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Luca SD, Yan Y, Schueller D, O'Donnell K. Exploring adolescent suicidal trajectories: The intersection of race/ethnicity, gender, and social connectedness. J Adolesc 2024. [PMID: 39099147 DOI: 10.1002/jad.12387] [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: 04/30/2023] [Revised: 07/20/2024] [Accepted: 07/24/2024] [Indexed: 08/06/2024]
Abstract
INTRODUCTION Understanding adolescent racial/ethnic and gender disparities in suicidal ideation and attempts longitudinally can help curb future suicidal risk. METHODS Survey data (1994-2008) from the Longitudinal Study of Adolescent to Adult Health (Add Health study, n = 18,887) examined racial/ethnic and gender ideation and attempt disparities over four waves of data from across the United States (51% female; 51% White; Mage = 17.43 years at Wave 1). Repeated-measures latent class analyses described how ideation and attempt patterns present longitudinally and how racial/ethnic minority groups predict different classes based on each wave and age-appropriate social supports (i.e., parents, peers). RESULTS Those most at-risk disclosed ideation and some attempt risk in early adolescence (Waves 1 and 2) and mostly identified as female. The second most prevalent group first disclosed ideation in their 20s and predominately identified as non-Hispanic White females. Peer connections were not significant for most groups except for non-Hispanic White males in Wave 3, while Black females who reported stronger school connections had decreased ideation and attempt rates in Wave 1 but not 2 (just 1 year later). A negative link between social supports and high-risk ideation and attempt classes was found among Black females, non-Hispanic Whites, and Latinos overall. CONCLUSIONS As the United States becomes more diverse, understanding the unique ideation and attempt disparities are crucial. Tailoring interventions to include risk and protective mechanisms among intersectional communities could eradicate disparities. Longitudinal studies can illuminate how protective and risk factors can change over time and even within and among racial/ethnic and gender groups.
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Affiliation(s)
- Susan De Luca
- Population Health Equity Research Institute, The MetroHealth Medical Center, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Psychiatry, MetroHealth Medical Center, Cleveland, USA
| | - Yueqi Yan
- University of California, Merced, California, USA
| | - Darerian Schueller
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Kari O'Donnell
- Population Health Equity Research Institute, The MetroHealth Medical Center, Cleveland, Ohio, USA
- Center for Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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Peralta V, Sánchez-Torres AM, Gil-Berrozpe G, de Jalón EG, Moreno-Izco L, Peralta D, Janda L, Cuesta MJ. Neurocognitive and social cognitive correlates of social exclusion in psychotic disorders: a 20-year follow-up cohort study. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02742-x. [PMID: 39090439 DOI: 10.1007/s00127-024-02742-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/21/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE Little is known about the relationship between social exclusion and cognitive impairment in psychosis. We conducted a long-term cohort study of first-episode psychosis to examine the association between comprehensive measures of cognitive impairment and social exclusion assessed at follow-up. METHODS A total of 173 subjects with first-episode psychosis were assessed after a 20-year follow-up for 7 cognitive domains and 12 social exclusion indicators. Associations between sets of variables were modeled using multivariate regression, where social exclusion indicators were the dependent variables, cognitive domains were the independent variables, and age, gender, and duration of follow-up were covariates. RESULTS The total scores on the measures of cognition and social exclusion were strongly associated (β = - .469, ∆R2 = 0.215). Participants with high social exclusion were 4.24 times more likely to have cognitive impairment than those with low social exclusion. Verbal learning was the cognitive function most related to social exclusion domains, and legal capacity was the exclusion domain that showed the strongest relationships with individual cognitive tests. Neurocognition uniquely contributed to housing, work activity, income, and educational attainment, whereas social cognition uniquely contributed to neighborhood deprivation, family and social contacts, and discrimination/stigma. Neurocognition explained more unique variance (11.5%) in social exclusion than social cognition (5.5%). CONCLUSION The domains of cognitive impairment were strongly and differentially related to those of social exclusion. Given that such an association pattern is likely bidirectional, a combined approach, both social and cognitive, is of paramount relevance in addressing the social exclusion experienced by individuals with psychotic disorders.
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Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain.
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
| | - Ana M Sánchez-Torres
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Gustavo Gil-Berrozpe
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Manuel J Cuesta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
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Peralta V, de Jalón EG, Moreno-Izco L, Peralta D, Janda L, Sánchez-Torres AM, Cuesta MJ. Social exclusion as a major outcome domain of psychotic disorders: early predictors, and associations with non-recovery and clinical staging 21 years after a first episode of psychosis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02650-0. [PMID: 38772974 DOI: 10.1007/s00127-024-02650-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/03/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE People with psychotic disorders have high levels of social exclusion; however, little is known about its early predictors. We present a long-term observational cohort study aimed at examining early risk factors for later social exclusion. METHODS A total of 243 subjects were assessed at their first psychotic episode for early risk factors including sociodemographic variables, familial risk of major mental disorders, perinatal complications, childhood factors, and adolescent factors and re-assessed after a mean follow-up of 21 years for 12 social exclusion domains: leisure activities, housing, work, income, neighborhood deprivation, educational attainment, physical and mental health, family and social support, legal competence, and discrimination. The ability of risk factors to predict social exclusion was examined using hierarchical linear regression. RESULTS Overall social exclusion was independently predicted by low parental socio-economic status, length of follow-up, familial risk of schizophrenia, obstetric complications, neurodevelopmental delay, poor childhood adjustment, childhood adversity, poor adolescent social networks, poor adolescent adjustment, and low premorbid IQ. The model explained 58.2% of the variance in total social exclusion score. Each social exclusion domain was predicted by a different set of variables, which explained between 17.8 and 57.0% of their variance, although low socio-economic status, familial risk of schizophrenia, obstetric complications, childhood adversity, and poor social networks predicted most of the social exclusion domains. CONCLUSION Early risk factors strongly predicted later social exclusion. A multifaceted approach to preventing later social exclusion is crucial in people with a first episode of psychosis and early risk factors of social exclusion.
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Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain.
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra (UPNA), Campus de Arrosadia, 31006, Pamplona, Spain
| | - Manuel J Cuesta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
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Nyce A, Roberts MA, Tichá R, Abery BH. The design and methodology for a pilot study of home and community-based services outcome measures. Disabil Health J 2024:101628. [PMID: 38692985 DOI: 10.1016/j.dhjo.2024.101628] [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: 11/03/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND The Research and Training Center on HCBS Outcome Measurement (RTC/OM) developed and piloted measures in six domains to assess the outcomes experienced by HCBS recipients. These measures were based upon the revised National Quality Forum's HCBS Outcome Measurement framework. OBJECTIVE The background and rationale for the pilot study are outlined along with the research design, sampling frame, and psychometric and statistical methods used. In addition, administration feasibility for all measures are described. Finally, a summary of results across all measures is provided. Detailed results for individual outcome measure domains are left to forthcoming publications. METHODS Measure construct under study were piloted on a sample of 107 participants identified as receiving HCBS or HCBS-like services and experiencing one of five disabilities: intellectual and developmental, age-related, or physical disabilities as well as Traumatic/Acquired Brain Injury and Serious Mental Health Conditions. Participants were interviewed either in-person or through HIPAA compliant online video conferencing over one to two sessions. Psychometric evidence was evaluated with internal consistency and test-retest reliability, as well as inter-observer agreement. Nonparametric methods were used to test for group comparisons. RESULTS Initial reliability and validity results of outcomes on five measures were good to excellent. No significant group differences between disability groups were found. CONCLUSIONS The psychometric evidence for the tested measures is very promising. Only two of the six measures required significant changes prior to their use in an upcoming field study. Details on results and revisions for individual measures will appear in later publications.
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Affiliation(s)
- Alec Nyce
- Institute on Community Integration, University of Minnesota, United States.
| | - Matthew A Roberts
- Institute on Community Integration, University of Minnesota, United States
| | - Renáta Tichá
- Institute on Community Integration, University of Minnesota, United States
| | - Brian H Abery
- Institute on Community Integration, University of Minnesota, United States
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Mose A, Chen Y, Tan X, Ren Q, Ren X. Association of social integration with cognitive function trajectories among Chinese older adults: evidence from the China health and retirement longitudinal study (CHARLS). Front Aging Neurosci 2024; 15:1322974. [PMID: 38274988 PMCID: PMC10808469 DOI: 10.3389/fnagi.2023.1322974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background The prevalence of cognitive impairment among older adults remains high. It has been proven that social integration is related to cognitive function. However, limited research has examined the association of social integration and its different dimensions with cognitive function trajectories of older adults. Methods The data were from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2013 (T1) to 2018 (T3). A total of 3,977 older adults were included in the final analysis. Cognitive function was measured with items from an adapted Chinese version of the Mini-Mini-Mental Mental State Examination (MMSE), while the measurement of social integration included three dimensions: economic integration, relational integration and community integration. A group-based trajectory model (GBTM) was used to identify cognitive trajectory groups among participants and an unordered multinomial logistic regression was employed to explore the association of baseline social integration and its three dimensions with cognitive function trajectories. Result Three cognitive function trajectory groups were identified: low-decline group (24.1%), medium-decline group (44.2%) and high-stable group (31.7%). Comparing to the medium-decline trajectory group, older adults with higher social integration scores were more likely to be in the high-stable trajectory group (OR = 1.087, 95%CI: 1.007 ~ 1.174), while less likely to be in the low-decline group (OR = 0.806, 95%CI: 0.736 ~ 0.882). Among the different dimensions of social integration, older adults with higher community integration scores were more likely to be in the high-stable trajectory group (OR = 1.222, 95%CI: 1.026 ~ 1.456); Older adults with higher relational integration scores were less likely to be in the low-decline trajectory group (OR = 0.816, 95%CI: 0.734 ~ 0.906). The economic integration was not found to correlate with the cognitive function trajectories. Stratified analyses revealed that the association between community integration and cognitive trajectories was only significant among older adults aged 60 to 69, and the association between relational integration and cognitive trajectories was only significant among older adults who was agricultural household registration. Conclusion The developmental trajectories of cognitive function among Chinese older adults are heterogeneous. Social integration is significantly related to the trajectories of cognitive function in Chinese older adults. Measures should be taken to promote social integration of Chinese older adults to reduce the decline of cognitive function.
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Affiliation(s)
- Amu Mose
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yanhong Chen
- The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaoshuang Tan
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qingman Ren
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaohui Ren
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Dykxhoorn J, Osborn D, Fischer L, Troy D, Kirkbride JB, Walters K. Measuring social exclusion and its distribution in England. Soc Psychiatry Psychiatr Epidemiol 2024; 59:187-198. [PMID: 37160438 PMCID: PMC10799797 DOI: 10.1007/s00127-023-02489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/30/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Social exclusion is a multidimensional concept referring processes which restrict the ability of individuals or groups to participate fully in society. While social exclusion has been used to explore patterns of disadvantage, it has been difficult to measure. Thus, we aimed to use population-based data to measure social exclusion and its constituent domains and to describe its distribution in England. METHODS We used data from Understanding Society in 2009/2010 develop a multidimensional measurement approach, replicated in 2018/2019. We defined five domains of social exclusion from the literature and expert consultation: material, relational, political, digital, and structural. In both waves, we identified measures for each domain, then conducted principal component analysis to identify the components. We generated domain scores and an overall social exclusion score. We described the distribution of social exclusion and its domains by sex, region, age, and ethnicity. RESULTS We found the level of social exclusion was higher in the youngest age group and decreased by age. We found elevated levels of overall social exclusion for ethnic minoritised groups including African, Arab, and Caribbean groups compared to White British groups. We found distinct patterns within each domain. DISCUSSION We developed an overall measure of social exclusion with five domains, and finding distinct patterns of social exclusion by age, ethnicity, and region which varied across domain. These findings suggest that attention should be paid to the separate domains due to different population distributions. This measurement approach moves beyond conceptual discussions of social exclusion and demonstrates the utility of a quantitative measure of social exclusion for use in health and social research.
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Affiliation(s)
- Jennifer Dykxhoorn
- Department of Primary Care and Population Health, UCL, Rowland Hill Street, London, NW3 2PF, UK.
- Division of Psychiatry, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - David Osborn
- Division of Psychiatry, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden & Islington NHS Trust, 4 St Pancras Way, London, NW1 0PE, UK
| | - Laura Fischer
- Department of Primary Care and Population Health, UCL, Rowland Hill Street, London, NW3 2PF, UK
| | - David Troy
- Bristol Population Health Sciences Institute, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK
| | - James B Kirkbride
- Division of Psychiatry, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Kate Walters
- Department of Primary Care and Population Health, UCL, Rowland Hill Street, London, NW3 2PF, UK
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Martínez-Medina A, Morales-Calvo S, Rodríguez-Martín V, Meseguer-Sánchez V, Molina-Moreno V. Sixteen Years since the Convention on the Rights of Persons with Disabilities: What Have We Learned since Then? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11646. [PMID: 36141926 PMCID: PMC9517366 DOI: 10.3390/ijerph191811646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Persons with disabilities have historically been subjected to discrimination and exclusion, placing them in dangerous situations of social vulnerability. The Convention on the Rights of Persons with Disabilities, passed on the 13th of December 2006, was an important legislative landmark for valuing the rights of this population group. This study involved a bibliometric analysis of 1024 research articles published in Scopus on the social, workplace, educational, and financial inclusion of persons with disabilities since the Convention. The results show an increase in scientific production, and there is also a great deal of multi-disciplinarity, which has led to important breakthroughs for the all-encompassing inclusion of this section of the population. The most productive journals, authors, institutions, and countries, as well as the international cooperation networks, are presented here. The review concludes by setting out the main themes and trends in the research.
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Affiliation(s)
- Andrés Martínez-Medina
- Health Sciences PhD Program, Catholic University of Murcia, Campus de los Jerónimos nº135, Guadalupe, 30107 Murcia, Spain
| | - Sonia Morales-Calvo
- Department of Research and Diagnostic Methods in Education, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
| | - Vicenta Rodríguez-Martín
- Department of Social Work and Social Services, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
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Lazarou I, Nikolopoulos S, Georgiadis K, Oikonomou VP, Mariakaki A, Kompatsiaris I. Exploring the Connection of Brain Computer Interfaces and Multimedia Use With the Social Integration of People With Various Motor Disabilities: A Questionnaire-Based Usability Study. Front Digit Health 2022; 4:846963. [PMID: 35990018 PMCID: PMC9385967 DOI: 10.3389/fdgth.2022.846963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
We have designed a platform to aid people with motor disabilities to be part of digital environments, in order to create digitally and socially inclusive activities that promote their quality of life. To evaluate in depth the impact of the platform on social inclusion indicators across patients with various motor disabilities, we constructed a questionnaire in which the following indicators were assessed: (i) Well Being, (ii) Empowerment, (iii) Participation, (iv) Social Capital, (v) Education, and (vi) Employment. In total 30 participants (10 with Neuromuscular Disorders-NMD, 10 with Spinal Cord Injury-SCI, and 10 with Parkinson's Disease-PD) used the platform for ~1 month, and its impact on social inclusion indicators was measured before and after the usage. Moreover, monitoring mechanisms were used to track computer usage as well as an online social activity. Finally, testimonials and experimenter input were collected to enrich the study with qualitative understanding. All participants were favorable to use the suggested platform, while they would prefer it for longer periods of time in order to become “re-awakened” to possibilities of expanded connection and inclusion, while it became clear that the platform has to offer them further the option to use it in a reclining position. The present study has clearly shown that the challenge of social inclusion cannot be tackled solely with technology and it needs to integrate persuasive design elements that foster experimentation and discovery.
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Affiliation(s)
- Ioulietta Lazarou
- Centre for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
- *Correspondence: Ioulietta Lazarou
| | - Spiros Nikolopoulos
- Centre for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
| | - Kostas Georgiadis
- Centre for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
| | - Vangelis P. Oikonomou
- Centre for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
| | - Agnes Mariakaki
- Muscular Dystrophy Association-Hellas (MDA-Hellas), Hellas, Athens, Greece
| | - Ioannis Kompatsiaris
- Centre for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
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O'Donnell P, Hannigan A, Ibrahim N, O'Donovan D, Elmusharaf K. Developing a tool for the measurement of social exclusion in healthcare settings. Int J Equity Health 2022; 21:35. [PMID: 35292025 PMCID: PMC8922776 DOI: 10.1186/s12939-022-01636-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Background Social exclusion is a complex concept that is recognised as a key determinant of health. Many measurement tools developed looked at people from single excluded groups in isolation. We know from experience and literature that exclusion is often intersectional and multi-layered. Therefore, the aim of this research was to develop a social exclusion measurement tool for use in healthcare settings with individuals from any excluded group that would include questions to investigate socioeconomic elements and subjective experiences in their lives. Methods Inductive and deductive methods were used to develop the tool. Early drafts were tested with experts (both academic and experts by experience) and modified in line with feedback received. The tool was then piloted with people in the community, and this allowed us to assess the internal consistency and validity of the tool. Exploratory factor analysis was carried out as part of this evaluation. Results The measurement tool was initially evaluated by 17 academic and ‘real world’ experts. It was then piloted with seven experts by experience, two gatekeepers and two participants who were presumed not to be excluded, resulting in the development of the final tool. This was then tested with 276 participants (127 presumed excluded, 149 presumed not excluded). The socioeconomic characteristics of these participants were documented, and exploratory factor analysis was carried out on data relating to subjective items. A four-factor structure emerged comprising 22 items. Internal consistency of the factors was high, and their ability to discriminate between the two groups was notable. Conclusions A tool for measuring the social exclusion of individuals has been developed by engaging with people from a variety of excluded groups. Socioeconomic indicators were combined with subjective items. The input of experts by experience, academics and others was sought to enhance the tool. The tool was applied to two distinct samples, showing obvious differences both in the socioeconomic items, and the items included in the factor analysis. The potential use of this tool could have positive implications for people who are excluded. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01636-1.
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Affiliation(s)
- Patrick O'Donnell
- School of Medicine, University of Limerick, Limerick, Ireland. .,Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ailish Hannigan
- School of Medicine, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Nuha Ibrahim
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Diarmuid O'Donovan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Northern Ireland
| | - Khalifa Elmusharaf
- School of Medicine, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
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Saadati F, Nadrian H, Hosseini Golkar M, Taghdisi MH, Gilani N, Ghassab-Abdollahi N, Fathifar Z. Indices and indicators developed to evaluate the "strengthening community action" mechanism of the Ottawa Charter for Health Promotion: a scoping review. Am J Health Promot 2022; 36:881-893. [PMID: 35081768 DOI: 10.1177/08901171211069130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine 1) the indexes/indicators used for evaluating the "strengthening community action" mechanism of the Ottawa Charter for health promotion, and 2) to extract the characteristics and key components of the indexes/indicators using a scoping review. DATA SOURCE In May 2020, the search was conducted across three databases; Medline (via Pub Med), Embase, and Scopus. INCLUSION AND EXCLUSION CRITERIA All primary studies relating to development, identification, and measurement of health promotion indices/indicators associated to the "strengthening community actions" were included. The review articles were excluded. DATA EXTRACTION The data were extracted to a data-charting form that was developed by the research team. Two authors reviewed the extracted data. Data Synthesis To summarize and report the data, a descriptive numerical analysis, and a narrative descriptive synthesizing approach were used. Results In total, 93 study articles were included. A majority of studies (82%) were conducted in developed countries. Different types of recognized indices were categorized into seven groups: social cohesion (n=3), community capacity (n=1), community participation (n=7), social capital (n=6), social network (n=3), social support (n=1), and others (n=5). CONCLUSIONS Having a collection of "strengthening community action" indices/indicators in hand, health policy-makers and health promotion specialists might be able to do their best in considering, selecting, and applying the most appropriate indices/indicators while evaluating community health promotion interventions in different settings.
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Affiliation(s)
- Fateme Saadati
- Dept. of Health Education and Promotion48432Tabriz University of Medical Sciences
| | - Haidar Nadrian
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.48432Tabriz University of Medical Sciences
| | - Mostafa Hosseini Golkar
- Health Foresight and Innovation Research Center, Institute for Futures Studies in Health48463Kerman University of Medical Sciences
| | | | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of Health,48432Tabriz University of Medical Sciences
| | | | - Zahra Fathifar
- School of Management and Medical Information48432Tabriz University of Medical Sciences
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Psychometric properties of a brief, self-report measure of social inclusion: the F-SIM16. Epidemiol Psychiatr Sci 2022; 31:e8. [PMID: 35060845 PMCID: PMC8786614 DOI: 10.1017/s2045796021000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS A disproportionate number of people with mental ill-health experience social exclusion. Appropriate measurement tools are required to progress opportunities to improve social inclusion. We have developed a novel measure, the Filia Social Inclusion Measure (F-SIM). Here we aimed to present a more concise, easy-to-use form, while retaining its measurement integrity by (i) refining the F-SIM using traditional and contemporary item-reduction techniques; and (ii) testing the psychometric properties of the reduced measure. METHODS Five hundred and six participants completed the F-SIM, younger and older groups of people with serious mental illness (including psychosis, mood, anxiety disorders) and same-aged community counterparts. The F-SIM was completed at baseline and 2-week follow-up, alongside other measures (including social inclusion, loneliness). The F-SIM was refined using multidimensional scaling network analysis, confirmatory factor analysis and item response theory. The psychometric evaluation included assessment of dimensionality, internal consistency, test-retest reliability, discriminant ability and construct validity. RESULTS The F-SIM was reduced from 135-items to 16; with 4-items in each domain of housing and neighbourhood, finances, employment and education and social participation and relationships. Psychometric properties were sound, including strong internal consistency within domains (all α > 0.85) and excellent overall (α = 0.92). Test-retest reliability was also high (γ = 0.90). Differences between groups were observed; clinical subgroups consistently reported lower levels of social inclusion compared to community counterparts. CONCLUSIONS The F-SIM16 is a sound, reliable, brief self-report measure of social inclusion suitable for use in clinical and research settings. It has the potential to evaluate the effectiveness of interventions, and aid in fostering targeted and personalised needs-based care.
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Gühne U, Richter D, Breilmann J, Täumer E, Falkai P, Kilian R, Allgöwer A, Ajayi K, Baumgärtner J, Brieger P, Frasch K, Heres S, Jäger M, Küthmann A, Putzhammer A, Schneeweiß B, Schwarz M, Becker T, Kösters M, Riedel-Heller SG. [Peer Support: Utilization and Benefit in Severe Mental Illness - Results from an Observational, Cross-Sectional Study]. Psychother Psychosom Med Psychol 2021; 71:499-507. [PMID: 34872153 DOI: 10.1055/a-1667-9966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Peer support is playing an increasing role in the treatment of severely mentally ill people. International findings are available on its effectiveness. However, little is known about knowledge, use and benefit assessment in Germany. This paper addresses this question and presents results from an observational study with 10 participating clinics in southern Germany. METHODS As part of the observational cross-sectional study with people with severe mental illness (IMPPETUS, N=359), sociodemographic and illness- and treatment-associated data were collected by trained study staff between March 2019 and September 2019. Binary logistic regression was used to analyse a possible association with peer support use. RESULTS 38% (N=138) of respondents reported knowledge about the possibility of peer support; 15% (N=55) affirmed its use. Use of peer support varied across sites (between 6.5 and 37.5%) and was associated with household income. Significantly less frequent use of peer support was among those with high versus low household income (OR=0.20 [95% CI: 0.06-0.68], p=0.01). Of respondents with peer support use (N=55), 78% reported perceiving peer support to be helpful or highly helpful. DISCUSSION Peer support not only proves to be effective under study conditions with regard to various outcomes, but is also assessed as beneficial under routine conditions in a defined care region by the majority of users. However, only a few respondents knew and used the possibility of peer support. CONCLUSION In order to implement peer support more strongly, information about this kind of service should be provided more effectively and a dialogue about successful implementation experiences should be initiated on a regional level.
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Affiliation(s)
- Uta Gühne
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät, Leipzig, Deutschland
| | - Daniel Richter
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät, Leipzig, Deutschland.,Institut für Qualitätssicherung und Transparenz im Gesundheitswesen (IQTIQ), Berlin, Deutschland
| | - Johanna Breilmann
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - Esther Täumer
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Peter Falkai
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Reinhold Kilian
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - Andreas Allgöwer
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - Klemens Ajayi
- Kbo-Isar-Amper-Klinikum, Region München, Deutschland
| | - Jessica Baumgärtner
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Augsburg, Universität Augsburg, Deutschland
| | - Peter Brieger
- Kbo-Isar-Amper-Klinikum, Region München, Deutschland
| | - Karel Frasch
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland.,Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Donauwörth, Deutschland
| | - Stephan Heres
- Kbo-Isar-Amper-Klinikum, Region München, Deutschland
| | - Markus Jäger
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland.,Fachkrankenhaus für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Kempten, Deutschland
| | - Andreas Küthmann
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Memmingen, Deutschland
| | - Albert Putzhammer
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Kaufbeuren, Deutschland
| | | | | | - Thomas Becker
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - Markus Kösters
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - Steffi G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät, Leipzig, Deutschland
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The adaptation of the community integration scale for adults with psychiatric disorders into Chinese: Cross-cultural adaptation, reliability and validity. Asian J Psychiatr 2021; 65:102847. [PMID: 34509900 DOI: 10.1016/j.ajp.2021.102847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 08/29/2021] [Indexed: 11/22/2022]
Abstract
Community integration problems are fundamental to psychosis and are part of the diagnostic criteria for schizophrenia, but there is a lack of relevant researches and validated scales available for use in China. We intend to translate and assess the reliability and validity of the Community Integration Scale for Adults with Psychiatric Disorders (CIS-APP) scale. A cross-sectional study was conducted on a sample of 612 schizophrenic patients in China. The CIS-APP was used to collect data, and the raw data were randomly divided into two parts for an exploratory factor analysis and a confirmatory factor analysis, to evaluate construct validity. Content validity and reliability were tested by content validity index and Cronbach's α coefficients、split-half reliability respectively. A six-factor structure was emerged, and it explained 61.762% of the total variance. The fit of the six-factor model was acceptable, and the standardized factor loadings ranged from 0.412 to 0.903. The computed reliability of the scale was 0.915. The CIS-APP has excellent psychometric properties, and can be applied to measure community integration levels in people with schizophrenia.
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Rios S, Meyer SB, Hirdes J, Elliott S, Perlman CM. The development and validation of a marginalization index for inpatient psychiatry. Int J Soc Psychiatry 2021; 67:324-334. [PMID: 32840439 DOI: 10.1177/0020764020950785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Marginalization is a multidimensional social construct that influences the mental health status of individuals and their use of psychiatric services. However, its conceptualization and measurement are challenging due to inconsistencies in definitions, and the lack of standard data sources to measure this construct. AIMS To create an index for screening marginalization based on an existing comprehensive assessment system used in inpatient psychiatry. METHOD Items anticipated to be indicative of marginalization were identified from the Resident Assessment Instrument-Mental Health (RAI-MH) that is used in all inpatient mental health beds in Ontario, Canada. Principal Component Analysis (PCA) and cluster analysis of these items was performed on a sample of 81,232 patients admitted into psychiatric care in Ontario between 1 January 2011 and 31 December 2016 to identify dimensions being measured. Various weights and scoring methods were tested to assess convergent validity on multiple outcomes of marginalization. Receiver Operating Characteristic (ROC) curve analysis was utilized to determine optimal cut-offs for the index by modeling the likelihood of different marginalization outcomes, including homelessness. RESULTS Fifteen items were identified for the development of the Marginalization Index (MI). PCA and cluster analysis identified that the items measured five dimensions. ROC curve analysis among homeless individuals identified an Area Under the Curve of 0.76 and an optimal cut-off of five on the MI. Frequency analysis of the index by different characteristics identified homeless individuals, frequent mental health service users, persons with a history of violence and police intervention, and persons with addictions issues, as groups with the highest scores, confirming the convergent validity of the index. CONCLUSION The MI is a valid measure of marginalization and is strong predictor of risk of homelessness among psychiatric inpatients. MI provides a resource that can be used for social and health policy, decision-support and evaluation.
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Affiliation(s)
- Sebastian Rios
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Samantha B Meyer
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - John Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Susan Elliott
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Christopher M Perlman
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Moyano M, Lobato RM, Ventsislavova P, Trujillo HM. Social inclusion level of Spanish and foreign adolescents: Proposal for an evaluation instrument. CURRENT PSYCHOLOGY 2020; 41:6880-6893. [PMID: 33230381 PMCID: PMC7673581 DOI: 10.1007/s12144-020-01201-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/26/2022]
Abstract
Social exclusion is one of the most complex and sensitive social problems nowadays. Of all social groups, adolescents are among the most vulnerable to social exclusion, which can interfere with their social development. Consequently, the evaluation of this construct in adolescents is an important matter. The aim of this investigation was to develop the Social Inclusion for Adolescents Scale (SIAS). Firstly, five psychosocial factors were proposed, which potentially contribute to social inclusion: (1) covered needs, (2) self-efficacy, (3) social support, (4) job training, and (5) social integration. From these five factors, a set of items was created and reduced using qualitative evaluations. The final set of items was used in three studies, with a Spanish population (N = 1540) and a foreign population (N = 460), to test the psychometric properties of the scale, its dimensional structure, the measurement invariance between Spanish and foreign people, the reliability of the instrument and the evidence of the validity of its measurements. The results indicate that this scale is psychometrically reliable enough to assess social inclusion in adolescents. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-020-01201-5.
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Affiliation(s)
- Manuel Moyano
- Department of Psychology, University of Cordoba, Cordoba, Spain
| | - Roberto M. Lobato
- Research & Projects Department, Euro-Arab Foundation for Higher Studies, C/ San Jerónimo, 27, 18001 Granada, Spain
| | - Petya Ventsislavova
- Department of Psychology, Nottingham Trent University, Nottingham, Great Britain
| | - Humberto M. Trujillo
- Department of Methodology for Behavioral Sciences, University of Granada, Granada, Spain
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Retzer A, Sayers R, Pinfold V, Gibson J, Keeley T, Taylor G, Plappert H, Gibbons B, Huxley P, Mathers J, Birchwood M, Calvert M. Development of a core outcome set for use in community-based bipolar trials-A qualitative study and modified Delphi. PLoS One 2020; 15:e0240518. [PMID: 33112874 PMCID: PMC7592842 DOI: 10.1371/journal.pone.0240518] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/28/2020] [Indexed: 01/24/2023] Open
Abstract
Background A core outcome set (COS) is a standardised collection of outcomes to be collected and reported in all trials within a research area. A COS can reduce reporting bias and facilitate evidence synthesis. This is currently unavailable for use in community-based bipolar trials. This research aimed to develop such a COS, with input from a full range of stakeholders. Methods A co-production approach was used throughout. A longlist of outcomes was derived from focus groups with people with a bipolar diagnosis and carers, interviews with healthcare professionals and a rapid review of outcomes listed in bipolar trials on the Cochrane database. An expert panel with personal and/or professional experience of bipolar participated in a modified Delphi process and the COS was finalised at a consensus meeting. Results Fifty participants rated the importance of each outcome. Sixty-six outcomes were included in Round 1 of the questionnaire; 13 outcomes were added by Round 1 participants and were rated in Round 2. Seventy-six percent of participants (n = 38) returned to Round 2 and 60 outcomes, including 4 outcomes added by participants in Round 1, received a rating of 7–9 by >70% and 1–3 by <25% of the sample. Fourteen participants finalised a COS containing 11 outcomes at the consensus meeting: personal recovery; connectedness; clinical recovery of bipolar symptoms; mental health and wellbeing; physical health; self-monitoring and management; medication effects; quality of life; service outcomes; experience of care; and use of coercion. Conclusions This COS is recommended for use in community-based bipolar trials to ensure stakeholder-relevant outcomes, facilitate data synthesis, and transparent reporting. The COS includes guidance notes for each outcome to allow the identification of suitable measurement instruments. Further validation is recommended for use with a wide range of communities and to achieve standardised measurement.
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Affiliation(s)
- Ameeta Retzer
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, and Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
| | - Ruth Sayers
- The McPin Foundation, London, United Kingdom
| | | | - John Gibson
- The McPin Foundation, London, United Kingdom
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Thomas Keeley
- GlaxoSmithKline (formerly of CPROR, University of Birmingham), London, United Kingdom
| | - Gemma Taylor
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Humera Plappert
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Bliss Gibbons
- Coventry and Warwickshire Partnership NHS Trust and Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Peter Huxley
- Centre for Mental Health and Society, Bangor University, Bangor, United Kingdom
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Maximillian Birchwood
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, and Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
- NIHR Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Research Centre and NIHR Applied Research Collaboration West Midlands, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom
- * E-mail:
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Research protocol of a multifaceted prospective mixed-method longitudinal study: Navigating Through Life - Western Australian study of transitions from out-of-home care. BMC Public Health 2020; 20:1180. [PMID: 32727442 PMCID: PMC7389677 DOI: 10.1186/s12889-020-09138-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/17/2020] [Indexed: 11/26/2022] Open
Abstract
Background Developing robust evidence is a challenge for researchers working with disadvantaged or vulnerable populations. For example, research shows that young people who have transitioned from out-of-home care (OOHC) to independent adulthood often experience poor long-term outcomes. However, evidence for the aetiology of those outcomes is weak due to methodological limitations such as small sample sizes and a lack of longitudinal data. This paper details the protocol for Navigating Through Life, a study that utilises novel research methods to better understand the pathways and outcomes of young people as they leave OOHC in Western Australia (WA). Methods Navigating Through Life is a longitudinal, mixed methods, population-based study. A prospective longitudinal study of young people aged 15–25 years will follow participants’ experiences and outcomes over a two-year period. Quantitative and qualitative data is being collected from participants five times over 2 years, using standardised outcome measures and individual interviews. Outcome measures focus on key dimensions of young people’s lives (e.g., social inclusion, well-being, resilience, self-determination). Interviews examine important influences and the variable contexts into which young people have transitioned from care. In addition, retrospective population-level data for young people transitioning from OOHC will be obtained from linked Western Australian government administrative records. Using a multitude of data sources, analysis will map pathways and outcomes of young people with care experience, and comparisons will be made with other population groups within WA. Discussion Navigating Through Life exemplifies a novel utilisation of multiple data sources to research outcomes for vulnerable and difficult to reach populations, and offers insights for other complex mixed-methods longitudinal studies. Results will provide new and more comprehensive data about specific pathways that may be influential to a range of post-care outcomes. Findings will extend evidence to inform better service-delivery models that improve outcomes and reduce disparities for vulnerable young people.
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Kim HC, Zhu ZY. Improving Social Inclusion for People with Physical Disabilities: The Roles of Mobile Social Networking Applications (MSNA) by Disability Support Organizations in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072333. [PMID: 32235632 PMCID: PMC7177844 DOI: 10.3390/ijerph17072333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 11/25/2022]
Abstract
Having friendships and interpersonal social connections is a normal and expected necessity of life that enhances an individual’s well-being. Digital platforms, such as mobile social network applications (MSNA), present a means for people with disabilities to integrate in society. This study combines intrinsic benefits (such as enjoyment experience and information) and extrinsic benefits (such as social networking) to explore the impact of these benefits on online friendships, and the influence of these online friendships on the perceived social connectedness and well-being of people with physical disabilities. The partial least squares methodology was used to conduct statistical analysis on survey data; the outputs were obtained through convergent analysis, discriminant analysis, and bootstrapping. The results showed that enjoyment experience and social network benefits significantly influence online friendships, which influence perceived social connectedness and well-being. In addition, the perceived social exclusion has a significant moderation effect. Our findings are expected to help local disability service organizations develop effective digital disability inclusion strategies to combat widespread social exclusion among people with disabilities.
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Affiliation(s)
- Hyeon-Cheol Kim
- School of Business Administration, College of Business and Economics, Chung-Ang University, Seoul 06974, Korea
- Correspondence:
| | - Zong-Yi Zhu
- Department of Arts and Cultural Management, Graduate School, Chung-Ang University, Seoul 06974, Korea;
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Validity, reliability, acceptability, and utility of the Social Inclusion Questionnaire User Experience (SInQUE): a clinical tool to facilitate social inclusion amongst people with severe mental health problems. Soc Psychiatry Psychiatr Epidemiol 2020; 55:953-964. [PMID: 32016512 PMCID: PMC7303067 DOI: 10.1007/s00127-019-01826-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/24/2019] [Indexed: 11/05/2022]
Abstract
BACKGROUND Individuals with severe mental health problems are at risk of social exclusion, which may complicate their recovery. Mental health and social care staff have, until now, had no valid or reliable way of assessing their clients' social inclusion. The Social Inclusion Questionnaire User Experience (SInQUE) was developed to address this. It assesses five domains: social integration; productivity; consumption; access to services; and political engagement, in the year prior to first psychiatric admission (T1) and the year prior to interview (T2) from which a total score at each time point can be calculated. AIMS To establish the validity, reliability, and acceptability of the SInQUE in individuals with a broad range of psychiatric diagnoses receiving care from community mental health services and its utility for mental health staff. METHOD Participants were 192 mental health service users with psychosis, personality disorder, or common mental disorder (e.g., depression, anxiety) who completed the SInQUE alongside other validated outcome measures. Test-retest reliability was assessed in a sub-sample of 30 participants and inter-rater reliability was assessed in 11 participants. SInQUE ratings of 28 participants were compared with those of a sibling with no experience of mental illness to account for shared socio-cultural factors. Acceptability and utility of the tool were assessed using completion rates and focus groups with staff. RESULTS The SInQUE demonstrated acceptable convergent validity. The total score and the Social Integration domain score were strongly correlated with quality of life, both in the full sample and in the three diagnostic groups. Discriminant validity and test-retest reliability were established across all domains, although the test-retest reliability on scores for the Service Access and Political Engagement domains prior to first admission to hospital (T1) was lower than other domains. Inter-rater reliability was excellent for all domains at T1 and T2. CONCLUSIONS The component of the SInQUE that assesses current social inclusion has good psychometric properties and can be recommended for use by mental health staff.
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Gardner A, Cotton S, O'Donoghue B, Killackey E, Norton P, Filia K. Group differences in social inclusion between young adults aged 18 to 25 with serious mental illness and same-aged peers from the general community. Int J Soc Psychiatry 2019; 65:631-642. [PMID: 31402736 DOI: 10.1177/0020764019868749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS Young adults with serious mental illness (SMI) are thought to be socially excluded. However, psychometric measures of social inclusion have not been employed to examine group differences relative to peers from the general community. The aim of this study was to employ such a measure to determine differences in social inclusion between young adults with SMI and peers from the general community. METHODS A cross-sectional hierarchical logistic regression was conducted to identify which dimensions and individual indicators from the Filia Social Inclusion Measure (F-SIM) discriminated between n = 152 young adults aged 18-25 from the general community (M = 21.36, SD = 2.16) and n = 159 young adults aged 18-25 with SMI (M = 21.13, SD = 2.21). RESULTS Group membership was accounted for by Interpersonal Connections (Nagelkerke R2 = .32), Vocational & Financial Security (Nagelkerke R2 = .32) and Healthy Independent Lifestyle (Nagelkerke R2 = .08) dimensions of the F-SIM. Relative to young adults from the general community, those with SMI were five times less likely to feel they had friends who would call on them in a crisis, odds ratio (OR) = .19 (95%CI = .04, .53), p = .04, almost five times more likely to live with their parents, OR = 4.79 (95%CI = 1.98,11.15), p = .004, almost four times less likely to have worked/studied any time over the past 12 months, OR = .27 (95%CI = .11,.64), p < .001, and three-and-a-half times more likely to report unstable accommodation, OR = 3.58 (95%CI = 1.14, 11.15), p = .03. CONCLUSION Young adults with SMI are socially excluded relative to peers from the general community in terms of interpersonal connections, vocational engagement, autonomy/independence and housing stability. In addition to the well-established focus on vocational engagement, interventions to improve social inclusion in this population must promote reciprocity within social relationships and healthy autonomy/independence (including stable housing).
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Affiliation(s)
- Andrew Gardner
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sue Cotton
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Brian O'Donoghue
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Eóin Killackey
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Peter Norton
- 2 School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kate Filia
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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Social inclusion of people with dementia – an integrative review of theoretical frameworks, methods and findings in empirical studies. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19001338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AbstractThe social inclusion of people with dementia (PwD) is recognised as a global goal of legislation, societal initiatives and service provision. Ensuring the social inclusion of PwD in these areas implies that its dimensions and domains are clear and unambiguous. However, the concept of social inclusion as it is currently used by researchers and practitioners is often vague or acts as a container concept for a variety of different approaches. This paper reports on an integrative review that analysed qualitative and quantitative studies on social inclusion and exclusion of PwD. It focused not only on the empirical results of the included studies but also on the theoretical embedding and methodological approaches to the concept of social inclusion and exclusion. We find that empirical studies on the social inclusion of PwD are scarce and largely characterised by a lack of or inconsistent conceptualisation. Against this background, the operationalisation of the concept and the assessment of the individual aspects of social inclusion with standardised instruments seem to be premature. Substantial theoretical and methodological work is needed to guide research on the social inclusion of PwD. The empirical results show that relationships with other people and being integrated into social networks are essential aspects of social inclusion. Likewise, the strategies and attitudes of caring persons can help to create or reinforce exclusion.
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Filia K, Jackson H, Cotton S, Killackey E. Understanding what it means to be socially included for people with a lived experience of mental illness. Int J Soc Psychiatry 2019; 65:413-424. [PMID: 31159628 DOI: 10.1177/0020764019852657] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Social inclusion is increasingly understood to have positive and beneficial implications for the mental health outcomes of people with severe mental illness. The concept is plagued by definitional inconsistencies and a lack of consensus regarding what it means to be socially included, in particular for groups most vulnerable to social exclusion, such as people with mental illness. The aim of this study was to obtain a consensus regarding the key contributors to social inclusion from the perspective of people with and without a lived experience of mental illness (consumers of mental health services, carers, and general community members). METHODS Delphi methodology was employed to reach consensus agreement. The Delphi questionnaire was based on a previous review of the literature and consisted of 147 items categorized into 13 domains. It was presented to participants over three rounds. Participants (N = 104) were recruited into three groups (32 consumers, 32 carers of people with a mental illness, and 40 members of the general community - neither consumers nor carers). Retention of participants from Round 1 to Round 3 was 79.8%. RESULTS Similarities and differences were observed between the groups. A number of items were very strongly endorsed as key contributors to social inclusion, relating to social participation, social supports, housing, neighbourhood, community involvement, employment and education, health and well-being and service utilization. CONCLUSION Findings supported previous work, indicating the importance of having a strong sense of connection with others as well as the importance of safe and stable housing, support services and personal motivation and hope. We obtained a well-rounded perspective among groups regarding the key contributors to social inclusion, with a particular relevance to people living with mental illness. This perspective has significant clinical and research utility.
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Affiliation(s)
- Kate Filia
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Henry Jackson
- 3 Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Sue Cotton
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Eoin Killackey
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Mason C, Weber J. What predictors are associated with the social inclusion of people with disabilities? A comparison of community-based rehabilitation participants to the general population in Vietnam. Disabil Rehabil 2019; 43:815-822. [PMID: 31335213 DOI: 10.1080/09638288.2019.1643413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To estimate which predictors from the World Health Organization's Community-Based Rehabilitation (CBR) Indicators have the strongest association with the social inclusion of people with disabilities who participate in CBR compared to the general population. METHODS Data were collected using the CBR Indicators survey in Vietnam, including both CBR participants and the general population. A social inclusion score was created using seven questions covering the domains of interpersonal relationships and community participation. Additional questions were used as predictors and were grouped into five theoretical categories: sociodemographic, health, education, livelihood, and empowerment. Multivariate linear regression was used to show which predictors had a significant association with social inclusion. RESULTS Seven predictors (one health, three livelihood, and three empowerment) explained 70.9% of the variance in social inclusion for CBR participants and seven predictors (two health, one education, three livelihood, and one empowerment) explained 58.8% of the variance for the general population. Age, gender, education, employment, and self-rated health had non-significant associations in both populations. CONCLUSIONS Livelihood and empowerment predictors showed the strongest association with social inclusion of CBR participants, and livelihood predictors for the general population. CBR programs should emphasize livelihood and empowerment activities to increase social inclusion of people with disabilities.Implications for rehabilitationSocial inclusion is a human right which has emerged as a major priority in the United Nation's Sustainable Development Goals.People with disabilities continue to experience low levels of social inclusion.It is important to determine which factors have the greatest impact on the social inclusion of people with disabilities.Although Community-Based Rehabilitation programs are often health focused, this study found that empowerment and livelihood predictors had the greatest association with social inclusion.Programs aiming to improve the social inclusion of people with disabilities should target empowerment and livelihood issues.
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Affiliation(s)
- Catherine Mason
- Department for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
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Tan CHS, Chiu YLM, Leong JYJ, Tan LYE. Social inclusion among mental health service users: A reliability test of the Mini-SCOPE Scale. J Clin Nurs 2019; 28:1847-1855. [PMID: 30667133 DOI: 10.1111/jocn.14798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVES To evaluate the reliability of the Mini-SCOPE scale through interitem consistency and test-retest consistency, as well as the initial correlation with outcome measures of recovery. BACKGROUND Adapted from a UK, Social and Communities Opportunities Profile (Mini-SCOPE) is a short version of an social inclusion measurement for English-speaking persons in recovery (PIR) in Singapore. Prior concept mapping sets the stage for this reliability study. DESIGN This study adopted a nonexperimental, pre- and postdesign to validate the psychosocial measurement tool for community services. METHOD Convenient sampling was conducted at the various designated clinics. A total of 170 voluntary participants from psychiatric outpatient clinics were recruited for this study. It evaluated the 4-week interval test-retest reliability of the Mini-SCOPE. "AGREE" equator checklist was completed to guide the reporting of clinical practice. "See Supporting Information File S1." RESULT Outcome demonstrated that the Mini-SCOPE scale has good strength of reliability. CONCLUSION This study showed that the Mini-SCOPE measurement has the potential to be used for programme evaluation in mental health settings. RELEVANCE TO CLINICAL PRACTICE Applicable to nurses and other mental health professionals to consider the social and wellness aspects of the patients in their care when planning appropriate services.
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Affiliation(s)
| | - Yu Lung Marcus Chiu
- Department of Social & Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | | | - Li Yan Elysia Tan
- Department of Psychology, National University of Singapore, Singapore City, Singapore
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Lu Y, Papagiannidis S, Alamanos E. Exploring the emotional antecedents and outcomes of technology acceptance. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2018.08.056] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gardner A, Filia K, Killackey E, Cotton S. The social inclusion of young people with serious mental illness: A narrative review of the literature and suggested future directions. Aust N Z J Psychiatry 2019; 53:15-26. [PMID: 30309242 DOI: 10.1177/0004867418804065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Social inclusion involves objective participatory (e.g. education/employment) and subjective (e.g. sense of belonging/acceptance) elements across multiple domains. It has been associated with enhanced physical and mental wellbeing yet is a novel construct in the empirical literature (i.e. measures have not been sufficiently developed). AIMS Young people with serious mental illness are reported to be socially excluded. It is unclear whether this is reflected in the social inclusion/exclusion literature. The aim of this narrative review is to determine whether such literature permits a comprehensive (i.e. multi-dimensional, objective and subjective) understanding of social inclusion among young people with serious mental illness. METHODS Searches to identify studies related to the social inclusion and/or exclusion of young people with serious mental illness were conducted on 16 February 2016, 24 August 2016, 16 February 2017, 24 August 2017 and 16 February 2018 in PsycINFO, MEDLINE, the Cochrane Library, SCOPUS, Open Grey, Web of Science, Google and Google Scholar. RESULTS There is a paucity of research in the explicit social inclusion literature involving young people either with or without serious mental illness as participants. Literatures exist in related independent areas of research (e.g. employment, social networks), but such studies employ heterogeneous methodologies. CONCLUSION Multi-dimensional measures of social inclusion incorporating objective and subjective indicators must be developed for young people with and without serious mental illness. This will enable the generation of normative and clinical data. Existing evidence for the social exclusion of young people with serious mental illness comes from objective indicators in isolated domains (e.g. unemployment). Subjective indicators continue to be under-researched. The above-described measures must be employed to further understanding of the apparent discrepancies between young people with serious mental illness and those without serious mental illness. This will elucidate the relationships between objective and subjective elements of social inclusion and the relationships between these elements and the psychological distress that young people with serious mental illness often experience. This has implications for intervention.
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Affiliation(s)
- Andrew Gardner
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kate Filia
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Eóin Killackey
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sue Cotton
- 1 Department of Research and Translation at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,3 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Spiegel JB, Ortiz Choukroun B, Campaña A, Boydell KM, Breilh J, Yassi A. Social transformation, collective health and community-based arts: ‘Buen Vivir’ and Ecuador's social circus programme. Glob Public Health 2018; 14:899-922. [DOI: 10.1080/17441692.2018.1504102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J. B. Spiegel
- Department of English and Department of Theatre, Concordia University, Montreal, Canada
- Faculty of Education, Simon Fraser University, Vancouver, Canada
| | | | - A. Campaña
- Universidad Andina Simón Bolívar, Quito, Ecuador
| | - K. M. Boydell
- Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - J. Breilh
- Universidad Andina Simón Bolívar, Quito, Ecuador
| | - A. Yassi
- Global Health Research Program, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Mazzi F, Baccari F, Mungai F, Ciambellini M, Brescancin L, Starace F. Effectiveness of a social inclusion program in people with non-affective psychosis. BMC Psychiatry 2018; 18:179. [PMID: 29879925 PMCID: PMC5992655 DOI: 10.1186/s12888-018-1728-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/04/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND People with psychotic illness suffer from reduced quality of life and often from an insufficient level of social inclusion. These variables are associated with several negative outcomes, such as higher neuro-cognitive deficits, negative symptoms, internalised stigma, increased cardiovascular risk and, most importantly, excess mortality. To date, only a minority of social interventions in psychosis have been investigated. Since 2011, the Department of Mental Health and Substance Abuse in Modena introduced the "Social Point" program, which provides social inclusion interventions to promote active social participation for patients suffering from severe mental illness. The aim of this study was to assess whether a social inclusion intervention is associated with better outcomes in terms of personal and social recovery, with particular reference to the areas of social functioning and activity, and subjective dimensions such as self-esteem, self-stigma and perceived quality of life. METHODS A cross-sectional design was adopted to compare 30 subjects, selected at the completion of "Social Point" program, with a group of subjects, matched for socio-demographic and clinical features, selected from a wait list for "Social Point". All subjects were evaluated by means of instruments assessing: level of disability, level of functioning, severity of psychopathology, self-esteem, internalised stigma and quality of life. RESULTS Overall, the results of the study suggest that social inclusion interventions may be effective in people suffering from non-affective psychosis. A dose-effect relationship was also found between higher number of activities per patient and better outcomes within both social and psychopathological domains. However, due to the cross-sectional design of the study no definitive causality can be inferred. CONCLUSION Psychosocial interventions promoting social inclusion are likely to represent an effective approach to improve personal and social recovery.
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Affiliation(s)
- Fausto Mazzi
- 0000 0004 1756 2640grid.476047.6Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124 Modena, Italy
| | - Flavia Baccari
- 0000 0004 1756 2640grid.476047.6Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124 Modena, Italy
| | - Francesco Mungai
- Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124, Modena, Italy.
| | | | - Lisa Brescancin
- Social Point Modena – Centro Servizi Volontariato, Modena, Italy
| | - Fabrizio Starace
- 0000 0004 1756 2640grid.476047.6Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124 Modena, Italy
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Santos JCD, Barros S, Huxley PJ. Social inclusion of the people with mental health issues: Compare international results. Int J Soc Psychiatry 2018. [PMID: 29536793 DOI: 10.1177/0020764018763941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Social inclusion of people with mental health issues is an aim of the World Health Organisation. Many countries have adopted that objective, including Brazil and the United Kingdom and both have focused treatment in the community. The aim of this article is to compare international results using the same inclusion instrument. METHODS The samples in this study were 225 people with mental health issues in community services in São Paulo, Brazil. Their results are compared to findings from 168 people with similar mental health issues in Hong Kong, China, and from the United Kingdom - a nationally representative sample of 212 people without mental health issues. The instrument used to measure a social inclusion called Social and Communities Opportunities Profile (SCOPE) has been validated for use in the United Kingdom, China and Brazil. RESULTS The results are that people with mental health issues have worse social inclusion when compared to general population. Between the people with mental health issues, the sample of São Paulo has the lowest social inclusion index but, in relation to access to the Brazilian revised mental health services, that sample has a similarly high inclusion rating to the general population of the United Kingdom. CONCLUSION Findings are important to understand mental health in the community context, as well as their adversities and potentialities.
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Affiliation(s)
| | - Sônia Barros
- 1 School of Nursing, University of São Paulo, São Paulo, Brazil
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O'Donnell P, O'Donovan D, Elmusharaf K. Measuring social exclusion in healthcare settings: a scoping review. Int J Equity Health 2018; 17:15. [PMID: 29391016 PMCID: PMC5796599 DOI: 10.1186/s12939-018-0732-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 01/24/2018] [Indexed: 12/05/2022] Open
Abstract
Background Social exclusion is a concept that has been widely debated in recent years; a particular focus of the discussion has been its significance in relation to health. The meanings of the phrase “social exclusion”, and the closely associated term “social inclusion”, are contested in the literature. Both of these concepts are important in relation to health and the area of primary healthcare in particular. Thus, several tools for the measurement of social exclusion or social inclusion status in health care settings have been developed. Methods A scoping review of the peer-reviewed and grey literature was conducted to examine tools developed since 2000 that measure social exclusion or social inclusion. We focused on those measurement tools developed for use with individual patients in healthcare settings. Efforts were made to obtain a copy of each of the original tools, and all relevant background literature. All tools retrieved were compared in tables, and the specific domains that were included in each measure were tabulated. Results Twenty-two measurement tools were included in the final scoping review. The majority of these had been specifically developed for the measurement of social inclusion or social exclusion, but a small number were created for the measurement of other closely aligned concepts. The majority of the tools included were constructed for engaging with patients in mental health settings. The tools varied greatly in their design, the scoring systems and the ways they were administered. The domains covered by these tools varied widely and some of the tools were quite narrow in the areas of focus. A review of the definitions of both social inclusion and social exclusion also revealed the variations among the explanations of these complex concepts. Conclusions There are several definitions of both social inclusion and social exclusion in use and they differ greatly in scope. While there are many tools that have been developed for measuring these concepts in healthcare settings, these do not have a primary healthcare focus. There is a need for the development of a tool for measuring social inclusion or social exclusion in primary healthcare settings. Electronic supplementary material The online version of this article (10.1186/s12939-018-0732-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick O'Donnell
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
| | - Diarmuid O'Donovan
- School of Medicine, Clinical Science Institute, National University of Ireland, Room 342, Galway, Ireland
| | - Khalifa Elmusharaf
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Papagiannidis S, Bourlakis M, Alamanos E, Dennis C. Preferences of smart shopping channels and their impact on perceived wellbeing and social inclusion. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.04.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wang J, Lloyd-Evans B, Giacco D, Forsyth R, Nebo C, Mann F, Johnson S. Social isolation in mental health: a conceptual and methodological review. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1451-1461. [PMID: 29080941 PMCID: PMC5702385 DOI: 10.1007/s00127-017-1446-1] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 10/04/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE Social isolation and related concepts have been discussed increasingly in the field of mental health. Despite this, there is a lack of conceptual clarity and consistency in the definition and operationalisation of these terms. This review aimed to provide a clear framework for social isolation and related concepts, and to identify well-established measures in the field of mental health for each conceptual domain discussed. METHODS We used an iterative strategy of expert consultation and literature searching. A multi-disciplinary group of senior academics was consulted both before and after the literature searching to identify relevant terms, conceptual papers, or recommended measures. Our conceptual framework was also validated through expert consultation. We searched the Web of Science database using terms suggested by experts and subsequently identified further relevant studies through review articles and by reading full texts and reference lists of included studies. A narrative synthesis was conducted. RESULTS We developed a model with five domains incorporating all the concepts relevant to social isolation in regular use in the mental health research literature. These five domains are: social network-quantity; social network-structure; social network-quality; appraisal of relationships-emotional; and appraisal of relationships-resources. We also identified well-developed measures suitable for assessing each of the five conceptual domains or covering multi-domains. CONCLUSIONS Our review proposes a conceptual model to encompass and differentiate all terms relating to social isolation. Potential uses are in allowing researchers and intervention developers to identify precisely the intended outcomes of interventions, and to choose the most appropriate measures to use in mental health settings.
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Affiliation(s)
- Jingyi Wang
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Domenico Giacco
- Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | - Rebecca Forsyth
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Cynthia Nebo
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Farhana Mann
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE, UK
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Cordier R, Milbourn B, Martin R, Buchanan A, Chung D, Speyer R. A systematic review evaluating the psychometric properties of measures of social inclusion. PLoS One 2017; 12:e0179109. [PMID: 28598984 PMCID: PMC5466312 DOI: 10.1371/journal.pone.0179109] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 05/10/2017] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Improving social inclusion opportunities for population health has been identified as a priority area for international policy. There is a need to comprehensively examine and evaluate the quality of psychometric properties of measures of social inclusion that are used to guide social policy and outcomes. OBJECTIVE To conduct a systematic review of the literature on all current measures of social inclusion for any population group, to evaluate the quality of the psychometric properties of identified measures, and to evaluate if they capture the construct of social inclusion. METHODS A systematic search was performed using five electronic databases: CINAHL, PsycINFO, Embase, ERIC and Pubmed and grey literature were sourced to identify measures of social inclusion. The psychometric properties of the social inclusion measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. RESULTS Of the 109 measures identified, twenty-five measures, involving twenty-five studies and one manual met the inclusion criteria. The overall quality of the reviewed measures was variable, with the Social and Community Opportunities Profile-Short, Social Connectedness Scale and the Social Inclusion Scale demonstrating the strongest evidence for sound psychometric quality. The most common domain included in the measures was connectedness (21), followed by participation (19); the domain of citizenship was covered by the least number of measures (10). No single instrument measured all aspects within the three domains of social inclusion. Of the measures with sound psychometric evidence, the Social and Community Opportunities Profile-Short captured the construct of social inclusion best. CONCLUSIONS The overall quality of the psychometric properties demonstrate that the current suite of available instruments for the measurement of social inclusion are promising but need further refinement. There is a need for a universal working definition of social inclusion as an overarching construct for ongoing research in the area of the psychometric properties of social inclusion instruments.
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Affiliation(s)
- Reinie Cordier
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Ben Milbourn
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Robyn Martin
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Angus Buchanan
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Donna Chung
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Renée Speyer
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
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Shioda A, Tadaka E, Okochi A. Reliability and validity of the Japanese version of the Community Integration Measure for community-dwelling people with schizophrenia. Int J Ment Health Syst 2017; 11:29. [PMID: 28428814 PMCID: PMC5393028 DOI: 10.1186/s13033-017-0138-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community integration is an essential right for people with schizophrenia that affects their well-being and quality of life, but no valid instrument exists to measure it in Japan. The aim of the present study is to develop and evaluate the reliability and validity of the Japanese version of the Community Integration Measure (CIM) for people with schizophrenia. METHODS The Japanese version of the CIM was developed as a self-administered questionnaire based on the original version of the CIM, which was developed by McColl et al. This study of the Japanese CIM had a cross-sectional design. Construct validity was determined using a confirmatory factor analysis (CFA) and data from 291 community-dwelling people with schizophrenia in Japan. Internal consistency was calculated using Cronbach's alpha. The Lubben Social Network Scale (LSNS-6), the Rosenberg Self-Esteem Scale (RSE) and the UCLA Loneliness Scale, version 3 (UCLALS) were administered to assess the criterion-related validity of the Japanese version of the CIM. RESULTS The participants were 263 people with schizophrenia who provided valid responses. The Cronbach's alpha was 0.87, and CFA identified one domain with ten items that demonstrated the following values: goodness of fit index = 0.924, adjusted goodness of fit index = 0.881, comparative fit index = 0.925, and root mean square error of approximation = 0.085. The correlation coefficients were 0.43 (p < 0.001) with the LSNS-6, 0.42 (p < 0.001) with the RSE, and -0.57 (p < 0.001) with the UCLALS. CONCLUSIONS The Japanese version of the CIM demonstrated adequate reliability and validity for assessing community integration for people with schizophrenia in Japan.
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Affiliation(s)
- Ai Shioda
- Graduate School of Health Management, Keio University, 4411, Endo, Fujisawa, Kanagawa 252-0883 Japan
| | - Etsuko Tadaka
- Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Ayako Okochi
- Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
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van Bergen APL, Hoff SJM, Schreurs H, van Loon A, van Hemert AM. Social Exclusion Index-for Health Surveys (SEI-HS): a prospective nationwide study to extend and validate a multidimensional social exclusion questionnaire. BMC Public Health 2017; 17:253. [PMID: 28288609 PMCID: PMC5348771 DOI: 10.1186/s12889-017-4175-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 03/07/2017] [Indexed: 11/25/2022] Open
Abstract
Background Social exclusion (SE) refers to the inability of certain groups or individuals to fully participate in society. SE is associated with socioeconomic inequalities in health, and its measurement in routine public health monitoring is considered key to designing effective health policies. In an earlier retrospective analysis we demonstrated that in all four major Dutch cities, SE could largely be measured with existing local public health monitoring data. The current prospective study is aimed at constructing and validating an extended national measure for SE that optimally employs available items. Methods In 2012, a stratified general population sample of 258,928 Dutch adults completed a version of the Netherlands Public Health Monitor (PHM) questionnaire in which 9 items were added covering aspects of SE that were found to be missing in our previous research. Items were derived from the SCP social exclusion index, a well-constructed 15-item instrument developed by the Netherlands Institute for Social Research (SCP). The dataset was randomly divided into a development sample (N =129,464) and a validation sample (N = 129,464). Canonical correlation analysis was conducted in the development sample. The psychometric properties were studied and compared with those of the original SCP index. All analyses were then replicated in the validation sample. Results The analysis yielded a four dimensional index, the Social Exclusion Index for Health Surveys (SEI-HS), containing 8 SCP items and 9 PHM items. The four dimensions: “lack of social participation”, “material deprivation”, “lack of normative integration” and “inadequate access to basic social rights”, were each measured with 3 to 6 items. The SEI-HS showed adequate internal consistency for both the general index and for two of four dimension scales. The internal structure and construct validity of the SEI-HS were satisfactory and similar to the original SCP index. Replication of the SEI-HS in the validation sample confirmed its generalisability. Conclusion This study demonstrates that the SEI-HS offers epidemiologists and public health researchers a uniform, reliable, valid and efficient means of assessing social exclusion and its underlying dimensions. The study also provides valuable insights in how to develop embedded measures for public health surveillance. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4175-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Addi P L van Bergen
- Department of Public Health, Municipality of Utrecht, Utrecht, Netherlands. .,Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands.
| | - Stella J M Hoff
- Department of Labour and Public Services, The Netherlands Institute of Social Research
- SCP, The Hague, Netherlands
| | - Hanneke Schreurs
- Department of Public Health, Municipality of Utrecht, Utrecht, Netherlands
| | - Annelies van Loon
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, Amsterdam, Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
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Chan K, Chiu MYL, Evans S, Huxley PJ, Ng YL. Application of SCOPE-C to Measure Social Inclusion Among Mental Health Services Users in Hong Kong. Community Ment Health J 2016; 52:1113-1117. [PMID: 26129905 DOI: 10.1007/s10597-015-9907-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/23/2015] [Indexed: 11/28/2022]
Abstract
This study describes the construction of the Chinese version of the Social and Communities Opportunities Profile (SCOPE), henceforth, the SCOPE-C, to measure social inclusion among mental health services users in Hong Kong. The SCOPE-C was developed based on concept-mapping and benchmarking of census questions. The questionnaire consisted of 56 items, went through a standardized linguistic validation process and was pilot tested with qualitative feedback from five users of mental health services. Altogether 168 Chinese service users were recruited through various NGO mental health services to have three times face-to-face interview between October 2013 and July 2014. Results indicated that items related to satisfaction with opportunities and perceived opportunities in various social domains had high consistency. Nearly all the Kappa statistics and Pearson correlation coefficients between the baseline and two rounds of re-test were significant. The SCOPE-C was considered a valid instrument for Hong Kong mental health user population.
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Affiliation(s)
- Kara Chan
- Department of Communication Studies, Hong Kong Baptist University, Kowloon, Hong Kong.
| | - Marcus Yu-Lung Chiu
- Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Sherrill Evans
- School of Human Sciences, Swansea University, Swansea, UK
| | - Peter J Huxley
- Centre for Mental Health and Society, Bangor University, Bangor, UK
| | - Yu-Leung Ng
- Department of Communication Studies, Hong Kong Baptist University, Kowloon, Hong Kong
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Ballert CS, Hopfe M, Kus S, Mader L, Prodinger B. Using the refined ICF Linking Rules to compare the content of existing instruments and assessments: a systematic review and exemplary analysis of instruments measuring participation. Disabil Rehabil 2016; 41:584-600. [PMID: 27414962 DOI: 10.1080/09638288.2016.1198433] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Existing instruments measuring participation may vary with respect to various aspects. This study aimed to examine the comparability of existing instruments measuring participation based on the International Classification of Functioning, Disability and Health (ICF) by considering aspects of content, the perspective adopted and the categorization of response options. METHODS A systematic literature review was conducted to identify instruments that have been commonly used to measure participation. Concepts of identified instruments were then linked to the ICF following the refined ICF Linking Rules. Aspects of content, perspective adopted and categorization of response options were documented. RESULTS Out of 315 instruments identified in the full-text screening, 41 instruments were included. Concepts of six instruments were linked entirely to the ICF component Activities and Participation; of 10 instruments still 80% of their concepts. A descriptive perspective was adopted in most items across instruments (75%), mostly in combination with an intensity rating. An appraisal perspective was found in 18% and questions from a need or dependency perspective were least frequent (7%). CONCLUSION Accounting for aspects of content, perspective and categorization of responses in the linking of instruments to the ICF provides detailed information for the comparison of instruments and guidance on narrowing down the choices of suitable instruments from a content point of view. Implications for Rehabilitation For clinicians and researchers who need to identify a specific instrument for a given purpose, the findings of this review can serve as a screening tool for instruments measuring participation in terms of the following: • Their content covered based on the ICF. • The perspective adopted in the instrument (e.g., descriptive, need/dependency or appraisal). • The categorization of their response options (e.g., intensity or frequency).
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Affiliation(s)
- Carolina S Ballert
- a Swiss Paraplegic Research, ICF Unit , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland
| | - Maren Hopfe
- a Swiss Paraplegic Research, ICF Unit , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland
| | - Sandra Kus
- c Department of Medical Informatics, Biometry and Epidemiology - IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health , Ludwig-Maximilians-University (LMU) , Munich , Germany
| | - Luzius Mader
- b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland
| | - Birgit Prodinger
- a Swiss Paraplegic Research, ICF Unit , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland.,d ICF Research Branch a Cooperation Partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI) , Nottwil , Switzerland
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Yassi A, Spiegel JB, Lockhart K, Fels L, Boydell K, Marcuse J. Ethics in Community-University-Artist Partnered Research: Tensions, Contradictions and Gaps Identified in an 'Arts for Social Change' Project. JOURNAL OF ACADEMIC ETHICS 2016; 14:199-220. [PMID: 27563284 PMCID: PMC4981172 DOI: 10.1007/s10805-016-9257-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Academics from diverse disciplines are recognizing not only the procedural ethical issues involved in research, but also the complexity of everyday “micro” ethical issues that arise. While ethical guidelines are being developed for research in aboriginal populations and low-and-middle-income countries, multi-partnered research initiatives examining arts-based interventions to promote social change pose a unique set of ethical dilemmas not yet fully explored. Our research team, comprising health, education, and social scientists, critical theorists, artists and community-activists launched a five-year research partnership on arts-for-social change. Funded by the Social Science and Humanities Research Council in Canada and based in six universities, including over 40 community-based collaborators, and informed by five main field projects (circus with street youth, theatre by people with disabilities, dance for people with Parkinson’s disease, participatory theatre with refugees and artsinfused dialogue), we set out to synthesize existing knowledge and lessons we learned. We summarized these learnings into 12 key points for reflection, grouped into three categories: community-university partnership concerns (n = 3), dilemmas related to the arts (n = 5), and team issues (n = 4). In addition to addressing previous concerns outlined in the literature (e.g., related to consent, anonymity, dangerous emotional terrain, etc.), we identified power dynamics (visible and hidden) hindering meaningful participation of community partners and university-based teams that need to be addressed within a reflective critical framework of ethical practice. We present how our team has been addressing these issues, as examples of how such concerns could be approached in community-university partnerships in arts for social change.
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Affiliation(s)
- Annalee Yassi
- School of Population and Public Health, University of British Columbia, 430-2206 East Mall, UBC, Vancouver, BC V6T 1Z3 Canada
| | - Jennifer Beth Spiegel
- International Centre for Art for Social Change and Faculty of Education, Simon Fraser University, Burnaby, BC Canada ; English Department, Concordia University, Montreal, QC Canada
| | - Karen Lockhart
- School of Population and Public Health, University of British Columbia, 430-2206 East Mall, UBC, Vancouver, BC V6T 1Z3 Canada
| | - Lynn Fels
- International Centre for Art for Social Change and Faculty of Education, Simon Fraser University, Burnaby, BC Canada
| | - Katherine Boydell
- Black Dog Institute, University of New South Wales, Sydney, Australia ; Departments of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Judith Marcuse
- International Centre for Art for Social Change and Faculty of Education, Simon Fraser University, Burnaby, BC Canada
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Huxley PJ, Chan K, Chiu M, Ma Y, Gaze S, Evans S. The social and community opportunities profile social inclusion measure: Structural equivalence and differential item functioning in community mental health residents in Hong Kong and the United Kingdom. Int J Soc Psychiatry 2016; 62:133-40. [PMID: 26490970 DOI: 10.1177/0020764015607550] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION China's future major health problem will be the management of chronic diseases - of which mental health is a major one. An instrument is needed to measure mental health inclusion outcomes for mental health services in Hong Kong and mainland China as they strive to promote a more inclusive society for their citizens and particular disadvantaged groups. AIM To report on the analysis of structural equivalence and item differentiation in two mentally unhealthy and one healthy sample in the United Kingdom and Hong Kong. METHOD The mental health sample in Hong Kong was made up of non-governmental organisation (NGO) referrals meeting the selection/exclusion criteria (being well enough to be interviewed, having a formal psychiatric diagnosis and living in the community). A similar sample in the United Kingdom meeting the same selection criteria was obtained from a community mental health organisation, equivalent to the NGOs in Hong Kong. Exploratory factor analysis and logistic regression were conducted. RESULTS The single-variable, self-rated 'overall social inclusion' differs significantly between all of the samples, in the way we would expect from previous research, with the healthy population feeling more included than the serious mental illness (SMI) groups. In the exploratory factor analysis, the first two factors explain between a third and half of the variance, and the single variable which enters into all the analyses in the first factor is having friends to visit the home. All the regression models were significant; however, in Hong Kong sample, only one-fifth of the total variance is explained. CONCLUSION The structural findings imply that the social and community opportunities profile-Chinese version (SCOPE-C) gives similar results when applied to another culture. As only one-fifth of the variance of 'overall inclusion' was explained in the Hong Kong sample, it may be that the instrument needs to be refined using different or additional items within the structural domains of inclusion.
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Affiliation(s)
- Peter John Huxley
- Centre for Mental Health and Society, School of Social Sciences, Bangor University, Bangor, Wales
| | - Kara Chan
- School of Communication, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Marcus Chiu
- Department of Social Work, Faculty of Arts & Social Sciences, National University of Singapore, Singapore
| | - Yanni Ma
- School of Communication, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Sarah Gaze
- School of Medicine, Swansea University, Swansea, Wales
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Abstract
BACKGROUND Social inclusion is crucial to mental health and well-being and is emphasised in Australia's Fourth National Mental Health Plan. There is a recognition that a measure of social inclusion would complement the suite of outcome measures that is currently used in public sector mental health services. This paper is an initial scope of candidate measures of social inclusion and considers their suitability for this purpose. METHODS We identified potential measures through searches of PsycINFO and Medline and a more general Internet search. We extracted descriptive and evaluative information on each measure identified and compared this information with a set of eight criteria. The criteria related to the measure's inclusion of four domains of social inclusion outlined in Australia's Fourth National Mental Health Plan, its usability within the public mental health sector and its psychometric properties. RESULTS We identified 10 candidate measures of social inclusion: the Activity and Participation Questionnaire (APQ-6); the Australian Community Participation Questionnaire (ACPQ); the Composite Measure of Social Inclusion (CMSI); the EMILIA Project Questionnaire (EPQ); the Evaluating Social Inclusion Questionnaire (ESIQ); the Inclusion Web (IW); the Social and Community Opportunities Profile (SCOPE); the Social Inclusion Measure (SIM); the Social Inclusion Questionnaire (SIQ); and the Staff Survey of Social Inclusion (SSSI). After comparison with the eight review criteria, we determined that the APQ-6 and the SCOPE-short form show the most potential for further testing. CONCLUSIONS Social inclusion is too important not to measure. This discussion of individual-level measures of social inclusion provides a springboard for selecting an appropriate measure for use in public sector mental health services. It suggests that there are two primary candidates, but neither of these is quite fit-for-purpose in their current form. Further exploration will reveal whether one of these is suitable, whether another measure might be adapted for the current purpose or whether a new, specifically designed measure needs to be developed.
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Affiliation(s)
- Tim Coombs
- 1New South Wales Institute of Psychiatry, Sydney, Australia
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