The Effect Of Public Information Sources On Satisfaction With Patient Search For A Physician

The purpose of this research study is to examine the effect of public information sources on an individual\u27s satisfaction with the search process undertaken to select a physician. A quasiexperimental research design was adopted to randomly divide the medical staff of a large central Florida medical group into control and intervention groups of approximately 77 physicians each. The intervention involved insertion of the website address to online physician report cards on to each intervention group physician’s profile in the physician directory on the medical group\u27s website. After two months, data were collected consisting of all individuals who had scheduled first-time appointments with one of the medical group\u27s physicians during the two-month intervention period. A random sample of patients was drawn from each group and sample members were mailed a 62-item questionnaire along with a cover letter, summary of the research and postage-paid reply envelope. A total of 706 questionnaires were mailed and 61 completed questionnaires were returned, an 8.64% response rate. Intent-to-treat analysis was conducted using independent-samples t-tests to compare the research study’s continuous variables\u27 mean scores for control and intervention group participants. The analysis revealed no significant difference in scores for control and intervention groups with the exceptions that the control group was somewhat more committed to conducting a search and selecting a new physician. The control group said the physician\u27s communications skills influenced their satisfaction with the search and selection of a new physician quite a lot while the intervention group said physician communication skills somewhat influenced their satisfaction with search and selection. iv Results of the covariance structure analysis demonstrated that information use and level of commitment to search and select a new physician independently predict search satisfaction. As information use and search commitment increase, a patient\u27s satisfaction with the search increases as well. Furthermore, as information use increases, the variety of information sources relied upon or used also increases. The findings support the alternative hypothesis that the positive or direct effect of physician report cards is demonstrated in the time and cost of patient search for a physician for both intervention and control groups. One other alternative hypothesis was partially supported, i.e., the effect of household income is confirmed in patient search and satisfaction in selecting a physician. The alternative hypotheses that proposed that physician report cards are more likely to be used to search for a medical specialist and that physician experience, office location and accepted insurance effect patient search and selection of a physician were not tested. Two other alternative hypotheses were rejected. The research findings also indicated that predictors of health care information search satisfaction vary based upon the environment and contextual factors in which the search is conducted

Designing a Patient-Centered Clinical Workflow to Assess Cyberbully Experiences of Youths in the U.S. Healthcare System

Cyberbullying or online harassment is often defined as when someone repeatedly and intentionally harasses, mistreats, or makes fun of others aiming to scare, anger or shame them using electronic devices [296]. Youths experiencing cyberbullying report higher levels of anxiety and depression, mental distress, suicide thoughts, and substance abuse than their non-bullied peers [360, 605, 261, 354]. Even though bullying is associated with significant health problems, to date, very little youth anti-bullying efforts are initiated and directed in clinical settings. There is presently no standardized procedure or workflow across health systems for systematically assessing cyberbullying or other equally dangerous online activities among vulnerable groups like children or adolescents [599]. Therefore, I developed a series of research projects to link digital indicators of cyberbullying or online harassment to clinical practices by advocating design considerations for a patient-centered clinical assessment and workflow that addresses patients’ needs and expectations to ensure quality care. Through this dissertation, I aim to answer these high-level research questions:RQ1. How does the presence of severe online harassment on online platforms contribute to negative experiences and risky behaviors within vulnerable populations? RQ2. How efficient is the current mechanism of screening these risky online negative experiences and behaviors, specifically related to cyberbully, within at-risk populations like adolescent in clinical settings? RQ3. How might evidence of activities and negative harassing experiences on online platforms best be integrated into electronic health records during clinical treatment? I first explore how harassment is presented within different social media platforms from diverse contexts and cultural norms (study 1,2, and 3); next, by analyzing actual patient data, I address current limitations in the screening process in clinical settings that fail to efficiently address core aspect of cyberbullying and their consequences within adolescent patients (study 4 and 5); finally, connecting all my findings, I recommend specific design guidelines for a refined screening tool and structured processes for implementation and integration of the screened data into patients’ electronic health records (EHRs) for better patient assessment and treatment outcomes around cyberbully within adolescent patients (study 6)

A randomized 3-month, parallel-group, controlled trial of CALMA m-health app as an adjunct to therapy to reduce suicidal and non-suicidal self-injurious behaviors in adolescents: study protocol

Background: Suicidal and non-suicidal self-injurious behaviors are among the leading causes of death and injury in adolescents and youth worldwide. Mobile app development could help people at risk and provide resources to deliver evidence-based interventions. There is no specific application for adolescents and young people available in Spanish. Our group developed CALMA, the first interactive mobile application with the user in Spanish, which provides tools based on Dialectical Behavioral Therapy to manage a crisis of suicidal or non-suicidal self-directed violence with the aim of preventing suicide in adolescents and youth. Methods: To test the effectiveness, safety and level of engagement of the CALMA app in people aged 10 to 19 who are treated in mental health services of two public hospitals, we will conduct a parallel-group, two-arm randomized controlled trial. Participants will be assessed face-to-face and via video call at four timepoints: day-0 (baseline), day-30, day-60, and day-90. A total of 29 participants per group will be included. Change in the frequency of suicidal and non-suicidal self-injurious behaviors will be compared between groups, as well as the level of emotional dysregulation, level of app engagement and time of psychiatric admission during the follow-up period. Discussion: This study is particularly relevant to young people given their widespread use of mobile technology, while there are currently no available smartphone app-based self-guided psychological strategies in Spanish that attempt to reduce suicidal behavior in adolescents who are assisted in the public health sector from low and middle-income countries in Latin America.Fil: Rodante, Demián. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; ArgentinaFil: Chiapella, Luciana Carla. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; ArgentinaFil: Olivera Fedi, Ramiro. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; ArgentinaFil: Papavero, Eliana Belen. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; ArgentinaFil: Lavoie, Kim L.. Université du Québec a Montreal; CanadáFil: Daray, Federico Manuel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

A Syndemic Perspective on Anti-Asian Racism and Asian American Mental Health During the COVID-19 Pandemic

Asian Americans have been negatively impacted by the COVID-19 pandemic, experiencing COVID-related anti-Asian racism as well as exacerbated pandemic-related stressors, such as increased negative mental health symptoms and economic challenges, due to existing structural inequities. Asian Americans are a diverse group made up of various ethnic and cultural groups with differential impacts from the pandemic. Examining differences within Asian Americans is therefore important to further understand the impacts of health inequities, economic challenges, and racism. Using a large, national dataset, I conducted three studies that examine Asian Americans’ experiences of anti-Asian racism, negative mental health symptoms, and economic challenges within the context of the COVID-19 pandemic. Study one examined Asian Americans’ prevalence rates of psychological distress and unmet mental health needs by sociodemographic subgroups. In study two, I examined rates of discrimination and awareness of anti-Asian COVID-related racism by sociodemographic subgroups as well as the impacts these two forms of racism have on psychological distress and physical health decline. Finally, in study three, I examined latent profiles of a proposed COVID-19 anti-Asian racism syndemic, describing how experiences of anti-Asian racism, mental and physical health, and economic challenges overlap and differ for Asian American subgroups. Asian Americans’ wellbeing is an important public health concern that needs to be addressed systemically. By examining subgroup differences in mental health and related disparities (i.e., anti-Asian racism and economic inequities), these three studies delineate specific Asian American subgroups who are most vulnerable and in need of services and policy change

Childrens Self-Perception: Investigating the Impact of Victimization and the Effectiveness of a Strengths-Based Camp Intervention

Childrens Self-Perception: Investigating the Impact of Victimization and the Effectiveness of a Strengths-Based Camp Interventio

Gamified family-based health exercise intervention to improve adherence to 24-h movement behaviors recommendations in children: "3, 2, 1 Move on Study"

Background Evidence suggests that movement patterns, including physical activity, sedentary behavior, and sleep duration, throughout a 24-h period, have a signifcant impact on biological processes and health outcomes for both young and adult populations. However, 80% of adolescents worldwide are not sufciently active, and many children do not meet international physical activity recommendations for their age. Thus, the aim of this study is to evaluate the impact of a 12-week gamifed family-based health and exercise intervention on physical ftness, basic motor competencies, mental and behavioral health, and adherence to 24-h movement guidelines in children aged 4 to 5 years old. The study will evaluate changes in sedentary levels, physical ftness, basic motor competencies, mental and behavioral disorders, adherence to the exercise program, and compliance with physical activity recom‑ mendations. In addition, the aim of this protocol is to describe the scientifc rationale in detail and to provide informa‑ tion about the study procedures. Methods/design A total of 80 children, aged 4 to 5 years old, will be randomly assigned in a 1:1 ratio to one of two groups: the exercise group and the routine care group. The exercise group will undergo a 12-week exercise interven‑ tion, followed by a 12-week follow-up period. On the other hand, the routine care group will undergo a 12-week period of routine care, followed by a 12-week follow-up control period. The exercise program will be implemented in a family setting and facilitated through a gamifed web platform with online supervision, with the hypothesis that it will have a positive impact on physical ftness, anthropometric measures, basic motor competencies, and adherence to 24-h movement guidelines. Discussion The results of this study will provide valuable insights into the impact of a gamifed, family-oriented health and exercise program on various aspects of health, including physical ftness, basic motor competencies, mental and behavioral well-being, and adherence to 24-h movement guidelines. The fndings will contribute to clos‑ ing the gap in current knowledge on the efectiveness of these types of interventions for children and their parents. These fndings will also contribute to the development of future guidelines for promoting physical activity in childrenOpen Access funding provided by Universidad Pública de Navarra. The “3, 2, 1 Move on Study” is supported in part by the Health Department of Gobierno de Navarra and 50% co-fnanced by the European Regional Development Fund (ERDF) under Operational Programme 2014–2020 in Navarre

Training Future Mental Health Professionals in an Evidence-Informed System of Care

High quality mental health services do not reach the youth who need them, leading to efforts to implement effective treatments more broadly. One focus of these efforts concerns training the mental health workforce, of which master’s-level social workers represent a large proportion. However, the curricula of master’s in social work (MSW) programs do not often emphasize evidence-based approaches. One possible solution is Managing and Adapting Practice (MAP; PracticeWise, LLC), a system that allows clinicians to (1) identify clinically indicated evidence-based programs by searching a growing evidence-base of randomized controlled trials (RCTs) and (2) build individualized evidence-informed treatment plans by focusing on common practice elements. MAP may also address the concerns about manual-based programs (e.g., inflexibility). Although some MSW programs have integrated MAP, the benefits of MAP training within MSW education have not yet been evaluated. This project evaluated multiple mechanisms of training in a semester-long MSW-focused MAP course relative to curriculum-as-usual control at a large public university. Participants were advanced MSW students (mean age = 27, SD = 5.8; 92.3% women; 59% white) either enrolled in the MAP course (n = 17) or enrolled in curriculum-as-usual (n = 22). The MAP course was co-taught by an expert MAP trainer and a MAP-trained social worker. Pre- and post-semester, participants completed a battery that included: (1) role-plays with standardized patients that were videotaped and coded using the Therapy Observational Coding System of Child Psychotherapy – Revised Strategies scale; (2) a written task that was subsequently coded to assess participants’ clinical decision-making skills during different phases of a standardized case; and (3) attitudinal factors that may be predictive of future MAP usage, such as attitudes toward evidence-based practice and the acceptability and feasibility of MAP. Results indicate significant uptake of cognitive and behavioral therapeutic strategies in the MAP condition. Overall, participants endorsed positive attitudes toward evidence-based practice broadly and MAP specifically. Findings may be used to inform the development of more effective evidence-informed curriculum for master’s-level clinical programs and future workforce training initiatives. Methodological considerations may inform advances in instrumentation to measure multidimensional training outcome

Couple\u27s Relationship with Diabetes: Transformation, Partnership, and Management

This study used an MFT perspective to examine a model of three bio-psychosocial constructs, seeking to depict key dimensions of what makes couples successful in managing the demanding self-care regimen of diabetes. The model includes a meaning and emotion-oriented construct called relationship with diabetes, a psychosocial relational construct of diabetes-specific partnering support, and their direct and indirect effects on an endogenous construct of success in diabetes management. Surveys from 118 adult couples with diabetes provided data to test the hypothesized path and measurement model. Correlational and multiple regression analysis examined variable relationships, factor analysis examined construct dimensionality, and structural equation modeling determined the model\u27s goodness of fit. It was found that relationship with diabetes and partnering support are positively associated and have direct and indirect effects promoting successful diabetes management. The emotion component of relationship with diabetes was especially important to management success. The current quantitative study extends and tests grounded theory from a previous qualitative study. Outcomes from this study expand our current understanding of how couples manage chronic illness and highlight the importance of developing a multidisciplinary approach to diabetes research, education, and intervention