Mindfulness-Based Stress Reduction Versus a Health Enhancement Program in the Treatment of Urge Urinary Incontinence in Older Adult Women: A Randomized Controlled Feasibility Study
Current treatment practices for older adult women with urge urinary incontinence (UUI) remain insufficient and ineffective. A randomized controlled feasibility trial was developed to evaluate three determinants of research feasibility and three determinants of intervention feasibility when comparing mindfulness-based stress reduction (MBSR) with a health enhancement program (HEP) in older adult women with UUI. Participants were recruited from the university health system, county senior centers, and community sites. Twenty-five postmenopausal women (mean age = 74 years) were randomized into MBSR treatment conditions or HEP comparison conditions for an 8-week intervention. Participants remained blinded to conditions. Research feasibility determinants were measured as recruitment, retention, and treatment delivery; intervention feasibility determinants were measured as acceptability, tolerability, and client receipt/enactment. Feasibility determinants established in the research literature as essential to intervention evaluation were recorded and evaluated throughout the current study. All six feasibility determinants confirmed positive results in the enrolled population. The use of MBSR and HEP as the active comparison to treat UUI in older adult women proved feasible in this trial. The results warrant the design of a larger-scale, multisite trial to study the efficacy of MBSR in treating UUI in older adult women.
A Culturally Informed Systematic Review of Mental Health Disparities Among Adult Indigenous Men and Women of the USA: What is known?
Related to a broader context of historical oppression, Indigenous peoples of the USA are overburdened with the mental health challenges that social workers tend to treat, including post-traumatic stress disorder (PTSD), depression, suicide and substance use disorders (SUD). The purpose of this systematic review is to use the Framework of Historical Oppression, Resilience and Transcendence (FHORT) to identify empirical research on risk and protective factors related to mental health and SUD amongst these populations. This systematic review includes peer-reviewed quantitative and qualitative research articles from 1980 to 2017 focusing on the mental health of US Indigenous adults. A total of thirty-eight peer-reviewed empirical articles met inclusion criteria. Results reveal adults within Indigenous populations are at a high risk for mental health outcomes, including PTSD, depression, suicide, SUD and comorbidity across these outcomes. Underlying risk factors across outcomes included historical oppression and loss, family problems and SUD. Protective factors tended to include family and social support and engagement with tribal cultural activities. Significant variability was identified based on gender and geographic regions. Given that protective factors tended to include cultural, familial and community tenets, holistic approaches are the most promising programmes for social workers to work towards.
Harsh physical punishment as a mediator between income, re-reports and out-of-home placement in a child protective services-involved population
Poverty is consistently associated with a higher risk of experiencing child maltreatment, and children from poor families are the majority of children involved in child protective services (CPS). However, the mediators in the relationship from income to CPS involvement are not entirely understood. Using theoretically-informed mediating path models and data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), this study tests the role of harsh physical punishment as a mediator between family income and CPS involvement. CPS involvement was measured by subsequent report of maltreatment and removal to out-of-home care. The direct paths from income to re-report and to removal were significant; with higher income associated with lower risk of report and removal. Lower income was significantly associated with higher rates of harsh physical punishment. However, harsh punishment did not mediate the relationship between income and the outcomes. These results suggest that even within a population primarily comprised of low-income families, lower income is a risk for subsequent reports and removals as well as a risk for higher rates of harsh physical punishment. However, in this sample harsh physical punishment is not the mechanism that results in higher subsequent-reports or removal rates.
The influence of peer and parental norms on first-generation college students’ binge drinking trajectories
First-generation college students are those whose parents have not completed a four-year college degree. The current study addressed the lack of research on first-generation college students’ alcohol use by comparing the binge drinking trajectories of first-generation and continuing-generation students over their first three semesters. The dynamic influence of peer and parental social norms on students’ binge drinking frequencies were also examined.1342 college students (n = 225 first-generation) at one private University completed online surveys. Group differences were examined at Time 1, and latent growth-curve models tested the association between first-generation status and social norms (peer descriptive, peer injunctive, parental injunctive) on binge drinking trajectories. Overall, binge drinking frequency tended to decline over the first three semesters of college. After controlling for demographics, substance-free dormitory residence, parental alcohol problems and norms, first-generation status was associated with steeper declines in binge drinking frequency. During the first semester, the association between parental injunctive norms and binge drinking frequency was stronger for first-generation students than for continuing-generation students; this influence declined over time for first-generation students. The influence of peer descriptive norms on binge drinking increased for continuing-generation students; while this influence remained stable over time for first-generation students. First-generation student status appears to be protective against binge drinking. Substance-free dormitory residence, and perceived parental and peer norms likely play a role in first-generation students’ tendency to engage in binge drinking less often over the first year of college.
Multimorbidity and healthcare utilization among early survivors of pediatric cancer
Early survivors of pediatric cancer are at increased risk of experiencing chronic conditions; however, little is known about the morbidity burden in this population. In this observational cohort study of commercially insured pediatric cancer survivors in the United States (2009-2014), we find that 22.5% of survivors had one chronic condition, and 36.3% had multiple. Compared with survivors without chronic conditions, the presence of multiple conditions significantly increased the odds of an emergency department visit by 70% (odds ratios [OR], 1.7; 95% confidence interval [CI], 1.4-2.1) and of a hospitalization almost four-fold (OR, 3.8; 95% CI], 2.5-5.5). Findings are important for informing pediatric survivorship care plans in the years following completion of therapy.
Challenges in health-care service use among Burmese refugees: A grounded theory approach
The timely use of health-care services is essential to achieve the best health outcomes. We explore barriers to health-care access among refugees from Burma through interviews with key community informants who serve their community as interpreters, health-care professionals, paraprofessionals, and/or representatives. The interviews with a convenience sampling of 11 leaders from Burmese and Karen ethnic communities revealed three stages of health-care use (i.e., before, during, and after doctor’s appointments), in which their community members encounter difficulties in accessing health-care services. Using grounded theory analysis approach, specific difficulties and cultural considerations for each stage were emerged. This study suggests that training programs for health-care providers on refugee populations’ needs, cultural expectations, attitudes, and health behaviors may ease the process for refugees during each of these three stages. Interpreters as cultural brokers have an important role in facilitating cross-cultural communications not only before and during the appointment but also after doctor’s visits, such as in the pharmacy and labs.
Effectiveness of the Adolescent Depression Awareness Program (ADAP) on Depression Literacy and Mental Health Treatment
BACKGROUND: Analysis of data from a NIMH‐supported study was conducted to evaluate the effectiveness of the Adolescent Depression Awareness Program (ADAP) in promoting depression literacy and help‐seeking behavior. METHODS: Eighteen Pennsylvania schools were matched on size, sex, race, test scores, median income, and free/reduced lunch status. Schools randomized to the intervention implemented ADAP as a compulsory part of the schools health curriculum, while control schools collected study measures. RESULTS: Post‐randomization analysis revealed no significant differences by sex on the pre‐assessments between intervention and control schools. In the intervention schools, a total of 1427 students received ADAP. Written parental consent and adolescent assent was obtained from 33.7% students. The online REDCap survey was completed by 41.78% of the consenting students. The Adolescent Depression Knowledge Questionnaire (ADKQ) findings suggest that ADAP significantly improved depression knowledge (Est. =1.07, SE =.25, p < .001), compared to those in the control group. ADAP was found to facilitate help‐seeking behavior by student report in those participating in the REDCap survey 4 months following the ADAP curriculum. CONCLUSIONS: Results of the survey suggests that ADAP facilitates help‐seeking behaviors in teens. This study supports the efficacy of a teacher delivered school‐based universal prevention program, ADAP, on depression literacy
Bridging mental health and criminal justice systems: A systematic review of the impact of mental health courts on individuals and communities
Existing reviews of mental health courts summarize the effectiveness of these programs without consideration of the component parts of the mental health court and who the court serves. This systematic review addresses this gap by using specific criteria for what constitutes a mental health court and presents results based on the charge type for the target population. Only experimental or quasi-experimental research designs are included in this review. Studies included involved mental health courts containing essential elements and included measures of recidivism or other mental health and quality of life-related outcomes. Twenty-nine articles were reviewed. Research on mental health courts primarily originated in the Unites States, covering 14 states. Findings are synthesized by whether the courts served people with felony, misdemeanor, or combination charges. These findings inform the need for national or international standards or clear guidelines for what components or elements define a mental health court. State-level policy is also needed to encourage the systematic collection of data on mental health courts to inform who mental health courts work for in specific communities. These data can also be used to inform local mental health court policy decisions.
Observed communication and relationship quality in female same-gender couples
Relationship interventions typically focus on reducing destructive communication patterns between partners. However, a dearth of research exists regarding communication dynamics within female same-gender (FSG) couples. The current study sought to expand basic science on communication dynamics within FSG couples with the overarching goal of informing relationship interventions. Participants included 102 adult FSG couples who provided self-report data and participated in observational communication tasks. Actor–partner interdependence models (Kenny, Kashy, & Cook, 2006) were used for analyses predicting relationship adjustment, dedication, and psychological aggression. Findings suggest that actors’ negative and positive communication patterns were associated with relationship quality outcomes. Negative communication demonstrated stronger associations with relationship quality and psychological aggression compared with positive communication, and partner’s positive communication was associated with psychological aggression. Overall, results suggest that communication processes traditionally addressed by relationship interventions would likely be beneficial to focus on with FSG couples. Clinical implications are discussed, including how to incorporate cultural competence into relationship interventions for FSG couples.
Mobile Health Interventions for Traumatic Brain Injuries
Mobile health (mHealth) interventions may be useful for individuals with traumatic brain injury (TBI), but there is minimal knowledge regarding how mHealth technology is currently being used for TBI treatment or rehabilitation. The purpose of this review is to examine the extant literature on the use of mHealth for intervention delivery in order to identify considerations for using mHealth with the TBI population, and to provide recommendations for further study. Recent Findings: Consistent with recent literature in other disability populations, mHealth shows promise for people with TBI as a compensatory strategy for cognitive impairment, a method for monitoring and reducing symptoms, and a means of addressing goals in social and educational spheres. Summary: In this review article, we summarize the results of 16 articles on mHealth interventions for individuals with TBI, highlighting relevant findings for clinical application and discussing challenges unique to the use of mHealh post-TBI.
Child Protective Service Referrals Involving Exposure to Domestic Violence: Prevalence, Associated Maltreatment Types, and Likelihood of Formal Case Openings
Childhood exposure to domestic violence (CEDV) is widely understood as potentially harmful to children. Accordingly, many child welfare systems in the United States construe CEDV as maltreatment when the exposure results in harm or threatened harm to the child. The purpose of the current study was to investigate substantiated child welfare referrals directly related to CEDV to better understand the prevalence and patterns of CEDV-related maltreatment and how child welfare workers respond under the “harm or threatened harm” standard. Data were drawn from 23,704 substantiated referrals between 2009 and 2013 in a large Midwestern child welfare system. Approximately 20% of substantiated referrals were CEDV related. A plurality of CEDV-related referrals included both a male caregiver and female caregiver who were co-substantiated for maltreatment. The most common maltreatment types substantiated for these referrals were neglect based rather than abuse based, and just under a quarter (23%) of CEDV-related referrals were formally opened for services. Referrals involving co-occurring substance abuse were most likely to be opened for services based on predicted probabilities derived from multilevel modeling. Implications for policy and practice are considered.
Community-Based, Caregiver-Implemented Early Language Intervention in High-Risk Families: Lessons Learned
High-quality, early caregiver-child interaction facilitates language, cognitive, and health outcomes. Children in low socioeconomic status households experience less frequent and lower-quality language interactions on average than their middle to high socioeconomic status peers. Early caregiver-implemented intervention may help to improve outcomes for these children. This article describes how we used community-based participatory research (CBPR) to develop and implement a community-based, caregiver-implemented early language intervention, including the challenges, solutions, and lessons learned in the process of CBPR. We adopted an ethnographic approach to document and analyze our CBPR experiences in multiple phases of the project, including intervention design, training, implementation, and evaluation. Developing the CBPR partnership, co-designing and implementing the study, and managing systems- level concerns like obtaining funding were central challenges for the researcher-community team. The CBPR model enhances early language intervention research by facilitating understanding of families in underserved communities and increasing the cultural relevancy of intervention materials.
Physical Education Class and Body Image Perception: Are They Related?
In this study, we examine if school physical education (PE) policy initiatives are related to body image among adolescents. Problems with body image often peak during adolescence, and it is important that there are ways of improving body image among youth. This cross-sectional study used data from the Health Behavior in School-Aged Children 2001–2002 survey and examined the relationship between PE (requiring PE, number of days spent in PE, and number of minutes spent exercising in PE) and both perceived body size and perceived attractiveness. Regression analyses were conducted with the three PE variables predicting perceived body size and perceived attractiveness. Among boys, requiring PE and the number of minutes spent exercising in PE were negatively related to body size perception. Among girls, number of days in PE and number of minutes spent exercising were negatively related to body size perception. The number of days spent in PE and the number of minutes spent exercising in PE were positively related to perceived attractiveness among boys, while requiring PE was negatively associated with perceived attractiveness among girls. Based on the results of this study, PE may be an important and cost-effective way of reducing negative body image among adolescents, although special consideration may be needed for reducing negative perceived attractiveness among girls. Therefore, school policy implications are discussed. Expanding school programs that promote physical activity, such as PE class, may be a great way of improving body image for a large number of students.
Local-level, place-based scholarships: a review of the literature
Local-level, place-based scholarships – synonymous with “promise” scholarships – are a policy strategy to improve college completion in the United States by directing financial aid to students in a particular school, district, or geographical area. There are currently upwards of 90 place-based scholarship programs across the US, most of which share three broad goals: to increase postsecondary access by making college more affordable, to build a college-going culture, and to catalyse economic development by drawing middle- and upper-class families to an area and retaining existing residents. As place-based scholarships grow in popularity and more communities, especially ones seeking economic revitalisation, consider investing resources in their own scholarships, there is interest in what impact, if any, these programs have. This paper reviews the research on place-based scholarships, which demonstrates generally positive effects on district enrolment, postsecondary enrolment and persistence, and housing prices. While there is some evidence of improvement in teacher expectations and school climate, the scholarships have not been associated with fundamental changes inside schools. Although most programs have not been empirically studied, the 33 studies included in this review indicate that place-based scholarships have the potential to foster change within school districts and struggling cities and promote positive student outcomes.
Opening the Black Box: Identifying Common Practice Approaches in Urban and Rural Rape Crisis Centers
This study sought to open the black box of services at rape crisis centers (RCCs), particularly related to counseling, to better understand what is available to survivors in urban and rural settings. Findings from a survey of directors and counselors in Texas RCCs reveal a number of strengths: supporting services for survivors of sexual assault and insights that can help to further advance the implementation of evidence-based trauma treatments in this sector. Although many areas of congruence were found between urban and rural settings, differences were noted that have implications for implementation of evidence-based trauma treatments.
Coping and culture: The protective effects of shift-&-persist and ethnic-racial identity on depressive symptoms in Latinx youth
Shift-&-persist is a coping strategy that has been shown to lead to positive health outcomes in low-SES youth but has not yet been examined with respect to psychological health. This study tests whether the shift-&-persist coping strategy works in tandem with ethnic-racial identity to protect against depressive symptoms in the face of two uncontrollable stressors: economic hardship and peer discrimination. In a sample of 175 Latinx youth (51.4% female; Mage = 12.9), shift-&-persist buffered the positive relation between economic hardship and depressive symptoms. In terms of peer discrimination, among youth who reported little use of shift and persist, discrimination was related to higher depressive symptoms, whereas youth who reported higher amounts of shift and persist (at and above the mean) were protected and did not evidence this association. However, among youth with high ethnic-racial identity, shift-&-persist failed to protect against the deleterious association between peer discrimination and depressive symptoms. These findings suggest that shift-&-persist is protective for Latinx youth, although the context in which it is protective changes based on the racialized/non-racialized nature of the stressor.
Understanding the Relationship Between Staff and Job Satisfaction, Stress, Turnover, and Staff Outcomes in the Person‐Centered Care Nursing Home Arena
Background: The provision of quality care in nursing home (NH) facilities is an ongoing challenge, and the literature indicates that the quality of care (QOC) is often suboptimal. While it is highly recommended that NH facilities adopt a culture of person‐centered care (PCC) to ensure quality care, the outcomes of this shift on staff working in NH settings has not been well studied. The purpose of this article was to understand the theoretical relationship between staff and job satisfaction, stress, turnover, and staff outcomes in PCC NH settings, by utilizing Cohen‐Mansfield’s (1995) comprehensive occupational stress model. Methods: An integrative review of the electronic databases of research published in English between 2000 and 2015 was conducted. Results: A review of 11 papers suggested that job satisfaction in the nursing workforce is positively related to consistency in QOC delivery and increased quality of life among residents in NHs. Management support and PCC practices positively correlate with improved QOC, staff satisfaction, and staff retention. Conclusions: This review showed that PCC intervention and training representing the key concept of workplace resources has a positive impact on NH staff job stress and satisfaction. Clinical Relevance: Supporting the NH workforce through PCC training is essential for promoting job satisfaction and reducing job‐related stress as well as turnover, which in turn will improve QOC delivered to the residents living in NHs.
Banking for all: Why financial institutions need to offer supportive banking features
Financial institutions are missing out on an opportunity to effectively serve the millions of Americans who live with a mental health disability.1 According to the National Alliance on Mental Illness, approximately one in five adults in the U.S. experiences mental illness in a given year. For the 43.8 million of us who experience a mental health issue annually, financial situations can be more complicated than they are for the rest of the population.
Deconstructing racial essentialism in the classroom : The impact of social constructionist curricula on student diversity interaction
This study aims to examine how change in white college students’ beliefs about race over the course of a semester impacted their interactions with diverse others. While there is an increasing interest in understanding people’s beliefs about race, there has been limited research examining how people’s beliefs about race can and do change over time and how education can facilitate this change. White students (N = 98) at a predominantly white college completed a multidimensional racial essentialism measure and measures of both self-report and behavioral interactions with diversity, at the beginning and end of a semester. Multilevel modeling with time-varying predictors was used to examine how change in beliefs about race related to change in diversity interactions. The impact of racial essentialism on student diversity interaction varied considerably depending on the type of racial essentialism. Higher levels of speciation and genotypic essentialism at Time 1 were related to lower interaction with diversity at Time 2. Decreases in phenotypic essentialism were concurrent with increases in diversity interaction over the duration of the semester. For a subgroup of students enrolled in a race and diversity course, unexpectedly, decreases in genotypic essentialism were concurrent with decreases in diversity interaction. By using a multidimensional model of beliefs about race with a longitudinal assessment, this study contributes to our understanding of how specific components of beliefs about race change over time and how change in these beliefs occurs concurrently with students’ diverse interactions. The findings are discussed in relation to the impact of education on students’ peer interactions with diverse others, with specific implications for race and diversity pedagogy.
, Iron Cage or Paper Cage? The Interplay of Worker Characteristics and Organizational Policy in Shaping Unequal Responses to a Standardized Decision-Making Tool
Studies are largely optimistic about the ability of standardized procedures to constrain decision-makers’ biases and produce more equitable results across fields. However, work that embraces standardization as an equalizing force stands in contrast to research on standardization and street-level bureaucrats, which asserts that standardized procedures are not self-actuating and cannot be understood apart from the environments in which they are used. I examine how frontline workers vary in their approach to an actuarial-based tool intended to standardize judgments. In a highly controlled decision-making environment, child welfare workers whose racial and sex characteristics afford them higher status report subverting the tool; conversely, workers in the same position whose ascriptive characteristics yield them lower status in terms of race and sex describe following the rules. In an environment where the same tool is adopted only ceremonially, all workers experience decision-making as unconstrained, regardless of their ascriptive characteristics. This work fills gaps in knowledge about how social status and organizational context intersect to affect rule abidance. Examining these dynamic relationships advances understanding of how organizations reproduce inequality and the limits and potential for standardization to transform social hierarchies.