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Anderson RE, Johnson N, Jones SCT, Patterson A, Anyiwo N. Racial Socialization and Black Adolescent Mental Health and Developmental Outcomes: A Critical Review and Future Directions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-24. [PMID: 39137924 DOI: 10.1080/15374416.2024.2384025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
OBJECTIVE Black American adolescents are beleaguered with the most frequent and severe experiences of racial discrimination (RD) among their peers. To protect Black adolescents' mental health and developmental outcomes from the pernicious impact of discrimination, parents and other proximal adults and peers often utilize racial socialization (RS), or communications and behaviors emphasizing the importance of race and the harms of racism. While several recent RS reviews have been conducted across ethnicity, a modern review investigating RS practices related to and predictive of Black adolescent psychosocial outcomes is needed. METHOD To ground our critical systematic review of 45 articles, we first highlighted the ways RD impacts the lives of Black adolescents. Then, drawing from integrative models for Black youth development, we synthesized recent psychological, academic, and sociocultural literatures to describe the role of RS in Black adolescents' wellness. RESULTS The impact of various tenets of RS was seen most clearly as a protective factor against RD with respect to adolescents' mental health (e.g. depression), academic achievement (e.g. GPA), and sociocultural identity (e.g. public and private racial regard) development. Cultural socialization, a strategy related to extolling pride for one's race, was the most consistent RS protective factor, with novel RS constructs (e.g. parental competency) emerging as a method to buffer youth internalizing and externalizing problems. CONCLUSIONS Recommendations are made for future research on understudied components of RS and multiple methods and reporters to capture a more holistic depiction of RS practices. We emphasize preventative and intervening approaches to reduce the impetus for RS and its impact, including burgeoning clinical and community-level programs and the importance for provider training to yield positive mental health outcomes for Black adolescents.
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Kaslow NJ, Clarke C, Hampton-Anderson JN. Culturally humble and anti-racist couple and family interventions for African Americans. FAMILY PROCESS 2024; 63:512-526. [PMID: 37712380 DOI: 10.1111/famp.12938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/09/2023] [Accepted: 08/26/2023] [Indexed: 09/16/2023]
Abstract
Anti-Black racism including structural racism and racism-related disparities have come to the foreground in recent years with the increasingly frequent and brutal police killings of innocent African Americans, the disproportionate impacts of the pandemic on the Black community, and the effectiveness of the Black Lives Matter movement. There have been calls to action to ensure cultural effectiveness of couples and family therapy for African Americans. As one response to these calls, this article provides recommendations for culturally humble and anti-racist couple and family interventions. These best practices focus on the necessity of embracing a systemic stance and a strengths-based culturally responsive lens when assessing and intervening with African American couples and families. They focus on the need for therapists to be intentional about and consistent in engaging in self-exploration and taking the necessary steps to be not just competent but also capable. The final set of best practices detailed relate to assessing and intervening using a strengths-based approach in a culturally responsive, anti-racist, and socially attuned fashion. The article concludes with recommendations for couple/family therapists to develop a critical consciousness, engage in anti-racist practices, and address oppression while advancing healing and liberation, all of which are essential to ensuring the resilience and well-being of African American couples and families.
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Affiliation(s)
- Nadine J Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Christina Clarke
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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Collins B, Garbacz SA, Powell T. Reframing family-school partnerships to disrupt disenfranchisement of Black families and promote reciprocity in collaboration. J Sch Psychol 2024; 104:101290. [PMID: 38871413 DOI: 10.1016/j.jsp.2024.101290] [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: 01/31/2022] [Revised: 03/27/2023] [Accepted: 01/24/2024] [Indexed: 06/15/2024]
Abstract
Research has long demonstrated the benefits of family-school partnerships. However, these benefits often fail to generalize to all families, especially Black families. A present and historical pattern of discrimination and exclusion has contributed to the lack of benefits yielded from Black family-school partnerships. A major contributing factor is the narrow way in which schools define family engagement. Such narrow definitions often marginalize families from non-dominant backgrounds, particularly Black families, and reinforce harmful narratives that Black parents and families are uninvolved in their children's education. The combination of continued discrimination and exclusion as well as harmful narratives has impacted Black family-school partnering. However, schools can work to repair harm and rebuild partnerships with Black families. In this article, we advance a framework for such work. After grounding the need for this framework in a historical context, we emphasize three essential components to forming equitable Black family-school partnerships: (a) grounding relationship building in social justice, (b) integrating reciprocity in family-school relationships, and (c) usage of multiple and non-dominant methods and modalities to build relationships.
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Power TG, Baker SS, Barale KV, Aragón MC, Lanigan JD, Parker L, Garcia KS, Auld G, Micheli N, Hughes SO. Using Mobile Technology for Family-Based Prevention in Families with Low Incomes: Lessons from a Randomized Controlled Trial of a Childhood Obesity Prevention Program. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:369-379. [PMID: 38321316 PMCID: PMC10891227 DOI: 10.1007/s11121-023-01637-8] [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] [Accepted: 12/28/2023] [Indexed: 02/08/2024]
Abstract
Researchers are increasingly using web-based technologies to deliver family-based, prevention programming. Few studies have examined the success of such approaches for families with low incomes. The purpose of this study was to describe the level of in-class and online engagement in a childhood obesity prevention program for parents with low incomes, to examine the demographic correlates of parent engagement, and to examine dosage effects on parental feeding outcomes as a function of online exposure. All participants attended in-class nutrition education classes (Eating Smart · Being Active) as part of the Expanded Food and Nutrition Education Program (EFNEP) in Colorado and Washington State (classes were offered in English and Spanish). Participants in this analysis were 168 parents from a larger cluster randomized controlled trial who had been randomly assigned to also receive a newly developed, mobile-based version of an efficacious, feeding-focused, childhood obesity prevention program. Results showed that despite high levels of in-person attendance (70%), participants only accessed 47% of the videos (online content). Older parents and parents of girls showed higher levels of in-person attendance; currently employed parents showed lower levels. Online engagement varied as a function of ethnicity and acculturation: non-Hispanic parents accessed the most videos, low-acculturated Hispanic parents accessed the second most, and highly acculturated Hispanic parents accessed the least. In contrast, low-acculturated Hispanic parents showed the highest in-person attendance. For all but one outcome, significant online program effects were found only for parents who accessed at least half of the videos. Implications for mobile-based, family-based prevention programs for parents with low incomes are considered.ClinicalTrials.gov Identifier: NCT03170700; Registration Date: March 08, 2017.
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Affiliation(s)
| | | | | | - M Catalina Aragón
- Washington State University Extension, Tacoma, WA, USA
- Maternal and Child Health, Oregon Health Authority, Portland, OR, USA
| | | | - Louise Parker
- Washington State University Extension, Seattle, WA, USA
| | - Karina Silva Garcia
- Washington State University, Pullman, WA, USA
- Department of Public Health, County of San Luis Obispo, San Luis Obispo, CA, USA
| | - Garry Auld
- Colorado State University, Ft. Collins, CO, USA
| | - Nilda Micheli
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA.
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O’Hara KL, Guastaferro K, Hita L, Rhodes CA, Thomas NA, Wolchik SA, Berkel C. Applying the resource management principle to achieve community engagement and experimental rigor in the multiphase optimization strategy framework. IMPLEMENTATION RESEARCH AND PRACTICE 2024; 5:26334895241262822. [PMID: 39139553 PMCID: PMC11320397 DOI: 10.1177/26334895241262822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
Preventing and treating mental health and substance use problems requires effective, affordable, scalable, and efficient interventions. The multiphase optimization strategy (MOST) framework guides researchers through a phased and systematic process of developing optimized interventions. However, new methods of systematically incorporating information about implementation constraints across MOST phases are needed. We propose that early and sustained integration of community-engaged methods within MOST is a promising strategy for enhancing an optimized intervention's potential for implementation. In this article, we outline the advantages of using community-engaged methods throughout the intervention optimization process, with a focus on the Preparation and Optimization Phases of MOST. We discuss the role of experimental designs in optimization research and highlight potential challenges in conducting rigorous experiments in community settings. We then demonstrate how relying on the resource management principle to select experimental designs across MOST phases is a promising strategy for maintaining both experimental rigor and community responsiveness. We end with an applied example illustrating a community-engaged approach to optimize an intervention to reduce the risk for mental health problems and substance use problems among children with incarcerated parents.
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Affiliation(s)
| | - Kate Guastaferro
- School of Global Public Health, New York University, New York, NY, USA
| | - Liza Hita
- REACH Institute, Arizona State University, Tempe, AZ, USA
| | | | | | | | - Cady Berkel
- REACH Institute, Arizona State University, Tempe, AZ, USA
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Murry VM, Bradley C, Cruden G, Brown CH, Howe GW, Sepùlveda MJ, Beardslee W, Hannah N, Warne D. Re-envisioning, Retooling, and Rebuilding Prevention Science Methods to Address Structural and Systemic Racism and Promote Health Equity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:6-19. [PMID: 36223046 PMCID: PMC9554395 DOI: 10.1007/s11121-022-01439-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/09/2022]
Abstract
The historic momentum from national conversations on the roots and current impacts of racism in the USA presents an incredible window of opportunity for prevention scientists to revisit how common theories, measurement tools, methodologies, and interventions can be radically re-envisioned, retooled, and rebuilt to dismantle racism and promote equitable health for minoritized communities. Recognizing this opportunity, the NIH-funded Prevention Science and Methodology Group (PSMG) launched a series of presentations focused on the role of Prevention Science to address racism and discrimination guided by a commitment to social justice and health equity. The current manuscript aims to advance the field of Prevention Science by summarizing key issues raised during the series' presentations and proposing concrete research priorities and steps that hold promise for promoting health equity by addressing systemic racism. Being anti-racist is an active practice for all of us, whether we identify as methodologists, interventionists, practitioners, funders, community members, or an intersection of these identities. We implore prevention scientists and methodologists to take on these conversations with us to promote science and practice that offers every life the right to live in a just and equitable world.
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Affiliation(s)
- Velma McBride Murry
- Departments of Health Policy & Human and Organizational Development, Vanderbilt University, Nashville, TN, USA.
| | - Cory Bradley
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - C Hendricks Brown
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - William Beardslee
- Harvard Medical School, Boston Children's Hospital, Judge Baker Children's Center, Boston, MA, USA
| | - Nanette Hannah
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Donald Warne
- Center for Indigenous Health, Johns Hopkins University, Baltimore, MD, USA
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Murry VM, Nyanamba JM, Hanebutt R, Debreaux M, Gastineau KAB, Goodwin AKB, Narisetti L. Critical examination of resilience and resistance in African American families: Adaptive capacities to navigate toxic oppressive upstream waters. Dev Psychopathol 2023; 35:2113-2131. [PMID: 37665095 DOI: 10.1017/s0954579423001037] [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] [Indexed: 09/05/2023]
Abstract
African American families navigate not only everyday stressors and adversities but also unique sociocultural stressors (e.g., "toxic upstream waters" like oppression). These adverse conditions are consequences of the historical vestiges of slavery and Jim Crow laws, often manifested as inequities in wealth, housing, wages, employment, access to healthcare, and quality education. Despite these challenges, African American families have developed resilience using strength-based adaptive coping strategies, to some extent, to filter these waters. To advance the field of resilience research, we focused on the following questions: (1) what constitutes positive responses to adversity?; (2) how is resilience defined conceptually and measured operationally?; (3) how has the field of resilience evolved?; (4) who defines what, when, and how responses are manifestations of resilience, instead of, for example, resistance? How can resistance, which at times leads to positive adaptations, be incorporated into the study of resilience?; and (5) are there case examples that demonstrate ways to address structural oppression and the pernicious effects of racism through system-level interventions, thereby changing environmental situations that sustain toxic waters requiring acts of resilience to survive and thrive? We end by exploring how a re-conceptualization of resilience requires a paradigm shift and new methodological approaches to understand ways in which preventive interventions move beyond focusing on families' capacity to navigate oppression and target systems and structures that maintain these toxic waters.
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Affiliation(s)
- Velma McBride Murry
- Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, USA
- Department of Health Policy, Vanderbilt University, Nashville, TN, USA
| | - Juliet M Nyanamba
- Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, USA
| | - Rachel Hanebutt
- Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, USA
| | - Marlena Debreaux
- Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, USA
| | - Kelsey A B Gastineau
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Aijah K B Goodwin
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lipika Narisetti
- Center for Medicine Health & Society, Vanderbilt University, Nashville, TN, USA
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Murry VM, Gonzalez CM, Debreaux ML, Coates EE, Berkel C. Implications of built and social environments on the academic success among African American youth: testing Strong African American Families intervention effects on parental academic racial socialization. Front Psychol 2023; 14:956804. [PMID: 37655195 PMCID: PMC10467428 DOI: 10.3389/fpsyg.2023.956804] [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: 05/30/2022] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
Studies exploring widening academic disparities have highlighted the role of racialized school settings, which have given way to incidents of discrimination and unfair treatment for students of color, disproportionately affecting African American youth. Research also shows that family-based preventive interventions may avert negative outcomes for this population through the promotion of protective socialization practices. Consequently, the current study tests the efficacy of a culturally tailored preventive family-based program to foster induced changes in academic promotive parenting practices that prepare youth to advance academically by navigating negative race-related experiences in school settings. Data collected over four time periods from the Strong African American Families (SAAF) efficacy trial (Murry and Brody, 2004) with 667 African American families in rural Georgia were used for this study. Structural equation modeling analyses demonstrated that the SAAF program was associated with positive intervention induced changes in parental academic race-related socialization, which in turn, was indirectly associated with reduced school compromising behaviors through the enhancement of racial pride. While discrimination compromised academic success, our findings highlight the protective nature of racial pride in dissuading academic failure and school dropout through the promotion of academic success. This study confirms that a family-based prevention program holds promise to address academic disparities through the enhancement of parenting and youth protective processes that buffer youth from succumbing to racialized social environments such as schools. Implications for research, educational policy, and preventive interventions are discussed.
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Affiliation(s)
- Velma McBride Murry
- Department of Human and Organizational Development, Department of Health Policy, School of Medicine, Peabody College, Vanderbilt University, Nashville, TN, United States
| | - Catherine M. Gonzalez
- Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, United States
| | - Marlena L. Debreaux
- Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, United States
| | - Erica E. Coates
- Department of Psychiatry, MedStar Georgetown University Hospital/Georgetown University School of Medicine, Washington, DC, United States
| | - Cady Berkel
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
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Willis HA, Gonzalez JC, Call CC, Quezada D, Galán CA. Culturally Responsive Telepsychology & mHealth Interventions for Racial-Ethnic Minoritized Youth: Research Gaps and Future Directions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:1053-1069. [PMID: 36227174 PMCID: PMC9627988 DOI: 10.1080/15374416.2022.2124516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Telepsychology and mHealth (TPmH) services for youth and their families have become increasingly prevalent in recent years. However, significant limitations in theory, research, and policy introduce questions about the effectiveness of such interventions, particularly for racial-ethnic minoritized youth and their families, who already contend with inequities in mental health treatment access and outcomes. Although TPmH have the potential to reduce barriers to mental health services in ways that may benefit racial-ethnic minoritized youth and their families, the mental health field must first grapple with limitations in culturally responsive TPmH work to avoid perpetuating existing mental health inequities. As such, this article begins by briefly reviewing extant literature on (1) TPmH for youth, (2) culturally adapted or culturally responsive evidence-based interventions for racial-ethnic minoritized youth and families, and (3) the intersection of TPmH and culturally responsive interventions. Informed by the gaps identified by this review, we provide recommendations for future directions in culturally responsive TPmH for racial-ethnic minoritized youth and families. These recommendations have been organized into four overarching categories: (1) conceptual and theoretical recommendations, (2) research priorities, (3) practice and policy recommendations, and (4) engagement and access recommendations. These recommendations offer novel ideas for researchers, clinicians, funding agencies, policy-makers, and other key stakeholders and are intended to facilitate equity in TPmH for racial-ethnic minoritized youth and their families.
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Affiliation(s)
| | - Juan Carlos Gonzalez
- Department of Counseling, Clinical, & School Psychology, University of California
| | | | - David Quezada
- Department of Psychology, University of Southern California
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Dolgin PhD MJ, Asper Ba A, Greizer Ba Y, Kariel Ba Y, Malka Ba M, Peretz Ba O, Rosenzweig Ba N, Shalev Ba S, Sandberg PhD DE. Meaningful Change and Treatment Responsivity in Intervention Research: A Targeted Review of Studies Published in the Journal of Pediatric Psychology. J Pediatr Psychol 2022; 47:723-741. [PMID: 35199833 DOI: 10.1093/jpepsy/jsac005] [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: 11/04/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Randomized-controlled trials (RCTs) in pediatric psychology form the foundation for evidence-based treatment and best practices in the field. Relying heavily on continuous outcome measures and group comparisons, questions concerning meaningful clinical change and treatment response rates remain open. This targeted review aimed to provide an initial description of the current state of intervention research in pediatric psychology in terms of attention to meaningful clinical change and efforts to assess and characterize participants in terms of treatment responsivity. METHODS Online databases were used to identify a sample of RCT published in the Journal of Pediatric Psychology from 2010 to 2021 using the term "randomized" in the title. Using predefined eligibility and exclusion criteria, 43 studies were identified and analyzed with regard to characteristics of intervention, population, measurement, data reporting, and reference to indicators of clinical significance, meaningful change, treatment responsivity rates, and predictors. RESULTS 26 studies (60%) made no reference at all to meaningful clinical change, treatment response criteria and rates, or characteristics of treatment responders. 15 studies (35%) reported measures of meaningful change in their interpretation of group differences, to calculate sample size, in relation to baseline data only, or in describing a measure. 2 studies (5%) reported criteria for assessing meaningful change to determine individual response rates and characteristics of responders. CONCLUSIONS These findings highlight the need for greater emphasis on defining standards and analyzing treatment outcome research in terms of metrics of meaningful change and treatment response in order to better target intervention and optimize limited resources.
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Affiliation(s)
| | - Ariel Asper Ba
- Department of Psychology, Ariel University, Ariel, Israel
| | | | | | - Meshi Malka Ba
- Department of Psychology, Ariel University, Ariel, Israel
| | - Or Peretz Ba
- Department of Psychology, Ariel University, Ariel, Israel
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11
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Garvin LA, Hu J, Slightam C, McInnes DK, Zulman DM. Use of Video Telehealth Tablets to Increase Access for Veterans Experiencing Homelessness. J Gen Intern Med 2021; 36:2274-2282. [PMID: 34027612 PMCID: PMC8141357 DOI: 10.1007/s11606-021-06900-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Veterans experiencing homelessness face substantial barriers to accessing health and social services. In 2016, the Veterans Affairs (VA) healthcare system launched a unique program to distribute video-enabled tablets to Veterans with access barriers. OBJECTIVE Evaluate the use of VA-issued video telehealth tablets among Veterans experiencing homelessness in the VA system. DESIGN Guided by the RE-AIM framework, we first evaluated the adoption of tablets among Veterans experiencing homelessness and housed Veterans. We then analyzed health record and tablet utilization data to compare characteristics of both subpopulations, and used multivariable logistic regression to identify factors associated with tablet use among Veterans experiencing homelessness. PATIENTS In total, 12,148 VA patients receiving tablets between October 2017 and March 2019, focusing on the 1470 VA Veterans experiencing homelessness receiving tablets (12.1%). MAIN MEASURES Tablet use within 6 months of receipt for mental health, primary or specialty care. KEY RESULTS Nearly half (45.9%) of Veterans experiencing homelessness who received a tablet had a video visit within 6 months of receipt, most frequently for telemental health. Tablet use was more common among Veterans experiencing homelessness who were younger (AOR = 2.77; P <.001); middle-aged (AOR = 2.28; P <.001); in rural settings (AOR = 1.46; P =.005); and those with post-traumatic stress disorder (AOR = 1.64; P <.001), and less common among those who were Black (AOR = 0.43; P <.001) and those with a substance use disorder (AOR = 0.59; P <.001) or persistent housing instability (AOR = 0.75; P = .023). CONCLUSIONS Telehealth care and connection for vulnerable populations are particularly salient during the COVID-19 pandemic but also beyond. VA's distribution of video telehealth tablets offers healthcare access to Veterans experiencing homelessness; however, barriers remain for subpopulations. Tailored training and support for these patients may be needed to optimize telehealth tablet use and effectiveness.
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Affiliation(s)
- Lynn A Garvin
- VA Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, 150 S. Huntington Avenue, Bldg 9, Rm 225, Boston, MA, 02130, USA.
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
| | - Jiaqi Hu
- VA Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Cindie Slightam
- VA Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - D Keith McInnes
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
- VA Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Donna M Zulman
- VA Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
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Olfert MD, Barr ML, Hagedorn RL, Long DM, Haggerty TS, Weimer M, Golden J, Maurer MA, Cochran JD, Hendershot T, Whanger SL, Mason JD, Hodder SL. Feasibility of a mHealth Approach to Nutrition Counseling in an Appalachian State. J Pers Med 2019; 9:E50. [PMID: 31757057 PMCID: PMC6963633 DOI: 10.3390/jpm9040050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 12/04/2022] Open
Abstract
West Virginia is a rural state with an aging population that may experience barriers to accessing nutritional and lifestyle counseling. This study examined feasibility of an online personalized nutrition tracking application, Good Measures (GM), with patients at seven health care clinics throughout the state. Fourteen healthcare providers and 64 patients 18 years or older with a Body Mass Index (BMI) greater than or equal to 30 and access to the Internet were recruited for this 12-week feasibility study. Patient participants logged meals and exercise into the GM application via smart phone, tablet, or computer and virtually engaged with a Registered Dietitian Nutritionist (RDN) in one-on-one sessions. The primary endpoint was to examine feasibility of the program by usage of the application and feedback questions regarding the benefits and challenges of the application. Participants were predominately white (92%) and female (76%). Minimal improvements in weight and systolic blood pressure were found. Participant attitude survey data declined from 4-weeks to 12-weeks of the intervention. Interestingly though, patients in a rural clinic had lesser declines in attitudes than peri-urban participants. Qualitative feedback data identified participants predominately had a positive overall feeling toward the approach. Participants expressed favorability of RDN access, the variety of foods, but did give suggestions for in-person meetings and more updating of the application. Implementing a technology approach to nutrition in rural areas of West Virginia using a mobile application with RDN access may be one strategy to address public health issues such as obesity.
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Affiliation(s)
- Melissa D. Olfert
- Department of Animal and Food Science, West Virginia University, Morgantown, WV 26505, USA; (M.L.B.); (R.L.H.)
| | - Makenzie L. Barr
- Department of Animal and Food Science, West Virginia University, Morgantown, WV 26505, USA; (M.L.B.); (R.L.H.)
| | - Rebecca L. Hagedorn
- Department of Animal and Food Science, West Virginia University, Morgantown, WV 26505, USA; (M.L.B.); (R.L.H.)
| | - Dustin M. Long
- School of Public Health, University of Alabama, Birmingham, AL 35487, USA;
| | - Treah S. Haggerty
- WVU Family Practice, Department of Family Medicine, Morgantown, WV 26501, USA;
| | - Mathew Weimer
- Valley Health System, Department of Family Medicine, Huntington, WV 25701, USA;
| | - Joseph Golden
- New River Health, Department of Family Medicine, Sophia, WV 25921, USA;
| | - Mary Ann Maurer
- CAMC Family Practice, Department of Family Medicine, Charleston, WV 25304, USA;
| | - Jill D. Cochran
- Robert C. Byrd Clinic and West Virginia School of Osteopathic Medicine, Lewisburg, WV 24901 USA;
| | - Tracy Hendershot
- Coplin Memorial Hospital, Family Practice, Elizabeth, WV 26143, USA;
| | - Stacey L. Whanger
- West Virginia Practice Based Research Network, Morgantown, WV 26506, USA; (S.L.W.); (J.D.M.)
| | - Jay D. Mason
- West Virginia Practice Based Research Network, Morgantown, WV 26506, USA; (S.L.W.); (J.D.M.)
| | - Sally L. Hodder
- West Virginia University Health Sciences Center, Clinical and Translational Science Institute, Morgantown, WV 26506, USA;
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13
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Cushing CC, Fedele DA, Riley WT. Introduction to the Coordinated Special Issue on eHealth/mHealth in Pediatric Psychology. J Pediatr Psychol 2019; 44:259-262. [PMID: 30806658 DOI: 10.1093/jpepsy/jsz010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 01/31/2019] [Accepted: 02/04/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christopher C Cushing
- Clinical Child Psychology Program and Schiefelbusch Institute for Life Span Studies, University of Kansas
| | - David A Fedele
- Department of Clinical & Health Psychology, University of Florida
| | - William T Riley
- National Institutes of Health, Office of Behavioral and Social Sciences Research
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