p><p><strong>Design: </strong>We drew on student baseline and follow-up surveys and an integral process evaluation from a non-randomised feasibility study involving four secondary schools.</p><p><strong>Setting: </strong>Southern England.</p><p><strong>Participants: </strong>Students in year 8 (age 12/13) at baseline and year 10 (age 14/15) at follow-up and school staff and students and intervention trainers and facilitators completing process evaluation tools.</p><p><strong>Interventions: </strong>Whole-school intervention featuring student needs assessment, action groups involving staff and students which selected actions from an evidence-based menu, restorative practice to improve relationships and address student behaviour and a social and emotional skills curriculum.</p><p><strong>Results: </strong>Restorative practice training was implemented with fidelity in all schools. Curriculum training was implemented with fidelity in three of four schools. The response rate to the needs survey across the three schools that participated was 79%. Action groups were implemented with fidelity. Action groups at all four schools completed at least one locally decided action and chose at least one action from the menu of evidence-based options. Restorative practice was implemented across all schools. Of lessons that were observed and lessons for which teachers returned logbooks, curriculum delivery was implemented with fidelity. However, two schools delivered 50% or less of the recommended lessons, and not all teachers completed logbooks. All students and staff completing surveys reported finding the Learning Together for Mental Health intervention a good way to promote student mental health. Over a third of students reported definite awareness of actions being undertaken by their schools to improve student mental health. All pre-defined progression criteria to proceed to a Phase III trial were met. The intervention was delivered with good fidelity and had strong acceptability.</p><p><strong>Limitations: </strong>Th
背景：尽管青少年心理健康问题的发生率很高，但很少有有效的学校干预措施来解决这一问题。整个学校的干预措施提供了一种促进心理健康的可行和可持续的手段，但迄今为止，很少有评估。之前，我们尝试了“一起学习”干预，包括当地需求评估、学生和员工参与决策、恢复性实践以及社交和情感技能课程。这不仅在防止欺凌（主要结果）方面有效，而且在促进精神健康和心理功能（次要结果）方面也有效。我们将“一起学习”改为“一起学习促进心理健康”，重点是促进心理健康。目的：本文报告干预实施保真度、覆盖范围和可接受性的定量数据，以评估III期试验的进展。设计：我们借鉴了学生基线和后续调查，并从涉及四所中学的非随机可行性研究中进行了整体过程评估。背景：英格兰南部。参与者：基线阶段的8年级学生（12/13岁）和后续阶段的10年级学生（14/15岁），以及完成过程评估工具的学校员工和学生、干预培训师和辅导员。干预措施：以学生需求评估为特色的全校干预措施，由教师和学生参与的行动小组，从基于证据的菜单中选择行动，改善关系和解决学生行为的恢复性实践，以及社交和情感技能课程。结果：各学校的恢复性实践训练实施情况良好。在四所学校中，有三所学校忠实地实施了课程培训。参与调查的三所学校的需求回复率为79%。行动小组被忠实地执行。所有四所学校的行动小组至少完成了一项当地决定的行动，并从基于证据的选项菜单中选择了至少一项行动。所有学校都实施了恢复性实践。在观察到的课程和教师归还日志的课程中，课程的实施是忠实的。然而，只有两所学校提供了50%或更少的推荐课程，并不是所有的老师都完成了日志。所有完成调查的学生和教职员都报告说，共同学习促进心理健康干预是促进学生心理健康的好方法。超过三分之一的学生报告说，他们明确意识到学校正在采取行动改善学生的心理健康。所有预先定义的进入III期试验的进展标准都得到满足。干预具有良好的保真度和很强的可接受性。限制：所涉及的学校可能不代表我们将招募参加第三期试验的学校。结论：该研究符合所有预先确定的进展标准，该干预措施已准备好进行III期试验，并进行了轻微调整。未来工作：III期有效性试验是合理的。资助：本文介绍了由国家卫生与保健研究所（NIHR）公共卫生研究计划资助的独立研究，奖励号为NIHR131594。
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引用次数: 0
Learning together for mental health: feasibility of measures to assess a whole-school mental health and wellbeing intervention in secondary schools. 共同学习促进心理健康：评估中学全校心理健康和福利干预措施的可行性。
Public health research (Southampton, England)
Pub Date : 2025-06-01 DOI: 10.3310/GFDT2323
Oliver Lloyd-Houldey, Joanna Sturgess, Neisha Sundaram, Steven Hope, Semina Michalopoulou, Elizabeth Allen, Lee Hudson, Stephen Scott, Dasha Nicholls, Deborah Christie, Rosa Legood, Chris Bonell, Russell Viner
<p><strong>Background: </strong>Population mental health in young people worsened during and since the COVID-19 pandemic. School environments can play a key role in improving young people's mental health. Learning Together for Mental Health is a whole-school intervention aiming to promote mental health and well-being among young people in secondary schools. Before progressing to a Phase III effectiveness evaluation of the intervention, it is critical to assess the feasibility of trial measures at baseline and follow-up.</p><p><strong>Objective: </strong>To evaluate the feasibility of trial measures and procedures within a feasibility study of a whole-school intervention aiming to promote mental health and well-being among young people in secondary schools, including whether we met our progression criterion of survey response rates of 60% or more in two or more schools at baseline and follow-up.</p><p><strong>Design and methods: </strong>We conducted a feasibility study which included assessment of the indicative primary and secondary outcomes measures and procedures to be used in a future Phase III trial.</p><p><strong>Setting and participants: </strong>Setting for our feasibility study included five state, mixed-sex secondary schools in southern England (one of which dropped out after baselines and one of which replaced this). We recruited year-7 students to participate in the baseline survey and year-10 students to participate in the follow-up survey at 12-month follow-up. Baseline and follow-up participants were different groups, as the focus was assessing feasibility of measures for the age groups that would be surveyed at baseline and follow-up in a Phase III randomised controlled trial. Our study was not powered or designed to estimate intervention effects.</p><p><strong>Interventions: </strong>As part of our feasibility study, all schools received the Learning Together for Mental Health intervention for one academic school year.</p><p><strong>Main outcome measures: </strong>The indicative primary outcome measure trialled was the total difficulties score of the Strengths and Difficulties Questionnaire. Indicative secondary outcomes measures trialled were the: Warwick-Edinburgh Mental Well-being Scale; Short Moods and Feelings Questionnaire; Generalised Anxiety Disorder-7 scale; Eating Disorders Examination - Questionnaire Short, self-harm (single item from the Health Behaviour in School-aged Children study); bullying victimisation (Gatehouse Bullying Scale); cyberbullying (two items adapted from the Dose Adjustment for Normal Eating II questionnaire); substance use (National Health Service measure); and Beyond Blue School Climate Questionnaire.</p><p><strong>Results: </strong>Trial measures and procedures were feasible to implement and were acceptable to year-7 and year-10 students, teachers and parents. At baseline, response rates ranged from 58% to 91% between schools. Only two students were opted out by parents, and no students opted out
背景：在2019冠状病毒病大流行期间和之后，年轻人的人口心理健康状况恶化。学校环境可以在改善青少年心理健康方面发挥关键作用。“共同学习促进心理健康”是一项全校干预措施，旨在促进中学生的心理健康和福祉。在进行干预措施的III期有效性评估之前，在基线和随访时评估试验措施的可行性至关重要。目的：评估旨在促进中学青少年心理健康和福祉的全校干预可行性研究中的试验措施和程序的可行性，包括我们是否符合基线和随访时两所或两所以上学校的调查回复率达到60%或以上的进展标准。设计和方法：我们进行了一项可行性研究，包括评估指示性主要和次要结果，测量和程序，用于未来的III期试验。设置和参与者：我们可行性研究的设置包括英格兰南部的五所州男女混合中学（其中一所在基线后退出，另一所取代了这所）。我们招募7年级学生参加基线调查，10年级学生参加12个月的随访调查。基线和随访参与者是不同的组，因为重点是评估将在基线和随访中进行III期随机对照试验的年龄组措施的可行性。我们的研究并不是为了评估干预效果而设计的。干预措施：作为我们可行性研究的一部分，所有学校都接受了一个学年的“共同学习促进心理健康”干预措施。主要结果测量：试验的指示性主要结果测量是优势和困难问卷的总困难得分。试验的指示性次要结局指标有：沃里克-爱丁堡心理健康量表；短期情绪与感受问卷；广泛性焦虑障碍-7量表；饮食失调检查——问卷简短，自残（来自学龄儿童健康行为研究的单一项目）；欺凌受害者（Gatehouse欺凌量表）；网络欺凌（两个项目改编自正常饮食剂量调整II调查问卷）；药物使用（国民保健服务措施）；以及Beyond Blue学校气候调查问卷。结果：试验措施和程序实施可行，七、十年级学生、教师和家长均能接受。在基线时，不同学校的回应率从58%到91%不等。只有两名学生被家长选择退出，没有学生提前选择退出。在调查当天拒绝同意的学生很少见（7%）。百分之十二的学生缺席。后续调查的总体反应率为66%，从44%到91%不等。只有两名学生被家长选择退出，三名学生提前退出。总的来说，12%的人在当天选择了退出。百分之二十的学生缺席。反应率的差异反映了某些学校的具体问题。调查的基线时间为40-45分钟，随访时间为30分钟。达到了有关反应率的试验进展标准，基线时四所学校中有三所，随访时四所学校中有两所的反应率超过60%。局限性：我们的研究涉及一个小的、有目的的学校和学生样本，这些样本不代表英格兰的学校和学生。结论：在对“一起学习促进心理健康”干预措施进行III期有效性评估时，试验措施和程序应稍加修改。今后的工作：如果基线调查和后续调查不安排在学期的最后几周、星期五或临近中学普通教育证书模拟考试的时候，调查的回复率可能会提高。如果问题的措辞适合七年级学生的年龄，可能会改善七年级学生完成一些措施（如饮食失调检查-问卷简短）。资助：本文介绍了由国家卫生与保健研究所（NIHR）公共卫生研究计划资助的独立研究，奖励号为NIHR131594。
{"title":"Learning together for mental health: feasibility of measures to assess a whole-school mental health and wellbeing intervention in secondary schools.","authors":"Oliver Lloyd-Houldey, Joanna Sturgess, Neisha Sundaram, Steven Hope, Semina Michalopoulou, Elizabeth Allen, Lee Hudson, Stephen Scott, Dasha Nicholls, Deborah Christie, Rosa Legood, Chris Bonell, Russell Viner","doi":"10.3310/GFDT2323","DOIUrl":"10.3310/GFDT2323","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Population mental health in young people worsened during and since the COVID-19 pandemic. School environments can play a key role in improving young people's mental health. Learning Together for Mental Health is a whole-school intervention aiming to promote mental health and well-being among young people in secondary schools. Before progressing to a Phase III effectiveness evaluation of the intervention, it is critical to assess the feasibility of trial measures at baseline and follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the feasibility of trial measures and procedures within a feasibility study of a whole-school intervention aiming to promote mental health and well-being among young people in secondary schools, including whether we met our progression criterion of survey response rates of 60% or more in two or more schools at baseline and follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design and methods: &lt;/strong&gt;We conducted a feasibility study which included assessment of the indicative primary and secondary outcomes measures and procedures to be used in a future Phase III trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and participants: &lt;/strong&gt;Setting for our feasibility study included five state, mixed-sex secondary schools in southern England (one of which dropped out after baselines and one of which replaced this). We recruited year-7 students to participate in the baseline survey and year-10 students to participate in the follow-up survey at 12-month follow-up. Baseline and follow-up participants were different groups, as the focus was assessing feasibility of measures for the age groups that would be surveyed at baseline and follow-up in a Phase III randomised controlled trial. Our study was not powered or designed to estimate intervention effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;As part of our feasibility study, all schools received the Learning Together for Mental Health intervention for one academic school year.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The indicative primary outcome measure trialled was the total difficulties score of the Strengths and Difficulties Questionnaire. Indicative secondary outcomes measures trialled were the: Warwick-Edinburgh Mental Well-being Scale; Short Moods and Feelings Questionnaire; Generalised Anxiety Disorder-7 scale; Eating Disorders Examination - Questionnaire Short, self-harm (single item from the Health Behaviour in School-aged Children study); bullying victimisation (Gatehouse Bullying Scale); cyberbullying (two items adapted from the Dose Adjustment for Normal Eating II questionnaire); substance use (National Health Service measure); and Beyond Blue School Climate Questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Trial measures and procedures were feasible to implement and were acceptable to year-7 and year-10 students, teachers and parents. At baseline, response rates ranged from 58% to 91% between schools. Only two students were opted out by parents, and no students opted out","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the effectiveness of the Drink Less smartphone app for reducing alcohol consumption compared with usual digital care: a comprehensive synopsis from a 6-month follow-up RCT. 与通常的数字护理相比，评估“少喝酒”智能手机应用程序减少酒精消费的有效性：一项为期6个月的随访随机对照试验的综合摘要。
Public health research (Southampton, England)
Pub Date : 2025-06-01 DOI: 10.3310/LNNB8060
Claire Garnett, Melissa Oldham, Gemma Loebenberg, Larisa Dinu, Emma Beard, Colin Angus, Robyn Burton, Matt Field, Felix Greaves, Matthew Hickman, Eileen Kaner, Susan Michie, Marcus Munafò, Elena Pizzo, Jamie Brown
<p><strong>Background: </strong>Digital interventions can be effective for reducing alcohol consumption. However, most digital interventions that have been evaluated are websites and there is little evidence on the effectiveness of smartphone apps, especially in a United Kingdom context. We developed an evidence- and theory-informed app, Drink Less, to help increasing-and-higher-risk drinkers (Alcohol Use Disorders Identification Test score ≥ 8) reduce their alcohol consumption.</p><p><strong>Objective: </strong>To evaluate the effectiveness of Drink Less for reducing alcohol consumption compared with usual digital care in the United Kingdom.</p><p><strong>Design: </strong>Two-arm, double-blind, parallel-group, randomised controlled trial with 1 : 1 group allocation and an embedded process evaluation, with 6-month follow-up.</p><p><strong>Setting: </strong>Remotely conducted among participants living in the United Kingdom, recruited from July 2020 to March 2022.</p><p><strong>Participants: </strong>Five thousand six hundred and two increasing-and-higher-risk drinkers aged 18+ who had access to an iPhone operating system device and wanted to drink less alcohol.</p><p><strong>Interventions: </strong>Participants were recommended to use the intervention (Drink Less) or recommended the comparator (National Health Service alcohol advice web page). Drink Less is an app-based intervention to help increasing-and-higher-risk drinkers reduce their alcohol consumption. It consists of evidence-based modules (e.g. goal setting, self-monitoring) and was systematically and transparently developed and refined. The National Health Service alcohol advice web page was considered usual digital care and provides tips on cutting down.</p><p><strong>Main outcome measures: </strong>The primary outcome was self-reported weekly alcohol consumption at 6-month follow-up (derived from the extended Alcohol Use Disorders Identification Test - Consumption), adjusted for baseline alcohol consumption.</p><p><strong>Results: </strong>The retention rate at 6-month follow-up was 80%. The data were not missing completely at random with differences detected in educational qualifications, occupation and income, indicating that multiple imputation was the most appropriate analytic approach. This found that Drink Less resulted in a 2.00 United Kingdom unit greater weekly reduction (95% confidence interval -3.76 to -0.24) at 6-month follow-up compared with the National Health Service alcohol advice web page. Compared with the National Health Service alcohol advice web page, Drink Less cost an additional £1.28 per user, when including the sunk costs (already incurred and cannot be recovered), but saved £0.04 per user when considering only the annual maintenance costs. Drink Less costs only an extra £0.64 per additional weekly unit of alcohol reduction, and may be cost saving if sufficient people use the app to cover the sunk costs. There was no statistically significant difference in quali
背景：数字干预措施可有效减少酒精消费。然而，大多数被评估的数字干预措施都是网站，几乎没有证据表明智能手机应用程序的有效性，尤其是在英国的情况下。我们开发了一个基于证据和理论的应用程序“少喝酒”，以帮助增加和高风险饮酒者（酒精使用障碍识别测试得分≥8）减少饮酒量。目的：在英国，与常规数字医疗相比，评估“少喝”减少酒精消费的有效性。设计：双臂，双盲，平行组，随机对照试验，1:1组分配和嵌入式过程评估，随访6个月。环境：在2020年7月至2022年3月期间，在居住在英国的参与者中远程进行。参与者：56002名年龄在18岁以上的酗酒者，他们有iPhone操作系统设备，并且想少喝酒。干预措施：建议参与者使用干预措施（少喝酒）或推荐比较者（国家卫生服务酒精建议网页）。“少喝”是一个基于应用程序的干预，旨在帮助越来越多和高风险的饮酒者减少饮酒量。它由以证据为基础的模块（例如目标设定、自我监督）组成，并经过系统和透明的开发和完善。英国国民健康服务机构的酒精建议网页被认为是常规的数字护理，并提供了减少饮酒的建议。主要结局指标：主要结局是6个月随访期间自我报告的每周饮酒量（来自延长的酒精使用障碍识别测试-消费），根据基线饮酒量进行调整。结果：随访6个月，保留率为80%。数据并非完全随机缺失，在学历、职业和收入等方面存在差异，表明多重imputation是最合适的分析方法。研究发现，在6个月的随访中，与国家卫生服务酒精建议网页相比，少喝酒每周减少2.00个英国单位（95%可信区间为-3.76至-0.24）。与英国国民健康服务（National Health Service）的饮酒建议网页相比，如果算上沉没成本（已经发生且无法收回的成本），“少喝”网站的人均成本为1.28英镑，但如果只考虑每年的维护成本，则为每位用户节省了0.04英镑。每周每减少一个单位的酒精摄入量，Drink Less只需要额外花费0.64英镑，如果有足够多的人使用该应用来弥补沉没成本，可能会节省成本。两组间的质量调整生命年无统计学差异。局限性：本试验依赖于回顾性自我报告的酒精摄入量。预先登记的多重归因敏感性分析的结果与预先登记的初级分析的结果不一致（一种对缺失数据的保守方法，假设无反应者在基线水平饮酒），与比较组相比，干预组每周减少0.98个单位（95%置信区间-2.67至0.70）。根据缺失数据的模式，独立的数据监测委员会建议进行多重输入。结论：与英国国家健康服务酒精建议网页相比，“少喝”似乎对减少饮酒人数增加和高风险的饮酒者有效，如果在人群中广泛使用，可能会节省成本。未来的工作：在英国，“少喝酒”计划将被广泛推广，并为日益增加和高风险的饮酒者提供廉价的支持。未来的工作应该研究不同的推广策略和在医疗环境中实施应用程序的方法，并使其适应其他国家。资助：本摘要介绍了由国家卫生和保健研究所（NIHR）公共卫生研究方案资助的独立研究，奖励号为NIHR127651。
{"title":"Evaluating the effectiveness of the Drink Less smartphone app for reducing alcohol consumption compared with usual digital care: a comprehensive synopsis from a 6-month follow-up RCT.","authors":"Claire Garnett, Melissa Oldham, Gemma Loebenberg, Larisa Dinu, Emma Beard, Colin Angus, Robyn Burton, Matt Field, Felix Greaves, Matthew Hickman, Eileen Kaner, Susan Michie, Marcus Munafò, Elena Pizzo, Jamie Brown","doi":"10.3310/LNNB8060","DOIUrl":"https://doi.org/10.3310/LNNB8060","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital interventions can be effective for reducing alcohol consumption. However, most digital interventions that have been evaluated are websites and there is little evidence on the effectiveness of smartphone apps, especially in a United Kingdom context. We developed an evidence- and theory-informed app, Drink Less, to help increasing-and-higher-risk drinkers (Alcohol Use Disorders Identification Test score ≥ 8) reduce their alcohol consumption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the effectiveness of Drink Less for reducing alcohol consumption compared with usual digital care in the United Kingdom.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Two-arm, double-blind, parallel-group, randomised controlled trial with 1 : 1 group allocation and an embedded process evaluation, with 6-month follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Remotely conducted among participants living in the United Kingdom, recruited from July 2020 to March 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Five thousand six hundred and two increasing-and-higher-risk drinkers aged 18+ who had access to an iPhone operating system device and wanted to drink less alcohol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Participants were recommended to use the intervention (Drink Less) or recommended the comparator (National Health Service alcohol advice web page). Drink Less is an app-based intervention to help increasing-and-higher-risk drinkers reduce their alcohol consumption. It consists of evidence-based modules (e.g. goal setting, self-monitoring) and was systematically and transparently developed and refined. The National Health Service alcohol advice web page was considered usual digital care and provides tips on cutting down.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The primary outcome was self-reported weekly alcohol consumption at 6-month follow-up (derived from the extended Alcohol Use Disorders Identification Test - Consumption), adjusted for baseline alcohol consumption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The retention rate at 6-month follow-up was 80%. The data were not missing completely at random with differences detected in educational qualifications, occupation and income, indicating that multiple imputation was the most appropriate analytic approach. This found that Drink Less resulted in a 2.00 United Kingdom unit greater weekly reduction (95% confidence interval -3.76 to -0.24) at 6-month follow-up compared with the National Health Service alcohol advice web page. Compared with the National Health Service alcohol advice web page, Drink Less cost an additional £1.28 per user, when including the sunk costs (already incurred and cannot be recovered), but saved £0.04 per user when considering only the annual maintenance costs. Drink Less costs only an extra £0.64 per additional weekly unit of alcohol reduction, and may be cost saving if sufficient people use the app to cover the sunk costs. There was no statistically significant difference in quali","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 5","pages":"1-26"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of parenting interventions for those with additional health and social care needs during pregnancy: THRIVE a multi-arm RCT with embedded economic and process components. 对怀孕期间有额外健康和社会护理需求的人的育儿干预措施的评估：THRIVE是一项包含经济和过程成分的多组随机对照试验。
Public health research (Southampton, England)
Pub Date : 2025-05-01 DOI: 10.3310/KYMT5407
Marion Henderson, Anja Wittkowski, Katie Buston, Karen Crawford, Alice MacLachlan, Alex McConnachie, Emma McIntosh, Claudia-Martina Messow, Catherine Nixon, Rosaleen O'Brien, Shona Shinwell, Daniel Wight, Yiqiao Xin, Rachel Calam, Ruth Dundas, James Law, Helen Minnis, Lucy Thompson, Philip Wilson
<p><strong>Background: </strong>Women who have additional social and care needs in pregnancy (e.g. social adversity, maternal depression and anxiety) are likely to produce high levels of stress hormones. This has the potential to affect fetal brain development, increase infant reactivity to stress, and impair sensitive mother-infant bonds from developing. These in turn may have long-term effects on children's health, social and educational outcomes. Parenting interventions show promising improvements to child outcomes; however, there is little evidence of their efficacy in the UK.</p><p><strong>Objective(s): </strong>THRIVE compared the impact of taking part in one of two antenatal parenting support programmes both incorporating cognitive-behavioural therapy (Enhanced Triple P for Baby or Mellow Bumps) with care-as-usual alone on the mental health and maternal attunement of vulnerable mothers-to-be, as well as the socioemotional and behavioural development of their children.</p><p><strong>Design: </strong>THRIVE is a three-arm randomised controlled trial. Pregnant women with additional social and care needs in pregnancies were invited to participate. Participants were randomly allocated to Enhanced Triple P for Baby, Mellow Bumps or care-as-usual.</p><p><strong>Setting: </strong>The study took place in National Health Service Greater Glasgow and Clyde and National Health Service Ayrshire and Arran health board areas. Intervention sessions were predominantly in community settings.</p><p><strong>Participants: </strong>Women identified as having additional social and care needs in pregnancies during pregnancy based on the National Health Service Greater Glasgow and Clyde's Special Needs in Pregnancy criteria were recruited to THRIVE (<i>n</i> = 485), slightly below the target of 500 women. Participants were block-randomised 5 : 5 : 2 to Enhanced Triple P for Baby, Mellow Bumps or care-as-usual. Subsequently their babies and accompanying person of choice were also invited.</p><p><strong>Interventions: </strong>Enhanced Triple P for Baby consists of four weekly group-based antenatal sessions followed by up to three postnatal home visits and one postnatal group session. It aims to provide babies with a healthy start to life by combining parenting skills training with strategies to enhance individual well-being and couple adjustment. Mellow Bumps in comparison, comprises of seven weekly antenatal sessions and one postnatal session. It aims to decrease maternal stress, increase understanding of neonates' capacity for social interaction, and emphasise the importance of early interaction for brain development and attachment. Recruitment to the trial took place between early 2014 and May 2018.</p><p><strong>Main outcome measures: </strong>Our two primary outcomes were the Hospital Anxiety and Depression Scale, plus outwardly directed irritability from the Adult Wellbeing Scale, and CARE Index mother-infant dyadic interaction synchrony.</p><p><strong>Results
背景：怀孕期间有额外社会和护理需求的妇女（如社会逆境、母亲抑郁和焦虑）可能产生高水平的应激激素。这有可能影响胎儿的大脑发育，增加婴儿对压力的反应，并损害敏感的母婴关系的发展。这反过来又可能对儿童的健康、社会和教育成果产生长期影响。父母干预显示出对儿童结局有希望的改善；然而，在英国几乎没有证据表明它们的有效性。目标(s): THRIVE比较了参加两种产前育儿支持方案之一的影响，这两种方案都结合了认知行为疗法（增强婴儿3p或Mellow Bumps）和常规护理，对脆弱的准妈妈的心理健康和母性调节，以及她们孩子的社会情感和行为发展。设计：THRIVE是一项三组随机对照试验。在怀孕期间有额外社会和护理需要的孕妇被邀请参加。参与者被随机分配到婴儿强化3p组、圆润肿块组或照旧组。环境：研究在国家卫生服务大格拉斯哥和克莱德地区以及国家卫生服务艾尔郡和阿伦卫生委员会地区进行。干预会议主要在社区环境中进行。参与者：根据国家卫生服务大格拉斯哥和克莱德孕期特殊需要标准，确定在怀孕期间有额外社会和护理需要的妇女被招募到THRIVE (n = 485)，略低于500名妇女的目标。参与者按5:5:2分组随机分配到婴儿强化3p，圆鼓鼓或照旧护理。随后，他们的孩子和陪伴的人也被邀请。干预措施：加强婴儿三重P包括每周四次以小组为基础的产前检查，随后是多达三次产后家访和一次产后小组会议。它旨在通过将育儿技能培训与提高个人福祉和夫妻关系调整的策略相结合，为婴儿提供一个健康的生命开端。相比之下，Mellow Bumps包括每周七次产前会议和一次产后会议。它旨在减少母亲的压力，增加对新生儿社会互动能力的理解，并强调早期互动对大脑发育和依恋的重要性。试验招募于2014年初至2018年5月进行。主要结果测量：我们的两个主要结果是医院焦虑和抑郁量表，加上成人幸福量表中的外向性易怒，以及CARE指数母婴二元互动同步。结果：联合积极干预组与常规护理组相比，医院焦虑抑郁量表和外显性易怒评分的基线变化无显著差异[效应值（95%置信区间）0.03(-0.24 ~ 0.29)]，或婴儿强化三联保与常规护理组相比[0.04(-0.24 ~ 0.32)]或Mellow Bumps与常规护理组相比[0.01(-0.27 ~ 0.30)]。Mellow Bumps具有成本效益的承诺，因为它有可能节省与常规医疗保健资源使用相关的成本。限制：THRIVE的主要限制是我们为婴儿和成熟肿块参与者提供的增强3p小组的出勤率（低于42%）很低。然而，根据出勤水平调整的亚组分析表明，随着参与的增加，结果不会有任何不同。结论：在THRIVE参与的人群中，在提供大量支持的怀孕阶段（许多育儿干预措施在没有严格评估的情况下提供），我们没有证据推荐为婴儿或Mellow Bumps推出增强3p。未来的工作：未来的工作可以探讨干预的时间和强度、干预小组的组成、联合制作的节目、在线会议以及解决不平等问题的影响。试验注册：该试验注册为当前对照试验ISRCTN21656568 (www.isrctn.com/ISRCTN21656568).Funding：该奖项由美国国家卫生与保健研究所（NIHR）公共卫生研究计划资助（NIHR奖励编号11/3002/01），全文发表在《公共卫生研究》上；第13卷第4期有关进一步的奖励信息，请参阅美国国立卫生研究院资助和奖励网站。
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引用次数: 0
Well-being package for foster carers and teachers of looked-after children aged 8 to 11 years: the STrAWB feasibility RCT. 8至11岁儿童的寄养照顾者和教师福利包：STrAWB可行性随机对照试验。
Public health research (Southampton, England)
Pub Date : 2025-03-26 DOI: 10.3310/NGXR5244
Nikki Luke, Robin Banerjee, Valerie Dunn, Nick Douglas, Áine Kelly, Helen Trivedi, Annette Bauer, Andrew Cook, Nick Midgley, Matt Woolgar
<p><strong>Background: </strong>Children in care are at elevated risk of mental health issues and poorer well-being, and social care and health services are under pressure to meet their needs. The Shared Training and Assessment for Well-Being programme is a recent approach to training and assessment designed to bring together foster carers and designated teachers to identify and meet the well-being needs of primary school-aged children in care, across the home and school contexts.</p><p><strong>Objectives: </strong>This feasibility randomised controlled trial addressed key questions concerning the acceptability of the Shared Training and Assessment for Well-Being intervention (including training, assessments, clinical review and feedback) and the feasibility of the research design for a larger randomised controlled trial (including recruitment, randomisation and outcome measures).</p><p><strong>Design: </strong>This was a two-arm randomised controlled trial (Shared Training and Assessment for Well-Being intervention vs. control group), with two points of data collection (baseline and 12-month follow-up) for our primary and secondary outcomes.</p><p><strong>Setting: </strong>The study focused on looked-after children from four local authorities in southern England. In the context of the COVID-19 pandemic, both the research and intervention activities were undertaken online with participants.</p><p><strong>Participants: </strong>Looked-after children aged 8-11 years were recruited from the participating local authorities, along with their foster/kinship carers and designated teachers. Carers for all children in the authorities meeting inclusion criteria were initially invited to participate. The original target sample size was 70 children, with 35 receiving the Shared Training and Assessment for Well-Being intervention and 35 in the control group. However, only 21 looked-after children were successfully recruited and randomised.</p><p><strong>Interventions: </strong>Shared Training and Assessment for Well-Being is an integrated approach that combines training on mental health, well-being and resilience for foster carers and designated teachers; a multi-informant assessment package; review of assessments by mental health experts; and feedback to enable key adults to respond to identified needs and strengths. COVID-19 adaptations enabled all key elements to be delivered remotely.</p><p><strong>Main outcome measures: </strong>Two multi-informant primary outcome measures were included as possible candidates for a larger randomised controlled trial: the Strengths and Difficulties Questionnaire and the Paediatric Quality of Life Scale. A further multi-informant secondary outcome measure was also included: the Behavioural and Emotional Rating Scale.</p><p><strong>Results: </strong>Feasibility was not demonstrated, as recruitment was heavily impacted by the COVID-19 pandemic and further attrition occurred over the extended project duration. For the small n
背景：接受照料的儿童出现精神健康问题的风险较高，福祉较差，社会照料和卫生服务面临着满足其需求的压力。福利共享培训和评估计划是最近的一种培训和评估方法，旨在将寄养照顾者和指定教师聚集在一起，以确定和满足在家庭和学校环境中照顾的小学学龄儿童的福利需求。目的：本可行性随机对照试验解决了有关福祉干预共享培训和评估（包括培训、评估、临床审查和反馈）的可接受性以及更大规模随机对照试验研究设计的可行性（包括招募、随机化和结果测量）的关键问题。设计：这是一项两组随机对照试验（幸福感干预的共享培训和评估与对照组），我们的主要和次要结果有两个数据收集点（基线和12个月随访）。环境：这项研究的重点是来自英格兰南部四个地方政府的受照顾儿童。在2019冠状病毒病大流行的背景下，研究和干预活动都是与参与者在线进行的。参与者：从参与的地方当局招募了8-11岁的被照顾儿童，以及他们的寄养/亲属照顾者和指定教师。当局中符合纳入标准的所有儿童的照料者最初被邀请参加。最初的目标样本量为70名儿童，其中35名接受幸福干预的共享培训和评估，35名作为对照组。然而，只有21名被照顾的儿童被成功招募并随机分配。干预措施：福祉共享培训和评估是一种综合方法，将对寄养照顾者和指定教师进行心理健康、福祉和复原力方面的培训结合起来；多信息提供者一揽子评估；审查心理健康专家的评估；以及反馈，使关键的成年人能够对确定的需求和优势做出反应。COVID-19适应使所有关键要素得以远程交付。主要结果测量：两个多信息的主要结果测量被纳入一个更大的随机对照试验的可能候选：优势和困难问卷和儿科生活质量量表。进一步的多信息来源次要结果测量也包括：行为和情绪评定量表。结果：由于招聘受到COVID-19大流行的严重影响，并且随着项目持续时间的延长，出现了进一步的人员流失，因此没有证明可行性。对于少数完成福利共享培训和评估一揽子计划的人来说，干预措施的关键要素对参与者来说是可以接受的。此外，除了招募和保留问题外，随机对照试验设计的关键方面，包括随机化，都是可以接受的。局限性：在确保提供和评估福祉共享培训和评估干预措施所需的能力和稳定性方面，不可能准确区分COVID-19的影响和更广泛的挑战。结论：幸福感共享培训与评估干预和随机对照试验过程的关键要素是可以接受的，但总体随机对照试验研究设计在本研究中是不可行的。2019冠状病毒病大流行对寄养照料者、学校、地方服务机构和儿童的影响严重影响了该项目。未来的工作：建议潜在的战略，以应对挑战，评估综合培训和评估方法，针对关键成人支持照看儿童。资助：本摘要介绍了由国家卫生和保健研究所（NIHR）公共卫生研究计划资助的独立研究，奖励号为NIHR127799。
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