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1.
J Consult Clin Psychol ; 89(6): 537-550, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34264701

RESUMO

OBJECTIVE: To determine if the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) improves functional impairment, psychiatric symptoms, and sleep and circadian functioning. METHOD: Adults diagnosed with serious mental illness (SMI) and sleep and circadian dysfunction (N = 121) were randomly allocated to TranS-C plus usual care (TranS-C + UC; n = 61; 8 individual weekly sessions) or 6 months of Usual Care followed by Delayed Treatment with TranS-C (UC-DT; n = 60). Schizophrenia (45%) and anxiety disorders (47%) were common. Blind assessments were conducted pre-treatment, post-treatment, and 6 months later (6FU). The latter two were the post-randomization points of interest. The location was Alameda County Behavioral Health Care Services (ACBHCS), a Community Mental Health Center (CMHC) in California. RESULTS: For the primary outcomes, relative to UC-DT, TranS-C + UC was associated with reduction in functional impairment (b = -3.18, p = 0.025, d = -0.58), general psychiatric symptoms (b = -5.88, p = 0.001, d = -0.64), sleep disturbance (b = -5.55, p < .0001, d = -0.96), and sleep-related impairment (b = -9.14, p < .0001, d = -0.81) from pre-treatment to post-treatment. These effects were maintained to 6-month follow-up (6FU; d = -0.42 to -0.82), except functional impairment (d = -0.37). For the secondary outcomes, relative to UC-DT, TranS-C + UC was associated with improvement in sleep efficiency and on the Sleep Health Composite score from pre-treatment to 6FU. TranS-C + UC was also associated with reduced total wake time and wake time variability from pre-treatment to post-treatment, as well as reduced hallucinations and delusions, bedtime variability, and actigraphy measured waking activity count variability from pre-treatment to 6FU. CONCLUSIONS: A novel transdiagnostic treatment, delivered within a CMHC setting, improves selected measures of functioning, symptoms of comorbid disorders, and sleep and circadian outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Centros Comunitários de Saúde Mental , Transtornos Mentais/terapia , Psicoterapia/métodos , Transtornos do Sono do Ritmo Circadiano/terapia , Transtornos do Sono-Vigília/terapia , Adulto , Ansiedade/terapia , Transtornos de Ansiedade/terapia , California , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Pessoa de Meia-Idade , Esquizofrenia/terapia , Sono , Transtornos do Sono do Ritmo Circadiano/complicações , Transtornos do Sono-Vigília/complicações , Resultado do Tratamento
2.
Health Psychol ; 39(9): 785-795, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32833480

RESUMO

OBJECTIVE: Parents have profound impacts on adolescents' health behaviors. Yet parents receive minimal training in the elements of conversations that optimally inspire their children toward engaging in healthy behaviors. The current study examines a novel interpersonal target: parent-adolescent conversations about adolescent health behavior change. Derived from advances in the science of behavior change, the Parent Behavior Change Intervention (PBC-I) contains conversational elements (e.g., behavior change techniques, positive communication strategies) hypothesized to reduce parent-adolescent coercion and conflict and facilitate upward spirals of healthy behavior change in adolescents. METHOD/DESIGN: The first phase of the study involves the development of the PBC-I in a small case series (N = 12 dyads). The second phase involves an open trial of the PBC-I (N = 36 dyads). Adolescents will receive six 50-min sessions of the Transdiagnostic Sleep and Circadian Intervention to improve sleep while their parents receive six50-min sessions of the PBC-I. Parent-adolescent dyads will be assessed before and after the intervention. The primary analysis will examine whether postintervention use of behavior change techniques and positive communication strategies by parents is higher than preintervention use and whether increased use by parents predicts more positive conversational behaviors, less parent-adolescent conflict, higher adolescent motivation for change, and improved adolescent sleep. DISCUSSION: This research provides an initial test of the hypothesis that improving the parent-adolescent conversation will improve adolescent sleep health behavior. While sleep-related health behaviors are the focus of this study, the research is designed to be relevant to a broad range of health behavior change in young people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtornos Mentais/psicologia , Pais/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Relações Pais-Filho/legislação & jurisprudência
3.
Acad Med ; 94(1): 20-24, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30067539

RESUMO

As part of their efforts to increase the diversity of their workforce and student body, medical schools, academic medical centers, and individual departments are increasingly crafting public statements about their value for and commitment to diversity. For these statements to effectively enhance diversity, however, care must be taken, as research shows that some diversity-related messages can backfire. To avoid the pitfalls and realize the promise of diversity statements, this article presents recommendations based on experimental studies that investigate the impact of diversity messages. These studies suggest that diversity statements be aspirational, emphasize autonomy, and express a value for difference. Aspirational statements avoid creating the impression that equity has been achieved, thus preventing the "illusion of fairness" and the "paradox of meritocracy," wherein espousing egalitarian values and the existence of a meritocracy can increase biased outcomes and workplace disparities. Statements that emphasize autonomy avoid the backlash that can occur when organizational members feel coerced into adopting prodiversity actions. Statements that emphasize the value of human differences convey a multicultural message that has shown positive outcomes compared with "colorblind" statements that acknowledge our common humanity. Although there are no studies specific to academic medicine, current research on a variety of organizations, including some studies from the health care industry, suggests that relying on these recommendations to craft a diversity statement may help contribute to academic medical centers' larger efforts to promote diversity and inclusion and may help them avoid some deleterious effects.


Assuntos
Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Diversidade Cultural , Política Organizacional , Faculdades de Medicina/organização & administração , Faculdades de Medicina/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , Adulto Jovem
4.
Acad Med ; 90(2): 221-30, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25374039

RESUMO

PURPOSE: Despite sincere commitment to egalitarian, meritocratic principles, subtle gender bias persists, constraining women's opportunities for academic advancement. The authors implemented a pair-matched, single-blind, cluster randomized, controlled study of a gender-bias-habit-changing intervention at a large public university. METHOD: Participants were faculty in 92 departments or divisions at the University of Wisconsin-Madison. Between September 2010 and March 2012, experimental departments were offered a gender-bias-habit-changing intervention as a 2.5-hour workshop. Surveys measured gender bias awareness; motivation, self-efficacy, and outcome expectations to reduce bias; and gender equity action. A timed word categorization task measured implicit gender/leadership bias. Faculty completed a work-life survey before and after all experimental departments received the intervention. Control departments were offered workshops after data were collected. RESULTS: Linear mixed-effects models showed significantly greater changes post intervention for faculty in experimental versus control departments on several outcome measures, including self-efficacy to engage in gender-equity-promoting behaviors (P = .013). When ≥ 25% of a department's faculty attended the workshop (26 of 46 departments), significant increases in self-reported action to promote gender equity occurred at three months (P = .007). Post intervention, faculty in experimental departments expressed greater perceptions of fit (P = .024), valuing of their research (P = .019), and comfort in raising personal and professional conflicts (P = .025). CONCLUSIONS: An intervention that facilitates intentional behavioral change can help faculty break the gender bias habit and change department climate in ways that should support the career advancement of women in academic medicine, science, and engineering.


Assuntos
Mobilidade Ocupacional , Docentes de Medicina , Hábitos , Sexismo/prevenção & controle , Conscientização , Análise por Conglomerados , Currículo , Feminino , Humanos , Masculino , Análise por Pareamento , Motivação , Autoeficácia , Método Simples-Cego
5.
J Divers High Educ ; 5(2): 63-77, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22822416

RESUMO

The National Science Foundation and others conclude that institutional transformation is required to ensure equal opportunities for the participation and advancement of men and women in academic science, technology, engineering, mathematics, and medicine (STEMM). Such transformation requires changing the habitual attitudes and behaviors of faculty. Approaching implicit bias as a remediable habit, we present the theoretical basis and conceptual model underpinning an educational intervention to promote bias literacy among university faculty as a step toward institutional transformation regarding gender equity. We describe the development and implementation of a Bias Literacy Workshop in detail so others can replicate or adapt it to their setting. Of the 220 (167 faculty and 53 nonfaculty) attendees from the initial 17 departments/divisions offered this workshop, all 180 who completed a written evaluation found the workshop at least "somewhat useful" and 74% found it "very useful." Over 68% indicated increased knowledge of the workshop material. Of the 186 participants who wrote a commitment to engage in new activities to promote gender equity, 87% incorporated specific workshop content. Twenty-four participants were interviewed 4-6 months after attending the workshop; 75% of these not only demonstrated increased bias awareness, but described plans to change-or had actually changed-behaviors because of the workshop. Based on our sample of faculty from a Midwestern university, we conclude that at least one third of STEMM faculty who are invited will attend a 2.5-hr Bias Literacy Workshop, that nearly all will find it useful, and that most will complete a written commitment to promoting gender equity. These findings suggest that this educational intervention may effectively promote institutional change regarding gender equity.

6.
Acad Med ; 85(6): 999-1007, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20505400

RESUMO

One opportunity to realize the diversity goals of academic health centers comes at the time of hiring new faculty. To improve the effectiveness of search committees in increasing the gender diversity of faculty hires, the authors created and implemented a training workshop for faculty search committees designed to improve the hiring process and increase the diversity of faculty hires at the University of Wisconsin-Madison. They describe the workshops, which they presented in the School of Medicine and Public Health between 2004 and 2007, and they compare the subsequent hiring of women faculty in participating and nonparticipating departments and the self-reported experience of new faculty within the hiring process. Attendance at the workshop correlates with improved hiring of women faculty and with a better hiring experience for faculty recruits, especially women. The authors articulate successful elements of workshop implementation for other medical schools seeking to increase gender diversity on their faculties.


Assuntos
Docentes de Medicina/normas , Seleção de Pessoal/normas , Mulheres , Centros Médicos Acadêmicos , Educação , Feminino , Humanos , Estados Unidos , Wisconsin
7.
J Womens Health (Larchmt) ; 14(8): 684-91, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16232100

RESUMO

One of the first National Institutes of Health (NIH) Roadmap initiatives to be launched was the Director's Pioneer Award. This award was established to "identify and fund investigators of exceptionally creative abilities and diligence, for a sufficient term (five years) to allow them to develop and test far-ranging ideas." Nine excellent scientists were chosen as NIH Pioneers, but the selection of all men is at odds with the percentage of women receiving doctoral degrees for the past three decades, serving as principal investigators on NIH research grants, and achieving recognition as scientific innovators in non-NIH award competitions. The absence of women Pioneers provokes the following question: In the context of extant research on the impact of gender-based assumptions on evaluation of men and women in traditionally male fields, such as science, were there aspects about the process of nomination, evaluation, and selection that inadvertently favored men? We present evidence to suggest that women scientists would be disadvantaged by the following components of the NIH Director's Pioneer Award initiative: (1) time pressure placed on evaluators, (2) absence of face-to-face discussion about applicants, (3) ambiguity of performance criteria, given the novelty of the award, combined with an emphasis on subjective assessment of leadership, potential achievements rather than actual accomplishments, and risk taking, (4) emphasis on self-promotion, (5) weight given to letters of recommendation, and (6) the need for finalists to make a formal, in-person presentation in which the individual and not his or her science was the focus of evaluation. We offer an analysis of this process to encourage the NIH to embark on self-study and to educate all reviewers regarding an evidence-based approach to gender and evaluation.


Assuntos
Distinções e Prêmios , Pesquisa Biomédica/normas , National Institutes of Health (U.S.)/normas , Médicas , Pesquisadores/normas , Atitude do Pessoal de Saúde , Feminino , Humanos , Relações Interprofissionais , Masculino , Médicas/normas , Estados Unidos
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