Kai Ruggeri

Psychometric Evaluation and Experimental Validation of the Statistics Anxiety Rating Scale

The Statistics Anxiety Rating Scale (STARS) was adapted into German to examine its psychometric properties (n = 400). Two validation studies (n = 66, n = 96) were conducted to examine its criterion-related validity. The psychometric properties of the questionnaire were very similar to those previously reported for the original English version in various countries and other language versions. Confirmatory factor analysis indicated 2 second-order factors: One was more closely related to anxiety and the other was more closely related to negative attitudes toward statistics. Predictive validity of the STARS was shown both in an experimental exam-like situation in the laboratory and during a real examination situation. Taken together, the findings indicate that statistics anxiety as assessed by the STARS is a useful construct that is more than just an expression of a more general disposition to anxiety.

mHealth and global mental health: still waiting for the mH2 wedding?

BackgroundTwo phenomena have become increasingly visible over the past decade: the significant global burden of disease arising from mental illness and the rapid acceleration of mobile phone usage in poorer countries. Mental ill-health accounts for a significant proportion of global disability-adjusted life years (DALYs) and years lived with disability (YLDs), especially in poorer countries where a number of factors combine to exacerbate issues of undertreatment. Yet poorer countries have also witnessed significant investments in, and dramatic expansions of, mobile coverage and usage over the past decade.DebateThe conjunction of high levels of mental illness and high levels of mobile phone usage in poorer countries highlights the potential for “mH2” interventions – i.e. mHealth (mobile technology-based) mental health interventions - to tackle global mental health challenges. However, global mental health movements and initiatives have yet to engage fully with this potential, partly because of scepticism towards technological solutions in general and partly because existing mH2 projects in mental health have often taken place in a fragmented, narrowly-focused, and small-scale manner. We argue for a deeper and more sustained engagement with mobile phone technology in the global mental health context, and outline the possible shape of an integrated mH2 platform for the diagnosis, treatment, and monitoring of mental health.SummaryExisting and developing mH2 technologies represent an underutilised resource in global mental health. If development, evaluation, and implementation challenges are overcome, an integrated mH2 platform would make significant contributions to mental healthcare in multiple settings and contexts.

Evidence on global medical travel

Abstract The potential benefits of travelling across national borders to obtain medical treatment include improved care, decreased costs and reduced waiting times. However, medical travel involves additional risks, compared to obtaining treatment domestically. We review the publicly-available evidence on medical travel. We suggest that medical travel needs to be understood in terms of its potential risks and benefits so that it can be evaluated against alternatives by patients who are seeking care. We propose three domains –quality standards, informed decision-making, economic and legal protection – in which better evidence could support the development of medical travel policies.

Design and delivery of a national pilot survey of capabilities

Understanding the numbers of people with different levels of ability in the population is important for informing design decisions for mainstream products, but a survey dataset for this purpose does not exist. This paper describes a key step towards obtaining such data. It describes a pilot survey of 362 people across England and Wales in preparation for a full national survey. Information was gathered on vision, hearing, hand and arm function, mobility, cognitive function, product use, psychological characteristics, anthropometrics and demographics. An interesting finding is that of those participants who reported any limitations in daily activities due to capability loss, 44% reported limitations due to loss of more than one capability. This finding highlights the importance of measuring multiple capabilities in a single survey. Top-level lessons learnt include: simplifying vision tests; reducing exclusion criteria for some of the tests; adopting a stratified sampling approach; and allocating more training for interviewers.

Mindfulness-based cognitive therapy in COPD: a cluster randomised controlled trial

A considerable proportion of patients with chronic obstructive pulmonary disease (COPD) entering pulmonary rehabilitation (PR) report psychological distress, which is often accompanied by poor physical health status. Mindfulness-based cognitive therapy (MBCT) has been shown to improve psychological and physical outcomes in other chronic diseases. We therefore evaluated the efficacy of MBCT as an add-on to a standard PR programme in COPD. COPD patients eligible for PR were cluster randomised to receive either an 8-week, group-based MBCT programme as an add-on to an 8-week PR programme (n=39), or PR alone (n=45). The primary outcomes of psychological distress and physical health status impairment were measured with the Hospital Anxiety and Depression Scale (HADS) and the COPD Assessment Test (CAT) before randomisation (T1), mid- (T2) and post-intervention (T3), and at 3 (T4) and 6 (T5) months’ follow-up . A statistically significant time×arm effect was found for the HADS (Cohens d=0.62, 95% CIs (d)=0.18–1.06, p=0.010). The treatment effect on the CAT failed to reach statistical significance (d=0.42, 95% CIs (d)=−0.06–0.90, p=0.061). MBCT showed a statistically significant and durable effect on psychological distress, indicating that MBCT may be an efficacious add-on to standard PR programmes in COPD. Mindfulness-based cognitive therapy: an efficacious add-on to PR programmes to reduce psychological distress in COPD http://ow.ly/9noC30hnlxr

Policy and population behavior in the age of Big Data

Policies are large-scale interventions that typically aim to influence behaviors and decision-making across entire populations to obtain a desired outcome. With the rapid increase in Big Data and its growing influence on policy, there is an emerging opportunity to produce meaningful and efficient mechanisms for improving public policy outcomes. However, there are still considerable gaps between existing theories in the behavioral sciences and evidence generated by Big Data, including the representation of key groups within the population. We outline the need for replicating established behavioral insights through Big Data that should coincide with clear ethical standards for implementing such approaches through evidence-based policymaking.

Are We There Yet? Exploring the Impact of Translating Cognitive Tests for Dementia Using Mobile Technology in an Aging Population.

This study examines implications of the expanded use of mobile platforms in testing cognitive function, and generates evidence on the impact utilizing mobile platforms for dementia screen. The Saint Louis University Mental State examination (SLUMS) was ported onto a computerized mobile application named the Cambridge University Pen to Digital Equivalence assessment (CUPDE). CUPDE was piloted and compared to the traditional pen and paper version, with a common comparator test for both groups. Sixty healthy participants (aged 50–79) completed both measurements. Differences were tested between overall outcomes, individual items, and relationship with the comparator. Significant differences in the overall scores between the two testing versions as well as within individual items were observed. Even when groups were matched by cognitive function and age, scores on SLUMS original version (M = 19.75, SD = 3) were significantly higher than those on CUPDE (M = 15.88, SD = 3.5), t(15) = 3.02, p < 0.01. Mobile platforms require the development of new normative standards, even when items can be directly translated. Furthermore, these must fit aging populations with significant variance in familiarity with mobile technology. Greater understanding of the interplay and related mechanisms between auditory and visual systems, which are not well understood yet in the context of mobile technologies, is mandatory.

Lively Social Space, Well-Being Activity, and Urban Design Findings From a Low-Cost Community-Led Public Space Intervention

Empirical urban design research emphasizes the support in vitality of public space use. We examine the extent to which a public space intervention promoted liveliness and three key behaviors that enhance well-being (“connect,” “be active,” and “take notice”). The exploratory study combined directly observed behaviors with self-reported, before and after community-led physical improvements to a public space in central Manchester (the United Kingdom). Observation data (n = 22,956) and surveys (subsample = 212) were collected over two 3-week periods. The intervention brought significant and substantial increases in liveliness of the space and well-being activities. None of these activities showed increases in a control space during the same periods. The findings demonstrate the feasibility of the research methods, and the impact of improved quality of outdoor neighborhood space on liveliness and well-being activities. The local community also played a key role in conceiving of and delivering an effective and affordable intervention. The findings have implications for researchers, policy makers, and communities alike.

A comparison of the methods used to support risk identification for patient safety in one UK NHS foundation trust

In healthcare, various methods are available to support risk identification in risk management process. However, there is no clear evidence on their contribution to risk identification. In this study, different methods used to support risk identification were therefore analysed to compare their contribution to overall risk identification. The study was conducted at Cambridge University Hospitals Foundation Trust, UK. Three main methods were selected to compare their support in risk identification: incident reports through their Risk Management Information System, risk registers through their Risk Registers system, and safety walkabouts through their internal patient safety assessment process. Where possible, simple comparison tests were run between the different methods of identifying risks as well as by the type of risks identified. It was found that each method has contributed to the risk identification by adding different sets of risk sources despite some overlaps. However, they produced discrete assessments from different aspects and none of them, on its own, could produce adequate results for effective risk identification. In any healthcare setting, having a system to put all risk information in one picture would help maximise the contribution of each method within the scope risk management process. Future studies may benefit from broader use of multiple and system-based risk identification approaches, and coding methods for more powerful analytical test.

Yin yoga and mindfulness: a five week randomized controlled study evaluating the effects of the YOMI program on stress and worry

ABSTRACT Background and objectives: The YOMI program is a psychoeducational training and physical practice-based program that bridges knowledge from evidence-based psychotherapy with the practice of mindfulness and yin yoga. It consists of 10 content-specific sessions and does not include home assignments. The primary purpose of this randomized controlled trial is to evaluate the effects of the five-week YOMI program on perceived stress, worry and mindfulness in a non-clinical sample. Design and method: In this randomized controlled trial participants were assigned to two groups. Group 1 participated in the five-week intervention twice a week while Group 2 was assigned to a waiting-list condition and participated in the intervention after Group 1. All measures were administered through self-report questionnaires, conducted via a web-based program. Results and conclusions: The results of the study indicated significant effects of the YOMI program on decreasing stress and worry, and increasing mindfulness. Notably these changes were still present at five-week follow up. Consistent with the hypotheses, results suggested that the YOMI program established a group setting where individuals learned to use tools and methods to facilitate better self-directed practice. The study shows moderate to large effect sizes.