Paul Okyere

Benefits of Disclosure of HIV Status to Infected Children and Adolescents: Perceptions of Caregivers and Health Care Providers.

&NA; The rate of disclosure of HIV status to infected children and adolescents remains low in developing countries. We used a mixed‐method approach to determine the perceptions of caregivers and health care providers about the benefits of HIV status disclosure to infected children and adolescents and to assess the support needed by caregivers during disclosure. We recruited a convenience sample of 118 caregivers of HIV‐infected children and adolescents for the quantitative component of the study and completed in‐depth qualitative interviews with 10 purposefully sampled key informants, including health care providers and volunteer workers. The main benefits of disclosure included improved medication adherence and healthier, more responsible adolescent sexual behavior. The main supports required by caregivers during disclosure included biomedical information, emotional and psychological support, and practical guidelines regarding disclosure. We confirmed the importance of disclosure to HIV‐infected children and adolescents and the need to develop culturally specific disclosure guidelines.

Motivational Interviewing Interventions and Alcohol Abuse Among College Students: A Systematic Review

Objective. The study sought to assess the effectiveness of Motivational Interviewing (MI) interventions in reducing alcohol consumption among college students, as compared to no intervention or alternative interventions. It also sought to identify the potential moderators to MI intervention effects. Data Source. Database sources consulted included Cochrane Central Register of Control Trials, PsycINFO, PsycARTICLE, PsycLIT, CINAHL, and MEDLINE. Study Inclusion and Exclusion Criteria. Included studies were (1) underpinned by experimental, quasi-experimental, and nonexperimental designs; (2) studies in which participants were either college males only or females only or both; and (3) studies in which adaptations of MI were based on key MI principles. Excluded studies were (1) non-English language studies; (2) studies not published from 2000–2012; (3) studies in which participants were not college students; (4) studies in which intervention was not delivered by face-to-face approach; and (5) studies that failed to embark on postintervention follow-ups. Data Extraction. A total of 115 abstracts were screened. These were narrowed down to 13 studies from which data for the study were extracted. Data Synthesis. Selected studies were underpinned by experimental, quasi-experimental, and nonexperimental designs. Owing to the heterogeneity in selected studies, a narrative synthesis was used. Results. MI interventions were found to be effective in reducing alcohol consumption among college students, when compared to alternative interventions or no intervention. Potential moderators of MI intervention effects were identified to include practitioners adherence to MI techniques and individuals drinking motives. Conclusion. MI presents itself as a promising tool that can augment the many existing social-environmental strategies of health promotion.

Health Behaviour Change: Advancing the Utility of Motivational Interviewing(MI) to Health Promotion

Originally developed to address addictive health behaviour, Motivational Interviewing (MI) is gaining recognition in health promotion as a style for eliciting individual’s intrinsic motivation to change. The growing recognition could be attributed to the increasing understanding that the practice of unhealthy behaviours may not be due to deficiency in knowledge of consequences, but rather a lack of adequate motivation to change. In this paper the utility of MI to the field of health promotion is discussed, elaborating the important contribution of MI to client empowerment. A model for MI delivery in health promotion has been suggested by authors, highlighting some essential elements to be targeted by practitioners. Though MI may not be a panacea to all addictive health behaviour change, it presents useful principles which may be lacking in conventional cognitive behavioural therapies. Thus, from literature, MI is presented as a promising approach which can augment the existing socio-environmental strategies of health promotion.

Effectiveness of Health Education in Increasing the Duration of Exclusive Breastfeeding in Low Income Countries: A Systematic Review

Background: The protective effects of exclusive breastfeeding (EBF) to the health of infants and mothers alike have been well documented. The rates of EBF remain low in spite of the recognized benefits and the persistent global call for infants to be breastfed exclusively on breast milk for the first six months of life. Health education has been widely suggested as one of the key intervention strategies for increasing the duration of EBF in low income countries. Objective: To conduct a systematic review to assess the effectiveness of health education interventions in increasing the duration of EBF in low income countries. A secondary objective of the review was to identify the theoretical bases of both effective/non-effective interventions and also to identify the educational methods that were utilized. Methods: Systematic review of experimental and quasi-experimental studies of health education interventions that evaluated exclusive breastfeeding outcome. Studies not published in English language and studies not reporting exclusive breastfeeding outcome were excluded. A narrative synthesis was used. Data Sources: Studies dating from 1980 – 2013 in English language were searched in the following databases: Cochrane Central Register of Controlled Trials, MEDLINE, Academic Search Complete. ScienceDirect and Google Scholar search engine. Results: Twelve (12) studies were identified. Five were randomized controlled trials and additional three were before-after studies with control groups. The remaining four were non-randomized controlled trial. Only one study applied a theoretical framework in developing and implementing the intervention. EBF rate was significantly higher in the intervention groups compared with the control groups in ten (10) of the studies. The remaining two (2) studies reported no difference in EBF rates between the intervention groups and the control groups. Most of the studies reviewed had important methodological limitations. Conclusion: Because of the methodological limitations of most of the included studies, firm conclusion on the effectiveness of health education interventions in increasing the duration of exclusive breastfeeding in low income countries cannot be made. Nonetheless there is a potential for this to be achieved if more methodologically rigorous health education interventions are developed and evaluated in low income countries.