Vught

This research evaluates the effectiveness of the RISE blended behavior change intervention in people who have experienced their first stroke. The study aims to prevent major adverse cardiovascular events such as recurrent stroke, transient ischemic attacks, acute coronary events, and cardiovascular death over a one-year follow-up period compared to standard care. It also investigates the intervention's impact on reducing sedentary behavior after hospital discharge in community-dwelling stroke survivors with sedentary movement patterns. Approximately 950 to 1000 participants are expected to be enrolled to account for loss to follow-up. Participants are randomly assigned to an experimental group receiving the 15-week RISE intervention alongside usual care or to a control group receiving only usual care. The RISE intervention involves coaching by a primary care physiotherapist who supports participants in balancing their 24-hour activity pattern, focusing on reducing and interrupting sedentary time to increase physical activity. This coaching includes the use of an activity monitor, a smartphone application with real-time feedback and e-learning modules, and a dashboard for the physiotherapist. Support from someone in the participant's social network is also included. Control group participants receive hospital-specific standard care. Participants will undergo assessments at baseline, immediately post-treatment (four months), and at six, nine, and twelve months after randomization. These assessments include wearing activity monitors, completing questionnaires, and performing physical tests, all of which are non-invasive and conducted either online or at home. Researchers monitor the occurrence of major adverse cardiovascular events as the primary outcome. The study's burden and risks are considered low, with physiotherapist visits conducted at home or online, and participants are physically capable of completing the required activities.

Researchers are evaluating the cost-effectiveness and efficacy of contingency management (CM) compared with standard cognitive behavioral therapy (CBT) for treating cannabis use disorder (CUD) in youth aged 16 to 22 years. The study aims to determine whether 12 weeks of outpatient CM leads to more cannabis-abstinent days than CBT during treatment and to assess the long-term effects and cost-effectiveness of both treatments at 6 and 12 months follow-up. Participants are randomly assigned to receive either 12 weeks of outpatient abstinence-focused CM or standard outpatient CBT. CM involves twice-weekly urine testing with monetary rewards for cannabis abstinence, starting at 5 and increasing up to 35 per negative test, plus bonuses, with earnings capped at 675. CBT consists of 12 weekly 60-minute sessions with a psychologist focusing on skills to reduce or stop cannabis use; participants also undergo urine testing twice weekly, but results are not shared and no rewards are given. During the study, assessments occur at baseline, after 6, 12, 26, and 52 weeks, and twice weekly during treatment. These include questionnaires, computer tasks, and urine sample collections. The main outcome measured is the number of biochemically verified cannabis-abstinent days over 12 weeks. Secondary outcomes include treatment response defined as at least a 50% reduction in cannabis use days. Cost-effectiveness analyses will evaluate the societal impact of both treatments over 12 months.