Browsing by Subject "acceptability"

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  • von Schoultz, Katja (Helsingin yliopisto, 2021)
    Trust and empowerment are popular management practices, with many big organizations having adopted initiatives involving the two concepts. Despite the popularity of these initiatives, most of them fail. To be able to design effective behavior change interventions we need to know what made the interventions successful or unsuccessful by evaluating them. Traditionally, effectiveness was evaluated but recently knowing why an intervention worked is perceived as essential. By understanding how participants of trust and empowerment initiatives perceive their acceptability, insights can be gained into why the intervention worked as it did. Intervention acceptability refers to how the intervention providers or receivers think or feel about an intervention. This study aims to examine the retrospective intervention acceptability, of an organizational pilot intervention focusing on trust and empowerment, from the perspective of the intervention recipients. To examine how the intervention participants perceive the acceptability of the intervention, the acceptability domains of the Theoretical Framework of Acceptability (TFA) will be used. As the TFA was developed for assessing the acceptability of healthcare interventions, the fit of the framework for assessing the acceptability of an organizational intervention will be evaluated. The study adopts a qualitative research methodology using theory-driven content analysis with a relativist perspective. The data was collected using online semi-structured focus group interviews. The sample included 12 team- or project leaders from different parts of the world. The results show that the intervention has high retrospective acceptability from the perspective of the intervention recipients. The participants mainly used the existing TFA domains in their construction of acceptability, with the addition of including appropriateness as a central domain. It, therefore, seems that the TFA works well for understanding how the participants of a trust and empowerment intervention conducted in an organizational setting, perceive its acceptability. It seems that the intervention is designed to suit the target group well, which increases the likelihood for a successful full-scale intervention when and if the organization decides to roll out the training on a larger scale. This study also provides insights into the applicability of using the TFA in a new context.
  • Treanor, Charlene J; Kouvonen, Anne; Lallukka, Tea; Donnelly, Michael (2021)
    Background: Mental ill-health presents a major public health problem. A potential part solution that is receiving increasing attention is computer-delivered psychological therapy, particularly during the COVID-19 pandemic as health care systems moved to remote service delivery. However, computerized cognitive behavioral therapy (cCBT) requires active engagement by service users, and low adherence may minimize treatment effectiveness. Therefore, it is important to investigate the acceptability of cCBT to understand implementation issues and maximize potential benefits. Objective: This study aimed to produce a critical appraisal of published reviews about the acceptability of cCBT for adults. Methods: An umbrella review informed by the Joanna Briggs Institute (JBI) methodology identified systematic reviews about the acceptability of cCBT for common adult mental disorders. Acceptability was operationalized in terms of uptake of, dropping out from, or completion of cCBT treatment; factors that facilitated or impeded adherence; and reports about user, carer, and health care professional experience and satisfaction with cCBT. Databases were searched using search terms informed by relevant published research. Review selection and quality appraisal were guided by the JBI methodology and the AMSTAR tool and undertaken independently by 2 reviewers. Results: The systematic searches of databases identified 234 titles, and 9 reviews (covering 151 unique studies) met the criteria. Most studies were comprised of service users with depression, anxiety, or specifically, panic disorder or phobia. Operationalization of acceptability varied across reviews, thereby making it difficult to synthesize results. There was a similar number of guided and unguided cCBT programs; 34% of guided and 36% of unguided users dropped out; and guidance included email, telephone, face-to-face, and discussion forum support. Guided cCBT was completed in full by 8%-74% of the participants, while 94% completed one module and 67%-84% completed some modules. Unguided cCBT was completed in full by 16%-66% of participants, while 95% completed one module and 54%-93% completed some modules. Guided cCBT appeared to be associated with adherence (sustained via telephone). A preference for face-to-face CBT compared to cCBT (particularly for users who reported feeling isolated), internet or computerized delivery problems, negative perceptions about cCBT, low motivation, too busy or not having enough time, and personal circumstances were stated as reasons for dropping out. Yet, some users favored the anonymous nature of cCBT, and the capacity to undertake cCBT in one's own time was deemed beneficial but also led to avoidance of cCBT. There was inconclusive evidence for an association between sociodemographic variables, mental health status, and cCBT adherence or dropping out. Users tended to be satisfied with cCBT, reported improvements in mental health, and recommended cCBT. Overall, the results indicated that service users' preferences were important considerations regarding the use of cCBT. Conclusions: The review indicated that "one size did not fit all" regarding the acceptability of cCBT and that individual tailoring of cCBT is required in order to increase population reach, uptake, and adherence and therefore, deliver treatment benefits and improve mental health.
  • Vartiainen, Outi; Elorinne, Anna-Liisa; Niva, Mari; Väisänen, Pertti (2020)
    Introducing and increasing the use of insect-based foods as an alternative source of protein has recently aroused academic and commercial interest in Europe. In this research, we examined Finnish consumers' intentions to consume insect-based foods in the near future. As a theoretical background we used Ajzen's theory of planned behaviour (TPB), where individuals' intentions to change their behaviour are affected by their attitude (A), subjective norm (SN) and perceived behavioural control (PBC). The data was obtained by using an online questionnaire and convenience sampling. For measuring TPB-components a self-administered 58-item Likert-type questionnaire was used. Food neophobia (FN) was measured by using the food neophobia scale. Respondents' (n=564) intentions to consume insect-based foods were explained significantly (80%) by their A (beta=0.749, P
  • Vironen, Aleksi (Helsingin yliopisto, 2021)
    Evidence based medicines alongside with age-appropriate dosage forms are essential in enabling appropriate treatment for any patient group. Pediatric pharmacotherapy, however, is lacking age-appropriate dosage forms and research-based evidence regarding the dosing, efficacy, and safety of medicines. Orally administered drugs require manipulation to enable administration and are often used against the indications approved in the marketing authorization and summary of product characteristics (SmPC). This off-label use puts pediatric patients at risk for medicational errors and adverse drug reactions. The aim of this study was to investigate recent trends in oral dosage forms used in pediatric randomized controlled trials (RCTs), with emphasis on age appropriateness. The results could be utilized in developing evidence-based dosage forms, suitable for all pediatric patients aged 0-17 years, and manufacturable in a small scale in a hospital pharmacy. This study was conducted as a systematic review following the PRISMA Statement. The literature search was carried out from Pubmed and Scopus databases and it covered a five-year period of 2015-2020. References from the databases were entered to the Covidence systematic review platform. After removing duplicates 3333 articles were left for screening. Two independent researchers selected the articles first screening by title and abstract, and then by full text review. A qualitative content analysis was conducted on the included articles. Altogether 77 articles met the inclusion criteria. Dosage forms included were tablets (n=37), liquids (n=21), capsules (n=18) and multiparticulates (n=6). Majority of the dosage forms were conventional (n=49) compared to more advanced novel modified release and fixed-dose combination formulations (n=33). Based on our results, orally administered dosage forms used in the recent pediatric RCTs are still limited by poor acceptability, palatability, and the need to manipulate dosage forms to enable administration. These issues are similar to the ones related to the off-label use of medicine that compromise patient safety. Majority of the dosage forms included in our study were tablets, indicating a positive shift towards more safe and acceptable dosage form. Formulations were also evolving towards dispersible, extended-release and fixed-dose combinations that offer additional benefits for pediatric patients. The low number of children < 2 years old included in study populations and the poor acceptability profile reported by most studies limit our conclusions on an ideal age-appropriate dosage form. Further research is needed on unifying the guidelines used in pediatric drug development.
  • Strömberg, Lisbeth (Helsingin yliopisto, 2020)
    Gestational diabetes mellitus (GDM) is a condition of glucose intolerance with onset or first recognition during pregnancy, and it poses multiple health risks for both the mother and the child. The prevalence of GDM is increasing globally and effective interventions are needed to reduce the associated risks. Mobile health (mHealth) solutions have a great potential in answering this need since they are cost-effective and able to reach large groups of people. mHealth solutions might be especially effective for management of chronic conditions that require patient behavior change. Investigating intervention acceptability has an important part in the process of developing successful interventions. The aim of this thesis is to investigate the prospective acceptability of an mHealth intervention for GDM from the perspective of its potential recipients. The thesis also seeks to find out whether there are any associations between technological experience and perceptions of intervention acceptability as well as ways in which the intervention acceptability could be improved. The thesis utilizes data collected in the first phase of the eMOM GDM study, a research project with the aim of developing an mHealth intervention to support the self-management of GDM. The application acceptability was studied with semi-structured interviews with 10 women currently diagnosed with GDM. Previous technological experience was self-reported by the participants in a background questionnaire. Theory-driven content analysis was used to analyze the interviews. The results show that the intervention has high prospective acceptability from the perspective of the potential participants. For most of the domains of acceptability there is still room for improvement, and several ideas for further improving the intervention’s acceptability are discussed. The results could also indicate a possible relationship between technological experience and mHealth intervention acceptability. This thesis contributes to the development of an intervention by providing insight on the factors influencing intervention acceptability and ideas on how to improve it. The results also provide valuable information for developing future mHealth solutions for GDM. The potential association between technological experience and intervention acceptability are interesting regarding all mHealth intervention development and should be studied further.
  • Palsola, Minttu; Renko, Elina; Kostamo, Katri; Lorencatto, Fabiana; Hankonen, Nelli (2020)
    Objectives Intervention participants' responses to and engagement with interventions are a key intermediate step between interventions and intended outcomes. The aim of this study was to qualitatively investigate crucial aspects of engagement, namely acceptability (experienced cognitive and emotional responses to the intervention), receipt (comprehension of intervention content), and skill enactment (skill performance in target settings), within the Let's Move It, a multi-component school-based physical activity intervention. Design A longitudinal qualitative study embedded in a cluster-randomized trial, with individual interviews of purposefully sampled intervention participants immediately post-intervention (n = 21) and at 14 months (n = 14). Methods Semi-structured interviews were analysed using thematic analysis. Abductive coding process was taken to identify categories for themes. Results The analysis resulted in 12 themes and 18 subthemes. Overall, participants reported perceived effectiveness of and affective attitude towards the intervention (acceptability) and understood the main messages and skills (receipt). For example, findings indicated comprehension of the non-judgemental nature and choice-providing messages of the intervention underpinned by self-determination theory. Despite reporting understanding how and why to perform the skills, not using them was a highlighted theme (skill enactment), particularly for self-regulatory techniques such as planning. Friends' role as key self-motivation technique was a prevalent theme. In the within-individual analysis, three different engager types were identified: positive, ambivalent, and negative. Conclusion Identifying misunderstandings and difficulties in skill acquisition can help interpret main trial outcomes and inform further intervention optimization. This study provides an example of how to use thematic analysis to assess acceptability, receipt, and enactment in interventions.