Search Results (24)

Background: While combined diet and physical activity interventions are recommended, evidence specific to low-risk pregnant women remains limited. As responses to combined interventions may vary by pre-pregnancy BMI, maternal health status and pregnancy outcomes, targeted evaluation in low-risk pregnant women is needed. Inconsistencies across studies, along with the lack of a comprehensive synthesis of both effects and intervention components, further limit their implementation. Objective: Our aims were to assess the effects of combined diet and physical activity interventions on gestational weight gain among low-risk women and to systematically characterize the intervention components. Design: We conducted a systematic review and meta-analysis following the Cochrane Handbook guidelines and PRISMA 2020. Methods: Eight databases and trial registries were searched from inception to 16 March 2026. Two reviewers independently conducted study selection, data extraction and risk of bias assessment. Intervention components were coded using the TIDieR checklist. The quality of included studies was assessed using the updated Cochrane risk of bias 2.0 tool. Meta-analyses were performed using Review Manager 5.4, and certainty of evidence was assessed using the GRADEpro online tool. Results: A total of 10 studies involving 3977 pregnant women were included. Combined diet and physical activity interventions significantly reduced total gestational weight gain (GWG) (MD = −0.78 kg, 95% CI: −1.12 to −0.44, p < 0.00001) and the risk of excessive gestational weight gain (EGWG) (OR = 0.63, 95% CI: 0.49–0.81, p = 0.0003). Additionally, individually delivered physical activity components and those implemented in healthcare facilities appeared to be associated with lower total GWG (MD = −0.76 kg, 95% CI: −0.98 to −0.53, p < 0.00001). For EGWG, lower risk was observed in interventions using combined face-to-face and remote formats (OR = 0.54, 95% CI: 0.41–0.72, p < 0.0001) and moderate frequency (diet: OR = 0.64, 95% CI: 0.51–0.81, p = 0.0002, physical activity: OR = 0.65, 95% CI: 0.52–0.83, p = 0.0004). Conclusions: Combined diet and physical activity interventions were associated with reduced total GWG and lower EGWG risk in low-risk pregnant women. Intervention characteristics, such as individual delivery formats, combined face-to-face and remote formats, moderate frequency and implementation in healthcare facilities, may be related to intervention effectiveness. Registration number: CRD420251013116 (PROSPERO). Full article

Background/Objectives: Safe delivery and correct identification of newborns are critical aspects of healthcare systems globally. The accreditation of healthcare and standards regulation significantly promotes the adoption of modern technologies to address risks related to infant abduction and misidentification. The effectiveness and extent of these mandates vary across settings and countries. Therefore, this study aims to map and explore modern technologies used for safe newborn delivery and correct identification aligned with healthcare accreditation and regulatory frameworks. Methods: This review adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) guidelines. The Problem, Intervention, Comparison, and Outcome (PICO) framework was employed to facilitate the development of the research question. This study examined studies reporting technologies such as radio frequency identification (RFID), biometric identification, and real-time monitoring across healthcare settings for infant protection through the Normalization Process Theory (NPT). Among three databases and search engines (PubMed, Google Scholar, and Web of Science). The risk of bias for each study was assessed using the AACODS Checklist, SQUIRE 2.0 Checklist, TIDieR Checklist, and JBI tools. Results: Out of 8753 records, only 27 reports were eligible to be included in this review. The most frequently reported technologies were RFID systems (11 studies, 37.9%) and biometric systems such as footprint and facial recognition (6 studies, 20.7%). Despite strong technological potential, many healthcare institutions struggled with the adoption of infant protection technologies. Accreditation systems among the high-resource settings actively mandate advanced technologies and support the integration of staff training and simulation drills. Comparably, middle- and low-income regions usually face challenges related to regulatory enforcement, infrastructure, staff readiness, and limited adoption of modern technologies. Conclusions: Accreditation and standards development are critical catalysts for the adoption of modern infant protection technology. Standards must be comprehensible, adaptable, and supported by investment in human resources and infrastructure. Future regulation must focus on strengthening enforcement, continuous quality improvement, and capacity building to achieve sustainable protection across the world. Full article

Introduction: Adolescent idiopathic scoliosis (AIS) presents not only physical but also psychological challenges for affected patients, frequently requiring comprehensive management that includes psychological interventions. Accurate and transparent reporting of interventions is essential to support reproducibility, facilitate clinical translation, and advance research quality. However, the completeness of intervention reporting and adherence to standardized guidelines in published studies on psychological interventions for pediatric AIS patients remains unclear. Methods: We searched Medline, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) for studies involving psychological interventions in AIS. Intervention reporting was analyzed using the Template for Intervention Description and Replication (TIDieR) checklist. Adherence to reporting guidelines was assessed for different study designs. Results: We identified 18 studies, which had suboptimal reporting of interventions. For key TIDieR items, all studies reported the brief name and rationale, but completeness for other elements varied: methods (14/18 studies), materials (10/18), provider (6/18), and mode of delivery (8/18) were described inconsistently. Setting was reported in only 3/18 studies, whereas the details about tailoring, modifications, and fidelity were largely lacking or deemed non-applicable. For eight randomized trials, several critical CONSORT items, such as trial design, randomization procedures, blinding, and trial registration were often unreported. Among five observational studies, reporting of STROBE key elements such as study design, setting, eligibility criteria, and funding was more consistent, but methods addressing bias, participant flow, missing data, and category boundaries for variables were largely insufficient. Similar gaps were observed for relevant TREND checklist items for nonrandomized intervention studies. Conclusions: The reporting of psychological interventions for AIS in the literature is frequently incomplete, especially for intervention details essential for the reproducibility of the intervention and assessment of risk of bias. Adoption of standardized reporting guidelines is necessary to improve intervention transparency, replicability, and translation into clinical practice. Future research should focus on prospective evaluations of reporting guideline implementation and its impact on research quality in this field. Full article

Background/Objectives: Limited access to mental health services contributes to poorer outcomes among individuals with mental health conditions, including major depressive disorder (MDD). Nurse-led interventions serve as a strategic model of care to improve mental health service delivery and enhance patient outcomes. This project aims to co-design a nurse-led telehealth family psychoeducation (FPE) for MDD and primarily assess its feasibility by evaluating the recruitment and retention rates. Methods: A multi-methods study encompassing a co-design phase (Study Phase 1) and a feasibility study (Study Phase 2). Study Phase 1 will involve semi-structured interviews with individuals with MDD and their families or significant others, as well as surveys and focus groups with mental health professionals to develop telehealth FPE for MDD. Study Phase 2 will evaluate the feasibility and acceptability of the intervention, which comprises three biweekly FPE sessions and a six-week follow-up with patient–family dyads using a single-group pre-post design. The primary outcomes comprise the feasibility and acceptability of intervention. Exploratory secondary outcomes include personal recovery, medication necessity beliefs and concerns, antidepressant adherence, and depression severity, measured at baseline, immediately post-intervention, and at 6-week follow-up using validated measures. Data analysis will primarily involve descriptive statistics and thematic analysis. The TIDieR checklist will be followed in reporting the intervention development. Conclusions: Findings from the proposed study will inform the design and protocol for a future randomised trial of telehealth FPE for improving clinical and non-clinical outcomes in MDD. The feasibility study was prospectively registered with the ClinicalTrial.gov on 8 June 2025 (NCT07014241). Full article

Background and Objectives: Sick-day medication guidance involves patients self-adjusting medications during sick days to prevent adverse events and minimise exacerbation of their disease states. This review aimed to summarise and synthesise all sick-day interventions provided by healthcare professionals (HCPs) for patients with chronic illnesses, including diabetes, cardiovascular disease, chronic kidney disease (CKD), adrenal insufficiency (AI), rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), and asthma. Materials and Methods: A search of Embase, Medline, International Pharmaceutical Abstract, Scopus, Google Scholar, and the grey literature was conducted until July 2025. The review followed the methodological framework according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Data were extracted using a modified TIDieR checklist, and the findings were summarised descriptively and presented thematically. Results: The search included 6932 documents, and 97 met the inclusion criteria: 57 published guidelines/education resources and 40 pieces of original research. Seventy-four interventions were identified for diabetes (18), asthma (32), AI (8), CKD (6), AKI prevention (4), COPD (4), and mixed conditions (2). The most common type of intervention was written information (action plans and information sheets), with education mostly provided by multidisciplinary teams. Novel interventions included 24h phone support and an educational mobile application. Participants showed interest in sick-day interventions and HCPs viewed these interventions as effective, important, and easy to provide. However, interventions did not always translate to improved clinical outcomes, with studies reporting mixed outcomes regarding healthcare utilisation. Nonetheless, some interventions showed improved patient knowledge and satisfaction with care. Conclusions: Multiple interventions are available for asthma and diabetes, with fewer targeting CKD or acute kidney injury (AKI) prevention. While demand for these interventions from consumers and HCPs is high, implementation challenges and inconsistent benefits remain. Further primary research is needed to clarify which intervention features are most effective in yielding meaningful clinical outcomes. Full article

Promoting active lifestyles among adolescents is essential due to their short-, medium-, and long-term contributions to young people’s holistic development and overall health. Beyond physical well-being, Physical Education foster physical activity, autonomy, social connectedness, motivation and emotional well-being, thus constituting a key dimension of quality education. Background/Objectives: The “Estilos de Vida Activos (EVA)” project is a school-based intervention designed to foster adolescent agency and motivation in adopting active habits. Grounded in the salutogenic model, self-determination theory, and the health-based Physical Education pedagogical model, this protocol describes the design and implementation strategies of a participatory intervention in secondary schools. Methods: A variety of research methods will be used to collect quantitative and qualitative data before, during, and after the intervention. Validated questionnaires will assess active commuting, socioeconomic status, satisfaction of basic psychological needs, motivation, levels and intention to engage in physical activity. Qualitative data include interviews with teachers, Photovoice sessions with students, observation notes, and programme materials. Intervention: The EVA intervention is collaboratively developed by students, teachers, and researchers using participatory action research. It includes needs analysis, participatory activities, and co-design of tailored physical activity programmes. The intervention is described using the Template for Intervention Description and Replication checklist (TIDieR) to enhance transparency and replicability. Conclusions: This protocol presents a theoretically grounded and participatory approach to school-based health promotion. By integrating educational and collaborative strategies, it offers a replicable model that promotes adolescent active lifestyles, from contextual relevance, and pedagogical coherence, serving as a guide for inclusive and sustainable interventions in school settings. Full article

Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an impairment of functional status, increasing dependency and mortality. The high prevalence among hospitalized patients has increased interest in active interventions such as exercise; however, the effectiveness of therapeutic exercise in this population remains unclear. This systematic review with a meta-analysis aims to evaluate the effectiveness of therapeutic exercises in hospitalized patients diagnosed with or at risk of sarcopenia. A systematic search was conducted in Medline, Web of Science, and Scopus databases following PRISMA guidelines. Randomized controlled trials assessing therapeutic exercises for sarcopenic or at-risk hospitalized patients were included. Methodological quality was evaluated using the TIDieR Checklist and the ROB2 tool. We performed a meta-analysis addressing muscle strength, physical performance and cognitive function. Six studies met the inclusion criteria, with a total of 1468 participants. Similar interventions were observed, including mainly resistance and balance exercises. Therapeutic exercises demonstrated significant improvements in physical performance (2.98 (1.13–4.83); p = 0.002; I² = 99%), muscle strength (2.11 (0.20–4.01); p = 0.03; I² = 99%) and cognitive function (0.77 (0.25–1.29); p = 0.004; I² = 98%) across several studies. Therapeutic exercises appear to improve sarcopenic outcomes in hospitalized patients, supporting their role as a non-pharmacological intervention to mitigate sarcopenia-related complications. However, due to the lack of reported muscle mass outcomes, as well as the limited number and methodological quality of the included studies, further well-designed trials are needed to confirm these findings. Full article

Introduction: Stroke is a leading cause of long-term disability and substantially affects the quality of life (QoL) of both survivors and their caregivers. The transition from hospital to home is a vulnerable period characterized by discontinuity of care and insufficient caregiver support. Dyadic interventions—targeting both the survivor and caregiver—have shown promise in improving recovery outcomes. This protocol outlines a mixed-methods study to evaluate the impact of a video-based training intervention on the stroke survivor–caregiver dyad during the first year post-discharge. Methods: A mixed-methods design based on the TIDieR checklist will be implemented. Stroke survivors and their caregivers will be recruited from stroke units and rehabilitation hospitals across Italy prior to discharge. Approximately 150 dyads will receive a video training intervention followed by nurse-led transitional care support. Assessments will occur at baseline (T0) and at 1 (T1), 3 (T2), 6 (T3), and 12 months (T4) post-discharge. Outcomes will include physical functioning, disability, anxiety, depression, caregiver preparedness, burden, social support, sleep quality, and both generic and stroke-specific QoL. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship, Rome, July 2024. Conclusions: Integrating caregivers into transitional care through structured training and support is essential for improving dyadic outcomes after stroke. Strengthening knowledge and preparedness in both survivors and caregivers enhances recovery, reduces caregiver burden, and may alleviate healthcare system costs associated with poor post-discharge outcomes. Full article

Background: Upper-limb impairment is a major cause of post-stroke disability, limiting participation in meaningful activities. Robotic rehabilitation may address this by delivering high-dosage, task-oriented training while reducing clinician workload. However, limited clinical translation of robotic interventions may be partly due to poor reporting in the literature. This systematic review evaluated the intervention-reporting quality (completeness and consistency) of randomized controlled trials (RCTs) comparing robotic and conventional upper-limb stroke rehabilitation. Methods: Four databases were searched for RCTs investigating robotic upper-limb interventions compared with dose-matched conventional interventions for people with stroke. Intervention reporting was assessed using the TIDieR-Rehab checklist. Trained reviewers independently extracted and evaluated data, resolving discrepancies through consensus. Completeness and consistency were analyzed descriptively. Results: Among 25 RCTs, the overall reporting completeness was low (43%). Robotic interventions were better described (50%) than conventional interventions (36%). While timing and total dose were commonly reported, critical details on provider expertise, active dose, progressive challenge, personalization, and harms were often omitted. Reporting consistency was moderate (68%), with key information dispersed across article sections. Conclusions: Inadequate reporting limits the transparency, replication, and implementation of robotic upper-limb interventions. Adopting structured reporting frameworks like TIDieR-Rehab is essential for advancing the field. Full article

Background: Mirror therapy (MT) creates a cerebral illusion of a normal movement in a paretic limb. Although mirror therapy has been studied as a suitable intervention for children with Unilateral Cerebral Palsy (UCP), a comprehensive understanding of its full range of benefits is still lacking. Thus, the aim of this systematic review and meta-analysis was to determine all motor and sensory effects of MT in children and adolescents with UCP. Methods: Clinical trials focused on the application of MT in the upper limb (UL) of children and adolescents with UCP were included. A search was performed in PubMed, Cochrane Library, Web of Science, and LILACS databases. Eleven studies were included in this systematic review. The PEDro scale and the MINORS scale were applied to evaluate the methodological quality of randomized and non-randomized controlled trials, respectively. The Risk of Bias tool was also employed to evaluate the potential bias. In addition, the TIDieR checklist was used to assess the quality of intervention reporting. A random-effects model was used for the meta-analysis. Results: The studies included children with UCP from three to eighteen years, classified in Manual Ability Classification System levels I–IV. Motor effects of MT were found in nine studies. Also, two studies reported sensory effects on registration, perception, and proprioception abilities. Qualitative and quantitative analysis showed that MT improved manual dexterity and tactile registration in children and adolescents with UCP. Conclusions: MT is a therapy capable of inducing motor and sensory improvements in the affected UL of children with UCP. Full article

The Farmworker Family Health Program (FWFHP) annually supports 600 farmworkers in connectivity-challenged rural areas. Traditional paper-based data collection poses validity concerns, prompting a pilot of direct data entry using tablets and satellite internet to enhance efficiency. The purpose of this article is to describe, using the TIDier checklist, a real-time, live data-entry EMR intervention made possible by satellite internet. Utilizing a customized REDCap database, direct data entry occurred through tablets and satellite internet. Patients received a unique medical record number (MRN) at the mobile health clinic, with an interprofessional team providing care. Medication data, captured in REDCap before the mobile pharmacy visit, exhibited minimal defects at 6.9% of 319 prescriptions. To enhance data collection efficiency, strategies such as limiting free text variables and pre-selecting options were employed. Adequate infrastructure, including tablets with keyboards and barcode scanners, ensured seamless data capture. Wi-Fi extenders improved connectivity in open areas, while backup paper forms were crucial during connectivity disruptions. These practices contributed to enhanced data accuracy. Real-time data entry in connectivity-limited settings is viable. Replacing paper-based methods streamlines healthcare provision, allowing timely collection of occupational and environmental health metrics. The initiative stands as a scalable model for healthcare accessibility, addressing unique challenges in vulnerable communities. Full article

Complex interventions are often poorly described, making it difficult to understand their development, implementation, and evaluation (i.e., context), which can aid in replicating and translating evidence into practice and policy. Therefore, we examined the development and implementation of an approach to scaling-out (increasing the numbers of) a psychosocial intervention for people affected by dementia across a rural county in England during 2019–2024. We used an adapted version of the TIDieR checklist to consider key items essential for replicating complex interventions at scale. We triangulated document analysis with interview data, and key programme stakeholders ratified the results of this study. We identified three programme components and sub-components, including how planned components were delivered, by whom, and under what conditions. Implementation outcomes related to the inner (e.g., top-down structure) and outer contexts (e.g., market failures) led to modifications that increased programme complexity. This study highlights the importance of programme leaders who can convene and drive systems and culture change to address implementation challenges, as well as the need for scaling science during programme development, for example, to determine optimal scale. Further research should include testing implementation outcomes to understand if the intervention is a scalable solution to the gap in post-diagnostic support in the UK. Full article

Background: The study’s aim is to identify the models of care used to provide survivorship care plans (SCPs) to cancer survivors in healthcare services, describing what kind of professionals are involved, in which settings and timings, and their feasibility. Methods: The Joanna Briggs Institute methodology for scoping reviews is followed. Studies that considered the SCPs applying different models of care, in any healthcare setting on any adult cancer survivors who completed oncological treatments, have been included. Pubmed, Embase, Cochrane Library, Scopus, and Cinahal were searched from 2013 to 2023 with these keywords: “Survivorship Care Plan”, “Oncology”, and “Program”. The study selection process was reported with the PRISMA-ScR. A total of 325 records were identified, 42 were screened, and, ultimately, 23 articles were included. Results: The models of care include: SCP standardization in hospitals; self-support oriented; consultation-based; primary or specialist direct referral; shared care; a multimodal approach. Multidisciplinary teams were involved in the SCP models of care. The settings were private clinics or cancer centers. One-hour SCP interventions were most frequently delivered through in-person visits, by telephone, or online. Conclusions: Implementing SCPs is feasible in healthcare contexts, but with challenges, like time and resource management. Patient-centered programs promoting coordinated care are promising models of care. Full article

Intervention parameters such as the challenge, amount, and dosage (challenge × amount) have the potential to alter the efficacy of rehabilitation interventions after stroke. This systematic review investigated the effect of intervention parameters of challenge, amount, and dosage on improvements in walking outcomes following treadmill training (TT) and comparison interventions in people with stroke. Randomized controlled trials were included if they: (i) investigated interventions of TT or bodyweight-supported TT (BWSTT); (ii) made comparisons with other physiotherapy interventions, other types of TT, or no intervention; (iii) studied people with stroke; (iv) reported sufficient data on challenge and amount parameters; and (v) measured walking speed or endurance. Completeness of reporting was evaluated using the TIDieR-Rehab checklist and risk of bias was assessed using the revised Cochrane risk-of-bias tool. The review included 26 studies; 15 studies compared TT or BWSTT with other physiotherapy interventions and 11 studies compared different types of TT. Meta-analyses provided evidence with low to moderate certainty that greater differences in challenge and dosage between treadmill and comparison physiotherapy interventions produced greater effects on walking endurance (p < 0.01). However, challenge and dosage did not influence walking speed outcomes. The analysis of intervention amount was limited by the lack of studies that manipulated the amount of intervention. Overall, the findings indicate that, after stroke, some of the efficacy of TT on walking endurance can be explained by the challenge level during training. This supports the implementation of TT at higher challenge levels in stroke rehabilitation practice. Full article

Interdisciplinary pain rehabilitation (IPR) is a recommended treatment for people with chronic pain. An inadequate description of the content of IPR programs makes it difficult to draw conclusions regarding their effects. The purpose of this study was to describe the perceptions and attitudes of healthcare professionals toward a content description of IPR programs for patients with chronic pain. Individual interviews with healthcare professionals (n = 11) working in IPR teams in Sweden were conducted between February and May 2019. Analysis of the interviews resulted in a theme: interdisciplinary pain rehabilitation is a complex intervention, with three categories: limitations in the description of IPR programs; lack of knowledge about IPR and chronic pain; and facilitating and hindering factors for using the content description of IPR programs. Conclusion: Healthcare professionals perceived that IPR programs could be described through a general content description. A general content description could enhance the quality of IPR programs through a better understanding of their content and a comparison of different IPR programs. Healthcare professionals also expressed the importance of a content description being a guide rather than a steering document. Full article