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Amsalem D, Jankowski SE, Markowitz JC, Stroup TS, Dixon LB, Pope LG. Comparing brief video interventions to reduce public and self-stigma: Randomized control trial. Early Interv Psychiatry 2024. [PMID: 38565326 DOI: 10.1111/eip.13524] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/16/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
AIM Stigma is a major mental healthcare barrier. This study compares the efficacy of two types of brief video interventions, targeting public and self-stigma, in reducing public stigma towards people living with psychosis. We hypothesized both interventions would similarly reduce public stigma and outperform the control group. As a secondary analysis, we explored the effect of familiarity with a person living with serious mental illness (SMI). METHODS Participants (N = 1215) aged 18-35 recruited through crowdsourcing were assessed pre- and post-intervention and at 30-day follow-up regarding five public stigma domains: social distance, stereotyping, separateness, social restriction and perceived recovery. Both videos present individual narratives using different approaches: the self-stigma video was created through focus groups, while the public stigma video portrays a single person's journey. RESULTS A 3 × 3 analysis of variance (ANOVA) revealed a significant group-by-time interaction across all five stigma-related domains (p's < .001). Effect sizes (Cohen's d) ranged from 0.29 to 0.52 (baseline to post-intervention), and 0.18 to 0.45 (baseline to 30-day follow-up). The two video interventions did not significantly differ. Linear mixed modelling showed a significant difference between participants familiar and unfamiliar with people living with SMI for the public stigma video, with greater stigma reductions for unfamiliar participants. CONCLUSIONS This study corroborates previous findings on the positive influence of social contact-based interventions on youth mental health perceptions. Results provide insights into the relationship between public and self-stigma and the impact that familiarity with SMI may have on the efficacy of stigma reduction efforts further validation in diverse groups is needed.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - Samantha E Jankowski
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - John C Markowitz
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - T Scott Stroup
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - Lisa B Dixon
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - Leah G Pope
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
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Song X, Anderson T, Lin T, Yu Fang B. The effects of a multimedia intervention on help-seeking process with a Chinese college student sample. J Clin Psychol 2024; 80:522-536. [PMID: 38098248 DOI: 10.1002/jclp.23629] [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: 03/11/2022] [Revised: 09/07/2023] [Accepted: 11/20/2023] [Indexed: 02/09/2024]
Abstract
Little is known about encouraging help-seeking in non-English speaking settings and relatively little research has been directed to facilitate help-seeking among Chinese-speaking people. This study examined the effects of a multimedia intervention on barriers, attitudes, and intentions for seeking counseling in China. The multimedia intervention was informed by prior empirical research on models of help-seeking for counseling. A total of 200 participants were randomly assigned to one of the two conditions: (1) a help-seeking media-exposed intervention group and (2) a control group, who watched a hospital advertisement that was unrelated to mental health help-seeking. Results indicated that the intervention was effective at increasing both positive attitudes toward therapy and intentions to seek therapy. The intervention also improved participants' perceptions about treatment accessibility. This intervention is available and can be a resource for Chinese language populations (both within China and other countries), especially for immigrants, rural, and persons who might benefit from mental health treatments such as psychotherapy.
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Affiliation(s)
- Xiaoxia Song
- University Health Services, University of California, Berkeley, California, USA
| | | | - Tao Lin
- Psychology Department, Ohio University, Athens, Ohio, USA
| | - Bi Yu Fang
- Counseling Center, Shanghai University of Engineering Science, Songjiang, Shanghai, China
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David JC, Rascle N, Auriacombe M, Serre F, Sutter-Dallay AL, Loyal D. A video-based intervention to overcome pregnancy smoking stigma among healthcare students: a randomised controlled trial. Psychol Health 2024:1-20. [PMID: 38372141 DOI: 10.1080/08870446.2024.2316677] [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: 09/15/2023] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES This study tests a video intervention to reduce pregnancy smoking stigma among French healthcare students. DESIGN The participants were randomly selected to watch online either an experimental video (presenting educational content regarding stigma and contact with pregnant smokers) or a control video (presenting standard educational content about the risks of smoking). The students completed scales assessing stigma, intention to address smoking cessation and self-efficacy to do so, before the intervention (T0, n = 252), one week after the intervention (T1, n = 187), and one month after the intervention (T2, n = 131). RESULTS Compared to the medical students, especially men, the midwifery students reported lower derogative cognitions (η2p = .18), negative behaviours (η2p = .07) and personal distress (η2p = .06). However, the midwifery students also reported lower levels of intention to address smoking (η2p = .02) than the medical students. The experimental video decreased derogative cognitions to a greater extent than the control video (η2p = .23) in both the short and medium term. This study is the first intervention designed to reduce the stigmatisation of pregnant smokers by healthcare students. We recommend that the issue of stigma should receive more attention in the medical curriculum.
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Affiliation(s)
- J-C David
- Université Paris Cité, CRPMS, Paris, France
| | - N Rascle
- Univ. Bordeaux, Inserm U1219 Bordeaux Population Health, Bordeaux, France
| | - M Auriacombe
- Hôpital Charles Perrens, Bordeaux, France
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - F Serre
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - A-L Sutter-Dallay
- Univ. Bordeaux, Inserm U1219 Bordeaux Population Health, Bordeaux, France
- Hôpital Charles Perrens, Bordeaux, France
| | - D Loyal
- Université Paris Cité, CRPMS, Paris, France
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Braun-Koch K, Rief W. Maintenance vs. Change of Negative Therapy Expectation: An Experimental Investigation Using Video Samples. Front Psychiatry 2022; 13:836227. [PMID: 35444567 PMCID: PMC9013760 DOI: 10.3389/fpsyt.2022.836227] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/25/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Therapy expectations contribute substantially to the outcome of psychotherapy. In contrast, psychotherapy expectations are rarely addressed and systematically optimised in studies on psychotherapy. MATERIALS AND METHODS A total of 142 mostly healthy participants with critical attitudes towards psychotherapy were randomised into two groups: (1) a control group that watched a video with patients who gave information about their symptoms or (2) an experimental group that watched an expectation-optimised video with the same patients giving additional information about their mostly positive therapy outcomes. The primary outcome was the Milwaukee Psychotherapy Expectation Questionnaire (MPEQ), which was filled in before and after watching the video. RESULTS Both groups showed a significant improvement of their process expectations and attitudes towards psychotherapy after watching the video. Participants in the experimental group changed their therapy outcome expectation while there was no change in the control group [F(1,140) = 9.72, p = 0.002, η2 = 0.065]. CONCLUSION A video intervention with patients presenting their positive therapy experiences improves therapy expectations in persons with critical attitudes. Expectation-optimised videos could be used for prevention programmes and when starting therapy. TRIAL REGISTRATION Trial was registered at clinicaltrials.gov (NCT03594903) on November 2018.
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Affiliation(s)
- Kristina Braun-Koch
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Morinelli TA, Taber DJ, Su Z, Rodrigue JR, Sutton Z, Chastain M, Tindal TT, Weeda E, Mauldin PD, Casey M, Bian J, Baliga P, DuBay DA. A Dialysis Center Educational Video Intervention Increases Patient Self-Efficacy and Kidney Transplant Evaluations. Prog Transplant 2021; 32:27-34. [PMID: 34874194 DOI: 10.1177/15269248211064882] [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] [Indexed: 11/15/2022]
Abstract
Introduction: The optimal treatment for end-stage kidney disease is renal transplant. However, only 1 in 5 (21.5%) patients nationwide receiving dialysis are on a transplant waitlist. Factors associated with patients not initiating a transplant evaluation are complex and include patient specific factors such as transplant knowledge and self-efficacy. Research Question: Can a dialysis center-based educational video intervention increase dialysis patients' transplant knowledge, self-efficacy, and transplant evaluations initiated? Design: Dialysis patients who had not yet completed a transplant evaluation were provided a transplant educational video while receiving hemodialysis. Patients' transplant knowledge, self-efficacy to initiate an evaluation, and dialysis center rates of transplant referral and evaluation were assessed before and after this intervention. Results: Of 340 patients approached at 14 centers, 252 (74%) completed the intervention. The intervention increased transplant knowledge (Likert scale 1 to 5: 2.53 [0.10] vs 4.62 [0.05], P < .001) and transplant self-efficacy (2.55 [0.10] to 4.33 [0.07], P < .001. The incidence rate per 100 patient years of transplant evaluations increased 85% (IRR 1.85 [95% CI: 1.02, 3.35], P = .0422) following the intervention. The incidence rates of referrals also increased 56% (IRR 1.56 [95% CI: 1.03, 2.37], P = .0352), while there was a nonsignificant 47% increase in incidence rates of waitlist entries (IRR 1.47 [95% CI: 0.45, 4.74], P = .5210). Conclusion: This dialysis center-based video intervention provides promising preliminary evidence to conduct a large-scale randomized controlled trial to test its effectiveness in increasing self-efficacy of dialysis patients to initiate a transplant evaluation.
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Affiliation(s)
| | - David J Taber
- Medical University of South Carolina, Charleston, SC, USA.,Ralph H. Johnson Veterans' Hospital, Charleston, SC, USA
| | - Zemin Su
- Medical University of South Carolina, Charleston, SC, USA
| | - James R Rodrigue
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Zachary Sutton
- Medical University of South Carolina, Charleston, SC, USA
| | - Misty Chastain
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Erin Weeda
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Michael Casey
- Medical University of South Carolina, Charleston, SC, USA
| | - John Bian
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Derek A DuBay
- Medical University of South Carolina, Charleston, SC, USA
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Valeri L, Amsalem D, Jankowski S, Susser E, Dixon L. Effectiveness of a Video-Based Intervention on Reducing Perceptions of Fear, Loneliness, and Public Stigma Related to COVID-19: A Randomized Controlled Trial. Int J Public Health 2021; 66:1604164. [PMID: 34475811 PMCID: PMC8407346 DOI: 10.3389/ijph.2021.1604164] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/26/2021] [Indexed: 01/27/2023] Open
Abstract
Objectives: During the first peak of the COVID-19 outbreak in the United States, we investigated the impact of digital interventions to reduce COVID-19 related fear, loneliness, and public stigma. Methods: We recruited and randomly assigned 988 United States residents to: 1) no intervention 2) informational sheet to learn about COVID-19, 3) (2) AND video encouraging digital social activity, 4) (2) AND video sensitizing to COVID-19 related stigma (registered in Clinicaltrials.gov). Surveys were conducted between April 2-16, 2020. We employed generalized linear mixed models to investigate intervention effects. Results: 10% of the participants reported not being afraid of people COVID-19+ and 32% reported not feeling lonely. Stigma and fear items reflected acute worries about the outbreak. Relative to the informational sheet only group, video groups led to greater reduction in perceptions of fear towards COVID-19+ (ORvideo.solo = 0.78, p-val<0.001; ORvideo.friend = 0.79, p-val<0.001) and of stigma (BETAvideo.solo = -0.50, p-val<0.001; BETAvideo.friend = -0.69, p-val<0.001). Conclusion: Video-based interventions lead to reductions in COVID-19-related fear and stigma. No difference in social activity among groups was found, potentially explaining lack of efficacy on loneliness.
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Affiliation(s)
- Linda Valeri
- Department of Biostatistics, Columbia University, New York, NY, United States
| | - Doron Amsalem
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
| | - Samantha Jankowski
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
| | - Ezra Susser
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Lisa Dixon
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
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Lara M, Díaz Fuentes C, Calderón J, Geschwind S, Tarver M, Han B. Pilot of a Community Health Worker Video Intervention for Immigrant Day Laborers at Occupational Health Risk. Front Public Health 2021; 9:662439. [PMID: 34368045 PMCID: PMC8339200 DOI: 10.3389/fpubh.2021.662439] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/01/2021] [Indexed: 11/13/2022] Open
Abstract
Significance: Immigrant day laborers suffer from disproportionate occupational health risks from hazardous reconstruction jobs after natural disasters. Methods: We conducted a randomized controlled trial of a short-video educational intervention to improve safety knowledge and intent to engage in safety preventive behaviors among 98 Hispanic day laborers (49 randomized to video and 49 control). The short video featured a male promotor and a female promotora who narrated 3 stories of day laborers who were injured while doing construction work in post-Katrina New Orleans. The main outcome measures were changes in scores for day laborer-reported safety knowledge and safety behaviors derived from interviewer-delivered baseline and post-intervention surveys. Results: Video participants reported improvement in overall average safety knowledge score (mean score of 11.3 out of a max score of 12 or 94% when standardized to 0–100% scale), as compared to the control group (mean score of 8.6 or 72%) who were not offered the video (p < 0.00001). The intervention was highly successful in workers stating that they learned and were willing to change their safety preventive behaviors to reduce their occupational risk. The average safety behavior score was higher among those watching the video (17.2 out of a max of 22 or 78.1% when standardized on a scale 0–100%) as compared to control (14.5 or 65.9%) (p = 0.0024). Conclusion: A short video intervention can improve knowledge and intent to engage in preventive behaviors among Hispanic workers for which there is a dearth of construction safety preventive research.
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Affiliation(s)
| | - Claudia Díaz Fuentes
- Department of Economics, University of New Mexico, Albuquerque, NM, United States
| | - Jorge Calderón
- Common Ground Health Clinic, New Orleans, LA, United States
| | | | - Meshawn Tarver
- Common Ground Health Clinic, New Orleans, LA, United States
| | - Bing Han
- RAND Corporation, Santa Monica, CA, United States.,Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
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He Z, Chen J, Pan K, Yue Y, Cheung T, Yuan Y, Du N, Zhao Y, Feng Y, Zhou D, Zhou Y, Lu F, Chen Y, He M, Xiang YT. The development of the 'COVID-19 Psychological Resilience Model' and its efficacy during the COVID-19 pandemic in China. Int J Biol Sci 2020; 16:2828-2834. [PMID: 33061799 PMCID: PMC7545720 DOI: 10.7150/ijbs.50127] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/12/2020] [Indexed: 11/15/2022] Open
Abstract
During the novel coronavirus disease 2019 (COVID-19) outbreak, traditional face-to-face psychological interventions have been suspended due to high risks of rapid transmission. Developing an effective online model of psychological intervention is deemed necessary to deal with the mental health challenges brought up by this disease. An integrated psychological intervention model coined 'COVID-19 Psychological Resilience Model' was developed in Chengdu, China including live media, 24-hour hotline consultations, online video intervention and on-site crisis intervention sessions to provide services to those in need. A total of 45 episodes of live media programs on COVID-19 outbreak-related psychological problems were broadcasted with over 10 million views. A total of 4,236 hotline consultations were completed. More than 50% of the clients had positive feedback about the hotline consultations. A total of 223 cases received online video intervention, of which 84.97% were redirected from the hotline consultation and 15.03% from COVID-19-designated hospital and community-based observation spots. Seventy one-on-one psychological interventions were conducted with 39 COVID-19 patients, and one-third were treated with medication. Additionally, 5 training sessions were conducted to 98 frontline medical staff. This 'COVID-19 Psychological Resilience Model' is proven effective to the general population during the COVID-19 pandemic. We have greatly improved the overall mental health of our target population during the COVID-19 pandemic. This model could provide valuable experiences and serve as a reference guide for other countries to offer effective psychological intervention, and reduce detrimental negative mental health outcomes in public health emergency.
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Affiliation(s)
- Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Jiajia Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Keliang Pan
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Yuchuan Yue
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yin Yuan
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Na Du
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Yan Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Yusu Feng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Die Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - You Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Yong Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Manxi He
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
- The Mental Health center of Chengdu, Sichuan, 610036, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
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Scherr CL, Nam K, Augusto B, Kasting ML, Caldwell M, Lee MC, Meade CD, Pal T, Quinn GP, Vadaparampil ST. A Framework for Pilot Testing Health Risk Video Narratives. Health Commun 2020; 35:832-841. [PMID: 30999777 PMCID: PMC6800594 DOI: 10.1080/10410236.2019.1598612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Narrative messages may be superior to didactic messages when providing educational information due to their natural format for information sharing, ability to engage audiences, and engender positive thoughts about the message. Although narrative messages are gaining popularity in health promotion, little guidance exists regarding the development phase. Our team created a psychosocial narrative video intervention grounded in the Health Belief Model to increase breast cancer survivors' attendance at genetic counseling after treatment. Here we report the use of Learner Verification (LV) during an iterative video development process. Using LV, we conducted individual semi-structured interviews with patients and providers, after they viewed the video. Demographic information was analyzed using descriptive statistics, and verbatim interview transcripts were used to conduct a two-phase qualitative content analysis. Patient and provider participants (n = 30) believed the video was attractive, relatable, and informative, and they identified areas for improvement including narrative coherence, changes to text and graphical information, and including more specific information. LV framework elicited audience feedback on the video intervention relevant to theoretical principles of narrative interventions, and highlighted audience preferences. In this study, LV interviews tapped into theoretical constructs of narratives and facilitated the iterative intervention design process.
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Affiliation(s)
| | - Kelli Nam
- Moffitt Cancer Center, Tampa, FL, USA
| | | | | | | | - Marie Catherine Lee
- Moffitt Cancer Center, Tampa, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Cathy D. Meade
- Moffitt Cancer Center, Tampa, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Tuya Pal
- Department of Medicine, Vanderbilt University, Nashville, USA
| | - Gwendolyn P. Quinn
- Moffitt Cancer Center, Tampa, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Susan T. Vadaparampil
- Moffitt Cancer Center, Tampa, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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10
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Neumann MS, Plant A, Margolis AD, Flores SA. Observed reactions among patients attending HIV treatment facilities to a brief video intervention on treatment initiation and adherence. AIDS Care 2019; 32:656-665. [PMID: 31766857 DOI: 10.1080/09540121.2019.1695729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 10/25/2022]
Abstract
Entertainment-education can affect positive behavior change. Taking Care of Me is an effective, video-based intervention designed to improve patients' continuum of HIV care outcomes. The study's aim was to refine the pre-final video at points where patients stopped watching and missed embedded health messages. We evaluated the video using systematic unobtrusive observations triangulated with electronic medical record (EMR) data. We conducted observations in three HIV treatment facilities' waiting rooms in the southern US in 2016. Using a web-based data collection instrument, one observer spent 8 h at each facility observing patients' engagement with the video. We mapped the embedded messages in each scene and identified the messages that patients missed when they stopped watching. We compared missed messages to treatment initiation, medication adherence, and retention in care data abstracted from each clinic's EMR system. We were able to identify specific scenes where low levels of engagement corresponded to lower than expected retention in care outcomes and edit these scenes to improve engagement. Identifying and editing video scenes to increase viewership potentially could enhance intervention efficacy. Our methods could be used to assess and refine other video-based interventions being developed in resource limited settings.
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Affiliation(s)
- Mary Spink Neumann
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
| | | | - Andrew D Margolis
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
| | - Stephen A Flores
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
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Naeem F, Munshi T, Gratzer D, Rodie D, Irfan M, Rao S, Husain N, Farooq S, Sanches M, Ayub M, Lecomte T. Video intervention for the psychiatric waiting room: proof-of-concept randomised controlled trial of RESOLVE (Relaxation Exercise, SOLVing problem and cognitive Errors). BJPsych Open 2019; 5:e77. [PMID: 31488227 PMCID: PMC6737517 DOI: 10.1192/bjo.2019.59] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The waiting room in psychiatric services can provide an ideal setting for offering evidence-based psychological interventions that can be delivered through electronic media. Currently, there is no intervention available that have been developed or tested in mental health. AIMS This proof-of-concept study aimed to evaluate a pilot design of RESOLVE (Relaxation Exercise, SOLving problem and cognitiVe Errors) to test the procedure and obtain outcome data to inform future, definitive trials (trial registration at Clinicaltrials.gov NCT02536924, REB Number: PSIY-477-15). METHOD Forty participants were enrolled and equally randomised to the intervention, RESOLVE plus treatment as usual arm (TAU), or to a control group (TAU only). Those in the intervention group watched RESOLVE in a room adjacent to the waiting area. Participants in the control received routine care. Outcome measures included the Hospital Anxiety and Depression Scale; the Clinical Outcomes in Routine Evaluations outcome measure; and the World Health Organization Disability Assessment Schedule. These measures were performed by a masked assessor at baseline and at 6-week follow-up. Additionally, we measured the number of contacts with mental health services during the prior 4 weeks. Both intention-to-treat and per protocol analyses were performed. RESULTS The study proved feasible. We were able to recruit the required number of participants. There was a statistically significant improvement in depression (P < 0.001), anxiety (P < 0.001), general psychopathology (P < 0.001) and disability (P = 0.0361) in favour of the intervention group. People in the intervention group were less likely to contact the service (P = 0.012) post-intervention. CONCLUSIONS Findings provide preliminary evidence that evidence-based psychosocial interventions can be delivered through electronic media in a waiting-room setting. The outcome data from this study will be used for future definitive trials. DECLARATION OF INTEREST None.
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Affiliation(s)
- Farooq Naeem
- Professor, Department of Psychiatry, University of Toronto; and Centre for Addiction and Mental Health, Toronto, Canada
| | - Tariq Munshi
- Assistant Professor, Department of Psychiatry, University of Toronto; and St Michaels Hospital, Canada
| | - David Gratzer
- Assistant Professor, Department of Psychiatry, University of Toronto; and Centre for Addiction and Mental Health, Canada
| | - David Rodie
- Assistant Professor, Department of Psychiatry, University of Toronto; and Centre for Addiction and Mental Health, Toronto, Canada
| | - Muhammad Irfan
- Professor, Department of Psychiatry, Riphah International University, Pakistan
| | - Sanjay Rao
- Assistant Professor, Department of Psychiatry, University of Ottawa, Canada
| | - Nusrat Husain
- Professor, Department of Psychiatry, University of Manchester, UK
| | - Saeed Farooq
- Professor, Department of Psychiatry, Keele University, UK
| | - Marcos Sanches
- Lecturer, Department of Psychiatry, University of Toronto; and Centre for Addiction and Mental Health, Toronto, Canada
| | - Muhammad Ayub
- Professor, Department of Psychiatry, Queens University, Canada
| | - Tania Lecomte
- Professor, Department of Psychiatry, University of Montreal, Canada
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Klingberg S, King R, Seeley J, Lubwama R, Namuganga M, Nabiryo B, Etima M, Musoke P, Butler LM. Courage and confidence to stop lying: caregiver perspectives on a video to support paediatric HIV disclosure in Kampala, Uganda. Afr J AIDS Res 2019; 17:273-279. [PMID: 30355059 DOI: 10.2989/16085906.2018.1521850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The World Health Organization (WHO) recommends that HIV-positive children are told their diagnosis by age 12 years. However, most perinatally-infected children reach adolescence without being told their HIV status. Effective strategies are needed to promote disclosure, and optimise children's health outcomes as they transition to adolescence and adulthood. This qualitative study explored how caregivers of HIV-positive children aged 7-12 years perceived and related to a video used as part of a larger behavioural intervention to promote full disclosure to children by age 12 years. Eight semi-structured interviews and 3 group reflection sessions with 28 caregivers were analysed thematically. Five themes were generated: courage and confidence; reasoning and empathy; child- caregiver relationship; foreign but relatable; and not reaching everyone. The video was found acceptable and appropriate for fostering readiness to disclose. Through watching it, participants reported they could see people similar to themselves prevail despite challenges, which gave them courage.
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Affiliation(s)
- Sonja Klingberg
- a Medical Research Council Epidemiology Unit & UK Clinical Research Collaboration Centre for Diet and Activity Research , University of Cambridge , Cambridge , United Kingdom.,b Medical Research Council/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine , Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Rachel King
- c Global Health Sciences , University of California , San Francisco , Kampala , Uganda
| | - Janet Seeley
- d Department of Global Health and Development , London School of Hygiene and Tropical Medicine , London , United Kingdom.,e Medical Research Council/Uganda Virus Research Institute , Uganda Research Unit on Aids , Entebbe , Uganda
| | - Resty Lubwama
- f Makerere University-Johns Hopkins University Research Collaboration , Kampala , Uganda
| | - Margaret Namuganga
- f Makerere University-Johns Hopkins University Research Collaboration , Kampala , Uganda
| | - Barbara Nabiryo
- f Makerere University-Johns Hopkins University Research Collaboration , Kampala , Uganda
| | - Monica Etima
- f Makerere University-Johns Hopkins University Research Collaboration , Kampala , Uganda
| | - Philippa Musoke
- f Makerere University-Johns Hopkins University Research Collaboration , Kampala , Uganda.,g Department of Paediatrics and Child Health , Makerere University , Kampala , Uganda
| | - Lisa M Butler
- h Institute for Collaboration on Health, Intervention and Policy , University of Connecticut , Storrs , Connecticut
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13
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Sleath B, Carpenter DM, Coyne I, Davis SA, Hayes Watson C, Loughlin CE, Garcia N, Reuland DS, Tudor GE. Provider use of a participatory decision-making style with youth and caregivers and satisfaction with pediatric asthma visits. Patient Relat Outcome Meas 2018; 9:147-154. [PMID: 29785146 PMCID: PMC5953316 DOI: 10.2147/prom.s152068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background We conducted a randomized controlled trial to test the effectiveness of an asthma question prompt list with video intervention to engage the youth during clinic visits. We examined whether the intervention was associated with 1) providers including youth and caregiver inputs more into asthma treatment regimens, 2) youth and caregivers rating providers as using more of a participatory decision-making style, and 3) youth and caregivers being more satisfied with visits. Methods English- or Spanish-speaking youth aged 11–17 years with persistent asthma and their caregivers were recruited from four pediatric clinics and randomized to the intervention or usual care groups. The youth in the intervention group watched the video with their caregivers on an iPad and completed a one-page asthma question prompt list before their clinic visits. All visits were audiotaped. Generalized estimating equations were used to analyze the data. Results Forty providers and their patients (n=359) participated in this study. Providers included youth input into the asthma management treatment regimens during 2.5% of visits and caregiver input during 3.3% of visits. The youth in the intervention group were significantly more likely to rate their providers as using more of a participatory decision-making style (odds ratio=1.7, 95% confidence interval=1.1, 2.5). White caregivers were significantly more likely to rate the providers as more participatory (odds ratio=2.3, 95% confidence interval=1.2, 4.4). Youth (beta=4.9, 95% confidence interval=3.3, 6.5) and caregivers (beta=7.5, 95% confidence interval=3.1, 12.0) who rated their providers as being more participatory were significantly more satisfied with their visits. Youth (beta=−1.9, 95% confidence interval=−3.4, −0.4) and caregivers (beta=−8.8, 95% confidence interval=−16.2, −1.3) who spoke Spanish at home were less satisfied with visits. Conclusion The intervention did not increase the inclusion of youth and caregiver inputs into asthma treatment regimens. However, it did increase the youth’s perception of participatory decision-making style of the providers, and this in turn was associated with greater satisfaction.
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Affiliation(s)
- Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - Scott A Davis
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Claire Hayes Watson
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ceila E Loughlin
- Department of Pediatric Pulmonology, School of Medicine University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nacire Garcia
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel S Reuland
- Division of General Internal Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gail E Tudor
- Department of Science and Mathematics, Husson University, Bangor, ME, USA
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14
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Frett B, Aquino M, Fatil M, Seay J, Trevil D, Fièvre MJ, Kobetz E. Get Vaccinated! and Get Tested! Developing Primary and Secondary Cervical Cancer Prevention Videos for a Haitian Kreyòl-Speaking Audience. J Health Commun 2016; 21:512-516. [PMID: 27050619 PMCID: PMC5019482 DOI: 10.1080/10810730.2015.1103330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although routine screening reduces cervical cancer rates between 60% and 90%, thousands of women worldwide are diagnosed with the disease on an annual basis because of inadequate screening. Haitian women in South Florida experience a disproportionate burden of cervical cancer, with disease rates 4 times higher than the average for women in Miami. An ongoing community-based participatory research initiative to assess and reduce this burden has revealed that a complex interplay of factors contributes to a lack of access to screening in this community, including socioeconomics, language barriers, and traditional understandings of health and disease. In an effort to address some of these barriers and encourage uptake of primary and secondary cervical cancer prevention strategies, 2 videos on cervical cancer prevention were created using a community-based participatory research framework. The video screenplays were created by a Haitian screenwriter using evidence-based medical information provided by academic researchers. The films feature Haitian actors speaking a Haitian Kreyòl dialogue with a storyline portraying friends and family discussing human papillomavirus disease and vaccination, Papanicolaou testing, and cervical cancer. Focus groups held with Haitian women in South Florida suggested that the films are engaging; feature relatable characters; and impact knowledge about human papillomavirus, cervical cancer development, and current prevention recommendations.
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Affiliation(s)
| | - Myra Aquino
- University of Miami Miller School of Medicine,
| | - Marie Fatil
- Univeristy of Miami Miller School of Medicine,
| | - Julia Seay
- Department of Psychology, University of Miami Miller School of Medicine,
| | | | | | - Erin Kobetz
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14 Street 1528, Miami, FL, USA 33136, 305.243.6185
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15
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Besera GT, Cox S, Malotte CK, Rietmeijer CA, Klausner JD, O'Donnell L, Margolis AD, Warner L. Assessing Patient Exposure to a Video-Based Intervention in STD Clinic Waiting Rooms: Findings From the Safe in the City Trial. Health Promot Pract 2016; 17:731-8. [PMID: 27091608 DOI: 10.1177/1524839916631537] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/16/2022]
Abstract
Safe in the City, a video intervention for clinic waiting rooms, was previously shown to reduce sexually transmitted disease (STD) incidence. However, little is known about patients' recall of exposure to the intervention. Using data from a nested study of patients attending clinics during the trial, we assessed whether participants recalled Safe in the City, and, if so, how the intervention affected subsequent attitudes and behaviors. Analyses were restricted to responses to a 3-month follow-up questionnaire among participants who were exposed to the video (n = 708). Impact was measured as participants' reports of the video's effect on behaviors and attitudes. Associations were evaluated using multivariable logistic regression. Of participants who were exposed, 685 (97%) recalled viewing the video, and 68% recalled all three vignettes. After watching the video, participants felt more positive about condoms (69%) and comfortable acquiring condoms (56%), were reminded of important information about STDs and condoms (90%), and tried to apply what they learned to their lives (59%). Compared with those who recalled viewing one or two vignettes, participants who recalled viewing all three vignettes reported more positive attitudes toward condoms and peer/provider communication. These findings demonstrate that a low-resource video intervention for waiting rooms can provide sufficient exposure to positively influence STD-related attitudes/behaviors.
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Affiliation(s)
- Ghenet T Besera
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shanna Cox
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | | | - Lee Warner
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Puri Singh A, Haywood C, Beach MC, Guidera M, Lanzkron S, Valenzuela-Araujo D, Rothman RE, Dugas AF. Improving Emergency Providers' Attitudes Toward Sickle Cell Patients in Pain. J Pain Symptom Manage 2016; 51:628-32.e3. [PMID: 26596878 PMCID: PMC4785055 DOI: 10.1016/j.jpainsymman.2015.11.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 11/04/2015] [Accepted: 11/09/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Provider biases and negative attitudes are recognized barriers to optimal pain management in sickle cell disease, particularly in the emergency department (ED). MEASURES This prospective cohort measures preintervention and postintervention providers' attitudes toward patients with sickle pain crises using a validated survey instrument. INTERVENTION ED providers viewed an eight-minute online video that illustrated challenges in sickle cell pain management, perspectives of patients and providers, as well as misconceptions and stereotypes of which to be wary. OUTCOMES Ninety-six ED providers were enrolled. Negative attitude scoring decreased, with a mean difference -11.5 from baseline, and positive attitudes improved, with a mean difference +10. Endorsement of red-flag behaviors similarly decreased (mean difference -12.8). Results were statistically significant and sustained on repeat testing three months after intervention. CONCLUSIONS/LESSONS LEARNED Brief video-based educational interventions can improve emergency providers' attitudes toward patients with sickle pain crises, potentially curtailing pain crises early, improving health outcomes and patient satisfaction scores.
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Affiliation(s)
- Aditi Puri Singh
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
| | - Carlton Haywood
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Mary Catherine Beach
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Mark Guidera
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sophie Lanzkron
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrea Freyer Dugas
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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17
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Riva Crugnola C, Ierardi E, Albizzati A, Downing G. Effectiveness of an Attachment-Based Intervention Program in Promoting Emotion Regulation and Attachment in Adolescent Mothers and their Infants: A Pilot Study. Front Psychol 2016; 7:195. [PMID: 26941673 PMCID: PMC4764729 DOI: 10.3389/fpsyg.2016.00195] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 02/01/2016] [Indexed: 11/16/2022] Open
Abstract
This pilot study examined the effectiveness of an attachment-based intervention program, PRERAYMI, based on video technique, psychological counseling and developmental guidance in improving the style of interaction and emotion regulation of adolescent mothers and their infants after 3 and 6 months of intervention. Analyses revealed that adolescent mothers who participated in the intervention (vs. control group adolescent mothers) increased their Sensitivity and reduced their Controlling style after both 3 and 6 months of treatment. Infants who participated in the intervention (vs. control group infants) increased their Cooperative style and reduced their Passive style from 3 to 9 months. Moreover, the intervention group dyads (vs. control group dyads) increased the amount of time spent in affective positive coordination states (matches), decreased the amount of time spent in affective mismatches, and had a greater ability to repair mismatches from 3 to 9 months. Furthermore, the intervention group dyads (vs. control group dyads) increased the amount of time spent in reciprocal involvement in play with objects from 3 to 9 months. The quality of maternal attachment did not affect the intervention effect.
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Affiliation(s)
| | - Elena Ierardi
- Department of Psychology, University of Milano-Bicocca Milan, Italy
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18
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Stalker C, Elander J. Effects of a pain self-management intervention combining written and video elements on health-related quality of life among people with different levels of education. J Pain Res 2015; 8:581-90. [PMID: 26316809 PMCID: PMC4548759 DOI: 10.2147/jpr.s85741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Combining written and video material could increase the impact of health education for people with less education, but more evidence is needed about the impact of combined materials in different formats, especially in the context of chronic pain self-management. This study tested the impact of combining written information about self-managing chronic joint pain, which used language at a high reading level, with a DVD containing narrative video material presented directly by patients, using language at a lower reading level. Physical and mental health-related quality of life (36-Item Short Form Health Survey) was measured among 107 men with hemophilia before and 6 months after being randomly assigned to receive an information booklet alone or the booklet plus the DVD. Analysis of covariance was used to compare health outcomes between randomized groups at follow-up, using the baseline measures as covariates, with stratified analyses for groups with different levels of education. The DVD significantly improved mental health-related quality of life among those with only high school education. Video material could therefore supplement written information to increase its impact on groups with less education, and combined interventions of this type could help to achieve health benefits for disadvantaged groups who are most in need of intervention.
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Affiliation(s)
- Carol Stalker
- Centre for Psychological Research, Department of Life Sciences, University of Derby, Derby, UK
| | - James Elander
- Centre for Psychological Research, Department of Life Sciences, University of Derby, Derby, UK
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Ingersoll KS, Farrell-Carnahan L, Cohen-Filipic J, Heckman CJ, Ceperich SD, Hettema J, Marzani-Nissen G. A pilot randomized clinical trial of two medication adherence and drug use interventions for HIV+ crack cocaine users. Drug Alcohol Depend 2011; 116:177-87. [PMID: 21306837 PMCID: PMC3102141 DOI: 10.1016/j.drugalcdep.2010.12.016] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/23/2010] [Accepted: 12/26/2010] [Indexed: 01/28/2023]
Abstract
BACKGROUND Crack cocaine use undermines adherence to highly active antiretroviral therapy (HAART). This pilot randomized clinical trial tested the feasibility and efficacy of 2 interventions based on the Information-Motivation-Behavioral Skill model to improve HAART adherence and reduce crack cocaine problems. METHODS Participants were 54 adults with crack cocaine use and HIV with <90% HAART adherence. Most participants were African-American (82%) heterosexual (59%), and crack cocaine dependent (92%). Average adherence was 58% in the past 2 weeks. Average viral loads (VL) were detectable (logVL 2.97). The interventions included 6 sessions of Motivational Interviewing plus feedback and skills building (MI+), or Video information plus debriefing (Video+) over 8 weeks. Primary outcomes were adherence by 14-day timeline follow-back and Addiction Severity Index (ASI) Drug Composite Scores at 3 and 6 months. Repeated measure ANOVA assessed main effects of the interventions and interactions by condition. RESULTS Significant increases in adherence and reductions in ASI Drug Composite Scores occurred in both conditions by 3 months and were maintained at 6 months, representing medium effect sizes. No between group differences were observed. No VL changes were observed in either group. Treatment credibility, retention, and satisfaction were high and not different by condition. CONCLUSIONS A counseling and a video intervention both improved adherence and drug problems durably among people with crack cocaine use and poor adherence in this pilot study. The interventions should be tested further among drug users with poor adherence. Video interventions may be feasible and scalable for people with HIV and drug use.
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Affiliation(s)
- Karen S. Ingersoll
- University of Virginia Department of Psychiatry and Neurobehavioral Sciences, 1670 Discovery Drive, Suite 110, Charlottesville, VA 22911
| | - Leah Farrell-Carnahan
- University of Virginia Department of Psychiatry and Neurobehavioral Sciences, 1670 Discovery Drive, Suite 110, Charlottesville, VA 22911
| | - Jessye Cohen-Filipic
- Virginia Commonwealth University Department of Psychology, PO Box 842018, Richmond, Virginia 23284-2018
| | - Carolyn J. Heckman
- Fox Chase Cancer Center, Prevention and Control Program, Young Pavilion 4th Floor, 333 Cottman Avenue, Philadelphia, PA 19111
| | - Sherry D. Ceperich
- Hunter Holmes McGuire Veterans’ Administration Medical Center, 1201 Broad Rock Blvd., Richmond, VA 23249
| | - Jennifer Hettema
- University of Virginia Department of Psychiatry and Neurobehavioral Sciences, 1670 Discovery Drive, Suite 110, Charlottesville, VA 22911
| | - Gabrielle Marzani-Nissen
- University of Virginia Department of Psychiatry and Neurobehavioral Sciences, 1670 Discovery Drive, Suite 110, Charlottesville, VA 22911
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