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991.
Background
Many users of Internet interventions do not persist with the full treatment program. As persistence may influence outcomes of such interventions, being able to maximize persistence is vital. However, while studies have begun to explore the predictors of dropout in Internet interventions, few have explored reasons why users persist with the programs, which may not just be the converse of the reasons for dropout.Objective
To answer the question of what influences persistence with online interventions.Methods
We interviewed participants in the Cardiovascular Risk E-couch Depression Outcome (CREDO), a trial evaluating the efficacy of an eHealth intervention (e-couch) in treating depressive symptoms in those with comorbid depression and cardiovascular risk factors. Interviews were semistructured in nature and were analyzed using a grounded theory approach. Interview numbers were curtailed (n = 12) after theoretical saturation.Results
All participants reported substantial barriers to completing the program including time constraints, competing priorities, anxiety about spending time on the computer, and perception of limited worth of the intervention. Participants who persisted with the trial reported intrinsic motivations such as personal values about task completion and sense of control, and recognized external motivators that aided the development of habits and identified personal benefits attributable to the program.Conclusions
Online interventions may benefit from content that enhances the intrinsic motivations such as a having sense of control and being able to identify with the program, and by increasing the relative value of the program in order to enhance persistence. Persistence within a trial setting appears modifiable through explicit messages regarding supporting others. In terms of motivators, the use of a hook to engage participants who are starting the intervention due to curiosity and the use of reminder systems to prompt participants may also improve persistence. The worth of such additions should be evaluated using adherence and outcomes metrics.Trial Registration
Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12610000085077; http://www.anzctr.org.au/ACTRN12610000085077.aspx (Archived by WebCite at http://www.webcitation.org/68MtyPO3w) 相似文献992.
Stone RL Nick AM McNeish IA Balkwill F Han HD Bottsford-Miller J Rupaimoole R Armaiz-Pena GN Pecot CV Coward J Deavers MT Vasquez HG Urbauer D Landen CN Hu W Gershenson H Matsuo K Shahzad MM King ER Tekedereli I Ozpolat B Ahn EH Bond VK Wang R Drew AF Gushiken F Collins K DeGeest K Lutgendorf SK Chiu W Lopez-Berestein G Afshar-Kharghan V Sood AK 《The New England journal of medicine》2012,366(7):610-618
993.
Karin E de Visser Metamia Ciampricotti Ewa M Michalak David Wei‐Min Tan Cheei‐Sing Hau Hans Clevers Nick Barker Jos Jonkers 《The Journal of pathology》2012,228(3):300-309
The leucine‐rich repeat‐containing heterotrimeric guanine nucleotide‐binding protein‐coupled receptor 5 (LGR5) has been identified as a marker of cycling stem cells in several epithelial tissues, including small intestine, colon, stomach and hair follicle. To investigate whether LGR5 also marks mammary epithelial stem cells, we performed in situ lineage‐tracing studies and mammary gland reconstitutions with LGR5‐expressing mammary epithelial cells. Interestingly, the LGR5 progeny population in mammary epithelium switches from the luminal to the myoepithelial compartment during the first 12 days of postnatal development, likely reflecting local changes in Wnt signalling. Together, our findings point to a stage‐specific contribution of LGR5‐expressing cells to luminal and basal epithelial lineages during postnatal mammary gland development. Copyright © 2012 Pathological Society of Great Britain and Ireland. 相似文献
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Lamb BW Brown KF Nagpal K Vincent C Green JS Sevdalis N 《Annals of surgical oncology》2011,18(8):2116-2125
Background
Factors that affect the quality of clinical decisions of multidisciplinary cancer teams (MDTs) are not well understood. We reviewed and synthesised the evidence on clinical, social and technological factors that affect the quality of MDT clinical decision-making. 相似文献997.
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