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International Journal of Environmental... Dec 2022Despite mounting recognition of the essential role of women's empowerment in household dietary and nutrition changes, the diversity of culture across African countries... (Review)
Review
Despite mounting recognition of the essential role of women's empowerment in household dietary and nutrition changes, the diversity of culture across African countries presents ambiguity as to whether its impact is experienced homogeneously across the continent. This article presents a systematic review of whether women's empowerment changes household dietary patterns, contributes to nutrition improvement, and consequently affects diet-related health outcomes in Africa. We find that whilst more research needs to be conducted, particularly with improved methodologies that can establish cause-effect relationships, there is consensus among the literature on the link between women's empowerment and some domains of food security and dietary improvement. Meanwhile, studies on women's empowerment and the additional demand pressure on some food categories are quite limited. This exacerbates the challenge of setting production plans that aim to address the continent's question of food.
Topics: Humans; Female; Power, Psychological; Nutritional Status; Empowerment; Africa; Food Security; Women's Rights
PubMed: 36612576
DOI: 10.3390/ijerph20010254 -
International Journal of Nursing Studies Oct 2023Pressure ulcers are a major health concern. They have a significant impact on the healthcare system and individuals, reducing quality of life across several domains. In... (Review)
Review
BACKGROUND
Pressure ulcers are a major health concern. They have a significant impact on the healthcare system and individuals, reducing quality of life across several domains. In community settings, self-management behaviours are central to their prevention. However, adherence with pressure ulcer prevention guidelines remains low, with little evidence guiding the relationship between patients and healthcare professionals to establish a concordant partnership.
OBJECTIVE
To synthesise evidence on factors contributing to community-based pressure ulcer prevention using the Theoretical Domains Framework and the Capability, Opportunity, Motivation, Behaviour (COM-B) model of behaviour.
DESIGN
Mixed methods systematic review and narrative synthesis.
METHOD
Systematic searches were conducted in the CINAHL, Cochrane, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases on 14th December 2022. Studies were eligible if they contained data on the factors associated with adherence and concordance with pressure ulcer prevention guidelines in the community for patients, caregivers, and healthcare professionals. Methodological quality was assessed using the Hawker tool. Findings were synthesised using the Theoretical Domains Framework. The resulting themes were mapped onto the Capability, Opportunity, Motivation, Behaviour (COM-B) model.
RESULTS
Thirty studies were included in the review, including quantitative, qualitative, and mixed methods research. The synthesis identified 12 of the 14 Theoretical Domains Framework domains, with knowledge, social influences, beliefs about consequences, and beliefs about capabilities the most prevalent. Although knowledge appears to be an important contributor to adherence with prevention guidelines, knowledge alone does not appear sufficient to achieve concordance. A concordant relationship was facilitated by healthcare professionals' knowledge, motivation to work alongside patients and their priorities, and interpersonal skills to build rapport and trust, whilst barriers included lack of healthcare professional skills to navigate sensitive issues, paternalistic views of patient compliance and organisational processes that impact building rapport.
CONCLUSIONS
Several psychosocial factors may affect the ability to achieve concordance between individuals, caregivers and healthcare professionals with pressure ulcer prevention guidelines in the community. However, data regarding the efficacy of behaviour change interventions targeting these constructs is limited, with further research required to guide intervention development in this area.
Topics: Humans; Pressure Ulcer; Quality of Life; Motivation; Health Personnel; Patient Compliance; Qualitative Research
PubMed: 37542960
DOI: 10.1016/j.ijnurstu.2023.104561 -
Bulletin of the World Health... Nov 2021To review the evidence on the impact on measurable outcomes of performance-based incentives for community health workers (CHWs) in low- and middle-income countries. (Review)
Review
OBJECTIVE
To review the evidence on the impact on measurable outcomes of performance-based incentives for community health workers (CHWs) in low- and middle-income countries.
METHODS
We conducted a systematic review of intervention studies published before November 2020 that evaluated the impact of financial and non-financial performance-based incentives for CHWs. Outcomes included patient health indicators; quality, utilization or delivery of health-care services; and CHW motivation or satisfaction. We assessed risk of bias for all included studies using the Cochrane tool. We based our narrative synthesis on a framework for measuring the performance of CHW programmes, comprising inputs, processes, performance outputs and health outcomes.
FINDINGS
Two reviewers screened 2811 records; we included 12 studies, 11 of which were randomized controlled trials and one a non-randomized trial. We found that non-financial, publicly displayed recognition of CHWs' efforts was effective in improved service delivery outcomes. While large financial incentives were more effective than small ones in bringing about improved performance, they often resulted in the reallocation of effort away from other, non-incentivized tasks. We found no studies that tested a combined package of financial and non-financial incentives. The rationale for the design of performance-based incentives or explanation of how incentives interacted with contextual factors were rarely reported.
CONCLUSION
Financial performance-based incentives alone can improve CHW service delivery outcomes, but at the risk of unincentivized tasks being neglected. As calls to professionalize CHW programmes gain momentum, research that explores the interactions among different forms of incentives, context and sustainability is needed.
Topics: Humans; Community Health Workers; Delivery of Health Care; Health Services; Motivation; Randomized Controlled Trials as Topic
PubMed: 34737473
DOI: 10.2471/BLT.20.285218 -
Nursing Open Sep 2021This study aimed to provide comprehensive information about the core determinants of fertility intentions. (Review)
Review
AIM
This study aimed to provide comprehensive information about the core determinants of fertility intentions.
DESIGN
Systematic review.
METHODS
Ovid, MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, SCOPUS and GOOGLE SCHOLAR were searched for the relevant articles published from 1946-December 2017. We updated our records by searching three computerized databases (Ovid MEDLINE, SCOPUS and WOS) from 2018-January 2021.
RESULTS
53 studies included in the qualitative synthesis. The results of some studies indicated the impact of demographic factors, physical and psychological health, happiness and child desire. The most frequent variables in a couple's mesosystem were marital status, parity, partnership satisfaction and gender role attitude. The mesosystem of childbearing intention also included family and peers network. The EXEO system of the ECSM includes certain variables, such as job characteristics, urban residence, housing condition. The macrosystem comprises cultural and societal principles with broader influences on the couple's system.
Topics: Child; Female; Fertility; Humans; Intention; Marital Status; Parity; Personal Satisfaction; Pregnancy
PubMed: 33705606
DOI: 10.1002/nop2.849 -
Journal of Occupational Health Sep 2017Physically active (PA) people have a lower risk of various diseases, compared to those with sedentary lifestyles. Evidence on the effects of PA promoting programs in the... (Review)
Review
INTRODUCTION
Physically active (PA) people have a lower risk of various diseases, compared to those with sedentary lifestyles. Evidence on the effects of PA promoting programs in the workplace is large, and several systematic reviews (SR) and/or meta-analyses (MA) have been published. However, they have failed to consider factors that could influence interventions. This paper aimed to classify and describe interventions to promote PA in the workplace based on evidence from SR/MA.
METHOD
A literature search for SR/MA was done using PubMed, Web of Science, and Science Direct (January 2006-February 2015). Quality assessment of SR/MA was performed using AMSTAR. The PRECEDE-PROCEED model was used for classifying the interventions into predisposing, enabling, reinforcing, environment, and policy domains of focus.
RESULTS
Eleven SR/MA included 220 primary studies, of which 139 (63%) were randomized controlled trials. Of 48 interventions identified, 22 (46%) and 17 (35%) focused on predisposing or enabling employees to have more PA, respectively. Of the 22 predisposing factors, 6 were information delivery, 5 were self-motivation, and 11 were program training. The enabling approaches were 12 instrument resources and 5 health service facilities. The reinforcing approaches were 4 incentive and 3 social support. The remaining interventions focused on the environmental development and policy regulation.
CONCLUSIONS
This systematic meta-review classified interventions using appropriate framework and described the intervention pattern.
Topics: Exercise; Health Promotion; Humans; Industry; Motivation; Occupational Health; Occupations; Randomized Controlled Trials as Topic; Social Support; Workplace
PubMed: 28740029
DOI: 10.1539/joh.16-0245-RA -
Psychology of Addictive Behaviors :... Dec 2017Gambling problems impact 0.2%-4.0% of the population, and research related to treating gambling has burgeoned in the last decades. This article reviews trials for... (Review)
Review
Gambling problems impact 0.2%-4.0% of the population, and research related to treating gambling has burgeoned in the last decades. This article reviews trials for psychosocial treatments of gambling problems. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses Standards, we identified 21 randomized trials. Eleven studies evaluated interventions delivered via multisession, in-person therapy: cognitive therapies, cognitive-behavioral (CB) therapies, and motivational interventions (MI) alone or with CB therapies. An additional 10 studies used approaches that involved 1 or fewer in-person sessions; these included workbooks with CB exercises alone or in combination with MI and brief feedback or advice interventions. Although most studies found some benefits of CB therapy (alone or combined with MI) and brief feedback or advice relative to the control condition in the short term, only a handful of studies demonstrated any long-term benefits. Nearly half the studies used waitlist controls, precluding an understanding of long-term efficacy, and standardized outcomes measures are also lacking. Populations also differ markedly across studies, from nontreatment-seeking persons who screened positive for gambling problems to those with severe gambling disorder, and these discrepant populations may require different interventions. Although problem gamblers with less pronounced symptoms may benefit from very minimal interventions, therapist contact generally improved outcomes relative to entirely self-directed interventions, and at least some therapist contact may be necessary for patients with more severe gambling pathology to benefit from CB interventions. As treatment services for gambling continue to grow, this review provides timely information on best practices for gambling treatment. (PsycINFO Database Record
Topics: Cognitive Behavioral Therapy; Gambling; Humans; Motivation; Motivational Interviewing; Randomized Controlled Trials as Topic
PubMed: 28639817
DOI: 10.1037/adb0000290 -
Obesity Reviews : An Official Journal... Dec 2021Recruitment of children into clinical trials is challenging. Most systematic reviews exploring facilitators and barriers of child recruitment in clinical trials are... (Review)
Review
Recruitment of children into clinical trials is challenging. Most systematic reviews exploring facilitators and barriers of child recruitment in clinical trials are related to drugs or experimental treatments for various health conditions. This may differ in nutrition, physical activity, and obesity interventions. The objective was to conduct a systematic review of facilitators and barriers for children's participation in nutrition, physical activity, and obesity interventions from the perspective of parents, children, and researchers. Studies were identified from five databases and restricted to children 2-18 years and the English language. Studies without results on facilitators and barriers of recruitment were excluded. Four hundred twenty-three records were identified; 94 duplicates and 269 unrelated records were initially excluded; 60 records were reviewed for full-text, and subsequently 34 were excluded, for a total of 26 included studies. The top barriers for recruiting children into clinical trials were time constraints, understanding of clinical trial information or complexity of consent/trial info, and transportation/lack of childcare. The most common facilitators were benefits to others and self, compensation/incentives, physician recommendations/referrals, and support. These barriers and facilitators should be addressed in future studies to assist in the successful recruitment of children into nutrition, physical activity, and obesity interventions.
Topics: Child; Exercise; Humans; Motivation; Nutritional Status; Obesity; Parents
PubMed: 34472191
DOI: 10.1111/obr.13335 -
JAMA Psychiatry Aug 2018The social motivation hypothesis posits that individuals with autism spectrum disorder (ASD) find social stimuli less rewarding than do people with neurotypical... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
The social motivation hypothesis posits that individuals with autism spectrum disorder (ASD) find social stimuli less rewarding than do people with neurotypical activity. However, functional magnetic resonance imaging (fMRI) studies of reward processing have yielded mixed results.
OBJECTIVES
To examine whether individuals with ASD process rewarding stimuli differently than typically developing individuals (controls), whether differences are limited to social rewards, and whether contradictory findings in the literature might be due to sample characteristics.
DATA SOURCES
Articles were identified in PubMed, Embase, and PsycINFO from database inception until June 1, 2017. Functional MRI data from these articles were provided by most authors.
STUDY SELECTION
Publications were included that provided brain activation contrasts between a sample with ASD and controls on a reward task, determined by multiple reviewer consensus.
DATA EXTRACTION AND SYNTHESIS
When fMRI data were not provided by authors, multiple reviewers extracted peak coordinates and effect sizes from articles to recreate statistical maps using seed-based d mapping software. Random-effects meta-analyses of responses to social, nonsocial, and restricted interest stimuli, as well as all of these domains together, were performed. Secondary analyses included meta-analyses of wanting and liking, meta-regression with age, and correlations with ASD severity. All procedures were conducted in accordance with Meta-analysis of Observational Studies in Epidemiology guidelines.
MAIN OUTCOMES AND MEASURES
Brain activation differences between groups with ASD and typically developing controls while processing rewards. All analyses except the domain-general meta-analysis were planned before data collection.
RESULTS
The meta-analysis included 13 studies (30 total fMRI contrasts) from 259 individuals with ASD and 246 controls. Autism spectrum disorder was associated with aberrant processing of both social and nonsocial rewards in striatal regions and increased activation in response to restricted interests (social reward, caudate cluster: d = -0.25 [95% CI, -0.41 to -0.08]; nonsocial reward, caudate and anterior cingulate cluster: d = -0.22 [95% CI, -0.42 to -0.02]; restricted interests, caudate and nucleus accumbens cluster: d = 0.42 [95% CI, 0.07 to 0.78]).
CONCLUSIONS AND RELEVANCE
Individuals with ASD show atypical processing of social and nonsocial rewards. Findings support a broader interpretation of the social motivation hypothesis of ASD whereby general atypical reward processing encompasses social reward, nonsocial reward, and perhaps restricted interests. This meta-analysis also suggests that prior mixed results could be driven by sample age differences, warranting further study of the developmental trajectory for reward processing in ASD.
Topics: Autism Spectrum Disorder; Brain; Humans; Magnetic Resonance Imaging; Motivation; Reinforcement, Social; Reward
PubMed: 29898209
DOI: 10.1001/jamapsychiatry.2018.1100 -
Human Resources For Health Nov 2016Physician retirement planning and timing have important implications for patients, hospitals, and healthcare systems. Unplanned early or late physician retirement can... (Review)
Review
BACKGROUND
Physician retirement planning and timing have important implications for patients, hospitals, and healthcare systems. Unplanned early or late physician retirement can have dire consequences in terms of both patient safety and human resource allocations. This systematic review examined existing evidence on the timing and process of retirement of physicians. Four questions were addressed: (1) When do physicians retire? (2) Why do some physicians retire early? (3) Why do some physicians delay their retirement? (4) What strategies facilitate physician retention and/or retirement planning?
METHODS
English-language studies were searched in electronic databases MEDLINE, Web of Science, Scopus, CINAHL, AgeLine, Embase, HealthSTAR, ASSA, and PsycINFO, from inception up to and including March 2016. Included studies were peer-reviewed primary journal articles with quantitative and/or qualitative analyses of physicians' plans for, and opinions about, retirement. Three reviewers independently assessed each study for methodological quality using the Newcastle-Ottawa Scale for quantitative studies and Critical Appraisal Tool for qualitative studies, and a fourth reviewer resolved inconsistencies.
RESULTS
In all, 65 studies were included and analyzed, of which the majority were cross-sectional in design. Qualitative studies were found to be methodologically strong, with credible results deemed relevant to practice. The majority of quantitative studies had adequate sample representativeness, had justified and satisfactory sample size, used appropriate statistical tests, and collected primary data by self-reported survey methods. Physicians commonly reported retiring between 60 and 69 years of age. Excessive workload and burnout were frequently cited reasons for early retirement. Ongoing financial obligations delayed retirement, while strategies to mitigate career dissatisfaction, workplace frustration, and workload pressure supported continuing practice.
CONCLUSIONS
Knowledge of when physicians plan to retire and how they can transition out of practice has been shown to aid succession planning. Healthcare organizations might consider promoting retirement mentorship programs, resource toolkits, education sessions, and guidance around financial planning for physicians throughout their careers, as well as creating post-retirement opportunities that maintain institutional ties through teaching, mentoring, and peer support.
Topics: Age Factors; Burnout, Professional; Humans; Job Satisfaction; Motivation; Personnel Turnover; Physicians; Retirement; Workload
PubMed: 27846852
DOI: 10.1186/s12960-016-0166-z -
Prevention Science : the Official... May 2022Strength training (ST) or resistance training is important in the development and maintenance of musculoskeletal and cardiovascular health in women of all ages; however,... (Review)
Review
Strength training (ST) or resistance training is important in the development and maintenance of musculoskeletal and cardiovascular health in women of all ages; however, uptake of ST amongst women is low. To improve female musculoskeletal health, it is vital that more women are encouraged to participate in ST to maintain musculoskeletal integrity. This systematic review aimed to identify motivators and barriers to women initiating and maintaining ST. Following protocol registration and systematic search, studies were included if they were primary qualitative or mixed-method studies reporting participant verbatim quotes, included adult women, and focused on motivators and barriers for ST. Searches generated 2534 articles from 3 databases, with 20 studies (N = 402 participants) meeting eligibility criteria. Participant quotes and authors' interpretations were analysed using thematic synthesis. The most frequently observed barriers were gender-based stigmas, discouragement, and negative comments, particularly in women currently engaging in ST. Other factors associated with poor adherence included boredom, poor knowledge of ST, poor gym accessibility, lack of supervision or routine, and difficulty in balancing work and family life. Social support from friends and family, words of affirmation, and accompaniment facilitated ST, particularly in older women. Women who saw expected results such as weight loss were motivated to continue ST. Interventions aimed at increasing participation in ST amongst women should focus on the specific benefits valued by women and the dissemination of accurate information to counter misconceptions and increase knowledge. The adaptation of gym environments to make them more welcoming to women, and reduce gender-focused criticism, is especially important.
Topics: Adult; Aged; Female; Humans; Motivation; Resistance Training; Social Support
PubMed: 34800250
DOI: 10.1007/s11121-021-01328-2