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Heilemann MV, Lai J, Cadiz MP, Meza JI, Flores Romero D, Wells KB. Community Members' Perceptions of a Resource-Rich Well-Being Website in California During the COVID-19 Pandemic: Qualitative Thematic Analysis. JMIR Form Res 2024; 8:e55517. [PMID: 38526558 PMCID: PMC11002734 DOI: 10.2196/55517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND To address needs for emotional well-being resources for Californians during the COVID-19 pandemic, the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website was developed in collaboration with multiple community partners across California, funded by the California Department of Health Care Services Behavioral Health Division federal emergency response. OBJECTIVE This qualitative study was designed to explore and describe the perspectives of participants affiliated with California organizations on the T4W/Juntos website, understand their needs for web-based emotional health resources, and inform iterative website development. METHODS After providing informed consent and reviewing the website, telephone interviews were conducted with 29 participants (n=21, 72% in English and n=8, 28% in Spanish) recruited by partnering community agencies (October 2021-February 2022). A 6-phase thematic analysis was conducted, enhanced using grounded theory techniques. The investigators wrote reflexive memos and performed line-by-line coding of 12 transcripts. Comparative analyses led to the identification of 15 overarching codes. The ATLAS.ti Web software (ATLAS.ti Scientific Software Development GmbH) was used to mark all 29 transcripts using these codes. After examining the data grouped by codes, comparative analyses led to the identification of main themes, each with a central organizing concept. RESULTS Four main themes were identified: (1) having to change my coping due to the pandemic, (2) confronting a context of shifting perceptions of mental health stigma among diverse groups, (3) "Feels like home"-experiencing a sense of inclusivity and belonging in T4W/Juntos, and (4) "It's a one-stop-shop"-judging T4W/Juntos to be a desirable and useful website. Overall, the T4W/Juntos website communicated support and community to this sample during the pandemic. Participants shared suggestions for website improvement, including adding a back button and a drop-down menu to improve functionality as well as resources tailored to the needs of groups such as older adults; adolescents; the lesbian, gay, bisexual, transgender, and queer community; police officers; and veterans. CONCLUSIONS The qualitative findings from telephone interviews with this sample of community members and service providers in California suggest that, during the COVID-19 pandemic, the T4W/Juntos website was well received as a useful, accessible tool, with some concerns noted such as language sometimes being too "professional" or "clinical." The look, feel, and content of the website were described as welcoming due to pictures, animations, and videos that showcased resources in a personal, colorful, and inviting way. Furthermore, the content was perceived as lacking the stigma typically attached to mental health, reflecting the commitment of the T4W/Juntos team. Unique features and diverse resources, including multiple languages, made the T4W/Juntos website a valuable resource, potentially informing dissemination. Future efforts to develop mental health websites should consider engaging a diverse sample of potential users to understand how to tailor messages to specific communities and help reduce stigma.
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Affiliation(s)
- MarySue V Heilemann
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jianchao Lai
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Madonna P Cadiz
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Daniela Flores Romero
- Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kenneth B Wells
- Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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Soderlund PD, Cheung EH, Cadiz MP, Siddiq H, Yerstein M, Lee S, Wells K, Heilemann MV. Bridging the gap: a qualitative study of providers' perceptions of a partnered crisis follow-up program for suicidal patients post-emergency department discharge. BMC Psychiatry 2023; 23:854. [PMID: 37978360 PMCID: PMC10655296 DOI: 10.1186/s12888-023-05106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/11/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Effective interventions are needed to address suicide risk following discharge from the hospital emergency department or inpatient setting. Studies that examine follow-up contact methods show promise, but little is known about how follow-up programs are implemented in the real world and who is benefitting. The purpose of this formative evaluation and analysis was to gain insight about the usefulness and value of a partnered suicide prevention follow-up program (academic medical center emergency department partnered with a regional suicide prevention center) from the standpoint of psychiatry resident physicians providing direct care and suicide prevention center crisis counselors making follow-up outreach telephone calls to patients. METHODS A qualitative thematic analysis was conducted with focus group data from a convenience sample of psychiatry residents who performed consultations in the emergency department setting and counselors at the suicide prevention center crisis follow-up program. Focus group sessions, using semi-structured question guides, were completed at each participant group's workplace. Grounded theory techniques were used to guide coding and analytic theme development. RESULTS Analyses resulted in four overarching themes: valuing the program's utility and benefit to patients, desiring to understand what happens from emergency department discharge to program follow-up, having uncertainty about which patients would benefit from the program, and brainstorming to improve the referral process. Psychiatry residents appreciated the option of an "active" referral service (one that attempts to actively engage a patient after discharge through outreach), while suicide prevention crisis counselors valued their ability to offer a free and immediate service that had potential for fostering meaningful relationships. Both participant groups desired a better understanding of their partner's program operations, a uniform and smooth referral process, and awareness of who may or may not benefit from program services. CONCLUSION Results revealed the need for improved communication and implementation, such as expanded inter-agency contacts, consistent provider training, more documentation of the requirements and rules, a consistent message about program logistics for patients, and coordination between the program elements.
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Affiliation(s)
- Patricia D Soderlund
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, 624 East 1St St, Duluth, MN, 20155805, USA.
- Division of General Internal Medicine, David Geffen School of Medicine, University of California Los Angeles, National Clinician Scholars Program, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA.
| | - Erick H Cheung
- David Geffen School of Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Resnick Neuropsychiatric Hospital, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Madonna P Cadiz
- Luskin School of Public Affairs, University of California Los Angeles, 337 Charles E Young Dr E, Los Angeles, CA, 90095, USA
| | - Hafifa Siddiq
- Charles R. Drew University College of Nursing, 1731 E. 120th St., Los Angeles, CA, 90059, USA
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA
| | - Maria Yerstein
- Boston University School of Medicine, St. Elizabeth's Medical Center, 736 Cambridge St, Brighton, MA, 02135, USA
| | - Sae Lee
- Didi Hirsch Mental Health Services, 4760 S. Sepulveda Blvd, Culver City, CA. 90230, USA
| | - Kenneth Wells
- David Geffen School of Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Resnick Neuropsychiatric Hospital, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
- Research Center for Health Services and Society, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Suite 17.369B, Los Angeles, CA, 90024, USA
- David Geffen School of Medicine, National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA
- Department of Mental Health, Veterans Affairs Greater Los Angeles HealthCare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA
| | - MarySue V Heilemann
- School of Nursing, Factor Building, University of California Los Angeles, Box 6919, Los Angeles, CA, 90095, USA
- Division of General Internal Medicine, David Geffen School of Medicine, University of California Los Angeles, National Clinician Scholars Program, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA
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Cadiz MP, Santos CE, Tibbe TD. A Longitudinal Mediation Analysis of the Interrelations among Exclusionary Immigration Policy, Ethnic Identity, and Self-Esteem of Latinx Early Adolescents. J Youth Adolesc 2023; 52:2045-2060. [PMID: 37328609 PMCID: PMC10371921 DOI: 10.1007/s10964-023-01801-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/29/2023] [Indexed: 06/18/2023]
Abstract
Little is known about how exclusionary immigration laws affect ethnic identity and self-esteem among Latinx middle school students. Arizona's SB 1070, which required local officers to verify the legal status of detained individuals, garnered national attention for its impact on immigrant and Latinx communities. This study tested a longitudinal parallel multiple mediation model where perceptions of the effects of an exclusionary immigration law (Arizona's SB 1070) on self-esteem were mediated by dimensions of ethnic identity (ethnic centrality, ethnic private regard, ethnic public regard). Data were collected from a two-wave survey of 891 early adolescents ranging in age from 10 to 14 years (M = 12.09 years; SD = 0.99), a majority (71%) of whom were of Mexican descent. Analyses revealed an indirect effect of T1 perceptions of this law on T2 self-esteem (7 months later), holding T1 measures constant, with T2 ethnic centrality, private regard, and public regard acting as mediators. Perceived effects of this exclusionary law led to increased self-esteem through increased dimensions of ethnic identity. Results reveal how ethnic identity functions as a multidimensional construct in the process through which exclusionary immigration policy may impact the self-esteem of Latinx early adolescents.
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Affiliation(s)
- Madonna P Cadiz
- Department of Social Welfare, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Carlos E Santos
- Department of Social Welfare, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tristan D Tibbe
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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