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Virtual health assistants (VHAs), interactive digital programs that emulate human communication, are being increasingly used in health care to improve patient education and care and to reduce the burden on health care providers. VHAs have the potential to promote cancer equity through facilitating patient engagement, providing round-the-clock access to information, and reducing language barriers. However, it is unclear to what extent audience-centeredness is being considered in the development of cancer-related applications. This systematic review identifies and synthesizes strategies used to make VHA-based cancer prevention and screening interventions audience-centered. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, we searched 4 databases (PubMed, Embase, Web of Science, and EBSCOhost) for peer-reviewed studies on VHA interventions promoting cancer screening (January 2022). Included studies focused on adult populations in primary care settings, with interventions emphasizing interactivity and immediacy (key VHA features). Excluded studies were on cancer treatment, noninteractive decision aids, or technical VHA development. Screening, data extraction, and quality assessment (Mixed Methods Appraisal Tool) were performed independently by multiple reviewers. Thematic synthesis was used to analyze audience-centered strategies. Of 1055 records screened, 17 studies met inclusion criteria. Most (n=11) targeted colorectal cancer, with others addressing prostate, breast, cervical, or lung cancer. A total of 16 studies were US-based; 1 study focused on Uganda. Key strategies for audience-centered design included: (1) Demographic Concordance: Race or gender alignment between VHA and users (eg, African American participants interacting with Black-coded avatars); (2) User Feedback: Iterative testing via interviews, think-aloud protocols, or pilot studies to refine interventions; (3) Preintervention Needs Assessment: Identifying cultural, linguistic, or literacy barriers (eg, myths about screening in Ugandan communities); (4) Theoretical Frameworks: The Health Belief Model (most common), the Modality, Agency, Interactivity, and Navigability (MAIN) model, or tailored messaging theories guided design; (5) Information Customization: Culturally adapted content (eg, Spanish-language interfaces, narratives addressing racial disparities); and (6) Feature Customization: Adjusting VHA appearance (eg, animations and fonts) based on user preferences. Notably, 7/17 studies focused on racially minoritized groups (eg, African Americans, Hispanic farmworkers), addressing systemic barriers like mistrust in health care. However, gaps persisted in intersectional tailoring (eg, rurality and income) and non-English languages (only 2/17 studies). Recruitment methods influenced diversity; community-based strategies yielded more representative samples than solely internet-based recruitment approaches. The systematic review identified the audience-centered development practices currently being used for VHA-based interventions in preventive cancer care. The majority of the studies included processes to diversify and segment the intended audience, focused on medically underrepresented population groups, and implemented strategies to be culturally sensitive to the population of interest. However, opportunities remain to address multidimensional inequities (eg, rural access and low literacy). Future interventions should integrate intersectional frameworks, expand language diversity, and measure social presence to enhance engagement. This review provides a roadmap for developing equity-focused eHealth tools in cancer prevention.

This book provides insight and findings from leading psychoanalysts who are involved in early prevention research and clinical work. Advances in the sciences of early development have brought a heightened awareness to the crucial importance of early experiences for health and development as well as building strong foundations for education and preventing disorder. New approaches are applied in home visitation, working with immigrant families, and those stressed by trauma, conflicts and economic disadvantage. Examples of clinical application and the implementation of promising programs in an outreach psychoanalysis are also provided.

ObjectiveTo provide researchers with guidance on actions to take during intervention development.Summary of key pointsBased on a consensus exercise informed by reviews and qualitative interviews, we present key principles and actions for consideration when developing interventions to improve health. These include seeing intervention development as a dynamic iterative process, involving stakeholders, reviewing published research evidence, drawing on existing theories, articulating programme theory, undertaking primary data collection, understanding context, paying attention to future implementation in the real world and designing and refining an intervention using iterative cycles of development with stakeholder input throughout.ConclusionResearchers should consider each action by addressing its relevance to a specific intervention in a specific context, both at the start and throughout the development process.

ObjectiveTo improve the quality and consistency of intervention development reporting in health research.DesignThis was a consensus exercise consisting of two simultaneous and identical three-round e-Delphi studies (one with experts in intervention development and one with wider stakeholders including funders, journal editors and public involvement members), followed by a consensus workshop. Delphi items were systematically derived from two preceding systematic reviews and a qualitative interview study.ParticipantsIntervention developers (n=26) and wider stakeholders (n=18) from the UK, North America and Europe participated in separate e-Delphi studies. Intervention developers (n=13) and wider stakeholders (n=13) participated in a 1-day consensus workshop.Resultse-Delphi participants achieved consensus on 15 reporting items. Following feedback from the consensus meeting, the final inclusion and wording of 14 items with description and explanations for each item were agreed. Items focus on context, purpose, target population, approaches, evidence, theory, guiding principles, stakeholder contribution, changes in content or format during the development process, required changes for subgroups, continuing uncertainties, and open access publication. They form the GUIDED (GUIDance for the rEporting of intervention Development) checklist, which contains a description and explanation of each item, alongside examples of good reporting.ConclusionsConsensus-based reporting guidance for intervention development in health research is now available for publishers and researchers to use. GUIDED has the potential to lead to greater transparency, and enhance quality and improve learning about intervention development research and practice.

Background Delirium, closely linked to increasing age and frailty, is a growing concern in the aging population, yet there is little understanding about how to support recovery for individuals and their carers. This paper details the design and development of RecoverED, a home-based rehabilitation intervention for delirium recovery. Methods A realist-informed approach was used to develop a programme theory and logic model for RecoverED. A rapid realist review had identified strategies for delirium recovery, followed by interviews with stakeholders (older adults, carers, and professionals), and an expert panel discussion. The intervention was then developed based on the refined programme theory of what had worked to improve recovery from delirium, for whom, and in what context. Results The RecoverED intervention, described using the TIDieR checklist, was a complex, multicomponent, 12 week home-based programme delivered by a multidisciplinary team in up to 10 sessions. The intervention comprised cognitive, physical, and psychosocial components. An intervention manual and training programme had been developed to support delivery teams. Conclusion The RecoverED intervention was being evaluated in a multi-centre feasibility trial with a qualitative process evaluation. This paper describes theory-based rehabilitation interventions for long-term delirium recovery. Further research through a randomised controlled trial is needed to assess its effectiveness and cost-effectiveness before broader implementation.

: This systematic review drew the significant findings of carefully selected interventions to promote the social and moral competence (SC and MC, respectively) of children and adolescents mostly by investigating the effect of these interventions and focusing on strategies used. : A number of English written, electronic databases (e.g., EBSCO, EBSCOhost Web, ERIC, Master FILE Premier, SPORT, SPORT Discus, and Web of Science) and grey literature – from 2005 to the present – were consulted from September 2021 to December 2021. School-based intervention studies that assessed moral competence (MC) or social competence (SC) were eligible for inclusion. The studies were stratified by pre-school and primary school children (<12 years of age) and adolescents (≥12 years of age). A total of N = 24 documents referring to different intervention studies were included in the review. N = 10 interventions focused on children; while N = 14 targeted adolescents. : The most used strategies in the interventions were the ones that included components of MC or evaluated SC using specific protocols and tools. : This review pointed at socio-emotional and moral skills which remained underdeveloped in school children unless physical education (PE) teachers adjusted teaching contents and methods during instruction; and implement them into interventions with strategies that targeted elements fostering the sound socio-moral development of a child into adulthood. A model-based approach appeared to be the most, but not the only effective designs in the examined interventions.

Background Despite the increasing popularity of the theory of change (ToC) approach, little is known about the extent to which ToC has been used in the design and evaluation of public health interventions. This review aims to determine how ToCs have been developed and used in the development and evaluation of public health interventions globally. Method s We searched for papers reporting the use of “theory of change” in the development or evaluation of public health interventions in databases of peer-reviewed journal articles such as Scopus, Pubmed, PsychInfo, grey literature databases, Google and websites of development funders. We included papers of any date, language or study design. Both abstracts and full text papers were double screened. Data were extracted and narratively and quantitatively summarised. Results A total of 62 papers were included in the review. Forty-nine (79 %) described the development of ToC, 18 (29 %) described the use of ToC in the development of the intervention and 49 (79 %) described the use of ToC in the evaluation of the intervention. Although a large number of papers were included in the review, their descriptions of the ToC development and use in intervention design and evaluation lacked detail. Conclusions The use of the ToC approach is widespread in the public health literature. Clear reporting of the ToC process and outputs is important to strengthen the body of literature on practical application of ToC in order to develop our understanding of the benefits and advantages of using ToC. We also propose a checklist for reporting on the use of ToC to ensure transparent reporting and recommend that our checklist is used and refined by authors reporting the ToC approach.

Background Interventions need to be developed prior to the feasibility and piloting phase of a study. There are a variety of published approaches to developing interventions, programmes or innovations to improve health. Identifying different types of approach, and synthesising the range of actions taken within this endeavour, can inform future intervention development. Methods This study is a systematic methods overview of approaches to intervention development. Approaches were considered for inclusion if they described how to develop or adapt an intervention in a book, website or journal article published after 2007, or were cited in a primary research study reporting the development of a specific intervention published in 2015 or 2016. Approaches were read, a taxonomy of approaches was developed and the range of actions taken across different approaches were synthesised. Results Eight categories of approach to intervention development were identified. (1) Partnership, where people who will use the intervention participate equally with the research team in decision-making about the intervention throughout the development process. (2) Target population-centred, where the intervention is based on the views and actions of the people who will use it. (3) Evidence and theory-based, where the intervention is based on published research evidence and existing theories. (4) Implementation-based, where the intervention is developed with attention to ensuring it will be used in the real world. (5) Efficiency-based, where components of an intervention are tested using experimental designs to select components which will optimise efficiency. (6) Stepped or phased, where interventions are developed with an emphasis on following a systematic set of processes. (7) Intervention-specific, where an approach is constructed for a specific type of intervention. (8) Combination, where existing approaches to intervention development are formally combined. The actions from approaches in all eight categories were synthesised to identify 18 actions to consider when developing interventions. Conclusions This overview of approaches to intervention development can help researchers to understand the variety of existing approaches, and to understand the range of possible actions involved in intervention development, prior to assessing feasibility or piloting the intervention. Findings from this overview will contribute to future guidance on intervention development. Trial registration PROSPERO CRD42017080553 .

Promoting health behaviors and preventing chronic diseases through a healthy lifestyle among those with a low socioeconomic status (SES) remain major challenges. eHealth interventions are a promising approach to change unhealthy behaviors in this target group. This review aims to identify key components, barriers, and facilitators in the development, reach, use, evaluation, and implementation of eHealth lifestyle interventions for people with a low SES. This review provides an overview for researchers and eHealth developers, and can assist in the development of eHealth interventions for people with a low SES. We performed a scoping review based on Arksey and O'Malley's framework. A systematic search was conducted on PubMed, MEDLINE (Ovid), Embase, Web of Science, and the Cochrane Library, using terms related to a combination of the following key constructs: eHealth, lifestyle, low SES, development, reach, use, evaluation, and implementation. There were no restrictions on the date of publication for articles retrieved upon searching the databases. The search identified 1323 studies, of which 42 met our inclusion criteria. An update of the search led to the inclusion of 17 additional studies. eHealth lifestyle interventions for people with a low SES were often delivered via internet-based methods (eg, websites, email, Facebook, and smartphone apps) and offline methods, such as texting. A minority of the interventions combined eHealth lifestyle interventions with face-to-face or telephone coaching, or wearables (blended care). We identified the use of different behavioral components (eg, social support) and technological components (eg, multimedia) in eHealth lifestyle interventions. Facilitators in the development included iterative design, working with different disciplines, and resonating intervention content with users. Facilitators for intervention reach were use of a personal approach and social network, reminders, and self-monitoring. Nevertheless, barriers, such as technological challenges for developers and limited financial resources, may hinder intervention development. Furthermore, passive recruitment was a barrier to intervention reach. Technical difficulties and the use of self-monitoring devices were common barriers for users of eHealth interventions. Only limited data on barriers and facilitators for intervention implementation and evaluation were available. While we found large variations among studies regarding key intervention components, and barriers and facilitators, certain factors may be beneficial in building and using eHealth interventions and reaching people with a low SES. Barriers and facilitators offer promising elements that eHealth developers can use as a toolbox to connect eHealth with low SES individuals. Our findings suggest that one-size-fits-all eHealth interventions may be less suitable for people with a low SES. Future research should investigate how to customize eHealth lifestyle interventions to meet the needs of different low SES groups, and should identify the components that enhance their reach, use, and effectiveness.