Stigma and Stigma Resilience: Role of the Undergraduate and the Campus Environment.

RATIONALE: Stigma permeates disability experiences and compounds disability-related challenges. OBJECTIVE: Identify individual and environmental factors of stigmatizing experiences of college students with learning disabilities (LDs) and attention-deficit/hyperactivity disorder (ADHD). METHODOLOGY: A qualitative descriptive design was used with a thematic analysis of 30 transcripts from group discussions among four cohorts of undergraduates with LD/ADHD (N = 52). The Person-Environment-Occupation-Performance Model was used in interpreting the stigmatizing experiences. FINDINGS: The themes Perceived Misconceptions and Stigmatizing Actions describe key social-environmental factors. The theme Overcoming Stigmatizing Experiences elucidates key skills and processes for developing stigma resilience. These skills and processes were anchored in self-awareness and personally contextualized understanding of disability-related challenges and strengths, which were fostered during positive interactions with supportive others, such as instructors and mentors. IMPLICATIONS: Findings illustrate the biopsychosocial nature of stigma and highlight the role of individual and social-environmental factors in building stigma resilience among young adults with LD/ADHD.

Understanding Stigma and Resilience Among College Students with Learning Disabilities and ADHDWe studied how college students with learning disabilities (LDs) and attention-deficit/hyperactivity disorder (ADHD) experience stigma, which means feeling judged or treated unfairly because of their disabilities. We talked to 52 undergraduates in four groups to understand their experiences and found three main things related to stigma. First, students feel like others have wrong ideas about them and their disabilities. Second, they experience actions from others that make them feel stigmatized. Third, they develop ways to overcome these experiences. Students became more resilient to stigma when they understood themselves better and had support from others like teachers and mentors. Stigma is not just a personal thing for students with LD/ADHD; but it is also influenced by the people around them and how they see themselves.

Theory-Based Self-Management Interventions for Community-Dwelling Stroke Survivors: A Systematic Review and Meta-Analysis.

IMPORTANCE: Self-management is a critical component of stroke rehabilitation. A better understanding of the use of theory and behavior change techniques (BCTs) informs the development of more effective stroke self-management interventions. OBJECTIVE: To examine what theories and BCTs have been applied in stroke self-management interventions; investigate the extent to which these interventions encourage implementation of behavior changes; and appraise their effectiveness to enhance self-efficacy, quality of life, and functional independence. DATA SOURCES: Ovid MEDLINE, Embase, Scopus, CINAHL, Cochrane Library, and ClinicalTrials.gov were searched from inception to May 26, 2020. STUDY SELECTION AND DATA COLLECTION: Randomized controlled trials (RCTs) in six databases were reviewed for inclusion and analysis. We included trials that involved community-dwelling adult stroke survivors, assessed the effectiveness of self-management interventions, and explicitly mentioned the use of theory in the development of the intervention. We assessed use of theory and BCTs using the Theory Coding Scheme and BCT taxonomy v1, respectively. FINDINGS: A total of 3,049 studies were screened, and 13 RCTs were included. The predominant theory and BCT categories were Social Cognitive Theory (7 studies) and goals and planning (12 studies), respectively. Significant and small effect sizes were found for self-efficacy (0.27) and functional independence (0.19). CONCLUSIONS AND RELEVANCE: Theory-based self-management interventions have the potential to enhance stroke outcomes. Systematic reporting on the use of theory and BCTs is recommended to enhance clarity and facilitate evaluations of future interventions. What This Article Adds: This review supports and guides occupational therapy practitioners to use theory-based self-management intervention as a routine part of stroke rehabilitation to improve stroke survivors' experience in the community.

The impact of digital health interventions on health-related outcomes in the workplace: A systematic review.

BACKGROUND: The impact of employee health on productivity in the workplace is generally evidenced through absenteeism and presenteeism. Multicomponent worksite health programmes, with significant online elements, have gained in popularity over the last two decades, due in part to their scalability and low cost of implementation. However, little is known about the impact of digital-only interventions on health-related outcomes in employee groups. The aim of this systematic review was to assess the impact of pure digital health interventions in the workplace on health-related outcomes. METHODS: Multiple databases, including MEDLINE, EMBASE, PubMed and PsycINFO, were used to review the literature using PRISMA guidelines. RESULTS: Of 1345 records screened, 22 randomized controlled trial studies were found to be eligible. Although there was a high level of heterogeneity across these studies, significant improvements were found for a broad range of outcomes such as sleep, mental health, sedentary behaviours and physical activity levels. Standardized measures were not always used to quantify intervention impact. All but one study resulted in at least one significantly improved health-related outcome, but attrition rates ranged widely, suggesting sustaining engagement was an issue. Risk of bias assessment was low for one-third of the studies and unclear for the remaining ones. CONCLUSIONS: This review found modest evidence that digital-only interventions have a positive impact on health-related outcomes in the workplace. High heterogeneity impacted the ability to confirm what interventions might work best for which health outcomes, although less complex health outcomes appeared to be more likely to be impacted. A focus on engagement along with the use of standardized measures and reporting of active intervention components would be helpful in future evaluations.