bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced Enrollment in the National Diabetes Prevention Program to Increase Engagement and Weight Loss for the Underserved: Protocol for a Randomized Controlled Trial
Authors: Ritchie Natalie D , Holtrop Jodi Summers , Gritz R Mark , Sauder Katherine Ann , Durfee Michael Josh , Dickinson L Miriam , Kaufmann Peter G 
Published: May 2020

BackgroundType 2 diabetes affects 9.4% of US adults with higher rates among racial and ethnic minorities and individuals of low socioeconomic status. The National Diabetes Prevention Program (NDPP) is an evidence-based and widely disseminated behavioral intervention to reduce diabetes incidence through modest weight loss. However, retention in the yearlong NDPP is problematic and leads to suboptimal weight loss, especially among diverse, underserved populations. Strategies to improve NDPP engagement and weight loss are needed urgently. Pilot results of the pre-NDPP, a novel enhancement to enrollment in the NDPP based on the Health Belief Model, were highly successful in a nonrandomized cohort study among 1140 racially diverse, predominately low-income participants. A total of 75 presession participants had doubled attendance and weight loss as compared with earlier participants who did not receive presessions. On the basis of these promising results, we are conducting a randomized controlled trial (RCT) to determine whether pre-NDPP reliably improves NDPP outcomes, as reported on ClinicalTrials.gov.ObjectiveThis study aims to (1) conduct an RCT comparing NDPP attendance and weight loss outcomes between participants who receive pre-NDPP versus direct enrollment into the NDPP (usual care), (2) examine potential effect mediators (perceived risk for developing diabetes and self-efficacy and readiness for weight control) and moderators (race and ethnicity; income level), and (3) evaluate implementation factors, including cost and projected return on investment.MethodsThis two-arm RCT will compare outcomes among diverse, predominately low-income participants who receive pre-NDPP versus direct enrollment into the NDPP (usual care). This is a type 1 hybrid effectiveness-implementation design to determine clinical effectiveness through an RCT, while assessing factors that may impact future pre-NDPP dissemination and implementation, including cost. Our primary research question is whether pre-NDPP improves NDPP attendance and weight loss compared with standard NDPP delivery.ResultsThis project was funded in April 2019. Recruitment is underway as of July 2019. Initial participants began the intervention in October 2019. Data analysis and results reporting are expected to be completed in 2024.ConclusionsThis RCT of pre-NDPP may lead to future dissemination of a scalable, evidence-based strategy to improve success of the NDPP, reduce disparities in NDPP effectiveness, and help prevent type 2 diabetes across the country.Trial RegistrationClinicalTrials.gov NCT04022499; https://clinicaltrials.gov/ct2/show/NCT04022499.International Registered Report Identifier (IRRID)PRR1-10.2196/15499
Investigating the Efficacy and Cost-Effectiveness of Technology-Delivered Personalized Feedback on Dietary Patterns in Young Australian Adults in the Advice, Ideas, and Motivation for My Eating (Aim4Me) Study: Protocol for a Randomized Controlled Trial
Authors: Haslam Rebecca L , Pezdirc Kristine , Truby Helen , Attia John , Hutchesson Melinda , Burrows Tracy , Callister Robin , Hides Leanne , Bonevski Billie , Kerr Deborah A , Lubans David , Kirkpatrick Sharon , Rollo Megan , McCaffrey Tracy , Collins Clare E 
Published: May 2020

Background
Web-based health interventions may be easier to access and time efficient relative to face-to-face interventions and therefore may be the most appropriate mode to engage young adults.

Objective
This study aims to investigate the impact of 3 different levels of personalized web-based dietary feedback and support on changes in diet quality.

Methods
The Advice, Ideas, and Motivation for My Eating (Aim4Me) study is a 12-month assessor-blinded, parallel-group randomized controlled trial evaluating the impact of 3 levels of web-based feedback on diet quality, measured using the Australian Recommended Food Score (ARFS). Participants (N=2570) will primarily be recruited via web-based methods and randomized to 1 of 3 groups. Group 1 (control) will receive the Healthy Eating Quiz, a web-based dietary assessment tool that generates a brief feedback report on diet quality. Individuals randomized to this group can use the brief feedback report to make positive dietary changes. Group 2 will receive the Australian Eating Survey, a web-based dietary assessment tool that generates a comprehensive feedback report on diet quality as well as macro- and micronutrient intake. Group 2 will use the comprehensive feedback report to assist in making positive dietary changes. They will also have access to the Aim4Me website with resources on healthy eating and tools to set goals and self-monitor progress. Group 3 will receive the same intervention as Group 2 (ie, the comprehensive feedback report) in addition to a tailored 30-min video consultation with an accredited practicing dietitian who will use the comprehensive feedback report to assist individuals in making positive dietary changes. The self-determination theory was used as the framework for selecting appropriate website features, including goal setting and self-monitoring. The primary outcome measure is change in diet quality. The completion of questionnaires at baseline and 3, 6, and 12 months will be incentivized with a monetary prize draw.

Results
As of December 2019, 1277 participants have been randomized.

Conclusions
The web-based delivery of nutrition interventions has the potential to improve dietary intake of young adults. However, the level of support required to improve intake is unknown.

Trial Registration
Australian New Zealand Clinical Trials Registry ACTRN12618000325202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374420

International Registered Report Identifier (IRRID)
DERR1-10.2196/15999
Patient-Reported Outcomes in a Nationally Representative Sample of Older Internet Users: Cross-sectional Survey
Authors: Seckin Gul , Hughes Susan 
Published: May 2020

Background
The rapid diffusion of the internet has decreased consumer reliance on health care providers for health information and facilitated the patients’ ability to be an agent in control of their own health. However, empirical evidence is limited regarding the effects of health-related internet use among older adults, which is complicated by the proliferation of online health and medical sources of questionable scientific accuracy.

Objective
We explore the effects of health-related internet use, education, and eHealth literacy on medical encounters and patient-reported outcomes. Patient-reported outcomes are categorized into two dimensions: (1) self-reported health problem and (2) affective distress (feeling worried and anxious) due to information obtained. We were particularly interested in whether education and eHealth literacy moderate the association between perceived strain in medical encounters and patient-reported outcomes.

Methods
Our study sample consisted of online panel members who have used the internet as a resource for health information, randomly drawn from one of the largest probability-based online research panels. This paper specifically reports results obtained from older panel members (age≥60 years: n=194). First, we examined descriptive statistics and bivariate associations (Pearson correlations and independent samples t tests). We used hierarchical ordinary least squares regression analyses by running separate regressions for each patient-reported outcome. In model 1, we entered the main effects. In model 2, technology and medical encounter variables were included. Model 3 added the statistical interaction terms.

Results
Age (β=–.17; P=.02), gender (β=–.22; P=.01), and medical satisfaction (β=–.28; P=.01) were significant predictors of self-reported health problems. Affective distress was positively predicted by gender (β=.13; P=.05) and satisfaction with medical encounters (β=.34; P<.001) but negatively predicted by education (β=–.18; P=.03) and eHealth literacy (β=–.32; P=.01). The association between experiencing a health problem in relation to health-related internet use and perception of strained medical encounters was greater among respondents with lower levels of education (β=–.55; P=.04). There was also a significant interaction between education and eHealth literacy in predicting the level of affective distress (β=–.60; P=.05), which indicated that higher levels of education predicted lower averages of feeling anxiety and worry despite lower eHealth literacy. Older women reported higher averages of affective distress (β=.13; P=.05), while older men reported higher averages of experiencing a self-reported health problem (β=–.22; P=.01).

Conclusions
This study provides evidence for the effect of health-related internet use on patient-reported outcomes with implications for medical encounters. The results could be used to guide educational and eHealth literacy interventions for older individuals.
User Experiences of an Internet-Based Stepped-Care Intervention for Individuals With Cancer and Concurrent Symptoms of Anxiety or Depression (the U-CARE AdultCan Trial): Qualitative Study
Authors: Igelström Helena , Hauffman Anna , Alfonsson Sven , Sjöström Jonas , Cajander Åsa , Johansson Birgitta 
Published: May 2020

Background
The internet-based stepped-care intervention iCAN-DO, used in the multicenter randomized controlled trial AdultCan, was developed for adult patients undergoing treatment for cancer and concurrently experiencing anxiety or depressive symptoms. iCAN-DO aimed to decrease symptoms of anxiety or depression. Step 1 comprises access to a library with psychoeducational material and a peer-support section, as well as the possibility to pose questions to a nurse. Step 2 of the intervention offers treatment consisting of internet-based cognitive behavioral therapy (iCBT) to participants still experiencing anxiety or depression at 1, 4, or 7 months after inclusion.

Objective
The study aimed to explore user experiences of delivery, design, and structure of iCAN-DO from the perspective of people with cancer.

Methods
We studied user experiences by interviewing 15 informants individually: 10 women with breast cancer (67%), 4 men with prostate cancer (27%), and 1 man with colorectal cancer (7%) with a mean age 58.9 years (SD 8.9). The interviews focused on informants' perceptions of ease of use and of system design and structure. Informants had been included in iCAN-DO for at least 7 months. They were purposefully selected based on activity in Step 1, participation in iCBT (ie, Step 2), gender, and diagnosis.

Results
Of the 15 informants, 6 had been offered iCBT (40%). All informants used the internet on a daily basis, but 2 (13%) described themselves as very inexperienced computer users. The analysis revealed three subthemes, concerning how user experiences were affected by disease-specific factors and side effects (User experience in the context of cancer), technical problems (Technical struggles require patience and troubleshooting), and the structure and design of iCAN-DO (Appealing and usable, but rather simple).

Conclusions
The results indicate that user experiences were affected by informants’ life situations, the technical aspects and the design of iCAN-DO, and informants’ preferences. The results have generated some developments feasible to launch during the ongoing study, but if iCAN-DO is to be used beyond research interest, a greater level of tailoring of information, features, and design may be needed to improve user experiences. The use of recurrent questionnaires during the treatment period may highlight an individual’s health, but also function as a motivator showing improvements over time.
Digital Gamification to Enhance Vaccine Knowledge and Uptake: Scoping Review
Authors: Montagni Ilaria , Mabchour Inass , Tzourio Christophe 
Published: May 2020

Background
Vaccine hesitancy is a growing threat to population health, and effective interventions are needed to reduce its frequency. Digital gamification is a promising new approach to tackle this public health issue.

Objective
The purpose of this scoping review was to assess the amount and quality of outcomes in studies evaluating gamified digital tools created to increase vaccine knowledge and uptake.

Methods
We searched for peer-reviewed articles published between July 2009 and August 2019 in PubMed, Google Scholar, Journal of Medical Internet Research, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, and SocINDEX. Studies were coded by author, year of publication, country, journal, research design, sample size and characteristics, type of vaccine, theory used, game content, game modality, gamification element(s), data analysis, type of outcomes, and mean quality score. Outcomes were synthesized through the textual narrative synthesis method.

Results
A total of 7 articles met the inclusion criteria and were critically reviewed. Game modalities and gamification elements were diverse, but role play and a reward system were present in all studies. These articles included a mixture of randomized controlled trials, quasi-experimental studies, and studies comprising quantitative and qualitative measures. The majority of the studies were theory-driven. All the identified gamified digital tools were highly appreciated for their usability and were effective in increasing awareness of vaccine benefits and motivation for vaccine uptake.

Conclusions
Despite the relative paucity of studies on this topic, this scoping review suggests that digital gamification has strong potential for increasing vaccination knowledge and, eventually, vaccination coverage.
Therapeutic Alliance in Technology-Based Interventions for the Treatment of Depression: Systematic Review
Authors: Wehmann Eileen , Köhnen Moritz , Härter Martin , Liebherz Sarah 
Published: May 2020

Background
There is growing evidence that technology-based interventions (TBIs) are effective for the treatment of depression. As TBIs are gaining acceptance, a question arises whether good therapeutic alliance, considered a key aspect of psychotherapy, can be established without or with minimal face-to-face contact or rather changes if blended concepts are applied. While therapeutic alliance has been studied extensively in the context of face-to-face therapy, only few studies have reviewed evidence on alliance ratings in TBIs.

Objective
The purpose of this study was to examine therapeutic alliance in technology-based psychological interventions for the treatment of depression.

Methods
We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, PSYNDEX, CINAHL, clinical trial registers, and sources of grey literature for randomized controlled trials on TBIs in the treatment of adults with unipolar depression. All publications were selected according to prespecified criteria. Data were extracted by two independent reviewers.

Results
A total of eight out of 98 studies (9.5%) included in the review on TBIs for depression considered therapeutic alliance as part of their evaluation. The available data covered eight different treatment conditions, including four stand-alone treatments (face-to-face psychotherapy, email, telephone, and internet program) and four combined treatments (face-to-face psychotherapy plus a smartphone app and an internet program combined with face-to-face psychotherapy, treatment as usual, or email/telephone). On average, patients rated the alliance positively across all groups. Importantly, no relevant group differences regarding therapeutic alliance sum scores were found in any of the studies. Five studies investigated the relationship between patients’ alliance ratings and treatment outcome, revealing mixed results.

Conclusions
Our results suggest that it is possible to establish a positive therapeutic alliance across a variety of different TBIs for depression, but this is based on a small number of studies. Future research needs to determine on what basis therapeutic alliance is formed in settings that do not allow for additional nonverbal cues, perhaps with adapted instruments to measure therapeutic alliance.

Trial Registration
PROSPERO International Prospective Register of Systematic Reviews CRD42016050413; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42016050413)

International Registered Report Identifier (IRRID)
RR2-10.1136/bmjopen-2018-028042
Modeling Early Gambling Behavior Using Indicators from Online Lottery Gambling Tracking Data: Longitudinal Analysis
Authors: Challet-Bouju Gaëlle , Hardouin Jean-Benoit , Thiabaud Elsa , Saillard Anaïs , Donnio Yann , Grall-Bronnec Marie , Perrot Bastien 
Published: May 2020

Background
Individuals who gamble online may be at risk of gambling excessively, but internet gambling also provides a unique opportunity to monitor gambling behavior in real environments which may allow intervention for those who encounter difficulties.

Objective
The objective of this study was to model the early gambling trajectories of individuals who play online lottery.

Methods
Anonymized gambling‐related records of the initial 6 months of 1152 clients of the French national lottery who created their internet gambling accounts between September 2015 and February 2016 were analyzed using a two-step approach that combined growth mixture modeling and latent class analysis. The analysis was based upon behavior indicators of gambling activity (money wagered and number of gambling days) and indicators of gambling problems (breadth of involvement and chasing). Profiles were described based upon the probabilities of following the trajectories that were identified for the four indicators, and upon several covariates (age, gender, deposits, type of play, net losses, voluntary self-exclusion, and Playscan classification—a responsible gambling tool that provides each player with a risk assessment: green for low risk, orange for medium risk and red for high risk). Net losses, voluntary self-exclusion, and Playscan classification were used as external verification of problem gambling.

Results
We identified 5 distinct profiles of online lottery gambling. Classes 1 (56.8%), 2 (14.8%) and 3 (13.9%) were characterized by low to medium gambling activity and low values for markers of problem gambling. They displayed low net losses, did not use the voluntary self-exclusion measure, and were classified predominantly with green Playscan tags (range 90%-98%). Class 4 (9.7%) was characterized by medium to high gambling activity, played a higher breadth of game types (range 1-6), and had zero to few chasing episodes. They had high net losses but were classified with green (66%) or orange (25%) Playscan tags and did not use the voluntary self-exclusion measure. Class 5 (4.8%) was characterized by medium to very high gambling activity, played a higher breadth of game types (range 1-17), and had a high number of chasing episodes (range 0-5). They experienced the highest net losses, the highest proportion of orange (32%) and red (39%) tags within the Playscan classification system and represented the only class in which voluntary self-exclusion was present.

Conclusions
Classes 1, 2, 3 may be considered to represent recreational gambling. Class 4 had higher gambling activity and higher breadth of involvement and may be representative of players at risk for future gambling problems. Class 5 stood out in terms of much higher gambling activity and breadth of involvement, and the presence of chasing behavior. Individuals in classes 4 and 5 may benefit from early preventive measures.
Analisis Kebijakan Penguatan Pendidikan Karakter Bela Negara Di SMK Sore Tulungagung
Authors: Khusnaini Khusnaini , Budiono Budiono 
Published: May 2020

Abstract: The Strengthening of National Defense Character Education Policy that has been implemented at the Vocational High School Sore Tulungagung in 2014/2015 is a new character education development policy. The policy must be analyzed to give other schools a clear picture of the effectiveness of character education. Therefore the researcher intends, to find out the implementation suitability and evaluate the effectiveness of the policy of strengthening the character education of the National Defense Vocational High School Sore Tulungagung. Through qualitative research methods, by triangulating research data, researchers analyze data by studying theory through the reduction of interview results. The results obtained, the planning of strengthening the character education of National Defense is not good, because of the lack of reference laws that are used, indicators of achievement of the basic values of the character of defending the country. In the implementation of the policy declared quite good, seen activities that teach nationality insight to students, but there needs to be supervision from the implementation team. Finally, the evaluation stage of the policy is still not good, because the evaluation of character education is in the form of violations in general, not on indicators of the basic values of Defending the State.Keywords: Policy, Character Education, National Defense Abstrak: Kebijakan Penguatan Pendidikan Karakter Bela Negarayang telah dilaksanakan di SMK Sore Tulungagung tahun 2014/2015 merupakan kebijakan pengembangan pendidikan karakter baru. Kebijakan tersebut harus dianalisis agar memberi gambaran jelas kepada sekolah lain efektifitas pendidikan karakter tersebut. Maka dari itu penelitian ini bermaksuduntuk mengetahui implementasi dan mengevaluasi efektifitas kebijakan penguatan pendidikan karakter Bela Negaradi SMK Sore Tulungagung. Melalui metode penelitian kualitatif, dengan triangulasi data-data penelitian, peneliti menganalisis data dengan kajian teori melalui reduksi hasil wawancara. Hasil penelitian yang didapatkan, perencanaan penguatan pendidikan karakter Bela Negarakurang baik, sebab minimnya acuan perundangan yang dipakai, indikator ketercapaian nilai-nilai dasar karakter bela negara. Pada implementasi kebijakan dinyatakan cukup baik, terlihat adanya kegiatan-kegiatan yang mengajarkan wawasan kebangsaan pada peserta didik, namun perlu adanya pengawasan dari tim pelaksana. Terakhir, tahap evaluasi kebijakan masih kurang baik, sebab evaluasi pendidikan karakter ini berupa pelanggaran secara umum, bukan pada indikator nilai-nilai dasar Bela Negara.Kata kunci: Kebijakan, Pendidikan Karakter, Bela Negara