A. Blair Irvine

Sex difference in signature whistle production of free-ranging bottlenose dolphins, Tursiops truncates

Signature whistles of 42 free-ranging bottle-nose dophin calves were compared to those of their mothers. Humans judged their similarity by inspection of spectrograms. There was a sex difference in the tendency of calves to produce whistles similar to or different from those of their mothers; most female calves produced whistles that were different from those of their mothers, whereas male calves were more likely to produce whistles that were similar to those of their mothers. Because matrilineally related females associate together and use signature whistles to establish and/or maintain contact with their calves, there may be a selective pressure for females to produce whistles that are distinct from those of their mothers. There may be fewer constraints governing whistle development in males, with the result that some males produce whistles similar to those of their mothers and others do not.

Web-based Intervention to Promote Physical Activity by Sedentary Older Adults: Randomized Controlled Trial

Background Physical activity (PA) for older adults has well-documented physical and cognitive benefits, but most seniors do not meet recommended guidelines for PA, and interventions are lacking. Objectives This study evaluated the efficacy of a 12-week Internet intervention to help sedentary older adults over 55 years of age adopt and maintain an exercise regimen. Methods A total of 368 sedentary men and women (M=60.3; SD 4.9) were recruited, screened, and assessed online. They were randomized into treatment and control groups and assessed at pretest, at 12 weeks, and at 6 months. After treatment group participants rated their fitness level, activity goals, and barriers to exercise, the Internet intervention program helped them select exercise activities in the areas of endurance, flexibility, strengthening, and balance enhancement. They returned to the program weekly for automated video and text support and education, with the option to change or increase their exercise plan. The program also included ongoing problem solving to overcome user-identified barriers to exercise. Results The multivariate model indicated significant treatment effects at posttest (P=.001; large effect size) and at 6 months (P=.001; medium effect size). At posttest, intervention participation showed significant improvement on 13 of 14 outcome measures compared to the control participants. At 6 months, treatment participants maintained large gains compared to the control participants on all 14 outcome measures. Conclusions These results suggest that an online PA program has the potential to positively impact the physical activity of sedentary older adult participants. More research is needed to replicate the study results, which were based on self-report measures. Research is also needed on intervention effects with older populations.

Mobile-Web App to Self-Manage Low Back Pain: Randomized Controlled Trial

Background Nonspecific low back pain (NLBP) is the diagnosis for individuals with back pain that has no underlying medical cause (eg, tumor, infection, fracture, herniated disc, spinal stenosis). The American College of Physicians (ACP) and American Pain Society (APS) recommend multidisciplinary treatments for NLBP that lasts more than 4 weeks. This approach, however, is impractical for many physicians to implement, and relatively few providers offer NLBP treatment that meets the joint ACP-APS guidelines. Objective This study evaluated the efficacy of a mobile-Web intervention called “FitBack” to help users implement self-tailored strategies to manage and prevent NLBP occurrences. Methods A total of 597 adults were recruited, screened, consented, and assessed online at baseline, at 2 months (T2), and at 4 months (T3). After baseline assessments, participants were randomized into three groups: FitBack intervention, alternative care group that received 8 emails urging participants to link to six Internet resources for NLBP, and control group. The FitBack group also received weekly email reminder prompts for 8 weeks plus emails to do assessments. The control group was only contacted to do assessments. Results Users of the FitBack program showed greater improvement compared to the control group in every comparison of the critical physical, behavioral, and worksite outcome measures at 4-month follow-up. In addition, users of the FitBack program performed better than the alternative care group on current back pain, behavioral, and worksite outcomes at 4-month follow-up. For example, subjects in the control group were 1.7 times more likely to report current back pain than subjects in the FitBack group; subjects in the alternative care group were 1.6 times more likely to report current back pain at 4-month follow-up. Further, the users of the FitBack program showed greater improvement compared to both the control and alternative care groups at 4-month follow-up on patient activation, constructs of the Theory of Planned Behavior, and attitudes toward pain. Conclusions This research demonstrated that a theoretically based stand-alone mobile-Web intervention that tailors content to users’ preferences and interests can be an effective tool in self-management of low back pain. When viewed from the RE-AIM perspective (ie, reach, efficacy/effectiveness, adoption, implementation fidelity, and maintenance), this study supports the notion that there is considerable value in this type of intervention as a potentially cost-effective tool that can reach large numbers of people. The results are promising considering that the FitBack intervention was neither supported by professional caregivers nor integrated within a health promotion campaign, which might have provided additional support for participants. Still, more research is needed on how self-guided mobile-Web interventions will be used over time and to understand factors associated with continuing user engagement. Trial Registration Clinicaltrials.gov NCT01950091; http://clinicaltrials.gov/ct2/show/NCT01950091 (Archived by WebCite at http://www.webcitation.org/6TwZucX77).

Get moving: a web site that increases physical activity of sedentary employees.

Purpose. Develop and test a Web site to encourage physical activity (PA) by sedentary workers. Design. Randomized control design with 30-day follow-up. Setting. Large manufacturing plant. Subjects. Included 221 workers; average body mass index was 29.5. Intervention. Get Moving was a repeat-visit Web site providing information and support to develop a personalized PA plan. Measures. Self-reported: PA, depression, anxiety, stage of change, attitudes, knowledge, self-efficacy, intention, perceived barriers to PA, and motivation. Analysis. Multivariate analysis of covariance and univariate analysis of covariance models were used to compare the two study conditions on posttest outcomes, controlling for baseline levels. Results. Compared with the control group, the treatment group showed significant improvement. The multivariate test was significant (p < .001), with a large effect size (η2 = .42). The treatment group differed significantly from the control participants on 11 outcomes (p < .005), with large effect sizes for PA status, min/d, and knowledge, attitudes, and behavioral intention. Medium effect sizes were measured for perceived barriers, depressive symptoms, motivation, and self-efficacy. Multiple visits resulted in significantly improved PA, motivation, self-efficacy, and intention, compared with one-time visits. Conclusions. The Get Moving Web site had positive effects and was well received. Interventions Web site have potential to increase the PA of sedentary individuals in worksites and elsewhere, but more research is needed into mediators of Web-based interventions. (Am J Health Promot 2011;25[3]:199–206.)

An Interactive Multimedia Program to Train Professional Caregivers

An interactive multimedia computer training program on CD-ROM was compared with a videotaped lecture-based training program for professional caregivers of patients with dementia. Both programs promoted use of appropriate communication skills including speaking skills, reacting skills, redirection skills, and use of communication cards for redirection. Professional and paraprofessional caregivers (N = 88) were recruited as participants and randomly assigned to view one of the training programs. In a pretest-posttest design, participants rated caregiver responses in video vignettes of specific caregiving situations. At posttest, those who viewed the interactive program were significantly more likely to: (a) identify the correct responses, (b) intend to use correct strategies, and (c) have increased self-efficacy to use correct strategies, compared to participants who saw the videotaped lecture.

Internet Training to Respond to Aggressive Resident Behaviors

PURPOSE This research evaluated an individualized Internet training designed to teach nurse aides (NAs) strategies to prevent or, if necessary, react to resident aggression in ways that are safe for the resident as well as the caregiver. DESIGN AND METHODS A randomized treatment and control design was implemented, with baseline, 1-, and 2-month assessments for 158 NAs. The training involved 2 weekly visits. The Internet intervention was a behaviorally focused and video-based training that included content on skills for safely dealing with physical aggression. Measures included video situation testing and assessment of psychosocial constructs associated with behavior change. RESULTS Analysis of covariance showed positive results for knowledge, attitudes, self-efficacy, and empathy, with medium-large effect sizes maintained after 2 months. The training was well received by participants. IMPLICATIONS Internet training is a viable approach to shape appropriate NA reactions to aggressive resident behaviors. This format has future potential because it offers fidelity of presentation and automated documentation, with minimal supervision.

Mental Illness Training for Long Term Care Staff

OBJECTIVES Mental illness is prevalent among nursing home residents, but staff are not well trained to deal with it. This research evaluated an Internet mental illness training program designed for certified direct care workers, ie, nurse aides (NAs). Pilot research was also conducted to explore effects and acceptance of the same program with a sample of licensed health professionals (LHPs). DESIGN Trial 1: Pre-post randomized treatment and control design for NAs; Trial 2: Quasi-experimental pre-post within-subjects design for LHPs. SETTING Both studies were conducted on the Internet. PARTICIPANTS Trial 1: n = 70 NAs; Trial 2: n = 16 LHPs. INTERVENTION Internet-based behavioral skills training and knowledge building, using video modeling with mastery learning instructional design. MEASUREMENTS Video situations testing and assessment of psychosocial constructs associated with behavior change; follow-up interviews with a sample of treatment NAs. RESULTS Trial 1: Multivariate analysis of covariance analysis showed positive results (P = .003) for knowledge, attitudes, self-efficacy, and behavioral intention, with medium-large effect sizes. The training was well received by the users. Trial 2: Paired t tests showed significant effects on 5 of 6 outcome measures, with medium-large effect sizes, and it was well received by the LHP sample. CONCLUSIONS Internet training can be an effective approach to help staff work with residents with mental illness. In this research, it showed significant positive effects and was well received by NAs and by LHPs.

Mental Illness Training for Licensed Staff in Long-Term Care

Licensed care staff working in long-term care facilities may be poorly prepared to work with residents with mental illness. This research reports on the program evaluation of Caring Skills: Working with Mental Illness, a training program delivered on the Internet. It was tested with a randomized treatment-control design, with an eight-week follow-up. The training provided video-based behavioral skills and knowledge training. Measures included video situations testing and assessment of psycho-social constructs including empathy and stigmatization. ANCOVA analysis at 4-weeks posttest showed significant positive effects with medium-large effect sizes, which were largely maintained at the 8-week follow-up. The training was well-received by the users.

A randomized study of internet parent training accessed from community technology centers.

Behavioral parent training (BPT) has been shown to be efficacious to improve parenting skills for problematic interactions with adolescents displaying oppositional and antisocial behaviors. Some research suggests that support group curricula might be transferred to the Internet, and some studies suggest that other curriculum designs might also be effective. In this research, a BPT program for parents of at-risk adolescents was tested on the Internet in a randomized trial (N = 307) from computer labs at six community technology centers in or near large metropolitan areas. The instructional design was based on asynchronous scenario-based e-learning, rather than a traditional parent training model where presentation of course material builds content sequentially over multiple class sessions. Pretest to 30-day follow-up analyses indicated significant treatment effects on parent-reported discipline style (Parenting Scale, Adolescent version), child behavior (Eyberg Child Behavior Inventory), and on social cognitive theory constructs of intentions and self-efficacy. The effect sizes were small to medium. These findings suggest the potential to provide effective parent training programs on the Internet.

Use of a Dementia Training Designed for Nurse Aides to Train Other Staff

Problematic resident behaviors may escalate in long-term care facilities (LTCs). If nurse aides (NAs) are not nearby, the nearest staff to intervene may be nondirect care workers (NDCWs), who have little or no dementia training. This pilot research tested Internet dementia-training program, designed for NAs, on NDCWs in a LTC setting. Sixty-eight NDCWs participated, filling out two baseline surveys at 1-month intervals and a posttest survey after training. The surveys included video-situation testing, items addressing psychosocial constructs associated with behavior change, and measures training-acceptance. Paired t tests showed significant positive effects on measures of knowledge, attitudes, self-efficacy, and behavioral intentions, with small-moderate effect sizes. Nursing staff as well as non–health care workers showed improved scores, and the website training program was well received by all participants. These results suggest that Internet training may allow staff development coordinators to conserve limited resources by cross-training of different job categories with the same program.