Decreasing Depression and Anxiety in College Youth Using the Creating Opportunities for Personal Empowerment Program (COPE)

Mental Health Interventions in Middle Schools: A 10-Year Review of Research

Schools can play an important role in addressing growing concerns about adolescent mental health. Mental health of high school students has predominantly been the focus in literature with less emphasis on younger adolescents. This review identified articles published in the last decade that described evaluations of middle school-based mental health interventions and randomized participants to an intervention or control condition. Fourteen interventions met the inclusion criteria. About two-thirds of interventions were based on mindfulness or cognitive behavioral therapy. Many trials utilized racially diverse, low-income samples. All interventions were delivered to groups, and three contained a parent component. Five trials increased rigor by using an active control condition. Almost two-thirds of the interventions were effective (p < .10) in reducing at least one depression, anxiety, affect, or internalizing symptom outcome compared to a control group. This article provides information about intervention characteristics, efficacy, theoretical framework, and acceptability/feasibility.

A study protocol for the modified interactive screening program plus MINDBODYSTRONG© RCT: A mental health resiliency intervention for nurses

BACKGROUND

Nurses, the largest workforce in healthcare, are at high risk of depression, anxiety, burnout, and suicidal ideation. Suicide among nurses is higher than the general population. This randomized controlled trial pairs the MINDBODYSTRONG© cognitive-behavioral skills building program with the American Foundation for Suicide Prevention's (AFSP) Modified Interactive Screening Program (mISP) to reduce depression, suicidal ideation, post-traumatic stress, anxiety, and burnout, and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in nurses with moderate to high risk of suicide.

AIMS

This study aims to determine the effects of the mISP combined with the digitized MINDBODYSTRONG© program versus the mISP alone on depression, suicidal ideation, burnout, anxiety, post-traumatic stress, healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in 364 U.S. nurses.

METHODS

A digitized version of MINDBODYSTRONG© combined with the mISP screening and referral platform will be compared to the AFSP mISP alone through a two-arm randomized controlled trial. Follow-up post-intervention data will be collected at week eight and months three, six, and 12.

DISCUSSION

If successful, this study's findings could assist nurses who are hesitant to use conventional mental health resources by providing them with confidential aid and learning opportunities to reduce suicidality, depression, anxiety, post-traumatic stress, and burnout and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction.

TRIAL/STUDY REGISTRATION

The Ohio State University Protocol Record 2021B0417, Modified Interactive Screening Program Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses, is registered and posted at ClinicalTrials.gov Identifier: NCT05582343. First posted date is October 17, 2022.

The evidence-based COPE program: Reducing the time between diagnosing and treating depression and anxiety in youth

ABSTRACT

The soaring prevalence of depression and anxiety in children, teenagers, and young adults is now a public health epidemic, yet access to timely evidence-based mental health treatment is often lacking due to a severe shortage of mental health providers. This article provides an overview of the current state of depression and anxiety in children and adolescents as well as first-line evidence-based treatment. The Creating Opportunities for Personal Empowerment (COPE) program, a cognitive-behavioral skills-building intervention, is highlighted as an evidence-based intervention for timely treatment that can be delivered by NPs, physicians, and physician associates/assistants in primary care settings, school-based health centers, and chronic care clinics with reimbursement as well as in schools and universities as a preventive mental health intervention.

State of Mental Health, Healthy Behaviors, and Wellness Support in Big 10 University Nursing and Health Sciences Faculty, Staff, and Students During COVID-19

BACKGROUND

Federal and national entities urge organizations to assess healthcare professionals' mental health and well-being as the COVID-19 pandemic has compounded the issue.

AIMS

This study aimed to (1) describe rates of mental health issues, healthy lifestyle behaviors, and perceptions of COVID-19's impact among Big 10 University nursing and health sciences faculty, staff, and students; (2) identify predictors of depression, anxiety, stress, and burnout; and (3) assess the relationships among perceived school wellness support, healthy lifestyle behaviors, physical/mental health, and mattering.

METHODS

A cross-sectional descriptive correlational design was used. Nursing and health science deans emailed invitations to faculty, staff, and students concerning an anonymous wellness assessment survey. Correlation coefficients tested associations among mental health indicators and wellness cultures. Multiple linear regression examined factors associated with mental health indicators.

RESULTS

Faculty, staff, and students responded (N = 1345). Findings indicated that most respondents were not getting adequate sleep, meeting physical activity recommendations, or eating the daily recommended number of fruits/vegetables. Fourteen to 54.9 % of participants reported depression, anxiety, and burnout. Overall, students, faculty and staff at colleges that operated under a strong wellness culture had better outcomes.

CONCLUSION

Wellness cultures impact the mental and physical health of faculty, staff, and students.

Thinking, Feeling, Behaving: Using the MINDBODYSTRONG ® Intervention to Improve Nurse Well-being Using a Virtual Format

OBJECTIVE

This study examined the impact of the MINDBODYSTRONG ® program on mental health and lifestyle behaviors among a sample of staff nurses, clinical nurse leaders, and faculty, when offered after the onset of the COVID-19 pandemic.

BACKGROUND

Previous studies have demonstrated the MINDBODYSTRONG program decreased anxiety and depressive symptoms, improved job satisfaction, and sustained healthy lifestyle behaviors in newly licensed RNs. This program has not been studied with experienced nurses. In addition, the use of a virtual format is unique.

METHODS

A pre-post design was used for this pilot study. Subjects were recruited from a large Midwestern medical center and affiliated school of nursing. Registered participants of the MINDBODYSTRONG program attended 7 weekly sessions virtually.

RESULTS

The MINDBODYSTRONG intervention suggests sustained improvement in perceived stress, anxiety, depression, and use of healthy behaviors.

CONCLUSION

This pilot study supports that the MINDBODYSTRONG program may be effective in addressing mental health and healthy lifestyle beliefs for staff nurses, clinical nurse leaders, and nursing faculty.

Factors Influencing Frontline Screening Nurses' Depression as a Long-Term Impact of COVID-19

Frontline screening nurses experienced exhaustion and depressive symptoms as a long-term impact of COVID-19. This study aimed to explore fatigue, depression, and empowerment among frontline screening nurses and examine the factors influencing depression. This was a descriptive cross-sectional study. The study included 140 frontline screening nurses in South Korea recruited from February to March 2021. The measures included a fatigue scale, the Text of Items Measuring Empowerment (TIME), and the Center for Epidemiological Studies Depression Scale (CES-D). The STROBE checklist was used for reporting aspects of the cross-sectional design. Frontline screening nurses showed high fatigue scores (M = 3.47, SD = 0.55), and 55.7% (n = 78) of them were depressed and had low empowerment scores (M = 3.53, SD = 0.69). Empowerment and fatigue were predictors of depression. Increased empowerment and decreased fatigue were important in decreasing depression. Therefore, efforts to provide sufficient staffing, screening for depression, and listening to nurses' voices are necessary.

Health education via "empowerment" digital marketing of consumer products and services: Promoting therapeutic benefits of self-care for depression and chronic pain

Increasing health care costs and high economic burden exemplify the impact of chronic diseases on public health. Multifaceted approaches to treating chronic diseases include pharmaceutical drugs, digital therapeutics, and lifestyle medicine. Chronic diseases are largely preventable, and health promotion yields positive outcomes. However, despite positive return on investment (ROI) and cost-to-benefit ratio (CBR) for health promotion (median ROI 2.2, median CBR 14.4), commercial marketing of healthy lifestyles and self-care is limited. The objective of this perspective article is to discuss how digital marketing of consumer goods and services that support therapeutic self-care can also bridge public health and for-profit interests. We describe how "empowerment" marketing campaigns can provide evidence-based associations between products/services and self-care benefits for people living with chronic pain and depression. Such a "health education as marketing" strategy is illustrated by educational ads describing how contact with nature, music, and yoga can improve chronic pain and reduce depressive symptoms. Creating associations between health-related benefits of these activities with products (outdoor and yoga apparel, audio equipment) and services (music streaming services, music mobile apps, eco-tourism, yoga studios) that support them expand their value proposition, thus incentivizing profit-driven companies to engage in public health campaigns. Long-term success of companies that incorporate evidence-based health education as marketing and branding strategies will depend on following ethical considerations and advertising guidelines defined by consumer protection regulatory agencies, such as the Federal Trade Commission (FTC). In conclusion, integration of health education about self-care and commercial marketing can support health care outcomes and disease prevention.

An Adaptation of the COPE Intervention for Adolescent Bullying Victimization Improved Mental and Physical Health Symptoms

OBJECTIVE

One in five children report experiencing bullying. Bullying in childhood affects the physical and emotional health and functioning of youth with immediate consequences, including depression, anxiety, somatic complaints, and suicidal ideation. Schools overwhelmingly are tasked with addressing bullying; however, school-based programs are often focused on preventing bullying from occurring. There is a paucity of evidence-based interventions for adolescents who have directly experienced bullying and suffer from adverse health outcomes, especially when they present to the mental health setting.

METHODS

This pre-experimental study examined the feasibility, acceptability, and preliminary effects of the MINDSTRONG to Combat Bullying Program for adolescents who have experienced bullying with concurrent mental health symptoms.

RESULTS

Twenty adolescents and their parent dyads enrolled in the MINDSTRONG to Combat Bullying program. Significant reductions were found over time in adolescent self-reported depressive, anxiety and somatic symptoms as well as bullying victimization frequency, with large positive effect sizes for the intervention. Significant increases in adolescent personal beliefs also were found.

CONCLUSIONS

Although several of the intervention sessions needed to be rescheduled and many of the adolescents did not complete their weekly skills building homework, MINDSTRONG to Combat Bullying was found to be a highly acceptable intervention for adolescents that was effective in reducing physical and mental health symptoms as well as perceptions of bullying victimization.

Effects of the Perceived Risk of Contracting COVID-19 on Nursing Students' Well-Being

BACKGROUND

Although mental health symptoms increased during the coronavirus disease 2019 (COVID-19) pandemic, little is known about the associations between nursing students' perceived risk of contracting COVID-19 and their academic and psychological well-being. This study examined associations between perceived COVID-19 risk, likelihood of completing nursing education, and mental health factors of nursing students.

METHOD

A total of 979 nursing students completed self-report measures of perceived COVID-19 risk, anticipated academic completion, anxiety and depressive symptoms, stress, coping self-efficacy, hope, and social support.

RESULTS

Students with higher perceived COVID-19 risk reported increased anxiety and depression as well as decreased likelihood of graduating, coping self-efficacy, and levels of social support.

CONCLUSION

Findings indicate the need for increased mental health support for nursing students for successful completion of their programs. Educators should increase support and proactively strengthen positive psychology factors to mitigate the effects of COVID-19 and other crises on nursing students' well-being. [J Nurs Educ. 2022;61(11):641-645.].

Associations between childhood psychological trauma, posttraumatic stress symptoms, and mental health in female college students: Mediation of coping styles

PURPOSE

To investigate the associations between childhood psychological trauma, posttraumatic stress symptoms (PTSS), and mental health in adulthood and to identify the mediation of active and passive coping on these associations in Korean female undergraduates.

CONCLUSIONS

Childhood psychological trauma had a direct association with current mental health in adulthood (β = 0.15, p < 0.001), which was mediated by PTSS (β = 0.34, p < 0.001). Each coping style partially mediated the relationship between (a) childhood psychological trauma and mental health and (b) PTSS and mental health.

PRACTICE IMPLICATIONS

It is necessary to develop nursing interventions to enhance coping strategies in female undergraduates to ensure better mental health and well-being.

Long-term mental health treatment on campus; a report from the University of Southern California

The demand for mental health treatment on university campuses continues to increase. This report will outline sources of increased demand and how traditional campus-based models have managed it. It will then describe the University of Southern California's work mobilizing resources to develop a unique model for insurance based long-term care emphasizing the importance of collaboration between long-term and short-term resources. Finally, this report will suggest interventions that may help to ease the burden of increased demand for mental health treatment on campuses.

Anxious Temperament Predicts Poor Acceptance of Self and Life in Bipolar Disorder during the COVID-19 Pandemic

The coronavirus disease (COVID-19) pandemic and the social distancing resulting thereof are having a great impact on psychological well-being. Studies investigating resilience found that it impacts mental health during crises. This study aimed to evaluate the influence of pre-crisis temperament on resilience in individuals with bipolar disorder during the COVID-19 pandemic. An online survey was conducted in Austria between April and June 2020, including 36 individuals with bipolar disorder and 39 healthy controls. Resilience was assessed with the 13-item resilience scale, and temperament was measured with the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire (TEMPS-A). The bipolar disorder group showed lower resilience than the control group, and scored higher on the TEMPS-A for depressive, cyclothymic, and anxious temperaments. Resilience could be predicted by anxious temperament in individuals with bipolar disorder, and correlated negatively with depressive symptoms in both groups. The results suggest that anxious temperament influences the resilience of individuals with bipolar disorder, likely more than temporary hardships, such as the first months of the COVID-19 crisis. It is therefore important to improve the resilience of individuals with bipolar disorder not only by short-term interventions, but by strengthening resilience and reducing anxious temperament in the long term.

Psychological Counseling Service "Together" at University of Genoa: Students' Psychological Profile in Pre and Post Pandemic

The present explorative study aims to analyze the profiles of students seeking help in the two areas (emotion/relation or learning areas) of a psychological counseling service for students at the University of Genoa to better understand their request for support in pre- and post-pandemic periods. A total of 229 university students seeking for help from November 2018 to December 2021 completed a psychological battery investigating emotion regulation difficulties and pathological domains of personality (students taken in charge by the emotion/relation area) or motivation issues and anxiety and resilience levels (students taken in charge by the learning area). Regarding the emotion/relation area, results show that problems in emotion dysregulation, and especially in regulating positive emotions, are associated to several pathological domains of personality, such as Psychoticism, Antagonism, Disinhibition, Detachment, and Negative Affectivity. Among the learning area, motivational aspects concerning confidence in one's intelligence, academic self-efficacy, and learning goals are differently associated with anxiety and resilience above and beyond other aspects, such as attributions. Some limited but significant differences emerge from the comparison between pre- and post-COVID periods: a reduction in detachment in students attending the emotion/relation area, an increase of students with high levels of anxiety in the learning area. These results support the importance of continually operating on emotional and motivational aspects to enhance the students' well-being and thus sustaining their academic careers.

Effects of the MINDSTRONG© CBT-based program on depression, anxiety and healthy lifestyle behaviors in graduate health sciences students

ObjectiveTo evaluate effects of the MINDSTRONG^© cognitive-behavioral skills building program versus an attention control program on mental health outcomes and lifestyle behaviors of graduate health professional students. Participants: 201 entering graduate students from seven health sciences colleges at a public land grant University in the U.S. Midwest. Methods: A randomized controlled trial was conducted with three-month follow-up. Valid and reliable instruments measured depression, anxiety, stress, healthy lifestyle beliefs and healthy lifestyle behaviors. Results: Students receiving MINDSTRONG^© reported less depression/anxiety and healthier lifestyle behaviors than those receiving the control program. Students with elevated levels of depression/anxiety at baseline demonstrated greater benefits from the program. Conclusions: MINDSTRONG^© can be used as a preventive and early intervention for improving mental health outcomes and lifestyle behaviors in graduate students. Because the program can be delivered by trained non-mental health professionals, it has the potential to be widely scaled on campuses throughout the U.S.

Assessing the Effects of the COVID-19 Pandemic on Nontraditional Students' Mental Health and Well-Being

The current study sought to measure how the COVID-19 pandemic affected the mental health and well-being of college students, particularly nontraditional students. Participants (n = 321) completed a series of surveys assessing their level of depression, anxiety, sleep disturbances, insomnia, and well-being. Participants also indicated their nontraditional student characteristics, level of resilience, and additional life stressors due to the pandemic. Statistical analyses found that participants reported higher levels of depression, anxiety, sleep disturbances, and insomnia, with corresponding lower levels of well-being across all students, compared with prepandemic levels. Results showed that while nontraditional students indicated an increased number of life stressors during the pandemic compared with their traditional peers, nontraditional students also demonstrated higher levels of resilience. Nontraditional students appear to be more successful at managing stressful life events due to the increased resilience that comes with age and experience, which can better prepare them to persevere and overcome challenges.

Effects of a cognitive-behavioral skills building program on the mental health outcomes and healthy lifestyle behaviors of veterinary medicine students

OBJECTIVE

To evaluate the effects of a cognitive-behavioral skills building program (ie, MINDSTRONG; The Ohio State University) on the mental health outcomes and healthy lifestyle beliefs and behaviors of Doctor of Veterinary Medicine (DVM) students.

Sample

DVM students (n = 62) before beginning their program at a large public Midwest land-grant university.

Procedures

All 171 incoming DVM students (class of 2024) were required to take the cognitive-behavioral skills building program (7 weeks in length) before starting their 2020 school year. Students were given the option to consent to the study portion of the program. Consenting participants completed a pre- and postsurvey containing demographic questions and 5 valid and reliable scales, including the Patient Health Questionnaire-9 that assesses depressive symptoms, the Generalized Anxiety Disorder-7 that evaluates anxiety, the Brief Inventory of Perceived Stress that measures stress, and the Healthy Lifestyle Beliefs and Healthy Lifestyle Behaviors scales. Descriptive statistics described sample characteristics, paired t tests assessed changes over time in the outcomes Personal Wellness Assessment, and Cohen's d determined effect sizes.

Results

62 DVM students completed both surveys. Postintervention, students had significant improvements in depressive symptoms, anxiety, and healthy lifestyle beliefs and behaviors.

Clinical Relevance

Although this study used a small convenience sample of DVM students from a single university, a cognitive-behavioral skills building program demonstrated the ability to decrease rates of depression, anxiety, and suicidal ideation and improve healthy lifestyle beliefs and behaviors. Requiring DVM students to participate in such programming could provide benefit during their professional education and throughout their careers.

The state of mental health and healthy lifestyle behaviors in nursing, medicine and health sciences faculty and students at Big 10 Universities with implications for action

BACKGROUND

High rates of mental health conditions and poor healthy lifestyle behaviors are reported in nurses, other clinicians, and health science students but have not been compared across different professions.

PURPOSE

The purpose of this study was threefold: (1) describe rates of mental health problems and healthy lifestyle behaviors across the Big 10 health professional faculty and students, (2) compare the health and healthy lifestyle behaviors of the Big 10 health sciences faculty and students across health sciences' professions, and (3) identify factors predictive of depression, stress, and anxiety.

METHODS

Faculty and students from eight health science colleges at the Big 10 Universities responded to the study survey, which included: demographics, healthy lifestyle behavior questions, and three valid/reliable mental health scales. Descriptive statistics described the findings and multiple linear regression identified factors associated with mental health conditions.

RESULTS

Eight-hundred and sixty-nine faculty and 1087 students responded. Approximately 50% of faculty and students reported 7 h of sleep/night, a third achieved 150 min of physical activity/week; 5.5%-9.9% screened positive for depression; and 11.5%-25.5% had anxiety. Age, sleep, and physical activity were associated with lower depression and anxiety.

CONCLUSIONS

University leadership must build wellness cultures that make healthy lifestyle behaviors easy to engage in and enhance mental well-being.

Work-life balance as a predictor of college student anxiety and depression

Few studies have examined how work-life balance may influence college student mental health. The current study addresses this gap in the literature by examining the process by which work-life balance may lead to college student anxiety and depressive symptoms. Participants: A total of 111 students from a private Midwestern college were sampled between October 2017 and November 2017. Method: A cross-sectional survey design was used to assess work-life balance, perceived stress, anxiety, and depressive symptoms. Results: Work-life balance was negatively related to students' perceived stress, general anxiety, and depressive symptoms. Path analysis results indicate that perceived stress fully mediated the relationship between work-life balance and anxiety, as well as the relationship between work-life balance and depressive symptoms. Conclusions: Work-life balance is an important antecedent of college students' mental health. Educational institutions should place more importance on assisting students with work-life balance in order to improve their college experience.

Variables asociadas a la ansiedad-depresión en estudiantes universitarios

La salud, como un estado subjetivo de bienestar, responde a las características del contexto sociodemográfico. Estudios previos sugieren que los indicadores de salud mental entre estudiantes universitarios son comparativamente menores que los del resto de la población, probablemente debido a la interacción de factores contextuales. Este estudio busca evaluar la relación entre variables sociodemográficas, ansiedad y depresión en estudiantes de una universidad en la costa Atlántica colombiana. En un diseño transversal, los participantes (n = 6.224) completaron la escala PROMIS y un cuestionario de información sociodemográfica. Mediante análisis descriptivos se examinaron la incidencia y comorbilidad de la ansiedad-depresión. El efecto de las variables sociodemográficas en la ansiedad-depresión se analizó con un modelo regresión logística. Resultados. 55.7 % de los participantes presentaron síntomas de ansiedad, 32.2 % presentaron síntomas de depresión, y 28.9 % presentaron comorbilidad. El sexo, estado civil, grupo étnico y estrato socioeconómico fueron predictores significativos de la ansiedad-depresión. Los hallazgos indican que la ansiedad y la depresión son frecuentes entre estudiantes universitarios. La importancia de desarrollar intervenciones para promover la salud en el desempeño profesional de los estudiantes es discutida.

Mindful BALANCE (breathe act learn about 'now' care everyday): A pilot project for depressed female adolescents

PROBLEM

Major depressive episodes in adolescent females have increased during the past decade, placing them at risk to engage in unhealthy lifestyle behaviors, unsafe thoughts, suicidal ideation, and lethal actions. Mindfulness, a tool for stress management, is underutilized.

METHODS

Mindful BALANCE (Breathe Act Learn About 'Now' Care Everyday), a group therapy pilot program introduced a variety of mindfulness activities. The extended mindfulness followed the Creating Opportunities for Personal Empowerment (COPE), a Cognitive Behavioral Therapy Skills Building (CBSB) Healthy Lifestyle program. The pilot program was offered in an outpatient mental health department for 7 weeks.

FINDINGS

Mindful BALANCE is a feasible program as an adjunct to individualized psychotherapy. Six subjects engaged without absence with a completion rate of 83%. Six subjects had pre- and post-scores for depression and anxiety decrease. Mindfulness practice was reported to decrease the perception of stress.

CONCLUSION

Mindful BALANCE decreased perceived depression and anxiety symptoms while positively impacting healthy activities in adolescent females. Further research is necessary to readdress feasibility and extended mindfulness components in improving global well-being and diminishing suicide risk.

Resilience and mental health among juveniles: role of strategies for coping with stress

BACKGROUND

Mental health is an important aspect of the process of individual adaptation and development. The present study analysed the role played by resilience in mental health while taking into account both positive and negative indicators among juveniles. The aim of the first study (Study 1) is to analyse the relationship between resilience and the broadly understood mental health of juveniles admitted to youth education centres. Study 2 aimed to understand the direct and indirect role of resilience in shaping the mental health of juveniles. In the model we tested, we looked at the relationship among resilience, coping strategies, and mental well-being.

METHODS

The first study involved 201 juveniles, and the second involved 253 juveniles. Resilience was measured by the Resilience Scale-14. Coping strategies were measured with the Brief-COPE Questionnaire, and information on mental health was obtained using the Kutcher Adolescent Depression Scale, the Satisfaction with Life Scale and the Warwick-Edinburgh Mental Well-being Scale.

RESULTS

The results of both studies have shown that resilience is an important predictor of the mental health of juveniles, primarily with respect to its positive indicator. The stronger the severity of resilience, the greater the satisfaction with life and mental well-being of the juveniles surveyed. In addition, two coping strategies (seeking support from others and coping through emotions) mediated the relationship between resilience and mental well-being.

CONCLUSIONS

The results obtained indicate that work at the level of juvenile resilience leads to the strengthening of positive mental health indicators and buffering of negative indicators.

Chronic Pain and Mental Health Co-Morbidity in Adolescents: An Urgent Call for Assessment and Evidence-Based Intervention

BACKGROUND

Nearly 30% of children are affected by chronic pain which puts a significant burden on the child's family and society with estimated cost of over $19.5 billion each year. Children and adolescent's quality of life is often impacted leading to physical disability, low self-esteem, depression, anxiety, school stress or decreased performance, insomnia, and fatigue. The purposes of this paper are to: 1) provide an overview of chronic pain in children and adolescents; 2) describe findings from a quality improvement project that assessed the prevalence of negative mood, quality of life, functional disability, and coping with pain in teens with chronic pain, and 3) discuss screening, assessment and evidence-based management of co-morbid chronic pain and mental health problems in children and teens.

FINDINGS

Findings for a quality improvement project indicated that 16.8% of the adolescents scored high risk for depression, which was higher than the national average. Approximately 57% of adolescents were screened as high risk on the Pediatric Quality of Life inventory (PedsQL™). One in four adolescents showed poor functioning on the Functional Disability Inventory and nearly one-third of the adolescents reported poor coping with pain on the Pain Coping Questionnaire. This project indicates that adolescents with chronic pain are at high risk for mental health problems. The outcomes suggest the mental health needs of adolescents with chronic pain need to be identified and addressed to help improve outcomes.

DISCUSSION

Children and youth with chronic pain need to be routinely screened and assessed for mental health problems, especially anxiety and depression. The use of Cognitive Behavioral Therapy (CBT) or CBT-skills building for children and youth with anxiety and depressive disorders has been widely studied and are helpful for children with chronic pain include psychoeducation, which helps the child to learn age and developmental specific information on chronic pain. Evidence-based manualized and internet-based CBT programs should be scaled rapidly to decrease depression and anxiety in children and youth with chronic pain.

Perinatal Anxiety and Depression in Minority Women

Depression and anxiety are common during pregnancy and are experienced at higher rates among women who are racial and ethnic minorities. Because depression and anxiety influence maternal and infant outcomes, intervening to improve perinatal mental health should be a priority for all healthcare providers. However, in the United States, a number of barriers including lack of mental health providers, lack of perinatal behavioral health systems, and stigma, limit access to care. Universal screening has been recommended and here we examine how universal screening can help nurses improve the mental health of childbearing women. Interventions that are currently in use to improve perinatal anxiety and depression are reviewed and include: psychopharmacology, cognitive behavioral therapy, interpersonal psychotherapy, and mindfulness. Recommendations for future research and healthcare system changes are made.

Establishing fidelity for the creating opportunities for personal empowerment: Symptom and technology management resources (COPE-STAR) intervention

AIM

To establish intervention fidelity for the Creating Opportunities for Personal Empowerment: Symptom and Technology Management Resources web-based intervention to assist caregivers of children aged 1-5 years in managing their child's symptoms and medical technology of tracheostomies and feeding tubes at home.

DESIGN

Descriptive study of the strategies used to establish intervention fidelity, specifically using expert and caregiver reviewers.

METHODS

To establish fidelity of the intervention, experts and caregivers were asked to evaluate the usefulness, ease of use, and acceptability of the intervention and provide any suggestions for the modules. Caregivers provided caregiver and child characteristics and were administered a health literacy measure, the Newest Vital Sign. Intervention fidelity was established from April 2019-July 2019.

RESULTS/FINDINGS

Expert and caregiver reviewers (N = 13) all agreed or strongly agreed that the intervention was useful, easy to use, and acceptable. In addition, caregiver reviewers provided care to children who required multiple technologies and a variety of care needs at home and confirmed adequate health literacy (N = 5).

CONCLUSION

The use of expert and caregiver reviewers was very beneficial in establishing intervention fidelity. Caregivers are experts in the care of their child and provide valuable feedback based on their daily experiences at home. Experts provided evidence-based feedback.

IMPACT

This nursing intervention addresses caregivers of children who require medical technology by targeting caregiver management for common symptoms, related technologies, and resources for the child and caregiver in the home setting. Intervention fidelity was established and expert and caregiver reviewers confirmed the usefulness, ease of use, and acceptability of the intervention. This study is essential to nursing, other healthcare providers, and healthcare systems in planning and implementing programmes and services for children and their caregivers and for nurse researchers establishing intervention fidelity.

TRIAL REGISTRATION

This study is not designated as a clinical trial per NIH/NINR study and grant proposal guidelines.

Nursing students' resilience, depression, well-being, and academic distress: Testing a moderated mediation model

AIM

Academic distress is a leading cause of attrition among nursing students. The present study tested a positive psychology-oriented model detailing the potential links between nursing students': (a) psychological resilience; (b) depressive symptoms; (c) intrapersonal well-being; (d) interpersonal well-being; and (e) academic distress. Additionally, we tested whether the academic benefits of resilience were conditional upon nursing students' perceptions of their campus climate as supportive of mental health and well-being.

DESIGN

A correlational, cross-sectional design was employed.

METHOD

Nursing students (N = 933) were selected from the national 2017-2018 Healthy Minds Study (HMS). Students completed measures of resilience, depressive symptoms, intrapersonal well-being (flourishing), interpersonal well-being (belonging), and academic distress.

RESULTS

Conditional process modelling tested depression, belonging, and flourishing as mediators of the associations between resilience and academic distress variables. Furthermore, perceptions of campus climate were included as potential moderators of these mediation effects. Results indicated that the protective academic benefits of resilience were primarily explained by decreases in depression but that this effect was strongest for nursing students with negative perceptions of their campus climate.

CONCLUSION

Findings highlight the psychological and academic benefits of greater resilience and the moderated mediation results suggest that such benefits were conditional on the broader campus climate.

IMPACT

Nurse educators and policymakers should consider addressing contextual factors, such as campus climate, in addition to resilience training in their efforts to reduce the negative academic impacts of mental health problems and stress in nursing school.

Creating Healthful Work Environments to Deliver on the Quadruple Aim: A Call to Action

Nurses face workplace stressors that contribute to job dissatisfaction, burnout, and turnover, impacting not only patient safety but the nurses' physical and emotional well-being. At the 2018 American Academy of Nursing conference, a policy dialogue "Creating Healthy Work Environments to Address the Quadruple Aim" was convened focusing on creating healthy work environments by addressing stressors such as violence and bullying. That discussion is encapsulated in this article, providing proven and practical strategies for reducing risk.

COPE for asthma: Outcomes of a cognitive behavioral intervention for children with asthma and anxiety

Asthma is the most common childhood chronic condition and a major contributor to school absences and lost instructional time. Children with asthma have a higher risk of internalizing disorders, such as anxiety and depression, which can further complicate asthma management. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary effects of a manualized, cognitive-behavioral skills-building intervention for children with asthma and anxiety. The design for this study was a one-group, pre/posttest preexperimental with a 6-week follow-up. This article presents the immediate posttest follow-up results. Children between 8 and 12 years of age and their caregivers were recruited from three elementary schools in a large public school district in Ohio. Thirty-two children with asthma and symptoms of anxiety completed the Creating Opportunities for Personal Empowerment (COPE) for Asthma program. Caregivers completed surveys, but they did not participate in the intervention. Results indicated that the program was feasible to implement in small groups during the school day. Self-reported findings indicated a significant reduction in separation anxiety and increased personal beliefs, child-management self-efficacy, and asthma illness representations. Parents and caregivers reported symptom reduction in their children on the Pediatric Symptom Checklist. The subgroup of children scoring high on anxiety at baseline showed reductions with the intervention, having large positive effect sizes for separation and social anxiety as well as medium and large positive effect sizes on the personal beliefs and asthma illness representations, respectively. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Reducing Healthcare Costs for Mental Health Hospitalizations With the Evidence-based COPE Program for Child and Adolescent Depression and Anxiety: A Cost Analysis

INTRODUCTION

Although depression and anxiety affect approximately 20% of children and adolescents, many of those affected do not receive treatment because, in large part to the shortage of mental health providers across the United States. As an alternative to traditional mental health counseling, the Creating Opportunities for Personal Empowerment (COPE) program is an evidence-based manualized 7-session cognitive behavioral therapy-based program that is being effectively delivered to children and teens with depression and anxiety by pediatric and family healthcare providers in primary care practices with reimbursement from insurers.

METHODS

The purpose of this study was to perform a cost analysis of delivering COPE and compare it to the cost of hospitalization for primary mental health diagnosis.

RESULTS

Findings indicated a cost savings of $14,262 for every hospitalization that is prevented.

DISCUSSION

Implementation of COPE can improve outcomes for children and teens with depression and anxiety, and could potentially result in millions of dollars of cost savings for the U.S. healthcare system.

Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students

BACKGROUND

Graduate and professional students are reported to have higher than average rates of depression compared to age- and gender-matched populations. Further, more than half of student health visits are due to anxiety, yet little is known about the relationships among depression, anxiety, and healthy lifestyle behaviors in this population as well as what factors predict depression and anxiety.

AIMS

The purposes of this study were as follows: (a) to examine the prevalence of depression, anxiety, stress, physical health, healthy beliefs, and lifestyle behaviors in incoming first-year health sciences professional students; (b) to describe the relationships among these variables; and (c) to determine predictors of depression and anxiety.

METHODS

A descriptive correlational study design was used with baseline data collected from first-year graduate health sciences students from seven health professions colleges who were participating in a wellness onboarding intervention program, including Dentistry, Medicine, Nursing, Optometry, Pharmacy, Social Work, and Veterinary Medicine.

RESULTS

Seventeen percent of incoming students reported moderate-to-severe depressive symptoms with 6% reporting suicidal ideation. In addition, 14% of the participating students reported moderate-to-severe anxiety. Factors that predicted depression and anxiety included having less than 7 hr of sleep per night, worse general health, lower healthy lifestyle beliefs, lower healthy lifestyle behaviors, higher stress, and a perceived lack of control.

LINKING EVIDENCE TO ACTION

These findings highlight the need to routinely screen incoming health sciences students for depression and anxiety upon entrance into their academic programs so that evidence-based interventions can be delivered and students who report severe depression or suicidal ideation can be immediately triaged for further evaluation and treatment. Providing cultures of well-being and emphasizing self-care throughout academic programs also are essential for students to engage in healthy lifestyles.

Making a Case for Integrating Evidence-Based Sexual Risk Reduction and Mental Health Interventions for Adolescent Girls

Recently identified as the top concern of teens, mental health issues now compete with sexual health risks as major threats to the well-being of adolescent females. Depression and anxiety can lead to or compound the negative repercussions of sexual behavior choices that result in disproportionately high rates of sexually-transmitted infections (STIs), hetero-sexually acquired HIV, and unplanned pregnancy rates in girls ages 15-19. There are a limited number of CDC- and DHHS-recognized HIV/STI and teen pregnancy evidence-based interventions (EBIs) targeted to adolescent girls of diverse races/ethnicities and none that simultaneously address common mental health disorders. The Health Improvement Project for Teens (HIPTeens), a manualized gender-specific sexual risk reduction intervention, and the Creating Opportunities for Personal Empowerment (COPE) Program, a manualized cognitive-behavioral skills intervention that reduces depression and anxiety, are recognized by national agencies as strong EBIs that have successfully improved their targeted outcomes. Baseline data from the HIPTeens clinical trial revealed that a substantial portion of the more than 700 girls enrolled had moderate to high levels of depressive symptoms as well as other mental health challenges (e.g., binge drinking and eating, cannabis use). Thus, there is an urgent need to combine EBIs, such as HIPTeens and COPE, to curtail these leading public health problems confronting today's adolescents.

Intervention Effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on Newly Licensed Registered Nurses' Mental Health, Healthy Lifestyle Behaviors, and Job Satisfaction

OBJECTIVE

The purpose of this study was to evaluate the effects of the MINDBODYSTRONG for Healthcare Professionals Program on stress, anxiety, depressive symptoms, healthy lifestyle behaviors, and job satisfaction on newly licensed RNs (NLRNs) participating in a nurse residency program.

BACKGROUND

The constellation of burnout, depression, and suicide in clinicians is a public health epidemic that affects the quality and safety of healthcare. The National Academy of Medicine's Action Collaborative on Clinician Well-being and Resilience has called for an increase in evidence-based interventions to combat this alarming problem. The MINDBODYSTRONG Program is a novel adaptation of an evidence-based cognitive behavioral skills-building intervention that provides a theory-based approach to improve the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction of NLRNs.

METHODS

A 2-group, cluster randomized controlled trial was used with 89 new nurses participating in a new-graduate nurse residency program. The experimental intervention, MINDBODYSTRONG, consisted of 8 manualized weekly 45-minute sessions. Data were collected at baseline, immediately following, and 3 months after intervention that measured stress, depressive symptoms, anxiety, healthy lifestyle beliefs and behaviors, and job satisfaction. Repeated-measures analysis of variance was used for data analysis.

RESULTS

The intervention group scored significantly better with moderate to large positive effects on the mental health variables as well as healthy lifestyle beliefs and healthy lifestyle behaviors at both follow-up time points compared with the attention control group. Moderate to large positive effects also were found for job satisfaction.

CONCLUSIONS

The MINDBODYSTRONG Program has excellent potential as an evidence-based intervention for improving the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction, in NLRNs.