Self-Management

This research aims to evaluate whether creating dedicated HIV teams in hospitals across ten European countries can increase HIV testing rates among patients showing signs of HIV-related conditions. The study uses a stepped-wedge design, where hospitals switch from routine care to the new intervention in sequence. This approach compares outcomes before and after the teams are in place, helping to understand the impact of the intervention across various locations and medical specialties. The intervention involves establishing local HIV teams led by specialists and supported by nurses and data experts. These teams identify patients needing HIV tests through electronic health records, provide feedback to doctors to encourage testing, offer education to healthcare staff about HIV, reduce stigma, and improve connections to prevention and care services. This program integrates smoothly into regular hospital routines and aims to close gaps in HIV diagnosis. Participants' HIV testing rates will be monitored by reviewing records before and after the intervention. Researchers will also assess new HIV diagnoses, changes in testing patterns by country and specialty, and healthcare professionals' knowledge and attitudes toward HIV. The study includes ongoing evaluation of how well the teams operate, resource use, and cost-effectiveness. Data collection extends up to several years to observe long-term effects, with continuous monitoring of care access and prevention services.

This research aims to compare the effectiveness of monitoring blood sugar levels at 1 hour versus 2 hours after meals in pregnant women diagnosed with Gestational Diabetes Mellitus who require treatment. The study focuses on understanding which monitoring time better supports managing blood sugar during pregnancy to improve outcomes for both mother and baby. Participants are pregnant women attending an antenatal clinic and are treated with metformin, insulin, or a combination. Participants will be randomly assigned to monitor their blood sugar either 1 hour or 2 hours after meals using self-monitoring of capillary blood glucose. Their blood sugar is tracked at seven staggered points to provide a detailed profile. This monitoring continues until delivery, with participants followed regularly in the research clinic. Throughout the study, women will have regular visits to assess their health and that of their baby. Researchers will collect data on mode of delivery, gestational age at birth, and fetal weight. They will also monitor maternal and perinatal complications from randomization to delivery. The total participation lasts from enrollment until the birth of the baby, allowing detailed observation of pregnancy outcomes related to the glucose monitoring method.

Researchers are studying the long-term effects of reducing household air pollution (HAP) from biomass fuel use on heart, lung, and immune health among women and children in semi-rural Bangladesh. The study evaluates whether a mobile phone-based behavioral change communication (mHealth BCC) intervention can increase the adoption and exclusive use of cleaner cooking fuel, Liquid Petroleum Gas (LPG). This research also investigates how lowering pollution exposure might influence immune responses to vaccines and subclinical cardiovascular and pulmonary changes. The study is a large household-level randomized controlled trial comparing two groups: one receiving the mHealth BCC intervention encouraging exclusive LPG use and a control group receiving no such intervention. Researchers will monitor personal and area levels of air pollutants like PM2.5 and black carbon before and after intervention, alongside detailed assessments including spirometry, chest X-rays, high-resolution CT scans, blood pressure, EKG, metabolic markers such as HbA1c and lipid profiles, and immune cell function. The intervention messages are delivered via mobile phone with frequency tailored to participant responses. Participants will be followed over two years with repeated measurements to assess pollutant exposure and health effects. Evaluations include lung function tests, imaging, cardiovascular markers, metabolic blood tests, and immune function assays. The study aims to provide insights into the health benefits of sustained LPG use and improved air quality. Total participation spans pre-intervention assessments through two years of follow-up, with ongoing monitoring of pollution exposure and health outcomes.

This research aims to evaluate a 5-session cognitive behavioral program called 1MoreStep, designed for Black women living with HIV who have experienced intimate partner violence in the past two years. The study focuses on teaching skills to access personal and external strengths, safety strategies, knowledge about HIV care and stigma, communication skills to handle stigma, and addressing barriers to HIV care. It also examines the program's acceptability and feasibility among participants. Participants are randomly assigned to either the 1MoreStep intervention or an equal attention control group. The intervention includes seven group sessions and one individual session held weekly, led by experienced facilitators from the Black community. Sessions cover topics such as safety planning, HIV care engagement, stigma communication, and goal setting using cognitive behavioral skills. The control group attends weekly support group sessions that cover general health topics important to Black women living with HIV but not directly related to the intervention's goals. Throughout the study, participants complete assessments at baseline, 3 months, and 6 months to measure changes in safety strategies and HIV care engagement. Measures include surveys, medical record reviews, and interviews to evaluate treatment acceptance, session attendance, and participant experiences. The study spans approximately 6 months post-baseline, with follow-up surveys and qualitative interviews to explore program fit and barriers to participation.

This research aims to examine the effects of an 8-week artificial intelligence-based structured exercise program on posture in healthy adults aged 18 to 25 years. Posture is the arrangement of body parts relative to each other, influenced by gravity, muscle tension, and bone structure. The study focuses on common posture disorders in young adults and uses measurements like the craniovertebral angle, thoracic kyphosis, and lumbar lordosis to assess changes. Participants will be randomly assigned to one of two groups. One group will perform exercises guided by an artificial intelligence application called "Musclewiki" alongside a physiotherapist, practicing three times a week for 8 weeks. The other group will not perform any exercise during this period. Posture measurements will be taken before and after the 8-week program using a mobile app to evaluate angles related to head, shoulder, and spine alignment. During the study, participants will have posture assessments using frontal and lateral images analyzed by the Posture Screen Mobile app. The primary outcome is the change in craniovertebral angle after 8 weeks. Secondary outcomes include changes in thoracic kyphosis and lumbar lordosis angles. The study will monitor participants throughout the 8-week period, with evaluations before and after the intervention to understand the exercise program's impact on posture.

Researchers are evaluating a digital health intervention using a mobile application called "Pust Deg Bedre" (PDB) to support self-management in patients with Chronic Obstructive Pulmonary Disease (COPD). COPD patients often experience symptoms like dyspnea, cough, and chronic mucus hypersecretion, which increase infection risks and exacerbate the disease. This study aims to explore the feasibility, patient and physiotherapist experiences, and implementation of the PDB app in managing these symptoms. The intervention involves physiotherapists providing patients with training on how to use the PDB app, which offers tailored breathing and airway clearance techniques based on clinical assessment. Patients will engage with the app's treatment plan over an 8-week period, with follow-up at 6 months. Adjustments to the treatment plan may be made during the intervention. The study includes qualitative interviews and video-recorded physiotherapy sessions to gain deeper insights into the interactions and experiences of patients and physiotherapists. Participants will be assessed through questionnaires and interviews at the end of the 8-week treatment and at the 6-month follow-up. Researchers will collect both quantitative and qualitative data, including health-related outcomes, adherence, adverse events, and patient satisfaction. Physiotherapists will also be followed up to explore the impact of participation on their clinical practice. The total study duration includes the initial intervention and a long-term follow-up, aiming to gather comprehensive information on the app's usefulness and acceptability.

This research aims to evaluate the KnowHow program, a 10-week digital intervention designed to promote healthy eating and activity behaviors among families with young children. The study focuses on assessing how feasible and acceptable this program is for parents of preschool-aged children, including how well families engage with the program and their intentions to continue its practices. The intervention targets health behavior improvements in early childhood by providing parent education on mindful parenting, nutrition, and physical literacy. The KnowHow program includes three main components: a custom mobile app delivering educational content and activities, virtual group discussions held via Zoom, and child-centered support materials mailed to families. The app is organized into five modules containing lessons, activities, and assessments focused on mindful parenting, healthy eating, and physical activity. Two groups are studied: one receives the 10-week intervention, and a delayed control group does not receive the program during the study period but gains access afterward. Participants will be assessed at baseline (week 0) and after the 10-week intervention (post-test) for several outcomes including recruitment, retention, usability, acceptability, digital engagement, and intention to sustain behaviors. Behavioral outcomes such as mindful parenting, parent-child feeding practices, and physical activity parenting practices are measured before and after the intervention. Parent self-efficacy and behavioral skills are also evaluated. The total study duration for participants is 10 weeks, with no additional assessments for the control group after the intervention period.

Young adults aged 25 to 39 who have cancer face unique challenges in coping, and their partners who provide care may feel burdened and less confident in their caregiving roles. Researchers are evaluating a brief psychotherapy intervention designed to improve how these young adults and their caregiving partners cope with cancer and maintain their relationships. This pilot study aims to test whether this intervention is feasible and acceptable in this specific group, providing important information for future larger studies. The intervention involves eight weekly virtual psychotherapy sessions lasting 45 to 60 minutes, delivered to young adults with cancer and their self-identified partners together. It is based on cognitive-behavioral therapy and couples-focused therapy principles tailored for young adults. A trained mental health practitioner will guide the sessions, which include teaching, practical exercises, and home practice. The study includes 10 young adults with cancer and their caregiving partners, totaling 20 participants. Participants will complete surveys before starting the intervention and again after finishing the eight sessions to measure feasibility and acceptability over approximately 14 weeks. They will also be invited to take part in optional interviews to share their experiences. This study is sponsored by Massachusetts General Hospital and does not include a control group or blinding. The total duration of involvement for participants is about three and a half months.

Researchers are evaluating a family-centred approach to prevent cardiovascular diseases (CVD) among adolescents and their families in Uganda. This 5-year study focuses on reducing risk factors like unhealthy diet and physical inactivity that contribute to CVD and other non-communicable diseases (NCDs). The study adapts a proven intervention from Asia to the Ugandan context, aiming to support healthier lifestyle behaviors during the critical adolescence period when habits form that affect adult health. The study includes two groups: one receiving the FaCe-D intervention, which involves home visits by Village Health Teams delivering diet, physical activity, and health messaging; and a control group receiving standard care with usual health promotion activities. The study is divided into three phases: adapting the intervention, implementing it, and evaluating its effectiveness and feasibility in 32 villages. Participants will be involved for at least 12 months, during which researchers will assess changes in cardiovascular health and sleep quality. Evaluations include monitoring behavior changes, health outcomes, and implementation costs. The study also considers adoption and feasibility to understand how well the intervention works in real community settings.

This research aims to explore how PhytoRx Families, an innovative produce prescription program, can impact nutrition, health, and healthcare use among families in rural North Carolina facing food insecurity. The study focuses on adults and school-aged children, addressing barriers like limited access to affordable healthy food in lower-resourced rural communities. Participants include 30 adult-child pairs with children aged 8 to 14 years. Healthcare providers at local clinics will refer eligible families who screen positive for food insecurity. The program provides fresh produce boxes and nutrition education over a 16-week period, aiming to improve fruit and vegetable intake and related health outcomes. During the study, participants will complete dietary recalls and health assessments at the start and end of the 16 weeks. Researchers will measure fruit and vegetable intake, diet quality, food security, blood pressure, HbA1C, body mass index, and various nutrition-related behaviors. The study will also track healthcare usage and evaluate changes over the intervention period.