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1.
Article in English | MEDLINE | ID: mdl-38963477

ABSTRACT

Standard models of well-child care may not sufficiently address preventive health needs of immigrant families. To augment standard individual well-child care, we developed a virtual group-based psychoeducational intervention, designed to be delivered in Spanish as a single, stand-alone session to female caregivers of 0-6 month-olds. The intervention included a video testimonial of an individual who experienced perinatal depression followed by a facilitated discussion by the clinic social worker and an orientation to relevant community resources by a community health worker. To assess feasibility and acceptability of the intervention, we conducted an open pilot within an academic pediatric practice serving predominantly Latinx children in immigrant families. Participants included 19 female caregivers of infants attending the practice, of whom 16 completed post-intervention measures and 13 completed post-intervention semi-structured interviews. Quantitative measures of acceptability and satisfaction with the intervention were high. We found preliminary effects of the intervention on postpartum depression knowledge and stigma in the expected direction. In interviews, participants described increases in their familiarity with postpartum depression and about relevant community resources, including primary care for caregivers. Participants reported an appreciation for the opportunity to learn from other caregivers and provided suggestions for additional topics of interest. Trial registration: Registered 6/21/22 as NCT05423093.

2.
Trauma Violence Abuse ; : 15248380241255735, 2024 Jun 21.
Article in English | MEDLINE | ID: mdl-38903028

ABSTRACT

Youth exposure to violence increases the risk of poor mental and physical health outcomes lasting into adulthood. Traumatic stress is an outcome of particular concern as the physiological stress response impacts the developing brain. Recently, youth exposure to police violence has been conceptualized as an adverse childhood experience that may impact traumatic stress. To examine this possibility, we conducted a systematic review, drawing upon five databases to gather the existing quantitative and qualitative peer-reviewed research on exposure to police violence and traumatic stress in youth. Searches yielded 27 relevant articles utilizing various study designs: thirteen quantitative, thirteen qualitative, and one mixed method. Twenty-six of the 27 studies found evidence of a relationship between police violence exposure and traumatic stress in youth. Police violence was associated with youth traumatic stress across three types of exposures: direct, vicarious, and anticipated. Studies also explored differential impacts by race and gender. The review revealed current gaps in the literature, such as a lack of data on select sociodemographic groups (e.g., rural youth, LGBTQ+ youth) and potential protective factors (e.g., resilience and school connectedness). In line with the findings, we put forth a research agenda as well as policy and practice recommendations to improve police interactions with youth and mental health services for youth who have been exposed to police violence. Recommendations include improving systematic data collection to track all types of police violence exposure, creating spaces for positive police interactions with youth, and training mental health practitioners to support youth exposed to police violence.

3.
Am J Community Psychol ; 73(3-4): 541-553, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38303603

ABSTRACT

Neighborhoods are one of the key determinants of health disparities among young people in the United States. While neighborhood deprivation can exacerbate health disparities, amenities such as quality parks and greenspace can support adolescent health. Existing conceptual frameworks of greening-health largely focus on greenspace exposures, rather than greening interventions. In this paper, we develop and propose a Greening Theory of Change that explains how greening initiatives might affect adolescent health in deprived neighborhoods. The theory situates greening activities and possible mechanisms of change in the context of their ability to modify distal social determinants of health factors, stemming from macrostructural and historical processes that lead to resource inequalities, affecting both the social and built environment in which adolescents live and develop. The framework illustrates both short- and long-term health, economic, and security effects of greening. We also describe how the theory informed the development of Project VITAL (Vacant lot Improvement to Transform Adolescent Lives) in Baltimore, MD, which aims to (1) build a citywide sharable database on vacant lot restoration activities, (2) evaluate the impact of greening initiatives on adolescent health outcomes, (3) conduct cost-effectiveness analyses, and (4) develop best practices for greening programs for improved adolescent health.


Subject(s)
Adolescent Health , Health Status Disparities , Residence Characteristics , Humans , Adolescent , Baltimore , Social Determinants of Health , Parks, Recreational , United States
4.
Health Promot Pract ; : 15248399231193002, 2023 Aug 22.
Article in English | MEDLINE | ID: mdl-37605565

ABSTRACT

This article describes the virtual implementation of Photovoice activities conducted as part of a project that sought to gather youths' perspectives on neighborhood and housing conditions, community redevelopment, and health and well-being in Baltimore. We discuss the original in-person design and how activities were implemented virtually, in light of coronavirus disease 2019 (COVID-19) physical distancing guidelines. Challenges to virtual implementation included establishing rapport with youth and families during recruitment and data collection, encouraging active participation during discussion sessions, and varying technological skills among youth. Facilitators of virtual implementation included partnering with a community organization, piloting virtual sessions to assess participant's technology skills, and providing various ways for youth to participate during discussion sessions, engage in group activities, and receive hands-on instruction. This article showcases the ways in which virtual implementation of Photovoice activities can be successfully implemented with youth and provides recommendations for future Photovoice projects that include virtual activities.

5.
JMIR Mhealth Uhealth ; 11: e43990, 2023 06 16.
Article in English | MEDLINE | ID: mdl-37327031

ABSTRACT

BACKGROUND: Interest in quitting smoking is common among young adults who smoke, but it can prove challenging. Although evidence-based smoking cessation interventions exist and are effective, a lack of access to these interventions specifically designed for young adults remains a major barrier for this population to successfully quit smoking. Therefore, researchers have begun to develop modern, smartphone-based interventions to deliver smoking cessation messages at the appropriate place and time for an individual. A promising approach is the delivery of interventions using geofences-spatial buffers around high-risk locations for smoking that trigger intervention messages when an individual's phone enters the perimeter. Despite growth in personalized and ubiquitous smoking cessation interventions, few studies have incorporated spatial methods to optimize intervention delivery using place and time information. OBJECTIVE: This study demonstrates an exploratory method of generating person-specific geofences around high-risk areas for smoking by presenting 4 case studies using a combination of self-reported smartphone-based surveys and passively tracked location data. The study also examines which geofence construction method could inform a subsequent study design that will automate the process of deploying coping messages when young adults enter geofence boundaries. METHODS: Data came from an ecological momentary assessment study with young adult smokers conducted from 2016 to 2017 in the San Francisco Bay area. Participants reported smoking and nonsmoking events through a smartphone app for 30 days, and GPS data was recorded by the app. We sampled 4 cases along ecological momentary assessment compliance quartiles and constructed person-specific geofences around locations with self-reported smoking events for each 3-hour time interval using zones with normalized mean kernel density estimates exceeding 0.7. We assessed the percentage of smoking events captured within geofences constructed for 3 types of zones (census blocks, 500 ft2 fishnet grids, and 1000 ft2 fishnet grids). Descriptive comparisons were made across the 4 cases to better understand the strengths and limitations of each geofence construction method. RESULTS: The number of reported past 30-day smoking events ranged from 12 to 177 for the 4 cases. Each 3-hour geofence for 3 of the 4 cases captured over 50% of smoking events. The 1000 ft2 fishnet grid captured the highest percentage of smoking events compared to census blocks across the 4 cases. Across 3-hour periods except for 3:00 AM-5:59 AM for 1 case, geofences contained an average of 36.4%-100% of smoking events. Findings showed that fishnet grid geofences may capture more smoking events compared to census blocks. CONCLUSIONS: Our findings suggest that this geofence construction method can identify high-risk smoking situations by time and place and has potential for generating individually tailored geofences for smoking cessation intervention delivery. In a subsequent smartphone-based smoking cessation intervention study, we plan to use fishnet grid geofences to inform the delivery of intervention messages.


Subject(s)
Mobile Applications , Smoking Cessation , Young Adult , Humans , Smartphone , Smoking Cessation/methods , Smokers , Self Report
6.
Mindfulness (N Y) ; : 1-16, 2023 May 25.
Article in English | MEDLINE | ID: mdl-37362191

ABSTRACT

Objectives: Stress has deleterious effects on teachers' well-being and interactions with students. While in-person mindfulness programs have demonstrated benefits for teachers' mental health, in-person classes are often not feasible due to teachers' busy schedules. This study assessed four components of feasibility (implementation, demand, acceptability, and limited-efficacy testing) for an online mindfulness intervention for teachers. Method: A volunteer sample of 50 primary school teachers was recruited across three urban public schools and was offered a 9-week online mindfulness program (DeStress Monday at School). The program provided weekly mindfulness practices for (1) self-care and (2) classroom use to promote teacher and student stress management. Surveys and focus group discussions assessed program feasibility. Paired t-tests were used to evaluate pre-post changes in teacher well-being. Results: Most participants had no technical problems, providing general support for implementation. Support for program demand was mixed; while 85% of participants used practices at least once, some never used practices, and over half used practices only 1-3 times. Those who used practices generally rated their acceptability favorably. Qualitative analyses showed significant pre-post improvements in work-related and overall stress, depressive and anxiety symptoms, and sleep; those who used practices reported more benefits than those who did not. Qualitative data corroborated these findings, with teachers describing improved stress- and emotion-management following program use. Conclusions: Our findings suggest mindfulness can be delivered online to teachers and may enhance mental health and wellness. Next steps include conducting more rigorous research with a control condition to better understand potential program impact. Preregistration: This study is not preregistered. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-023-02142-3.

7.
Mindfulness (N Y) ; 14(1): 218-229, 2023.
Article in English | MEDLINE | ID: mdl-36684062

ABSTRACT

Objectives: Mothers with infants in the neonatal intensive care unit (NICU) are at increased risk of psychological distress, which can have lasting negative impacts on both mother and infant. However, few interventions are available to promote these mothers' mental health and wellbeing. In the context of a pilot randomized controlled trial testing a mindfulness intervention for mothers with infants in the NICU, we explore the experiences of the mothers participating in the mindfulness-based intervention, with mothers in the control group as comparison, and the ways they felt it influenced their time in the NICU. Method: Twenty-six participants (15 participants in the intervention arm and 11 participants in the control arm) recruited from two NICUs in an urban center in Eastern United States completed semi-structured interviews. Interviews explored the mothers' NICU experience as well as experience with the mindfulness and health education (control) programs. Data was analyzed using an iterative, thematic constant comparison process informed by grounded theory. Results: Mothers reported that participation in the mindfulness intervention helped them to calm the chaos through recentering and fostering connections, find comfort through non-judgmental acceptance, gain perspective on the situation, and facilitate self-care. These were experienced only among the mothers in the intervention arm. These themes did not vary based on demographics of the mothers in the mindfulness study arm or their pre-study awareness of mindfulness. Conclusions: Mindfulness interventions may foster new practices and perspectives for mothers with infants in the NICU, potentially leading to improved mental health wellbeing.

8.
Prev Sci ; 24(4): 663-675, 2023 05.
Article in English | MEDLINE | ID: mdl-36630022

ABSTRACT

Determining the factors that influence implementation of school-based wellbeing and health programs is essential for achieving desired program effects. Using a convergent mixed-methods, multiple informant design, this study considered factors that influence implementation of health programs for ninth grade students and in what ways implementation is differentially perceived by multiple informants (i.e., participants, instructors, and independent observers). Two types of programs-mindfulness and health education-were implemented with ninth graders (N = 70) in three schools situated in low-resourced urban neighborhoods. Study outcomes were derived from four data sources: (1) focus group participants (N = 45); (2) program instructor fidelity ratings; (3) independent observer fidelity ratings and notes; and (4) instructor open-ended session responses. Using thematic and mixed methods integration analyses, we identified themes related to implementation promoting or challenging factors. Theme names differed when data sources were separately analyzed by informant. Mixed methods integration analysis indicated that four themes were common across all informant groups: (1) competent, attentive, and engaging instructors are essential; (2) programs should involve interactive components (e.g., physical activities, applied learning opportunities); (3) adequate time for program delivery is key for student exposure and engagement; and (4) students' availability and preferences should guide program scheduling. A fifth theme, unique to instructor and observer perspectives, was that program implementation was negatively impacted by distractions from multiple sources, including instructors, students, and settings. Recommendations from students, instructors, and observers for implementation optimization are discussed.


Subject(s)
Adolescent Health , Schools , Adolescent , Humans , Students , Learning
9.
J Clin Child Adolesc Psychol ; 52(2): 171-183, 2023.
Article in English | MEDLINE | ID: mdl-33819113

ABSTRACT

OBJECTIVE: To identify subgroups of urban youth based on their self- and teacher-reported mental health symptoms, and to explore characteristics of these subgroups. METHODS: Cross-sectional data from 426 eighth-grade students (Mage = 13.22 years; 70.1% Black/African American; 58.7% female) across 20 Baltimore City public schools were analyzed using latent profile analysis and latent regressions. Variables for latent profile analysis included self-reported symptoms (i.e., anxiety, depression, trauma, interpersonal issues, social problems, and behavioral dysfunction) and teacher-reported symptoms (i.e., externalizing, internalizing, and problems in social and emotional competence). Regressions used profile membership to predict trauma exposure, coping mechanisms, and substance use. RESULTS: A 3-profile solution was found from the latent profile analysis. The profile with high student- and teacher-reported symptoms had more trauma exposures, greater use of maladaptive coping mechanisms, and higher substance use. CONCLUSIONS: The current study may help in the identification of urban youth who are at risk of developing multiple co-occurring psychological disorders to target for prevention efforts.


Subject(s)
Mental Health , Substance-Related Disorders , Humans , Adolescent , Female , Male , Cross-Sectional Studies , Anxiety/psychology , Comorbidity , Substance-Related Disorders/epidemiology
10.
Clin Pediatr (Phila) ; 62(5): 423-432, 2023 06.
Article in English | MEDLINE | ID: mdl-36286247

ABSTRACT

We sought to describe processes of psychosocial screening and discussion with immigrant Latino families in the context of group well-child care. We conducted longitudinal direct observations of the 1-, 2-, 4-, and 6-month visits of 7 group well-child care cohorts at an academic pediatric clinic using unstructured observations of visit and group processes as well as structured observations to code facilitators' behavior. A range of psychosocial and social determinants of health topics were incorporated into discussions. In general, providers skillfully navigated group discussions, but inconsistently introduced the visit purpose. Asking participants to define psychosocial terms (eg, stress) and conversations about managing fussy infants were effective strategies to engage families in psychosocial discussions (eg, about postpartum depression). Some challenges with workflow were identified. Strategies to enhance screening and discussion of psychosocial topics may benefit from adaptation to maximize the effectiveness of this care mechanism.


Subject(s)
Child Care , Depression, Postpartum , Infant , Female , Child , Humans , Depression, Postpartum/diagnosis , Depression, Postpartum/therapy , Child Health
11.
Fam Syst Health ; 40(3): 364-382, 2022 09.
Article in English | MEDLINE | ID: mdl-35708921

ABSTRACT

INTRODUCTION: Group well-child care (GWCC) is an alternative to traditional pediatric well-child care designed to increase parental social support and peer learning. This mixed methods study explored the adaptation and implementation of GWCC to a virtual format during coronavirus disease 2019 (COVID-19 pandemic) among Spanish-speaking Latino immigrant families. METHOD: Interviews were conducted with eight providers and 10 mothers from May through September 2020. Qualitative analyses used a priori codes based on an implementation science framework. Quantitative data included demographics, the COVID-19 Impact Scale, and virtual group attendance. Bivariate analyses identified correlates of virtual visit attendance. RESULTS: Eighty percent of mothers reported the pandemic had moderately or extremely impacted at least one major life domain such as daily life, food security, or family conflict. Of 27 mothers offered virtual groups, 67% attended. Mothers who attended virtual groups reported lower English proficiency (p = .087) and fewer friends and family members with COVID-19 (M = 1.0 vs. 5.1, p < .05) than those who did not attend. Women described virtual GWCC as acceptable and a source of social support. Some described differences in group dynamics compared with in-person groups and had privacy concerns. Providers noted scheduling and billing challenges affecting feasibility and sustainability. They reported that visits with good attendance were productive. Mothers and pediatric providers offered recommendations to improve feasibility and privacy and address sustainability. DISCUSSION: Competing demands for those most impacted by COVID-19 may outweigh benefits of attendance. Virtual Spanish language GWCC appears acceptable and feasible for Spanish speaking Latina mothers. Thematic analysis and recommendations identify areas of improvement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Child Care , Child , Female , Humans , Hispanic or Latino , Mothers , Pandemics , Emigrants and Immigrants , Child Health , Telemedicine , United States
12.
Acad Pediatr ; 22(1): 80-89, 2022.
Article in English | MEDLINE | ID: mdl-33992841

ABSTRACT

OBJECTIVE: Group Well-Child Care (GWCC) has been described as providing an opportunity to enhance well-being for vulnerable families experiencing psychosocial challenges. We sought to explore benefits and challenges to the identification and management of psychosocial concerns in Group Well-Child Care (GWCC) with immigrant Latino families. METHODS: We conducted a case study of GWCC at an urban academic general pediatric clinic serving predominantly Limited English Proficiency Latino families, combining visit observations, interviews, and surveys with Spanish-speaking mothers participating in GWCC, and interviews with providers delivering GWCC. We used an adapted framework approach to qualitative data analysis. RESULTS: A total of 42 mothers and 9 providers participated in the study; a purposefully selected subset of 17 mothers was interviewed, all providers were interviewed. Mothers and providers identified both benefits and drawbacks to the structure and care processes in GWCC. The longer total visit time facilitated screening and education around psychosocial topics such as postpartum depression but made participation challenging for some families. Providers expressed concerns about the effects of shorter one-on-one time on rapport-building; most mothers did not express similar concerns. Mothers valued the opportunity to make social connections and to learn from the lived experiences of their peers. Discussions about psychosocial topics were seen as valuable but required careful navigation in the group setting, especially when fathers were present. CONCLUSIONS: Participants identified unique benefits and barriers to addressing psychosocial topics in GWCC. Future research should explore the effects of GWCC on psychosocial disclosures and examine ways to enhance benefits while addressing the challenges identified.


Subject(s)
Child Health Services , Emigrants and Immigrants , Child , Child Care , Female , Hispanic or Latino , Humans , Mothers
13.
Child Adolesc Psychiatr Clin N Am ; 31(1): 45-70, 2022 01.
Article in English | MEDLINE | ID: mdl-34801155

ABSTRACT

Nearly 70% (67.6%) of US children with mental, emotional, and behavioral problems (MEB) experienced significant social health risks (SHR) and/or relational health risks (RHR). Shifts are needed in child mental health promotion, prevention, diagnosis, and treatment to address both RHR and SHR. Public health approaches are needed that engage families, youth, and the range of child-serving professionals in collaborative efforts to prevent and mitigate RHR and SHR and promote positive mental health at a community level. Building strong family resilience and connection may improve SR and, in turn, academic and social outcomes among all US children with or without MEB.


Subject(s)
Mental Health , Resilience, Psychological , Adolescent , Family , Family Health , Humans , Schools
14.
Article in English | MEDLINE | ID: mdl-38846374

ABSTRACT

Purpose: Exposure to police brutality is a significant risk to adolescent mental health. This study extends this literature by exploring connections between anticipation of racially motivated police brutality and multiple facets of adolescent mental health. Methods: Students ages 14 to 18 (n = 151) were recruited from a study administered in Baltimore City public schools. Between December 2020 and July 2021, participants completed a questionnaire assessing anticipatory stress regarding racially motivated police brutality and current mental health. Regression models examined associations between this anticipatory stress and mental health. Latent profile and regression analyses were used to examine whether anticipatory stress was more salient among adolescents with comorbid mental health symptoms, compared to those without comorbid symptoms. Results: Youth with anticipatory stress stemming from both personal and vicarious police brutality had more symptoms of anxiety, depression, and PTSD, as well as lower hope, compared to youth without anticipatory stress. The association between anticipatory stress and anxiety was stronger for girls than boys. Conclusions: Findings from this study highlight racialized police brutality as a common anticipated stressor among youth, particularly for girls. Findings have implications for policing interventions, including development of additional trainings for police officers and promoting positive police/youth interactions.

15.
Article in English | MEDLINE | ID: mdl-34761223

ABSTRACT

BACKGROUND: Implementation strategies used to enhance the implementation of interventions during efficacy and effectiveness studies are rarely reported. Tracking and reporting implementation strategies during these phases has potential to improve future research studies and real-world implementation. We present an exemplar of how this might be executed by specifying and reporting the implementation strategies that were used during a school-based efficacy trial, Project POWER, which tested a trauma-informed prevention program delivered by a university research team, community members, and school staff facilitators in 29 schools. METHODS: Following the conclusion of the 4-year trial, core Project POWER research team members identified the implementation strategies that supported intervention delivery during the trial using an established taxonomy of school-based implementation strategies. The actors, actions, action targets, temporality, dose, and implementation outcomes were specified using established implementation strategies reporting guidelines. RESULTS: The research team identified 37 implementation strategies that were used during the Project POWER trial. Most strategies fell within the categories of Train and Educate Stakeholders, Use Evaluative and Iterative Strategies, and Develop Stakeholder Interrelationships. Actors included members of the research team and partner schools. Strategies were used multiple times during the preparation and implementation phases. Action targets were most often characteristics of individuals, implementation process, and characteristics of the inner setting. Strategies predominantly targeted the implementation outcomes of fidelity, acceptability, feasibility, and adoption. CONCLUSIONS: This study provided evidence that implementation strategies are used and can be identified in efficacy research using a retrospective approach. Identifying and specifying implementation strategies used during the initial phases of the translational research pipeline can inform the implementation strategies that are carried forward, adapted, or discontinued in future trials and routine practice to improve implementation and effectiveness outcomes.

16.
J Youth Adolesc ; 50(11): 2249-2261, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34613544

ABSTRACT

Prior work has identified the need for replication of psychological research; however, validation efforts are rare. The purpose of the current study was to confirm latent profiles of comorbid psychological symptoms in an urban adolescent sample and examine differences in gender and trait mindfulness across these profiles. Cross-sectional data from 201 eighth grade students (63% female; Mage = 13.24; 86% Black) across nine Baltimore City public middle schools were analyzed. Confirmatory latent profile analyses showed that the previously-identified 3-profile solution with boundary constraints was the best fit for the data, and significant sex and trait mindfulness differences were identified. The current study supports the need for future replication studies using this methodology to improve theory and targeted interventions.


Subject(s)
Mindfulness , Adolescent , Cross-Sectional Studies , Female , Humans , Male , Schools , Sex Factors
17.
Am J Public Health ; 111(10): 1885-1893, 2021 10.
Article in English | MEDLINE | ID: mdl-34554817

ABSTRACT

Objectives. To explore associations between police stops, self-harm, and attempted suicide among a large, representative sample of adolescents in the United Kingdom. Methods. Data were drawn from the 3 most recent sweeps of the UK Millennium Cohort Study (MCS), from 2012 to 2019. The MCS is an ongoing nationally representative contemporary birth cohort of children born in the United Kingdom between September 2000 and January 2002 (n = 10 345). Weights were used to account for sample design and multiple imputation for missing data. Results. Youths experiencing police stops by the age of 14 years (14.77%) reported significantly higher rates of self-harm (incidence rate ratio = 1.52; 95% confidence interval [CI] = 1.35, 1.69) at age 17 years and significantly higher odds of attempted suicide (odds ratio = 2.25; 95% CI = 1.84, 2.76) by age 17 years. These patterns were largely consistent across examined features of police stops and generally did not vary by sociodemographic factors. In addition, 17.73% to 40.18% of associations between police stops and outcomes were explained by mental distress. Conclusions. Police-initiated encounters are associated with youth self-harm and attempted suicide. Youths may benefit when school counselors or social workers provide mental health screenings and offer counseling care following these events. (Am J Public Health. 2021;111(10):1885-1893. https://doi.org/10.2105/AJPH.2021.306434).


Subject(s)
Juvenile Delinquency/statistics & numerical data , Police , Self-Injurious Behavior/epidemiology , Suicide, Attempted/statistics & numerical data , Adolescent , Cohort Studies , Fear/psychology , Female , Humans , Juvenile Delinquency/psychology , Male , Risk Factors , Self-Injurious Behavior/psychology , Suicide, Attempted/psychology , United Kingdom
18.
Child Abuse Negl ; 117: 105061, 2021 07.
Article in English | MEDLINE | ID: mdl-33845241

ABSTRACT

Child sexual abuse (CSA) is common, severe, and substantively contributes to the global burden of disease through its impact on physical, mental, and behavioral health problems. While CSA is preventable through non-justice system response efforts, the vast majority of resources support criminal justice efforts to identify, prosecute, punish and monitor offenders after CSA has already occurred. Policy makers have not supported CSA prevention efforts in part because the public does not view CSA as a preventable public health problem. Here, we describe a program of research to be conducted to bridge the gaps between expert and public opinion about CSA as a preventable public health problem. We propose such research use a three-step approach to alter the way experts communicate about CSA to increase audiences' understanding of CSA as preventable. The three steps are: 1) identify consensus expert and public perspectives about CSA and the differences between these perspectives; 2) develop and test communication strategies to align public with expert perspectives; and 3) broadly disseminate validated communication strategies. Through this approach, we seek to develop and disseminate an informed communications strategy that effectively and accurately translates the science of CSA prevention to the public and the media.


Subject(s)
Child Abuse, Sexual , Child Abuse , Criminals , Child , Communication , Humans , Public Health
19.
School Ment Health ; 13: 174-185, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33628336

ABSTRACT

Limited research exists about factors that influence the sustainability of preventive school mental health interventions when research support ends. This study assessed barriers and facilitators to sustaining RAP (Relax, be Aware, do a Personal rating) Club, a trauma-informed universal mental health intervention, in urban schools following efficacy trial implementation. Between 2016-2018, 13 Baltimore City schools implemented RAP Club. We evaluated RAP Club sustainability using semi-structured interviews with administrators (n=10) and school staff trained to deliver the intervention (n=11), as well as review of intervention fidelity logs (n=137) and notes from supervision calls (n=10) with school staff and research team members who implemented the program. Although most school staff described RAP Club as acceptable and beneficial, none of the 13 schools sustained the intervention. Barriers to sustainability included low self-efficacy among school staff trained to deliver the intervention, school staff turnover, logistical challenges with space and time in the regular school calendar to deliver the program, insufficient funding to sustain the program outside of the research context, and limited planning and ongoing communication between school personnel and researchers about sustainability. Recommendations for increasing post-trial program sustainability include developing sustainability plans with schools during the pre-implementation phase, enhancing ongoing support for school staff during the implementation phase, and using academic-community partnerships to facilitate sustainability and intervention scale-up during the post-implementation phase. Increasing sustainability of beneficial school-based mental health programs has the potential to reduce mental health disparities and promote health equity.

20.
Int J Yoga Therap ; 31(1)2021 Jan 01.
Article in English | MEDLINE | ID: mdl-33444438

ABSTRACT

A growing body of literature supports the use of mindfulness-based practices to increase resilience and reduce emotional and behavioral problems of low-income youth of color who are exposed to chronic trauma. The current study, the first of its kind, addresses existing gaps in the literature by examining the social and emotional effects of mindfulness on instructors of color, a largely understudied population. All trainees (n = 25) in a year-long, mindfulness-based workforce development program in Baltimore were invited to participate in this qualitative descriptive study that involved semistructured interviews regarding the personal emotional impact of participating in the program, as well as possible changes in the subjects' perceptions of yoga and the potential role of yoga in their communities. We applied a transcript-based analysis approach to the data from the individual interviews and derived themes using the constant comparative method. Twenty-one trainees (84%) participated in semistructured interviews. Participants were between the ages of 18 and 29 and were predominantly male (71.4%) and African-American (85.7%). We identified four key themes related to participating in the program: (1) changes in emotional functioning and self-perception, (2) changes in interactions with others, (3) changes in perception of yoga and mindfulness, and (4) perceived real-world application of yoga and mindfulness. The current study adds to the literature by exploring the public health implications of mindfulness, particularly in addressing effects of chronic trauma in low-income communities of color. The workforce development program also merits further evaluation as a potential model for enabling local and national nonprofit organizations to offer low-income youth and youth of color employment options that enhance resources in trauma-affected communities.


Subject(s)
Mindfulness , Yoga , Adolescent , Adult , Black or African American , Humans , Male , Qualitative Research , Workforce , Young Adult
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