Browsing by Author "White, David"

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Challenges in the design, planning and implementation of trials evaluating group interventions
(2020-01-29)
Biggs, Katie
;
Hind, Daniel
;
Gossage-Worrall, Rebecca
;
Sprange, Kirsty
;
White, David
Background Group interventions are interventions delivered to groups of people rather than to individuals and are used in healthcare for mental health recovery, behaviour change, peer support, self-management and/or health education. Evaluating group interventions in randomised controlled trials (RCTs) presents trialists with a set of practical problems, which are not present in RCTs of one-to-one interventions and which may not be immediately obvious. Methods Case-based approach summarising Sheffield trials unit's experience in the design and implementation of five group interventions. We reviewed participant recruitment and attrition, facilitator training and attrition, attendance at the group sessions, group size and fidelity aspects across five RCTs. Results Median recruitment across the five trials was 3.2 (range 1.7-21.0) participants per site per month. Group intervention trials involve a delay in starting the intervention for some participants, until sufficient numbers are available to start a group. There was no evidence that the timing of consent, relative to randomisation, affected post-randomisation attrition which was a matter of concern for all trial teams. Group facilitator attrition was common in studies where facilitators were employed by the health system rather than the by the grant holder and led to the early closure of one trial; research sites responded by training 'back-up' and new facilitators. Trials specified that participants had to attend a median of 62.5% (range 16.7%-80%) of sessions, in order to receive a 'therapeutic dose'; a median of 76.7% (range 42.9%-97.8%) received a therapeutic dose. Across the five trials, 75.3% of all sessions went ahead without the pre-specified ideal group size. A variety of methods were used to assess the fidelity of group interventions at a group and individual level across the five trials. Conclusion This is the first paper to provide an empirical basis for planning group intervention trials. Investigators should expect delays/difficulties in recruiting groups of the optimal size, plan for both facilitator and participant attrition, and consider how group attendance and group size affects treatment fidelity.
Challenges in the design, planning and implementation of trials evaluating group interventions
(2019-10-01)
Biggs, Katie
;
Hind, Daniel
;
Gossage-Worrall, Rebecca
;
Sprange, Kirsty
;
White, David
Exposure assessment and engineering control strategies for airborne nanoparticles: an application to emissions from nanocomposite compounding processes
(2012-07-01)
Tsai, Candace S. -J.
;
White, David
;
Rodriguez, Henoc
;
Munoz, Christian E.
;
Huang, Cheng-Yu
"In this study, nanoalumina and nanoclay particles were compounded separately with ethylene vinyl acetate (EVA) polymer to produce nanocomposites using a twin-screw extruder to investigate exposure and effective controls. Nanoparticle exposures from compounding processes were elevated under some circumstances and were affected by many factors including inadequate ventilation, surrounding air flow, feeder type, feeding method, and nanoparticle type. Engineering controls such as improved ventilation and enclosure of releasing sources were applied to the process equipment to evaluate the effectiveness of control. The nanoparticle loading device was modified by installing a ventilated enclosure surrounding the loading chamber. Exposures were studied using designed controls for comparison which include three scenarios: (1) no isolation; (2) enclosed sources; and (3) enclosed sources and improved ventilation. Particle number concentrations for diameters from 5 to 20,000 nm measured by the Fast Mobility Particle Sizer and aerodynamic particle sizer were studied. Aerosol particles were sampled on transmission electron microscope grids to characterize particle composition and morphology. Measurements and samples were taken at the near-and far-field areas relative to releasing sources. Airborne particle concentrations were reduced significantly when using the feeder enclosure, and the concentrations were below the baseline when two sources were enclosed, and the ventilation was improved when using either nanoalumina or nanoclay as fillers."