Text Message Delivered Peer Network Counseling for Adolescent Smokers: A Randomized Controlled Trial

Abstract:

Although adolescent tobacco use has declined in the last 10 years, African American high school seniors’ past 30-day use has increased by 12 %, and as they age they are more likely to report lifetime use of tobacco. Very few urban youth are enrolled in evidenced-based smoking prevention and cessation programming. Therefore, we tested a text messaging smoking cessation intervention designed to engage urban youth through an automated texting program utilizing motivational interviewing-based peer network counseling. We recruited 200 adolescents (90.5 % African American) into a randomized controlled trial that delivered either the experimental intervention of 30 personalized motivational interviewing-based peer network counseling messages, or the attention control intervention, consisting of text messages covering general (non-smoking related) health habits. All adolescents were provided smart phones for the study and were assessed at baseline, and at 1, 3, and 6 months post intervention. Utilizing repeated measures general linear models we examined the effects of the intervention while controlling for race, gender, age, presence of a smoker in the home, and mental health counseling. At 6 months, participants in the experimental condition significantly decreased the number of days they smoked cigarettes and the number of cigarettes they smoked per day; they significantly increased their intentions not to smoke in the future; and significantly increased peer social support among girls. For boys, participants in the experimental condition significantly reduced the number of close friends in their networks who smoke daily compared to those in the control condition. Effect sizes ranged from small to large. These results provide encouraging evidence of the efficacy of text messaging interventions to reduce smoking among adolescents and our intervention holds promise as a large-scale public health preventive intervention platform

My opinion:

This program is similar with the one program that I proposed before, with several differences. The program using text messages (SMS) that I proposed is mainly to advertise the existence of smoking cessation class in school with other purpose to broadcast the risk/danger of smoking. Instead the program in this journal is intended as the cessation program itself, without classes or clinics that helps students in stopping smoking.

This differences happens because in reality, the needs to help cessation of smoking is different in each individual, and Indonesian's students tend to insist on it's principal, especially because smoking promotes friendship. Then it's impossible to cater to those needs using SMS alone, and also the cost to manually send SMS to each individual will be paramount. Perhaps the program on this journal will be able to apply if more governmental and NGOs that sponsor the program, in meanwhile it's rather impossible.

As I stated in paragraphs above, the program in this journal maybe will be effective in proper conditions, unfortunately it will not be effective if it is applied now in Jogjakarta.

Reference of Journal:

Mason, M., Mennis, J., Way, T., Zaharakis, N., Campbell, L., Benotsch, E., Keyser-Marcus, L. and King, L. (2016). Text Message Delivered Peer Network Counseling for Adolescent Smokers: A Randomized Controlled Trial. The Journal of Primary Prevention.

University campus settings and the promotion of physical activity in young adults: lessons from research in Australia and the USA

The Department of Community Medicine (IKM) of Medicine Faculty of Gadjah Mada University (UGM), under the supervision of dr Mubasysyir had asked the team of 15202 to conduct and plan a program to tackle few problems that happen in our society and try to come out with few suggestions that might be able to reduce or even prevent before it became a much larger issue. With the help of Dr Mub, we had manage to use Project Libre (an open software), backed with few articles that we think it might support our planning.

Abstract:

Describes the decreasing prevalence of physical activity participation over the young adult years and the patterns of difference in the physical activity habits of young men and young women. Physical activity habits during the young adult years are likely to be important influences on habitual physical activity during overall adult life and, consequently, have significant implications for long-term health outcomes. Tertiary-education campuses are settings where there exist important yet partially neglected opportunities to influence the physical activity habits of young adults. Uses examples from Australia and the USA are used to characterize relevant contextual and practical aspects of the campus setting and the physical activity promotion opportunities that it may provide. Reviews findings from two campus-based physical activity intervention studies. In conclusion, identifies a set of issues that require further research.

My Opinion:

The article written by Leslie et al point out that the prevalence of younger generation specifically the college students in involving in physical activities are getting reduce in this industrial era. Probably due to certain elements such as campus settings that might not suit the taste of certain group of campus students. The articles also give some idea on what kind of diseases that could be inherit if less physical activities are conducted, typically obesity.

The article also explained the research that conducted to post-collegiate individual that their physical activities decline drastically, probably due to time constraint, since work and family are the main priority, which I agree since after college, carrier and family will be top focus. Thus, it is important to actually expose the in-college students of having physical activities.

To me, having an essential and promising environment to conduct physical activities are necessary. To be honest, we tend to get bored when doing our routine fitness schedule if the environment is restricting it. The term environment here includes the people, the facilities, programs, and supporting. Campus students are still under peer pressure. Thus, lead to why the more people join a program of physical activity, the more interested other students to follow. Having a good program need a lot investment on the facilities. The articles mentioned that smaller size of universities will have problem in providing a proper facility.

Finance kind of a matter to college or university students. For a bigger university that backed up by several foundations, that enable the board to provide free access to all of the students to utilize the sport facilities. This indirectly give more push to the effort of university for encouraging students to get involve in physical activities.

Few studies that have the purpose of maintaining, and provide follow up for post collegiate students to still having physical activity are also discussed in the articles. Mostly conducted in America and Australia. I guess, it is a pin point, since campus students are the pioneer of today line of working force. If they are the leading cause of the trigger of obesity and other chronic diseases, then, sooner or later, in the future, the world will be not able to maintain its productivity but burdened with sick human.

     

Reference:

1.       http://www.emeraldinsight.com/doi/abs/10.1108/09654280110387880

Self-Management Education for Adults With Type 2 Diabetes

Abstract:

OBJECTIVE — To evaluate the efficacy of self-management education on GHb in adults with type 2 diabetes. 

RESEARCH DESIGN AND METHODS — We searched for English language trials in Medline (1980–1999), Cinahl (1982–1999), and the Educational Resources Information Center database (ERIC) (1980–1999), and we manually searched review articles, journals with highest topic relevance, and reference lists of included articles. Studies were included if they were randomized controlled trials that were published in the English language, tested the effect of self-management education on adults with type 2 diabetes, and reported extractable data on the effect of treatment on GHb. A total of 31 studies of 463 initially identified articles met selection criteria. We computed net change in GHb, stratified by follow-up interval, tested for trial heterogeneity, and calculated pooled effects sizes using random effects models. We examined the effect of baseline GHb, follow-up interval, and intervention characteristics on GHb. 

RESULTS — On average, the intervention decreased GHb by 0.76% (95% CI 0.34–1.18) more than the control group at immediate follow-up; by 0.26% (0.21% increase - 0.73% decrease) at 1–3 months of follow-up; and by 0.26% (0.05–0.48) at 4 months of follow-up. GHb decreased more with additional contact time between participant and educator; a decrease of 1% was noted for every additional 23.6 h (13.3–105.4) of contact. 

CONCLUSIONS — Self-management education improves GHb levels at immediate followup, and increased contact time increases the effect. The benefit declines 1–3 months after the intervention ceases, however, suggesting that learned behaviors change over time. Further research is needed to develop interventions effective in maintaining long-term glycemic control.

My Opinion:

The article from Norris et al. discusses the meta-analysis carried out on one type of intervention to curb type 2 diabetes among adults via self-management. Self-management simply means that the individual takes full responsibility in dealing with the situation and handling all factors and outcomes. In the case of type 2 diabetes, these factors may be the person's lifestyle and diet. The outcome of this is the glycohemoglobin (GHb) levels of the person.

Diabetic self-management education (DSME) is essential because diabetic persons vary from one another due to their multi-factorial condition. Through DSME, the person will be able to customize their lifestyle and diet that fits their needs specifically to help them manage their condition. Self-management can optimize metabolic control, prevent acute and chronic complications, and optimize quality of life, while keeping costs acceptable. DSME need only be given once or twice a year and has been proved to reduce GHb after standard and nutrition educations.

In an Asian setting, this method could prove effective because DSME does not require high-end technology, gadgets or complicated measures. DSME can be started from the main hospitals patients obtain treatment from and further monitored by their family physicians, general physicians, nurses or midwives who live in the vicinity of the patients. In order for the aforementioned task forces to be able to educate and monitor the progress of the patients, seminars and clinical updates can be held to equip these medical professionals with the necessary knowledge and skills.

In Yogyakarta, diabetes is a common enemy due to the lifestyle and diet of a developing country. Rice is the staple food of the nation and is consumed a minimum of thrice daily. It is proven that carbohydrates affect postprandial glycemia and research has been done to prove if the source or amount of carbohydrate bears more importance. With DSME, patients can have a better understanding of what is happening to them individually and therefore they may be able to help themselves better, rather than seeking general assistance. DSME in Yogyakarta has to tackle this disease medically, culturally and socially.

References:

1. http://care.diabetesjournals.org/content/diacare/25/7/1159.full.pdf
2. http://www.chronicdisease.org/?page=DiabetesDSMEresource
3. http://link.springer.com/article/10.1007/s11892-001-0031-9