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Manning JB, Blandford A, Edbrooke-Childs J. Facilitators of and Barriers to Teachers' Engagement With Consumer Technologies for Stress Management: Qualitative Study. J Med Internet Res 2024; 26:e50457. [PMID: 39437381 DOI: 10.2196/50457] [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: 07/01/2023] [Revised: 07/25/2024] [Accepted: 08/30/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Consumer technology is increasingly being adopted to support personal stress management, including by teachers. Multidisciplinary research has contributed some knowledge of design and features that can help detect and manage workplace stress. However, there is less understanding of what facilitates engagement with ubiquitous "off the shelf" technologies, particularly in a specific occupational setting. An understanding of features that facilitate or inhibit technology use, and the influences of contexts on the manner of interaction, could improve teachers' stress-management opportunities. OBJECTIVE The aim of the study was to investigate the interaction features that facilitated or inhibited engagement with 4 consumer technologies chosen by teachers for stress management, as well as the influence of the educational contexts on their engagement. We also examined how use of well-being technology could be better supported in the school. METHODS The choice of consumer technologies was categorized in a taxonomy for English secondary school teachers according to stress-management strategies and digital features. Due to the COVID-19 pandemic, we adapted the study so that working from home in the summer could be contrasted with being back in school. Thus, a longitudinal study intended for 6 weeks in the summer term (in 2020) was extended into the autumn term, lasting up to 27 weeks. Teachers chose to use either a Withings smartwatch or Wysa, Daylio, or Teacher Tapp apps. Two semistructured interviews and web-based surveys were conducted with 8 teachers in England in the summer term, and 6 (75%) of them took part in a third interview in the autumn term. Interviews were analyzed using reflexive thematic analysis informed by interpretive phenomenological analysis. RESULTS Technology elements and characteristics such as passive data collation, brevity of interaction, discreet appearance, reminders, and data visualization were described by teachers as facilitators. Lack of instructions and information on features, connectivity, extended interaction requirements, and nondifferentiation of activity and exercise data were described as barriers. Mesocontextual barriers to engagement were also reported, particularly when teachers were back on school premises, including temporal constraints, social stigma, and lack of private space to de-stress. Teachers had ideas for feature improvements and how educational leadership normalizing teachers' stress management with consumer technologies could benefit the school culture. CONCLUSIONS Having preselected their stress-management strategies, teachers were able to harness design features to support themselves over an extended period. There could be an important role for digital interventions as part of teachers' stress management, which the school leadership would need to leverage to maximize their potential. The findings add to the holistic understanding of situated self-care and should inform developers' considerations for occupational digital stress support.
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Affiliation(s)
- Julia B Manning
- UCL Interaction Centre, Department of Computer Science, University College London, London, United Kingdom
| | - Ann Blandford
- UCL Institute of Healthcare Engineering, University College London, London, United Kingdom
| | - Julian Edbrooke-Childs
- Evidence-based Practice Unit, University College London and Anna Freud Centre, London, United Kingdom
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Mengelkoch S, Miryam Schüssler-Fiorenza Rose S, Lautman Z, Alley JC, Roos LG, Ehlert B, Moriarity DP, Lancaster S, Snyder MP, Slavich GM. Multi-omics approaches in psychoneuroimmunology and health research: Conceptual considerations and methodological recommendations. Brain Behav Immun 2023; 114:475-487. [PMID: 37543247 PMCID: PMC11195542 DOI: 10.1016/j.bbi.2023.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/04/2023] [Accepted: 07/30/2023] [Indexed: 08/07/2023] Open
Abstract
The field of psychoneuroimmunology (PNI) has grown substantially in both relevance and prominence over the past 40 years. Notwithstanding its impressive trajectory, a majority of PNI studies are still based on a relatively small number of analytes. To advance this work, we suggest that PNI, and health research in general, can benefit greatly from adopting a multi-omics approach, which involves integrating data across multiple biological levels (e.g., the genome, proteome, transcriptome, metabolome, lipidome, and microbiome/metagenome) to more comprehensively profile biological functions and relate these profiles to clinical and behavioral outcomes. To assist investigators in this endeavor, we provide an overview of multi-omics research, highlight recent landmark multi-omics studies investigating human health and disease risk, and discuss how multi-omics can be applied to better elucidate links between psychological, nervous system, and immune system activity. In doing so, we describe how to design high-quality multi-omics studies, decide which biological samples (e.g., blood, stool, urine, saliva, solid tissue) are most relevant, incorporate behavioral and wearable sensing data into multi-omics research, and understand key data quality, integration, analysis, and interpretation issues. PNI researchers are addressing some of the most interesting and important questions at the intersection of psychology, neuroscience, and immunology. Applying a multi-omics approach to this work will greatly expand the horizon of what is possible in PNI and has the potential to revolutionize our understanding of mind-body medicine.
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Affiliation(s)
- Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | | | - Ziv Lautman
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - Jenna C Alley
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Lydia G Roos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Benjamin Ehlert
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - Daniel P Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | | | | | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
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Auerbach RP, Lan R, Galfalvy H, Alqueza KL, Cohn JF, Crowley RN, Durham K, Joyce KJ, Kahn LE, Kamath RA, Morency LP, Porta G, Srinivasan A, Zelazny J, Brent DA, Allen NB. Intensive Longitudinal Assessment of Adolescents to Predict Suicidal Thoughts and Behaviors. J Am Acad Child Adolesc Psychiatry 2023; 62:1010-1020. [PMID: 37182586 PMCID: PMC10524866 DOI: 10.1016/j.jaac.2023.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 03/24/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Suicide is a leading cause of death among adolescents. However, there are no clinical tools to detect proximal risk for suicide. METHOD Participants included 13- to 18-year-old adolescents (N = 103) reporting a current depressive, anxiety, and/or substance use disorder who owned a smartphone; 62% reported current suicidal ideation, with 25% indicating a past-year attempt. At baseline, participants were administered clinical interviews to assess lifetime disorders and suicidal thoughts and behaviors (STBs). Self-reports assessing symptoms and suicide risk factors also were obtained. In addition, the Effortless Assessment of Risk States (EARS) app was installed on adolescent smartphones to acquire daily mood and weekly suicidal ideation severity during the 6-month follow-up period. Adolescents completed STB and psychiatric service use interviews at the 1-, 3-, and 6-month follow-up assessments. RESULTS K-means clustering based on aggregates of weekly suicidal ideation scores resulted in a 3-group solution reflecting high-risk (n = 26), medium-risk (n = 47), and low-risk (n = 30) groups. Of the high-risk group, 58% reported suicidal events (ie, suicide attempts, psychiatric hospitalizations, emergency department visits, ideation severity requiring an intervention) during the 6-month follow-up period. For participants in the high-risk and medium-risk groups (n = 73), mood disturbances in the preceding 7 days predicted clinically significant ideation, with a 1-SD decrease in mood doubling participants' likelihood of reporting clinically significant ideation on a given week. CONCLUSION Intensive longitudinal assessment through use of personal smartphones offers a feasible method to assess variability in adolescents' emotional experiences and suicide risk. Translating these tools into clinical practice may help to reduce the needless loss of life among adolescents.
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Affiliation(s)
- Randy P Auerbach
- Columbia University, New York, and New York State Psychiatric Institute, New York; Sackler Institute, New York.
| | - Ranqing Lan
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Hanga Galfalvy
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Kira L Alqueza
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | | | | | - Katherine Durham
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Karla J Joyce
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Rahil A Kamath
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | | | - Giovanna Porta
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Apoorva Srinivasan
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Jamie Zelazny
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - David A Brent
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Burani K, Brush CJ, Shields GS, Klein DN, Nelson B, Slavich GM, Hajcak G. Cumulative lifetime acute stressor exposure interacts with reward responsiveness to predict longitudinal increases in depression severity in adolescence. Psychol Med 2023; 53:4507-4516. [PMID: 37698514 PMCID: PMC10388334 DOI: 10.1017/s0033291722001386] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 04/11/2022] [Accepted: 04/27/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Life stress and blunted reward processing each have been associated with the onset and maintenance of major depressive disorder. However, much of this work has been cross-sectional, conducted in separate lines of inquiry, and focused on recent life stressor exposure, despite the fact that theories of depression posit that stressors can have cumulative effects over the lifespan. To address these limitations, we investigated whether acute and chronic stressors occurring over the lifespan interacted with blunted reward processing to predict increases in depression over time in healthy youth. METHOD Participants were 245 adolescent girls aged 8-14 years old (Mage = 12.4, s.d. = 1.8) who were evaluated at baseline and two years later. The reward positivity (RewP), an event-related potential measure of reward responsiveness, was assessed at baseline using the doors task. Cumulative lifetime exposure to acute and chronic stressors was assessed two years later using the Stress and Adversity Inventory for Adolescents (Adolescent STRAIN). Finally, depressive symptoms were assessed at both baseline and follow-up using the Children's Depression Inventory. RESULTS As hypothesized, greater lifetime acute stressor exposure predicted increases in depressive symptoms over two years, but only for youth exhibiting a blunted RewP. This interaction, however, was not found for chronic stressors. CONCLUSIONS Lifetime acute stressor exposure may be particularly depressogenic for youth exhibiting a blunted RewP. Conversely, a robust RewP may be protective in the presence of greater acute lifetime stressor exposure.
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Affiliation(s)
- Kreshnik Burani
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - C. J. Brush
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Brady Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Kulkarni P, Kirkham R, McNaney R. Opportunities for Smartphone Sensing in E-Health Research: A Narrative Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:3893. [PMID: 35632301 PMCID: PMC9147201 DOI: 10.3390/s22103893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 12/10/2022]
Abstract
Recent years have seen significant advances in the sensing capabilities of smartphones, enabling them to collect rich contextual information such as location, device usage, and human activity at a given point in time. Combined with widespread user adoption and the ability to gather user data remotely, smartphone-based sensing has become an appealing choice for health research. Numerous studies over the years have demonstrated the promise of using smartphone-based sensing to monitor a range of health conditions, particularly mental health conditions. However, as research is progressing to develop the predictive capabilities of smartphones, it becomes even more crucial to fully understand the capabilities and limitations of using this technology, given its potential impact on human health. To this end, this paper presents a narrative review of smartphone-sensing literature from the past 5 years, to highlight the opportunities and challenges of this approach in healthcare. It provides an overview of the type of health conditions studied, the types of data collected, tools used, and the challenges encountered in using smartphones for healthcare studies, which aims to serve as a guide for researchers wishing to embark on similar research in the future. Our findings highlight the predominance of mental health studies, discuss the opportunities of using standardized sensing approaches and machine-learning advancements, and present the trends of smartphone sensing in healthcare over the years.
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Affiliation(s)
- Pranav Kulkarni
- Department of Human Centered Computing, Faculty of IT, Monash University, Clayton, VIC 3168, Australia; (R.K.); (R.M.)
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