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Psychosocial Intervention in European Addictive Behaviour Recovery Programmes: A Qualitative Study.

ABSTRACT: BACKGROUND:The vulnerability of drug users in treatment increases their risk of social exclusion. Psychosocial interventions aim to solve or minimise this risk, increasing social integration for individuals in treatment. In this study, the effectiveness of various European drug recovery programmes was studied by examining psychosocial intervention groups with vulnerable populations. METHODS:Research was conducted utilising qualitative methodology in the following manner: bibliographical review (reports and papers) and 18 interviews with key informants (from nine European countries). RESULTS:Treatment programmes were found to be effective for recovery from opiate use, however, social recovery programmes were not found to be effective. For females in treatment and young drug users, the adequacy of programmes received medium-to-low evaluations. CONCLUSION:It is necessary to increase the effectiveness of psychosocial intervention in recovery-based programmes. In addition, the relevance of these programmes in relation to psychosocial characteristics of the various risk groups (except opioid consumers) should be validated and revisited. Additionally, psychosocial intervention professionals should take a more active role in such programmes, especially in intervention with young people (in health education, prevention, early detection, and intervention) and with women (in regard to the detection and effective intervention for socio-health problems, social and job reintegration, access inequality, and use of services available due to gender).

SUBMITTER: Molina A

PROVIDER: S-EPMC7551656 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Psychosocial Intervention in European Addictive Behaviour Recovery Programmes: A Qualitative Study.

Molina Antonio A Saiz Jesús J Gil Francisco F Cuenca María Luisa ML Goldsby Tamara T

Healthcare (Basel, Switzerland) 20200813 3

<h4>Background</h4>The vulnerability of drug users in treatment increases their risk of social exclusion. Psychosocial interventions aim to solve or minimise this risk, increasing social integration for individuals in treatment. In this study, the effectiveness of various European drug recovery programmes was studied by examining psychosocial intervention groups with vulnerable populations.<h4>Methods</h4>Research was conducted utilising qualitative methodology in the following manner: bibliogra ...[more]

PMID: 32823779

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Project description:IntroductionCodesign is a meaningful end-user engagement in research design. The integrated knowledge translation (IKT) framework involves adopting a collaborative research approach to produce and apply knowledge to address real-world needs, resulting in useful and useable recommendations that will more likely be applied in policy and practice. In the field of food addiction (FA), there are limited treatment options that have been reported to show improvements in FA symptoms.ObjectivesThe primary aim of this paper is to describe the step-by-step codesign and refinement of a complex intervention delivered via telehealth for adults with FA using an IKT approach. The secondary aim is to describe our intervention in detail according to the TIDieR checklist.DesignThis study applies the IKT process and describes the codesign and refinement of an intervention through a series of online meetings, workshops and interviews.ParticipantsThis study included researchers, clinicians, consumers and health professionals.Primary outcome measureThe primary outcome was a refined intervention for use in adults with symptoms of FA for a research trial.ResultsA total of six female health professionals and five consumers (n=4 female) with lived overeating experience participated in two interviews lasting 60 min each. This process resulted in the identification of eight barriers and three facilitators to providing and receiving treatment for FA, eight components needed or missing from current treatments, telehealth as a feasible delivery platform, and refinement of key elements to ensure the intervention met the needs of both health professionals and possible patients.ConclusionUsing an IKT approach allowed for a range of viewpoints and enabled multiple professions and disciplines to engage in a semiformalised way to bring expertise to formulate a possible intervention for FA. Mapping the intervention plan to the TIDieR checklist for complex interventions, allowed for detailed description of the intervention and the identification of a number of areas that needed to be refined before development of the finalised intervention protocol.

Project description:The 'European Alliance Against Depression' community-based intervention approach simultaneously targets depression and suicidal behaviour by a multifaceted community based intervention and has been implemented in more than 115 regions worldwide. The two main aims of the European Union funded project "Optimizing Suicide Prevention Programmes and Their Implementation in Europe" were to optimise this approach and to evaluate its implementation and impact. This paper reports on the primary outcome of the intervention (the number of completed and attempted suicides combined as 'suicidal acts') and on results concerning process evaluation analysis. Interventions were implemented in four European cities in Germany, Hungary, Portugal and Ireland, with matched control sites. The intervention comprised activities with predefined minimal intensity at four levels: training of primary care providers, a public awareness campaign, training of community facilitators, support for patients and their relatives. Changes in frequency of suicidal acts with respect to a one-year baseline in the four intervention regions were compared to those in the four control regions (chi-square tests). The decrease in suicidal acts compared to baseline in the intervention regions (-58 cases, -3.26%) did not differ significantly (?2 = 0.13; p = 0.72) from the decrease in the control regions (-18 cases, -1.40%). However, intervention effects differed between countries (?2 = 8.59; p = 0.04), with significant effects on suicidal acts in Portugal (?2 = 4.82; p = 0.03). The interviews and observations explored local circumstances in each site throughout the study. Hypothesised mechanisms of action for successful implementation were observed and drivers for 'added-value' were identified: local partnership working and 'in-kind' contributions; an approach which valued existing partnership strengths; and synergies operating across intervention levels. It can be assumed that significant events during the implementation phase had a certain impact on the observed outcomes. However, this impact was, of course, not proven.

Project description:BackgroundHypertensive disorders of pregnancy have longer-term implications, increasing women's lifetime cardiovascular disease risk. The Blood Pressure Postpartum study is a multi-centre randomised three-arm trial of interventions, ranging in intensity and including education and lifestyle coaching, to support women to maintain or adopt healthy eating and physical activity during the first postpartum year. This qualitative sub-study nested within the main trial aimed to investigate whether and how women adopted healthy behaviours after a pregnancy complicated by a hypertensive disorder.MethodsSemi-structured telephone interviews were recorded, transcribed and analysed thematically, following Braun and Clarke principles. They explored behaviour change among new mothers following their hypertensive pregnancy, and the intervention's effect on their capacity and motivation to pursue healthy lifestyles.ResultsThirty-four women from all three trial arms participated at 10-12 months postpartum. The three main themes were 1) Awareness of cardiovascular risk: some did not acknowledge the health risks, whereas others embraced this information. 2) Sources of motivation: while the majority were motivated to make a concerted effort to adapt their health behaviour, motivation often centred on their baby and family rather than their own needs. 3) Sustaining behaviour change with a new baby: women in the more intensive intervention arm demonstrated increased recognition of the importance of reducing cardiovascular health risks, with greater motivation and guidance to change their health behaviour. There was minimal evidence of crossover amongst groups, with women largely accepting their randomised level of intervention and not seeking additional help when randomised to minimal intervention.ConclusionsAmong women participating in an early post-hypertensive disorders of pregnancy randomised controlled trial aimed at improving their cardiovascular disease risk profile, the majority recognised the future health risks and appeared motivated to improve their lifestyle, particularly women in the highest-intensity intervention group. This highlights the importance of structured support to assist women embrace healthy lifestyles especially during the challenges of new parenthood.Trial registrationThe Blood Pressure Postpartum study was prospectively registered as a clinical trial with the Australian New Zealand Clinical Trials Registry (anzctr.org.au) on 13 December 2018 (registration number: ACTRN12618002004246).

Project description:To investigate staff and trainer perspectives on the barriers and facilitators to implementing a complex intervention to help staff support the recovery of service users with a primary diagnosis of psychosis in community mental health teams.Process evaluation nested within a cluster randomised controlled trial (RCT).28 interviews with mental health care staff, 3 interviews with trainers, 4 focus groups with intervention teams and 28 written trainer reports.14 community-based mental health teams in two UK sites (one urban, one semi-rural) who received the intervention.The factors influencing the implementation of the intervention can be organised under two over-arching themes: Organisational readiness for change and Training effectiveness. Organisational readiness for change comprised three sub-themes: NHS Trust readiness; Team readiness; and Practitioner readiness. Training effectiveness comprised three sub-themes: Engagement strategies; Delivery style and Modelling recovery principles.Three findings can inform future implementation and evaluation of complex interventions. First, the underlying intervention model predicted that three areas would be important for changing practice: staff skill development; intention to implement; and actual implementation behaviour. This study highlighted the importance of targeting the transition from practitioners' intent to implement to actual implementation behaviour, using experiential learning and target setting. Second, practitioners make inferences about organisational commitment by observing the allocation of resources, Knowledge Performance Indicators and service evaluation outcome measures. These need to be aligned with recovery values, principles and practice. Finally, we recommend the use of organisational readiness tools as an inclusion criteria for selecting both organisations and teams in cluster RCTs. We believe this would maximise the likelihood of adequate implementation and hence reduce waste in research expenditure.Controlled-Trials.com ISRCTN02507940.

Project description:BackgroundAlcohol use is a major public health challenge in France, where at the age of 17 half the young people report an episode of severe alcohol intoxication in the month preceding the survey. Numerous prevention programmes have a general objective, but in adolescence individual vulnerabilities towards addictions differ significantly with personality traits. Prevention targeting personality traits enables work on risk factors for addictive behaviours, and has shown genuine efficacy. Among existing programmes, PREVENTURE has shown an effect on the reduction in alcohol consumption by targeting four personality traits: impulsivity, sensation-seeking, negative thoughts and anxiety. This programme has been tested on samples recruited in adolescent populations in school environments, identifying adolescents at risk, but it has not been tested on a more targeted recruitment of adolescents seen in consultation.MethodsThe main hypothesis of this study is that the targeted prevention programme PREVENTURE will have an impact on the prevalence of binge-drinking episodes. The secondary hypotheses explore other factors such as associated substance use, anxiety and depression, as well as the acceptability of the programme. This article presents the study protocol of "PREVADO" study. We intend to assess the impact of the targeted intervention programme PREVENTURE on the prevalence of binge-drinking episodes among adolescents aged 14 to 17 years consulting in one of the participating centres or referred by a school doctor. The study will be prospective, randomised, controlled and open-label, and will comprise an intervention group and a control group. The adolescents will then be followed and assessed 1, 3, 6 and 12 months after the intervention. The study needs to include 700 subjects in order to reach 340 adolescents randomised, 170 in each group. It will concern 33 centres.DiscussionThis project could favour the targeting of addictive behaviours among vulnerable adolescents, and its application on a larger scale could be envisaged.Trial registrationThe Trial registration number is NCT04599270 , and it was registered on the ClinicalTrials.gov public website.

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Psychosocial Intervention in European Addictive Behaviour Recovery Programmes: A Qualitative Study.

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Psychosocial Intervention in European Addictive Behaviour Recovery Programmes: A Qualitative Study.

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