Supported employment interventions with people who have severe mental illness: Systematic mixed-methods umbrella review.

BACKGROUND/AIMS: Primary and review studies show that supported employment interventions showed promise in assisting people with severe mental illness (SMI) in achieving successful employment and health-related outcomes. This umbrella review synthesises evidence from across review studies on supported employment interventions for individuals with SMI, to identify key findings and implementation challenges in relation to five key outcomes: (1) employment, (2) quality of life, (3) social functioning, (4) clinical/service utilisation, and (5) economic outcomes. METHODS: A systematic search of eleven databases and registers (CINAHL, Cochrane, EmCare, JBI EBP, ProQuest, PsycINFO, PubMed, Scopus, and Web of Science, and Prospero and Campbell) was conducted to identify meta-analyses and systematic reviews on supported employment interventions for individuals with SMI, peer reviewed and published in English. Quality assessment and data extraction were performed using standardised Joanna Briggs Institute (JBI) tools. A mixed-methods synthesis approach was employed to integrate both quantitative and qualitative evidence. RESULTS: The synthesis of 26 review studies primarily focused on the Individual Placement and Support (IPS) model among various supported employment interventions. Overall, combining supported employment with targeted interventions such as neurocognitive therapy and job-related social skill training showed a positive effect on employment (including job retention) and non-employment outcomes (e.g., health, quality of life, social functioning) relative to standard forms of supported employment for people with SMI. Contextual factors (intervention fidelity, settings, systemic barriers) were important considerations for intervention implementation and effectiveness. DISCUSSION: Significant overlap of primary studies across 26 review studies exposed considerable variations in interpretation and conclusions drawn by authors, raising questions about their reliability. High volume of overlap reporting from the USA on IPS interventions in review studies is likely to have biased perceptions of effectiveness. There is no one-size-fits-all solution for supporting individuals with SMI in obtaining and maintaining employment. Tailoring strategies based on individual needs and circumstances appears crucial to address the complexity of mental health recovery. We propose creating centralised registries or databases to monitor primary studies included in reviews, thus avoiding redundancy. OTHER: This umbrella study was registered with PROSPERO (No. CRD42023431191).

Social Support Postpartum: Bengali Women from India on Their Coping Experiences following Childbirth.

Undertaken in Kolkata, India, our study aimed to explore the experiences of Bengali middle-class women on perceived stressful events, social support, and coping experiences following childbirth. Becoming a mother following childbirth is a shared phenomenon irrespective of culture, social strata, or country, while stress during the postpartum period or depression is not. Discrete medical intervention does not sufficiently address the complexities of postpartum experiences since influencing factors also include economic, political, cultural, and social backgrounds. Adopting a feminist and phenomenological approach, individual in-person interviews were conducted with twenty women recruited via snowball sampling. Our findings revealed that events experienced as stressful may lead to poor postpartum well-being. Underpinned by gendered discourse and biases, stressful events included familial imperatives for a male child, poor social and emotional support from the family, mostly partners and fathers, and systemic workplace barriers. The women in our study commonly resided with their mothers postpartum. They expressed feeling sheltered from these experiences, cared for, and supported. We discuss the women's experiences from a feminist pragmatic worldview, which advocates for a flexible feminism recognizant of the unique and nurturing relationship experiences between Bengali middle-class women and their mothers. In conclusion, we advocate for culturally sensitive, women-centered postpartum care practices that may entail the inclusion of intergenerational care during this critical phase of maternal well-being. These insights underscore the necessity of tailoring postpartum support systems to align with the cultural and familial contexts of the individuals they serve.

Older women's experience with COVID-19 pandemic: A study of risk perception and coping among culturally and linguistically diverse population in South Australia.

BACKGROUND: A global catastrophe-the COVID-19 pandemic-appears to have two-dimensional health consequences for older adults: high risk of being infected and psychological distress. There is limited evidence on how the pandemic has impacted the life and coping of older adults who are culturally and linguistically diverse (CALD), women in particular. This study explored the COVID-19 risk perception and coping strategies of older CALD women in South Australia. METHODS: A mixed-methods research design was employed, involving a 31-items coping and emergency preparation scale for survey and semi-structured interviews with participants. The older CALD women were approached through 11 multicultural NGOs. One hundred and nine women participants from 28 CALD communities completed the online surveys; 25 of them agreed to a telephone interview and provided their contact details. 15 older CALD women ultimately participated in interviews. RESULTS: Mean sum-score of dread risk, unknown risk, and fear (M: 43.5; SD: 4.9) indicated that the participants were somewhat anxious and worried. Mean sum-score of coping (M: 79.8; SD: 9.3) reported their compliance with expert advice and disinfection practices but accessing health information (M: 2.8; SD 1.4) and tendency to minimize anxiety (M: 2.1; SD: 1.2) were below neutral. Significant variations were found in coping in terms of age, meaning that the women aged 75 years and older were less likely to cope with the pandemic (P = 0.01). Emergency preparation differed based on the participants' residence and occupation status. The deductive-inductive thematic analysis of interview data was framed around three priori themes: risks of being affected, emotional and behavioral coping, and emergency preparation and access to services. CONCLUSIONS: Evidence shows a fear among the older CALD women with an endeavor to cope and prepare for emergency situations. This suggests the requirements for interventions that improve coping and reduce the risk of stress among them.

Exploring Social Determinants of Mental Health of Older Unforced Migrants: A Systematic Review.

BACKGROUND AND OBJECTIVES: Although the vulnerabilities stemming from the intersection of aging and migration are widely recognized, the migration contexts and the factors influencing the mental health of older unforced migrants have received scant attention. This review explores the drivers of unforced migrations in later life and the individual, relational, and structural factors influencing their mental health and well-being. RESEARCH DESIGN AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of 7 databases for English peer-reviewed journal articles was conducted. A total of 21 studies were identified and analyzed inductively. RESULTS: The review classified motivations for migration as push factors and pull factors: push factors such as escaping structural inequities in the homeland and pull factors included seeking better lifestyle opportunities and reuniting with family. The positive determinants of mental health included cordial family relationships, paid employment, the presence of a partner, and strong support networks. Advanced age, absence of a partner, lifestyle changes, lack of intergenerational support, poor language proficiency, unfavorable policies, lack of access to resources, and systemic biases negatively affected the mental health of older unforced migrants. DISCUSSION AND IMPLICATIONS: The review highlights the need to recognize the diversity among older migrants to develop policies and programs that address their specific circumstances. Recognizing their strengths, rather than focusing solely on their vulnerabilities will help create a more positive and supportive environment, enabling them to thrive in their new communities.

Interprofessional Education in Child Protection for Preservice Health and Allied Health Professionals: A Scoping Review.

Health and allied health professionals are uniquely positioned to collaborate in prevention, early intervention and responses to child maltreatment. Effective collaboration requires comprehensive interprofessional education (IPE), and inadequate collaboration across sectors and professions continually contributes to poor outcomes for children. Little is known about what interprofessional preparation health and allied health professionals receive before initial qualification (preservice) that equips them for interprofessional collaboration and provision of culturally safe care in child protection. This scoping review aimed to identify what is known internationally about IPE in child protection for preservice health and allied health professionals. Thirteen manuscripts reporting 12 studies met the inclusion criteria and were included in the synthesis. Key characteristics of the educational interventions are presented, including target disciplines, core content and their learning objectives and activities. Findings demonstrated primarily low-quality methodologies and educational interventions that had not been replicated beyond their initial context. Many educational interventions did not provide comprehensive content covering the spectrum of prevention, early intervention and responses for all types of child maltreatment, and/or did not clearly indicate how IPE was achieved. Key challenges to delivering comprehensive interprofessional child protection include lack of institutional support and competing priorities across disciplines who must meet requirements of separate regulatory bodies. Consequently, there is a need for further development and robust evaluation of educational interventions to explore how interprofessional collaborative skills for child protection can be developed and delivered in preservice health and allied health professional education.

Professional Quality of Life of Foster and Kinship Carers in Australia, United Kingdom, and the United States: A Scoping Review.

Professional quality of life (ProQOL) refers to workers' subjective feelings associated with work involved in helping others who have experienced trauma. It consists of positive and negative aspects, that is, subscales of compassion satisfaction, and burnout and secondary traumatic stress. Foster and kinship caring inherently involves risks associated with exposure to the trauma responses of children in their care. This exposure can lead to poor ProQOL, carer attrition, and placement instability. While limited studies specifically explore ProQOL of carers, many studies have examined factors and interventions related to ProQOL. However, there is a lack of synthesis of these studies. To fill such a research gap, we undertook a scoping review of 70 empirical studies from Australia, the United Kingdom, and the United States, published from 2012 to 2022 reporting on ProQOL, and its related factors and concepts. We applied a multilevel ecosocial construct to examine complex interrelationships between private and governance settings to better understand factors related to ProQOL of carers and interventions aimed to improve it in these dynamic systems. In our review, some studies showed positive outcomes for carers, such as reduced stress or burnout associated with training. However, there was insufficient attention to factors associated with ProQOL at relational and sociopolitical levels. It is crucial to improve carers' ProQOL or well-being to ensure their retention and placement stability. Long-term systemic improvements require interventions across different levels of the system.

Australian Trends in Academic Literature Concerned With Family and Domestic Violence Perpetrators: A Bibliometric Literature Review.

In this article, we used a novel hybrid approach to review literature concerned with family and domestic violence (FADV) perpetrators. Our intention was to chart the research and publication activity of authors with Australian affiliation to identify homegrown evidence related to stopping the perpetration of violence. This involved systematic searching of literature from the Scopus electronic database, utilization of VOSviewer to sort keyword co-occurrences and authorship linking for 1,494 publication records over a 30-year period, and the review of 21 articles with perpetrator focus, identified from the 50 most cited publications. We found that Australians' authoring interests in FADV, over the last three decades, with perpetrator focus were predominantly concentrated on gender, rape and sexual assault, coercive control, and child abuse. In the most cited literature, six major themes were identified: perpetrator motivations, perpetrator interventions, patterns of violence, pandemic duet, perception of blame, and cyberstalking and violence. An upward curve in Australian authoring activity in the period under review aligns with societal shifts in which FADV was once considered a private issue and has now become ubiquitous in the public domain. Our findings revealed that research into perpetrators is insufficient to promote a zero-tolerance approach to FADV. Our corresponding in-depth literature review provides valuable insights surrounding perpetrator intervention programs with the goal of more effectively addressing the emerging challenge of technology-facilitated coercive control.

A Scoping Review of Changes to Patient-Doctor Communication During COVID-19.

Effective communication between patients and doctors is fundamental to high-quality healthcare, patient safety, and overall satisfaction. However, the onset of COVID-19 has prompted significant shifts in communication from in-room and face-to-face interactions to virtual consults. The impact of this pandemic-related change on patient-doctor communication goals, processes, attributes, and environment remains unclear. We undertook a scoping review involving the systematic search of seven academic databases for relevant articles published up to and including June 2021. In total, 47 articles were identified that met the inclusion criteria. We applied the patient-doctor communication framework to guide our deductive thematic analysis of articles included, sorting results from reported studies and position papers into themes and sub-themes. The theme of communication goals highlighted sub-themes related to patient safety, convenience, affordability, and satisfaction; preparation included sub-themes on technology interventions, workforce training, and digital literacy; participant attributes included compassion for doctors and rebuilding trust among patients; and communication process included issues related to telemedicine or video conferencing, challenges with diminished patient privacy, and distractions in the patient's home setting. Finally, the environment theme included insights into doctors' workload, isolation, and anxiety and how changes requiring increases in virtual consults iteratively altered confidence in care provision and communication with patients. Results of the scoping review provide important insights for strengthening virtual patient-doctor interactions, including target areas for training and professional development during and beyond the current pandemic.

Health and Social Care Outcomes in the Community: Review of Religious Considerations in Interventions with Muslim-Minorities in Australia, Canada, UK, and the USA.

The aims of this integrative review included examining the intervention characteristics, religious tailoring, and behavioural outcomes of health and social care interventions with Muslim-minorities in Australia, Canada, UK, and the USA. Nineteen articles were included, and each showed some level of improved health and social care outcomes associated with interventions that were religiously tailored to Islamic teachings, and when notions of health were extended to physical, psychological, spiritual and social domains. Future studies should measure levels of religiosity to understand whether religiously tailored interventions produce a significant intervention effect when compared to non-religiously tailored interventions with Muslims.

The COVID-19 risk perceptions, health precautions, and emergency preparedness in older CALD adults in South Australia: A cross-sectional study.

BACKGROUND: In Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults' risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia. METHODS: A cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0. RESULTS: Mean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian ß 3.40; 95% CI 1.21, 5.59; African ß 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [ß 1.82; 95% CI 0.65, 2.99]; and fear [ß 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants' responses, on average, did not prevent them from buying large quantities and storing essential goods. CONCLUSION: A pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.

COVID-19 risk perceptions and precautions among the elderly: A study of CALD adults in South Australia.

Background: Coping with COVID-19 is a challenge for culturally and linguistically diverse (CALD) older adults. In Australia, little attention has been given to understanding associations between cultural contexts, health promotion, and socio-emotional and mental health challenges of older CALD adults during the COVID-19 pandemic. Therefore, we have collected data from older CALD adults to examine their COVID-19 risk perceptions and its association with their health precautions, behavioural dimensions and emergency preparation. Methods: A cross-sectional survey was conducted in South Australia. The CALD population aged 60 years and above were approached through 11 South Australian multicultural NGOs. Results: We provide the details of 155 older CALD South Australians' demographics, risk perceptions, health precautions (problem-and-emotion-focused), behavioural dimensions and emergency preparation.  The explanatory variables included demographic characteristics (age, gender, education and ethnicity); and risk perception (cognitive [likelihood of being affected] and affective dimension [fear and general concerns], and psychometric paradigm [severity, controllability, and personal impact]. The outcome measure variables were health precautions (problem-focused and emotion-focused), behavioral adaptions and emergency preparation. Conclusions: This dataset may help the researchers who investigate multicultural health or aged care in the pandemic and or who may have interest to link with other datasets and secondary use of this primary dataset in order to develop culturally tailored pandemic-related response plan. The data set is available from Harvard Dataverse.

Risk Perception and Health Precautions Towards COVID-19 Among Older Culturally and Linguistically Diverse Adults in South Australia: A Cross-Sectional Survey.

Background: Risk perceptions and precaution-taking against COVID-19 are affected by individuals' health status, psychosocial vulnerabilities and cultural dimensions. This cross-sectional study investigates risk perceptions associated with COVID-19 and specifically the problem- and emotion-focused health precautions of older, culturally and linguistically diverse (CALD) South Australians. Methods: Cross-sectional research involving self-administration of an online survey. Participants were CALD adults living in South Australia, aged 60 years and above (n = 155). Multi-indicator surveys were analyzed using Stata/MP version 13.0 and multiple linear regression models fitted to examine associations between risk perceptions and problem- and emotion-focused health precautions. Results: Dread risk returned the highest mean score; COVID-19 was perceived as a catastrophe. Mean scores for fear showed that participants were worried about COVID-19 and scared of becoming infected. Participants followed health advice as they were worried [ß 0.15; 95% CI 0.07, 0.23] and realized the effect of COVID-19 on them [ß 0.15; 95% CI 0.02, 0.28], or worried and had trust in experts' knowledge and managing capacity [ß 0.17; 95% CI 0.06, 0.28]. Age was negatively associated with sum-score of problem-focused coping: compared to participants aged 60-69 years, 80+ years revealed a decrease in problem-focused health precautions. Variables like education (primary schooling [ß 2.80; 95% CI 0.05, 5.55] and bachelor degree [ß 3.16; 95% CI 0.07, 6.25] versus no formal education), self-confidence in reducing risk, and fear [ß 0.84; 95% CI 0.31, 1.36] significantly affected emotional-focused health precautions. Conclusion: This local study has global implications. It showed that COVID-19 has psychosocial and environmental implications for older CALD adults. When many CALD populations have existing vulnerabilities to intersecting disadvantage, cultural-tailoring of interventions and pandemic response plans may buffer the effects of compounding disaster. Larger studies are needed to compare risk perception and health response patterns across countries and cultural groupings.

The Aging Experiences of LGBTQ Ethnic Minority Older Adults: A Systematic Review.

BACKGROUND AND OBJECTIVES: In gerontological research and practice, an increasing amount of attention is being paid to lesbian, gay, bisexual, transgender, and queer (LGBTQ) older people and how their experiences differ from their heterosexual and cisgender counterparts. However, LGBTQ older adults themselves are not a homogenous group. Moreover, as the immigrant populations in industrialized nations age, the number of LGBTQ older adults from ethnic minority backgrounds will only grow. This systematic review hence investigates the experiences of LGBTQ ethnic minority older adults. RESEARCH DESIGN AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we conducted a systematic search in 5 databases for English peer-reviewed studies. The retrieved articles were coded and analyzed inductively using an intersectional framework to tease out the varying influences of ethnicity, age, gender, and sexual identity on the LGBTQ ethnic minority older adults' experiences. RESULTS: A total of 30 articles across 21 studies (13 qualitative, 7 quantitative, and 1 mixed-methods) were identified. Six key themes emerged from the studies: stigma and discrimination; isolation, support and belonging; interactions with services and institutions; self-acceptance, resilience, and agency; mental health and well-being; and uncertain futures. DISCUSSION AND IMPLICATIONS: The experiences of LGBTQ ethnic minority older adults echo those of LGBTQ ethnic majority older adults when they are shaped by gender and sexual identity factors. Nevertheless, significant differences in experiences-both positive and negative-emerge when cultural and ethnicity-related factors come to the fore. These findings emphasize the need for intersectional aging policies and services that go beyond catering for LGBTQ older adults to include the diversity within this subpopulation.

Falling in love with romantic ideals: women in relationships with child molesters.

Drawing on data from a larger research study, this paper explores intersecting and competing social relations that influenced the romantic desires of women who became intimately involved with men who molested children. Through a feminist poststructuralist lens, women's narratives were analysed with the use of feminist interpretations of Foucauldian discourse theory. Analysis informed of a discursive power over participants that made the attainment of romantic desires an imperative for ensuring social respect, worth and credibility as women. When all was not ideal, these same romantic desires compelled women to fix and hold onto their relationships--even when with men that attract damning societal responses towards them. Even upon acknowledgement of their partners' sexual transgressions, the fear of relationship breakdown meant that romantic desires again featured as imperatives for the women. The imagined pleasure of achieving romantic desires is discursive; so powerful that it outweighed women's fears and dangers of precarious intimate life with men who commit abhorrent acts.