No abstract

BackgroundComputer tailoring and motivational interviewing show promise in promoting lifestyle change, despite few head-to-head comparative studies.PurposeVitalum is a randomized controlled trial in which the efficacy of these methods was compared in changing physical activity and fruit and vegetable consumption in middle-aged Dutch adults.MethodsParticipants (n = 1,629) were recruited via 23 general practices and randomly received either four tailored print letters, four motivational telephone calls, two of each type of intervention, or no information. The primary outcomes were absolute change in self-reported physical activity and fruit and vegetable consumption.ResultsAll three intervention groups (i.e., the tailored letters, the motivational calls, and the combined version) were equally and significantly more effective than the control group in increasing physical activity (hours/day), intake of fruit (servings/day), and consumption of vegetables (grams/day) from baseline to the intermediate measurement (week 25), follow-up 1 (week 47) and 2 (week 73). Effect sizes (Cohen’s d) ranged from 0.15 to 0.18. Participants rated the interventions positively; interviews were more positively evaluated than letters.ConclusionsTailored print communication and telephone motivational interviewing or their combination are equally successful in changing multiple behaviors.Electronic supplementary materialThe online version of this article (doi:10.1007/s12160-010-9231-3) contains supplementary material, which is available to authorized users.

No abstract

Disclosure was stimulated if people felt morally obliged to do so or when they anticipated regret if something happened because it is preventable. Motivation to disclose seemed to increase if there were, especially fatal, cancer cases in the family. Presence of external cues (e.g. professionals) appeared important for disclosure as well. Disrupted and tense family relations were reasons not to disclose, as well as young age of the message recipients and negative experiences at their first attempt to disclose (a novel finding). Disclosure was merely restricted to the nuclear family. A personal approach in this respect was preferred. With respect to content of the disclosure, participants reported to solely announce the presence of the hereditary defect and the possibility of testing. It was mostly considered the recipients' responsibility and own choice to obtain further (technical/medical) information.

Background Maternal distress can have adverse health outcomes for mothers and their children. Antenatal interventions may reduce maternal distress.Objective To assess the effectiveness of antenatal interventions for the reduction of maternal distress during pregnancy and for up to 1 year postpartum.Search strategy EBSCO, Medline, PubMed, Cochrane, secondary references of Cochrane reviews and review articles, and experts in the field.Selection criteria Randomised controlled trials in which the association between an antenatal intervention and the reduction of maternal distress was reported.Data collection and analysis Two authors independently abstracted data from each trial. A random-effects meta-analysis assessed the reduction of maternal distress associated with antenatal preventive and treatment interventions, compared with routine antenatal care or another intervention.Main results Ten trials with 3167 participants met the inclusion criteria, and nine trials (n = 3063) provided data for the meta-analysis of six preventive interventions and three treatment interventions. The preventive interventions indicated no beneficial reduction of maternal distress (six trials; n = 2793; standardised mean difference, SMD -0.06; 95% confidence interval, 95% CI À0.14-0.01). The treatment interventions indicated a significant effect for the reduction of maternal distress (three trials; n = 270; SMD -0.29; 95% CI -0.54 to -0.04). A sample of women, selected retrospectively, who were more vulnerable for developing maternal distress showed a significant reduction of maternal distress after the interventions (three trials; n = 1410; SMD -0.25; 95% CI -0.37 to -0.14).Author's conclusions Preventive antenatal interventions for maternal distress show no effect. Antenatal interventions for women who have maternal distress or are at risk for developing maternal distress are associated with a small reduction in maternal distress.