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Tran JT, Rigg KK, Galea JT, Kosyluk KA. Examining the Effects of Digital Stories to Address Mental Illness and Sexual and Gender Minority-Related Stigma. JOURNAL OF HOMOSEXUALITY 2024:1-18. [PMID: 38923913 DOI: 10.1080/00918369.2024.2368204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Sexual and gender minority (SGM) individuals living with mental illness often experience stigma associated with marginalized identities of sexual orientation, gender identity, and mental illness (MI). Sharing stories of lived experiences is an effective approach to reducing various forms of stigma; however, it is unclear whether stories shared by SGM living with mental illness (SGM MI) can reduce MI- and SGM-related stigma. METHODS Using a randomized controlled trial design, participants watched digital stories of self-identified SGM individuals living with a mental illness, non-SGM individuals living with mental illness, or a control condition (TedTalks on environmental issues and growing up in China) to examine the use of representative digital stories in addressing SGM- and MI-related stigma. RESULTS In a sample of 218 participants, digital stories of SGM MI effectively reduced MI-related stigma (personal stigma (from 33.19 to 31.90) and discrimination (from 8.33 to 7.57)), but were ineffective at reducing SGM-related personal stigma (negative attitudes toward lesbians and gay men, transphobia, or genderism; p > .05). CONCLUSION Our study highlights the need to develop culturally adapted anti-stigma programs in collaboration with individuals with lived intersectional SGM and MI experiences.
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Affiliation(s)
- Jennifer T Tran
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida, USA
| | - Khary K Rigg
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida, USA
| | - Jerome T Galea
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Kristin A Kosyluk
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida, USA
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Rigg KK, Proctor SL, Kusiak ES, Barber SA, Asous LW, Bartholomew TS. Assessing Feasibility and Barriers to Implementing a Family-Based Intervention in Opioid Treatment Programs. J Behav Health Serv Res 2024; 51:151-163. [PMID: 38097913 DOI: 10.1007/s11414-023-09873-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 03/16/2024]
Abstract
Families Facing the Future (FFF) is an intervention designed specifically for families with a parent in methadone treatment. FFF is unique because it addresses prevention for children and recovery for parents in a single intervention. The primary goals of the program are to prevent parents' relapse, help them cope with relapse if it occurs, and teach parenting skills in order to reduce the likelihood of substance use among their children. FFF has been implemented as an adjunct to treatment in several Opioid Treatment Programs, but has not been widely adopted due to various implementation barriers. The aims of this study, therefore, were to (1) assess the perceived feasibility of implementing FFF and (2) identify/describe barriers to implementing FFF. An online survey was used to assess implementation feasibility, while individual qualitative interviews were conducted to explore specific barriers to implementation. Data collection from a total of 40 participants (20 patients and 20 providers) was conducted from August 2022 to October 2022 at two Opioid Treatment Programs in Florida. Analyses revealed high feasibility scores, indicating that FFF was viewed by both patients and providers as a practical intervention to implement. Despite strong perceived feasibility of the intervention, qualitative findings identified several implementation barriers with respect to difficulty attending parent training sessions, aversion to in-home visits, and lack of funding (inability to provide patient incentives/bill insurance). This study provides evidence that while patients and providers view FFF as having high feasibility, significant implementation barriers exist. This paper fills a void in the literature by informing if and which modifications might be necessary to facilitate wider adoption of FFF in real-world Opioid Treatment Program settings.
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Affiliation(s)
- Khary K Rigg
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL, 33612, USA.
| | | | - Ethan S Kusiak
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Sharon A Barber
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Lara W Asous
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Tyler S Bartholomew
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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McNeish Taormina R, Massey T, Walker-Egea C, Sowell C, Rigg KK, Simmons C, Tran Q. Building capacity to create community change (BC 4): A model to support successful program planning and implementation. EVALUATION AND PROGRAM PLANNING 2023; 97:102225. [PMID: 36638766 DOI: 10.1016/j.evalprogplan.2023.102225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/07/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Community-based interventions (CBIs) are increasingly used to address health problems and are usually implemented by organizations outside and/or inside the community. CBIs are complex and organizations need to have, or be able to build the capacity needed to implement CBIs effectively. The importance of organizational capacity building is well established in the literature, but less attention is focused on how to build capacity, particularly for prevention-focused and mental health CBIs. As part of the longitudinal process evaluation of a national initiative to promote the mental health and wellbeing of men and boys in the United States, this study developed a capacity-building model to identify areas and associated factors that were integral to grantee organizations' ability to build capacity to create change in their communities. The findings identified five domains used to comprise the Building Capacity to Create Community Change model, which contributed to organizational capacity building and as a result, implementation progress: Administrative Support, Leadership, Vision and Mission, Partnership Development, and Community Engagement. Strength in each domain increased grantees' capacity to impact the lives of participants and progress towards the goal of creating community change.
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Affiliation(s)
| | - Tom Massey
- Department of Child & Family Studies, University of South Florida, USA
| | | | - Cathy Sowell
- Department of Child & Family Studies, University of South Florida, USA
| | - Khary K Rigg
- Department of Mental Health Law & Policy, University of South Florida, USA
| | | | - Quynh Tran
- Department of Child & Family Studies, University of South Florida, USA
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Lipien L, Ismajli F, Rigg KK. Psychometric properties of the
LifeSkills Training
middle school health survey. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Lodi Lipien
- Department of Child and Family Studies College of Behavioral and Community Sciences Tampa Florida USA
| | - Flandra Ismajli
- Department of Child and Family Studies College of Behavioral and Community Sciences Tampa Florida USA
| | - Khary K. Rigg
- Department of Mental Health Law and Policy College of Behavioral and Community Sciences University of South Florida Tampa Florida USA
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Spencer RA, Numer M, Rehman L, Kirk SFL. Picture perfect? Gazing into girls' health, physical activity, and nutrition through photovoice. Int J Qual Stud Health Well-being 2021; 16:1874771. [PMID: 33491602 PMCID: PMC7850428 DOI: 10.1080/17482631.2021.1874771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Women face contradictions regarding their health: Pressure to be feminine, but also athletic; Criticism for being too sporty or muscular, but equally so for being perceived as lazy or overweight. These complexities are perpetuated through media and discourse. Purpose: Using a feminist post-structural approach and photovoice, this study explored health, physical activity, and nutrition in adolescent girls and young women. Methods: Photovoice enables reflection, promotes dialogue, and sparks change. The process involved conducting a workshop, collecting photos, and participatory analysis sessions, which engaged the participants (n = 7, ages 13–26) in photo selection, contextualization, and codifying. Results: This resulted in three themes: First, (Breaking) Stereotypes, in which participants identified gender norms, conflicts, and contradictions; Second, Emotional Safety, or the contexts in which girls and young women feel confident and comfortable; Finally, Being Outside in Nature emerged as significant. Each theme is supported by quotations and photographs. This work suggests being outside in nature provides important context for girls and young women to feel emotionally safe, such that they may engage in the complex navigation of competing discourses surrounding health.
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Affiliation(s)
- Rebecca A Spencer
- School of Health & Human Performance, Dalhousie University , Halifax, NS, Canada
| | - Matthew Numer
- School of Health & Human Performance, Dalhousie University , Halifax, NS, Canada
| | - Laurene Rehman
- School of Health & Human Performance, Dalhousie University , Halifax, NS, Canada
| | - Sara F L Kirk
- Healthy Populations Institute, Dalhousie University , Halifax, NS, Canada
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Donkers SJ, Oosman S, Milosavljevic S, Musselman KE. Addressing Physical Activity Behavior in Multiple Sclerosis Management: A Qualitative Account of Health Care Providers' Current Practices and Perspectives. Int J MS Care 2020; 22:178-186. [PMID: 32863786 DOI: 10.7224/1537-2073.2019-029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Although physical activity (PA) is considered the most important nonpharmaceutical intervention for persons with multiple sclerosis (MS), less than 20% of people with MS are engaging in sufficient amounts to accrue benefits. Promotion of PA is most effective when combined with additional behavior change strategies, but this is not routinely done in clinical practice. This study aimed to increase our understanding of current practice and perspectives of health care providers (HCPs) in Canada regarding their use of interventions to address PA behavior in MS management. Investigating HCPs' perspectives on implementing PA behavior change with persons with MS will provide insight into this knowledge-to-practice gap. Methods Semistructured focus groups were conducted with 31 HCPs working with persons with MS in Saskatchewan, Canada. Based on interpretive description, data were coded individually by three researchers, who then collaboratively developed themes. Analysis was inductive and iterative; triangulation and member reflections were used. Results Five themes were established: 1) prescribing, promoting, and impacting wellness with PA; 2) coordinating communication and continuity in practice; 3) timely access to relevant care: being proactive rather than reactive; 4) enhancing programming and community-based resources; and 5) reconciling the value of PA with clinical practice. Conclusions The HCPs value PA and want more support with application of behavior change strategies to deliver PA behavioral interventions, but due to the acute and reactive nature of health care systems they feel this cannot be prioritized in practice. Individual- and system-level changes are needed to support consistent and effective use of PA behavioral interventions in MS.
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Golden TL, Wendel ML. Public Health's Next Step in Advancing Equity: Re-evaluating Epistemological Assumptions to Move Social Determinants From Theory to Practice. Front Public Health 2020; 8:131. [PMID: 32457863 PMCID: PMC7221057 DOI: 10.3389/fpubh.2020.00131] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/31/2020] [Indexed: 11/13/2022] Open
Abstract
The field of public health has increasingly promoted a social ecological approach to health, shifting from an individual, biomedical paradigm to a recognition of social and structural determinants of health and health equity. Yet despite this shift, public health research and practice continue to privilege individual- and interpersonal-level measurements and interventions. Rather than adapting public health practice to social ecological theory, the field has layered new concepts (“root causes,” “social determinants”) onto a biomedical paradigm—attempting to answer questions presented by the social ecological schema with practices developed in response to biomedicine. This stymies health equity work before it begins—limiting the field's ability to broaden conceptions of well-being, redress histories of inequitable knowledge valuation, and advance systems-level change. To respond effectively to our knowledge of social determinants, public health must resolve the ongoing disconnect between social ecological theory and biomedically-driven practice. To that end, this article issues a clarion call to complete the shift from a biomedical to a social ecological paradigm, and provides a basis for moving theory into practice. It examines biomedicine's foundations and limitations, glosses existing critiques of the paradigm, and describes health equity challenges presented by over-reliance on conventional practices. It then offers theoretical and epistemological direction for developing innovative social ecological strategies that advance health equity.
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Affiliation(s)
- Tasha L Golden
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, United States.,International Arts + Mind Lab, Brain Science Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Monica L Wendel
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, United States
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Abstract
Increasing attention has been devoted to the important role that primary care will play in improving population health. One innovation, the patient-centered medical home (PCMH), aims to unite a variety of professionals with patients in the prevention and treatment of illness. Although patient perspectives are critical to this model, this article questions whether the PCMH in practice is truly community-based. That is, do physicians, planners, and other health care professionals take seriously the value of integrating local knowledge into medical care? The argument presented is that community-based philosophy contains a foundational principle that the perspectives of health care practitioners and community members must be integrated. Although many proponents of the PCMH aim to offer patient-centered and sustainable health care, focusing on this philosophical shift will ensure that services are organized by communities in collaboration with health care professionals.
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Affiliation(s)
- Berkeley A Franz
- Assistant Professor of Community-Based Health at the Heritage College of Osteopathic Medicine in Athens, OH.
| | - John W Murphy
- Professor of Sociology at the University of Miami in FL.
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True G, Rigg KK, Butler A. Understanding Barriers to Mental Health Care for Recent War Veterans Through Photovoice. QUALITATIVE HEALTH RESEARCH 2015; 25:1443-1455. [PMID: 25488935 DOI: 10.1177/1049732314562894] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Despite an urgent need for mental health care among U.S. service members returning from deployments to Iraq and Afghanistan, many veterans do not receive timely or adequate treatment. We used photovoice methods to engage veterans in identifying barriers to utilizing mental health services. Veterans described how key aspects of military culture and identity, highly adaptive during deployment, can deter help-seeking behavior and hinder recovery. Veterans' photographs highlighted how mental health symptoms and self-coping strategies operated as barriers to care. Many veterans' photos and stories revealed how negative health care encounters contributed to avoidance and abandonment of treatment; some veterans described these experiences as re-traumatizing. Visual methods can be a powerful tool for engaging recent war veterans in research. In particular, community-based participatory research approaches, which have rarely been used with veterans, hold great promise for informing effective interventions to improve access and enhance provision of patient-centered care for veterans.
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Affiliation(s)
- Gala True
- Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Khary K Rigg
- University of South Florida, Tampa, Florida, USA
| | - Anneliese Butler
- Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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Abstract
Primary health care has received a lot of attention since the Alma Ata Conference, convened by the World Health Organization in 1978. Key to the strategy to improve health care outlined at the Alma Ata conference is citizen participation in every phase of service delivery. Although the goals of primary health care have not been achieved, the addition of narrative medicine may facilitate these ends. But a new epistemology is necessary, one that is compatible with narrative medicine, so that local knowledge is elevated in importance and incorporated into the planning, implementation, and evaluation of health programs. In this way, relevant, sustainable, and affordable care can be provided. The aim of this article is to discuss how primary health care might be improved through the introduction of narrative medicine into planning primary health care delivery.
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Affiliation(s)
- John W Murphy
- Professor of Sociology at the University of Miami in Coral Gables, FL.
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