1
|
Ando M, Kao YC, Lee YC, Tai SA, Mendez SR, Sasaki K, Tang W, Papatheodorou S. Remote cognitive behavioral therapy for older adults with anxiety symptoms: A systematic review and meta-analysis. J Telemed Telecare 2023:1357633X231151788. [PMID: 36794548 DOI: 10.1177/1357633x231151788] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
INTRODUCTION In-person cognitive behavioral therapy (CBT) can reduce self-reported anxiety in older adults. However, studies are limited for remote CBT. We assessed the effectiveness of remote CBT in mitigating self-reported anxiety in older adults. METHODS We conducted a systematic review and meta-analysis based on a literature search of PubMed, Embase, PsycInfo, and Cochrane databases up to March 31, 2021, for randomized controlled clinical trials comparing the effectiveness of remote CBT versus non-CBT controls on mitigating self-reported anxiety in older adults. We calculated within-group pre-to-post-treatment standardized mean difference using Cohen's d, obtained the difference between a remote CBT group and a non-CBT control group as our effect size for cross-study comparison, and conducted a random-effects meta-analysis. Changes in scores on self-reported anxiety symptoms (Generalized Anxiety Disorder-7 item Scale, Penn State Worry Questionnaire, or Penn State Worry Questionnaire - Abbreviated), and self-reported depressive symptoms (Patient Health Questionnaire-9 item Scale or Beck Depression Inventory) were primary and secondary outcomes, respectively. RESULTS Six eligible studies, containing 633 participants with a pooled mean age of 66.6 years, were included in the systematic review and meta-analysis. There was a significant mitigating effect of intervention on self-reported anxiety, favoring remote CBT over non-CBT controls (between-group effect size: -0.63; 95% CI: -0.99 to -0.28). We also found a significant mitigating effect of intervention on self-reported depressive symptoms (between-group effect size: -0.74; 95% CI: -1.24 to -0.25). DISCUSSION Remote CBT is more effective in reducing self-reported anxiety and depressive symptoms than non-CBT control in older adults.
Collapse
Affiliation(s)
- Mariko Ando
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ying-Chia Kao
- Department of Occupational Therapy, 38023Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Chien Lee
- Department of Family Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Sung-An Tai
- Department of Otolaryngology-Head and Neck Surgery, 40293Taichung Veterans General Hospital, Taichung, Taiwan
| | - Samuel R Mendez
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kosuke Sasaki
- Department of Mathematics and Statistics, 1846Boston University, Boston, MA, USA
| | - Wenze Tang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | |
Collapse
|
2
|
Simon MA, O’Brian CA, Tom L, Wafford QE, Mack S, Mendez SR, Nava M, Dahdouh R, Paul-Brutus R, Carpenter KH, Kern B, Holmes KL. Development of a web tool to increase research literacy in underserved populations through public library partnerships. PLoS One 2021; 16:e0246098. [PMID: 33534794 PMCID: PMC7857632 DOI: 10.1371/journal.pone.0246098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 01/13/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Inadequate diversity in clinical trials is widely recognized as a significant contributing factor to health disparities experienced by racial/ethnic minorities and other diverse populations in the US. To address this in a scalable way, we sought to develop a web tool that could help enhance underserved minority participation in clinical research. METHODS We used our research literacy support flashcard tool as the initial prototype for human-centered design and usability testing of the web tool Health for All in public library settings. After forming partnerships with leadership from Chicago Public Libraries (CPL), local medical libraries, and the Chicago Department of Public Health, we conducted seven iterative design sessions with focus groups of library patrons and library staff from six CPL branches serving underserved communities followed by two rounds of usability testing and website modification. RESULTS Based on the qualitative research findings from Design Sessions 1-7, we enacted the design decision of a website that was a hybrid of fact-filled and vignette (personal stories) paper prototypes divided into 4 modules (trust, diversity, healthy volunteers, pros/cons), each with their own outcome metrics. The website was thus constructed, and navigation issues identified in two rounds of usability testing by library patrons were addressed through further website modification, followed by the launch of a beta version of a hybridized single-scrolling and guided module prototype to allow further development with website analytics. CONCLUSIONS We report the development of Health for All, a website designed to enhance racial/ethnic minority participation in clinical trials by imparting research literacy, mitigating distrust engendered by longstanding racism and discrimination, and providing connections to clinical trials recruiting participants.
Collapse
Affiliation(s)
- Melissa A. Simon
- Center for Health Equity Transformation and Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Catherine A. O’Brian
- Center for Health Equity Transformation and Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Laura Tom
- Center for Health Equity Transformation and Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Q. Eileen Wafford
- Galter Health Sciences Library & Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Shenita Mack
- Chicago Public Library, Chicago, Illinois, United States of America
| | - Samuel R. Mendez
- Center for Health Equity Transformation and Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Magdalena Nava
- Center for Health Equity Transformation and Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Rabih Dahdouh
- Center for Health Equity Transformation and Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Rachelle Paul-Brutus
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Kathryn H. Carpenter
- University Library, University of Illinois-Chicago, Chicago, Illinois, United States of America
| | - Barbara Kern
- The John Crerar Library, University of Chicago, Chicago, Illinois, United States of America
| | - Kristi L. Holmes
- Galter Health Sciences Library & Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| |
Collapse
|
4
|
Ramanadhan S, Mendez SR, Rao M, Viswanath K. Social media use by community-based organizations conducting health promotion: a content analysis. BMC Public Health 2013; 13:1129. [PMID: 24313999 PMCID: PMC3924229 DOI: 10.1186/1471-2458-13-1129] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 11/25/2013] [Indexed: 12/03/2022] Open
Abstract
Background Community-based organizations (CBOs) are critical channels for the delivery of health promotion programs. Much of their influence comes from the relationships they have with community members and other key stakeholders and they may be able to harness the power of social media tools to develop and maintain these relationships. There are limited data describing if and how CBOs are using social media. This study assesses the extent to which CBOs engaged in health promotion use popular social media channels, the types of content typically shared, and the extent to which the interactive aspects of social media tools are utilized. Methods We assessed the social media presence and patterns of usage of CBOs engaged in health promotion in Boston, Lawrence, and Worcester, Massachusetts. We coded content on three popular channels: Facebook, Twitter, and YouTube. We used content analysis techniques to quantitatively summarize posts, tweets, and videos on these channels, respectively. For each organization, we coded all content put forth by the CBO on the three channels in a 30-day window. Two coders were trained and conducted the coding. Data were collected between November 2011 and January 2012. Results A total of 166 organizations were included in our census. We found that 42% of organizations used at least one of the channels of interest. Across the three channels, organization promotion was the most common theme for content (66% of posts, 63% of tweets, and 93% of videos included this content). Most organizations updated Facebook and Twitter content at rates close to recommended frequencies. We found limited interaction/engagement with audience members. Conclusions Much of the use of social media tools appeared to be uni-directional, a flow of information from the organization to the audience. By better leveraging opportunities for interaction and user engagement, these organizations can reap greater benefits from the non-trivial investment required to use social media well. Future research should assess links between use patterns and organizational characteristics, staff perspectives, and audience engagement.
Collapse
Affiliation(s)
- Shoba Ramanadhan
- Center for Community-Based Research, Dana-Farber Cancer Institute, 450 Brookline Ave, LW 703, Boston, MA 02215, USA.
| | | | | | | |
Collapse
|
5
|
Abstract
A survey of indoor air quality under warm weather conditions, in a variety of Houston area residences not selected in response to occupant complaints, revealed a distribution of indoor formaldehyde concentrations ranging from less than 0.008 ppm to 0.29 ppm, with an arithmetic mean of 0.07 ppm. Approximately 15% of the monitored residences had concentrations greater than 0.10 ppm. Formaldehyde levels were observed to depend on both age of dwelling and the structural classification of the residence. These factors are not independent and reflect the influence of more fundamental variables, such as the rate of exchange of indoor and outdoor air and the overall emission potential of indoor materials. The results of this survey suggest that considerable population exposures to excess (greater than 0.10 ppm) formaldehyde concentrations may occur in the residential environment, indicating the need for improved control strategies.
Collapse
|