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1.
AIDS Care ; 36(4): 569-579, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38157344

RESUMO

Existing HIV prevention interventions, such as pre-exposure prophylaxis (PrEP), and behavioral health treatments inadequately reach Latino men who have sex with men (LMSM) in the US. This study involved formative research to inform the content, design, and implementation of a scalable, low resource implementation strategy - peer ambassador stories - stories from peers to normalize using PrEP, HIV testing, and behavioral health treatment. We conducted semi-structured interviews with 20 LMSM to elucidate their content, design, and implementation preferences for peer ambassador stories. Men were asked about story prompts, story contributor characteristics, story platform features, design preferences, and recommendations for enhancing the adoption and use of the peer ambassador technology platform among LMSM. Interviews were transcribed and analyzed via rapid qualitative analysis. Qualitative analyses identified 14 themes within 4 pre-specified domains. Collectively, the themes unified around the central concept that technology-delivered peer ambassador stories require a personalized, relational, culturally relevant touch to be acceptable and appropriate for LMSM. This study suggests that disseminating peer ambassador stories using electronic platforms and audio/video formats may enhance the reach of services and if they are personalized, relational, and culturally relevant. Findings have broad implications for informing other peer-based strategies to mitigate HIV disparities among LMSM.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Masculino , Humanos , Homossexualidade Masculina , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Infecções por HIV/tratamento farmacológico , Florida , Pesquisa Qualitativa , Teste de HIV
2.
J Pediatr Psychol ; 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38853703

RESUMO

OBJECTIVE: Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents. METHODS: Data were collected from a U.S. sample of 1859 adolescents aged 10-17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics. RESULTS: Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing. CONCLUSION: Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication.

3.
Dev Psychopathol ; : 1-16, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38801123

RESUMO

Recent theories suggest that for youth highly sensitive to incentives, perceiving more social threat may contribute to social anxiety (SA) symptoms. In 129 girls (ages 11-13) oversampled for shy/fearful temperament, we thus examined how interactions between neural responses to social reward (vs. neutral) cues (measured during anticipation of peer feedback) and perceived social threat in daily peer interactions (measured using ecological momentary assessment) predict SA symptoms two years later. No significant interactions emerged when neural reward function was modeled as a latent factor. Secondary analyses showed that higher perceived social threat was associated with more severe SA symptoms two years later only for girls with higher basolateral amygdala (BLA) activation to social reward cues at baseline. Interaction effects were specific to BLA activation to social reward (not threat) cues, though a main effect of BLA activation to social threat (vs. neutral) cues on SA emerged. Unexpectedly, interactions between social threat and BLA activation to social reward cues also predicted generalized anxiety and depression symptoms two years later, suggesting possible transdiagnostic risk pathways. Perceiving high social threat may be particularly detrimental for youth highly sensitive to reward incentives, potentially due to mediating reward learning processes, though this remains to be tested.

4.
Health Expect ; 27(2): e14034, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38567865

RESUMO

CONTEXT: Engaging with peers is gaining increasing interest from healthcare systems in numerous countries. Peers are people who offer support by drawing on lived experiences of significant challenges or 'insider' knowledge of communities. Growing evidence suggests that peers can serve as a bridge between underserved communities and care providers across sectors, through their ability to build trust and relationships. Peer support is thus seen as an innovative way to address core issues of formal healthcare, particularly fragmentation of care and health inequalities. The wide body of approaches, goals and models of peer support speaks volumes of such interest. Navigating the various labels used to name peers, however, can be daunting. Similar terms often hide critical differences. OBJECTIVES/BACKGROUND: This article seeks to disentangle the conceptual multiplicity of peer support, presenting a conceptual map based on a 3-year knowledge synthesis project involving peers and programme stakeholders in Canada, and international scientific and grey literature. SYNTHESIS/MAIN RESULTS: The map introduces six key questions to navigate and situate peer support approaches according to peers' roles, pathways and settings of practice, regardless of the terms used to label them. As a tool, it offers a broad overview of the different ways peers contribute to integrating health and community care. DISCUSSION: We conclude by discussing the map's potential and limitations to establish a common language and bridge models, in support of knowledge exchange among practitioners, policymakers and researchers. PATIENT OR PUBLIC CONTRIBUTION: Our team includes one experienced peer support worker. She contributed to the design of the conceptual map and the production of the manuscript. More than 10 peers working across Canada were also involved during research meetings to validate and refine the conceptual map.


Assuntos
Grupo Associado , Feminino , Humanos , Canadá
5.
Cult Health Sex ; 26(1): 93-107, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37014229

RESUMO

Learning to negotiate relationships is a key feature of adolescence, yet insight into young people's perspectives on what constitutes healthy relationships is lacking. In this study, therefore, insights were sought on healthy relationship qualities, common issues encountered, and relevant educational experiences. Semi-structured interviews were undertaken with 18 young people (11 self-identified as female, 5 male, and 2 trans/gender-diverse) aged 14-20 years, residing in Adelaide, South Australia. Relationships with parents, siblings, peers and intimate partners were topics for discussion. Reflexive thematic analysis was utilised to generate codes and themes. The Five Cs of Positive Youth Development were used to aid understanding of findings. Young people's accounts suggested a disjuncture between desired relationship qualities, realities and education on relationships and sexual health. Young people articulated tensions navigating peer norms and societal expectations in relation to dating and sex, including unrealistic representations, gender stereotyping and strong 'sexpectations'. Participants in this study relied more heavily on personal experience and observation than formal education to develop an understanding of healthy relationships. Achieving healthy relationships was generally perceived to be complex and requiring skills or understanding informants were unsure about. Positive Youth Development could provide a framework for meeting the needs expressed by young people, notably by building communication skills, confidence and agency.


Assuntos
Comportamento Sexual , Parceiros Sexuais , Adolescente , Humanos , Masculino , Feminino , Identidade de Gênero , Grupo Associado , Nível de Saúde
6.
J Med Internet Res ; 26: e53607, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38900546

RESUMO

BACKGROUND: Despite the well-documented health benefits associated with wearable monitoring devices (WMDs), adherence among community-dwelling older adults remains low. By providing guidance on the purpose and benefits of using WMDs, facilitating goal-setting aligned with the device's features, promoting comprehension of the health data captured by the device, and assisting in overcoming technological challenges, peers and health care professionals can potentially enhance older adults' adherence to WMDs. However, the effectiveness of such support mechanisms in promoting adherence to WMDs among older adults remains poorly understood. OBJECTIVE: The aims of this systematic review were to examine the effects of peer- or professional-led intervention programs designed to improve adherence to WMDs among community-dwelling older adults and to identify the intervention components that may positively influence the effects of the intervention. METHODS: We conducted a comprehensive search across 7 electronic databases (Cochrane Central Register of Controlled Trials [CENTRAL], PubMed, EMBASE, PsycINFO, British Nursing Index, Web of Science, and CINAHL) to identify articles published between January 1, 2010, and June 26, 2023. We specifically targeted randomized controlled trials that examined the impact of peer- or professional-led interventions on enhancing adherence to WMDs among individuals aged 60 years and older residing in the community. Two independent reviewers extracted data from the included studies and assessed the potential risk of bias in accordance with the Cochrane Risk of Bias tool for randomized trials, version 2. RESULTS: A total of 10,511 studies were identified through the database search. Eventually, we included 3 randomized controlled trials involving 154 community-dwelling older adults. The participants had a mean age of 65 years. Our review revealed that increasing awareness of being monitored and implementing the SystemCHANGE approach, a habit change tool focusing on personal goals and feedback, were effective strategies for enhancing adherence to WMDs among older adults. All of the included studies exhibited a low risk of bias. CONCLUSIONS: By collaboratively designing specific goals related to WMDs with health care professionals, including nurses and physicians, older adults exhibited a higher likelihood of adhering to the prescribed use of WMDs. These goal-setting tools provided a framework for structure and motivation, facilitating the seamless integration of WMDs into their daily routines. Researchers should prioritize interventions that target awareness and goal-setting as effective approaches to enhance adherence to WMDs among older adults, thereby maximizing the realization of associated health benefits.


Assuntos
Vida Independente , Ensaios Clínicos Controlados Aleatórios como Assunto , Dispositivos Eletrônicos Vestíveis , Humanos , Idoso , Cooperação do Paciente/estatística & dados numéricos , Grupo Associado , Pessoa de Meia-Idade , Feminino , Masculino , Idoso de 80 Anos ou mais
7.
J Intellect Disabil Res ; 68(2): 95-112, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37821423

RESUMO

BACKGROUND: There is limited understanding of the context surrounding physical activity (PA) of young people with intellectual disabilities (ID), which has an impact on the development of PA promotion programmes. Peer social connectedness seems to be a vital correlate to focus on, but has not been included in current studies examining the correlates and determinants of PA levels of young people with ID. This study aims to synthesise the evidence on (1) the social constructs researchers have used to conceptualise peer social connectedness in a PA context among young people with ID, (2) the measurement tools that have been used and (3) the relationship between PA and peer social connectedness in young people with ID. METHODS: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ovid MEDLINE, Ovid Embase, Web of Science, ERIC, CINAHL and PsycINFO were searched from 1 January 1996 up to, and including, July 2023 to identify English-language studies, which examined associations between PA and peer social connectedness in adolescents and young adults (13-24 years) with ID. Study quality was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. RESULTS: Thirteen studies met the inclusion criteria and were included in the review. Ten peer social connectedness constructs and 18 measurement instruments were identified. Studies were predominantly focused on Special Olympics participants and unified activity formats. Participation in PA can increase social connectedness, but there is a lack of studies examining whether PA can also be increased by focusing on peer social connectedness in young people with ID. CONCLUSIONS: Results show that peer social connectedness is recognised as relevant to researchers developing and testing PA programmes for young people with ID.


Assuntos
Deficiência Intelectual , Esportes , Adolescente , Adulto Jovem , Humanos , Exercício Físico , Grupo Associado
8.
J Res Adolesc ; 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38716808

RESUMO

Past research has linked peer and teacher discrimination to risk factors for school discipline, but few studies have examined whether peer and teacher discrimination have a direct impact on school discipline. This study examines the effects of general peer and teacher discrimination at the individual- and school-level on school suspension using nationally representative, secondary data on almost 12,000 youth across 131 schools. Hierarchical logistic regression models indicated that general teacher discrimination at the individual- and school-level-but not general peer discrimination-increased the odds of receiving school suspension. Findings suggest that general discrimination by direct learning instructors and teachers representing the broader school culture can shape student conduct. Reducing school discipline thus falls on teachers, staff, principals, and learners.

9.
Aggress Behav ; 50(4): e22163, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38949228

RESUMO

Whereas research on aggression and status motivation in youth has predominantly looked at a promotion focus (striving for popularity), a prevention focus (wanting to avoid low popularity) could also be an important determinant of aggression, as youth who fear low popularity may use strategic aggression to secure their position. The aim of the current study was to develop reliable measures for both popularity motivations, and examine how both motivations are uniquely and jointly related to aggression. Participants were 1123 Dutch secondary school students (M age = 14.4 years, 48% girls), who completed a 3-item measure of striving for high popularity based on existing questionnaires (Li & Wright, 2014; Ojanen et al., 2005), and a 3-item measure of avoiding low popularity consisting of an adapted version of the high popularity items. Aggressive behavior was measured through peer nominations. Motivations were moderately correlated (r = .51), but did not always co-occur within the same person, as 17% of the sample belonged to a cluster that scored low on striving for popularity, but moderately high on avoiding low popularity. When considered simultaneously, striving for high popularity was not related to any type of aggression, whereas avoiding affiliation with unpopular peers was related to strategic aggression. For physical and verbal aggression, gossiping, excluding and bullying, the association of avoiding low popularity with aggression was strongest when youth also strived for high popularity. Future work should take both popularity motivations into account to better understand, predict and intervene on youth's aggression toward peers.


Assuntos
Comportamento do Adolescente , Agressão , Motivação , Humanos , Agressão/psicologia , Feminino , Adolescente , Masculino , Comportamento do Adolescente/psicologia , Grupo Associado , Desejabilidade Social , Estudantes/psicologia , Países Baixos , Bullying/psicologia , Inquéritos e Questionários
10.
J Adolesc ; 96(2): 394-410, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38167998

RESUMO

INTRODUCTION: Risky sexual behaviors in adolescence are associated with negative health and psychological functioning outcomes. Although the association between behavior problems and risky sexual behaviors is well established, addressing these problems requires understanding the mechanisms that help explain this association. Adolescent attachment, while related to risky sexual behavior, has not been extensively explored as an outcome of childhood externalizing problems. The two objectives of this study were to explore the links between parental and peer attachment and risky sexual behaviors and to examine the mediating effect of attachment on the links between behavior problems and risky sexual behaviors. METHODS: Five hundred and ninety-eight French-Canadian adolescents (46.2% girls), Mage at T1 = 13.23; Mage at T2 = 14.28; Mage at T3 = 17.35) participated in this longitudinal study. RESULTS: The quality of parental attachment at T2 was significantly and negatively associated with risky sexual behaviors 3 years later, at T3. More specifically, a lower quality parental attachment relationship was associated with having nonexclusive partners as well as with inconsistent condom use. Finally, parental attachment (T2) was a significant mediator between behavior problems (T1) and risky sexual behaviors (T3), but only for younger adolescents. CONCLUSIONS: Findings suggest that in addition to behavior problems in adolescence, the quality of parental attachment relationships may help in understanding risky sexual behaviors in adolescence.


Assuntos
Comportamento do Adolescente , Feminino , Humanos , Adolescente , Lactente , Pré-Escolar , Masculino , Estudos Longitudinais , Comportamento do Adolescente/psicologia , Canadá/epidemiologia , Comportamento Sexual/psicologia , Sexo Seguro , Assunção de Riscos
11.
BMC Med Educ ; 24(1): 208, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38424552

RESUMO

BACKGROUND: Understanding professionalism is an essential component of becoming a doctor in order to ensure the trust of patients and wider society. Integrally linked to the concept of professionalism is the importance of identifying and raising concerns to ensure high quality, safe patient care. It is recognised that medical students are uniquely placed to identify and report concerns given their frequent rotations through multiple clinical placements and their peer relationships and, in so doing, develop and enact their own medical professionalism. Although there is existing literature exploring medical students' willingness to raise concerns about observed professionalism lapses, this has largely been in the context of clinical interactions. Medical students will however undoubtedly encounter concerning behaviours or attitudes in their fellow students, an area that has not specifically been reported upon. This study therefore set out to explore medical students' willingness to report professionalism concerns they encounter both within and away from the clinical setting, particularly focusing on peer-related concerns. METHODS: 10 medical students, in later clinical years of a large UK medical school, volunteered to take part in in-depth semi-structured interviews. Interviews were recorded, transcribed and then analysed thematically to generate themes and subthemes to represent central organising concepts. RESULTS: Three broad themes were generated from the data. Hidden curricular effects including role models, hierarchical structures and the operational systems in place to raise concerns subconsciously influenced students' decisions to raise concerns. Secondly, students offered a range of justifications to defend not taking action, including considering their own vulnerabilities and values alongside demonstrating empathy for perceived mitigating circumstances. The third theme highlighted the complex interplay of influencing factors that students considered when encountering professionalism issues in their peers including wider peer cohort effects and a desire to maintain individual peer-relationships. CONCLUSIONS: Medical students will inevitably encounter situations where the professionalism of others is brought into question. However, despite clear curricular expectations to report such concerns, these findings demonstrate that students undergo a complex decision-making process in determining the threshold for reporting a concern through navigating a range of identified influencing factors. This study highlights the important role medical schools play in helping reduce the inner conflict experienced by medical students when raising concerns and in ensuring they provide supportive processes to empower their students to raise concerns as part their own developing professionalism.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Profissionalismo , Pesquisa Qualitativa , Grupos Focais , Confiança
12.
Artigo em Inglês | MEDLINE | ID: mdl-39008199

RESUMO

Parent-child informant discrepancies on psychopathology provide important knowledge on the parent-child relationship and the child's mental health, but mechanisms underlying parent-child informant discrepancies are largely unknown. Therefore, we investigated the relationship between attachment problems and mentalizing capacity and parent-child informant discrepancies on borderline personality disorder (BPD) severity, internalizing, and externalizing pathology in a clinical sample of 91 adolescent girls with BPD and their parents. Results showed that more attachment problems to parents and peers were related to adolescents reporting more severe BPD than parents. Adolescents who described more internalizing symptoms relative to parents, reported more parental attachment problems, but enhanced peer attachment, suggesting those adolescents who do not feel recognized by their parents might turn to their friends. When parents rated adolescents higher on externalizing behaviors, the adolescent reported more attachment problems to parents and lower mentalizing capacity, indicating that this sub-group of adolescents may reflect less about how their behavior affects others.

13.
Scand J Caring Sci ; 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38988314

RESUMO

INTRODUCTION: Symptoms of anxiety, eating disorders and social isolation are prevalent among teenagers with food allergy compared to peers without. Treatment of teenagers with food allergy focus on preventing anaphylactic reactions, with little attention to promoting social and emotional well-being. The aim of the study was to explore young adults' perspectives on everyday life with food allergy during their teenage years to improve future clinical practice. METHODS: Critical psychological practice research. During a 2-day camp the perspectives of 10 young adults (18-23 years) were explored through participant observation and informal interviews. Three follow up interviews were conducted. A co-researcher group discussed preliminary results, clinical challenges and ways forward. RESULTS: Being together with peers with food allergy was crucial, fostering belonging and normalisation. The shift in responsibility of managing the risk feels overwhelming and stressful during teen age. Self-understanding was influenced when managing food allergy in social contexts, inducing feelings of burden and isolation. Acceptance and understanding from social relations became important for all participants, and they all underlined desire for being viewed as individuals rather than being defined by their allergy. CONCLUSION: Support from other peers with food allergy is crucial for the participants. Transition to independently managing risks introduces uncertainty and social constraints, affecting self-understanding and interactions. Clinicians should prioritise peer support and empower teenagers in managing the risk and psychosocial challenges.

14.
Cleft Palate Craniofac J ; : 10556656241259885, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38831630

RESUMO

I've Just Seen a Face is a new resource produced by author Amy Mendillo and is designed for parents of children with cleft lip and/or palate to help them to navigate the first year of life. In this invited article, Kenny Ardouin provides an overview of the book, and offers perspective on the content contained within, including potential issues for professionals working with cleft to consider. The review ends with recommendations for likely beneficiaries of the book, as well as considerations for additional future versions of the book.

15.
J Youth Adolesc ; 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38864954

RESUMO

Students' academic engagement is greatly informed by a classroom's social climate. However, more research is needed regarding how specific peer behavior, especially prosocial behavior, come to shape academic engagement. The present study investigated whether students' perceptions about their classmates' prosocial behavior were associated with their academic engagement (cognitive, behavioral, affective) across the school year. Indirect effects via increases in students' own prosocial behavior were examined. Participants were 905 middle school students from rural, low-income communities in the Midwestern United States (50% girls, 46% boys; Mage = 12.94 years). Students completed self-report surveys in the fall and spring of the 2022-2023 school year. Results revealed that students' perceptions of their classmates' prosocial behavior were positively associated with students' own prosocial behavior. Students' own prosocial behavior was positively associated with all three dimensions of engagement. The positive indirect effect of classmates' prosocial behavior on engagement through students' own prosocial behavior was significant. The findings highlight the importance of classmates' behavior on individuals' academic engagement and offer insights into classroom-based interventions aimed at improving collective behavior.

16.
J Drug Educ ; : 472379241246368, 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38629144

RESUMO

We examined the prevalence of self-reported motivations and barriers to helping intoxicated peers among emerging adults (N = 377; Mage = 18.64; 75% women, 88% White) attending a Southeastern university and whether motivations and barriers differed by age, gender, race, and class standing. Respondents aged 19-24 were more likely to endorse the motivation item "Because it was your "turn" to be the helper/designated driver (DD) that night" than eighteen-year-olds. Race differences were also reported for the motivation item, "Because the person was your friend", where White participants were more likely to endorse this item than non-White participants. Men also reported more Burden/Hassles-related barriers than did women.

17.
Child Adolesc Ment Health ; 29(1): 33-42, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37431157

RESUMO

BACKGROUND: Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. METHOD: Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. RESULTS: SMA was significantly associated with greater sleep disturbance, ß = .11, 95% CI [.01, .21] and shorter sleep duration, ß = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, ß = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, ß = .24 [.15, .34], and peer problems, ß = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, ß = .13 [.04, .21], and attention problems, ß = .12 [.02, .22], and fewer peer problems, ß = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, ß = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. CONCLUSIONS: Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.


Assuntos
Comportamento Problema , Transtornos do Sono-Vigília , Adolescente , Criança , Humanos , Pais , Sono , Duração do Sono , Transtornos do Sono-Vigília/epidemiologia , Pré-Escolar
18.
J Gen Intern Med ; 38(16): 3460-3471, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37723366

RESUMO

BACKGROUND: Social isolation is a global public health threat. Veterans are particularly at risk for social isolation due to high rates of comorbid physical and mental health problems. Yet, effective interventions are limited. OBJECTIVES: Our primary objective was to assess the feasibility and acceptability of CONNECTED, a novel, transdiagnostic intervention to reduce social isolation that includes individual and group components and is delivered by peers via telehealth. Secondary objectives were to identify appropriate outcome measures and explore preliminary intervention effects. METHODS: This was a two-phase study. In Phase 1, to evaluate study feasibility, we surveyed 200 veterans to assess prevalence of social isolation and their interest in social connectedness interventions. In Phase 2, we employed a mixed-methods, pre-post study design in which we piloted CONNECTED with 19 veterans through 2 successive cohorts to further assess feasibility, to evaluate acceptability, and to explore preliminary effectiveness. Quantitative analyses involved descriptive and bivariate analyses as well as multivariate modeling. Qualitative interviews were analyzed using thematic analysis. RESULTS: For Phase 1, 39% of veterans surveyed were socially isolated. Participants who were ≤ 55 years old, caregivers, and those who experienced unmet social needs were more likely to report social isolation. Over 61% expressed interest in VA programs to reduce social isolation. For Phase 2, the pilot intervention, recruitment rate was 88% and the enrollment rate was 86%. Retention rates for the two cohorts were 80% and 50%, respectively, and satisfaction rates among intervention completers were 100%. Results also showed statistically significant improvements in social isolation (+ 5.91, SD = 4.99; p = .0028), social support (+ 0.74, SD = 1.09; p = .03), anxiety (-3.92, SD = 3.73; p = .003), and depression (-3.83, SD = 3.13; p = .001). Results for the other measures were not statistically significant. CONCLUSION: CONNECTED is a feasible and acceptable intervention and is likely to be an effective tool to intervene on social isolation among veterans.


Assuntos
Telemedicina , Saúde dos Veteranos , Humanos , Pessoa de Meia-Idade , Estudos de Viabilidade , Projetos Piloto , Isolamento Social
19.
Psychol Med ; 53(3): 966-976, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-34247667

RESUMO

BACKGROUND: Despite the fact that social deficits among individuals with autism spectrum disorder (ASD) are lifelong and impact many aspects of personal functioning, evidence-based programs for social skills training were not available until recently. The Program for the Education and Enrichment of Relational Skills (PEERS®) has been shown to effectively improve social skills for adolescents on the spectrum across different social cultures. However, the effectiveness for young adults beyond North America has yet to be examined. This study aimed to investigate the effectiveness of the PEERS intervention in Taiwanese young adults with ASD, and examine its durability and clinical correlates. METHODS: We recruited 82 cognitively-able young adults with ASD, randomized to the PEERS treatment or treatment-as-usual. RESULTS: Following treatment, significant improvement was found in aspects of social deficits, autism severity, social interaction anxiety, empathy, and social skills knowledge either by self-report or coach-report. Additionally, communicative behaviors rated by observers improved throughout the sessions, showing a trend toward more appropriate eye contact, gestures, facial expression during conversation, and appropriate maintenance of conversation and reciprocity. Most effects maintained at 3-month and 6-month follow-ups. The improvement of social deficits was positively correlated with baseline severity, while gains in social skills knowledge were positively correlated with IQ. The improvement of social deficits, autism severity, and empathy were positively correlated with each other. CONCLUSION: Overall, the PEERS intervention appears to effectively improve social functioning in Taiwanese young adults with ASD. Improvement of social response and knowledge may be predicted by baseline severity and intelligence respectively.


Assuntos
Transtorno do Espectro Autista , Habilidades Sociais , Adolescente , Humanos , Adulto Jovem , Transtorno do Espectro Autista/terapia , Grupo Associado , Ajustamento Social , Interação Social
20.
Stress ; 26(1): 2240909, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37489893

RESUMO

School burnout is a serious concern, as it impairs students' health and academic success. According to the Conservation of Resources Theory, burnout results from the depletion of personal coping resources and can be counteracted by supportive social relationships. However, it is not yet clear how students' relatedness with their peers is linked to their burnout. Next to students' self-reported fatigue, biomarkers such as telomere length (TL), which presents an indicator of aging, complement stress research. To identify school-related factors that may prevent students from experiencing burnout and to link TL to students' self-reported burnout, the current study investigated how relatedness with peers as well as TL at the beginning of the school year explained students' burnout at the end of the school year. The sample included 78 students (Mage = 13.7 ± 0.7 years; 48% girls). Results of multilevel analysis in Mplus indicate that, over the school year, students with higher TL and those who experienced relatedness with their peers reported lower levels of burnout. Moreover, students who felt related to their peers exhibited a longer TL. The study implies that students' relatedness with their peers may be a promising setscrew to prevent students' burnout and support their physical health. This is one of the first studies to link TL with school-related variables such as burnout and relatedness to peers in a non-clinical student sample, providing a baseline for interventions and future interdisciplinary studies in the field of education and stress.


Assuntos
Esgotamento Psicológico , Estudantes , Feminino , Humanos , Masculino , Esgotamento Psicológico/genética , Telômero/genética , Adolescente , Relações Interpessoais , Grupo Associado
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