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Young people moving from adolescent secure inpatient units to adult care in the UK present with multiple and complex needs and are more likely to experience poor transition outcomes related to enduring dependency on mental health services. However, there is lack of knowledge about the feasibility of transitional care models improving transition outcomes.
Objectives
The MOVING FORWARD study aims to implement a new transition intervention model for young people transitioning from adolescent secure services to adult-oriented settings and test the feasibility of a future cluster trial measuring its effectiveness.
Methods
The design of the study is a three-arm feasibility, cluster randomised controlled trial comparing the MOVING FORWARD intervention against standard transition preparation in six adolescent secure services.Young people between 17-19 years, their parents/carers and key workers will be allocated in two conditions and will receive four transition preparation workshops across six months. Data will be collected at three time points: (T0) baseline, (T1) 6-12 months post-intervention, and (T2)18-24 months post-baseline.
Results
Thirteen young people and 17 staff members have contributed to the intervention design through online Advisory Groups. Common identified themes included appropriateness of module content and support during delayed transitions. An intra-class correlation coefficient will be calculated to inform the power of sample size. With a sample size of 50, we will be able to estimate a drop-out rate of 80%.
Conclusions
This research will provide practitioners and policy makers with an evidence-based framework about barriers and facilitators to the proposed intervention and will enable services to reflect on quality of transitional care delivery.
DIALOG+ is a digital psychosocial intervention aimed at making routine meetings between patients and clinicians therapeutically effective. This study aimed to evaluate the cost-effectiveness of implementing DIALOG+ treatment for patients with psychotic disorders in five low- and middle-income countries in Southeast Europe alongside a cluster randomised trial.
Methods
Resource use and quality of life data were collected alongside the multi-country cluster randomised trial of 468 participants with psychotic disorders. Due to COVID-19 interruptions of the trial’s original 12-month intervention period, adjusted costs and quality-adjusted life years (QALYs) were estimated at the participant level using a mixed-effects model over the first 6 months only. We estimated the incremental cost-effectiveness ratio (ICER) with uncertainty presented using a cost-effectiveness plane and a cost-effectiveness acceptability curve. Seven sensitivity analyses were conducted to check the robustness of the findings.
Results
The average cost of delivering DIALOG+ was €91.11 per participant. DIALOG+ was associated with an incremental health gain of 0.0032 QALYs (95% CI –0.0015, 0.0079), incremental costs of €84.17 (95% CI –8.18, 176.52), and an estimated ICER of €26,347.61. The probability of DIALOG+ being cost-effective against three times the weighted gross domestic product (GDP) per capita for the five participating countries was 18.9%.
Conclusion
Evidence from the cost-effectiveness analyses in this study suggested that DIALOG+ involved relatively low costs. However, it is not likely to be cost-effective in the five participating countries compared with standard care against a willingness-to-pay threshold of three times the weighted GDP per capita per QALY gained.
The objective of the current study was to evaluate the impact of the Market to MyPlate (M2MP) program on participants’ reported farmers’ market (FM) attitudes and shopping behaviours, frequency of serving vegetables to their families, food resource management behaviours and food security. A secondary objective was to identify facilitators and barriers to shopping at FM and food waste reduction techniques used by low-income families.
Design:
The current study used a mixed methods evaluation embedded within a cluster randomised trial of the M2MP intervention.
Setting:
The 7-week M2MP program was delivered at Extension offices and community centres in central Illinois.
Participants:
Participants included 120 adults and their families. Class cohorts were randomly assigned to one of three treatment groups: (1) nutrition education and cooking classes with produce allocations (PAE, n 39); (2) nutrition education and cooking classes only (EO, n 36) or (3) control group (n 45).
Results:
Compared with control participants, PAE participants were significantly more likely to report shopping at FM (P = 0·029) and reported serving more vegetables to their families (P = 0·010) (EO participants did not differ from the control group on any outcomes). There were no differences between conditions in survey-based measures of food security or food resource management behaviours. Interview results describe facilitators and barriers to shopping at FM and a variety of food waste reduction techniques (including food placement and food resource management).
Conclusions:
These findings suggest that fresh produce provision coupled with nutrition and culinary education can positively impact shopping and dietary behaviours.
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