Mental health literacy

وَقَالُواْ يَٰٓأَيُّهَا ٱلَّذِي نُزِّلَ عَلَيۡهِ ٱلذِّكۡرُ إِنَّكَ لَمَجۡنُونࣱ‏

They say, ‘Receiver of this Quran! You are definitely mad

قَالَ إِنَّ رَسُولَكُمُ ٱلَّذِيٓ أُرۡسِلَ إِلَيۡكُمۡ لَمَجۡنُونࣱ‏

Pharaoh said, ‘This messenger who has been sent to you is truly possessed.’

وَيَقُولُونَ أَئِنَّا لَتَارِكُوٓاْ ءَالِهَتِنَا لِشَاعِرࣲ مَّجۡنُونِۭ

and said, ‘Are we to forsake our gods for a mad poet?’

ثُمَّ تَوَلَّوۡاْ عَنۡهُ وَقَالُواْ مُعَلَّمࣱ مَّجۡنُونٌ

they turned their backs on him, saying, ‘He is tutored! He is possessed!’

فَتَوَلَّىٰ بِرُكۡنِهِۦ وَقَالَ سَٰحِرٌ أَوۡ مَجۡنُونࣱ‏

Pharaoh turned away with his supporters, saying, ‘This is a sorcerer, or maybe a madman,’

كَذَٰلِكَ مَآ أَتَى ٱلَّذِينَ مِن قَبۡلِهِم مِّن رَّسُولٍ إِلَّا قَالُواْ سَاحِرٌ أَوۡ مَجۡنُونٌ

Every previous people to whom a messenger was sent also said, ‘A sor-cerer, or maybe a madman!’

And they that is the disbelievers of Mecca say to the Prophet s ‘O you to whom the Remembrance the Qur’ān — as you claim — has been revealed lo! you are indeed possessed!

He said ‘Verily this messenger of yours sent to you is a madman!’

and would say ‘Are we to abandon our gods for a mad poet?’ that is for the sake of what Muhammad (s) says? as regards the hamzas in a-innā ‘are we’ the same applies as mentioned above.

And they say: "O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed! Verily, you are a madman (6)"Why do you not bring angels to us if you are of the truthful? (7)We do not send the angels down except with the truth, and in that case, they (the disbelievers) would have no respite (8)Verily, We, it is We Who revealed the Dhikr (i.e. the Qur'an) and surely We will guard it (from corruption)(9) The Accusation that the Prophet (ﷺ) was a Madman and Demands for Him to bring down Angels Allah tells us about the disbelief, arrogance and stubbornness of the disbelievers as reflected in their words: يَا أَيُّهَا الَّذِي نُزِّلَ عَلَيْهِ الذِّكْرُ (O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed!) i.e., the one who claims to receive it. إِنَّكَ لَمَجْنُونٌ (Verily, you are a mad man!) i.e., by your invitation to us to follow you and leave the way of our forefath

Fir'awn said: "And what is the Lord of Al-'Alamin (23)(Musa) said: "The Lord of the heavens and the earth, and all that is between them, if you seek to be convinced with certainty. (24)(Fir'awn) said to those around: "Do you not hear (what he says)? (25)(Musa) said: "Your Lord and the Lord of your ancient fathers! (26)(Fir'awn) said: "Verily, your Messenger who has been sent to you is a madman! (27)(Musa) said: "Lord of the east and the west, and all that is between them, if you did but understand! (28) Allah tells us about the disbelief, rebellion, oppression and denial of Fir'awn, as He says: وَمَا رَبُّ الْعَالَمِينَ ((Fir'awn said:) "And what is the Lord of the 'Alamin") This is because he used to say to his people: مَا عَلِمْتُ لَكُم مِّنْ إِلَٰهٍ غَيْرِي (I know not that you have a god other than me.)(28:38) فَاسْتَخَفَّ قَوْمَهُ فَأَطَاعُوهُ (Thus he fooled his people, and

And they will turn to one another and question one another (27)They will say: "It was you who used to come to us from the right side. (28)They will reply: "Nay, you yourselves were not believers. (29)"And we had no authority over you. Nay! But you were a transgressing people. (30)"So now the Word of our Lord has been justified against us, that we shall certainly taste (the torment). (31)"So we led you astray because we were ourselves astray. (32)Then verily, that Day, they will (all) share in the torment (33)Certainly, that is how We deal with the criminals (34)Truly, when it was said to them: "La ilaha illallah," they puffed themselves up with pride (35)And (they) said: "Are we going to abandon our gods for the sake of a mad poet? (36)Nay! he has come with the truth and he confirms the Messengers (37) The arguing of the Idolators on the Day of Resurrection Allah tells us that the disb

ولو كشف الغطاء لرأيت أكثر النفوس البشرية صرعى مع هذه الأرواح الخبيثة وهي في أسرها وقبضتها تسوقها حيث شاءت ولا يمكنها الامتناع عنها ولا مخالفتها وبها الصرع الأعظم الذي لا يفيق صاحبه إلا عند المفارقة والمعاينة فهناك يتحقق أنه كان هو المصروع حقيقة وبالله المستعان وعلاج هذا الصرع باقتران العقل الصحيح إلا الإيمان بما جاءت به الرسل وأن تكون الجنة والنار نصب عينه وقبلة قلبه ويستحرض أهل الدنيا وحلول المثولات والآفات بهم ووقوعها خلال ديارهم كمواقع القطر وهم صرعى لا يفيقون وما أشد أعداء هذا الصرع ولكن لما عمت البلية به بحيث ينظر الإنسان لا يرى إلا مصروعا لم يصر مستغربا ولا مستنكرا بل صار لكثرة المصروعين عين المستنكر المستغرب خلافة فإذا أراد الله بعبد حيرا أفاق من هذه الصرعة ونظر إلى أبناء الدنيا مصروعين حوله يمينا وشمالا على اختلاف طبقاتهم فمنهم من أطبق به الجنون ومنهم من يفيق أحيانا قليلة ويعود إلى جنونه ومنهم من يجن مرة ويفيق أخرى فإذا أفاق عمل عمل أهل الإفاقة والعقل ثم يعاوده الصرع فيقع في التخ

الثاني أن هذا باطل بصور كثيرة منها دخول الماء في العود والسحاب ودخول النار في الحديد ودخول الغذاء في جميع أجزاء البدن ودخول الجن في المصروع فالروح للطافتها لا يمتنع عليها مشابكة البدن والدخول في جميع أجزائه

فالعقل فن واحد وطريقه % أدرى فأرصد و الجنون فنون

هكذا ضعف الدين في قرون سالفة فكيف الظن بزمانك هذا وقد انتهى الأمر إلى أن مظهر الإنكار يستهدف لنسبته إلى الجنون فالأولى أن يشتغل الإنسان بنفسه ويسكت

وأما القسم الثاني، وهو المدح بسبب الجاه والمال، فالفرح بذلك، كالفرح بنبات الأرض الذي يصير عن قريب هشيما، ولا يفرح بذلك إلا من قل عقله، وإن كنت خاليا عن الصفة التي مدحت بها، ففرحك بالمدح غاية الجنون.

قالوا وكيف يمدح أمر يمنع القرار ويسلب المنام ويوله العقل ويحدث الجنون بل هو نفسه جنون كما قال بعض الحكماء الجنون فنون والعشق فن من فنونه كما قال بعض العشاق

The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth.: Aim: Conduct a systematic review for the effectiveness of school mental health literacy programs to enhance knowledge, reduce stigmatizing attitudes and improve help-seeking behaviours among youth (12-25 years of age). Methods: Reviewers independently searched PubMed, PsycINFO, Cochrane Library, CINAHL, ERIC, grey literature and reference lists of included studies. They reached a consensus on the included studies, and rated the risk of bias of each study. Studies that reported three outcomes: kn

Is It Possible to "Find Space for Mental Health" in Young People? Effectiveness of a School-Based Mental Health Literacy Promotion Program.: Lack of knowledge regarding, and the stigma associated with, mental disorders have been identified as major obstacles for the promotion of mental health and early intervention. The present study aimed to evaluate the effectiveness of a school-based intervention program focused on the promotion of mental health literacy (MHL) in young people (“Finding Space for Mental Health”). A sample of 543 students (22 classes), aged between 12 and 14 years old, participated in the study. Each class of studen

Facilitators and Barriers for Advance Care Planning Among Ethnic and Racial Minorities in the U.S.: A Systematic Review of the Current Literature.: Growing evidence suggests a low engagement in advance care planning (ACP) among ethnic minorities in the U.S. The purpose of this study was to synthesize findings from prior research about ACP among ethnic minorities. An extensive literature search was conducted using multiple electronic databases. After applying inclusion criteria, 26 studies were included. Four categories of facilitators and barriers to ACP were identified: (1) Socio-demographic factors, (2) health status, literacy and experie

Adolescent health literacy and health behaviors: A systematic review.: Objectives: To systematically review and synthesize literature on the relationship between health literacy and health behaviors in adolescents. Methods: Searches in PsychInfo, PUBMED/MEDLINE, and Educational Resources Information Center (ERIC) were conducted. Studies were included if they reported original data on the relationship between health literacy and a health behavior in adolescents, were written in English, and the population did not have a chronic illness or disability. Results: Sevent

The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure.: Background: Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy. Methods: The effect o

Workplace Interventions Targeting Mental Health Literacy, Stigma, Help-Seeking, and Help-Offering in Male-Dominated Industries: A Systematic Review.: Mental ill-health and suicide represent a significant proportion of the burden of global disease among men. Connell's relational theory of masculinities provides a useful framework to explore how mental health literacy, mental health stigma, and delayed help-seeking and help-offering behaviors are associated with mental ill-health among men, particularly within male-dominated industries. To address the high incidences of mental ill-health in male-dominated industries, several workplace intervent

Psychoeducation and online mood tracking for patients with bipolar disorder: A randomised controlled trial.

Background: Psychoeducation is an effective adjunct to medications in bipolar disorder (BD). Brief psychoeducational approaches have been shown to improve early identification of relapse. However, the optimal method of delivery of psychoeducation remains uncertain. Here, our objective was to compare a short therapist-facilitated vs. self-directed psychoeducational intervention for BD. Methods: BD outpatients who were receiving medication-based treatment were randomly assigned to 5 psychoeducation sessions administered by a therapist (Facilitated Integrated Mood Management; FIMM; n=60), or self-administered psychoeducation (Manualized Integrated Mood Management; MIMM; n=61). Follow-up was based on patients' weekly responses to an electronic mood monitoring programme over 12 months. Results: Over follow-up, there were no group differences in weekly self-rated depression symptoms or relapse…

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Receiving care for intimate partner violence in primary care: Barriers and enablers for women participating in the weave randomised controlled trial.

Background: Interventions in health settings for intimate partner violence (IPV) are being increasingly recognised as part of a response to addressing this global public health problem. However, interventions targeting this sensitive social phenomenon are complex and highly susceptible to context. This study aimed to elucidate factors involved in women's uptake of a counselling intervention delivered by family doctors in the weave primary care trial (Victoria, Australia). Methods: We analysed associations between women's and doctors' baseline characteristics and uptake of the intervention. We interviewed a random selection of 20 women from an intervention group women to explore cognitions relating to intervention uptake. Interviews were audio-recorded, transcribed, coded in NVivo 10 and analysed using the theory of planned behaviour (TPB). Results: Abuse severity and socio-demographic ch…

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An Ecological Momentary Intervention for weight loss and healthy eating via smartphone and Internet: study protocol for a randomised controlled trial.

Background: Long-term weight loss maintenance is difficult to achieve. Effectiveness of obesity interventions could be increased by providing extended treatment, and by focusing on person-environment interactions. Ecological Momentary Intervention (EMI) can account for these two factors by allowing an indefinite extension of a treatment protocol in everyday life. EMI relies on observations in daily life to intervene by providing appropriate in-the-moment treatment. The Think Slim intervention is an EMI based on the principles of cognitive behavioural therapy (CBT), and its effectiveness will be investigated in the current study. Methods: A randomised controlled trial (RCT) will be conducted. At least 134 overweight adults (body mass index (BMI) above 25 kg/m(2)) will be randomly assigned to an 8-week immediate intervention group (Diet + Think Slim intervention, n = 67) or to an 8-week di…

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A complex behavioural change intervention to reduce the risk of diabetes and prediabetes in the pre-conception period in Malaysia: study protocol for a randomised controlled trial.

Background: Over the past two decades, the population of Malaysia has grown rapidly and the prevalence of diabetes mellitus in Malaysia has dramatically increased, along with the frequency of obesity, hyperlipidaemia and hypertension. Early-life influences play an important role in the development of non-communicable diseases. Indeed, maternal lifestyle and conditions such as gestational diabetes mellitus or obesity can affect the risk of diabetes in the next generation. Lifestyle changes can help to prevent the development of type 2 diabetes mellitus. This is a protocol for an unblinded, community-based, randomised controlled trial in two arms to evaluate the efficacy of a complex behavioural change intervention, combining motivational interviewing provided by a community health promoter and access to a habit formation mobile application, among young Malaysian women and their spouses pr…

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Combining behavioural activation with physical activity promotion for adults with depression: findings of a parallel-group pilot randomised controlled trial (BAcPAc).

Background: Depression is associated with physical inactivity, which may mediate the relationship between depression and a range of chronic physical health conditions. However, few interventions have combined a psychological intervention for depression with behaviour change techniques, such as behavioural activation (BA), to promote increased physical activity. Methods: To determine procedural and clinical uncertainties to inform a definitive randomised controlled trial (RCT), a pilot parallel-group RCT was undertaken within two Improving Access to Psychological Therapies (IAPT) services in South West England. We aimed to recruit 80 adults with depression and randomise them to a supported, written self-help programme based on either BA or BA plus physical activity promotion (BAcPAc). Data were collected at baseline and 4 months post-randomisation to evaluate trial retention, intervention…

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Reducing and preventing internalizing and externalizing behavior problems in children with type 1 diabetes: a randomized controlled trial of the Triple P-Positive Parenting Program.

Background: Children with type 1 diabetes are at increased risk of mental health problems, which in turn are associated with poor glycemic control, diabetes-related complications, and long-term psychiatric morbidity. We tested the efficacy of the Triple P-Positive Parenting Program in reducing or preventing mental health problems and improving glycemic control in children with type 1 diabetes in a randomized controlled trial. Methods: Participants were recruited from the Diabetes Clinic, Royal Children's Hospital, Melbourne, Australia, and randomized to Triple P or standard diabetes care. The primary outcome was child internalizing and externalizing behavior problems 3 and 12 months postrandomization. Secondary outcomes were glycemic control, parent mental health, parenting skills, and family functioning at 3 and 12 months, and glycemic control at 24 months. Results: A total of 76 partic…

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The effect of an information and communication technology (ICT) on older adults' quality of life: study protocol for a randomized control trial.

Background: This study investigates the use of an information and communication technology (Elder Tree) designed for older adults and their informal caregivers to improve older adult quality of life and address challenges older adults face in maintaining their independence (for example, loneliness and isolation, falling, managing medications, driving and transportation). Methods/design: This study, an unblinded randomized controlled trial, will evaluate the effectiveness and cost of Elder Tree. Older adults who are at risk for losing their independence - along with their informal caregivers, if they name them - are randomized to two groups. The intervention group has access to their usual sources of information and communication as well as to Elder Tree for 18 months while the control group uses only their usual sources of information and communication. The primary outcome of the study i…

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Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial.

Background: Adherence is a challenge in obesity treatment. Motivational interviewing (MI) may promote patient adherence. MI Values is a randomized controlled trial of MI implemented as an adjunct to an adolescent obesity treatment [Teaching Encouragement Exercise Nutrition Support (T.E.E.N.S.)]. Objective: Assess effects of MI Values on T.E.E.N.S. attrition and adherence. Methods: Participants were randomized to MI (n = 58) or control (n = 41). At weeks 1 and 10, MI participants had brief MI sessions; controls viewed health education videos. All participants continued with T.E.E.N.S. (biweekly dietitian and behavioural support visits; 3 times per week supervised physical activity). Assessments were repeated at baseline, 3 and 6 months. T-tests and chi-square analyses examined T.E.E.N.S. attrition and adherence by group. Results: Adolescents (N = 99) were primarily African-American (73%) …

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Explore Transplant at Home: a randomized control trial of an educational intervention to increase transplant knowledge for Black and White socioeconomically disadvantaged dialysis patients.

Background: Compared to others, dialysis patients who are socioeconomically disadvantaged or Black are less likely to receive education about deceased donor kidney transplant (DDKT) and living donor kidney transplant (LDKT) before they reach transplant centers, often due to limited availability of transplant education within dialysis centers. Since these patients are often less knowledgeable or ready to pursue transplant, educational content must be simplified, made culturally sensitive, and presented gradually across multiple sessions to increase learning and honor where they are in their decision-making about transplant. The Explore Transplant at Home (ETH) program was developed to help patients learn more about DDKT and LDKT at home, with and without telephone conversations with an educator. Methods and study design: In this randomized controlled trial (RCT), 540 low-income Black and …

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Participation and diffusion effects of a peer-intervention for HIV prevention among adults in rural Malawi.

This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n = 415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication…

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Promoting healthy eating and physical activity among school children: findings from Health-E-PALS, the first pilot intervention from Lebanon.

Background: In Lebanon, childhood obesity doubled during the past decade. Preventive measures should start early in life and Schools are considered an important environment to promote energy balance health behaviours. School-based programmes promoting healthy lifestyles are lacking. The purpose of this study was to evaluate the feasibility and effectiveness of a multicomponent school-based intervention to promote healthy eating and physical activity (and prevent obesity) with school children aged 9-11 years in Lebanon. Methods: The intervention was developed based on the constructs of the Social Cognitive Theory and adapted to the culture of Lebanese and Arab populations. It consisted of three components: class curriculum, family involvement and food service. Eight schools were purposively selected from two communities of different socioeconomic status (SES) in Beirut and, within each sc…

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A self-management programme for COPD: a randomised controlled trial.

Studies of programmes of self-management support for chronic obstructive pulmonary disease (COPD) have been inconclusive. The Self-Management Programme of Activity, Coping and Education (SPACE) FOR COPD is a 6-week self-management intervention for COPD, and this study aimed to evaluate the effectiveness of this intervention in primary care. A single-blind randomised controlled trial recruited people with COPD from primary care and randomised participants to receive usual care or SPACE FOR COPD. Outcome measures were performed at baseline, 6 weeks and 6 months. The primary outcome was symptom burden, measured by the self-reported Chronic Respiratory Questionnaire (CRQ-SR) dyspnoea domain. Secondary outcomes included other domains of the CRQ-SR, shuttle walking tests, disease knowledge, anxiety, depression, self-efficacy, smoking status and healthcare utilisation. 184 people with COPD were…

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Feasibility of a prototype web-based acceptance and commitment therapy prevention program for college students.

Objective: This study examined the feasibility of a prototype Web-based acceptance and commitment therapy (ACT) program for preventing mental health problems among college students. Participants: Undergraduate first-year students (N = 76) participated between May and November 2011. Methods: Participants were randomized to ACT or a waitlist, with assessments conducted at baseline, posttherapy, and 3-week follow-up. Waitlist participants accessed the program after the second assessment. Results: Program usability/usage data indicated high program acceptability. Significant improvements were found for ACT knowledge, education values, and depression with ACT relative to waitlist. Subgroup analyses indicated that ACT decreased depression and anxiety relative to waitlist among students with at least minimal distress. Within the ACT condition, significant improvements were observed from baselin…

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Putting habit into practice, and practice into habit: a process evaluation and exploration of the acceptability of a habit-based dietary behaviour change intervention.

Background: Forming 'habit' - defined as a learned process that generates automatic responses to contextual cues - has been suggested as a mechanism for behaviour maintenance, but few studies have applied habit theory to behaviour change. This study used process evaluation data, taken from a randomised controlled trial of a healthy child-feeding intervention for parents previously shown to be effective, to explore the applicability to dietary behaviour change of predictions and recommendations drawn from habit theory. The intervention supported parents in pursuing child-feeding habit goals in three domains (giving fruit and vegetables, water, healthy snacks), over four fortnightly home visits. We explored whether (a) the habit-formation model was acceptable to participants, (b) better-specified habit-formation goals yielded greater habit gains, and (c) habit gains were sustained (d) even…

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Improved Strain and Psychosocial Outcomes for Caregivers of Individuals with Dementia: Findings from Project ANSWERS.

Purpose: This study examined the efficacy of a newly developed intervention, Acquiring New Skills While Enhancing Remaining Strengths (ANSWERS), for family caregivers of individuals with dementia. ANSWERS was designed for dyads comprised of an individual with dementia and his/her family caregiver. Using a strength-based approach, ANSWERS combined educational skills (traditionally used with caregivers) and cognitive rehabilitation skills training (traditionally used with individuals with dementia) into a single protocol for addressing the dyad's care issues and needs. Key domains addressed by the intervention included: education about dementia and memory loss; effective communication; managing memory; staying active; and recognizing emotions and behaviors. This analysis focused on outcomes for caregivers. Design & methods: The Stress Process Model guided the study's hypotheses and design.…

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An Internet-based intervention for eating disorders consisting of automated computer-tailored feedback with or without supplemented frequent or infrequent support from a coach: study protocol for a randomized controlled trial.

Background: Several Internet-based interventions for eating disorders have shown their effectiveness. Still, there is a need to refine such interventions given that most existing programs seem to be limited by their static 'one-size-fits-all' approach. 'Featback', an Internet-based intervention for symptoms of eating disorders provides a more individualized approach. It consists of several components (psychoeducation, a fully automated monitoring and feedback system, and support from a coach), which can be matched to participants' needs and preferences. Until now, it is unclear whether online self-help interventions for eating disorders with support are more effective than those without. The aims of the current study are i) to examine the relative effectiveness of (the different components of) Featback; ii) to examine predictors, moderators and mediators of intervention responses; iii) t…

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Increased cancer awareness among British adolescents after a school-based educational intervention: a controlled before-and-after study with 6-month follow-up.

Background: There is a lack of evidence around the effectiveness of school-based interventions designed to raise adolescents' cancer awareness. To address this deficit this study assessed the impact of an intervention delivered in the United Kingdom by Teenage Cancer Trust on: recall (open question) and recognition (closed question) of cancer warning signs; knowledge of common childhood, teenage, male and female cancers; awareness of the relationship between cancer and age; anticipated medical help-seeking delay; perceived barriers to seeking medical advice about cancer; and examined variation of intervention effect by gender and whether adolescents reported that they knew someone with cancer. Methods: The Cancer Awareness Measure (CAM) was completed by 422 adolescents (male: 221, 52.4%) aged 11-17 years old (mean age=13.8, standard deviation=1.26) two weeks before and two weeks after th…

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Promoting healthy lifestyles in high school adolescents: a randomized controlled trial.

Background: Although obesity and mental health disorders are two major public health problems in adolescents that affect academic performance, few rigorously designed experimental studies have been conducted in high schools. Purpose: The goal of the study was to test the efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program, versus an attention control program (Healthy Teens) on: healthy lifestyle behaviors, BMI, mental health, social skills, and academic performance of high school adolescents immediately after and at 6 months post-intervention. Design: A cluster RCT was conducted. Data were collected from January 2010 to May of 2012 and analyzed in 2012-2013. Setting/participants: A total of 779 culturally diverse adolescents in the U.S. Southwest participated in the trial. Intervention: COPE was …

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Predicting adoption of exposure therapy in a randomized controlled dissemination trial.

The present study examined organizational, client, and therapist characteristics as predictors of use of and proficiency in exposure therapy (ET) after training. Therapists naïve to ET (N=181) were randomized to: (1) online training (OLT), (2) OLT plus motivational enhancement (ME), or (3) OLT+ME plus a learning community. Twelve weeks after training, self-reported use of ET in clinical practice was high (87.5%) and therapists demonstrated moderate clinical proficiency. Use of ET was predicted by therapist degree, self-efficacy, and knowledge. Clinical proficiency was predicted by therapist anxiety sensitivity, attitudes, and knowledge, as well as organizational and client barriers. Several of these effects were moderated by training condition, indicating that therapists who received more comprehensive training were less impacted by barriers and showed enhanced adoption in the presence o…

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Participant experiences and facilitators and barriers to pill use among men who have sex with men in the iPrEx pre-exposure prophylaxis trial in San Francisco.

In 2010, the iPrEx study demonstrated efficacy of daily emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) pre-exposure prophylaxis (PrEP) in reducing HIV acquisition among men who have sex with men. Adherence to study product was critical for PrEP efficacy, and varied considerably, with FTC/TDF detection rates highest in the United States. We conducted a qualitative study to gain insights into the experiences of iPrEx participants in San Francisco (SF) where there was high confirmed adherence, to understand individual and contextual factors influencing study product use in this community. In 2009 and 2011, we conducted focus groups and in-depth interviews in 36 and 16 SF iPrEx participants, respectively. Qualitative analyses indicate that participants joined the study out of altruism. They had a clear understanding of study product use, and pill taking was facilitated by establishing…

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Brief oral health promotion intervention among parents of young children to reduce early childhood dental decay.

Background: Severe untreated dental decay affects a child's growth, body weight, quality of life as well as cognitive development, and the effects extend beyond the child to the family, the community and the health care system. Early health behavioural factors, including dietary practices and eating patterns, can play a major role in the initiation and development of oral diseases, particularly dental caries. The parent/caregiver, usually the mother, has a critical role in the adoption of protective health care behaviours and parental feeding practices strongly influence children's eating behaviours. This study will test if an early oral health promotion intervention through the use of brief motivational interviewing (MI) and anticipatory guidance (AG) approaches can reduce the incidence of early childhood dental decay and obesity. Methods: The study will be a randomised controlled study…

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Enhancing oral health via sense of coherence: a cluster-randomized trial.

Sense of coherence (SOC) has been related to oral health behaviors and oral-health-related quality of life (OHRQoL) in observational studies. This cluster-randomized trial aimed to test the effect of an intervention to enhance SOC on OHRQoL in children. Twelve primary schools were randomly allocated to intervention and control groups. The intervention was comprised of 7 sessions over 2 mos, focusing on child participation and empowerment. The first 4 sessions were classroom activities, and the last 3 involved working on healthy school projects. Trained teachers who received a one-day course delivered the intervention. Socio-demographic and clinical data, together with self-reported measures of OHRQoL, SOC, and oral health beliefs, were obtained from 261 total 10- to 12-year-olds (133 in the intervention and 128 in the control groups). Data were collected at baseline, 2 wks after the inte…

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Mediating effects of group cohesion on physical activity and diet in women of color: health is power.

Purpose: To determine the effects and mediating factors of a physical activity (PA) or vegetable and fruit (VF) group cohesion intervention. Design: Longitudinal design. Setting: Harris County and Travis County, Texas. Participants: Community-dwelling African-American and Hispanic or Latina women. Intervention: Three hundred ten women were randomized to a PA (n  =  204) or VF (n  =  106) intervention group. Women met in groups six times over the course of 6 months and were exposed to a group cohesion intervention to promote walking or to increase VF consumption. Measures: Women completed the International PA Questionnaire, National Cancer Institute VF and fat screeners, PA Group Environment Questionnaire, and 7-day accelerometer protocol at baseline and post-intervention. Analyses: The direct and mediated effects of the intervention on outcomes were evaluated using a mediational chain mo…

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Community-based control of Aedes aegypti by adoption of eco-health methods in Chennai City, India.

Background: Dengue is highly endemic in Chennai city, South India, in spite of continuous vector control efforts. This intervention study was aimed at establishing the efficacy as well as the favouring and limiting factors relating to a community-based environmental intervention package to control the dengue vector Aedes aegypti. Methods: A cluster randomized controlled trial was designed to measure the outcome of a new vector control package and process analysis; different data collection tools were used to determine the performance. Ten randomly selected intervention clusters (neighbourhoods with 100 houses each) were paired with ten control clusters on the basis of ecological/entomological indices and sociological parameters collected during baseline studies. In the intervention clusters, Aedes control was carried out using a community-based environmental management approach like prov…

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Minimizing risks and monitoring safety of an antenatal care intervention to mitigate domestic violence among young Indian women: The Dil Mil trial.

Background: Domestic violence - physical, psychological, or sexual abuse perpetrated against women by one or more family members - is highly prevalent in India. However, relatively little research has been conducted on interventions with the potential to mitigate domestic violence and its adverse health consequences, and few resources exist to guide safety planning and monitoring in the context of intervention research. Dil Mil is a promising women's empowerment-based intervention developed in India that engages with young women (daughters-in-law) and their mothers-in-law to mitigate domestic violence and related adverse health outcomes. This paper describes the design of a randomized controlled trial of Dil Mil in Bengaluru, India, with a focus on strategies used to minimize study-related risks and monitor safety. Methods/design: A phase 2 randomized controlled trial using a parallel co…

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