Motivational Interviewing Via Co-Active Life Coaching as an Intervention for Tobacco Control

The purpose of this Motivational Interviewing (MI) via Co-Active Life Coaching (CALC) research program in tobacco control was to assess the effectiveness of this individualized, interactive intervention. This was achieved through a critical appraisal and literature review of the individual dimensions of MI currently used in cognitive-behavioural smoking cessation interventions, as well as MI applied via CALC intervention studies at both the individual- and population-levels. Article 1 provides the critically appraised and systematic review of literature exploring three dimensions of MI (social support, motivation, and tailored interventions) which were implemented independently in cognitive-behavioural cessation interventions. The effectiveness of these dimensions at promoting cessation was assessed and yielded mixed results. The purpose of Article 2 was to assess the impact of MI-via-CALC on selected cessation outcomes among young adults (19-25 years) and found the immediate intervention group, compared to the waitlist group, had a significant reduction in smoking behaviours (number of cigarettes smoked per day and cigarette dependency) and significant increases in personal competency (self-esteem and self-efficacy). Additionally, at 12-months post-intervention a cessation rate of 31.4% was reported and biochemically verified. Lastly, Article 3 assessed the impact of a full-day application-based MI-via-CALC training on the perceived competency of employees of a national smokers’ telephone hotline to facilitate behaviour change among callers. Post- training participants described skill development, increased competency at facilitating behaviour change, and desire for additional training. This research program was comprised of three unique studies. This was the first critical appraisal and literature review to assess cognitive-behavioural cessation interventions through an MI lens. The core components of MI-via-CALC are similar to components already utilized individually in cessation interventions; however, unique to MI-via-CALC is the incorporation of these components into one intervention. Moreover, this was the largest individual MI-via-CALC intervention tobacco study to date and the only one with a control group. Furthermore, the cessation rates observed in this intervention study are beyond those currently observed in other cognitive-behavioural interventions as well as nicotine replacement therapy studies. Lastly, the MI-via-CALC training offered to employees of a national smoker’s hotline was also a first, as the hotline typically does not allow outside researchers within their organization. Overwhelmingly, the training was well received, and the impact was self-reported behaviour change resulting in ameliorated client interactions to promote cessation. Together, the important findings of these ground-breaking studies underscore the need for continued investigation of MI-via-CALC as an intervention for tobacco control

ASSESSING THE IMPACT OF CO-ACTIVE LIFE COACHING AS AN INTERVENTION FOR SMOKING CESSATION: A DEMONSTRATION STUDY

The purpose of this demonstration study involving adults aged 19-29 was to assess Co- Active Life Coaching (CALC) compared to a control condition on facilitating smoking cessation utilizing various constructs linked with cessation. The study also qualitatively explore smoking triggers and obstacles to cessation, and participants’ coaching experiences. In this repeated measures, between groups design 20 participants were randomly assigned to either the CALC or control group. Between groups there was a statistically significant difference in group retention (90% CALC versus 30% control group,/) \u3c .05). Across time, statistically significant differences were observed in smoking cessation; decrease in number of cigarettes smoked per day and cigarette dependency; and increases in both internal and external self-efficacy. Qualitatively, stress and social situations were identified as triggers; the main cessation obstacle was the control and cigarette relationship; and only the CALC group found coaching to aid in cessatio

Criticai discourse analysis of policies impacting the intersection of health and experiences of intimate partner violence for rural women in Ontario, Canada

Introduction: Intimate partner violence (IPV) impacts approximately one quarter of Canadian women, and services provided to support women are heavily influenced by policy. Policy sets the stage and tone for action in all sectors. To date, there have been no critical discourse analyses examining how provincial, hospital, and women\u27s shelter policies intersect and impact women in rural communities. Methods: A critical discourse analysis using a case study of one rural community in south-western Ontario was undertaken by a multisectoral team of researchers using a critical, feminist, intersectional lens. The selected policies were (1) Domestic Violence Action Plan for Ontario (ODVAP), (2) the rural women\u27s shelter policy, and (3) the hospital policy. Results: The internal analysis of the policies revealed that ODVAP Rural and Remote Health rrh. org. au focused on societal solutions to violence requiring cross-sectoral cooperation with a focus on marginalized populations, whereas the rural shelter policy focused on creating a philosophical orientation to underpin their work with clients. There was no formal hospital policy related to the provision of services for women who have experienced violence. The policies revealed a disconnect between the stated goals and the specifics concerning how the policies would come together to achieve these goals. Obstacles such as having no clear link for how ODVAP and the shelter policy would work together, idealization of training but a lack of specificity on what training would be useful, and the requirement of affirmative action on the part of women to engage with services functioned as a means to maintain the status quo, that is, working in a siloed approach to care. Conclusions: Integrative systems are important for women who have experienced IPV given the wide range of health, social, and economic consequences of violence. Policy alignment is important for women who have experienced or are experiencing IPV, particularly in rural contexts where services are fraught with additional barriers

Assessing motivational interviewing through co-active life coaching tools as a smoking cessation intervention: A demonstration study

Abstract The objective of this study was to explore smoking triggers and obstacles to cessation, and intervention experiences among nine 19-28 year old smokers who participated in a 3-month coaching-administered Motivational Interviewing (MI) intervention. In addition to qualitative methods, quantitative trends regarding self-efficacy, self-esteem, cigarette dependency, and average daily cigarettes use were assessed via a repeated measures design. Participants engaged in 9 sessions with a certified coach over 3-months. In-depth interviews and previously validated quantitative assessments were conducted at baseline, 1, 3, and 6-months. Qualitatively, stress and social situations were primary smoking triggers. Cessation obstacles were a sense of personal identify as a smoker and feeling controlled by cigarettes. Through the intervention participants reportedly gained: personal insights related and unrelated to smoking; helpful ways to cope with smoking challenges; and heightened awareness about other choices. Quantitatively, all constructs' trends supported qualitative findings. The application of motivational interviewing using coaching tools is valuable for reducing smoking, and for providing smokers' with insights about their behaviours, their triggers, and what they need to be and stay smoke-free. Additional research with a larger sample over a longer time is warranted

Examining the impact of trauma-informed cognitive behavioral therapy on perinatal mental health outcomes among survivors of intimate partner violence (the PATH study): Protocol for a feasibility study

Background: Intimate partner violence (IPV) is a pervasive public health problem, impacting the health and quality of life of survivors worldwide. The trauma of IPV is associated with a high incidence of mental illness, namely depressive and anxiety disorders, and posttraumatic stress disorder (PTSD). Moreover, literature endorses cognitive behavioral therapy (CBT) interventions as a gold standard for those with symptomatology consistent with anxiety disorders, mood disorders, and PTSD. However, efficacy has not been evaluated among a population of pregnant survivors of IPV. Objective: We present the protocol that will be used to explore the efficacy of trauma-informed cognitive behavioral therapy on maternal and child health outcomes for pregnant women with PTSD, depression, or anxiety symptomatology resulting from IPV. A secondary aim will be to test the validity and feasibility of study methodology to support the successful implementation of a full-scale randomized controlled trial. Methods: The Promoting Attachment Through Healing (PATH) study will use a mixed-methods approach grounded in an intersectional feminist framework to explore the effectiveness of trauma-informed CBT for pregnant survivors of IPV. Study participants will be recruited through the hospital-based Perinatal Mental Health Clinic (London, Ontario, Canada). A feasibility sample of 20 pregnant women (cohort 1) will be selected to engage in an eight-session antenatal CBT intervention facilitated by the program\u27s perinatal clinical nurse specialist, with evaluation at baseline, at two months postpartum (intervention and online questionnaire), and at six and twelve months postpartum (online questionnaire only). Concurrently, we will conduct a retrospective audit of 100 medical charts (cohort 2; 50 charts of perinatal women who received CBT and 50 charts of women who did not receive perinatal CBT) from the past five years. The efficacy of the intervention will be based on a reduction of mental illness symptomatology, improved maternal-infant attachment, maternal coping, and maternal quality of life. Additionally, the feasibility of the protocol and acceptability of the intervention from the women\u27s perspective will be examined. Inductive content analysis of all qualitative data will be used to determine common themes. Additionally, descriptive statistics, including measures of central tendency and dispersion, will be computed for all continuous variables. Alternatively, frequency tables will be constructed for all categorical variables. Results: The work reported here is in the proposal phase. Once the protocol is implemented, we will report the results in a follow-up paper. Participant recruitment for cohort 1 has started and we have finished data collection for cohort 2. It is anticipated that the results will be available by the end of 2018. Conclusions: Findings will assess the acceptability of the study methodology and protocol for a full-scale randomized controlled trial. Furthermore, if CBT is proven effective for pregnant survivors of IPV, this intervention could be readily adopted by health care and social support services, thereby contributing to an improved standard of care for this unique population

Navigating multiple pandemics: A critical analysis of the impact of COVID-19 policy responses on gender-based violence services

COVID-19 illustrated what governments can do to mobilise against a global threat. Despite the strong governmental response to COVID-19 in Canada, another ‘pandemic’, gender-based violence (GBV), has been causing grave harm with generally insufficient policy responses. Using interpretive description methodology, 26 interviews were conducted with shelter staff and 5 focus groups with 24 executive directors (EDs) from GBV service organizations in Ontario, Canada. Five main themes were identified and explored, namely that: (1) there are in fact four pandemics at play; (2) the interplay of pandemics amplified existing systemic weaknesses; (3) the key role of informal partnerships and community support, (4) temporary changes in patterns of funding allocation; and (5) exhaustion as a consequence of addressing multiple and concurrent pandemics. Implications and recommendations for researchers, policy makers, and the GBV sector are discussed

Experiences of At-Risk Women in Accessing Breastfeeding Social Support During the Covid-19 Pandemic

Background: With strict public health measures implemented in March 2020 due to the COVID-19 pandemic, many breastfeeding parents, who are within an at-risk population, have experienced limited formal and/or informal breastfeeding social support. In the Canadian context, the experiences of these women is unknown. Research Aim: To explore the experiences of at-risk postpartum breastfeeding women in accessing formal and informal breastfeeding social support during the COVID-19 pandemic. Methods: This was a prospective, longitudinal interpretive description study using mixed methods. Data were gathered using an online survey and one 52–112-min semi-structured interview at 12-weeks postpartum. At-risk breastfeeding participants were those who lack social support and had at least one of the following: age \u3c 25 years; experiencing or had experienced intimate partner violence; or of low income. We sought participants’ experiences of accessing breastfeeding social support during the first few months of the COVID-19 pandemic/lockdown. Seven participants completed the survey and the interview. Results: Participants identified that the COVID-19 pandemic created barriers to accessing formal and informal breastfeeding social support, which stemmed from public health restrictions and difficulties communicating online with families and healthcare providers. Additionally, participants identified that the COVID-19 pandemic/lockdowns facilitated feelings of connectedness, protection, and resiliency. Conclusion: We provide preliminary insight into the experiences of trying to access breastfeeding social support during the COVID-19 pandemic. Future researchers should seek to prioritize improved communication and resources in supporting breastfeeding during COVID-19 and future pandemics/lockdowns

Kindness as an Intervention for Student Social Interaction Anxiety, Resilience, Affect, and Mood: The KISS of Kindness Study II

The purpose of this study was to assess the impact of deliberate acts of kindness (DAKs) plus access to a stress management booklet (intervention), compared to the booklet alone (control) on the stress-related outcomes of resilience, social interaction anxiety, affect, and mood of undergraduate and graduate students. Participants’ study-related experiences were also explored, as were the types of DAKs. This repeated-measures, randomized controlled trial included 112 students (80 undergraduate and 32 graduate) with 56 in each condition. Four previously validated scales were implemented at baseline, immediate post-intervention, and 3-months post-intervention. A linear mixed effects model was utilized with group and time entered as fixed effects. Content analysis of open-ended question responses and DAKs logs was conducted. The KISS of Kindness II had a statistically significant interaction effect on the intervention group participants’ resilience (p = 0.0099), social anxiety (p = 0.0016), and negative affect (p = 0.0033), but had no significant impact on their positive affect or mood. Intervention participants described improvements in mental wellbeing. DAKs were plentiful (1,542 DAKs, 26 types), and show promise for university-based mental health interventions