A cognitive-behavioral skills building program improves mental health and enhances healthy lifestyle behaviors in nurses and other hospital employees.

BACKGROUND: Mental health outcomes in nurses have historically indicated a greater prevalence of anxiety, depression, and suicide than the general population. It is vital to provide programming for healthcare workers to gain the necessary skills to reduce burnout and improve their mental and physical health. AIMS: The aims of this study were to evaluate mental health outcomes and healthy lifestyle beliefs and behaviors among nurses and other hospital employees who completed MINDBODYSTRONG, a cognitive-behavioral skill building program. METHODS: A pre-experimental, pre- and poststudy design was used to examine mental health and well-being outcomes among 100 hospital personnel who participated in MINDBODYSTRONG, a program designed to improve coping and resiliency and decrease stress, anxiety, and depressive symptoms. Outcomes measured included healthy lifestyle behaviors, healthy lifestyle beliefs, anxiety, depression, stress, and burnout. RESULTS: One hundred hospital personnel, including 93 nurses, completed the pre- and post-survey. Among all participants, post- MINDBODYSTRONG scores for healthy lifestyle beliefs (p = .00; Cohen's d = 0.52) and healthy lifestyle behaviors (p = .00; Cohen's d = -0.74) increased significantly with medium effects, while depression (p = .00; Cohen's d = -0.51), anxiety (p = .00; Cohen's d = -0.54), stress (p = .00; Cohen's d = -0.33), and burnout (p = .00; Cohen's d = -0.37) decreased significantly with small and medium effects. The program produced even stronger positive effects on mental health outcomes for participants who started the study with higher levels of depression and anxiety. LINKING EVIDENCE TO PRACTICE: Anxiety, depression, stress, and burnout decreased significantly postintervention. Participants also significantly improved their healthy lifestyle beliefs and behaviors with the MINDBODYSTRONG program. MINDBODYSTRONG is an effective program that reduces anxiety, depression, burnout, and stress and improves healthy lifestyle beliefs and behaviors in hospital-based clinicians. It is of utmost importance to provide evidence-based programs to improve mental resiliency and decrease stress, anxiety, burnout, and depressive symptoms, which will ultimately improve the safety and quality of health care.

Associations Among Nurses' Mental/Physical Health, Lifestyle Behaviors, Shift Length, and Workplace Wellness Support During COVID-19: Important Implications for Health Care Systems.

Work cultures supportive of wellness and shorter shift length have been associated with better mental/physical health outcomes in nurses, but how the coronavirus disease-19 (COVID-19) pandemic impacted such outcomes is not known. This study's aims were to (1) describe the mental/physical health, well-being, and healthy lifestyle behaviors of nurses during the pandemic; (2) explore the pandemic's impact on their health and healthy lifestyle behaviors; and (3) determine the associations of perceived workplace wellness support and shift length with nurses' health, well-being, and healthy lifestyle behaviors. A cross-sectional descriptive design was used with 264 nurses associated with Trusted Health. Nurses completed a survey containing valid and reliable scales measuring depression, anxiety, burnout and quality of life, perceived wellness culture, and healthy lifestyle behaviors. Results indicated that more than 50% of nurses had worsening mental/physical health relating to the pandemic. Compared with nurses whose workplaces provided little/no wellness support, nurses with workplaces that supported their wellness were 3 to 9 times as likely to have better mental/physical health, no/little stress, no burnout, and high quality of life. Nurses who worked longer shifts had poorer health outcomes. These findings indicate that workplace wellness support and shorter shifts positively impacted nurse mental/physical health and professional quality of life amidst the pandemic.

Evidence, expertise, and patient/family preferences to maximize health for older adults with implications for evidence-based practice.

BACKGROUND: As Americans live longer and with chronic conditions, the healthcare system, researchers, faculty, practicing providers, patients, and families must adapt to changing societal needs and goals. AIMS: The aim of this commentary was to offer recommendations that align with the six vital directions to improve the health care and quality of life for older Americans. METHODS: This article expands upon the six vital directions from an evidence-based practice (EBP) perspective that values the three legs of the EBP stool: (1) research evidence, (2) clinician expertise, and (3) patient preferences, values, and circumstances. RESULTS: The recommendations reflect the scientific literature, our expertise in EBP and research, our nursing roles and expertise, and our experiences in the care of our older parents. By sharing our experiences as nurse scientists and daughters, we offer insight to raise the healthcare bar for older adults through EBP and meaningful, person-centered care. LINKING ACTION TO EVIDENCE: Vital directions for improving the health care and quality of life for older Americans include promoting interprofessional education to create an adequately prepared workforce; researching and implementing pathways to minimize the social determinants of health for older adults; disseminating findings that remediate older adult health disparities; innovating approaches for managing chronic health conditions at home; and studying and implementing approaches for allocating resources for end-of-life care that are satisfying for the patients, their family, and clinicians.

Chronic Pain and Mental Health Co-Morbidity in Adolescents: An Urgent Call for Assessment and Evidence-Based Intervention.

BACKGROUND: Nearly 30% of children are affected by chronic pain which puts a significant burden on the child's family and society with estimated cost of over $19.5 billion each year. Children and adolescent's quality of life is often impacted leading to physical disability, low self-esteem, depression, anxiety, school stress or decreased performance, insomnia, and fatigue. The purposes of this paper are to: 1) provide an overview of chronic pain in children and adolescents; 2) describe findings from a quality improvement project that assessed the prevalence of negative mood, quality of life, functional disability, and coping with pain in teens with chronic pain, and 3) discuss screening, assessment and evidence-based management of co-morbid chronic pain and mental health problems in children and teens. FINDINGS: Findings for a quality improvement project indicated that 16.8% of the adolescents scored high risk for depression, which was higher than the national average. Approximately 57% of adolescents were screened as high risk on the Pediatric Quality of Life inventory (PedsQL™). One in four adolescents showed poor functioning on the Functional Disability Inventory and nearly one-third of the adolescents reported poor coping with pain on the Pain Coping Questionnaire. This project indicates that adolescents with chronic pain are at high risk for mental health problems. The outcomes suggest the mental health needs of adolescents with chronic pain need to be identified and addressed to help improve outcomes. DISCUSSION: Children and youth with chronic pain need to be routinely screened and assessed for mental health problems, especially anxiety and depression. The use of Cognitive Behavioral Therapy (CBT) or CBT-skills building for children and youth with anxiety and depressive disorders has been widely studied and are helpful for children with chronic pain include psychoeducation, which helps the child to learn age and developmental specific information on chronic pain. Evidence-based manualized and internet-based CBT programs should be scaled rapidly to decrease depression and anxiety in children and youth with chronic pain.

The Fuld Institute for EBP Community Core: Supporting the Patient Perspective in EBP for Optimal Health and Wellness.

Health information and communication fall within patient preferences in evidence-based practice. Now more than ever, patients and families in the community have free access to "evidence" and healthcare information on the internet. However, is that information trustworthy, and how can we encourage people to use evidence to promote their optimal health and wellness? The recent rise of global spread of mis- and disinformation through social media outlets has affected public health. There is growing recognition that social media platforms provide magnified podiums leading to unfortunate outcomes. While much work has been done during the COVID-19 pandemic to address health misinformation, there is still much more work to do. We must respond to the widespread misinformation as a collective healthcare community to prevent poor healthcare decisions. Urging the public to be alert to information spread, assess the quality of health information (and whether it is evidence-based), and use shared decision-making tools is a path we can travel together.

The MINDBODYSTRONG Intervention for New Nurse Residents: 6-Month Effects on Mental Health Outcomes, Healthy Lifestyle Behaviors, and Job Satisfaction.

BACKGROUND: In 2017, the National Academy of Medicine convened its Action Collaborative for Clinician Well-being and Resilience in an effort to stem the epidemic levels of burnout, depression, and suicide among healthcare clinicians. Nurses report higher rates of substance abuse, depression, and suicide than the national average. Newly licensed registered nurses (NLRNs) report high levels of burnout and stress. Suboptimal health in nurses is linked to medical errors. Few studies address the mental health and lifestyle behaviors of NLRNs or provide evidence-based solutions to improve these outcomes. AIMS: This study evaluated the 6-month effects of the MINDBODYSTRONG for Healthcare Professionals program on the mental health, healthy lifestyle behaviors, and job satisfaction of NLRNs participating in a nurse residency program. METHODS: A two-group randomized controlled trial was conducted with 89 NLRNs at a large, Midwestern academic medical center. The intervention group received eight 30- to 35-min weekly sessions as part of the MINDBODYSTRONG program, a cognitive behavioral skill-building program incorporating strategies to improve mental and physical health. The control group acted as the attention control group receiving eight weekly 30- to 35-min debriefing sessions as part of the normal nurse residency program. RESULTS: Data were collected at baseline, immediately postintervention, 3 months postintervention, and 6 months postintervention. The intervention group scored better on mental health outcomes, healthy lifestyle behaviors, and job satisfaction at 6 months postintervention than the control group. Significant improvements were found for depressive symptoms and job satisfaction; there were moderate to large positive effects for the MINDBODYSTRONG program on all variables. LINKING EVIDENCE TO ACTION: The MINDBODYSTRONG program sustained its positive effects across time and has excellent potential as an evidence-based intervention for improving the mental health, healthy lifestyle behaviors, and job satisfaction in NLRNs.

Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students.

BACKGROUND: Graduate and professional students are reported to have higher than average rates of depression compared to age- and gender-matched populations. Further, more than half of student health visits are due to anxiety, yet little is known about the relationships among depression, anxiety, and healthy lifestyle behaviors in this population as well as what factors predict depression and anxiety. AIMS: The purposes of this study were as follows: (a) to examine the prevalence of depression, anxiety, stress, physical health, healthy beliefs, and lifestyle behaviors in incoming first-year health sciences professional students; (b) to describe the relationships among these variables; and (c) to determine predictors of depression and anxiety. METHODS: A descriptive correlational study design was used with baseline data collected from first-year graduate health sciences students from seven health professions colleges who were participating in a wellness onboarding intervention program, including Dentistry, Medicine, Nursing, Optometry, Pharmacy, Social Work, and Veterinary Medicine. RESULTS: Seventeen percent of incoming students reported moderate-to-severe depressive symptoms with 6% reporting suicidal ideation. In addition, 14% of the participating students reported moderate-to-severe anxiety. Factors that predicted depression and anxiety included having less than 7 hr of sleep per night, worse general health, lower healthy lifestyle beliefs, lower healthy lifestyle behaviors, higher stress, and a perceived lack of control. LINKING EVIDENCE TO ACTION: These findings highlight the need to routinely screen incoming health sciences students for depression and anxiety upon entrance into their academic programs so that evidence-based interventions can be delivered and students who report severe depression or suicidal ideation can be immediately triaged for further evaluation and treatment. Providing cultures of well-being and emphasizing self-care throughout academic programs also are essential for students to engage in healthy lifestyles.

Intervention Effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on Newly Licensed Registered Nurses' Mental Health, Healthy Lifestyle Behaviors, and Job Satisfaction.

OBJECTIVE: The purpose of this study was to evaluate the effects of the MINDBODYSTRONG for Healthcare Professionals Program on stress, anxiety, depressive symptoms, healthy lifestyle behaviors, and job satisfaction on newly licensed RNs (NLRNs) participating in a nurse residency program. BACKGROUND: The constellation of burnout, depression, and suicide in clinicians is a public health epidemic that affects the quality and safety of healthcare. The National Academy of Medicine's Action Collaborative on Clinician Well-being and Resilience has called for an increase in evidence-based interventions to combat this alarming problem. The MINDBODYSTRONG Program is a novel adaptation of an evidence-based cognitive behavioral skills-building intervention that provides a theory-based approach to improve the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction of NLRNs. METHODS: A 2-group, cluster randomized controlled trial was used with 89 new nurses participating in a new-graduate nurse residency program. The experimental intervention, MINDBODYSTRONG, consisted of 8 manualized weekly 45-minute sessions. Data were collected at baseline, immediately following, and 3 months after intervention that measured stress, depressive symptoms, anxiety, healthy lifestyle beliefs and behaviors, and job satisfaction. Repeated-measures analysis of variance was used for data analysis. RESULTS: The intervention group scored significantly better with moderate to large positive effects on the mental health variables as well as healthy lifestyle beliefs and healthy lifestyle behaviors at both follow-up time points compared with the attention control group. Moderate to large positive effects also were found for job satisfaction. CONCLUSIONS: The MINDBODYSTRONG Program has excellent potential as an evidence-based intervention for improving the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction, in NLRNs.

A systematic review of mediators of physical activity, nutrition, and screen time in adolescents: Implications for future research and clinical practice.

BACKGROUND: Adolescents are not meeting current recommendations for daily physical activity, nutrition, and screentime which has been associated with overweight and obesity. Understanding the mediators that facilitate teens in improving their healthy lifestyle behaviors may be helpful in halting this crisis. PURPOSE: The purpose of this systematic review was to assess published findings regarding mediators of adolescent energy balance behaviors. METHOD: We followed the Institute of Medicine guidelines for completing a systematic review. DISCUSSION: Fourteen analyses from 12 studies were included with mediating variables tested for nutrition, physical activity, and screen time. Mediators were identified for all three behaviors and were primarily on the individual level of the social ecological model. CONCLUSIONS: Combining findings from this and other reviews of mediators can help guide researchers in choosing mediating factors for specific target behaviors.

COPE: A Pilot Study With Urban-Dwelling Minority Sixth-Grade Youth to Improve Physical Activity and Mental Health Outcomes.

Approximately one in three preadolescents (34%) is obese/overweight and one in four (25%) experience a mental health issue. Urban youth suffer from higher rates of these problems, and at earlier ages than their peers. This study's purpose was to determine feasibility/acceptability and preliminary effects of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotion, Exercise, and Nutrition) intervention on physical activity (PA) and mental health outcomes of 11- to 13-year-olds. A one group pre- and posttest design was used in a Midwest urban middle school. Preadolescents (n = 31) who received COPE reported significant decreases in anxiety and increases in healthy lifestyle beliefs and PA. Further, preadolescents at baseline with elevated anxiety, depression, suicide risk, and below average self-concept who received COPE reported significant increases in self-concept and decreases in anxiety, depression, and suicidal ideation. The COPE program is a promising intervention that can improve physical and mental health outcomes.

Enhancing Pediatric Mental Health Care in an Outpatient Primary Care Setting Using the Keep Your Children/Yourself Safe and Secure (KySS) Program: A Multidisciplinary Quality Improvement Project.

INTRODUCTION: This project aimed to enhance access to pediatric mental primary health care. METHOD: The Keep Your Children/Yourself Safe and Secure (KySS) training was offered to a multidisciplinary team at a Federally Qualified Health Clinic in the Midwest United States. Confidence was measured using the Healthcare Provider Confidence Scale (HPCS). Frequencies of visits and mental health referrals were compared preintervention/postintervention. HPCS scores were compared using Wilcoxon rank-sum and Cohen's d. RESULTS: Referrals in 2022 were greater than in 2020 but less than in 2021 (p = .25). The total number of visits declined from 431 in 2021 to 385 in 2022. HPCS (n = 9) scores trended higher following the KySS Program in prescribing and general positive beliefs. DISCUSSION: Referrals to mental health providers increased, although not significantly. The number of mental health visits varied between 2020-2022. Provider confidence was not significantly affected, whereas beliefs in prescribing did increase significantly. More work is necessary to understand the impact of delivery to a multidisciplinary team.

Improving Self-Reported Person-centered Care Competency in Nursing Students: A Pilot Study Using Interactive Case Studies.

BACKGROUND: To prepare nursing students to deliver high-quality care, educators need strategies to foster person-centered care (PCC). PURPOSE: This pilot study evaluated an intervention with interactive case studies on undergraduate nursing students' PCC competency. METHODS: We conducted a pilot study with sophomore undergraduate nursing students (n = 39) from a Midwestern US university. We developed a 90-minute class seminar with interactive case studies highlighting how patient preferences, values, and circumstances could influence fall risk. We assessed PCC using the Patient-Centered Care Competency Scale. RESULTS: Although there was no statistically significant change in overall PCC competency before and after the intervention, we noted a small to medium effect size on PCC competency per Cohen's d standards (d = 0.35). Content analysis of students' open-ended responses reflected PCC and clustered into 5 themes. CONCLUSIONS: Findings suggest that educators may use interactive case studies to foster nursing student PCC competency.

Effects of Two Group Prenatal Care Interventions on Mental Health: An RCT.

INTRODUCTION: Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined. STUDY DESIGN: This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content. SETTING/PARTICIPANTS: Black and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate. INTERVENTION: Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting. MAIN OUTCOME MEASURES: Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors. RESULTS: There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased. CONCLUSIONS: Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens. TRIAL REGISTRATION: This study is registered with clinicaltrials.gov NCT03416010.

A study protocol for the modified interactive screening program plus MINDBODYSTRONG© RCT: A mental health resiliency intervention for nurses.

BACKGROUND: Nurses, the largest workforce in healthcare, are at high risk of depression, anxiety, burnout, and suicidal ideation. Suicide among nurses is higher than the general population. This randomized controlled trial pairs the MINDBODYSTRONG© cognitive-behavioral skills building program with the American Foundation for Suicide Prevention's (AFSP) Modified Interactive Screening Program (mISP) to reduce depression, suicidal ideation, post-traumatic stress, anxiety, and burnout, and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in nurses with moderate to high risk of suicide. AIMS: This study aims to determine the effects of the mISP combined with the digitized MINDBODYSTRONG© program versus the mISP alone on depression, suicidal ideation, burnout, anxiety, post-traumatic stress, healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in 364 U.S. nurses. METHODS: A digitized version of MINDBODYSTRONG© combined with the mISP screening and referral platform will be compared to the AFSP mISP alone through a two-arm randomized controlled trial. Follow-up post-intervention data will be collected at week eight and months three, six, and 12. DISCUSSION: If successful, this study's findings could assist nurses who are hesitant to use conventional mental health resources by providing them with confidential aid and learning opportunities to reduce suicidality, depression, anxiety, post-traumatic stress, and burnout and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction. TRIAL/STUDY REGISTRATION: The Ohio State University Protocol Record 2021B0417, Modified Interactive Screening Program Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses, is registered and posted at ClinicalTrials.gov Identifier: NCT05582343. First posted date is October 17, 2022.

Creating a Community Advisory Board.

ABSTRACT: Health leaders in an academic setting sought to engage with community members to gain insight into their health information needs. Using evidence-based practice methodology, they established a community advisory board that represents and articulates patients' perspectives, which are then incorporated into educational efforts to assist the public in using evidence to make health decisions.

Depression, anxiety, and stress in pregnant Black people: A case for screening and evidence-based intervention.

BACKGROUND: Guidelines call for pregnant people to be screened for depression and anxiety. Screening may be particularly important for pregnant Black individuals who are reported to be more likely than non-Hispanic White pregnant people to experience prenatal stress, anxiety, and depressive symptoms. The purpose of this study was to determine if depression, anxiety, and stress co-occur in pregnant Black people and to identify which demographic factors are related to these mental health concerns. METHODS: A subset analysis of an ongoing randomized controlled trial examined the risk of coexisting mental health conditions in pregnant Black people who screened eligible to participate (that is, they had high levels of depression, anxiety, and/or stress) in two urban clinics using a descriptive correlational design. RESULTS: Of the 452 pregnant Black people who were screened for eligibility, 194 (42.9%) had elevated scores on depression, anxiety, and/or stress measures and were enrolled in the larger study. The average scores of the 194 enrolled participants were anxiety, mean (M) = 9.16 (standard deviation [SD] = 4.30); depression, M = 12.80 (SD = 4.27); and stress, M = 21.79 (SD = 4.76). More than one-third (n = 70, 36.1%) experienced two symptoms and 64 (33.0%) reported all three symptoms. CONCLUSION: Pregnant Black individuals experience high levels of comorbid mental health distress including depression, anxiety, and stress. The findings indicate that treatment for mental health concerns needs to be broad-based and effective for all three conditions. Prenatal interventions should aim to address mental health distress through screening and treatment of depression, anxiety, and stress, especially for pregnant Black individuals. This study furthers understanding of the prevalence of prenatal mental health conditions in pregnant Black people.

Effects of the MINDSTRONG© CBT-based program on depression, anxiety and healthy lifestyle behaviors in graduate health sciences students.

ObjectiveTo evaluate effects of the MINDSTRONG© cognitive-behavioral skills building program versus an attention control program on mental health outcomes and lifestyle behaviors of graduate health professional students. Participants: 201 entering graduate students from seven health sciences colleges at a public land grant University in the U.S. Midwest. Methods: A randomized controlled trial was conducted with three-month follow-up. Valid and reliable instruments measured depression, anxiety, stress, healthy lifestyle beliefs and healthy lifestyle behaviors. Results: Students receiving MINDSTRONG© reported less depression/anxiety and healthier lifestyle behaviors than those receiving the control program. Students with elevated levels of depression/anxiety at baseline demonstrated greater benefits from the program. Conclusions: MINDSTRONG© can be used as a preventive and early intervention for improving mental health outcomes and lifestyle behaviors in graduate students. Because the program can be delivered by trained non-mental health professionals, it has the potential to be widely scaled on campuses throughout the U.S.

Effects of a cognitive-behavioral skills building program on the mental health outcomes and healthy lifestyle behaviors of veterinary medicine students.

OBJECTIVE: To evaluate the effects of a cognitive-behavioral skills building program (ie, MINDSTRONG; The Ohio State University) on the mental health outcomes and healthy lifestyle beliefs and behaviors of Doctor of Veterinary Medicine (DVM) students. Sample: DVM students (n = 62) before beginning their program at a large public Midwest land-grant university. Procedures: All 171 incoming DVM students (class of 2024) were required to take the cognitive-behavioral skills building program (7 weeks in length) before starting their 2020 school year. Students were given the option to consent to the study portion of the program. Consenting participants completed a pre- and postsurvey containing demographic questions and 5 valid and reliable scales, including the Patient Health Questionnaire-9 that assesses depressive symptoms, the Generalized Anxiety Disorder-7 that evaluates anxiety, the Brief Inventory of Perceived Stress that measures stress, and the Healthy Lifestyle Beliefs and Healthy Lifestyle Behaviors scales. Descriptive statistics described sample characteristics, paired t tests assessed changes over time in the outcomes Personal Wellness Assessment, and Cohen's d determined effect sizes. Results: 62 DVM students completed both surveys. Postintervention, students had significant improvements in depressive symptoms, anxiety, and healthy lifestyle beliefs and behaviors. Clinical Relevance: Although this study used a small convenience sample of DVM students from a single university, a cognitive-behavioral skills building program demonstrated the ability to decrease rates of depression, anxiety, and suicidal ideation and improve healthy lifestyle beliefs and behaviors. Requiring DVM students to participate in such programming could provide benefit during their professional education and throughout their careers.

Adolescents as Agents of Parental Healthy Lifestyle Behavior Change: COPE Healthy Lifestyles TEEN Program.

INTRODUCTION: Obesity is a leading health crisis around the world. An intervention strategy scarcely utilized for behavior change is that of a child as change agent. The purpose of this study was to describe the impact of teens reviewing newsletters from a healthy lifestyle intervention with their parents. METHOD: Evaluation data from a randomized controlled trial, COPE Healthy Lifestyle TEEN Program, was analyzed. A descriptive study was conducted of parents' and teens' lifestyle behaviors as reported by parents. RESULTS: One hundred sixty-nine parents completed evaluations. Two thirds of parents reported changing a behavior as a result of the program. Nearly three quarters of parents reported behavior changes in their teens. Over 90% reported they would recommend this or a similar program. DISCUSSION: The obesity epidemic shows no signs of reversal, and hence multiple approaches to impact healthy lifestyles are urgent. Including children as a change agent is a potential target for interventions addressing obesity.

Randomized controlled trial of the COPE-P intervention to improve mental health, healthy lifestyle behaviors, birth and post-natal outcomes of minority pregnant women: Study protocol with implications.

BACKGROUND: Emotionally distressed pregnant minority women experience multiple adverse outcomes, including pre-eclampsia, preterm birth, operative deliveries and low birth weight. Although the United States Preventive Services Task Force recommends screening in pregnant women, many practices do not screen because efficacious interventions and systems are not in place to treat them. AIM: Purpose of this randomized controlled trial (RCT) is to test a group delivered manualized cognitive-behavioral skills building intervention entitled COPE-P versus an attention control program on the mental health, birth and postpartum outcomes of minority pregnant women experiencing depressive, anxiety and stress symptoms. METHODS: Design is a longitudinal randomized block RCT with repeated measures (beginning with screening prior to 18 weeks, group prenatal care in both groups from 16 + 1 to 31 + 1 weeks and ending at 6 months postpartum) at two study sites (New York city and Columbus, Ohio). Race/ethnicity is being blocked to ensure equal numbers of Hispanic and Black women. 384 women are being recruited from antenatal clinics if they are: between 18 and 40 years; in an uncomplicated singleton pregnancy <18 weeks; and self-identify as Black or Hispanic. Valid and reliable measures are being used to assess healthy lifestyle behaviors and mental health outcomes immediately following the interventions, six - eight weeks postpartum and at the children's six-month well baby visit. Birth and delivery outcomes also are being assessed. CONCLUSION: If found to be efficacious, the COPE-P intervention could be a key solution to managing those with emotional distress and improving their outcomes.