Childhood embedded: childhood abuse and chronic physical health conditions over a 10-year period.

BACKGROUND: Childhood abuse is linked to experiencing multiple chronic health problems in midlife adults. Research has seldom examined whether childhood abuse is associated with a greater number of chronic physical health issues over time. The current study was to examine the contributions of childhood abuse on the development of chronic health conditions over a 10-year period. PARTICIPANTS AND SETTING: Data were taken from the study of Midlife Development in the United States. Using three waves of data, 661 married adults were included in the analysis. RESULTS: Using hierarchical regression, we found that childhood abuse was uniquely associated with the development of a greater number of chronic physical health conditions over a 10-year period. Post-hoc analysis found that neither gender nor age moderated the associations. CONCLUSIONS: Findings of the study indicate that childhood abuse was uniquely associated with a greater number of chronic physical health conditions over a 10-year period. These findings suggest that abuse in childhood may speed up biological aging and erode adult's health over time leaving adults vulnerable to chronic health conditions. Prevention efforts should assess adults for childhood abuse and the impact of childhood abuse on adult health over time may be preventable or more manageable.

A Phenomenological Exploration of Families' Experiences of the Mental Health System of Care in the Monadnock Region.

Accessing mental health treatment in rural locations is a unique challenge for families with youth experiencing adverse mental health conditions. Families often experience a variety of difficulties accessing and negotiating changes within the system of care. This study aimed to understand the experiences of families and their youth in navigating the mental health system in a rural community. Interpretative phenomenological analysis was used to examine how participants interpret their experiences within the local system of care. Qualitative interviews were conducted with eight families. Results included five main themes: youth experience, family experience, access to a system of care, relationships between stakeholders, and larger societal beliefs. Families highlighted their experiences accessing the local care system and their hope for strengthening community access and partnerships. Findings indicate that prioritizing family voices should be encouraged by local systems.

Incorporating Behavioral Health Providers onto Inpatient Medical Teams: A Feasibility Study.

Behavioral health providers (BHPs) have long been incorporated into clinical medical settings, however, they have yet to be included in inpatient hospital settings. Inclusion of BHPs in this setting is logical given the high rates of psychosocial problems experienced by hospitalized patients and because BHPs can effectively treat psychosocial challenges, including mental health disorders and behavioral health difficulties. We worked to determine the feasibility of incorporating BHPs onto the inpatient medical team and to discover if integrating BHPs onto the team could decrease the barriers present in standard consult-liaison models of care. Researchers collected information on patient and provider satisfaction with BHP services and tracked admission diagnosis, reasons for referral, and interventions delivered. Results indicated that the integration of BHPs onto the inpatient team is feasible and reduces numerous barriers. The incorporation of BHPs onto inpatient medical teams can mitigate barriers experienced within the current consult-liaison model.

The Longitudinal Association Between Childhood Abuse and Positive and Negative Family Interactions in Midlife and Older Adults: The Role of Mindfulness Meditation and Gender.

OBJECTIVES: Childhood abuse has been linked to problematic familial relationships in adulthood; however, it remains unclear what factors buffer the association. Mindfulness research has demonstrated promise in improving relationships among adults abused during childhood, but research has focused on couples, with fewer studies examining familial relationships. METHODS: Using a data sample of 2430 adults from the Midlife Development in the United States, the current study examined mindfulness as a moderator of childhood abuse and familial support and strain in adults. RESULTS: Analysis of hierarchical regression revealed that mindfulness was a moderator of childhood abuse and family strain over a 10-year period in women, but not men. However, mindfulness did not moderate childhood abuse and support. DISCUSSION: This examination of mindfulness in the context of familial relationships may help women more successfully manage negative familial interactions. Results indicate mindfulness-based interventions may be helpful in improving familial relationships among adults abused by family members in childhood.

A qualitative exploration of the feasibility of incorporating depression apps into integrated primary care clinics.

The use of mobile applications or "apps" is beginning to be identified as a potential cost-effective tool for treating depression. While the use of mobile apps for health management appears promising, little is known on how to incorporate these tools into integrated primary care settings-especially from the viewpoints of patients and the clinic personnel. The purpose of this study was to explore patient- and clinic-level perceptions of the use of depression self-management apps within an integrated primary care setting. Patients (n = 17), healthcare providers, and staff (n = 15) completed focus groups or semi-structured interviews in-person or via Zoom between January and July 2020. Participants were asked about barriers and facilitators to app use, how to best integrate it into care, and reviewed pre-selected mental health apps. Data were analyzed using a directed content analysis approach. From a patient perspective, features within the app such as notifications, the provision of information, easy navigation, and a chat/support function as well as an ability to share data with their doctor were desirable. Providers and staff identified integration of app data into electronic health records to be able to share data with patients and the healthcare team as well as clear evidence of effectiveness as factors that could facilitate implementation. All participants who reviewed apps identified at least one of them they would be interested in continuing to use. Overall, patients, healthcare providers, and staff believed depression apps could be beneficial for both patients and the clinic.

Recruiting Low-Income African American Men in Mental Health Research: A Community-Based Participatory Research Feasibility Study.

African Americans (AAs) are 20% more likely to develop serious psychological distress compared to Whites but are less likely to use mental health services. The study objective was to evaluate the effectiveness of recruitment strategies to engage AA fathers in a mental health intervention.Using the community-based participatory research (CBPR) approach, a community-academic partnership (CAP) developed and implemented direct and indirect referral strategies to engage AA fathers in a mental health intervention. Direct referral strategies focused on community partner identification of potentially eligible participants, providing information about the study (i.e., study flyer), and referring potential participants to the study. Indirect referrals included posting flyers in local businesses frequented by AA men, radio advertisements, and social media posts from community organizations.From January to October 2019, 50 direct and 1388 indirect referrals were documented, yielding 24 participants screened and 15 enrolled. Of all participants screened, 58% were referred through indirect referral, 38% were referred directly by community partners, and 4% of the participants were referred through both direct and indirect referrals. Twenty percent of those exposed to the direct referral methods and 1% of those exposed to the indirect referral methods were enrolled. The indirect referrals accounted for 60% of enrollment, whereas the direct referrals accounted for 33.3% of enrollment.Collaborating with the community partners to engage hard-to-reach populations in mental health studies allowed for broad dissemination of recruitment methods, but still resulted in low participant accrual. Additional focus on increasing direct referral methods appears to be a fruitful area of CBPR.