Variability in the Integration of Peers in a Multi-site Digital Mental Health Innovation Project.

Peer support specialists ("peers") who have the lived experience of, and are in recovery from, mental health challenges are increasingly being integrated into mental health care as a reimbursable service across the US. This study describes the ways peers were integrated into Help@Hand, a multi-site innovation project that engaged peers throughout efforts to develop and offer digital mental health interventions across counties/cities ("sites") in California. Using a mixed methods design, we collected quantitative data via quarterly online surveys, and qualitative data via semi-annual semi-structured phone interviews with key informants from Help@Hand sites. Quantitative data were summarized as descriptive findings and qualitative data from interviews were analyzed using rapid qualitative analysis methods. In the final analytic phase, interview quotes were used to illustrate the complex realities underlying quantitative responses. 117 quarterly surveys and 46 semi-annual interviews were completed by key informants from 14 sites between September 2020 and January 2023. Peers were integrated across diverse activities for support and implementation of digital mental health interventions, including development of training and educational materials (78.6% of sites), community outreach (64.3%), technology testing (85.7%), technology piloting (90.9%), digital literacy training (71.4%), device distribution (63.6%), technical assistance (72.7%), and cross-site collaboration (66.7%). Peer-engaged activities shifted over time, reflecting project phases. Peer-provided digital literacy training and technology-related support were key ingredients for project implementations. This study indicates the wide range of ways peers can be integrated into digital mental health intervention implementations. Considering contextual readiness for peer integration may enhance their engagement into programmatic activities.

Community Engagement in Behavioral Medicine: A Scoping Review.

BACKGROUND: Behavioral medicine has made key contributions toward improving health outcomes. Engaging community partners in research is critical to addressing persistent health inequities. The aim of this scoping review was to explore how researchers engaged community partners within the field of behavioral medicine research from 2005 to 2023. METHOD: Publication databases and gray literature were searched for research that engaged community partners to address questions relevant to behavioral medicine. Articles were screened by title and abstract, and then by full text. Articles meeting the inclusion criteria were coded using the framework provided by the Engagement Navigator to identify engagement approaches, methods, and tools and when they were used during the research. RESULTS: Of 1486 articles initially identified, 58 met the inclusion criteria. Most articles used well-known approaches (e.g., community-based participatory research; 67%), methods (e.g., advisory committees; 59%), and tools (e.g., interviews; 41%), and engaged with healthcare service providers (62%) and/or patients (53%). Community partners were most often included in research planning and design (79%), and less often in dissemination (45%). CONCLUSION: Community engagement has considerable potential to address health inequities. Our assessment of the approaches, methods, and tools used by behavioral medicine researchers to engage with a diverse range of community partners points toward promising strategies for enhancing the impact of community engagement. Researchers should incorporate explicit descriptions of community engagement strategies in publications, an outcome that could be facilitated by clear publishing guidelines, structured reporting tools, and clear messaging from funders about the value of community engagement in behavioral medicine research.

Psychological need satisfaction, intrinsic motivation and affective response to exercise in adolescents.

OBJECTIVES: To further understanding of the factors influencing adolescents' motivations for physical activity, the relationship of variables derived from Self-Determination Theory to adolescents' affective response to exercise was examined. DESIGN: Correlational. METHOD: Adolescents (N = 182) self-reported psychological needs satisfaction (perceived competence, relatedness, and autonomy) and intrinsic motivation related to exercise. In two clinic visits, adolescents reported their affect before, during, and after a moderate-intensity and a hard-intensity exercise task. RESULTS: Affective response to exercise and psychological needs satisfaction independently contributed to the prediction of intrinsic motivation in hierarchical linear regression models. The association between affective response to exercise and intrinsic motivation was partially mediated by psychological needs satisfaction. CONCLUSIONS: Intrinsic motivation for exercise among adolescents may be enhanced when the environment supports perceived competence, relatedness, and autonomy, and when adolescents participate in activities that they find enjoyable.

Personality, physical fitness, and affective response to exercise among adolescents.

PURPOSE: Evidence shows that aspects of personality are associated with participation in physical activity. We hypothesized that, among adolescents, behavioral activation (BAS) and behavioral inhibition (BIS) systems would be associated with physical fitness (cardiovascular fitness and percent body fat), enjoyment of exercise, tolerance of and persistence in high-intensity exercise, and affective response to an acute exercise bout. METHODS: One hundred and forty-six healthy adolescents completed a cardiovascular fitness test, percent body fat assessment (dual-energy x-ray absorptiometer), and two 30-min cycle ergometer exercise tasks at moderate and hard intensities. Questionnaires evaluated BIS/BAS, enjoyment of exercise, and preference and tolerance for high-intensity activity. Affect in response to exercise was assessed using the Feeling Scale (FS) and the Activation Deactivation Adjective Check List (AD ACL). RESULTS: BIS was negatively correlated with cardiovascular fitness and tolerance for high-intensity exercise, and adolescents with high BIS scores reported more negative FS in response to exercise at both moderate and hard intensities. BAS was positively correlated with enjoyment of exercise, and adolescents with high BAS scores reported having more positive FS and higher energetic arousal on the AD ACL in response to moderate-intensity exercise. The association between BAS and affect was attenuated for the hard-intensity exercise task. CONCLUSION: These findings suggest that both the drive to avoid punishing stimuli (BIS) and the drive to approach rewarding stimuli (BAS) are related to the affective response to exercise. The BIS may be more strongly associated with fitness-related exercise behavior among adolescents than the BAS, whereas the BAS may play a relatively greater role in terms of subjective exercise enjoyment.