Reducing Smoking Cessation Disparities: Capacity for a Primary Care- and Technology-Based Approach Among Medicaid Recipients.

While cigarette use among U.S adults has recently decreased, vulnerable subgroups continue to smoke at high rates, including individuals receiving Medicaid insurance. These individuals have also experienced treatment access disparities, highlighting the need for approaches that leverage their strong desire to quit. We conducted interviews with 100 adult primary care patients receiving Medicaid who were current tobacco users about their use, openness to technology-based interventions, and readiness to change. Most (92%) reported current cigarette use and readiness to change averaged 6.98 out of 10 (SD = 2.82). Nearly all were open to completing an iPad-based tobacco screening (95%) and brief intervention (90%) at their next appointment, while 91% and 88% were willing to talk with their provider or a cessation counselor, respectively, about the subsequent results. Results persisted across age, sex, and race/ethnicity. Openness to technology-based interventions in this population provides support for future work that may ultimately reduce disparities.

Patient perspectives for improving treatment initiation for new episodes of depression in historically minoritized racial and ethnic groups.

OBJECTIVE: Depression is one of the costliest and most prevalent health conditions in the U.S. with 21 million adults having experienced at least one major depressive episode. Despite the availability of evidence-based treatments for depression, a large proportion of people with new diagnoses fail to initiate formal mental health treatment. Although individuals across all racial and ethnic groups fail to initiate treatment for depression, historically minoritized racial/ethnic groups are at even greater risk. METHOD: Thirty-four participants representing historically underserved racial and ethnic populations from two large health care systems in the U.S. participated in qualitative interviews or focus group to identify factors that impede and facilitate depression treatment initiation in primary care settings. RESULTS: Participants identified individual and systemic barriers and facilitators of treatment initiation for depression and suggested several ideas for increasing treatment engagement (i.e., increased communication and education from providers, community events, information on social media). CONCLUSION: Novel interventions are needed to improve treatment initiation following initial diagnosis of depression in primary care settings. Findings from this study offer suggestions for improving treatment initiation in traditionally underserved communities.

A mixed-methods investigation into the us versus them mentality in Facebook groups for chronic pain.

OBJECTIVE: Social media groups for chronic pain have become increasingly popular, but the effects of these groups are largely unknown, and members may be exposed to both helpful and harmful group processes. We created a Facebook intervention for adults with chronic pain and used a mixed-methods design to evaluate the effects of group membership on social support, including examining social dynamics that may benefit or impede existing pain care. METHOD: A total of 119 adults participated in either peer-led or professionally-guided Facebook groups for 1 month. Chronic pain support was assessed at baseline, post-intervention, and 1-month follow-up, and qualitative data were collected to explore social dynamics. RESULTS: Chronic pain support increased for participants in both group types from baseline to post-intervention and then decreased at follow-up. Thematic analysis of qualitative data (i.e., participant posts and comments in response to posts) revealed an overarching theme: us versus them-a dichotomizing view of the world that distinguishes people with pain (us) versus everyone else who does not understand pain (them). Participants discussed their tendency to withdraw socially due to feeling misunderstood regarding their pain. CONCLUSIONS: Facebook groups for chronic pain enhance perceptions of support among peers. Although generally beneficial, group cohesion may facilitate an us versus them mentality, resulting in isolation and potentially poorer outcomes. Future research should explore ways to maintain benefits of the us versus them mentality, while reducing its costs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Facing Pain Together: A Randomized Controlled Trial of the Effects of Facebook Support Groups on Adults With Chronic Pain.

Despite the popularity and affordances of social media groups for people with chronic conditions, there have been few controlled tests of the effects of these groups. This randomized controlled superiority trial examined the effects of Facebook groups on pain-related outcomes and tested whether a professional-led group leads to greater effects than a support group alone. We randomly assigned 119 adults with chronic pain to one of two Facebook group conditions: a standard condition (n = 60) in which participants were instructed to offer mutual support, or a professional-led condition (n = 59) in which the investigators disseminated empirically-supported, socially-oriented psychological interventions. Four groups were run (2 standard, 2 professional-led), each lasting 4 weeks and containing approximately 30 participants. Measures were administered at baseline, post-intervention, and 1-month follow-up. Across conditions, participants improved significantly in primary outcomes (pain severity and interference; medium-large effects) and a secondary outcome (depressive symptoms; small-medium effect), and they retained their outcomes 1 month after the groups ended. The 2 conditions did not differ on improvements. Overall, this study supports the use of social media groups as an additional tool to improve chronic pain-related outcomes. Our findings suggest that professional intervention may not have added value in these groups and that peer support alone may be driving improvements. Alternatively, the psychosocial intervention components used in the current study might have been ineffective, or more therapist direction may be warranted. Future research should examine when and how such guidance could enhance outcomes. PERSPECTIVE: Findings from this randomized trial support the use of both standard and professional-led Facebook groups as an accessible tool to enhance the lives of adults with chronic pain. This article provides direction for how to improve social media groups to optimize outcomes and satisfaction for more users.