Sources of strength: a process evaluation of a university-high school partnership to promote mental health protective factors.

The purpose of this manuscript was to discuss the implementation process of a student-led positive psychological and behavioral program (i.e., Sources of Strength) at a local high school to prevent opioid use and suicide behavior. Over the course of 2 years of programming, university undergraduate students worked alongside and mentored high school students to implement school-wide and focused campaigns that targeted each of the domains of the Sources of Strength wheel (i.e., mental health, family support, positive friends, mentors, healthy activities, generosity, spirituality, and medical access). The summed total student reach for 2 years of implementation was 8,682 students. The average participation was 456.95 students per campaign. The average percentage of the school population that engaged in each campaign was 34.7%. While no outcome opioid use or suicide behavior data were collected, the participation in the programming was high. Universities can continue to engage with local high schools to provide support, collaboration, and mentorship to promote positive and supportive school culture. Using university undergraduate students to serve as leaders can provide them with applied learning opportunities, mentorship for high school students, and reduce the expectancy for high school staff to establish the program on their own.

A Process Evaluation of a Mobile App for Medical Students Aimed at Increasing Resilience and Decreasing Stigma in Mental Health.

OBJECTIVE: The purpose of this pilot study was to conduct a process evaluation of a mental health and wellness mobile health (mHealth) application for medical students designed to increase resilience and decrease mental health stigma. METHODS: The customized application, MindfulMEDS, was developed with peer-focused interactive modules specific to medical students within an existing system called Sharpen®. The Sharpen® system contains an extensive library of didactic and experiential mental health and wellness content built specifically to promote evidence-based protective factors for resilience. A mixed-methods approach including surveys and focus groups assessed participant resiliency, perception of mental health within the context of medical school, and evaluation of the app. Assessments were conducted at baseline (n = 66), six months (n = 30), and one year (n = 24). Demographic information was collected once at baseline as a part of the initial survey.  Results: A total of 215 users were registered in MindfulMEDS, consumed 83 courses, and engaged in 1,428 "connect clicks" to community resources and crisis-response supports. Resilience levels did not change significantly between surveys; however, a significant decrease in the perception of mental health stigma associated with utilizing mental health resources was observed. Focus group participants (n = 11) reported the screening tools to be useful, encouraged expansion, and suggested additional reminders to access the app to increase engagement. CONCLUSION: Findings of this pilot study demonstrate the feasibility of implementing MindfulMEDS (an mHealth app focused on mental health and wellness) among medical students. Students found the app experience valuable, accessed mental health screeners embedded within the app, utilized the app to seek help, and engaged with the app to learn more about mental health. There was also a decrease in mental health stigma observed during the course of the study. Based on these results, we propose that medical schools incorporate mobile-based technology into their mental health support programs.

An Analysis of an Exercise is Medicine on Campus ® Program: A Case Report.

BACKGROUND: The objective of this study was to assess the efficacy of an Exercise is Medicine on Campus® program on university student biometrics and muscular endurance. It was hypothesized that participants in the 12-week program would experience significant improvements in body mass index, blood pressure, body fat percentage, waist circumference, and muscular endurance. METHODS: To be eligible for the program, participants must have met two of the three criteria: (1) blood pressure over 140 and/or 90 (3 consecutive measurements over 2 weeks), (2) BMI over 30, and/or (3) diagnosed chronic condition or currently taking medication for chronic condition. Participants engaged in six bi-weekly exercise instructional meetings that lasted approximately 30 minutes in length. Participants completed measures of resting heart rate, waist-to-hip ratio, body composition percentage via bioelectrical impedance, and muscular endurance before and after the program. RESULTS: Although not statistically significant, there was a decrease in BMI, blood pressure, body fat percentage, and waist circumference from pre- to post-program. Two-tailed t-tests revealed significant improvements in squats (P = .04), pushups (P = .05), and curl-ups (P = .03) from pre- to post-program. CONCLUSION: The results are discussed in terms of current research and future university campus application.

A RE-AIM Analysis of a Mental Health App for Undergraduate and Medical Students during the COVID-19 Pandemic: A Retrospective Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to use the RE-AIM framework to evaluate the implementation of a mental health app designed for undergraduate and medical students during the COVID-19 pandemic. PARTICIPANTS: Medical (n = 270) and undergraduate students (n = 1386) from five universities in the Appalachian region in the United States participated in this study. METHODS: Universities from the United States were recruited to deploy the Sharpen app for medical and undergraduate students. The Sharpen app provided psychoeducational modules in mental health literacy, social-emotional learning, mindfulness-based stress reduction, and suicide prevention to promote protective factors for students. The utilization of the Sharpen app was analyzed using the RE-AIM framework using a retrospective, cross-sectional design. RESULTS: Reach: A total of 12.72% of medical students and 6.00% of undergraduate students participated in the study. EFFICACY: Medical students viewed significantly more pages, had a significantly higher unique page view average, and a statistically significant exit percentage when compared to undergraduate students. Adoption: A total of 100% of the universities that were recruited participated in the study. IMPLEMENTATION: Five out of six implementation criteria were included, indicating high implementation. Maintenance: All of the universities continued using the Sharpen app following the end of data collection, resulting in a 100% maintenance rate. CONCLUSIONS: The RE-AIM framework indicated usability and maintenance by medical and undergraduate students. Future research needs to implement a more rigorous design to determine the impact of the Sharpen app on mental health outcomes in medical and undergraduate students.

Persevering in Nursing with Godly Purpose.

ABSTRACT: COVID-19 impacted the psychological and spiritual wellness of healthcare providers, in addition to their physical health. Christian nurses must continue to look for reassurance of God's provision and control of circumstances as a means of coping through adversity in their work. Practical Scripture applications are provided to sustain nurses' resilience and encouragement.

Contextualizing Adolescent Female Physical Activity Behavior: A Descriptive Study.

Physical activity (PA) behavior tends to decline as youth get older, especially in female adolescents. The purpose of this study was to develop an understanding of female adolescent moderate-to-vigorous physical activity (MVPA) behavior. Baseline MVPA data was collected during year one of a female-specific PA related program. The Youth Activity Profile was administered to contextualize current middle school female PA levels. Data were collected on over 600 6th-8th grade youths with even distributions by grade. No significant differences between grade, race/ethnicity, and MVPA minutes were found. The average estimated value for daily MVPA across all grades was 43.93 (+/-12.97) min, which is considerably lower than the public health recommendation of 60 min per days. Similar amounts were observed for weekend days 45.03 (+/-19.98) and weekdays 45.50 (+/-13.14); however, allocations were smaller during school (9.45 +/- 5.13 min) than at home (34.04 +/- 11.15). The findings from this study highlight the need for further investigation in developing sustainable and innovative PA interventions that target adolescent females.

A RE-AIM analysis of the sources of strength program in a United States high school.

The purpose of this study was to analyze the Sources of Strength program implemented at a high school in the southeastern United States using the RE-AIM framework. Students (n = 1,250) were recruited from one high school in the southeastern United States that was implementing Sources of Strength. College undergraduate students mentored high school peer leaders to implement Sources of Strength to promote opioid and suicide protective factors for the high school. This was a cross-sectional design in which a post-implementation survey assessed program effectiveness, satisfaction, and feedback for maintenance. Analysis used the RE-AIM framework of reach, effectiveness, adoption, implementation, and maintenance. Reach: 100 % of students participated in at least one campaign. Effectiveness: Mean protective factor scores were 3.83 for happiness; 3.93 for knowledge of coping skills, and 3.38 for practice of coping skills. Adoption: One high school and 100 % of classrooms participated in at least one campaign. Implementation: 18 high school peer leader meetings were facilitated by the undergraduate mentors. Maintenance: High school students qualitatively provided input on future campaign needs, and the program was continued following this RE-AIM analysis. The Sources of Strength program promoted suicide and opioid protective factors in high school students during COVID-19. Future research should compare the efficacy of Sources of Strength at baseline and follow-up with multiple high school sites.

A pilot evaluation of the Food as Medicine program for patients with type 2 diabetes.

The objective of this study was to determine the effectiveness of the Food as Medicine Program (modified and adapted based on supporting research of the Fresh Food Farmacy™ program) that was implemented at a southeast regional hospital with voluntary participants with diabetes. It was hypothesized that participants would experience a decline in type 2 diabetes symptoms following the 12-month program of bi-monthly healthy groceries, nutritional guidance, educational sessions, and group health coaching. For this initial pilot study, four cohorts of patients were admitted consisting of 20 participants. The 12-month program included bi-monthly food pick-ups, nutritional recipes, and bi-monthly group educational and health coaching sessions for participants. They also completed pre- and post-program assessments, including a medical history questionnaire, biometric screening (HbA1c, weight, BMI, and blood pressure), and health behavior questionnaires. While there were not statistically significant differences from pre- to post-program, mean HbA1c slightly decreased from the time of the initial test (i.e., month 1) to follow-up testing (i.e., month 12). The pre- to post-program trends for diabetes self-care activities indicated improvements for general and specific diet maintenance, days of exercise per week, blood glucose testing per week, foot care, and smoking habits. Participants also exhibited a decrease in diabetes distress for emotional, physical, regimen, and interpersonal distress from pre- to post-program. This is very important as self-regulation of behaviors is necessary to successful management of diabetes. The results are discussed in relation to the limitations created by COVID-19, along with future implementation suggestions.

Benefits of mindful self-compassion for frontline nurses.

ABSTRACT: Nurses who regularly engage in self-compassion training may be more resilient to stressors and burnout, and thus able to provide more compassionate care to patients. The article explores the benefits and strategies of practicing mindful self-compassion (MSC) for nurses, reviews the effectiveness of an MSC curriculum, and discusses practical techniques for nurses to put MSC theory into practice.

The impact of COVID-19 on college anxiety, optimism, gratitude, and course satisfaction.

ObjectiveTo examine the relationship between college student anxiety, optimism, gratitude, and perception of the Physical Activity and Lifestyle program (PAL) instructional response/effectiveness following COVID-19. Participants: Data were collected from a southeastern, midsize university (n = 1640) during April 2020. Methods: Participants responded to a Web-based survey that included mental health factors (optimism, gratitude, anxiety) and perceptions of COVID-19 academic response. Results: The results of this study revealed a significant, negative relationship between anxiety and optimism (r = .36), gratitude (r = -.12), and perceived instruction following COVID-19 (r = -.11). There were statistically significant differences in perceived PAL instructional response/effectiveness following COVID-19 between anxiety classification, with severely anxious students expressing lower instructional response to COVID-19 when compared to moderately or mildly anxious students, [F(2,1516) = 10.60, p < .001]. Conclusions: The results inform educators on the importance of effective education and coping strategies following online transition during a pandemic.

Mindful self-compassion for nurses: a systematic review.

This article details a systematic review that aimed to synthesise and analyse the published research on the effects of mindful self-compassion interventions on stress in nurses. Five studies were identified that met the inclusion criteria and were analysed in terms of sample characteristics, intervention, measurement of self-compassion, additional psychosocial outcome measures, intervention duration and adherence, intervention outcomes and effect size and follow-up. The review found that mindful self-compassion interventions had medium-to-large effect sizes for self-compassion, traumatic stress, burnout, stress and compassion satisfaction. There was also high intervention adherence (mean=86%) in the included studies. Since these interventions can improve self-compassion and compassion in nurses, they have the potential to enhance the quality of compassionate care provided by nurses who undergo training in mindful self-compassion.

Self-compassion training within a workplace physical activity program: A pilot study.

BACKGROUND: Desire2Move (D2M) is an 8-week team-based, workplace program that incorporates competition and self-monitoring to encourage physical activity (PA). OBJECTIVE: The purpose of this pilot study was to evaluate the effectiveness of a self-compassion (SC) intervention within the existing workplace PA program. METHODS: University employees (n = 20) were assigned to a SC treatment group or an attention control group. Participants logged their PA minutes using MapMyRun. Treatment group. participants received a 7-week, SC podcast intervention. Participants self-reported PA, SC, and demographic information at pre- and post-intervention. Separate ANOVAs were used to determine group differences. RESULTS: There was not a statistically significant group x time interaction for SC, F(1, 18) = 0.02, p = 0.90, or main effects for time, F(1, 18) = 0.28, p = 0.61, or group, F(1, 18) = 1.70, p = 0.21, g = -0.42 [95%CI = -3.13, 2.29]. There were not significant differences between groups for total PA minutes during D2M, F(1, 18) = 2.15, p = 0.16, g = -0.63 [-1.53,0.27]. Overall, participants engaged in more than the recommended levels of PA each week. CONCLUSIONS: This pilot study provided feedback and guidance for future online SC training within a workplace PA intervention.

Examining the Impact of Wellness Champions on the Effectiveness of a Workplace Health and Well-Being Program.

PURPOSE: To evaluate the impact of Desire2Move (D2M) implementation fidelity by Wellness Champions on program effectiveness. DESIGN: Cross-sectional. SETTING: Years 1, 3, and 5 of D2M; an annual peer support health and well-being initiative for university employees. PARTICIPANTS: D2M participants included 422 employees from 28 teams; however, only 144 provided survey data (34.1% response rate). INTERVENTION: During the 8-week program, departments competed as teams to accumulate the greatest average physical activity (PA) minutes. Each team selected a Wellness Champion who delivered program information. Each team member recorded PA minutes with MapMyFitness. MEASURES: An electronic survey assessed program implementation fidelity and program satisfaction. ANALYSIS: Median split (median [Mdn] = 21.2) categorized teams into "high" (n = 14; Mdn = 24.0, range = 21.4-25.0) and "low" (n = 14; Mdn = 19.4, range = 14.3-21.0) implementation groups. Independent samples t tests evaluated differences between groups on program satisfaction and team program average PA minutes. RESULTS: Groups were significantly different for program satisfaction, t(26) = -2.76, P = .011, and team program average PA minutes, t(26) = -2.40, P = .024. The "high" implementation group reported greater program satisfaction (mean [M] = 12.6, standard deviation [SD] = 1.8) and team program average PA minutes (M = 2104.4, SD = 807.4) than the "low" implementation group (program satisfaction M = 11.1, SD = 1.1; team program average minutes M = 1340.8, SD = 875.8). CONCLUSION: Wellness Champions positively impacted employee PA participation and program satisfaction.