American journal of preventive medicine
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Practice Guideline Randomized Controlled Trial Comparative Study Clinical Trial Guideline
Implementing guidelines for smoking cessation: comparing the efforts of nurses and medical assistants.
It is unclear how different types of intake clinicians (registered nurses [RNs], and less costly licensed practical nurses [LPNs] and medical assistants [MAs]) compare in the performance of smoking-cessation activities recommended in the Agency for Healthcare Research and Quality (AHRQ) smoking-cessation clinical practice guideline. ⋯ Although both MAs and LPNs showed marked improvements in performance in response to the guideline intervention, patients seen by these intake clinicians were less likely to receive guideline-recommended counseling, compared to those patients seen by RNs. Given their important role in the delivery of preventive care, MAs and LPNs should receive proper training in cessation counseling, should have strong physician and administrative support, and should be included in efforts to implement smoking-cessation guidelines in primary care.
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Randomized Controlled Trial Clinical Trial
Promoting and maintaining physical activity in people with type 2 diabetes.
Limited research has investigated how to promote physical activity in people with type 2 diabetes. This study evaluated physical activity counseling over 12 months in people with type 2 diabetes. ⋯ Physical activity counseling was effective for promoting physical activity over 12 months in people with type 2 diabetes.
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Randomized Controlled Trial Clinical Trial
Body and soul. A dietary intervention conducted through African-American churches.
Body and Soul was a collaborative effort among two research universities, a national voluntary agency (American Cancer Society), and the National Institutes of Health to disseminate and evaluate under real-world conditions the impact of previously developed dietary interventions for African Americans. ⋯ The results suggest that research-based interventions, delivered collaboratively by community volunteers and a health-related voluntary agency, can be effectively implemented under real-world conditions.
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Randomized Controlled Trial Comparative Study Clinical Trial
Impact of an educational program on the safety of high-risk, visually impaired, older drivers.
Older drivers (licensed drivers aged 60 years and older) have among the highest rates of motor vehicle collision involvement per mile driven of all age groups. Educational programs that promote safe driving strategies among seniors are a popular approach for addressing this problem, but their safety benefit has yet to be demonstrated. The objective of this study was to determine whether an individualized educational program that promoted strategies to enhance driver safety reduces the crash rate of high-risk older drivers. DESIGN/ SETTING: Randomized, controlled, single-masked intervention evaluation at an ophthalmology clinic. ⋯ An educational intervention that promoted safe-driving strategies among visually impaired, high-risk older drivers did not enhance driver safety, although it was associated with increased self-regulation and avoidance of challenging driving situations and decreased driving exposure by self-report.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The study designed by a committee: design of the Multisite Violence Prevention Project.
This article describes the research design of the Multisite Violence Prevention Project (MVPP), organized and funded by the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC). CDC's objectives, refined in the course of collaboration among investigators, were to evaluate the efficacy of universal and targeted interventions designed to produce change at the school level. The project's design was developed collaboratively, and is a 2 x 2 cluster-randomized true experimental design in which schools within four separate sites were assigned randomly to four conditions: (1) no-intervention control group, (2) universal intervention, (3) targeted intervention, and (4) combined universal and targeted interventions. ⋯ The nesting of students within teachers, families, schools and sites created a number of challenges for designing and implementing the study. The final design represents both resolution and compromise on a number of creative tensions existing in large-scale prevention trials, including tensions between cost and statistical power, and between internal and external validity. Strengths and limitations of the final design are discussed.