11 research outputs found
National Autism Indicators Report: Transition into Young Adulthood
There is very little research published concerning how people with autism do in the adult portion of their lifespans. We analyzed data from "The National Longitudinal Transition Study-2" and "The Survey of Pathways to Diagnosis and Services" to examine the service needs and life outcomes of adolescents and young adults on the autism spectrum. This report describes the prevalence of a wide variety of indicators related to transition planning, services access, unmet needs, employment, postsecondary education, living arrangements, social participation, and safety and risk
Medical Students’ Perceptions, Knowledge, and Competence in Treating Neurodivergent, Disability, and Chronic Illness (NDCI) Populations: Results from a Cross-Sectional Study
Background: Globally, Neurodivergent, Disability, and Chronic Illness (NDCI) populations face significant health disparities. Lack of physician knowledge about NDCI is a key mechanism underlying these disparities. The current study aimed to describe medical students’ perceptions, knowledge, and competence regarding NDCI.
Methods: A cross-sectional study was carried out using an online survey of medical students at a large public university with no NDCI-specific curriculum (n = 97; response rate = 18%). The survey asked about students’ perceptions, knowledge, and competence pertaining to NDCI populations.
Results: Most (n = 93, 96%) indicated it is important for physicians to understand the influence of NDCI on patient health and clinical encounters. Yet only seven (7%) and 15 (15%) reported that the NDCI curriculum in their medical school was sufficient, and they felt comfortable taking care of patients with NDCI respectively. Most (n = 87, 90%) wanted their medical school to provide additional NDCI training. Few reported high knowledge about ableism (n = 12, 12%), self-determination (n = 7, 7%), coordinating care (n = 4, 4%) and accommodations (n = 10, 10%). Few indicated high competence in cognitive, physical, social-emotional, and other NDCI types (n = 7 – 32, 7-33%). Existing knowledge often came from personal experiences or the news and media.
Conclusion: Findings demonstrated the gaps in medical education, as exemplified by medical students surveyed in one U.S. public university. Results can inform efforts to ameliorate global health disparities associated with a lack of physician knowledge about NDCI
The Needle Anxiety Program: A Patient-Centered Initiative for Individuals With Developmental Disabilities.
Examining the Influence of the Social Ecosystem on Mental Health Development during the Transition to Adulthood
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Examining the Influence of the Social Ecosystem on Mental Health Development during the Transition to Adulthood
This dissertation explores the complex connection between the social ecosystem and mental health development during the transition to adulthood. Utilizing a comprehensive approach, the social ecosystem is evaluated through three fundamental constructs: social support, social connectedness, and social capital. Mental health is assessed holistically, encompassing mental health conditions, well-being evaluations, and perceived mental health needs. Embracing an interdisciplinary perspective, the conceptual framework integrates population health strategies with a Life Course Health Development (LCHD) perspective grounded in developmental psychology principles. The primary objective is to advance our understanding of how youth’s social ecosystem interacts with other developmental factors to shape mental health. The first paper examines factors within youth’s social ecosystem fostering resilience amid adverse family environments. The second paper assesses the impact of social connectedness and social media on youth mental health. The third paper explores how youth social support influences mental health help-seeking behavior. In conclusion, this dissertation emphasizes the importance of promoting positive mental health strategies, advocating for relational agency, and considering the lasting effects of social factors on mental health. The insights gleaned from these papers are instrumental in developing effective interventions and policies to support the mental well-being of young people. As the exploration of these dynamics continues, collaborative efforts across disciplines remain crucial for sustaining the mental well-being of youth and future generations
Examining the Influence of the Social Ecosystem on Mental Health Development during the Transition to Adulthood
Mindfulness and Wellbeing Among College Students During the COVID-19 Pandemic: A Qualitative Analysis of Emergent Themes and Concerns
Mindfulness and Wellbeing Among College Students During the COVID-19 Pandemic: A Qualitative Analysis of Emergent Themes and Concerns
Emerging adulthood (ages of 18-30 years) is a critical developmental period characterized by mental health challenges, particularly for college students who experience distinct mental health issues. Mindfulness-based approaches have been associated with mental health benefits. This study aimed to assess the mental health and wellbeing of college students with qualitative data obtained via their participation in a mindfulness exercise. We analyzed the sentiments and concerns of college students nearly a year into the coronavirus disease 2019 (COVID-19) pandemic. The results led to the development of four major themes: a source code of the COVID-19 pandemic, assessments of mindfulness and wellbeing, emergent concerns, and coping strategies. The findings from this paper can inform combined internal medicine and pediatrics (Med-Peds) providers' efforts to improve the mental and physical health outcomes among emerging adults
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Implementation of a Minimal Sedation Protocol for Patients With Developmental Disabilities and Needle Phobia.
Objective Patients with intellectual and developmental disabilities (IDD) experience needle phobia at greater rates than individuals in the general population. Needle phobia deters patients with IDD from receiving routine medical procedures, which impacts their physical health outcomes. The aim of this quality improvement study was to assess the feasibility of a minimal sedation protocol in an outpatient care setting for patients with IDD and needle phobia. Methods The sample included 18 patients characterized as having a diagnosis of IDD only or IDD and needle phobia compared to patients with only a diagnosis of needle phobia. Reasons for referral to intervention included routine lab work, therapeutic drug monitoring, and routine vaccination. The minimal sedation intervention involved intranasal administration of a benzodiazepine (midazolam) by a registered nurse. Outcomes of interest were administration of the sedation and administration of medical orders. Results Nearly a third of patients were children (33.3%, n=6), and 39% of patients were female (n=7). Individuals with IDD (including those both with and without needle phobias) comprised 72.2% of patients (n=13). Half of intervention encounters were successful in both administering the sedation and performing the medical orders (n=9). Among individuals with IDD, 38.4% successfully completed the intervention (n=5). Conclusion This pilot study assessed the feasibility of implementing a minimal sedation protocol in primary care outpatient care settings. The preliminary results suggest that the minimal sedation protocol may improve the uptake of needle-related medical procedures for patients with IDD and/or needle phobia. The minimal sedation protocol should be studied in a larger sample and among multiple outpatient settings to establish effectiveness of the intervention
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The Needle Anxiety Program: A Patient-Centered Initiative for Individuals With Developmental Disabilities.
Objective To describe the development process of a patient-centered initiative focused on improving primary care health outcomes of patients with intellectual and developmental disabilities (IDD) and needle-related anxiety using evidence-based practices and novel approaches that can be implemented in outpatient settings. The overall outcome of the program is to increase vaccine uptake and accessibility in the IDD population as well as improve needle-related procedures in primary care settings to be more humane and effective. Methods The development process occurred in the context of a large healthcare system serving a diverse patient population in the U.S. and was led by an expert committee made of an multidisciplinary team of physicians, psychologists, ambulatory and clinic nurses, pharmacists, and anesthesiologists committed to promoting quality healthcare for the IDD population. Committee members were recruited within the healthcare system based on their relevant expertise. The methodology included an iterative and collaborative process that took place over three development phases: ideation and design, literature review and synthesis, and expert engagement. The ideation and design phase included a series of planning meetings among the expert committee, in which committee members identified preliminary concerns based on their expertise in the field and background knowledge on the current procedures related to improving routine care for individuals with IDD and/or needle-related anxiety. The literature review and synthesis phase led to the development of an annotated bibliography of research and clinical guidelines that synthesized findings on needle anxiety in clinical care. The expert engagement phase included all Committee members meeting for a final discussion to establish a tiered approach to utilizing evidence-based strategies that could be implemented across clinics within the healthcare system. Results The multidisciplinary team of experts developed a three-tier system, deployed sequentially as needed. The first tier focuses on training nurses in evidence-based behavioral modification strategies to implement as standard of care. The second tier uses the addition of a distraction device and topical analgesic to reduce anxiety in patients with slightly elevated procedural anxiety. The third tier involves a novel minimal sedation protocol using intranasal midazolam for patients with needle phobia that can be administered in an outpatient setting. Conclusion The Needle Anxiety Program eases the administration of needle-related medical procedures in the primary care setting for patients with IDD and needle-related anxiety. The use of evidence-based practices and a novel minimal sedation protocol for individuals with needle phobia assists in the completion of routine healthcare procedures, such as vaccinations and phlebotomy, in a patient-preferred setting. The purpose of delineating needle-related processes and procedures through the Needle Anxiety Program is to reduce health disparities for patients with IDD and promote uptake of the Needle Anxiety Program in similar healthcare settings