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Bacher J, Stadler C, Unternaehrer E, Brunner D. Testing the effectiveness of the culturally adapted skills training START NOW to reduce mental health problems in adolescent refugees: study protocol for a randomized controlled trial. Front Public Health 2024; 12:1408026. [PMID: 38919921 PMCID: PMC11196762 DOI: 10.3389/fpubh.2024.1408026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/30/2024] [Indexed: 06/27/2024] Open
Abstract
Background Adolescent refugees are particularly vulnerable to mental health problems, as they experience many risk factors associated with their resettlement at crucial stages of their physical and emotional development. However, despite having a greater healthcare needs than others, they face significant barriers to accessing healthcare services. Therefore, this study aims to test the effectiveness of a low-threshold, culturally adapted version of the skills training START NOW - START NOW Adapted - in reducing mental health problems among adolescent refugees. Methods We will recruit 80 adolescent refugees (15-18 years) with symptoms of anxiety and depression or high perceived stress in Northwestern Switzerland. They will be randomly assigned to one of two study groups: an intervention group, receiving START NOW Adapted, and a control group, receiving treatment as usual (TAU). The intervention will last 10 weeks and will consist of one-hour sessions per week provided by a trained facilitator with the same cultural background, in the respective language. Assessments to collect depressive and anxious symptoms, perceived stress, social-ecological resilience, and emotion recognition abilities will be conducted pre-intervention, post-intervention (11 weeks later) and at the 3-month follow-up. Multilevel models will be computed with primary and secondary outcome measures as dependent variables. An effect of at least moderate size will be considered clinically relevant. Discussion This randomized controlled trial aims to investigate the effectiveness of a culturally adapted version of START NOW, providing valuable insights to improve current health promotion for adolescent refugees in Switzerland (or rather lack thereof). Ultimately, the effects of START NOW may facilitate integration and promote healthy development while decreasing costs associated with treating migration- or conflict-related trauma.Clinical trial registration: ClinicalTrials.gov, identifier: NCT06324864.
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Affiliation(s)
- Janine Bacher
- Child and Adolescent Psychiatric Research Department, University Psychiatric Clinics, University of Basel, Basel, Switzerland
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Butter S, Shevlin M, Gibson-Miller J, McBride O, Hartman TK, Bentall RP, Bennett K, Murphy J, Mason L, Martinez AP, Levita L. Psychological distress, wellbeing and resilience: modelling adolescent mental health profiles during the COVID-19 pandemic. DISCOVER MENTAL HEALTH 2024; 4:16. [PMID: 38780717 PMCID: PMC11116324 DOI: 10.1007/s44192-024-00071-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/21/2024] [Indexed: 05/25/2024]
Abstract
There has been concern about adolescent mental health during the pandemic. The current study examined adolescent mental health during the initial phase of the COVID-19 pandemic in the UK. Using indicator of psychological distress, wellbeing and resilience, latent profile analysis was used to identify homogeneous mental health groups among young people aged 13-24 (N = 1971). Multinomial logistic regression was then used to examine which sociodemographic and psychosocial variables predicted latent class membership. Four classes were found. The largest class (Class 1, 37.2%) was characterised by moderate symptomology and moderate wellbeing. Class 2 (34.2%) was characterised by low symptomology and high wellbeing, while Class 3 (25.4%) was characterised by moderate symptomology and high wellbeing. Finally, Class 4 was the smallest (3.2%) and was characterised by high symptomology and low wellbeing. Compared to the low symptomology, high wellbeing class, all other classes were associated with less social engagement with friends, poorer family functioning, greater somatic symptoms, and a less positive model of self. A number of unique associations between the classes and predictor variables were identified. Although around two-thirds of adolescents reported moderate-to-high symptomology, most of these individuals also reported concurrent moderate-to-high levels of wellbeing, reflecting resilience. Furthermore, these findings demonstrate how a more comprehensive picture of mental health can be gained through adopting a dual-continua conceptualisation of mental health that incorporates both pathology and well-being. In this way, at-risk youth can be identified and interventions and resources targeted appropriately.
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Affiliation(s)
- Sarah Butter
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | | | - Orla McBride
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, England
| | - Kate Bennett
- Department of Psychology, University of Liverpool, Liverpool, England
| | - Jamie Murphy
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, England
| | - Anton P Martinez
- Department of Psychology, University of Sheffield, Sheffield, England
| | - Liat Levita
- School of Psychology, University of Sussex, Falmer, England
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Withdrawal: Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation and White Mountain Apache Tribe During COVID-19. THE JOURNAL OF SCHOOL HEALTH 2024; 94:481. [PMID: 38225814 PMCID: PMC10987271 DOI: 10.1111/josh.13419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 01/17/2024]
Abstract
Withdrawal: 'Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation and White Mountain Apache Tribe During COVID-19' by Shannon Archuleta MPH, Joshuaa D. Allison-Burbank PhD, Allison Ingalls MPH, Renae Begay MPH, Ryan Grass BS, Francene Larzelere PhD, Vanessa Begaye BS, Lacey Howe BS, Alicia Tsosie BS, Angelina Phoebe Keryte BA, Emily E. Haroz PhD, J Sch Health 2024, 10.1111/josh.13419. The above article, published online on 15 January 2024 in Wiley Online Library (https://onlinelibrary.wiley.com/doi/full/10.1111/josh.13419) has been withdrawn by agreement between the authors, the journal's Editor in Chief, Michael W. Long, the American School Health Association and Wiley Periodicals LLC. The withdrawal has been agreed because consent for publication from one of the tribes participating in the study was pending at the time of publication.
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Ballard PJ, Arnold TJ, Vidrascu EM, Hernandez GC, Ozer E, Wolfson M, Lassiter R, Nayyar H, Daniel SS. Pathways to opioid use and implications for prevention: voices of young adults in recovery. Subst Abuse Treat Prev Policy 2024; 19:8. [PMID: 38238852 PMCID: PMC10795392 DOI: 10.1186/s13011-023-00584-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/24/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Opioid use remains a major public health issue, especially among young adults. Despite investment in harm reduction and supply-side strategies such as reducing overprescribing and safe medication disposal, little is known about demand-side issues, such as reasons for use and pathways to opioid use. Adolescents and young adults who struggle with opioid use disorder (OUD) are multifaceted individuals with varied individual histories, experiences, challenges, skills, relationships, and lives. METHODS To inform the development of prevention strategies that hold promise for addressing opioid use, this study employs brief structured surveys and semi-structured in-depth interviews with 30 young adults (ages 18-29; 19 female, 23 White, 16 from Suburban areas) in recovery from OUD. For survey data, we used descriptive statistics to summarize the means and variance of retrospectively reported risk and protective factors associated with opioid use. For in-depth interview data, we used a combination of thematic analysis and codebook approaches to generate common themes and experiences shared by participants. RESULTS Surveys revealed that the most endorsed risk factors pertained to emotions (emotional neglect and emotional abuse) followed by sexual abuse, physical abuse, and physical neglect. Themes generated from qualitative analyses reveal challenging experiences during adolescence, such as unaddressed mental health, social, and emotional needs, which were often reported as reasons for opioid initiation and use. Through surveys and interviews, we also identified positive assets, such as skills and social relationships that were present for many participants during adolescence. CONCLUSION Implications include the need for universal prevention strategies that include emotion-focused interventions and supports alongside current harm reduction and environmental strategies to regulate prescriptions; the potential utility of more emotion-focused items being included on screening tools; and more voices of young people in recovery.
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Affiliation(s)
- Parissa J Ballard
- Wake Forest University School of Medicine, 1920 West 1st St, Winston-Salem, NC, 27104, USA.
| | - Taylor J Arnold
- Wake Forest University School of Medicine, 1920 West 1st St, Winston-Salem, NC, 27104, USA
| | - Elena M Vidrascu
- Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Emily Ozer
- Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Mark Wolfson
- Department of Social Medicine, Population, and Public Health, University of California, Riverside, CA, 92521, USA
| | | | | | - Stephanie S Daniel
- Wake Forest University School of Medicine, 1920 West 1st St, Winston-Salem, NC, 27104, USA
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Marquez J, Francis-Hew L, Humphrey N. Protective factors for resilience in adolescence: analysis of a longitudinal dataset using the residuals approach. Child Adolesc Psychiatry Ment Health 2023; 17:140. [PMID: 38115137 PMCID: PMC10731682 DOI: 10.1186/s13034-023-00687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION The residuals approach, in which residual scores from regression models are used as a proxy for resilient functioning, offers great potential to increase understanding of resilience processes. However, its application in child and adolescent wellbeing research is limited to date. We use this approach to examine how adversity exposure impacts later wellbeing (life satisfaction, and internalising mental health difficulties) in the early-to-middle adolescence transition; whether gender and ethnic differences in resilience exist; which internal and external factors confer protective effects for resilience; and, whether the protective effect of these factors differs by gender and level of adversity exposure. METHOD Secondary analysis of the #BeeWell longitudinal data set (N = 12,130 adolescents, aged 12/13 at T1 and 13/14 at T2, representative of Greater Manchester, England) was undertaken, using a series of linear regressions to establish adversity indices for later wellbeing, before assessing the protective effects of internal and external factors on resilience. RESULTS Multiple adversity factors (e.g., home material deprivation, sexuality discrimination, bullying) were found to impact later wellbeing. Girls and white adolescents presented lower levels of resilience than their peers. Internal psychological factors (self-esteem, emotional regulation, optimism) consistently conferred the strongest protective effects, but behavioural/activity factors (physical activity, sleep) also contributed to resilience. Among external factors, friendships and peer support were the most salient. Physical activity yielded stronger protective effects among boys (compared to girls). Effects of protective factors were stronger among those at lower (compared to higher) levels of adversity exposure. CONCLUSION The residuals approach can make a considerable contribution to our understanding of the interplay between adversity exposure and access to protective factors in determining adolescent wellbeing outcomes. Moreover, its application provides clear implications for policy and practice in terms of prevention (of adversity exposure) and intervention (to facilitate resilience).
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Affiliation(s)
- Jose Marquez
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK.
| | - Louis Francis-Hew
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
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Al-Omari H, Aljawarneh Y, Alshoufi M. The Impact of COVID-19 Pandemic on Resilience of University Students in the United Arab Emirates: A Cross-Sectional Study. J Am Psychiatr Nurses Assoc 2023:10783903231212904. [PMID: 38031420 DOI: 10.1177/10783903231212904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND The outbreak of the novel Coronavirus pandemic resulted in a sudden change to the daily activities of individuals, including the academic institutions. University-level students are vulnerable to psychological health issues when faced with a large-scale crisis such as the coronavirus disease (COVID-19) pandemic; they need resilience to help them successfully manage and cope with changes. AIM The aim of this study was to examine the resilience and associated predictors among university students during the COVID-19 pandemic in the United Arab Emirates. METHODS This study employed a cross-sectional descriptive design to examine the levels of resilience and associated predictors of university students. No sampling criterion was set up and all active students from all programs were eligible to participate. A convenience sampling technique was employed for its practical feasibility and efficiency. The data were collected between February 2021 and May 2021. RESULTS A total of 2,085 students completed the study questionnaires. The mean score of total resilience among the students was 65.01 (±14.697), while the mean score for personal resilience and caregiver resilience was 38.08 (±8.675) and 26.92 (±6.694), respectively. Comparing total resilience, personal resilience, and caregiver resilience with students' Cumulative Grade Point Average level revealed a significant difference. The predictors of resilience include academic level and number of courses the students enrolled in. CONCLUSION Academic institutions need to support the establishment of resilience training programs to prepare students for any challenging time, such as the COVID-19 pandemic.
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Affiliation(s)
- Hasan Al-Omari
- Hasan Al-Omari, RN, MSN, ARNP, PhD, The Hashemite University, Zarqa, Jordan
| | - Yousef Aljawarneh
- Yousef Aljawarneh, RN, MSN, PhD, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
| | - Maha Alshoufi
- Maha Alshoufi, RN, MSN, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
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Urbański PK, Schroeder K, Nadolska A, Wilski M. Symptoms of depression and anxiety among Ukrainian children displaced to Poland following the outbreak of the Russo-Ukrainian war: Associations with coping strategies and resilience. Appl Psychol Health Well Being 2023. [PMID: 37974535 DOI: 10.1111/aphw.12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
This study sought to discern the association of resilience, coping, and contextual factors on depression and anxiety among Ukrainian children displaced to Poland following the Russo-Ukrainian war. A cross-sectional analysis was undertaken with 284 Ukrainian children, aged 11-15 years, relocated to Poland in 2022 due to the ongoing conflict. Participants were assessed using validated tools for anxiety, depression, resilience, and coping, alongside a study-specific questionnaire. Notable associations emerged between depression and variables including age (Mage = 12.04, 49% females), emotional coping, relational resilience, and significant loss, accounting for 39% of the variance (p < .001). Anxiety was intricately linked with heightened emotional coping and diminished problem-solving capabilities, accounting for notable variances (state: 32%, trait: 45%, p < .001). Resilience, particularly in relational contexts, and the experience of bereavement stood out as paramount determinants of mental health outcomes. Children's mental health in conflict zones is shaped by a convoluted interplay of individual and environmental factors. This study accentuates the pivotal role of relational resilience, bereavement, and coping mechanisms in modulating depression and anxiety amidst war-related adversities. It underscores the imperative for targeted interventions, fostering positive relationship frameworks, and enhancing adaptive coping mechanisms.
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Affiliation(s)
- Piotr Kazimierz Urbański
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Kingsley Schroeder
- Department of Psychology, Springfield College, Springfield, Massachusetts, USA
| | - Anna Nadolska
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
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Marquez J, Humphrey N, Black L, Cutts M, Khanna D. Gender and sexual identity-based inequalities in adolescent wellbeing: findings from the #BeeWell Study. BMC Public Health 2023; 23:2211. [PMID: 37946184 PMCID: PMC10636841 DOI: 10.1186/s12889-023-16992-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Gender and sexual minority adolescents experience greater symptoms of psychological distress than their peers, but little is known about broader aspects of their wellbeing. This study examines wellbeing inequalities relating to gender and sexual identity among adolescents from Greater Manchester in the United Kingdom. METHOD 37,978 adolescents (aged 12-15, attending 165 secondary schools) completed surveys of life satisfaction, positive and negative affect (hedonic framework); autonomy, self-esteem, optimism, and positive relationships (eudaimonic framework); and, symptoms of distress and mental wellbeing (complete state framework). Structural correlated factors models were used to assess gender and sexual identity wellbeing inequalities. RESULTS The magnitude of wellbeing inequalities pertaining to gender and sexual identity were routinely substantially greater than those concerning other characteristics (e.g., socio-economic disadvantage). Gender identity wellbeing inequalities followed a consistent pattern, with the largest disparities evident between gender diverse adolescents and boys. Sexual identity wellbeing inequalities also followed a consistent pattern, with the largest disparities evident between sexual minority youth (both gay/lesbian and bi/pansexual) and their heterosexual peers. Finally, variation was evident across wellbeing domains. For example, observed gender identity (boys vs. girls) and sexual identity (heterosexual vs. sexual minority) disparities were substantially greater for symptoms of distress than for mental wellbeing in the complete state model. CONCLUSIONS LGBTQ + adolescents experience lower wellbeing than their peers, and this is evident across a range of wellbeing domains. Accordingly, there is an urgent need for the prioritisation of improved prevention and intervention efforts that can better meet the needs of gender diverse and sexual minority youth, and future research should be conducted to improve understanding of the mechanisms underpinning the wellbeing inequalities observed.
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Affiliation(s)
- Jose Marquez
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK.
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Louise Black
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Megan Cutts
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Devi Khanna
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
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Giroletti T, Paterson-Young C. Contextualizing Resilience in Young People: The Use of Child and Youth Resilience Measure Revised and Interviews in a Mixed Method Approach. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2023; 20:981-1003. [PMID: 37605925 DOI: 10.1080/26408066.2023.2237505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
PURPOSE This paper seeks to understand the role of an innovative Employability Programme on developing the resilience of young people Not in Education Training or Employment (NEET). METHOD Through a mixed-method approach, this paper explores the individual, contextual, and social aspects that impact on individual resilience. Combining the Child and Youth Resilience Measure-Revised (CYRM-R) with qualitative interviews allows for the investigation of how context, relationships, and support shape young people's resilience offering a holistic approach. RESULTS The quantitative results reveal a significant association between higher levels of resilience and factors such as school attendance and living in areas with lower crime rates. Lower resilience is observed among individuals experiencing higher levels of deprivation. Qualitative findings shed light on the multifaceted nature of resilience, highlighting its connection to community and society (sub-themes: education and employment, external pressure, support and access to services) as well as individual and psychological aspects (sub-themes: managing stressful situations and bouncing back). DISCUSSION These findings emphasize that resilience is not a static or one-dimensional process dependent on a single factor, it is a dynamic and ongoing process influenced by multiple factors. The interactions between young people and families, friends, education providers, and other service providers play a crucial role in promoting resilience. CONCLUSION Overall, this research aids our understanding of how connections between all these levels can boost or limit individual resilience. It can help practitioners and policymakers understand how tailored activities, accounting for multiple aspects, are able to improve individual resilience.
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Affiliation(s)
- Toa Giroletti
- Institute for Social Innovation and Impact, University of Northampton, Northampton, UK
| | - Claire Paterson-Young
- Institute for Social Innovation and Impact, University of Northampton, Northampton, UK
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Hodgson C, Taylor-Piliae R, Rainbow J. Understanding the resilience of children living on an American Indian reservation: A mixed methods participatory study. J Adv Nurs 2023; 79:4411-4424. [PMID: 37350100 DOI: 10.1111/jan.15734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/29/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023]
Abstract
AIM To explore the resilience of children, six to thirteen years old, living on a Northern Plains American Indian Reservation using a situation specific nursing theory. BACKGROUND American Indian and Alaska Native children experience mental health inequities compared to their white peers, including substance use, suicide, depression, and anxiety. Resilience is a strength of children that can be leveraged to improve their mental health. DESIGN A parallel convergent mixed methods design. METHODS A community advisory board culturally adapted resilience instruments. During two weeks in summer 2022, forty-seven children/caregiver dyads completed surveys about the child's resilience. Descriptive statistics gave the scores of each child's personal, relational, and total resilience. A subset of 20 children participated in a semi-structured interview. RESULTS Children scored high on overall resilience, and higher on the relational subscale than the personal subscale. Caregiver survey scores were not significantly correlated with their child's scores and were higher than the children's scores. Qualitative coding revealed six themes of resilience. Integration of data showed a concordance and expansion of the quantitative data across themes. CONCLUSION The children reported high resilience supported by a strong ecosystem of relationships. Resilience, as explained through children's voices, corroborated with findings from the surveys. IMPLICATIONS FOR NURSING Findings will help nurses across sectors of primary, secondary, and tertiary care create resilience-enhancing interventions and prevent mental health crises in this community. IMPACT STATEMENT This findings from this study will inform local mental health interventions on the Reservation. The study provides a reproducible design to adapt to other Indigenous communities. PUBLIC CONTRIBUTION A community advisory board was a partner in every stage of the study. Children and caregivers participated in data collection. CONTRIBUTION TO THE WIDER CLINICAL COMMUNITY This research provides knowledge that will further social justice efforts within nursing to promote health equity across diverse populations.
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Affiliation(s)
| | | | - Jessica Rainbow
- College of Nursing, The University of Arizona, Tucson, Arizona, USA
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Wawrzynski SE, Cloyes KG, Arasteh K, Guo JW, Linder L, Reblin M, Alderfer MA. Online Experiences, Internet-Fostered Connection, Resilience, and Adjustment Among Adolescent Siblings of Children With Cancer. Cancer Nurs 2023:00002820-990000000-00172. [PMID: 37862436 PMCID: PMC11031615 DOI: 10.1097/ncc.0000000000001284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
BACKGROUND Pediatric cancer disrupts the lives of siblings in many ways, including physical separations from family and friends that increase risk for distress. Research suggests that siblings use technology and social media to connect with friends and family and seek social support and interaction. However, this may expose siblings to negative online experiences that can erode self-esteem, reducing resilience. OBJECTIVE This study explored the relationship between online experiences, internet-fostered connection, resilience, and psychosocial health among siblings of children with cancer. METHODS Participants included adolescent siblings (N = 81; aged 12-17 years) of children with cancer. Most were female (56.8%), and 50.6% represented racially or ethnically minoritized groups. Online experiences, social media use, resilience, and psychosocial health were self-reported and analyzed using structural equation modeling. RESULTS A majority of siblings reported moderate to severe posttraumatic stress symptoms (PTSSs) (59%) and elevated emotional and behavioral difficulties (EBDs) (53%). Experiencing more positive online experiences was associated with greater perceived connection to family and friends online, but not resilience, PTSSs, or EBDs. In contrast, higher negative online experience scores were significantly associated with more PTSSs and EBDs. In addition, the association between negative online experiences and EBDs was significantly mediated by a negative association between negative online experiences and resilience. CONCLUSIONS Although social media may be a valuable tool for helping siblings of children with cancer garner social support, negative online experiences may be detrimental to their adjustment. IMPLICATIONS FOR PRACTICE Efforts should be made to preserve and foster resilience among siblings who use social media for support.
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Affiliation(s)
- Sarah E Wawrzynski
- Author Affiliations: Center for Healthcare Delivery Science, Nemours Children's Hospital, Wilmington, Delaware (Drs Wawrzynski, Alderfer and Arasteh); Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (Dr Alderfer); College of Nursing, University of Utah (Drs Guo and Linder); and Primary Children's Hospital, Intermountain Health (Dr Linder); and Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, University of Utah (Dr Linder), Salt Lake City; College of Medicine, University of Vermont, Burlington (Dr Reblin); and School of Nursing, Oregon Health and Sciences University, Portland (Dr Cloyes)
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Altamirano J, Odero IA, Omollo M, Awuonda E, Ondeng’e K, Kang JL, Behl R, Ndivo R, Baiocchi M, Barsosio HC, Sarnquist CC. Understanding ART Adherence among Adolescent Girls and Young Women in Western Kenya: A Cross-Sectional Study of Barriers and Facilitators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6922. [PMID: 37887660 PMCID: PMC10606388 DOI: 10.3390/ijerph20206922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND HIV remains a leading cause of death for adolescent girls and young women (AGYW) in sub-Saharan Africa. This population has a high incidence of HIV and other comorbidities, such as experiencing violence, and low antiretroviral therapy (ART) adherence. To reach global HIV goals, data are needed on the specific adherence barriers for AGYW living with HIV, so interventions can be targeted effectively. METHODS Cross-sectional data were collected at urban and rural health facilities in and around Kisumu County, western Kenya, from January to June 2022, from AGYW 15-24 years of age who were living with HIV. Surveys included questions on intimate partner violence, mental health issues, food security, and orphanhood. Adherence was categorized using viral load testing where available and the Center for Adherence Support Evaluation (CASE) adherence index otherwise. Logistic regression was used to assess associations between potential explanatory variables and adherence. FINDINGS In total, 309 AGYW participated. AGYW with experiences of emotional violence (Odds Ratio [OR] = 1.94, 95% Confidence Interval [CI] = 1.03-3.66), moderate or severe depression (OR = 3.19, 95% CI = 1.47-6.94), and/or substance use (OR = 2.71, 95% CI = 1.24-5.92) had significantly higher odds of poor adherence when compared to AGYW without these respective experiences. Physical and sexual violence, food insecurity, and orphanhood were not associated with poor adherence in this cohort. INTERPRETATION Elucidating the risk factors associated with poor adherence among AGYW living with HIV allows us to identify potential targets for future interventions to improve ART adherence and HIV care outcomes. Mental health and violence prevention interventions, including combination interventions, may prove to be promising approaches.
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Affiliation(s)
- Jonathan Altamirano
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Isdorah A. Odero
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu 40100, Kenya; (I.A.O.); (M.O.); (E.A.); (K.O.); (R.N.); (H.C.B.)
| | - Mevis Omollo
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu 40100, Kenya; (I.A.O.); (M.O.); (E.A.); (K.O.); (R.N.); (H.C.B.)
| | - Eucabeth Awuonda
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu 40100, Kenya; (I.A.O.); (M.O.); (E.A.); (K.O.); (R.N.); (H.C.B.)
| | - Ken Ondeng’e
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu 40100, Kenya; (I.A.O.); (M.O.); (E.A.); (K.O.); (R.N.); (H.C.B.)
| | - Jennifer L. Kang
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; (J.L.K.); (R.B.); (C.C.S.)
| | - Rasika Behl
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; (J.L.K.); (R.B.); (C.C.S.)
| | - Richard Ndivo
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu 40100, Kenya; (I.A.O.); (M.O.); (E.A.); (K.O.); (R.N.); (H.C.B.)
| | - Michael Baiocchi
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Hellen C. Barsosio
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu 40100, Kenya; (I.A.O.); (M.O.); (E.A.); (K.O.); (R.N.); (H.C.B.)
| | - Clea C. Sarnquist
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; (J.L.K.); (R.B.); (C.C.S.)
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Bandeira M, Graham MA, Ebersöhn L. The significance of feeling safe for resilience of adolescents in sub-Saharan Africa. Front Psychol 2023; 14:1183748. [PMID: 37663363 PMCID: PMC10469746 DOI: 10.3389/fpsyg.2023.1183748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents. Methods Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health). Results This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique. Discussion The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.
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Affiliation(s)
- Monica Bandeira
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - Liesel Ebersöhn
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
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Haar K, El-Khani A, Lodi R, Molin V, Pelosi A, Yassine A, Campello G, Maalouf W. Assessing the Efficacy of a Brief Universal Family Skills Programme on Violence and Substance-Use Indicators in Youth in Trentino and Parma, Italy: Study Protocol for a Multi-Centre, Non-Blinded, Cluster-Randomised Controlled Trial (cRCT) of Family UNited. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6548. [PMID: 37623134 PMCID: PMC10454720 DOI: 10.3390/ijerph20166548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
Homes in which families are experiencing stressful and challenging circumstances can foster a social space that engenders violent behaviours in parents, inadequate childcare, and the exposure of children to criminal and antisocial behaviours at an early age in addition to many other negative social and health consequences throughout their development. Family Skills Training offers a combination of parenting knowledge, skill building, competency enhancement, and support to strengthen family protective factors, such as communication, trust, problem-solving skills, and conflict resolution. Through over a decade-long experience piloting evidence-based family skills packages globally, we developed a universal open-source family skills package, "Family UNited" (FU), designed for families with children aged 8 to 15 years living in low- and middle-income countries (LMIC). The current study aims to explore the efficacy, fidelity, and acceptability of FU in Trentino and Parma, Italy. We plan to conduct a multi-site, non-blinded, two-armed, cluster-randomised controlled trial to assess efficacy in 160 families: the intervention group receiving FU and the waitlist/control group only receiving FU after the completion of all data collection points. We will prospectively collect outcome data, assessing changes in parenting skills and family adjustment in caregivers, children's behaviour, resilience capacities, and attitudes towards peer violence. To assess programme delivery, fidelity, feasibility, and acceptability we will include an embedded process evaluation. This study aims to evaluate the improvement in parenting skills, child well-being, and family mental health after participation in FU, compared to no intervention. Even though this trial is to be conducted in a high-income country, such results complement the existing piloting experience in LMIC. with impact-related measures encouraging the adoption of such approaches globally and beyond the EU borders.
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Affiliation(s)
- Karin Haar
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Aala El-Khani
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Riccardo Lodi
- S.O.L.E. Italia, Strada Corte Delle Grazie 21, 43126 Parma, Italy;
| | - Valentina Molin
- Department of Sociology and Social Research, University of Trento, Via Tarter 2 Baselga di Piné, 30122 Trento, Italy;
| | - Annalisa Pelosi
- Neurosciences Unit, Department of Medicine and Surgery, University of Parma, Via Volturno 139, 43125 Parma, Italy;
| | - Ali Yassine
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Giovanna Campello
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Wadih Maalouf
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
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Chandrasekhar JL, Bowen AE, Heberlein E, Pyle E, Studts CR, Simon SL, Shomaker L, Kaar JL. Universal, School-Based Mental Health Program Implemented Among Racially and Ethnically Diverse Youth Yields Equitable Outcomes: Building Resilience for Healthy Kids. Community Ment Health J 2023; 59:1109-1117. [PMID: 36757609 PMCID: PMC10289906 DOI: 10.1007/s10597-023-01090-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023]
Abstract
Although suicide is a leading cause of mortality among racial and ethnic minority youth, limited data exists regarding the impact of school-based mental health interventions on these populations, specifically. A single-arm pragmatic trial design was utilized to evaluate the equity of outcomes of the universal, school-based mental health coaching intervention, Building Resilience for Healthy Kids. All sixth-grade students at an urban middle school were invited to participate. Students attended six weekly sessions with a health coach discussing goal setting and other resilience strategies. 285 students (86%) participated with 252 (88%) completing both pre- and post-intervention surveys. Students were a mean age of 11.4 years with 55% identifying as girls, 69% as White, 13% as a racial minority, and 18% as Hispanic. Racial minority students exhibited greater improvements in personal and total resilience compared to White students, controlling for baseline scores.
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Affiliation(s)
- Jessica L Chandrasekhar
- Division of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Erin Heberlein
- Children's Hospital Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Emily Pyle
- Children's Hospital Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Christina R Studts
- Division of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Stacey L Simon
- Division of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Lauren Shomaker
- Division of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Jill L Kaar
- Division of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
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Walsh BM, Grobbel H, Christ SL, Tichenor SE, Gerwin KL. Exploring the Relationship Between Resilience and the Adverse Impact of Stuttering in Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:2278-2295. [PMID: 37390495 PMCID: PMC10468119 DOI: 10.1044/2023_jslhr-23-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/22/2023] [Accepted: 04/05/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE People who stutter often experience significant adverse impact related to stuttering. However, it is unclear how adverse impact develops in children who stutter (CWS) and whether there are protective factors that may mitigate its development. This study examined the relationship between resilience, a potentially protective factor, and stuttering's adverse impact in CWS. Resilience comprises external factors, such as family support and access to resources as well as personal attributes, making it a comprehensive protective factor to explore. METHOD One hundred forty-eight CWS aged 5-18 years completed the age-appropriate version of the Child and Youth Resilience Measure (CYRM) and the Overall Assessment of the Speaker's Experience of Stuttering. Parents completed a caregiver version of the CYRM and a behavioral checklist for their child. The adverse impact of stuttering was modeled as a function of resilience (external, personal, and total), controlling for child age and behavioral checklist score. We also estimated correlations between child-report and parent-report CYRM measures to assess rater agreement. RESULTS Children reporting greater external, personal, or total resilience were more likely to experience lower degrees of adverse impact related to their stuttering. We documented stronger correlations between younger child and parent ratings of resilience and weaker correlations between older child and parent ratings. CONCLUSIONS These results yield valuable insight into the variability of adverse impact experienced by CWS and offer empirical support for strength-based speech therapy approaches. We discuss the factors that contribute to a child's resilience and provide practical suggestions for how clinicians can incorporate resilience-building strategies into intervention for children experiencing significant adverse impact from their stuttering. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23582172.
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Levante A, Martis C, Bianco F, Castelli I, Petrocchi S, Lecciso F. Internalizing and externalizing symptoms in children during the COVID-19 pandemic: a systematic mixed studies review. Front Psychol 2023; 14:1182309. [PMID: 37397311 PMCID: PMC10313408 DOI: 10.3389/fpsyg.2023.1182309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Given the vulnerability of children during the COVID-19 pandemic, paying close attention to their wellbeing at the time is warranted. The present protocol-based systematic mixed-studies review examines papers published during 2020-2022, focusing on the impact of the COVID-19 pandemic on children's internalizing/externalizing symptoms and the determinants thereof. Method PROSPERO: CRD42022385284. Five databases were searched and the PRISMA diagram was applied. The inclusion criteria were: papers published in English in peer-reviewed journals; papers published between January 2020 and October 2022 involving children aged 5-13 years; qualitative, quantitative, and mixed studies. The standardized Mixed Method Appraisal Tool protocol was used to appraise the quality of the studies. Results Thirty-four studies involving 40,976 participants in total were analyzed. Their principal characteristics were tabulated. The results showed that children's internalizing/externalizing symptoms increased during the pandemic, largely as a result of disengagement from play activities and excessive use of the internet. Girls showed more internalizing symptoms and boys more externalizing symptoms. Distress was the strongest parental factor mediating children's internalizing/externalizing symptoms. The quality of the studies was appraised as low (n = 12), medium (n = 12), and high (n = 10). Conclusion Gender-based interventions should be designed for children and parents. The studies reviewed were cross-sectional, so long-term patterns and outcomes could not be predicted. Future researchers might consider a longitudinal approach to determine the long-term effects of the pandemic on children's internalizing and externalizing symptoms. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022385284, identifier: CRD42022385284.
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Affiliation(s)
- Annalisa Levante
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Chiara Martis
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Federica Bianco
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Ilaria Castelli
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Serena Petrocchi
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Flavia Lecciso
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
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Iuzzini-Seigel J, Case J, Grigos MI, Velleman SL, Thomas D, Murray E. Dose frequency randomized controlled trial for Dynamic Temporal and Tactile Cueing (DTTC) treatment for childhood apraxia of speech: protocol paper. BMC Pediatr 2023; 23:263. [PMID: 37226208 DOI: 10.1186/s12887-023-04066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/10/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Childhood apraxia of speech (CAS) is a pediatric motor-based speech sound disorder that requires a specialized approach to intervention. The extant literature on the treatment of CAS commonly recommends intensive treatment using a motor-based approach, with some of the best evidence supporting the use of Dynamic Temporal and Tactile Cueing (DTTC). To date, a rigorous and systematic comparison of high and low dose frequency (i.e., frequency of therapy sessions) has not been undertaken for DTTC, resulting in a lack of evidence to guide decisions about the optimal treatment schedule for this intervention. The current study aims to fill this gap in knowledge by comparing treatment outcomes when dose frequency is varied. METHODS A randomized controlled trial will be conducted to examine the efficacy of low versus high dose frequency on DTTC treatment outcomes in children with CAS. A target of 60 children, 2;6-7;11 years of age, will be recruited to participate in this study. Treatment will be provided in the community setting by speech-language pathologists who have completed specialized training administering DTTC in a research reliable manner. True randomization with concealed allocation will be used to assign children to either the low or high dose frequency group. Treatment will be administered in 1-h sessions either 4 times per week over a 6-week period (high dose) or 2 times per week over a 12-week period (low dose). To measure treatment gains, probe data will be collected before treatment, during treatment, and 1 day, 1 week, 4 weeks, and 12 weeks post-treatment. Probe data will consist of customized treated words and a standard set of untreated words to assess generalization of treatment gains. The primary outcome variable will be whole word accuracy, encompassing segmental, phonotactic, and suprasegmental accuracy. DISCUSSION This will be the first randomized controlled trial to evaluate dose frequency for DTTC treatment in children with CAS. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT05675306, January 6, 2023.
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Affiliation(s)
- Jenya Iuzzini-Seigel
- Department of Speech Pathology and Audiology, Marquette University, PO Box 1881, Harriet Barker Cramer Hall, Milwaukee, WI, 53201, USA.
| | - Julie Case
- Speech-Language-Hearing Sciences, Hofstra University, Davison Hall 106B, 110, Hempstead, NY, 11549, USA
| | - Maria I Grigos
- Communicative Sciences and Disorders, New York University, 665 Broadway, 9th floor, New York, NY, 10012, USA
| | - Shelley L Velleman
- University of Vermont, Pomeroy Hall, 489 Main St, Burlington, VT, 05405, USA
| | - Donna Thomas
- University of Sydney, Susan Wakil Health Building, Western Avenue, Camperdown, NSW, 2006, Australia
| | - Elizabeth Murray
- University of Sydney, Susan Wakil Health Building, Western Avenue, Camperdown, NSW, 2006, Australia
- Remarkable Speech and Movement, 52 Anderson Avenue, Panania, NSW, 2213, Australia
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Cherewick M, Dahl RE, Rubin D, Leiferman JA, Njau PF. Psychometric validation of the collective asset Utu: associations with coping strategies and resilience during adolescence. Glob Health Res Policy 2023; 8:15. [PMID: 37198701 DOI: 10.1186/s41256-023-00303-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/07/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Utu is a Kiswahili term with a long history of cultural significance in Tanzania. It conveys a value system of shared, collective humanity. While variants of Utu have been studied in other contexts, a measure of Utu that captures this important collective asset has not been developed in Tanzania. The aims of this study were to (1) examine dimensional constructs that represent Utu, (2) validate a measurement scale of Utu for use with adolescents, (3) examine differences between orphan and non-orphan adolescents in self-reported Utu and, (4) examine structural paths between adverse life experiences, coping strategies, Utu, and resilience. METHODS: This study collected survey data from adolescents from three districts in peri-urban Tanzania in two samples: 189 orphan adolescents ages 10-17 in May 2020 and 333 non-orphan adolescents ages 10-14 in August 2020. Confirmatory factor analysis was used to validate the hypothesized factor structure of the developed Utu measure. Structural equation models were used to examine path associations with adverse life experiences, coping and resilience. RESULTS The five dimensional constructs comprising the Utu measure included Resource Sharing, Group Solidarity, Respect and Dignity, Collectivity, and Compassion. Confirmatory factor analysis of the Utu measure demonstrated excellent fit (CFI = 0.98; TLI = 0.97; SRMR = 0.024; RMSEA = 0.046) and internal consistency (α = 0.94) among adolescents in this study. Positive, significant associations were found between Utu and coping (β = 0.29, p < 0.001) and Utu and intra/interpersonal and collective resilience (β = 0.13, p < 0.014). Utu was not significantly associated with adverse life experiences, age or gender. CONCLUSIONS A five-dimensional measurement scale for Utu was validated in a sample of orphan and non-orphan adolescents in Tanzania. Utu is a collective asset associated with higher levels of reported resilience in both orphan and non-orphan adolescent populations in Tanzania. Promoting Utu may be an effective universal public health prevention approach. Implications for adolescent programming are discussed.
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Affiliation(s)
- Megan Cherewick
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, 13001 East 17th Place, Aurora, CO, 80045, USA.
| | - Ronald E Dahl
- Institute of Human Development, University of California Berkeley, 2121 Berkeley Way West, Berkeley, CA, 94720-1690, USA
| | - Daphna Rubin
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Jenn A Leiferman
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Prosper F Njau
- Health for a Prosperous Nation, P.O. Box 13650, Dar es Salaam, Tanzania
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Rava J, Hotez E, Halfon N. The role of social capital in resilience among adolescents with adverse family environments. Curr Probl Pediatr Adolesc Health Care 2023; 53:101436. [PMID: 37833122 DOI: 10.1016/j.cppeds.2023.101436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
The Life Course Health Development (LCHD) framework underscores the profound impact of stressors during critical developmental phases on an individual's lifelong health, including their mental well-being. Among these developmental transitions, adolescence emerges as a pivotal life stage where an adolescent's mental health trajectory is significantly influenced by the various risk and promotive factors embedded within their social ecosystem. Adolescents from adverse family environments (AFEs) face heightened susceptibility to mental health challenges. Nevertheless, there are opportunities within the adolescent's environment to foster resilience. In this paper, we employ an interdisciplinary approach grounded in the LCHD framework to assess existing research pertaining to resilience, social capital, and health development. Furthermore, we aim to provide actionable recommendations tailored to healthcare providers, with a specific emphasis on strategies to augment mental health outcomes among adolescent populations, particularly those experiencing AFEs.
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Affiliation(s)
- Julianna Rava
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine, Health Services Research, 911 Broxton Ave, Los Angeles, CA 90095, United States; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States.
| | - Emily Hotez
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine, Health Services Research, 911 Broxton Ave, Los Angeles, CA 90095, United States; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Neal Halfon
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States
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21
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Nielsen SS, Mikkelsen LJ, Quaade N, Gladstone TRG, Beardslee WR, Bonnemose K, Rosenberg NK, Hjorthøj C, Thorup AAE, Nordentoft M, Ranning A. A study protocol for the randomized controlled trial SAFIR FAMILY TALK: a selective primary preventive intervention vs. service as usual for children of parents with mental illness. Trials 2023; 24:291. [PMID: 37087437 PMCID: PMC10122450 DOI: 10.1186/s13063-023-07256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/14/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Children of parents with mental illness have an increased risk of developing mental illness themselves throughout their lifespan. This is due to genetic factors but also environmental disadvantages during childhood associated with parental mental illness. Selective primary preventive interventions for the children are recommended to mitigate risk factors and strengthen protective factors, but large-scale, longitudinal studies are needed. This study aims to investigate the effect of the Family Talk Preventive Intervention in a cohort of children and their parents with mental illness. METHODS The study is a randomized controlled trial with 286 planned families with at least one parent with any mental illness and at least one child aged 7 to 17 years. It will be carried out in the mental healthcare system in the Capital Region of Denmark. Families will be referred from hospitals and municipalities. The children and parents will be assessed at baseline and then randomized and allocated to either the Family Talk Preventive Intervention or service as usual. The intervention group will be assigned to Family Talk Preventive Intervention, a manualized programme consisting of ~ seven sessions for the family, including psychoeducation about parental mental illness and resilience in children, stimulating dialogue between family members and creating a common family narrative. The study period for both groups will be 12 months. Follow-up assessments will be conducted after 4 months and 12 months. The primary outcomes are the children's level of functioning, parental sense of competence and family functioning. DISCUSSION Given the prevalence of transgenerational transmission of mental illness, a systematic approach to prevention is needed in the mental healthcare setting. This study provides valuable knowledge on the Family Talk Preventive Intervention with a large sample size, inclusion of any parental mental illness and examination of the primary outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT05615324. Registered on 26 October 2022. Retrospectively registered.
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Affiliation(s)
- Signe S Nielsen
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | - Lisbeth J Mikkelsen
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | - Nikolaj Quaade
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | | | | | - Katrina Bonnemose
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | | | - Carsten Hjorthøj
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne A E Thorup
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen, Capital Region of Denmark, Denmark
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Ranning
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark.
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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Weidman S, Levine DT, Louwagie F, Blackmore K, Theron LC, Stekel DJ. The role of multisystemic resilience in fostering critical agency: UK adolescents during the COVID-19 Pandemic. CURRENT PSYCHOLOGY 2023:1-15. [PMID: 37359567 PMCID: PMC10072812 DOI: 10.1007/s12144-023-04578-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 04/07/2023]
Abstract
Critical agency (CA) refers to an individual's feeling of power in relation to social inequalities. Research has demonstrated that high CA is associated with positive adolescent outcomes, however, less is known about what supports are important for its development. Moreover, a large majority of the literature is based on studies from the US and various countries in Africa; although the UK is saturated with inequalities there is little research within a UK context. In this paper we examine (a) the validity of using an existing measure of CA with a sample of UK adolescents and (b) the extent to which resilience supports account for variance in CA. Our analysis identified two distinct factors of CA: justice-oriented and community-oriented. High CA in both factors was explained by resilience supports associated with peer relationships (p < 0.01). Our findings push us towards new relational, ecological ways of understanding adolescent CA. We close by instantiating a translational framework for those devising policies in support of youth resilience and CA. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-023-04578-1.
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Affiliation(s)
| | - Diane T. Levine
- University of Leicester, Leicester, UK
- University of Johannesburg, Johannesburg, South Africa
| | | | | | | | - Dov J. Stekel
- University of Johannesburg, Johannesburg, South Africa
- University of Nottingham, Nottingham, UK
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Jefferies P, Höltge J, Fritz J, Ungar M. A Cross-Country Network Analysis of Resilience Systems in Young Adults. EMERGING ADULTHOOD (PRINT) 2023; 11:415-430. [PMID: 36926198 PMCID: PMC10009297 DOI: 10.1177/21676968221090039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Multisystemic resilience has been conceptualised as involving a constellation of protective factors which operate at different levels to promote adaptation and thriving despite experiences of adversity. We used network modelling to discover how protective factors at two different systemic levels (intrapersonal strengths and social-ecological resources) interrelate, drawing on survey data from 5283 emerging adults (M = 24.53 years; 52% female) in Brazil, China, Indonesia, Russia, Thailand, the US and Vietnam. Results indicated that the level of connectivity within and between protective factor levels was similar between the countries, but that there was substantial variation in the specific interrelations among protective factors (both within and between levels), including the presence of some country-specific negative interrelations between protective factors at different levels. The findings support the importance of cultural context in studies of resilience, with implications for the development of appropriate resilience-building interventions for this age group.
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Affiliation(s)
- Philip Jefferies
- Faculty of Health, Resilience Research Centre, Dalhousie University, Halifax, NS, Canada
| | - Jan Höltge
- Faculty of Health, Resilience Research Centre, Dalhousie University, Halifax, NS, Canada
| | - Jessica Fritz
- Department of Psychiatry, Addenbrooke’s Hospital, University of Cambridge, Cambridge, UK
| | - Michael Ungar
- Faculty of Health, Resilience Research Centre, Dalhousie University, Halifax, NS, Canada
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Aghebati A, Javaherirenani R, Amin R, Pazhooyan M, Farahani H, Ahadianfard P. Psychometric properties of Persian version of child and youth resilience measure‐revised in adolescents. PSYCHOLOGY IN THE SCHOOLS 2023. [DOI: 10.1002/pits.22860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Asma Aghebati
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health Iran University of Medical Sciences Tehran Iran
| | - Razieh Javaherirenani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health Iran University of Medical Sciences Tehran Iran
| | - Razieh Amin
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health Iran University of Medical Sciences Tehran Iran
| | - Mahdiye Pazhooyan
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health Iran University of Medical Sciences Tehran Iran
| | - Hojjatollah Farahani
- Department of Psychology, School of Humanities Tarbiat Modares University Tehran Iran
| | - Pantea Ahadianfard
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health Iran University of Medical Sciences Tehran Iran
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Zuo Z, Luo Y, Xi J, Ji W. Development and Validation of a Chinese Resilience Scale for Young Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2216. [PMID: 36767583 PMCID: PMC9915069 DOI: 10.3390/ijerph20032216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Resilience research began in the child population as a validity scale to describe children's psychological wellbeing and ability to cope with negative events, and to some extent, to predict recovery and adaptation when they experience adversity again. In view of the important developmental implications of resilience in young children and the lack of a Chinese children's resilience scale, this study developed a resilience scale for young Chinese children based on a systematic review of existing international resilience scales and the characteristics of the Chinese cultural background. (2) Methods: The scale was developed by referring to existing scales, expert interviews, item collation and item finalization, developing original items, then deleting and determining items through item analysis, and finally, comparing with existing scales to obtain the internal and external validity of this scale. (3) Results: The results showed that the scale has good measurement properties, internal consistency reliability, and internal and external validity. (4) Conclusions: Through the development and validation of the Resilience Scale for young children in China, the scale can be used to measure the resilience of young children in China.
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Affiliation(s)
- Zhihong Zuo
- Department of Preschool Education, Faculty of Education, East China Normal University, Shanghai 200062, China
| | - Yirui Luo
- Shanghai Key Laboratory of Mental Health and Psychological Crisis, Affiliated Mental Health Center (ECNU), Positive Education China Academy, Juzhe Xi’s Master Workroom of Shanghai School Mental Health Service, School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Juzhe Xi
- Shanghai Key Laboratory of Mental Health and Psychological Crisis, Affiliated Mental Health Center (ECNU), Positive Education China Academy, Juzhe Xi’s Master Workroom of Shanghai School Mental Health Service, School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Weidong Ji
- Affiliated Mental Health Center (ECNU), Shanghai Changning Mental Health Center, Shanghai 200335, China
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Resilience among Parents and Children with Autism Spectrum Disorder. Ment Illn 2023. [DOI: 10.1155/2023/2925530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Resilience plays a pivotal role to offset stress among families of children with autism spectrum disorder (ASD). Although the majority of previous studies investigated resilience in parents, it is unclear what factors contribute to resilience in children. Thus, we aimed to explore resilience experienced by parents of children with ASD and how it affects children’s resilience. We invited 50 parents of a child with ASD, 13 years old or younger, across various Canadian provinces in an online survey. Parental resilience was positively associated with household income and negatively associated with parental stress. Resilience in children with ASD was positively associated with their social participation at home and community. Findings indicate a relationship between resilience in children with ASD and their participation, suggesting new ways to increase resilience in children with ASD by enhancing their participation.
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Boima V, Yorke E, Ganu V, Gyaban-Mensah A, Ekem-Ferguson G, Kretchy IA, Mate-Kole CC. Coping strategies and resilience among patients with hypertension in Ghana. Front Psychol 2023; 13:1038346. [PMID: 36687852 PMCID: PMC9845887 DOI: 10.3389/fpsyg.2022.1038346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
Background Hypertension is associated with high morbidity and mortality and this has been linked to poor treatment and control rates. To optimize drug treatment, patient-centered strategies such as coping, resilience, and adherence to medication may improve control rates and decrease the morbidity and mortality associated with hypertension. This study, therefore, assessed coping skills and resilience among patients with hypertension in Ghana. Methods A cross-sectional study was conducted at Korle Bu Teaching Hospital. 224 consented patients with a diagnosis of hypertension were consecutively selected from the outpatient clinic. Questionnaires comprising socio-demographic characteristics, clinical parameters, Adult Resilience Measure, and the Africultural Coping Systems Inventory were administered. Data were analyzed using Stata version 16.1 and significance level was set at p-value of ≤ 0.05. Results The mean age of participants was 62.03 ± 11.40 years and the majority were female (63%). The overall coping strategy mean score was 43.13 ± 13.57. For resilience, median relational and personal resilience (PR) scores were 32 (IQR-7) and 39 (IQR-9), respectively. Increased systolic BP significantly increases the overall coping strategy score. Collective coping strategy and systolic BP significantly increased coping scores (95%CI = 0.05-3.69 vs. 95%CI = 0.58-5.31). Overall coping strategy significantly increased personal and relational resilience (RR) domain scores by 0.004 (95%CI = 0.002-0.01) and 0.005 (95%CI = 0.003-0.006) units, respectively. This study demonstrated that Cognitive and emotional debriefing coping strategy was mostly used by patients with hypertension. Conclusion Coping strategies had a positive and significant correlation with personal and RR, specifically collective and cognitive debriefing had a significant positive association with resilience among study participants. There is a need to actively put in measures that can improve the coping strategies and resilience among patients with hypertension to adjust to the long-term nature of the illness and treatment as this will promote better treatment outcomes.
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Affiliation(s)
- Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Ernest Yorke
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Vincent Ganu
- Department of Medicine and Therapeutics, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Anna Gyaban-Mensah
- Department of Psychology/Center for Ageing Studies, College of Humanities, University of Ghana, Accra, Ghana
| | | | - Irene Akwo Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Charles Christopher Mate-Kole
- Department of Psychology/Center for Ageing Studies, College of Humanities, University of Ghana, Accra, Ghana
- Department of Psychiatry, Korle-Bu Teaching Hospital, Korle-Bu, Ghana
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The Impact of a Universal Mental Health Intervention on Youth with Elevated Negative Affectivity: Building Resilience for Healthy Kids. CONTEMPORARY SCHOOL PSYCHOLOGY 2023; 27:53-60. [PMID: 34336376 PMCID: PMC8314847 DOI: 10.1007/s40688-021-00388-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 12/03/2022]
Abstract
Objective In response to the rise in mental health needs among youth, a school-based resilience intervention was implemented for sixth graders at an urban middle school. The goal of this analysis is to examine improvements in key mental health parameters among students who endorsed negative affectivity at baseline. Method A total of 285 11-12-year-olds (72% white, 18% Hispanic, 55% female) participated in a single-arm, non-randomized 6-week 1:1 school-based coaching intervention, Healthy Kids. Youth completed validated surveys at baseline and 6-week follow-up assessing depression/anxiety symptoms, bullying, self-efficacy, academic pressure, grit, and resilience. Participants were determined to have elevated negative affectivity if they reported mild-to-severe symptoms for both depression and anxiety symptoms. General linear models examined differences between groups for each mental health parameter, as well as change in outcomes from baseline to follow-up. Results A third of participants (38%) at baseline endorsed negative affectivity. Youth who endorsed negative affectivity were more often female (71% vs 29%; p < 0.001) and identified as victims of cyberbullying (25% vs 8%; p < 0.001). Youth with baseline negative affectivity scored lower for self-efficacy (total 70.5 vs 86.8; p < 0.0001). Baseline negative affectivity was a significant moderator for change in mental health parameters. Post-intervention, those who endorsed baseline negative affectivity, medium effect sizes were observed for self-efficacy (g = 0.6; 95%CI 0.3, 0.9; p < 0.001) and anxiety symptoms (g = - 0.70; 95%CI - 1.0, - 0.4; p < 0.001). Among all youth, there were significant medium intervention effects in resilience (g = 0.5; 95%CI 0.3, 0.7; p < 0.001) and self-efficacy (g = 0.7; 95%CI 0.4, 0.9; p < 0.001). Conclusions A universal resiliency program may improve self-efficacy and symptoms of anxiety among youth experiencing negative affectivity, while improving resilience and self-efficacy among all youth. Our findings suggest a universal school-based coaching program benefits all youth, while also specifically targeting the needs of youth with negative affectivity who are most at risk for mental health concerns.
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Nearchou F. Self-harm in Young People: Investigating the Role of Resilience and Posttraumatic Stress Related to the COVID-19 Pandemic. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022:1-12. [PMID: 36590446 PMCID: PMC9795111 DOI: 10.1007/s40653-022-00511-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Evidence shows that young people may have experienced increased levels of posttraumatic stress and depression during the COVID-19 pandemic. However, the landscape on self-harm is still unclear. This study aimed to examine the role of COVID-19 related posttraumatic stress, depression and resilience as predictors of self-harm with and without suicidal intent. Participants were 625 young people aged 17-25 years old (M = 20.2 years, SD = 2.47). Resilience was measured using the self-reported Child & Youth Resilience Scale Measure - Revised (CYRM-R). Posttraumatic stress related to COVID-19 were measured using the Impact of Event Scale- Revised. Depression was measured using the depression subscale of the Depression, Anxiety and Stress Scale-21. Self-harm was evaluated with two dichotomous items. Participants reported high levels of depression and COVID-19 posttraumatic stress, and a significant percentage reported engaging in self-harm. Hierarchical logistic regressions showed that caregiver resilience decreased approximately 20% the odds of engaging in self harm with and without suicidal intent remaining a consistent predictor even after accounting posttraumatic stress and depression in the models. Posttraumatic stress and depression predicted a one-fold increase in the odds of engaging in self-harm with and without suicidal intent. However, posttraumatic stress was no longer a significant predictor when depression was entered in the model in self-harm without suicidal intent. The COVID-19 pandemic may have increased the likelihood of engaging in self-harm in young people. However, caregiver resilience seems to operate as a protective factor. This important finding carries implications beyond the context of the COVID-19 pandemic.
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Affiliation(s)
- Finiki Nearchou
- School of Psychology, University College Dublin, Newman Building, Belfield Campus, Dublin, Dublin 4 Ireland
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Bhatia K, Rath S, Pradhan H, Samal S, Copas A, Gagrai S, Rath S, Gope RK, Nair N, Tripathy P, Rose-Clarke K, Prost A. Effects of community youth teams facilitating participatory adolescent groups, youth leadership activities and livelihood promotion to improve school attendance, dietary diversity and mental health among adolescent girls in rural eastern India (JIAH trial): A cluster-randomised controlled trial. SSM Popul Health 2022; 21:101330. [PMID: 36618545 PMCID: PMC9811248 DOI: 10.1016/j.ssmph.2022.101330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Objectives To evaluate whether and how community youth teams facilitating participatory adolescent groups, youth leadership and livelihood promotion improved school attendance, dietary diversity, and mental health among adolescent girls in rural India. Design A parallel group, two-arm, superiority, cluster-randomised controlled trial with an embedded process evaluation. Setting intervention and participants 38 clusters (19 intervention, 19 control) in West Singhbhum district in Jharkhand, India. The intervention included participatory adolescent groups and youth leadership for boys and girls aged 10-19 (intervention clusters only), and family-based livelihood promotion (intervention and control clusters) between June 2017 and March 2020. We surveyed 3324 adolescent girls aged 10-19 in 38 clusters at baseline, and 1478 in 29 clusters at endline. Four intervention and five control clusters were lost to follow up when the trial was suspended due to the COVID-19 pandemic. Adolescent boys were included in the process evaluation only. Primary and secondary outcome measures Primary: school attendance, dietary diversity, and mental health; 12 secondary outcomes related to education, empowerment, experiences of violence, and sexual and reproductive health. Results In intervention vs control clusters, mean dietary diversity score was 4·0 (SD 1·5) vs 3·6 (SD 1·2) (adjDiff 0·34; 95%CI -0·23, 0·93, p = 0·242); mean Brief Problem Monitor-Youth (mental health) score was 12·5 (SD 6·0) vs 11·9 (SD 5·9) (adjDiff 0·02, 95%CI -0·06, 0·13, p = 0·610); and school enrolment rates were 70% vs 63% (adjOR 1·39, 95%CI 0·89, 2·16, p = 0·142). Uptake of school-based entitlements was higher in intervention clusters (adjOR 2·01; 95%CI 1·11, 3·64, p = 0·020). Qualitative data showed that the community youth team had helped adolescents and their parents navigate school bureaucracy, facilitated re-enrolments, and supported access to entitlements. Overall intervention delivery was feasible, but positive impacts were likely undermined by household poverty. Conclusions Participatory adolescent groups, leadership training and livelihood promotion delivered by a community youth team did not improve adolescent girls' mental health, dietary diversity, or school attendance in rural India, but may have increased uptake of education-related entitlements. Trial registration ISRCTN17206016.
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Affiliation(s)
- Komal Bhatia
- Institute for Global Health, University College London, London, UK,Corresponding author. Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
| | | | | | | | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | | | | | | | | | | | - Kelly Rose-Clarke
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Audrey Prost
- Institute for Global Health, University College London, London, UK
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Hurtado Choque GA, García Cosavalente HP, Chan AE, Rodriguez MR, Sumano E. The Development and Pilot Evaluation of a Family-Based Education to Strengthen Latinx Adolescent Mental Health in the United States: The Familias Activas Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:207. [PMID: 36612524 PMCID: PMC9819405 DOI: 10.3390/ijerph20010207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Adolescent years are a time of joy and can represent a challenge for parents and youth, especially for immigrants to the US who are adjusting to their host country. Programs focusing on family skills and positive youth development (PYD) can contribute to youth wellbeing especially, however, few exist for low-income immigrant families. (1) Background: The major goals of this project are to strengthen both PYD and healthy parenting practices by implementing an evidence-informed program, Familias Activas. A theory of change guided the development of Familias Activas in which three factors: parent training, positive youth development, and youth physical activity sessions (soccer) aimed to improve Latinx youth mental health. Youth participated in weekly soccer practices led by trained soccer coaches while parents/caregivers attended parent education. Both sessions lasted eight weeks. (2) Method: We describe the formative stage of the research project as well as the pilot implementation of the Familias Activas program, which provides critical insights for the development of a PYD program. (3) Results: Evaluation surveys were administered to youth and their parents. Thirty youths and sixteen parents completed the survey. The Kidscreen scale had a mean for most items ranging from 3.6 to 4.2. Participating youth were 11 years old and most affirmed they were Latinx. The feasibility program quality mean was 4.2 indicating an overall positive result for the pilot program.. Implications of PYD programs for Latinx youth are discussed. (4) Conclusions: The current paper presents a model for positively influencing the physical and mental wellbeing of Latinx youth and their parents. The model is culturally responsive in its involvement of both parents and youth in programming.
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Affiliation(s)
- Ghaffar Ali Hurtado Choque
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | | | - Alexander E. Chan
- College of Agriculture and Natural Resources, Extension, University of Maryland, College Park, MD 20742, USA
| | | | - Eva Sumano
- CASA de Maryland, Adelphi, MD 20783, USA
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Leybas Nuño V, Mantina NM, Dawodu O, Dykinga M, Carr DL, Pogreba-Brown K, Cordova-Marks F, Jehn M, Peace-Tuskey K, Barraza L, Garcia-Filion P. Consequences of COVID-19 on adolescents in Arizona: A longitudinal study protocol. Front Public Health 2022; 10:945089. [PMID: 36589965 PMCID: PMC9797691 DOI: 10.3389/fpubh.2022.945089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The long-term impact of COVID-19 is unknown. We developed a 5-year prospective cohort study designed to generate actionable community-informed research about the consequences of COVID-19 on adolescents ages 12-17 years in Arizona. Methods The study has two primary outcomes: 1) acute and long-term outcomes of COVID-19 illness and 2) symptoms of depression and anxiety. Data is collected using an online survey with plans to integrate qualitative data collection methods. The survey is administered at baseline, 4, and 8 months in year one, and annually in years two through five. This study is informed by Intersectionality Theory, which considers the diverse identities adolescents have that are self and socially defined and the influence they have collectively and simultaneously. To this end, a sample of variables collected is race/ethnicity, language usage, generational status, co-occurring health conditions, and gender. Additional measures capture experiences in social contexts such as home (parent employment, food, and housing security), school (remote learning, type of school), and society (racism). Results Findings are not presented because the manuscript is a protocol designed to describe the procedure instead of report results. Discussion The unique contributions of the study is its focus on COVID-19 the illness and COVID-19 the socially experienced pandemic and the impact of both on adolescents.
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Affiliation(s)
- Velia Leybas Nuño
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health (MEZCOPH), University of Arizona, Tucson, AZ, United States,*Correspondence: Velia Leybas Nuño
| | - Namoonga M. Mantina
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Oriyomi Dawodu
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Maureen Dykinga
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Dametreea L. Carr
- Department of Epidemiology and Biostatistics, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Kristen Pogreba-Brown
- Department of Epidemiology and Biostatistics, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Felina Cordova-Marks
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Megan Jehn
- School of Human Evolution and Social Change, Arizona States University, Tempe, AZ, United States
| | - Kimberly Peace-Tuskey
- Department of Health Promotion Sciences, MEZCOPH, University of Arizona, Tucson, AZ, United States
| | - Leila Barraza
- Department of Community, Environment and Policy, MEZCOPH, University of Arizona, Tucson, AZ, United States
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Orbuch R, Rosenow WT, Yousuf S, Sheehan K. Childhood Protective Factors and Future Adult Health Outcomes in an Urban Environment. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1063-1068. [PMID: 36439666 PMCID: PMC9684365 DOI: 10.1007/s40653-022-00457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 06/16/2023]
Abstract
Purpose To evaluate protective factors that help individuals overcome adverse health outcomes associated with childhood trauma in an urban environment. Methods This retrospective cohort study included adults born between 1970 and 1995 who grew up in the former Cabrini-Green Homes, a low-income, Chicago public housing development. Participants completed surveys asking about general health, smoking, and mental health status. Surveys included questions related to neighborhood and family support, community safety, and childhood youth program participation. Simple regression models were performed to compare childhood exposure of adverse and protective factors to adult health outcomes. Multivariable logistic regression models were constructed to adjust for age, sex, and educational attainment. Results 334 former residents completed the survey, and only those that reported an adversity score ≥ 2 were included in the analysis (n = 248). For those individuals who reported that their families cared for them as children, they described feeling hopeful about the future (OR 2.77, 95% CI, 1.28-6.00, aOR 2.63, 95% CI, 1.21-5.75) and reported decreased smoking rates as adults (OR 0.30, 95% CI, 0.14-0.66, aOR 0.35, 95% CI, 0.16-0.78). Better self-reported adult health status was associated with residents who believed the neighborhood looked out for one another (OR 2.31, 95% CI, 1.21-4.42, aOR 2.01, 95% CI, 1.02-3.95). Conclusion These findings suggest that a caring family and neighborhood connectedness are protective in mitigating childhood adversity. Devoting resources to strengthen families and communities is a promising strategy to promote healthier adult behaviors.
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Affiliation(s)
- Rachel Orbuch
- Feinberg School of Medicine, Northwestern University, 420 E Superior St, 60611 Chicago, IL United States
| | - Will T Rosenow
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, 60611 Chicago, IL United States
| | - Sana Yousuf
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, 60611 Chicago, IL United States
| | - Karen Sheehan
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, 60611 Chicago, IL United States
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Sánchez-Teruel D, Robles-Bello MA, Sarhani-Robles A, Sarhani-Robles M. Adaptation of the Suicide Attempt Resilience Scale (SRSA-18, Spanish version) for adolescents. BJPsych Open 2022; 8:e193. [PMID: 36325958 PMCID: PMC9634591 DOI: 10.1192/bjo.2022.601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The assessment of resilience as an outcome in adolescents remains a challenge, with few instruments available. Some studies have focused on risk factors, but few have focused on protective factors as a formula for measuring resilient outcomes. AIMS To adapt a new Suicide Attempt Resilience Scale (SRSA-18) for use with adolescents, analysing its structural validity, the gender and age invariance of the measure, and divergent and convergent validity, together with its reliability. METHOD The psychometric properties of the scale were assessed in 628 participants aged between 13 and 18 years, of whom 342 (54.5%) were girls. RESULTS After a process of adaptation for adolescents, exploratory and confirmatory factor analysis yielded a three-dimensional structure with adequate goodness-of-fit indices, invariance of the measure according to gender and age, adequate levels of reliability (ω = 0.91), high convergent validity with the 14-Item Resilience Scale and high divergent validity with the suicidal act/planning subdimension of the Adolescent Suicidal Behavior Assessment Scale. CONCLUSIONS There is a need to create and adapt instruments to measure resilience in some populations with high psychosocial vulnerability as a key aspect for measuring the impact of prevention and mental health promotion programmes in adolescents.
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Affiliation(s)
- David Sánchez-Teruel
- Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
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The Martinsburg Initiative: A Collaboration Between Public Safety, Public Health, and Schools to Address Trauma and Substance Use. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:S355-S358. [PMID: 36194806 PMCID: PMC9531965 DOI: 10.1097/phh.0000000000001591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The Martinsburg Initiative (TMI) is a community-based model developed in Martinsburg, West Virginia, that implements a comprehensive approach to adverse childhood experiences and substance use prevention and mitigation by leveraging partnerships in public health and health care, public safety, and education. TMI receives coordinated federal funding and technical assistance from the Centers for Disease Control and Prevention, the Washington-Baltimore High Intensity Drug Trafficking Agency, and the National Association of County and City Health Officials to integrate evidence-based and promising strategies. It advances such strategies by translating them for implementation within the community, evaluating the reach and potential impact of the model, and by engaging key stakeholders. Preliminary results describing program reach and short-term outcomes collected for a subset of the interventions during implementation are presented. The model uses touchpoints across multiple community sectors in the city of Martinsburg to break the cycle of trauma and substance use across the life span.
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Allison-Burbank JD, Ingalls A, Rebman P, Chambers R, Begay R, Grass R, Tsosie A, Archuleta S, Barlow A, Larzelere F, Hammitt L, Tingey L, Haroz E. Measuring the effects of the COVID-19 pandemic on Diné and White Mountain Apache school personnel, families, and students: protocol for a prospective longitudinal cohort study. BMC Public Health 2022; 22:1481. [PMID: 35927650 PMCID: PMC9351121 DOI: 10.1186/s12889-022-13208-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background This paper describes the protocol for a longitudinal cohort study, “Project SafeSchools” (PSS), which focuses on measuring the effects of COVID-19 and the return to in-person learning on Diné (Navajo) and White Mountain Apache (Apache) youth, parents, and educators. The early surges of the COVID-19 pandemic led to the closure of most reservation and border town schools serving Diné and Apache communities. This study aims to: (1) understand the barriers and facilitators to school re-opening and in-person school attendance from the perspective of multiple stakeholders in Diné and Apache communities; and (2) evaluate the educational, social, emotional, physical, and mental health impacts of returning to in-person learning for caregivers and youth ages 4–16 who reside or work on the Diné Nation and the White Mountain Apache Tribal lands. Methods We aim to recruit up to N = 200 primary caregivers of Diné and Apache youth ages 4–16 and up to N = 120 school personnel. In addition, up to n = 120 of these primary caregivers and their children, ages 11–16, will be selected to participate in qualitative interviews to learn more about the effects of the pandemic on their health and wellbeing. Data from caregiver and school personnel participants will be collected in three waves via self-report surveys that measure COVID-19 related behaviors and attitudes, mental health, educational attitudes, and cultural practices and beliefs for both themselves and their child (caregiver participants only). We hypothesize that an individual’s engagement with a variety of cultural activities during school closures and as school re-opened will have a protective effect on adult and youth mental health as they return to in-person learning. Discussion The results of this study will inform the development or implementation of preventative interventions that may help Diné and Apache youth and their families recover from the negative impact of the COVID-19 pandemic, and positively impact their health and wellness. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13208-7.
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Affiliation(s)
- Joshuaa D Allison-Burbank
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA.
| | - Allison Ingalls
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Paul Rebman
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Rachel Chambers
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Renae Begay
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Ryan Grass
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Alicia Tsosie
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Shannon Archuleta
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Allison Barlow
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Francene Larzelere
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Laura Hammitt
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Lauren Tingey
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Emily Haroz
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
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Socio-ecological Resilience Relates to Lower Internalizing Symptoms among Adolescents during the Strictest Period of COVID-19 Lockdown in Perú. Res Child Adolesc Psychopathol 2022; 50:1429-1444. [PMID: 35675003 PMCID: PMC9174627 DOI: 10.1007/s10802-022-00928-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/02/2022]
Abstract
The COVID-19 pandemic has touched the lives of adolescents around the world. This short-term longitudinal, observational study followed 1,334 adolescents (11–17 yo) to investigate whether social-ecological resilience relates to intra- and inter-personal resources and/or the caregiver relationship relates to changes in internalizing symptoms during five stressful weeks of COVID-19 lockdown in Perú. In this work, we contextualize social-ecological resilience in relation to culturally-relevant personal and caregiver resources that youth can use to adapt to stressful situations. We found that adolescents who reported higher levels of personal, caregiver, and overall resilience had lower levels of anxiety and depressive symptoms at week six. We also find that personal, caregiver, and overall resilience moderated the change in anxiety symptoms from week 6 to week 11 of lockdown in 2020. Our findings underscore the importance of social-ecological resilience related to both intra/interpersonal resources and the caregiver relationship for minimizing the harmful impacts of COVID-19 on adolescent internalizing symptoms.
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Fogarty A, Brown S, Gartland D, Mensah F, Seymour M, Savopoulos P, FitzPatrick K, Papadopoullos S, Giallo R. Psychosocial factors associated with adolescent depressive and anxiety symptoms during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2022. [DOI: 10.1177/01650254221084100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The COVID-19 pandemic has created many challenges for adolescents across the world. The current study aimed to investigate the prevalence of depressive and anxiety symptoms and suicidal ideation in adolescents living in Melbourne, Australia, during the state of Victoria’s second lockdown. The study also sought to identify pre-existing and current psychosocial stressors associated with adolescent’s depressive and anxiety symptoms, and to identify the extent to which adolescents experiencing mental health difficulties sought professional help during the pandemic. A COVID-19 sub-study of the Mothers’ and Young People’s Study—an 18-year longitudinal cohort study—was conducted between July and September 2020, an online survey completed by 257 adolescents aged 14–17 years and their mothers, which asked about pandemic-related stressors, remote learning, family life, and mental health. Descriptive statistics and hierarchical multiple regression analysis were conducted. Mental health difficulties were common with 38% and 20% of adolescents reporting clinically significant depressive and anxiety symptoms, respectively, and 21% reporting frequent suicidal or self-harm ideation. Factors associated with depressive and anxiety symptoms included being female, exposure to current maternal depressive symptoms, lower levels of resilience, experiences of loneliness, stressful life events, and school- and family-related stressors. Two-thirds of adolescents who were experiencing clinically significant depressive or anxiety symptoms had not sought professional help. Our findings highlight the urgent mental health need among adolescents and the importance of reducing barriers to accessing support.
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Affiliation(s)
| | - Stephanie Brown
- Murdoch Children’s Research Institute, Australia
- The University of Melbourne, Australia
| | - Deirdre Gartland
- Murdoch Children’s Research Institute, Australia
- The University of Melbourne, Australia
| | - Fiona Mensah
- Murdoch Children’s Research Institute, Australia
- The University of Melbourne, Australia
| | | | | | | | | | - Rebecca Giallo
- Murdoch Children’s Research Institute, Australia
- The University of Melbourne, Australia
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Korczak DJ, Cost KT, LaForge-MacKenzie K, Anagnostou E, Birken CS, Charach A, Monga S, Crosbie J. Ontario COVID-19 and Kids Mental Health Study: a study protocol for the longitudinal prospective evaluation of the impact of emergency measures on child and adolescent mental health during the COVID-19 pandemic. BMJ Open 2022; 12:e057248. [PMID: 35236733 PMCID: PMC8895414 DOI: 10.1136/bmjopen-2021-057248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has impacted the mental health (MH) of children, adolescents and parents. Whereas youth with MH disorders and neurodevelopmental disorders (NDD) may be at higher risk for exacerbations in emotional and behavioural distress, children and adolescents without pre-existing MH disorders or NDD may also experience MH deterioration due to increases in stress, changes in health behaviours, loss of activities/school closures or loss of resources. Little is known about the impact of the COVID-19 emergency measures (EMs) on children's MH over the course of the pandemic. METHODS AND ANALYSIS Longitudinal study of four well-established, pre-existing cohorts in Ontario (two recruited in clinical settings, two recruited in community settings). Primary outcomes include the impact of EMs on six MH domains: depression, anxiety, irritability, inattention, hyperactivity and obsessive-compulsive behaviours. Risk and protective factors related to youth MH profiles and trajectories will be identified. In addition, the effects of school mitigation strategies, changes in MH services and family factors (ie, parental MH, economic deprivation and family functioning) on children's MH will be examined. Data will be collected via repeated online survey measures selected to ensure reliability and validity for the proposed populations and distributed through the pandemic periods. ETHICS AND DISSEMINATION The study was approved by institutional research ethics boards at participating research sites. Results will be disseminated through a robust knowledge translation partnership with key knowledge users. Materials to inform public awareness will be co-developed with educators, public health, and MH and health service providers. Connections with professional associations and MH advocacy groups will be leveraged to support youth MH policy in relation to EMs. Findings will further be shared through conference presentations, peer-reviewed journals and open-access publications.
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Affiliation(s)
- Daphne J Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Katherine T Cost
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Evdokia Anagnostou
- Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
- Department of Pediatrics, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Catherine S Birken
- Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alice Charach
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Suneeta Monga
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
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Simon SL, Ware MA, Bowen AE, Chandrasekhar JL, Lee JA, Shomaker LB, Gulley LD, Heberlein E, Kaar JL. Sleep Moderates Improvements in Mental Health Outcomes in Youth: Building Resilience for Healthy Kids. Am J Health Promot 2022; 36:772-780. [PMID: 35081761 DOI: 10.1177/08901171211068455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the role of sleep in a school-based resiliency intervention. DESIGN Single group feasibility study. SETTING Urban middle school Subjects: Sixth grade students Intervention: A total of 285, 11-12-year-old students (70% White, 18% Hispanic, 55% female) participated in the six-week 1:1 Healthy Kids intervention. Youth (n=248) completed electronic surveys at pre-post the 6-week study assessing mental health parameters and self-reported bed and wake time. MEASURES Students were categorized as having insufficient sleep opportunity if they reported time in bed of <9 hours per night. ANALYSIS General linear models examined differences between groups for each mental health parameters pre-post study. RESULTS A third of participants (28%) were classified as having insufficient sleep opportunity. Youth with insufficient sleep were more often Hispanic (27% vs 16%; p<0.001) and were more often classified with both mild to severe depression and anxiety symptoms (55% vs 35%; p=0.004). The health coaching intervention was found to have a significant improvement on overall resilience and self-efficacy only among students who reported sufficient sleep, while no significant intervention effect was found for those students who reported insufficient sleep. CONCLUSIONS Our findings suggest that youth with poor sleep health may not benefit from school-based resiliency interventions.
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Affiliation(s)
- Stacey L Simon
- 129263University of Colorado Denver - Anschutz Medical Campus
| | - Meredith A Ware
- 129263University of Colorado Denver - Anschutz Medical Campus
| | | | | | - Joey A Lee
- Health Sciences14676University of Colorado at Colorado Springs
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McEwen C, Alisic E, Jobson L. Moderating role of moral injury in the mental health of adolescent refugees. J Clin Psychol 2022; 78:1478-1490. [PMID: 34993952 DOI: 10.1002/jclp.23306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/02/2021] [Accepted: 12/21/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study investigated whether moral injury appraisals moderated the relationships between trauma, postmigration living difficulties, resilience, and mental health outcomes in adolescent refugees. METHOD Eighty-five adolescent refugees from a community sample completed an online survey. RESULTS A significant interaction was found between moral injury and discrimination for externalizing and posttraumatic stress disorder (PTSD) symptoms; adolescents whom had experienced high levels of discrimination combined with high levels of moral injury had poorer mental health. A significant interaction was found between moral injury and resilience for internalizing symptoms: high levels of resilience appeared to buffer the association between moral injury and internalizing symptoms. Contrary to predictions, stressful life experiences and postmigration living difficulties did not interact significantly with moral injury to predict mental health. CONCLUSIONS Discrimination may contribute to perpetuating poor mental health in adolescent refugees with high levels of moral injury. Resilience may buffer some of the negative effects of moral injury.
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Affiliation(s)
- Cassandra McEwen
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Eva Alisic
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Laura Jobson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
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De Stefano C, Laurent I, Kaindje-Fondjo VC, Estevez M, Habran E, Falissard B, Haag P, Khireddine I, D'Hont F, Baubet T, Oppenchaim N, Vandentorren S, Rezzoug D. Children and Adolescents Psychological Distress Scale During COVID-19 Pandemic: Validation of a Psychometric Instrument (CONFEADO Study). Front Psychiatry 2022; 13:843104. [PMID: 36003975 PMCID: PMC9393589 DOI: 10.3389/fpsyt.2022.843104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
AIM AND OBJECT PURPOSE OF THE STUDY In March 2020, the WHO declared a pandemic (COVID-19) due to the SARS-CoV-2 virus. In France, school closures and lockdowns were implemented. In this unprecedented context for French adolescents and children, the CONFEADO study surveyed children aged 9 to 18 years to assess their mental health, psychological distress, and resilience during and after the lockdown in relation to their living and housing conditions. To assess psychological distress, a psychometric tool (Children and Adolescent Psychological Distress Scale-CAPDS-10) was specifically designed for the research. This article presents the psychometric validity of the CAPDS-10. METHODS This cross-sectional study collected data from June 9 to September 14, 2020, from children and adolescents (9 to 18 years of age) via an online questionnaire after sending it to a large network of partners. Psychological distress, resilience, and trait anxiety were assessed using the CAPDS-10, the Child and Youth Resilience Measure (CYRM), and the State-Trait Anxiety Inventory for Children (STAIC). The CAPDS-10 measured perceived psychological distress in the most recent 2 weeks (primary endpoint). The predictive power of the CAPDS-10 was determined by statistical analysis. We proceeded to a confirmatory factor analysis to validate the scale at a clinical level. We carried out a psychometric validation with a step to verify the uni-dimensionality of the scale (PCA analysis) and the calculation of convergent and divergent validity, correlation coefficient between items and subscales, Cronbach's alpha for reliability, determination of a cut-off score for the AUROC index. RESULTS Three thousand and forty eight children and adolescents completed the CAPDS-10. Analysis confirmed a three-factor model (anxiety, depression, and aggressive behavior) (RMSEA = 0.072 [0.067; 0.077], CFI = 0.954), with a correlation coefficient between items >0.4. PCA analysis concluded that the scale is unidimensional. Reliability was satisfactory with Cronbach's alpha coefficients >0.7 (0.86). In addition, prediction was good with an AUROC index equal to 0.73 and a threshold score for severe distress greater than or equal to 19. CONCLUSION The CAPDS-10 measures psychological distress over the most recent 2-week period with good psychometric qualities. It could be used in crisis or prevention contexts in the general population or in clinical settings.
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Affiliation(s)
- Carla De Stefano
- Université Paris 13 Sorbonne Paris Nord, Bobigny, France.,AP-HP, Urgences - Samu 93, Hôpital Avicenne, Bobigny, France.,AP-HP, Department of Child and Adolescent Psychiatry and General Psychiatry, Avicenne Hospital, Bobigny, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - Isaura Laurent
- Ecole Nationale de Statistique et Analyse de l'Information (ENSAI), Bruz, France
| | | | - Mégane Estevez
- INSERM UMR 1219, Population Health, Phare Team, University of Bordeaux, Bordeaux, France
| | | | - Bruno Falissard
- Centre de Recherche en épidemiologie et santé des populations (CESP), Université Paris Saclay, Villejuif, France
| | - Pascale Haag
- Laboratoire BONHEURS, Ecole des Hautes Etudes en Sciences Sociales (EHESS), LabSchool Network, Paris, France
| | - Imane Khireddine
- Santé Publique France, Scientific and International Direction, Saint-Maurice, France
| | - Fabien D'Hont
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Centre Hospitalier Universitaire de Lille Inserm, University Lille, LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Thierry Baubet
- Université Paris 13 Sorbonne Paris Nord, Bobigny, France.,AP-HP, Department of Child and Adolescent Psychiatry and General Psychiatry, Avicenne Hospital, Bobigny, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Centre de Recherche en épidemiologie et santé des populations (CESP), Université Paris Saclay, Villejuif, France
| | - Nicolas Oppenchaim
- Université de Tours, UMR CITERES, Allée Ferdinand de Lesseps, Tours, France
| | - Stéphanie Vandentorren
- Fonds FHF Recherche et Innovation, Paris, France.,Santé Publique France, Scientific and International Direction, Saint-Maurice, France
| | - Dalila Rezzoug
- Université Paris 13 Sorbonne Paris Nord, Bobigny, France.,AP-HP, Department of Child and Adolescent Psychiatry and General Psychiatry, Avicenne Hospital, Bobigny, France.,Centre de Recherche en épidemiologie et santé des populations (CESP), Université Paris Saclay, Villejuif, France
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Burt SA, Klump KL, Vazquez AY, Shewark EA, Hyde LW. Identifying Patterns of Youth Resilience to Neighborhood Disadvantage. RESEARCH IN HUMAN DEVELOPMENT 2021; 18:181-196. [PMID: 34737681 DOI: 10.1080/15427609.2021.1935607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The present report describes the motivation for the Michigan Twin Neurogenetic Study (MTwiNS), which seeks to illuminate underlying biological mechanisms through which familial and community factors support resilience (i.e., adaptive competence in the face of adversity) in youth exposed to neighborhood disadvantage. To accomplish these goals, we must first understand how resilience manifests in this cohort. The current study uncovers evidence of three domains of youth resilience: psychiatric health, social engagement, and scholastic success. Although all three domains were relatively stable across a one-to-two year period, variability in this stability was observed. Additionally, although resilience in one domain was quite common, resilience across all 3 domains was less common. Finally, we show substantial variability in resilience within and across families, with substantial co-twin discordances that can be leveraged in future analyses that examine promotive contexts that are environmental in origin.
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Affiliation(s)
- S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | | | | | - Luke W Hyde
- Department of Psychology & Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Mariani Wigley ILC, Mascheroni E, Bulletti F, Bonichini S. COPEWithME: The Role of Parental Ability to Support and Promote Child Resilient Behaviors During the COVID-19 Emergency. Front Psychol 2021; 12:732745. [PMID: 34721197 PMCID: PMC8552018 DOI: 10.3389/fpsyg.2021.732745] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/25/2021] [Indexed: 12/02/2022] Open
Abstract
The COVID-19 pandemic has led to lockdown in many countries and Italy was the first one interested in Europe. The lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, but it is very demanding for the population involved and especially for children and their families. The aims of the present study are: (a) to explore the psychometric properties of the COPEWithME questionnaire, a new tool to evaluate parents' ability to support and promote child resilient behaviors, (b) to investigate the relation between parents' resilience and their ability to support and promote child resilient behaviors with child resilience and child stress-related behaviors assessed during the COVID-19 outbreak. Participants (N = 158 mothers, with 6- to 11-years-old children, 53% female), who were volunteers and anonymous, filled out an online questionnaire composed by CD-RISC 25, PMK-CYRM-R, and COPEWithME. With regard to the COPEWithME, validation exploratory factor analyses revealed a one-factor solution of 18 items. The COPEWithME positively correlates both with mothers' resilience and with children's resilience. Mediation analysis showed that the association between mothers' resilience and children's stress-related behaviors was mediated by the mothers' ability to support and promote child resilient behaviors. The COPEWithME, to our knowledge, is the first measure of parents' ability to support and promote resilient behaviors in school-age children, a key parenting skill that may help children in dealing with stressful situations such as the COVID-19 outbreak. These findings represent useful insights to advance mental health interventions in the post-pandemic phases suggesting focusing on a family's resources and resilience processes.
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Affiliation(s)
| | - Eleonora Mascheroni
- 0-3 Center for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Francesca Bulletti
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Sabrina Bonichini
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
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Haar K, El-Khani A, Mostashari G, Hafezi M, Malek A, Maalouf W. Impact of a Brief Family Skills Training Programme ("Strong Families") on Parenting Skills, Child Psychosocial Functioning, and Resilience in Iran: A Multisite Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111137. [PMID: 34769656 PMCID: PMC8583328 DOI: 10.3390/ijerph182111137] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022]
Abstract
Caregivers have a key role in protecting children’s wellbeing, and, with appropriate skills, can prevent a multitude of negative social outcomes, particularly in challenged or humanitarian settings. Accordingly, the Strong Families programme was designed as a light touch family skills programme, with a focus of supporting caregiving during stressful situations. To evaluate the short-term impact of the Strong Families programme, we performed a time-convenience, randomized, controlled trial in Iran. A total of 292 families (63% from Iranian decent, 39% from Afghan decent, and 1% other), with children aged eight to twelve years, were recruited through ten centers in Iran and allocated to an intervention (n = 199) or waitlist/control group (n = 93). The two groups did not differ demographically at baseline. We assessed families prospectively, through three scales, PAFAS (parenting and family adjustment scales), SDQ (strengths and difficulties questionnaire), and CYRM-R (child and youth resilience measure). Caregivers in the intervention group improved (highly) statistically significantly on all but one PAFAS subscales (parental consistency, coercive parenting, positive encouragement, parental adjustment, family relationships, and parental teamwork), which was not noted in the waitlist group. On the SDQ, there were (highly) significant positive changes in scores in the intervention group on all sub-scales and the “total difficulty scale“, whereas the waitlist/control group also improved on three (prosocial, conduct problems, and hyperactivity) of the five SDQ subscales. Children originating from Afghanistan improved significantly on the overall resilience scale of the CYRM-R in the intervention group, but not in the waitlist/control group. Overall, all our stratified results of the different scales reflect an accentuated improvement in families with higher levels of problems at baseline. Our comparative results indicated a strong alignment of the strong families programme with its intended short-term impact, per its logical frame on parenting practices and family management skills, children behaviour, caregivers and children mental health, and capacity to cope with stress. We postulate that the potential nudging or diffusion of knowledge (cross-contamination between intervention and waitlist/control group) at the community level could explain improvements in the waitlist/control group on some indicators, however, further research on this is recommend.
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Affiliation(s)
- Karin Haar
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, Division of Operations, United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria;
- Correspondence: (K.H.); (W.M.); Tel.: +43-1-26060-83126 (K.H.); +43-1-26060-5182 (W.M.)
| | - Aala El-Khani
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, Division of Operations, United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria;
| | - Gelareh Mostashari
- United Nations Office on Drugs and Crime, Field Office I.R. of Iran, P.O. Box 15875-4557, Tehran 1994715311, Iran; (G.M.); (M.H.); (A.M.)
| | - Mahdokht Hafezi
- United Nations Office on Drugs and Crime, Field Office I.R. of Iran, P.O. Box 15875-4557, Tehran 1994715311, Iran; (G.M.); (M.H.); (A.M.)
| | - Atoosa Malek
- United Nations Office on Drugs and Crime, Field Office I.R. of Iran, P.O. Box 15875-4557, Tehran 1994715311, Iran; (G.M.); (M.H.); (A.M.)
| | - Wadih Maalouf
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, Division of Operations, United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria;
- Correspondence: (K.H.); (W.M.); Tel.: +43-1-26060-83126 (K.H.); +43-1-26060-5182 (W.M.)
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Affiliation(s)
- Ann S. Masten
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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O’Connor K, Seager J. Displacement, Violence, and Mental Health: Evidence from Rohingya Adolescents in Cox's Bazar, Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5318. [PMID: 34067724 PMCID: PMC8156348 DOI: 10.3390/ijerph18105318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/23/2021] [Accepted: 05/14/2021] [Indexed: 11/17/2022]
Abstract
The Rohingya have endured generations of trauma through displacement and targeted violence in Myanmar. Hundreds of thousands have been forced out of the country, with a large proportion settling in refugee camps in Cox's Bazar, Bangladesh. This study examines the impacts of exposure to trauma on mental health outcomes among Rohingya adolescents living in Bangladesh. Post-traumatic stress disorder (PTSD) and depression are examined as outcomes. The main explanatory variable is a measure of exposure to trauma at two levels of proximity (experiencing and witnessing). Resilience is investigated as a potential effect modifier. Experiencing and witnessing traumatic events are positively and significantly associated with PTSD and depression. However, this effect is only seen for PTSD as a continuous measure, reflecting high rates of low-level PTSD in this population. Resilience is found to reduce the effects of trauma on depression, indicating an effect modification of this relationship.
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Affiliation(s)
| | - Jennifer Seager
- Department of Global Health, George Washington University, 950 New Hampshire Ave, Washington, DC 20052, USA;
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Lee JA, Heberlein E, Pyle E, Caughlan T, Rahaman D, Sabin M, Kaar JL. Study protocol for a school-based single group pragmatic trial to promote resilience in youth: Building Resilience for Healthy Kids. Contemp Clin Trials Commun 2021; 21:100721. [PMID: 33665468 PMCID: PMC7897985 DOI: 10.1016/j.conctc.2021.100721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/08/2020] [Accepted: 01/15/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is a growing prevalence of mental health disorders among youth. Helping youth develop skills that promote and support mental well-being is an important strategy for addressing this public health concern. Building Resilience for Healthy Kids (Healthy Kids) is a school-based program designed to improve resiliency in youth aged 9-13 years old using an innovative health coaching framework. METHODS Healthy Kids is a multi-phased intervention that aims to improve youth resilience using a 6-week, 1:1 health coaching program. The program develops youth resilience and was derived from models for developing youth resilience: Positive Relationships, Coping, Skill Development, Healthy Lifestyle, Sense of Culture, and Connectedness. Effectiveness of the intervention will be evaluated using a single-group, pragmatic trial design with pretest-posttest and follow-up assessments up to 12 months. Process measures will evaluate youth's acceptance and satisfaction of the program and attendance rates. Effectiveness will be evaluated by examining changes in resilience and mental health indicators from pre-to-post program and tracking sustainment of changes in mental health indicators over time. DISCUSSION Given the pragmatic nature of the study design to work with generally healthy populations of students, we expect small, but sustainable, improvements in youth resilience to be achieved through the intervention. Further, this study will provide insight into the potential effectiveness of using health coaching as a strategy to support and promote youth mental well-being in school settings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04202913. Registered December 18, 2019.
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Affiliation(s)
- Joey A. Lee
- University of Colorado Colorado Springs, Department of Health Sciences, Colorado Springs, CO, USA
| | - Erin Heberlein
- Children's Hospital Colorado, Colorado Springs, Colorado Springs, CO, USA
| | - Emily Pyle
- Children's Hospital Colorado, Colorado Springs, Colorado Springs, CO, USA
| | - Thomas Caughlan
- Children's Hospital Colorado, Colorado Springs, Colorado Springs, CO, USA
| | - Darvi Rahaman
- Children's Hospital Colorado, Colorado Springs, Colorado Springs, CO, USA
- University of Colorado School of Medicine, Department of Pediatrics, Aurora, CO, USA
| | - Margaret Sabin
- Children's Hospital Colorado, Colorado Springs, Colorado Springs, CO, USA
| | - Jill L. Kaar
- University of Colorado School of Medicine, Department of Pediatrics, Aurora, CO, USA
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Cherewick M, Lebu S, Su C, Richards L, Njau PF, Dahl RE. Study Protocol of a Distance Learning Intervention to Support Social Emotional Learning and Identity Development for Adolescents Using Interactive Mobile Technology. Front Public Health 2021; 9:623283. [PMID: 33585394 PMCID: PMC7879395 DOI: 10.3389/fpubh.2021.623283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/05/2021] [Indexed: 12/18/2022] Open
Abstract
Background: The maturational period from age 10 to 14-often referred to as very young adolescents (VYAs)-represents a dynamic period of learning and neurobehavioral development as individuals transition from childhood to adolescence. This developmental period presents a window of opportunity for strategic investment to improve trajectories of health, education and well-being among young people. More specifically, neurodevelopmental changes during pubertal maturation influence neural circuitry involved in processing emotions, risks, rewards and social relationships. Technology can be leveraged to create social emotional learning experiences for VYAs and provide opportunities for flexible, distance learning in low-income countries. The aim of this study protocol is to detail how insights from developmental science can be used to inform the intervention design, implementation and evaluation of a distance learning, social emotional learning intervention for VYAs. Methods: This study will be delivered to 500 VYAs in Temeke District, Dar es salaam. Study participants will watch culturally-relevant, animated videos on social emotional mindsets and skills and content will be paired with experiential learning activities over a period of 10 weeks. A nested smart-phone based study will practice learning social emotional skills and mindsets through engagement with multi-media material via the WhatsApp messenger application. Surveys and in-depth interviews will be administered to adolescents, their parents/caregivers and teachers before and after the intervention to evaluate the effect of the intervention on study outcomes. Discussion: This study is among the first to provide results on how to effectively design a distance-learning intervention to promote social emotional learning and identity development within a low-resource context. The findings will provide substantial evidence to inform new intervention approaches that are effective in low-resource contexts and strategies to reach scale among similar programs invested in leveraging technology to support adolescent health and development. Clinical Trial registration: Study registered with ClinicalTrials.gov. Identifier number NCT0445807.
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Affiliation(s)
- Megan Cherewick
- Department of Health Sciences, California State University East Bay, Hayward, CA, United States
| | - Sarah Lebu
- Institute of Human Development, University of California Berkeley, Berkeley, CA, United States
| | - Christine Su
- Institute of Human Development, University of California Berkeley, Berkeley, CA, United States
| | - Lisa Richards
- Health for a Prosperous Nation, Dar es Salaam, Tanzania
| | | | - Ronald E. Dahl
- Institute of Human Development, University of California Berkeley, Berkeley, CA, United States
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Wahab S, Yong LL, Chieng WK, Yamil M, Sawal NA, Abdullah NQ, Muhdisin Noor CR, Wd Wiredarma SM, Ismail R, Othman AH, Damanhuri HA. Post-traumatic Stress Symptoms in Adolescents Exposed to the Earthquake in Lombok, Indonesia: Prevalence and Association With Maladaptive Trauma-Related Cognition and Resilience. Front Psychiatry 2021; 12:680393. [PMID: 34819880 PMCID: PMC8606579 DOI: 10.3389/fpsyt.2021.680393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Natural disasters may physically and psychologically affect individuals and their surrounding community. This study determines the prevalence of post-traumatic stress (PTS) symptoms and its association with maladaptive trauma-related cognition and resilience among adolescents post-earthquake. Materials and Methods: Data were collected, in this cross-sectional study, during an intervention program post-earthquake held in a state high school located at Lombok, Indonesia. The study sample engaged students 14-19 years of age using the purposive sampling method. The questionnaires used to measure PTS symptoms, maladaptive trauma-related cognition, and resilience were Children's Revised Impact of Event Scale-13 (CRIES-13), Child Post-Traumatic Cognitions Inventory (CPTCI), and Child and Youth Resilience Measure-Revised (CYRM-R), respectively. Results: The prevalence of PTS symptoms was 69.9%. Among the respondents, 61.37% were female and 56.48% had mothers with lower educational levels. Using multiple linear regression, the final predictors of PTS symptoms were excessive reactions (e.g., wailing loudly, miserable shrieking) of proxy during earthquake (β = 3.283, p = 0.005), maladaptive trauma-related cognition (β = 0.224, p = 0.002), and resilience (β = 0.192, p < 0.001) with female gender (β = 7.350, p < 0.001) as a control variable. Through simple linear regression, victims who witnessed injury or death during the earthquake (p = 0.003), had a proxy died during the earthquake (p = 0.01), and trapped victims or those who had difficulty escaping (p = 0.01) were identified to potentially predict the occurrence of PTS symptoms, warranting further study. Conclusion: The presence of excessive proxy reactions during the earthquake, maladaptive trauma-related cognition, and resilience in adolescents exposed to a natural disaster are worth targeting and prioritizing in future post-disaster interventions.
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Affiliation(s)
- Suzaily Wahab
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Li Ling Yong
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Wei Keong Chieng
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Myristica Yamil
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Noor Azah Sawal
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Nurul Qiyaam Abdullah
- Faculty of Health Science, Universitas Muhammadiyah Mataram, Kota Mataram, Indonesia
| | | | | | - Rosnah Ismail
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Aisya Hanim Othman
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Hanafi Ahmad Damanhuri
- Department of Biochemistry, Faculty of Medicine, The National University of Malaysia, Wilayah Persekutuan Kuala Lumpur, Malaysia
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