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Introduction: The Västerbotten Intervention Programme (VIP) in the Region Västerbotten Sweden is one of the very few cardiovascular disease (CVD) prevention programmes globally that is integrated into routine primary health care. The VIP has been shown as a cost-effective intervention to significantly reduce CVD mortality. However, little is known about the effectiveness of a digital solution to tailor risk communication strategies for supporting behavioral change. STAR-C aims to develop and evaluate a technical platform for personalized digital coaching that will support behavioral change aimed at preventing CVD.Methods: STAR-C employs a mixed-methods design in seven multidisciplinary projects, which runs in two phases during 2019–2024: (i) a formative intervention design and development phase, and (ii) an intervention implementation and evaluation phase. In the 1st phase, STAR-C will model the trajectories of health behaviors and their impact on CVDs (Project 1), evaluate the role of the social environment and social networks on behavioral change (Project 2) and assess whether and how social media facilitates the spread of health information beyond targeted individuals and stimulates public engagement in health promotion (Project 3). The findings will be utilized in carrying out the iterative, user-centered design, and development of a person-tailored digital coaching platform (Project 4). In the 2nd phase, STAR-C will evaluate the implementation of the coaching programme and its effectiveness for promoting behavioral change and the spreading of health information across social networks and via social media (Project 5). The cost-effectiveness (Project 6) and ethical issues (Project 7) related to the coaching programme intervention will be evaluated.Discussion: The STAR-C research programme will address the knowledge and practice research gaps in the use of information technologies in health promotion and non-communicable disease (NCD) prevention programmes in order to narrow the health inequality gaps.Ethics: STAR-C has received approval from the Swedish Ethical Review Authority (Dnr. 2019-02924;2020-02985).Dissemination: The collaboration between Umeå University and Region Västerbotten will ensure the feasibility of STAR-C in the service delivery context. Results will be communicated with decision-makers at different levels of society, stakeholders from other regions and healthcare professional organizations, and through NGOs, local and social media platforms.

Background: Progressive lung disease is the main cause of clinical deterioration and mortality in cystic fibrosis (CF) patients. Being able to assess the effectiveness of interventions is very significant. Objectives: To assess the response to intravenous (IV) treatment among CF patients, using forced expired volume in 1st second (FEV1) and Lung Clearance Index (LCI) as outcome measures and to compare the effect of IV treatment on lung function and LCI between CF children being treated on a regular basis, or in case of a pulmonary exacerbation. Subjects and Methods: Thirty-two CF patients (15 males) with mean age 9.90 (range: 2-23) years, performed spirometry and multiple breath washout (MBW) before and one month after IV antibiotic treatment. Nineteen patients received a course of elective treatment (group A) and 13 received IV antibiotic regimens for an acute exacerbation (group B). Results: Statistically significant differences after treatment were seen in LCI (p≤0.001), and Forced Expiratory Flow (FEF) z-scores (p<0.05). FEV1 did not change significantly after drug intervention. Dividing patients into two groups, only LCI showed significant change (p<0.05), when treatment was administered on a regular basis. Patients being treated for an acute pulmonary exacerbation showed significant improvement in most of the lung function parameters: LCI (p=0.0001), FEV1% (p=0.05), FEV1 z-score (p=0.033) and FEF25-75 (p=0.046). The mean LCI difference was significantly greater in group B compared to group A (p=0.001). Conclusion: LCI is more sensitive marker than FEV1 to assess the effect of IV antibiotic treatment among CF children. IV antibiotics are more effective on lung function parameters, when they are administered for an acute exacerbation, than when they are given on a regular basis. [ABSTRACT FROM AUTHOR]

ObjectiveFollowing the adoption of food policies replacing unhealthy products by healthy foods in school, the present study tested the effectiveness of an intervention aimed at encouraging high-school students to stay in school for lunch instead of eating in fast-food restaurants.DesignA 12-week multi-strategy intervention targeting specific determinants of behaviour was evaluated via a quasi-experimental pre- and post-intervention design. A self-administered questionnaire was employed based on the theory of planned behaviour.SettingAn experimental (n 129) and a control school (n 112) in central Canada.SubjectsHigh-school students aged 12 to 17 years.ResultsCompared with control school students, those in the experimental school significantly increased the mean number of days that they stayed in school for lunch (relative risk = 1·55; 95 % CI 1·06, 2·27; P = 0·024), as well as the proportion who remained in school for lunch every day (relative risk = 1·21; 95 % CI 1·04, 1·40; P = 0·014). Among the psychosocial variables targeted, only self-efficacy appeared to be influenced by the intervention, mainly because of a decline in control group values. Mediation analysis indicated a significant mediating effect of self-efficacy on the mean number of days that students stayed in school for lunch (bias-corrected and accelerated point estimate = 0·079; 95 % CI 0·0059, 0·1958).ConclusionsThese results suggest that interventions aimed at enhancing self-efficacy can successfully contribute to students staying in school during lunch time. Such interventions should be considered in obesity prevention programmes adapted to high-school students. [ABSTRACT FROM PUBLISHER]

Aim: The London borough of Newham is ethnically diverse and is one of the poorest regions in the UK. Rates of teenage pregnancy, sexually transmitted infections (STIs) and HIV are high compared to the rest of the country. One strand of the local school-based HIV-prevention programme for young people utilizes performance arts as a tool for HIV education and prevention. This study evaluated HIV knowledge, confidence and intention to use a condom in two groups of 13-16 year olds who had participated in performance-based events. Method: Group 1 (n = 14) participated in a six-week programme of performance arts-based HIV education and prevention workshops, which culminated in a theatre-based performance. Group 2 (n = 65) were audience members who attended the performance. Participants completed a short questionnaire containing both qualitative and quantitative items. Results: Qualitative data suggested that the participants had learned about condoms and their efficacy in preventing acquisition of HIV and sexually transmitted diseases. Quantitative results indicated that after participation in the events, respondents had more information about HIV and condom use; were more confident that they could insist on condom use with partners; and planned to use condoms in the future. There was a statistically significant difference between Groups 1 and 2 but because of the small numbers in Group 1 this result should be interpreted cautiously. Conclusions: Performance-based HIV-prevention activities may be a useful way to deliver HIV-prevention messages to young people. This evaluation will form the basis of a more systematic and robust evaluation of future events. [ABSTRACT FROM AUTHOR]

This article critically reviews 11 participatory ergonomic interventions carried out in Québec by the Occupational Health and Safety Research Institute (IRSST). In the introduction, the characteristics of the approach used are situated in relation to the literature on this subject. Based on the "Ergo team" formula, the approach aims to provide company personnel with the skills to analyze and correct hazardous workstations in relation to musculoskeletal disorders (MSD), using an analysis process that the researchers developed. Although isolated workstations were corrected, the process aims for more general impacts on the company. In the 11 interventions, 40 work situations were analyzed, and in 31 cases, changes were implemented to reduce MSD risks. The most common changes dealt with the tools/equipment (77.4% and physical layouts (84%); changes involving work methods (29% and work organization (12.9%) were less common. The difficulties encountered in the interventions are summarized, and the possible impacts of the interventions on the organization and psychosocial factors are discussed. The authors then address the limitations of the paper and the factors that should be considered in evaluating such a participatory process. The authors conclude that the participatory process was successful in implementing changes in companies and that other studies are necessary for a better understanding of the process and its impacts. [ABSTRACT FROM AUTHOR]