Mat Pilates and belly dance: Effects on patient-reported outcomes among breast cancer survivors receiving hormone therapy and adherence to exercise

BackgroundBreast cancer treatment leads to several side effects. Exercise can help to reduce these side effects. However, it is unknown whether a mat Pilates or a belly dance intervention can improve the patient-reported outcomes of these women.ObjectiveExamine the effects of a 16-week exercise intervention (mat Pilates or belly dance) on patient reported outcomes (PROs) among breast cancer survivors, at 16 weeks, six months, and 12 months; and investigate sociodemographic and clinical predictors of intervention adherence.MethodsSeventy-four breast cancer survivors who were receiving hormone therapy were randomly allocated into mat Pilates (n = 25), belly dance (n = 25) or control group (educational sessions) (n = 24). Mat Pilates and belly dance groups received a 16-week intervention, delivered three days a week and 60 min a session. The control group received three education sessions and continue usual care. The patient reported outcomes assessed were depressive symptoms (Beck Depression Inventory), stress (Perceived Stress Scale), optimism (Life Orientation Test), fatigue (FACT-F), sleep quality (Pittsburgh Sleep Quality Index) and pain (VAS), clinical and sociodemographic characteristics, and habitual physical activity (IPAQ short).ResultsAll three groups showed a significant improvement in fatigue, and this effect was maintained during follow-up. No significant effects were found for depressive symptoms, optimism, stress, or pain. A history of exercise prior to breast cancer and be inactive after diagnosis were significant predictors of adherence to interventions.ConclusionMat Pilates, belly dance and a few educational sessions can be effective in improving fatigue after 16 weeks of intervention.RegistrationClinicalTrials.gov (NCT03194997).     

Body weight support-Tai Chi footwork for balance of stroke survivors with fear of falling: A pilot randomized controlled trial

Background and purposeBalance impairment is the predominant risk factor for falls in stroke survivors. This study examined the effects of body weight support-Tai Chi (BWS-TC) footwork on balance control among stroke survivors with fear of falling (FOF).Materials and methodsTwenty-eight stroke survivors with FOF were randomly allocated to either control or BWS-TC groups. Those in BWS-TC underwent Tai Chi training for 12 weeks. Outcomes were assessed in all participants by evaluation of the limits of stability test, modified clinical test of sensory integration of balance, fall risk index, and Fugl-Meyer assessment of lower limbs at baseline and 12 weeks.ResultsThe BWS-TC group displayed significant enhancement in dynamic control and vestibular and somatosensory integration.ConclusionBWS-TC may enhance dynamic control and sensory integration of balance and reduce the risk of fall in stroke survivors with FOF.     

Tai Chi for anxiety and depression symptoms in cancer,stroke, heart failure,and chronic obstructive pulmonary disease: A systematic review and meta-analysis

BackgroundMany middle-aged and older adults have more than one chronic health condition. It is therefore important to explore the effectiveness of interventions for multiple chronic conditions. Tai Chi is widely used in China and other countries, and many studies have examined the effect of Tai Chi on anxiety and depression. However, there are no systematic reviews of the effect of Tai Chi on anxiety and depression in various chronic conditions. This systematic review and meta-analysis aimed to evaluate the effects of Tai Chi on anxiety and depression symptoms in four chronic conditions: cancer, stroke, heart failure (HF), and chronic obstructive pulmonary disease (COPD).MethodsWe searched Chinese and English databases (Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database, and Sinomed) from inception to October 2020. Review Manager version 5.2 and Stata version 12.0 were used to perform a systematic review. The quality of the included studies was evaluated using the Cochrane risk of bias tool. The study was registered with the PROSPERO database (number CRD42020209594).ResultsOf the 596 studies identified, we included 25 randomized controlled trials involving 1819 participants. Combined analysis of the four diseases showed statistically significant differences between the Tai Chi and control groups for anxiety symptoms (SMD −0.99, 95%CI: −1.5, −0.47; P < 0.01) and depressive symptoms (SMD 0.70, 95%CI: −1.01, −0.39; P < 0.01). Subgroup analyses showed statistically significant differences between the Tai Chi and control groups for depressive symptoms in stroke (SMD −0.43, 95%CI: −0.67, −0.18; P < 0.01) and HF (SMD −0.57, 95%CI: −0.8, −0.33; P < 0.01). However, no statistically significant differences were found for depressive symptoms in COPD or cancer. There were statistically significant differences between the Tai Chi and control groups for anxiety symptoms in stroke (SMD −0.60, 95%CI: −0.88, −0.32; P < 0.01) and cancer (SMD −0.69, 95%CI: −1.22, −0.17; P < 0.01), but not in COPD or HF. Subgroup, sensitivity, meta regression, and publication bias analyses showed high heterogeneity correlated with a single study and study quality. Sensitivity analysis showed that most meta-analysis results had good stability, but those for anxiety symptoms in COPD were unstable; therefore, careful interpretation is required.ConclusionTai Chi has a positive effect on anxiety and depression, especially for patients with cancer, stroke, and HF. However, given the weak evidence, this approach is not a substitute for psychiatric treatment.     

Factors affecting perceived change in physical activity in pregnancy

Objectivereduction of physical activity (PA) during pregnancy is common but undesirable, as it is associated with negative outcomes, including excessive gestational weight gain. Our objective was to explore changes in five types of activity that occurred during pregnancy and the behavioural determinants of the reported changes in PA.Designwe performed a secondary analysis of a cross sectional survey that was constructed using the ASE-Model – an approach to identifying the factors that drive behaviour change that focuses on Attitude, Social influence, and self-Efficacy.Participants455 healthy pregnant women of all gestational ages, receiving prenatal care from midwifery practices in the Netherlands.Findingsmore than half of our respondents reported a reduction in their PA during pregnancy. The largest reduction occurred in sports and brief rigorous activities, but other types of PA were reduced as well. Reduction of PA was more likely in women who considered themselves as active before pregnancy, women who experienced pregnancy-related barriers, women who were advised to reduce their PA, and multiparous women. Fewer than 5% increased their PA. Motivation to engage in PA was positively associated with enjoying PA.Key conclusions and implications for practiceall pregnant women should be informed about the positive effects of staying active and should be encouraged to engage in, or to continue, moderately intensive activities like walking, biking or swimming. Our findings concerning the predictors of PA reduction can be used to develop an evidence-based intervention aimed at encouraging healthy PA during pregnancy.     

A systematic mixed-methods review of interventions,outcomes and experiences for midwives and student midwives in work-related psychological distress

Backgroundwithin challenging work environments, midwives and student midwives can experience both organisational and occupational sources of work-related psychological distress. As the wellbeing of healthcare staff directly correlates with the quality of maternity care, this distress must be met with adequate support provision. As such, the identification and appraisal of interventions designed to support midwives and student midwives in work-related psychological distress will be important in the pursuit of excellence in maternity care.Objectivesto identify interventions designed to support midwives and/or student midwives in work-related psychological distress, and explore any outcomes and experiences associated with their use.Data sources; study eligibility criteria, participants, and interventions This systematic mixed-methods review examined 6 articles which identified interventions designed to support midwives and/or student midwives in work-related psychological distress, and reports both the outcomes and experiences associated with their use. All relevant papers published internationally from the year 2000 to 2016, which evaluated and identified targeted interventions were included.Study appraisal and synthesis methodsthe reporting of this review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The quality of each study has been appraised using a scoring system designed for appraising mixed-methods research, and concomitantly appraising qualitative, quantitative and mixed-methods primary studies in mixed reviews. Bias has been assessed using an assessment of methodological rigor tool. Whilst taking a segregated systematic mixed-methods review approach, findings have been synthesised narratively.Findingsthis review identified mindfulness interventions, work-based resilience workshops partnered with a mentoring programme and the provision of clinical supervision, each reported to provide a variety of both personal and professional positive outcomes and experiences for midwives and/or student midwives. However, some midwives and/or student midwives reported less favourable experiences, and some were unable to participate in the interventions as provided for practical reasons.Limitationseligible studies were few, were not of high quality and were limited to international findings within first world countries. Additionally, two of the papers included related to the same intervention. Due to a paucity of studies, this review could not perform sensitivity analyses, subgroup analyses, meta-analysis or meta-regression.Conclusions and implications of key findingsthere is a lack of evidence based interventions available to support both midwives and student midwives in work-related psychological distress. Available studies reported positive outcomes and experiences for the majority of participants. However, future intervention studies will need to ensure that they are flexible enough for midwives and student midwives to engage with. Future intervention research has the opportunity to progress towards more rigorous studies, particularly ones which include midwives and student midwives as solitary population samples     

Evidence of religious/spiritual singing and movement in mental health: A systematic review

BackgroundWhile mental health care needs have increased during the global pandemic, access to care has been reduced. Easily accessible alternative interventions may supplement existing mental health services to meet the increased need of mental health care. Our review explored the evidence of two alternative interventions, religious/spiritual (R/S) singing and R/S movement (dynamic meditation and praise dance), in relation to mental health outcomes.MethodAfter registering with PROSPERO (CRD42020189495), a systematic search of three major databases (CINAHL, MEDLINE, and PsycINFO) was undertaken using predetermined eligibility criteria. Reference lists of identified papers and additional sources such as Google Scholar were searched. Quality of studies was assessed using the Mixed Method Appraisal Tool (MMAT). Data was extracted, tabulated, and synthesised according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines.ResultsSeven of the 259 identified studies met inclusion criteria. Three studies considered R/S singing, while four considered R/S movement. In R/S movements, three studies considered dynamic meditation while one investigated praise dance. Although moderate to poor in quality, included studies indicated a positive trend for the effectiveness of R/S singing and movement in dealing with mental health concerns.ConclusionWhile R/S singing and R/S movement (praise dance and dynamic meditation) may be of value as mental health strategies, findings of the review need to be considered with caution due to methodological constraints. The limited number and poor quality of included studies highlight the need for further quality research in these R/S practices in mental health.     

Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship

BackgroundMindfulness-based interventions (MBIs) are increasingly recognized as an effective strategy for supporting female cancer survivors experiencing sexual health concerns.AimTo examine the feasibility of a sexual health MBI, Mindful After Cancer, which was adapted to meet the needs of breast and gynecologic cancer survivors in a community setting and for delivery via videoconference.MethodsA mixed-methods approach was used to evaluate the acceptability, feasibility, and appropriateness of the 8-week virtual MBI. Weekly sessions were 1.5–2 hours in duration and included guided meditations and group discussion about sexuality after cancer and mindfulness in daily life. Home practice activities related to both mindfulness practice and sexual health. Participants completed online surveys at baseline and 1-month post-intervention. A purposive sample of 10 participants were invited to complete a follow-up interview 2–3 months post-intervention.OutcomesPrimary outcomes included both qualitative and quantitative assessments of acceptability, appropriateness, and feasibility of the Mindful After Cancer intervention for sexual health in cancer survivorship.ResultsTwenty-two women completed the intervention (Mean age 53.2 years, SD = 9.4, Range= 39–73), with time since diagnosis ranging from 1 to 27 years (Mean 6.0 years, SD = 5.9). Participants completed 6.8 sessions on average (Range = 2 – 8) and 77% reported that the time commitment was manageable. Both qualitative and quantitative findings support the feasibility, acceptability, and appropriateness of the intervention.Clinical ImplicationsMany cancer survivors experience sexual dysfunction and related distress after diagnosis and well after treatment ends, yet there are few interventions available. Improved access to effective interventions can improve the delivery of survivorship care and patient outcomes.Strengths & LimitationsThe sample size is small for this pilot study, and a control group was not included. The intervention was offered over two time periods, one prior to COVID-19 pandemic and one during the pandemic, resulting in both limitations associated with potential differences between the experiences of participants and the opportunity to learn more about the feasibility of the intervention during times of crisis.ConclusionResults suggest that virtual delivery of the MBI is feasible, acceptable, and appropriate for breast and gynecologic cancer survivors.Gorman JR, Drizin JH, Smith E, et al. Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship. J Sex Med 2022;19:1131–1146.     

Biochemical and psychometric evaluation of Self-Healing Qigong as a stress reduction tool among first year nursing and midwifery students

BackgroundQigong, a traditional Chinese exercise, has a potential role in the management of stress.ObjectiveTo examine the influence of Qigong training on depression, anxiety and stress.DesignA randomised control trial among first year student participants.MethodsQigong was practised twice a week by the study group (n = 18) while a control group (n = 16) had no intervention. The Depression, Anxiety and Stress (DASS-21) and Patient Health Questionnaires (PHQ) were administered. Salivary biomarkers were also measured over a 10-week period.ResultsAfter 10 weeks, only the Qigong group showed a statistically significant improvement in their depression, anxiety and stress scores. Similarly, increases in secretion rates of salivary immunoglobulin-A, and decreases in salivary cortisol concentrations were seen only in the Qigong group.ConclusionsThe practice of Qigong improves psychological states and mucosal immunity; as indicated by psychometric tests and biochemical markers of stress.     

Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: a pilot study

IntroductionFew couple‐focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners.AimsWe examined the effects of a five‐session Intimacy‐Enhancing Therapy (IET) vs. Usual Care (UC) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners. Pre‐intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects.MethodsSeventy‐one survivors and their partners completed a baseline survey and were subsequently randomly assigned to receive five sessions of IET or UC (no treatment). Eight weeks after the baseline assessment, a follow‐up survey was administered to survivor and partner.Main Outcome MeasuresDistress, well‐being, relationship satisfaction, relationship intimacy, and communication were investigated as the main outcomes.ResultsIET effects were largely moderated by pre‐intervention psychosocial and relationship factors. Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET. Similar moderating effects for pre‐intervention levels were reported for the effects of IET on self‐disclosure, perceived partner disclosure, and perceived partner responsiveness. Among partners beginning the intervention with higher cancer‐specific distress, lower marital satisfaction, lower intimacy, and poorer communication, IET improved these outcomes.ConclusionsIET had a marginally significant main effect upon survivor well‐being but was effective among couples with fewer personal and relationship resources. Subsequent research is needed to replicate these findings with a larger sample and a longer follow‐up. Manne SL, Nelson CJ, Kissane DW, Mulhall JP, Winkel G, and Zaider T. Intimacy‐enhancing psychological intervention for men diagnosed with prostate cancer and their partners: A pilot study.     

Creative versus repetitive dance therapies to reduce the impact of fibromyalgia and pain: A systematic review and meta-analysis

Background and purposePhysical exercise is one of the most effective interventions to reduce fibromyalgia symptoms. Previous studies have reported benefits of dance-based intervention on the fibromyalgia impact, health-related quality of life and pain, regardless the interventions were based on creative- or repetitive dance. This study aimed to compare the effectiveness of creative and repetitive dance interventions.MethodsPRISMA guidelines were followed in this systematic review. The Cochrane Library, PubMed, Trip, Google Scholar, Web of Science (WOS), Embase and Scopus databases were selected to identify potential articles. Studies were included if they met the following inclusion criteria: to be a clinical trial or a randomized controlled trial, include people with fibromyalgia, have a comparison group and evaluate the impact of the disease, pain or quality of life. Fifteen articles fulfilled the inclusion criteria. The methodological quality of the studies was assessed using the Cochrane Collaboration's tool.ResultsDance-based interventions significantly reduced fibromyalgia impact (standardized mean difference = −0.69), pain (standardized mean difference = −0.70 and increased quality of life (standardized mean difference = 0.43) of people with fibromyalgia. The effectiveness of dance interventions is increased when a creative component is added, since it can lead to higher improvements in pain, impact of the disease and improving quality of life.ConclusionDance-based interventions are significantly effective in reducing the impact of fibromyalgia, pain as well as increasing health-related quality of life. Subgroup analyses suggest that creative dance-based interventions could be more effective than repetitive dance-based interventions to reduce pain and fibromyalgia impact. However, results must be taken with caution due to the large heterogeneity and the small number of articles.     

Neonatal cerebral lesions predict 2-year neurodevelopmental impairment in children treated with laser surgery for twin–twin transfusion syndrome

Objective: The objective of this study is to assess whether postnatally detected cerebral abnormalities are predictive of neurodevelopmental impairment (NDI) in survivors of twin–twin transfusion syndrome (TTTS) that underwent laser surgery.

Materials and methods: Ninety-nine children treated for TTTS had neurodevelopmental assessment at age 2-years (±6 weeks). ‘High-risk survivors’ had cerebral imaging in the neonatal period. ‘High-risk survivors’ were defined as (1) delivered at <32 weeks; or (2) cerebral imaging clinically indicated. NDI was a composite outcome of: Battelle Developmental Inventory 2nd edition (BDI-2) score <70, cerebral palsy, blindness, and/or deafness. Multilevel logistic regression with robust standard errors was used to evaluate associations between cerebral lesions and NDI.

Results: Fifty-six children were ‘high-risk survivors’ and had neonatal cerebral imaging. Ten twins (18%) had at least one cerebral lesion, including grade 1–2 intraventricular hemorrhage (8), cystic periventricular leukomalacia (2), ventriculomegaly (1), and bilateral subependymal cyst (1). The risk of NDI in the ‘high-risk survivors’ was 7% (4/56) compared with 0% (0/43) in the remaining group. Among ‘high-risk survivors’, cerebral lesions were a significant risk factor for NDI (OR?=?19.28, p?Conclusions: Among ‘high-risk survivors’ of TTTS treated with laser surgery, cerebral lesions identified on neonatal imaging were associated with NDI at 2-years.     

A Prospective Single-Arm Study Evaluating the Effects of a Multimodal Physical Therapy Intervention on Psychosexual Outcomes in Women With Dyspareunia After Gynecologic Cancer

BackgroundDyspareunia affects most women after treatment for gynecologic malignancies. However, to date, evidence-based interventions remain limited and no study has examined the effects of multimodal physical therapy on psychosexual outcomes in these patients.AimTo assess the effects of multimodal physical therapy on psychosexual outcomes including sexual distress, body image concerns, pain anxiety, pain catastrophizing, pain self-efficacy and depressive symptoms in women with dyspareunia after treatment for gynecologic malignancies.MethodsThirty-one gynecologic cancer survivors with dyspareunia enrolled in this prospective single-arm interventional study. The participants undertook 12 weekly sessions of physical therapy incorporating education, pelvic floor muscle exercises with biofeedback, manual therapy and home exercises. Outcome measures were evaluated pre- and post-treatment. Paired t-tests were conducted to investigate the changes from pre-treatment (P-value ? 0.05) while effect sizes (Cohen's d) were calculated to measure the magnitude of the change.Main Outcome MeasuresSexual distress (Female Sexual Distress Scale-Revised), body image concerns (Body Image Scale), pain anxiety (Pain Anxiety Symptoms Scale), pain catastrophizing (Pain Catastrophizing Scale), pain self-efficacy (Painful Intercourse Self-Efficacy Scale) and depressive symptoms (Beck Depression Inventory-II).ResultsSignificant changes were found from pre- to post-treatment for all psychosexual outcomes. Women reported reductions in sexual distress (P ? 0.001, d = 1.108), body image concerns (P ? 0.001, d = 0.829), pain anxiety (P ? 0.001, d = 0.980), pain catastrophizing (P ? 0.001, d = 0.968) and depression symptoms (P = 0.002, d = 0.636) with an increase in pain self-efficacy (P ? 0.001, d ≥ 0.938) following the intervention.Clinical ImplicationsThe results suggest that multimodal physical therapy significantly improves sexual distress, body image concerns, pain anxiety, pain catastrophizing, pain self-efficacy and depressive symptoms in our sample of women with dyspareunia after treatment for gynecologic malignancies. The medium to large effect sizes obtained with the high proportion of women presenting meaningful changes according to the known minimal clinically important difference or clinical cut-off underlines the significance of these effects.Strengths & LimitationsThe current study used validated questionnaires to assess the psychosexual outcomes of a well-designed physical therapy intervention using multiple modalities to address the multifaceted aspect of dyspareunia in cancer survivors. This study did not include a control group, which may limit drawing definitive conclusions.ConclusionFindings showed that multimodal physical therapy yielded significant improvements in psychosexual outcomes in gynecologic cancer survivors with dyspareunia. A randomized controlled trial is indicated to confirm these results.Cyr M-P, Dumoulin C, Bessette P, et al. A Prospective Single-Arm Study Evaluating the Effects of a Multimodal Physical Therapy Intervention on Psychosexual Outcomes in Women With Dyspareunia After Gynecologic Cancer. J Sex Med 2021;18:946–954.     

Effects of Tai Chi Yunshou on upper-limb function and balance in stroke survivors: A systematic review and meta-analysis

Background and purposePhysical rehabilitation plays an important role in the recovery of motor function after a stroke. This study aimed to evaluate the effects of Tai Chi Yunshou (TCY), a form of physical therapy, on upper-limb function and balance in stroke survivors.MethodsMEDLINE, Embase, CENTRAL and five Chinese databases were retrieved from inception to July 1, 2020 (updated on March 31, 2022). Randomized controlled trials of TCY versus no-treatment for stroke were included. The RoB-2 was used to evaluate the quality of included studies. Upper-limb motor impairment, balance, and activities of daily living (ADLs) were measured by Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE), Berg Balance Scale (BBS), and Barthel Index (BI), respectively. Data synthesis was performed using RevMan (v5.3), and expressed as mean difference (MD) with 95% confidence intervals (CI).ResultsSeven studies with 529 participants were included. Compared with no-treatment, TCY improved FMA-UE (MD = 7.31, 95% CI: 5.86–8.77, minimal clinically important difference [MCID]: 9–10), BBS (MD = 4.68, 95% CI: 0.28–9.07, MCID: 4), and BI (MD = 4.12, 95% CI: 3.28–4.96, MCID: 1.85) in stroke survivors.ConclusionTCY may benefit balance and ADLs in rehabilitation after a stroke, but it may not improve upper-limb function clinically.     

Effects of an online mindfulness-based intervention on Fear of Cancer Recurrence and quality of life among Chinese breast cancer survivors

ObjectiveMindfulness-based interventions (MBIs) targeting cancer-related emotions and quality of life have attracted extensive attention in recent years. The purpose of the current study was to assess the feasibility and acceptability of an online mindfulness-based intervention and examine its effects on Chinese breast cancer survivors.MethodsSixty-five breast cancer survivors were randomized to either an online MBI or to wait for the next available program. The control group received usual care, while the intervention group also received six weeks of online MBI training. Participants completed the Short Form of the Fear of Cancer Recurrence Inventory (FCRI-SF), Five Facet Mindfulness Questionnaire (FFMQ) and European Organization for Research and Treatment of Cancer questionnaire (EORTC-QLQ-C30) at baseline (T1), immediately after the intervention (postintervention: T2) and 1 month later (1-month postintervention: T3). In addition, answers provided to questions about the experience of participating in the course were analyzed.ResultsCompared with the control group, the mindfulness, emotional and cognitive function of the MBI group was significantly improved after the intervention, and the FCR of breast cancer survivors was significantly alleviated. These effects were still significant 1 month after the end of the intervention. Additionally, participants were satisfied with the online MBI through the qualitative survey.ConclusionThis online MBI showed promise for Chinese breast cancer survivors, facilitating a reduction in FCR and improving their quality of life. The results of our study indicated that online MBI treatment could offer a scalable approach to manage FCR and maintain mental health for breast cancer survivors.     

Effectiveness of interventions using apps to improve physical activity,sedentary behavior and diet: An umbrella review

Technology has been recently found to be an effective tool to deliver public health interventions [1]. More specifically, the effects of interventions using apps to improve health have been targeted lately [2]. The goal of the present study was to conduct a systematic review of systematic reviews to summarize the scientific evidence. Three research questions were formulated to guide the research: RQ1. Are interventions using apps effective to improve PA? RQ2. Are interventions using apps effective to improve sedentary behavior? RQ3. Are interventions using apps effective to improve diet? This review of reviews was registered with PROSPERO (CRD42022345909). Systematic reviews were included following the PICOTS framework (population, intervention, comparator, outcomes, time and setting). In addition, reviews with several research objectives were included only when they comprised more than two-thirds of the studies analyzing one or more of the objectives of this review. As a result, 12 systematic reviews were selected for data extraction. Findings uncovered that apps could be effective to improve individuals’ PA, sedentary behavior and diet. However, elements like the intervention components, the context/environment/setting, the length of the intervention or the population targeted should be carefully considered in future studies.     

Effect of Previous Adverse Reproductive Health Outcomes on Young Women's Engagement in a Health Coaching Intervention to Improve Contraceptive Continuation

Study ObjectiveNonadherence in sexual risk reduction interventions might be common among adolescents. We compared intervention completion rates among adolescent and young adult women with and without a previous pregnancy or sexually transmitted infection (STI) participating in a program to improve contraceptive continuation.DesignSecondary data analysis from a feasibility study of a health-coaching intervention to improve contraceptive continuation.SettingThree urban pediatric clinics in Philadelphia.ParticipantsWomen ages 14-22 years who were English-speaking, sexually active in the past year, not desiring pregnancy in the next year, and starting a new contraceptive method.InterventionsAt baseline, participants completed a sociodemographic questionnaire and semistructured interview, followed by 5 monthly coaching sessions. Interviews and coaching sessions were audio-recorded, transcribed, and coded for thematic content.Main Outcome MeasuresIntervention completion was defined as the number of completed coaching sessions. Secondary outcomes were qualitatively explored group differences in reproductive knowledge, attitudes, and risk perception.ResultsParticipants with a previous adverse outcome (a previous STI and/or a previous pregnancy) completed fewer coaching sessions than those without such history (median: 2 vs 4; P = .03). Both groups had low HIV/STI knowledge, negative attitudes toward pregnancy, and low HIV/STI risk perception. Those with a previous adverse reproductive outcome held more negative attitudes toward condoms.ConclusionDespite similar reproductive knowledge, attitudes, and risk perception, young women who have experienced an adverse reproductive outcome might be less likely to fully engage in sexual risk reduction interventions. Future studies should confirm these findings and consider strategies to optimize the intervention's reach for vulnerable youth.     

Recommendations for a culturally-responsive mindfulness-based intervention for African Americans

BackgroundAfrican Americans are at increased risk for stress-related disparities. Mindfulness-based interventions are effective in reducing adverse outcomes; yet, racial/ethnic minorities are underrepresented in these interventions. Also, the development of culturally-responsive interventions has been mostly non-existent.Materials and methodsFocus group and interview data were acquired following a four-week mindfulness intervention with African American women.ResultsUsing Brigg's (2011) mental health utilization model to guide analysis, several recommended culturally-responsive modifications emerged. Recommended modifications internal to the intervention included using African American facilitators, incorporating cultural values, using culturally-familiar terminology, and providing cultural resources. Suggested modifications to the intervention's external factors included offering the intervention within culturally-familiar settings. Individual-level factors to address were religious concerns, perceived benefits, and holistic health goals.ConclusionsThemes were used to propose a model toward the creation of a culturally-responsive mindfulness-based interventions to guide culturally-relevant treatment modifications and improve underserved communities’ engagement in these interventions.     

Systematic Review of Lifestyle Interventions for Gestational Diabetes Mellitus in Pregnancy and the Postpartum Period

ObjectiveTo examine the characteristics and effectiveness of lifestyle interventions for gestational diabetes mellitus (GDM) in pregnancy and the postpartum period to prevent Type 2 diabetes.Data SourcesWe conducted searches in seven databases, including Ovid MEDLINE, CINAHL, Ovid Embase, Cochrane Central, Web of Science, Ovid PsycInfo, and ProQuest Dissertations and Theses for articles published from inception to January 2021.Study SelectionWe included articles on controlled intervention studies in which researchers evaluated a lifestyle intervention provided during pregnancy and the postpartum period for women with or at risk for GDM that were published in English.Data ExtractionTwelve articles that were reports of seven studies met the inclusion criteria. In some cases, more than one article was selected from the same study. For example, articles reported different outcomes from the same study. We extracted data with the use of a data collection form and compared and synthesized data on study design, purpose, sample, intervention characteristics, recruitment and retention, and outcomes.Data SynthesisAll seven studies focused on weight management and/or healthy lifestyle behaviors (diet and physical activity). Outcomes included glucose regulation, weight, lifestyle behaviors, and knowledge. The interventions varied in duration/dosage, strategies, and modes of delivery. In four studies, researchers reported interventions that had significant effects on improving glucose regulation and/or weight change. Some characteristics from the four effective interventions included goal setting, individualized care, and good retention rates. In the other three studies, limitations included low rates of participant retention, lack of personalized interventions, and limited population diversity or lack of culturally sensitive care.ConclusionLifestyle interventions provided during and after pregnancy to reduce the risk associated with GDM have the potential to improve outcomes. Health care counseling to promote healthy lifestyle behaviors related to the prevention of Type 2 diabetes is needed at different stages of maternity care for women with GDM. Additional high-quality studies are needed to address the limitations of current studies.