Relationships between social climate and indoor environmental quality and frequently reported health symptoms among teachers and staff in a suburban school district.

Public school teachers represent one of the largest occupational groups in the United States and are vulnerable to job stress and burnout. School social and physical environments may be adversely impacting the health of teachers and other staff, though few studies have explored these relationships. We partnered with a suburban school district in Colorado to assess the association between school environmental quality, social climate, and staff member health. We modeled the number of self-reported frequent health symptoms (experienced at least once a week) using generalized linear models. School-level predictors of interest included: overall social climate scores (unitless), building operations report card (ORC) scores (unitless), and indoor air quality (IAQ) scores (unitless). In total, we had data from 134 staff members from 11 schools in the district. A majority (62%) of our participants were teachers, who reported a greater number of frequent (i.e., at least once a week) health symptoms (mean = 3.2 symptoms experienced at least once per week) compared to staff in other roles (mean = 2.3 symptoms per week). We found that a one standard-deviation (10.5) increase in the overall social climate score was associated with a 0.77-fold (95% CI: 0.60-0.99) change in the number of frequent health symptoms reported. However, this association was attenuated among teachers compared to other staff members. Our results suggested effect modification by social climate on the relationship between IAQ and health, albeit with some uncertainty. For participants with a school climate score below the mean, a one standard-deviation (10.5) increase in IAQ score was associated with a 0.49-fold (95% CI: 0.35-0.70) change in the number of frequently reported symptoms. Overall, our study suggests school climate may be associated with self-reported health symptoms, but that the benefits of improved school climates may not be as strong for teachers compared to other staff. Future work should assess perceived climate at the individual level to assess how staff roles impact how school environments are associated with health outcomes.

Complexity leadership in action: a team science case study.

Introduction: This team science case study explores one cross-disciplinary science institute's change process for redesigning a weekly research coordination meeting. The narrative arc follows four stages of the adaptive process in complex adaptive systems: disequilibrium, amplification, emergence, and new order. Methods: This case study takes an interpretative, participatory approach, where the objective is to understand the phenomena within the social context and deepen understanding of how the process unfolds over time and in context. Multiple data sources were collected and analyzed. Results: A new adaptive order for the weekly research coordination meeting was established. The mechanism for the success of the change initiative was best explained by complexity leadership theory. Discussion: Implications for team science practice include generating momentum for change, re-examining power dynamics, defining critical teaming professional roles, building multiple pathways towards team capacity development, and holding adaptive spaces. Promising areas for further exploration are also presented.

Feasibility of an adaptive riding pilot study and acceptability to dementia care partners: "Your spirits are lifted".

OBJECTIVES: We sought to assess the feasibility and acceptability of an adaptive riding program with dyads (persons living with dementia, family care partners) and a gardening comparison condition. DESIGN: This is a two-arm (adaptive riding and adaptive gardening), mixed methods, convergent, feasibility study that occurred February 2019-June 2019. INTERVENTIONS: Upon enrollment, dyads (n=9) self-selected into either community-based adaptive riding (n=5) or adaptive gardening (n=4), two complementary interventions in Northern Colorado. Interventions occurred for hour-long, weekly sessions for eight weeks. OUTCOME MEASURES: Feasibility was measured with recruitment (actual/planned, response rate, participants enrolled/month) retention, adherence to study procedures (attendance, retention, fidelity), and data collection processes (planned versus collected); and analyzed with descriptive statistics. Acceptability of adaptive riding was measured with pre/post care partner interviews and analyzed using thematic analysis. Afterwards, findings were converged. RESULTS: We recruited n=10/24 dyads (6 dyads per month), with the highest response rates for referrals and in-person events, n=9 dyads enrolled. We adhered to study procedures with attendance (6/8 gardening, 8/8 riding), retention (100%), fidelity (100%) and data collected (98%). Care partners (n=5) found the adaptive riding intervention acceptable with two themes Overall hopes: "Joy in the present moment" and "Experience as a Whole: "Your spirits are lifted," affirming quantitative attendance and retention data. CONCLUSION: Findings underscore the feasibility and acceptability of including care partners of persons living with dementia in complementary interventions involving horsemanship activities. Feasibility data can guide study designs and implementation processes for other nature-based complementary interventions for this population.

A comparison of quality of life indicators during two complementary interventions: adaptive gardening and adaptive riding for people with dementia.

OBJECTIVES: We sought to provide a fine-grain description and comparison of how people living with dementia responded to adaptive gardening and adaptive riding through durations of their observed participation and emotional well-being, two dimensions of quality of life. DESIGN: A descriptive case study design enabled in-depth description and comparison of participation and emotional well-being, two quality of life indicators, observed during four videotaped sessions of adaptive gardening and adaptive riding. INTERVENTIONS: Eight people living with dementia self-selected into one of two complementary interventions, community-based adaptive gardening (n = 4) or adaptive riding (n = 4), in Northern Colorado. Both occurred for hour-long, weekly sessions for eight-weeks. OUTCOME MEASURE: Durations of observed quality of life indicators of participation and apparent affect were documented using a modified version of the Activity-in-Context-in-Time on 31 hours of videotaped data. Durations for each quality of life indicator were averaged per participant and aggregated by group for comparison using a Wilcoxon Mann-Whitney U test RESULTS: Both interventions supported emotional well-being and participation. Longer durations of active participation were observed during adaptive riding with significantly higher durations of complex active participation (U = 16, p= 0.029). CONCLUSION: Both interventions supported quality of life and merit continued development. Adaptive riding appeared to support longer durations of active participation with more complex forms when compared to adaptive gardening. Findings can inform healthcare providers' recommendations for adaptive gardening and adaptive riding for people with dementia. More research is needed with a larger sample size to further examine similarities and differences.

Surviving and Thriving: Qualitative Results from a Multi-Year, Multidimensional Intervention to Promote Well-Being among Caregivers of Adults with Dementia.

(1) Introduction: Caring for an adult with dementia is both challenging and rewarding. Research indicates that community-based, social support, and/or arts engagement interventions can play a key role in ameliorating the negative outcomes associated with caregiving while enhancing its more positive attributes. This study explores the psychosocial outcomes experienced by dementia caregivers who participated in a multi-year, multidimensional intervention aimed at promoting caregiver and care recipient well-being. This intervention included bringing caregivers and people with Alzheimer's disease or related dementias (ADRD) to local symphony performances, hosting a social reception prior to the performance, and assessing the outcomes of participation for both caregiver and the care recipient. (2) Materials, Methods, and Analysis: Qualitative data from participant phone interviews (n = 55) as well as focus groups are analyzed using thematic analysis from a phenomenological perspective. (3) Results: Across three years of participation, caregivers reported three main program benefits: relationship building (both with other participants as well as within the broader community); restored humanity (experiencing a greater sense of personal dignity and momentary return to normalcy), and positivity (experiencing positive emotions during the program). (4) Discussion: These findings point to the value of creating caregiver programming that brings together multiple dimensions of successful interventions in order to enhance caregiver experiences and positive intervention outcomes.

B Sharp-The cognitive effects of a pilot community music program for people with dementia-related disorders.

INTRODUCTION: Dementia has been described as the greatest global challenge for healthcare in the 21st century. Pharmaceutical interventions have dominated dementia treatment despite limited efficacy. There is increasing interest in alternatives to delay the progression of cognitive decline, such as community-based programs, promoting social and stimulating experiences. This article discusses a pilot music-based community program (B Sharp) for persons with dementia-related disorders. METHOD: In the pilot study, we assessed 23 persons with dementia-related disorders who, with their caregivers, attended the symphony season and accompanying social hours over a 10-month period. Participants completed a baseline and follow-up brief neuropsychological test to assess cognitive changes. RESULTS: Significant improvements were observed between the pre- and post-B Sharp program assessments (P < .010). DISCUSSION: Results support the feasibility of the B Sharp program as a community-based program to target cognitive decline. Additional research is needed to understand the mechanisms involved in the improvements observed in this program.

A Multidisciplinary Research Framework on Green Schools: Infrastructure, Social Environment, Occupant Health, and Performance.

BACKGROUND: Sustainable school buildings hold much promise to reducing operating costs, improve occupant well-being and, ultimately, teacher and student performance. However, there is a scarcity of evidence on the effects of sustainable school buildings on health and performance indicators. We sought to create a framework for a multidisciplinary research agenda that links school facilities, health, and educational outcomes. METHODS: We conducted a nonsystematic review of peer review publications, government documents, organizational documents, and school climate measurement instruments. RESULTS: We found that studies on the impact of physical environmental factors (air, lighting, and thermal comfort) on health and occupant performance are largely independent of research on the social climate. The current literature precludes the formation of understanding the causal relation among school facilities, social climate, occupant health, and occupant performance. CONCLUSIONS: Given the average age of current school facilities in the United States, construction of new school facilities or retrofits of older facilities will be a major infrastructure investment for many municipalities over the next several decades. Multidisciplinary research that seeks to understand the impact of sustainable design on the health and performance of occupants will need to include both an environmental science and social science perspective to inform best practices and quantification of benefits that go beyond general measures of costs savings from energy efficiencies.