Co-occurring risk factors among U.S. high school students at risk for suicidal thoughts and behaviors
Background: Suicidal thoughts and behaviors (STBs) are increasing among adolescents in the United States and are challenging to predict and prevent. The current study identifies subtypes of youth at risk for suicidal thoughts and behaviors (STBs) in school-based settings. Method: Data are from the CDC’s 2015 and 2017 National Youth Risk Behavior Survey of US high school students. Among students reporting depression symptoms, latent class analysis is used to identify subtypes at risk for STBs based on personal characteristics, risk behaviors and environments. Results: Two distinct subtypes of youth were found to be at high risk for STBs: The first, larger subtype (22%) is predominately females in early high school, many of whom identify as bisexual, experienced past-year bullying, and are likely to have experienced sexual victimization. These students have low levels of externalizing risk behaviors making them difficult to detect. The second high-risk subtype (7%) is characterized by students with significant social integration challenges, with extremely high levels of substance abuse, fighting, physical and sexual victimization and poor academic performance. Many of these students have low English fluency, and identify as sexual minority. Limitations: Due to attrition or language barriers, experiences of some students at high-risk for STBs may not have been captured by this survey. Conclusion: Universal screening in clinical settings, and universally focused suicide prevention programs in school-based settings are needed and should be introduced early on. Interventions should be tailored to reach high-risk students with language, cultural and social integration challenges.
Utilizing Crisis Intervention Teams in Prison to Improve Officer Knowledge, Stigmatizing Attitudes, and Perception of Response Options
People with mental illness (MI) are overrepresented in prisons, in part, because people with MI stay in prison longer. Correctional officers (COs) use discretion in force, violations, and segregation. Crisis intervention teams (CITs) are being used in corrections to reduce disparities in sanctioning and improve safety. This quasi-experimental, mixed-methods study includes 235 CIT COs who were surveyed before and after training on knowledge of MI, stigmatizing attitudes, and perception of response options. Non-CIT (n = 599) officers completed the same survey. Randomly selected CIT COs completed interviews 6 to 9 months following training (n = 17). CIT COs had significantly lower stigmatizing attitudes, more mental health knowledge, and better perceptions of options following CIT training compared with non-CIT COs. This preliminary work on CIT use in prison is promising; additional work is needed to determine whether these changes result in behavior change among COs and improvements in outcomes for people with MI.
Characterizing the predictive validity of measures of susceptibility to future use of combustible, vaporized and edible cannabis products in adolescent never-users
Background and aims: The construct of susceptibility to substance use initiation (i.e. cognitive proclivity to future use) is critical for prevention efforts in adolescent populations. This study aimed to provide empirical evidence for the validity of the susceptibility construct for different cannabis products (i.e. combustible, edible or vaporized cannabis), and evaluate whether susceptibility measures are predictive of subsequent initiation. Design: Prospective cohort study including baseline data (Spring 2015) and four follow-up surveys administered every 6 months through Spring 2017. Setting: Ten schools in the Los Angeles, California metropolitan area. Participants: Adolescents [n = 2100; mean age = 16.1; standard deviation (SD) = 0.41; 54% female] who reported never having used any cannabis product at baseline.Measurements: We assessed five indices of a susceptibility to use cannabis composite index at baseline, adapted from a validated tobacco use index (intention to use, willingness, curiosity and positive/negative cannabis use outcome expectancies, with four response categories, definitely not  to definitely yes ), by cannabis product (combustible, edible or vaporized). A composite index was created for each product by averaging responses across the five susceptibility items. Subsequent initiation of use of each cannabis product was assessed at each follow-up wave. Findings: Factorial validity for unidimensionality for each five-item index (by product) was confirmed. The composite index for susceptibility to cannabis use was greatest for combustible (mean = 1.44; SD = 0.58), moderate for edible (mean = 1.37; SD = 0.53) and lowest for vaporized cannabis (mean = 1.30; SD = 0.44). The associations of each composite susceptibility index with subsequent initiation of that product and each of the other cannabis products over follow-up (i.e. cross-product associations) were statistically significant, with hazard ratios ranging from 2.30 to 2.80 across 24 months of follow-up (all Ps < 0.05). Conclusions: A five-item susceptibility to cannabis use composite index (by product) appears to be useful for characterizing and predicting youth at risk for cannabis use initiation across a spectrum of cannabis products.
Collective Threat: Conceptualizing Blumer’s Threat as a Collective Emotion
This manuscript lays the groundwork for considering racial threat as a collective emotion. Although sociologists regularly study racial threat, a disconnect exists between Blumer’s theoretical framework (1958) and modern empirical measurement. Research has largely measured racial threat as perceptions of competition or increases in racism. Neither, however, squarely fits the symbolic interactionist framework that Blumer championed. This manuscript frames racial threat as an affective group response that is generated through sustained interaction with social groups and group representations. After showing how Blumer’s threat conceptualization fits the parameters of a collective emotion, I demonstrate how quantitative measurement and experimental research design can be used to capture threat as Blumer outlines it. Then, using factor analyses and regression, I illustrate that collective threat is distinct from other collective emotions and operates according to Blumer’s theoretical predictions. The manuscript concludes with a discussion of how ongoing attempts to measure collective threat and the evolution of racism in the United States highlight the continued relevance of Blumer’s work.
Putting Quality Metrics in Context: A Novel Index Approach to Measuring Inpatient Utilization
To determine the preliminary feasibility and reliability of a novel health plan‐level quality index reflecting multiple aspects of inpatient utilization currently measured by separate quality metrics. Analysis of three Healthcare Effectiveness Data and Information Set (HEDIS) measures: Acute Hospital Utilization (AHU), Hospitalizations for Potentially Preventable Conditions (HPC), and Plan All‐Cause Readmissions (PCR). Proportion of plans able to report these measures were examined within and between measurement years. Individual measure performance was scored on the observed‐to‐expected (O/E) ratio: O/E = 1 “as expected” (score of 0), O/E < 1 “better than expected” (score of +1), and O/E > 1 “worse than expected” (score of ‐1). Measure scores were summed to create an index (‐3 to +3). Performance variation was examined. Index unidimensionality and reliability were evaluated using coefficient omega (total and hierarchical) and explained common variance (ECV). Medicare Advantage (MA) plans reporting HEDIS in measurement years (MY) 2017 (505 plans) and 2018 (525 plans). To align reporting strata across the three metrics, analysis was restricted to beneficiaries age 65 and older. A majority of plans were able to report measures in both MY2017 and MY2018 (AHU: 67.0%, HPC: 65.7%, PCR: 60.7%). In MY2018, 71.4% of plans reported all three measures. The strongest correlation in O/E ratios was observed between AHU and HPC (Pearson: 0.29, Spearman: 0.64), the weakest between AHU and PCR (Pearson: 0.19, Spearman: 0.17). A moderate correlation was observed between PCR and HPC (Pearson: 0.31, Spearman: 0.36). “Better than expected” (+1) was the most common measure‐level score on AHU (48.0%) and HPC (51.4%). “As expected” (0) was the most common score (58.5%) on PCR. The most common index score was +2 (25.1%), and mean score was 0.3. HPC performance scores were most likely to contribute to an increased index score (52.4% of cases), and AHU performance was most likely to contribute to a decreased index score (42.1% of cases). PCR performance was as likely to increase (20.5%) as decrease (21.1%) the index score. When the original O/E ratio for each measure was retained, moderate‐to‐good reliability was observed. Omega hierarchical approached the minimum 0.50 threshold (0.49), and ECV met the 0.85 threshold for unidimensionality. Omega hierarchical decreased significantly (0.33), and ECV no longer achieved the 0.85 threshold when the composite was scored as an ordinal index (‐3 to +3). A composite inpatient utilization index is feasible and demonstrates meaningful variation. Index‐style scoring is useful for visualization and identification of trends; however, composite reliability is achieved only when original O/E ratios are maintained. Alternative scoring approaches should be examined. Inpatient utilization is a primary driver of health care costs and critical target for quality improvement. Current health plan accountability metrics focus on different components of utilization separately and may miss the relationships between them. Interventions to improve one metric may overlap into another, while over‐focusing on one aspect in isolation may lead to perverse incentives (eg, keeping total hospitalizations high to make readmission rates appear low). The proposed composite approach provides a more complete representation of inpatient care, improving transparency and accountability.
The Influence of Implicit Theories of Depression on Treatment-Relevant Attitudes
Implicit theories (beliefs about the malleability of self-relevant traits) of emotion are associated with various motivational and emotional responses. Less is known about implicit theories of depression. The present study examined the effects of a manipulation of implicit theories of depression on depression symptom severity, engagement in a self-help task, and treatment-relevant attitudes. Participants experiencing clinically significant levels of depression (N = 142) were randomly assigned to receive education about depression emphasizing either the malleability of depression (incremental condition) or depression as a chronic condition (entity condition). Participants subsequently completed a self-help task for depression. Symptom severity, stigma, prognostic pessimism, psychotherapy and antidepressant credibility, psychological flexibility, and time spent on the self-help task were assessed. Participants in the incremental condition endorsed a greater incremental theory of depression than did those in the entity condition. To the extent that the experimental condition was associated with the adoption of an incremental theory of depression, depression symptom severity and stigma decreased, and treatment-relevant attitudes were more favorable. The experimental condition had no effect on self-help task persistence. Presenting depression as malleable may be associated with more positive attitudes towards treatment, although the impact on actual treatment engagement warrants future investigation.
“Let Me Be Bill-free”: Consumer Debt in the Shadow of Incarceration
Low-income U.S. households are increasingly burdened by unaffordable debt, with profound long-term economic and health consequences. Households of color are disproportionately negatively affected. This article examines the nexus of this rising indebtedness and mass incarceration through the experiences of a particularly marginalized group, people with mental illness. Drawing on qualitative research with 31 individuals with mental illness and recent incarceration in the city of New Haven, Connecticut, we show how carceral institutions and predatory financial practices intersect to create complex entanglements for poor and vulnerable people. While a growing body of scholarship focuses on criminal justice fines and fees, we highlight other types of debt that add to the overall burden, describing how incarceration deepens people’s existing debts of poverty and adds new debts from in-prison costs and identity theft. After release, those debts complicate the search for housing, employment, and financial stability, leading to further debt, stressing social relationships and reproducing social and economic inequality. The experiences of people with mental illness illuminates structures of marginalization and disadvantage that affect many others involved with the criminal justice system.
The measurement of interpersonal interactions with continuous spatiotemporal data: Application to a study of the effects of resource competition on racial group interactions
We describe a sequential qualitative ➔ quantitative mixed-method procedure used to construct conceptually grounded quantitative metrics of interpersonal behavior from continuous spatiotemporal data. Metrics were developed from data collected during an experiment in which racially diverse participants interacted with self-resembling avatars at social events hosted in the virtual world Second Life. In the qualitative stage, the researchers conceptualized four distinct patterns of movement from overhead video recreations of participants interacting during the social events. In the quantitative stage, these patterns of movement were operationalized into metrics to reflect each type of observed interpersonal behavior. The metrics were normalized through a series of transformations, and construct validity was assessed through correlations with self-report measures of intergroup behavior. Finally, the metrics were applied to an analysis of the virtual-world study examining the influence of resource competition on racial group interactions. The findings contribute to our understanding of the influence of resource competition on Blacks’, Asians’, and Whites’ group dynamics. Applications of these metrics for the future of the psychological study of interpersonal behavior are discussed.
Intimate partner violence victimization among college students with disabilities: Prevalence, help-seeking, and the relationship between adverse childhood experiences and intimate partner violence victimization
Intimate partner violence (IPV) is a major public health issue. Almost one third of college students in the U.S. experience IPV victimization. However, existing studies have focused primarily on college students without disabilities with little to no attention to college students with disabilities. In addition, few studies have explored the patterns of help-seeking and the relationship between adverse childhood experiences (ACEs) and IPV victimization among college students with disabilities. This study aimed to explore the prevalence of IPV victimization, ACEs, and help-seeking, the patterns of survivors’ help-seeking behaviors, and the relationship between ACEs and IPV victimization. Data from a cross-sectional online survey, which was conducted with samples from six universities in the U.S. and Canada (N = 3,308) between March 2016 and June 2017, were used. Descriptive bivariate and multivariate regression analyses were performed. The results show clear evidence that compared to college students without disabilities, college students with disabilities experienced higher rates of IPV victimization and ACEs. In addition, 42% of the survivors with disabilities sought some sort of support and they sought more formal support than their counterparts without disabilities. Furthermore, the associations between ACEs and IPV victimization among college students with disabilities were substantial after controlling for other risk factors. Specific, targeted university policies and programs as well as increased investment in programs that prevent ACEs are urgently needed to reduce violence against college students with disabilities.
Youth involvement in food preparation practices at home: A multi-method exploration of Latinx youth experiences and perspectives
Youth are frequently involved in preparing meals for themselves and family members. Latinx youth may be more likely to be involved in food preparation compared to youth from other ethnic backgrounds. Involvement in food preparation has been linked to various positive health outcomes, such as better diet quality and higher self-esteem. However, little is known about how youth come to be involved in food preparation at home. In addition, previous research has failed to explore the perspectives of youth regarding their role in food preparation. The objective of the present study was to qualitatively explore the food preparation practices of youth from im/migrant Latinx families. A multi-method study consisting of participatory focus groups embedded within an ethnographic fieldwork period was conducted. Participatory focus groups with Latinx youth featured inclusive discussions and participatory techniques, such as draw-write-tell activities, photo-elicitation activities, a decision-making chart activity, and listing activities. Twenty-three youths ages 9–17 years participated in this study. A thematic analysis uncovered themes related to gender norm expectations, specific cooking skills bound by age and food type, and food preparation as an important household contribution. Findings illustrate the diverse experiences of Latinx youth in food preparation. The investigation of youth involvement in food preparation in the home environment may identify potential targets for obesity prevention and dietary health promotion.
Enhancing vocational training in corrections: A type 1 hybrid randomized controlled trial protocol for evaluating virtual reality job interview training among returning citizens preparing for community re-entry
The Michigan Department of Corrections operates the Vocational Villages, which are skilled trades training programs set within prisons that include an immersive educational community using virtual reality, robotics, and other technologies to develop employable trades. An enhancement to the Vocational Villages could be an evidence-based job interview training component. Recently, we conducted a series of randomized controlled trials funded by the National Institute of Mental Health to evaluate the efficacy of virtual reality job interview training (VR-JIT). The results suggested that the use of VR-JIT was associated with improved job interview skills and a greater likelihood of receiving job offers within 6 months. The primary goal of this study is to report on the protocol we developed to evaluate the effectiveness of VR-JIT at improving interview skills, increasing job offers, and reducing recidivism when delivered within two Vocational Villages via a randomized controlled trial and process evaluation. Our aims are to: (1) evaluate whether services-as-usual in combination with VR-JIT, compared to services-as-usual alone, enhances employment outcomes and reduces recidivism among returning citizens enrolled in the Vocational Villages; (2) evaluate mechanisms of employment outcomes and explore mechanisms of recidivism; and (3) conduct a multilevel, mixed-method process evaluation of VR-JIT implementation to assess the adoptability, acceptability, scalability, feasibility, and implementation costs of VR-JIT.
Measuring the ‘dose’ of person‐centred care in aged care: Development of staff and family questionnaires
Aims: To develop a theoretically and psychometrically sound instrument to measure the ‘dose’ of person‐centred care practice in long‐term care. Background: Although person‐centred care has been adopted for long‐term care across the world, there is a lack of theory‐based instruments to measure its impact. Two questionnaires were developed to measure person‐centred care from the perspectives of staff and family based on current person‐centred care frameworks: Kitwood, Nolan, and Eden Alternative. Methods: Phase I: literature review and focus groups identified potential items for the questionnaires. Phase II: academic experts, local staff, and family members of residents assessed content validity. Phase III: psychometric testing. Results: A 34‐item staff questionnaire (Cronbach’s Alpha = 0.942) with two factors “Making person‐centredness real” and “Making the environment meaningful for life and work”. A 30‐item family questionnaire (Cronbach’s Alpha = 0.947), with three factors “Staff care about what is meaningful to my family member”, “Staff know and respect my family member”, and “We are all part of a family”. The factors did not directly reflect the theoretical constructs from Kitwood’s and Nolan’s work. Conclusion: Two instruments, capturing the ‘dose’ or active practice of delivering person‐centred care, have demonstrated sound psychometric properties. The study contributes to understanding the theoretical components of person‐centred care. Impact: The study addressed the lack of robust tools to measure how much person‐centred care is taking place in aged care facilities. Staff and family questionnaires were produced based on strong theoretical foundations combining concepts of prominent person‐centred theories and rigorous psychometric testing. The instruments can be used to determine if person‐centred care makes a difference, to compare if person‐centred care changes or develops over time or between facilities. Ultimately residents, families, and staff will benefit from the ability to measure how much person‐centred care residents receive.
Consensus Parameter: Research Methodologies to Evaluate Neurodevelopmental Effects of Pubertal Suppression in Transgender Youth
Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment. Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were included in the consensus parameter. Results: The Delphi procedure identified 160 initial expert recommendations, 44 of which ultimately achieved consensus. Consensus study design elements include the following: a minimum of three measurement time points, pubertal staging at baseline, statistical modeling of sex in analyses, use of analytic approaches that account for heterogeneity, and use of multiple comparison groups to minimize the limitations of any one group. Consensus study comparison groups include untreated transgender youth matched on pubertal stage, cisgender (i.e., gender congruent) youth matched on pubertal stage, and an independent sample from a large-scale youth development database. The consensus domains for assessment includes: mental health, executive function/cognitive control, and social awareness/functioning. Conclusion: An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.
Occupational therapists need to be involved in developing and evaluating technological solutions to support remote working
COVID-19 has led to increased remote working for occupational therapists and other health and social care professionals. Despite the rapid move to video consultations during COVID, the impact and implications of remote working still need consideration. Prior to COVID, digitisation was already recognised as essential, given the demands on health and social care (NHS, 2019). The National Health Service (NHS) long-term plan pledged to make digitally enabled care mainstream within the next decade (NHS, 2019). Technological innovation has the potential to improve care quality and cost savings across health and social care (Maguire et al., 2018). Allied health professionals (AHPs) have been urged to lead digital health innovations and use new technologies for patient benefit (NHS England, 2019). Video consultations had already emerged as a service model, with potential for improved efficiency and patient experiences (Greenhalgh et al., 2018a).
Sleep coach intervention for teens with type 1 diabetes: Randomized pilot study
Teens with type 1 diabetes (T1D) experience increased sleep disturbances, which have been linked to problems with adherence and glycemic control. As such, sleep represents a novel target to improve outcomes in teens. To evaluate the feasibility, acceptability, and preliminary efficacy of a sleep-promoting intervention in teens with T1D. Teens aged 13 to 17 with T1D (n = 39) completed measures of sleep quality and diabetes management and wore actigraphs to obtain an objective measure of sleep. Hemoglobin A1C (HbA1c) was collected from medical records. Teens were randomized to Usual Care (n = 19) or the Sleep Coach intervention (n = 20). Teens in the Sleep Coach group received educational materials on healthy sleep habits and completed three individual telephone sessions. Follow-up data were collected at 3 months, including exit interviews with teens and parents. Feasibility of the study was excellent; 80% of teens in the Sleep Coach group completed all three sessions, and retention was high (90%). Based on actigraphy data, a significant improvement in sleep efficiency and sleep duration was observed (48-minute increase) among teens randomized to the Sleep Coach intervention, and teens in the control group were 7.5 times more likely to report poor sleep quality after 3 months than intervention participants. No change in HbA1c was observed. The Sleep Coach intervention for teens with T1D is a feasible and acceptable program that increased sleep duration and improved sleep quality for this high-risk population.
The mediating role of child-teacher dependency in the association between early mother-child attachment and behavior problems in middle childhood
This study examines child-teacher dependency in preschool as a pathway through which mother-child attachment is associated with children’s behavior problems across middle childhood. Data include direct assessments of attachment security and styles, teacher reports of child-teacher dependency, and maternal reports of behavior problems from the NICHD SECCYD (N = 769 children). Children with more secure attachments at 24 months were less likely to exhibit child-teacher dependency at 54 months. Children with ambivalent, controlling, or insecure/other attachments at 36 months had higher levels of child-teacher dependency at 54 months. Results from multi-level models showed that child-teacher dependency at 54 months was associated with higher levels of internalizing, but not externalizing, behavior problems across middle childhood. Child-teacher dependency partially mediated the association between insecure/other mother-child attachment and internalizing behaviors in middle childhood. Supporting preschool teachers to reduce child-teacher dependency may help ameliorate risk for internalizing behaviors posed by insecure/other attachment.
State Politics, Race, and “Welfare” as a Funding Stream: Cash Assistance Spending Under Temporary Assistance for Needy Families
Race and racism have long been identified as influences on state cash assistance policy under Temporary Assistance for Needy Families (TANF; “welfare” in the United States) and its predecessor programs. TANF is structured as a flexible block grant with a state contribution requirement and cash benefits now account for only about one‐quarter of all program expenditures. Both proportion of effort devoted to cash assistance and change over time since passage of the 1996 welfare reform law vary by state. In this article, I consider the relationship between prevalence of negative stereotyping of blacks among whites in a state and emphasis on cash assistance as a TANF expenditure priority from 1998 to 2013. I find that prevalence of stereotyping of blacks among whites is related to TANF cash assistance effort, while evidence that it is related to the rate of decline in cash assistance over time is ambiguous.
Academic Safety Planning: Intervening to Improve the Educational Outcomes of Collegiate Survivors of Interpersonal Violence
Demonstrated impacts of intimate partner violence (IPV) and sexual assault (SA) for college students include negative outcomes related to mental, physical, emotional, and academic well-being. As a result of increasing awareness of the long-standing epidemic of IPV and SA on college campuses, Institutions of Higher Education (IHEs) are expanding the services provided to survivors of IPV and SA, including campus-based advocacy services that are adapted from community models. Like community advocacy, campusbased advocacy services focus on empowerment, support, resource provision, and addressing safety needs. However, the unique context of higher education produces specific student-centered needs, including an increased focus on educational goals, academic accommodations, and safety planning. The current study seeks to shed new light on the specific foci and tasks of advocacy in the context of IHEs, related to what we call “academic safety planning,” and to highlight the experience of student service recipients utilizing these forms of advocacy. Thematic analysis of 48 qualitative interviews with advocates (n = 23) and service users (n = 25) from five programs at three universities was used to discover practices applied by campus-based advocates and to understand student-survivor needs and preferences within academic safety planning. Findings reveal the core components of academic safety planning, which are: (a) Advocating for emotional and physical safety in the university context, (b) Assessing and identifying needed academic accommodations, and (c) rebuilding connections and institutional trust at school. These interviews reveal that academic safety planning has the potential to enhance the academic outcomes of survivors, which in turn could lead to important improvements in long-term personal safety, wellbeing, and economic security for student-survivors.
Individual and Social Network Correlates of Sexual Health Communication Among Youth Experiencing Homelessness
Despite the potential for sexual health communication to be leveraged for HIV prevention among youth experiencing homelessness (YEH), there has yet to be a rigorous examination of individual and network or relational characteristics associated with sexual health communication in this group of young people. Cross-sectional survey and social network data from 1014 YEH aged 14–25 recruited in Los Angeles, California, were utilized to assess individual and network or relational characteristics associated with communication regarding condom use and HIV testing among YEH. Results suggest that social networks are key to understanding sexual health communication; YEH’s engagement in sexual health communication was significantly related to the composition of their networks. To increase testing and decrease new HIV cases, a prudent strategy would be to train existing social network members (e.g., staff members, home-based peers, or partners) as agents of change in naturally occurring social networks of YEH.
Using the Life Story Book With Mentally Alert Residents of Nursing Homes
Depression and lack of meaning in life (MIL) are common among residents of nursing homes (NHs) and contribute to a reduction in overall health and well-being. Life Story Book (LSB), a reminiscence intervention, is designed to provide a person with the opportunity to review their past and capture their life stories and photographs into a book. LSB has demonstrated positive outcomes for residents of NHs with dementia, yet little is known for residents without dementia. A switching replication design was used to examine the effects of LSB among 21 mentally alert residents from two NHs (NH-A and NH-B) in Houston, Texas. Participants in NH-A received three weeks of the LSB intervention, while NH-B received three weeks of care-as-usual; the intervention was then switched. The GDS-12R and the MIL questionnaire (MLQ) were used to measure depressive symptoms and MIL respectively. Participants from NH-A (n =11) and NH-B (n = 10) had a mean age of 75 years (SD =11.34); 81% female; 52% non-Hispanic white and 33% African American. Results from a one-way MANCOVA found no statistically significant difference on the GDS-12R and MLQ (F(3, 14) = 2.50, p = .102; Wilks’ Lambda = .652; η2 = .35). Further analyses comparing the pre-intervention and post-intervention scores for the entire sample (N =21) found a significant reduction in depressive symptoms (M = 2.67; SD = 2.52) and (M =1.67, SD = 2.29); (t (20) = 2.21, p = 0.039). The potential benefits of LSB for mentally alert residents of NHs warrants further research.