Dataset Information

Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial.

ABSTRACT:

Background

Functional capacity (FC) has been identified as a key outcome to improve real-world functioning in schizophrenia. FC is influenced by cognitive impairments, negative symptoms, self-stigma and reduced physical activity (PA). Psychosocial interventions targeting FC are still under-developed.

Methods

we conducted a quasi-experimental study evaluating the effects of an exercise-enriched integrated social cognitive remediation (SCR) intervention (RemedRugby [RR]) compared with an active control group practicing Touch Rugby (TR). To our knowledge, this is the first trial to date evaluating the effectiveness of such a program provided in a real-life environment.

Results

Eighty-seven people with schizophrenia were included and allocated to either the RR group (n = 57) or the TR group (n = 30) according to the routine clinical practice of the recruiting center. Outcomes were evaluated at baseline and post-treatment in both groups and after 6 months of follow-up in the RR group using standardized scales for symptom severity, social functioning, self-stigma, and a large cognitive battery. After treatment we observed moderate to large improvements in social function (Personal and Social Performance Scale [PSP], p < 0.001, d = 1.255), symptom severity (Positive and Negative Syndrome Scale [PANSS] negative, p < 0.001, d = 0.827; PANSS GP, p < 0.001, d = 0.991; PANSS positive, p = 0.009, d = 0.594), verbal abstraction (p = 0.008, d = 0.554), aggression bias (p = 0.008, d = 0.627), and self-stigma (stereotype endorsement, p = 0.019, d = 0.495; discrimination experiences, p = 0.047; d = 0.389) that were specific to the RR group and were not observed in participants playing only TR. Effects were persistent over time and even larger between post-treatment and follow-up.

Conclusions

Exercise-enriched integrated SCR appears promising to improve real-life functioning in schizophrenia. Future research should investigate the potential effects of this intervention on neuroplasticity and physical fitness.

SUBMITTER: Dubreucq J

PROVIDER: S-EPMC7355162 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Publications

Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial.

Dubreucq Julien J Gabayet Franck F Ycart Bernard B Faraldo Megane M Melis Fanny F Lucas Thierry T Arnaud Benjamin B Bacconnier Mickael M Bakri Motassem M Cambier Gentiane G Carmona Florian F Chereau Isabelle I Challe Titaua T Morel Sophie S Pires Sylvie S Roussel Celine C Lamy Philippe P Legrand Guillaume G Pages Emmanuelle E Pommier Romain R Rey Romain R Souchet Yohan Y Llorca Pierre-Michel PM Massoubre Catherine C

European psychiatry : the journal of the Association of European Psychiatrists 20200430 1

<h4>Background</h4>Functional capacity (FC) has been identified as a key outcome to improve real-world functioning in schizophrenia. FC is influenced by cognitive impairments, negative symptoms, self-stigma and reduced physical activity (PA). Psychosocial interventions targeting FC are still under-developed.<h4>Methods</h4>we conducted a quasi-experimental study evaluating the effects of an exercise-enriched integrated social cognitive remediation (SCR) intervention (RemedRugby [RR]) compared wi ...[more]

PMID: 32349835

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Project description:BackgroundSocial cognitive impairments are prevalent in schizophrenia spectrum disorder (SSD) and have detrimental effects on functioning. Cognitive remediation (CR) has shown its efficacy in improving social cognitive impairments, although the transfer of these skills to daily life and the personalization of these interventions remain challenging. RC2S (Remédiation Cognitive de la Cognition Sociale dans la Schizophrénie; Cognitive remediation of social cognition in Schizophrenia) is a French CR that combines the learning of strategies and practice using paper-and-pencil exercises and digital relational simulations. This French program was designed as an in-person intervention.ObjectiveThis project aims to culturally adapt the RC2S program, in French-Canadian and North American English and to assess the feasibility, acceptability, safety, and implementation of a remote version in people with SSD. An exploratory objective is to assess the preliminary effect of remote RC2S on goal attainment, social cognition, and psychosocial outcomes.MethodsWe will use a pre-post quasi-experimental design. First, the translation and cultural adaptation in North American English and French-Canadian of RC2S is presented. Then, 20 participants aged ≥18 years with a diagnosis of SSD, presenting with a subjective or an objective impairment in social cognition, will be included to receive RC2S. In addition, 5 therapists will be included as research participants to assess their perspective on RC2S. Participants with SSD will undergo a baseline remote assessment of their social cognition, clinical symptoms, and functioning. They will then start remote RC2S for 24 biweekly individual 1-hour sessions with a therapist. Following the case formulation and goal setting, participants will complete personalized paper-and-pencil exercises to develop strategies and integrative digital relational simulations, during which they will help an avatar navigate through a variety of social contexts and relationships. The last 2 sessions are dedicated to the transfer to daily life. All participants will complete in-session questionnaires assessing therapeutic alliance, motivation, acceptability, feasibility, and implementation. Following RC2S, the participants with SSD will repeat the same assessment as the baseline. Descriptive statistics will be used to summarize the data about acceptability, feasibility, safety, and implementation. To assess the preliminary effect of RC2S, an intention-to-treat approach will be used with linear mixed models for repeated measures with fixed effects of time.ResultsSo far, 45% (9/20) of participants with SSD (mean age 37.9, SD 9.3 years) have completed the project. They received a mean of 20.5 out of 24 (SD 3.5) sessions of RC2S. A total of 5 therapists also completed the project.ConclusionsImproving social cognitive impairments is an important target in SSD to promote functional recovery. Using digital technologies to address these impairments and deliver the intervention is a promising approach to increase the ecological validity of CR and access to the intervention.Trial registrationClinicalTrials.gov NCT05017532; https://classic.clinicaltrials.gov/ct2/show/NCT05017532.International registered report identifier (irrid)DERR1-10.2196/54251.

Project description:BackgroundCommunicating (dynamic) social norms is considered a promising tool to stimulate healthy and sustainable food choices. The aim of the present study was to evaluate to what extent a (dynamic) social norm intervention in real-world supermarkets could increase sales (grams per week) of meat alternatives (i.e. meat substitutes and legumes).MethodsA quasi-experimental study, including three intervention and three control supermarkets, was conducted during a 12-week period. The intervention supermarkets communicated dynamic norms textually on stickers and banners at different in-store locations (e.g. at the entrance, meat aisles). Moreover, the prominence of meat substitutes was (optically) increased and legumes were conveniently placed near the meat and meat substitutes section. Weekly sales data over a period of 75 weeks were obtained, 62 pre-intervention and 13 during intervention. Comparative interrupted time series analyses were conducted to analyse changes in meat alternative sales (in grams) during the intervention period in the intervention supermarkets compared to pre-intervention sales trends and to control supermarkets. Secondary outcomes included meat sales in grams per week and the ratio of protein content of meat alternatives to protein content of meat sales.ResultsAverage meat alternative sales in weekly grams before the intervention were M = 371,931.2 (SD = 113,055.3) in the control supermarkets and M = 299,012.5 (SD = 91,722.8) in the intervention supermarkets. The intervention did not change meat alternative sales in intervention supermarkets compared to pre-implementation sales trends and to control supermarkets (B = - 685.92, 95% CI [- 9904.8; 8525.7]). Sales of meats were also unaffected (B = - 130.91, 95% CI [- 27,127.50; 26,858.33]), as well as the ratio of protein content of meat alternatives to protein content of meat in grams sold per week (B = - 670.54, 95% CI [- 8990.6; 7644.4]).ConclusionsCommunicating (dynamic) social norms via textual and environmental cues (i.e. increasing the prominence of meat alternatives in supermarkets) did not increase meat alternative sales nor reduce meat sales. With supermarkets playing an important role in modulating sustainable food choices, more substantial effort or changes are needed to increase plant-based food purchases and lower meat purchases.

Project description:BackgroundTo improve quality of care for patients with hip and knee osteoarthritis (OA), general practitioners (GPs) and physiotherapists (PTs) in a Norwegian municipality initiated an intervention. The intervention aimed to increase provision of core OA treatment (information, exercise, and weight control) prior to referral for surgery, rational use of imaging for assessing OA and improve communication between healthcare professionals. This study assessed the effectiveness of this intervention.MethodsForty-eight PTs and one hundred one GPs were invited to the intervention that included two interactive workshops outlining best practice and an accompanying template for PT discharge reports. Using interrupted time series research design, the study period was divided into three: pre-implementation, transition (implementation) and post-implementation. Comparing the change between pre- and post-implementation, the primary outcome was patient-reported quality of OA care measured with the OsteoArthritis Quality Indicator questionnaire. Secondary outcomes were number of PT discharge reports, information included in GP referral letters to orthopaedic surgeon, the proportion of GP referral letters indicating use of core treatment, and the use of imaging within OA assessment. Analyses involved linear mixed and logistic regression models.ResultsThe PT workshop had 30 attendees, and 31 PTs and 33 GPs attended the multidisciplinary workshop. Two hundred eight and one hundred twenty-five patients completed the questionnaire during pre- and post-implementation, respectively. The adjusted model showed a small, statistically non-significant, increase in mean total score for quality of OA care (mean change = 4.96, 95% CI -0.18, 10.12, p:0.057), which was mainly related to items on OA core treatment. Patients had higher odds of reporting receipt of information on treatment alternatives (odds ratio (OR) 1.9, 95% CI 1.08, 3.24) and on self-management (OR 2.4, 95% CI 1.33, 4.32) in the post-implementation phase. There was a small, statistically non-significant, increase in the proportion of GP referral letters indicating prior use of core treatment modalities. There were negligible changes in the number of PT discharge reports, in the information included in the GP referral letters, and in the use of imaging for OA assessment.ConclusionThis study suggests that a primary care intervention including two inter-active workshops can shift the quality of care towards best practice recommendations.Trial registrationClinicalTrials.gov: NCT02876120 .

Dataset Information

Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial.

Background

Methods

Results

Conclusions

Publications

Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial.

Similar Datasets

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