Background:Uptake of bowel cancer screening is lowest in London, in populations of lower socio-economic status, and in particular ethnic or religious groups.Methods:We report on the evaluation of two interventions to improve uptake in an area including populations of low socio-economic status and considerable ethnic diversity. The interventions were face-to-face health promotion on bowel cancer screening at invitees' general practice and health promotion delivered by telephone only. Nine large general practices in East London were chosen at random to offer face-to-face health promotion, and nine other large practices to offer telephone health promotion, with 24 practices of similar size as comparators. Data at practice level were analysed by Mann–Whitney–Wilcoxon tests and grouped-logistic regression.Results:There were 2034 invitees in the telephone intervention practices, 1852 in the face-to-face intervention practices and 5227 in the comparison practices. Median gFOBt kit uptake in the target population (aged 59–70) was 46.7% in the telephone practices, 43.8% in the face-to-face practices and 39.1% in the comparison practices. Significant improvements in the odds of uptake were observed following telephone intervention in both males (OR=1.39, 95% CI=1.20–1.61, P<0.001) and females (OR=1.49, 95% CI=1.29–1.73, P<0.001), while the face-to-face intervention mainly impacted uptake in males (OR=1.23, 95% CI=1.10–1.36), P<0.001) but did not lead to a significant increase in females (OR=1.12, 95% CI=0.96–1.29, P=0.2).Conclusions:Personally delivered health promotion improved uptake of bowel cancer screening in areas of low socio-economic status and high ethnic diversity. The intervention by telephone appears to be the most effective method.
College students with ADHD are at risk for a host of negative outcomes in academic, social, and emotional domains. However, the majority of college campuses do not provide comprehensive and individualized services to target the executive functioning difficulties and psychological comorbidity seen in college students with ADHD. The current manuscript describes the development of a specialized semester-long program to address the unique needs of college students with ADHD (Students Understanding College Choices: Encouraging and Executing Decisions for Success; SUCCEEDS) as well as the clinical, research, and training mission of this venture. Results from reliable change indices indicate that among the eight students in this case series, the majority reported significant improvements in organizational skills. Additionally, the majority of students with elevated rates of depression or alcohol use at baseline also reported significant improvement in these comorbid symptoms. A descriptive case study is also provided to further demonstrate the individualization and implementation of SUCCEEDS. Preliminary evidence suggests that SUCCEEDS is an effective method for addressing the personalized and wide-ranging difficulties experienced by college students with ADHD. Lessons learned and future directions for research are discussed.
The COVID-19 pandemic is an unprecedented social-emotional stressor significantly impacting intervention services for at-risk college students with attention-deficit/hyperactivity disorder (ADHD). In order to succeed in the new remote learning context, students are tasked with employing strong organizational, time management, and planning skills. They must self-regulate thoughts, actions, and emotions, inhibit task-irrelevant activity, and cope with unprecedented stressors. These ingredients for success nearly completely overlap with the core dysfunctions of ADHD. Recognizing the importance of providing psychosocial services during this high-risk time and in response to social distancing and university guidelines, we initiated a telehealth version of our program for college students with ADHD (i.e., SUCCEEDS). In the current paper, we describe novel and creative clinical strategies designed to assist students with ADHD in problem solving, adaptive coping, organizational skills, and time management strategies during the COVID-19 pandemic. Specifically, we: (1) detail the initial set-up of remote delivery services and supervision, (2) describe key components of the SUCCEEDS program developed to support students' unique needs during the COVID-19 pandemic, (3) present focus group and qualitative feedback from SUCCEEDS coaches and students, (4) provide an illustrative case vignette of application, and (5) discuss future directions and "lessons learned" in moving SUCCEEDS to a remote platform. In so doing, our hope is to contribute to an ongoing dialog surrounding optimal delivery of remote services to college students with ADHD, particularly during high-risk periods.
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