Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska

In 2010, Alaska Department of Health and Social Services (DHSS) received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT) to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 1419 instead of the original curriculum intended age range of 1214. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a) the professional growth of peer educators and development of peer education, (b) difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c) the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.Ye

Perceived spirituality, mindfulness and quality of life in psychiatric patients

There is some evidence of the relationship between spirituality and quality of life, but there are few bibliographic references on these constructs for patients suffering from mental illness; thus, this study was aimed at revealing the possible role of spiritual outlooks as a protective factor in these individuals. The sample consisted of 96 Portuguese psychiatric patients, selected from a psychiatric hospital and assessed based on parameters for quality of life, spirituality and mindfulness. The data support some theories about the nature of the spirituality. Spiritual beliefs are poorly correlated with the quality of life index, and there is a moderate association between these beliefs and some aspects of mindfulness. It is suggested that a spiritual outlook of psychiatric patients should be taken into account in psychological interventions

Vulnerable researchers : opportunities, challenges and collaborative co-design in regional research

Co-designed research is rightly promoted as offering opportunities for vulnerable or marginalised groups and communities to become co-designers in research, rather than subjects of it. There are well-documented benefits in bringing diverse perspectives and experiences into research dialogues. Ensuring that researchers are not detached observers is integral to these processes. However, in adopting these research approaches, researchers can be exposed to the circumstantial vulnerabilities of others and their emotions in navigating them. These intersecting relationships alter the perspectives of researchers. Through them, researchers are no longer detached from the experiences of their research participants, nor from the systemic and structural conditions that underpin them. This chapter provides personal reflections upon some of the challenges and privileges of co-designed research focused on improving health outcomes in the Inner Gippsland and Latrobe City regional communities. © The Author(s) 2020

Laughter as the Best Medicine: Exploring Humour-Mediated Health Applications

Despite the physiological and psychological benefits of humour on health, many health applications for aging hold very little humour. We investigate the potential of humour in health for aging, reviewing studies from humour therapy. To show the potential of humour in this domain, we look at the functions of humour and discuss their application to the design of virtual agents. Then, we propose new conceptual designs based on the therapeutic use of humour: agents as comic relief, agent as comic partners, and agents as virtual clowns. We aim to initiate a new research agenda in this domain and stimulate further investigations in the use of humour-mediated technology

Experiences of participation inbereavement groups from significant others’ perspectives : a qualitative study

Background: When death ends a life, the impact of caring for person who suffered a period of illness or diseasecontinues for significant others who are left to grieve. They should be offered support to avoid complicated grief.This can be provided in different ways and individually or in groups. This study aims to describe significant others’experiences of participation in bereavement groups.Methods: Ten bereavement groups that each met five times offered support for the significant others of deceasedloved ones who had been cared for by a palliative-care team. After the five meetings, the grieving members (n =46)completed written comments about the role of the groups; they also commented one year after participating (n =39).Comments were analyzed with qualitative content analysis with a directed approach using the theory of a good deathaccording to the 6S’s: self-image, self-determination, social relationships, symptom control, synthesis and summation,and surrender.Results: Bereavement groups were found to be a source for alleviating grief for some significant others, but not allexperienced relief. Moreover, grief was found to persist during participation. Another finding involved the impact ofthe role of the palliative home-care team on bereavement support. To evaluate the experience of participating in abereavement group, the use the 6S’s as a model was a strength of the analysis. Bereavement groups could enhancethe self and offer relief from grief. Participation was described as social relationships that offered a sense of coherenceand understanding in grief. The effects of participation were more meaningful close to the loss and could lose efficacyover time. Bereavement support provided before a loved one’s death was seen as valuable.Conclusion: Overall, the bereavement groups eased the grief of significant others close to the death of their lovedone. However, moving forward, several of the significant others were not sure that their participation eased their grief.To identify persons who may remain in a state of complicated grief, a routine of planned contacts with the bereavedshould begin before death and be followed up later than six months after the death of a loved one