Strategies to promote language inclusion at 17 CTSA hubs.

The prioritization of English language in clinical research is a barrier to translational science. We explored promising practices to advance the inclusion of people who speak languages other than English in research conducted within and supported by NIH Clinical Translational Science Award (CTSA) hubs. Key informant interviews were conducted with representatives (n = 24) from CTSA hubs (n = 17). Purposive sampling was used to identify CTSA hubs focused on language inclusion. Hubs electing to participate were interviewed via Zoom. Thematic analysis was performed to analyze interview transcripts. We report on strategies employed by hubs to advance linguistic inclusion and influence institutional change that were identified. Strategies ranged from translations, development of culturally relevant materials and consultations to policies and procedural changes and workforce initiatives. An existing framework was adapted to conceptualize hub strategies. Language justice is paramount to bringing more effective treatments to all people more quickly. Inclusion will require institutional transformation and CTSA hubs are well positioned to catalyze change.

Training Psychiatrists in New Mexico: Reflections from Psychiatry Residents Who Participated in a Rural Track Versus a Traditional Program Alone over the Past Decade.

OBJECTIVE: With over 60% of rural Americans living in mental health professional shortage areas, there is a need for providing psychiatry residents training experiences in rural communities with the goal of increasing the likelihood that they will end up practicing in those same communities following graduation. The purpose of this study was to survey previous and current psychiatry residents, with the goal of describing the impact of the program on rural track residents compared to those in the traditional residency track. METHODS: Psychiatry residents 2010-2020 completed an online survey. For those who participated in the rural residency track, the survey asked additional questions regarding barriers experienced practicing in rural areas (e.g., professional isolation) and whether the goals of the rural track were met. RESULTS: Seventy-four residents completed surveys, with 26% in the "Rural Track Group" (RTG) and 74% in the "Non-rural Track Group" (NTG). More RTG reported they were more likely to practice in rural, frontier, or underserved areas after residency compared to NTG (74% versus 60%). Most RTG (72%) strongly agreed the rural program helped meet goals. Distance from family was a top barrier for current RTG (63%), followed by concerns about local schools, social isolation, and reduced career opportunities for partners (45%). CONCLUSIONS: Residents of the RTG were more likely to consider a career in a rural area than those of the traditional program alone. Psychiatry residency requirements should be reviewed to address top rural training barriers to promote retention in rural areas.

Community health worker insights on promoting research engagement with diverse populations.

Representation of diverse populations in health research enhances our ability to understand the factors that impact health, generalize results, implement findings, and promote social justice. The primary objective of the study was to understand the unique perspectives of frontline community health workers (CHWs) to identify actionable barriers and facilitators that may impact representation of diverse groups in health research. Focus groups with CHWs were conducted followed by thematic analysis. Results revealed five main themes: barriers/risks to research participation, facilitation of research, CHW roles, recommendations, and transparency. A novel finding was that some CHWs see themselves as both facilitators and gatekeepers. As facilitators, CHWs ensure their patient populations receive resources and benefit from being involved in research; as gatekeepers CHWs feel that they protect patient populations from experiencing further trauma, especially when engaging in research. Recognizing that in many communities there is a high reliance and trust with CHWs, can promote genuine and informed participation at all stages of research.

Effectiveness of Peer-Delivered Trauma Treatment in a Rural Community: A Randomized Non-inferiority Trial.

This randomized controlled non-inferiority trial explored the effectiveness of Seeking Safety (SS) delivered by peer providers compared to its delivery by licensed behavioral health clinicians. The study enrolled 291 adults with PTSD and/or substance use disorders. Data were collected at 3 and 6-months post start of treatment. With respect to long-term outcomes, at 6 months PTSD symptoms decreased by 5.1 points [95% CI (- 9.0, - 1.1)] and by 4.9 points [95% CI (- 8.6, - 1.1)] and coping skills increased by 5.5 points [95% CI (0.4, 10.6)] and by 5.6 points [95% CI (0.8, 10.4)], in the peer- and clinician-led groups, respectively. This study demonstrated non-inferiority of peer-delivered SS compared to clinician-delivered SS for reducing PTSD symptoms and similar outcomes for both groups with respect to coping skills. A confirmatory study on the effectiveness of peer-delivered trauma-specific services is warranted, especially given the potential for increasing access to such treatment in underserved rural communities.

Perceived helpfulness of peer-delivered trauma specific treatment: A randomized controlled trial.

Peer providers have been associated with positive outcomes in behavioral health, but little is known about the perceived helpfulness of their services. We used a mixed-methods randomized controlled trial to compare the perceived helpfulness of seeking safety (SS) led by peer providers compared to its delivery by licensed behavioral health clinicians (including both a licensed alcohol and drug abuse counselor and licensed clinical mental health counselor). Participants (N = 278) rated the helpfulness of 12 SS topics at the end of every session. A subset (n = 245) of participants also rated the helpfulness of SS overall and its treatment components; 3 and 6 months following their first SS group. We also collected qualitative data to inform our understanding of the ways perceived helpfulness varied among participants in peer-led (PL) and clinician-led (CL) groups. Ratings of overall and topic-specific helpfulness were high among both groups, and while ratings were slightly higher among participants in PL groups, the difference was not significant. Participants in PL-SS rated certain treatment components significantly more helpful compared to participants in CL-SS, including the focus on learning coping skills (81.6% PL vs. 64.9% CL, p = .020) and safety as a priority of treatment (81.6% PL vs. 61.5% CL, p = .006). Because of the homogeneity of helpfulness ratings, the relationship between perceived helpfulness and treatment retention and outcomes could not be examined. Future research on this association is warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Self-regulation and working memory in musical performers.

Performing music in front of others can be stressful, even for experienced performers. The physiological effects of stress, namely, increases in cortisol and sympathetic nervous system activity, have been shown to have detrimental effects on cognition, particularly working memory. This study used an audition-like performance scenario to elicit a stress response in performers who differed in their degree of musical experience. We expected that participants with more musical experience would be better able to regulate their stress response, would report lower levels of anxiety, insecurity, and nervousness, and would show better working memory following the stressor, compared to participants with less musical experience. Although we did not find differences between more and less experienced performers in their sympathetic nervous system activity or their self-reported feelings of anxiety and nervousness, we did find some important differences: following the stressor, more experienced performers were less insecure, they showed better regulation of their cortisol response, and they demonstrated better working memory.

Does visual information influence infants' movement to music?

Humans are often exposed to music beginning at birth (or even before birth), yet the study of the development of musical abilities during infancy has only recently gained momentum. The goals of the present study were to determine whether young infants (ages four to seven months) spontaneously moved rhythmically in the presence of music, and whether the presence of visual information in addition to music would increase or decrease infants' movement. While nearly all infants moved in the presence of music, very few infants demonstrated rhythmic movement. Results revealed that, when visual information was present, and particularly when infants appeared to show focused attention toward the visual information, infants moved less than when only auditory information was present. The latter result is in agreement with most studies of sensory dominance in adults in which visual stimuli are dominant over auditory stimuli.