Empowering Chinese university health service providers to become mental health champions: insights from the ACE-LYNX intervention.

Background: Evidence shows that there is a high prevalence of mental health challenges including depression and anxiety, among Chinese university students. Providing mental health care providers with professional training is crucial to implementing effective mental health promotion initiatives in university settings. Globally, the focus of the mental health system is shifting to recovery and the importance of empowerment is increasingly being emphasized. There is a call to integrate empowerment education into professional training programs for health service providers with the goal of mobilizing them to become mental health champions capable of advancing mental health care. Method: The ACE-LYNX (Acceptance and Commitment to Empowerment-Linking Youth and Xin i.e., "heart(s)" in Chinese) intervention took place at six universities in Jinan, Shandong Province, China. It aimed to promote mental health literacy and build capacity among mental health service providers (MHSPs) to enable them to become mental health champions at their universities and beyond. A total of 139 university MHSPs participated. We collected pre-, immediate post- and three-month-post-surveys. In addition, we recruited forty-five participants to take part in three-month- post-intervention focus group interviews to explore their experiences taking part in ACE-LYNX and applying the knowledge, skills, and insights they gained from the intervention. Result: This paper reports on the effects of empowerment education, which is a key component of ACE-LYNX, on the MHSPs. Four themes were identified: 1) conscious awareness and behavioral change through psychological empowerment users; 2) professional insights and motivation for organizational empowerment; 3) non-self in the continuum of collective empowerment; and 4) interdisciplinary challenges and divergences in empowerment action. Discussion: We found that it is critical to integrate empowerment education into professional training. The process of MHSPs developing their empowerment practice is characterized by their moving from individual to collective empowerment along a continuum, with organizational and collective empowerment taking place in a longer time frame. Experiential learning, empathy education, and critical reflection accelerated the continuous iterative transformative process of empowerment practices. To advance the integration of empowerment into mental health care, the engagement of organizational decision-makers and policy makers in empowerment training is critical to ensure alignment of empowerment values and competence at all levels of service provision.

Investigation of Play Intervention for Dementia (PID) Activities in Addressing Cognitive Domains Reflected in Hong Kong Montreal Cognitive Assessment (HK-MoCA).

Background/Objectives: Yee Hong Play Intervention for Dementia (PID) is a community program strengthening East Asians >65 years with dementia in their daily functional activities. We analyzed how PID activities align with Hong Kong Montreal Cognitive Assessment. Methods: Utilizing observation sheets procured from documentation notes from the twice-weekly PID sessions, cognitive domains were identified. Mean time duration and activity frequencies were compared between high and low competency client groups. Results: Independent of competency group, activities predominantly targeted attention/concentration (23.8% HC, 16.4% LC), and hand-eye coordination (19.1% HC, 28.7% LC). Less focused domains were delayed recall (3.1-4.7%) and naming (1.3-1.5%). Conclusions: Yee Hong PID tested innovative cognitive domains not currently covered in HK-MoCA screening assessment, emphasizing attention/concentration-oriented activities and none assessing orientation and language domains. Additionally, presence of new domains such as hand-eye coordination and fine motor dexterity suggested that strict adherence with standardized screening tools (e.g., MoCA) may not be ideal. Likely, facilitators have developed innovative measures to assess individual competency to strengthen resilience in our geriatric population.

Including formal and informal caregivers in the development of Play Intervention for Dementia: a qualitative study.

BACKGROUND: Play Intervention for Dementia is a practice initiative using play to help people living with dementia (PWD) experience engagements, autonomy, and cognitive stimulation. This program was developed under a participatory paradigm, with extensive contribution from formal and informal caregivers. This article describes how caregivers contributed to the practice principles, materials, and assessment during the development phase of Play Intervention for Dementia through community-based participatory research (CBPR). METHODS: Three service supervisors, 16 formal caregivers and 14 informal caregivers from the community participated in this study. Based on CBPR, the study progressed in a reflexive, iterative and collaborative way. Data were collected from diverse sources, including practice journals, observation notes and reflexive focus group interviews. Two trained qualitative researchers conducted thematic analysis on the data collected, with focus on practical skills, outcomes, and caregivers' general experience during the intervention. RESULTS: The therapeutic and liberating power of play was thoroughly discussed by the caregivers. They considered play as an innovative way to understand, engage, and connect with the PWD. Also, improvement in energy level, motivation and communicative capacity was observed among the PWD. The researcher and caregivers collaboratively refined and designed the protocol of Play Intervention for Dementia, adding localized principles and games to the original design. CONCLUSION: Caregivers found play to be a meaningful way to engage with PWD, as it provided an equal platform for them. The intervention also enabled them to reflect upon ageing and disease at a deeper level. Caregivers have contributed significantly to the refinement and contextualisation of the intervention. The efficiency of the refined program should be further tested on a larger scale.

Cognitive Stimulating Play Intervention for Dementia: A Feasibility Randomized Controlled Trial.

This study investigates the feasibility and the preliminary efficacy of a Cognitive Stimulating Play Intervention on cognitive functions. Thirty older people with early to moderate dementia were recruited from 2 day-care centers, which were randomized into intervention and control groups. The recruitment, attendance, completion rates, and the interview with staff showed that the intervention was feasible. Analysis of covariance results showed that there was a significant difference between groups on memory storage and retrieval functions. The mean memory storage and retrieval functions were 5.92 (95% confidence interval [CI]: 1.83-9.91; P = .006) and 4.12 (95% CI: 0.75-7.50; P = .018) points higher than that for the control group, respectively, which contributed moderate to large effects (partial η2 = 0.189-0.248). There was no significant difference between groups in global cognition measured using the Montreal Cognitive Assessment and verbal fluency. Practical issues that emerged during implementation were discussed.

Relationships between culture and health status: a multi-site study of the older Chinese in Canada.

This study examined the relationships between culture and the health status of older Chinese in Canada. Data were collected through face-to-face interviews with a cross-sectional, randomly selected sample of 2,272 older Chinese between 55 and 101 years of age in seven Canadian cities. Health status was assessed by the number of chronic illnesses, by limitations in ADL and IADL, and by information on the Medical Outcome Study Short Form SF-36. Although cultural variables explained only a small proportion of variance in health status, having a stronger level of identification with traditional Chinese health beliefs was significant in predicting physical health, number of illnesses, and limitations on IADL. Other cultural variables, including religion, country of origin, and length of residence in Canada, were also significant in predicting some health variables. Interventions to improve health should focus on strategies to enhance cultural compatibility between users and the health delivery system.