Supporting doctors' well‐being and resilience during COVID‐19: A framework for rapid and rigorous intervention development

Abstract Disadvantaged populations, including unemployed adults, often exhibit low levels of health literacy. Exploring subjectively perceived health literacy needs in these populations can serve as an entry point for participatory intervention development. We aimed to assess health literacy needs of unemployed adults by triangulating qualitative interviews data and a scoping review. Using a parallel approach, we combined results of an interview study with 10 participants of a job-reintegration program in Germany and a scoping review. The interviews, conducted in early 2021, focused on health topics of interest to the participants and their sources of health-related information. Data were analysed using thematic analysis. For the scoping review, we searched MEDLINE, CINAHL, PsycInfo and SCOPUS up to January 2021 for studies containing “unemployed” AND “health literacy” in titles/abstracts. Study selection and data extraction were done independently by two researchers. Nutrition and physical activity emerged as core themes during the interviews, with some participants referring to the importance of both for mental health. Doctors and the institution running the job-reintegration program were the sources of health-related information often mentioned. The Corona pandemic was reported to have limited physical activity and affected psycho-social well-being. Five out of 2696 studies were included in the review. Four focused on mental health literacy, the fifth assessed information seeking practices in unemployed adults. The qualitative analysis revealed that health literacy needs of unemployed adults go beyond mental health literacy. As nutrition and physical activity impact mental health, interventions targeting such topics might also improve mental health literacy in unemployed adults. Study findings will be discussed with unemployed persons and social workers in co-production workshops that aim to identify and prioritize health literacy needs for intervention development. Key messages Health literacy programs for unemployed adults should target nutrition and physical activity. Workforce re-integration programs play a pivotal role in improving health literacy of unemployed adults.

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The Clinical Practice Model for Persons with Dementia: Application to Music Therapy

Music Therapy Perspectives ◽

10.1093/mtp/miab006 ◽

2021 ◽

Author(s):

Alaine E Reschke-Hernández

Keyword(s):

Clinical Practice ◽

Music Therapy ◽

Behavioral Interventions ◽

Clinical Decision Making ◽

Evidence Based Practice ◽

Intervention Development ◽

Well Being ◽

Future Research ◽

Evidence Based ◽

Practice Model

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.

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The Experience of Cancer in American Indians Living in Oklahoma

Journal of Transcultural Nursing ◽

10.1177/1043659616634169 ◽

2016 ◽

Vol 28 (3) ◽

pp. 259-268 ◽

Cited By ~ 1

Author(s):

Melissa Craft ◽

Beverly Patchell ◽

Jack Friedman ◽

Lancer Stephens ◽

Kathy Dwyer

Keyword(s):

Pilot Study ◽

American Indians ◽

Intervention Development ◽

Well Being ◽

Social And Emotional ◽

Semistructured Interviews ◽

Living With Cancer ◽

Cancer Experience ◽

Personal Challenges

Many cancers in American Indians (AIs) are not diagnosed early leading to effects on physical, social, and emotional well-being or quality of life (QOL). Little research has been done on QOL of AIs in Oklahoma. This study examined the experience of living with cancer of AIs in Oklahoma to gain greater understanding of QOL issues and provide a basis for interventions to improve QOL. Twenty AIs diagnosed with cancer and receiving care in Oklahoma participated in this pilot study through semistructured interviews. Data were analyzed using thematic analysis. Themes identified included circles of support, finding meaning in the experience, and facing personal challenges such as health care–related issues, including mental health needs and fragmented care. The findings from this pilot study provide insights into the cancer experience of AIs in Oklahoma and demonstrate that care navigation and social support are important aspects to address in intervention development.

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Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development

Journal of Diabetes Research ◽

10.1155/2015/428349 ◽

2015 ◽

Vol 2015 ◽

pp. 1-18 ◽

Cited By ~ 33

Author(s):

Jeff C. Huffman ◽

Christina M. DuBois ◽

Rachel A. Millstein ◽

Christopher M. Celano ◽

Deborah Wexler

Keyword(s):

Type 2 Diabetes ◽

Theoretical Model ◽

Health Behaviors ◽

Positive Affect ◽

Intervention Development ◽

Well Being ◽

Behavioral Approach ◽

Wide Range ◽

Suboptimal Adherence

Most patients with type 2 diabetes (T2D) have suboptimal adherence to recommended diet, physical activity, and/or medication. Current approaches to improve health behaviors in T2D have been variably effective, and successful interventions are often complex and intensive. It is therefore vital to develop interventions that are simple, well-accepted, and applicable to a wide range of patients who suffer from T2D. One approach may be to boost positive psychological states, such as positive affect or optimism, as these constructs have been prospectively and independently linked to improvements in health behaviors. Positive psychology (PP) interventions, which utilize systematic exercises to increase optimism, well-being, and positive affect, consistently increase positive states and are easily delivered to patients with chronic illnesses. However, to our knowledge, PP interventions have not been formally tested in T2D. In this paper, we review a theoretical model for the use of PP interventions to target health behaviors in T2D, describe the structure and content of a PP intervention for T2D patients, and describe baseline data from a single-arm proof-of-concept (N=15) intervention study in T2D patients with or without depression. We also discuss how PP interventions could be combined with motivational interviewing (MI) interventions to provide a blended psychological-behavioral approach.

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Moments of Connection for the Disconnected: People with Negative Relations with Others Experience Less, but Benefit More from, Positive Everyday Interaction

Communication Research ◽

10.1177/00936502211005890 ◽

2021 ◽

pp. 009365022110058

Author(s):

Andy J. Merolla ◽

Afsoon Hansia ◽

Jeffrey A. Hall ◽

Shuangyue Zhang

Keyword(s):

Social Interaction ◽

Intervention Development ◽

Well Being ◽

Positive Interaction ◽

Positive Communication ◽

Relationship Partners ◽

Established Relationship ◽

Everyday Interaction ◽

To Come ◽

Partner Responsiveness

Analysis of over 2,000 moments of social interaction collected through smartphone-based experience sampling showed that, over a week-long period, people who have experienced negative relations with others (relative to those who have not), interacted with individuals from less-established relationships, perceived less partner responsiveness during interactions (particularly from their established relationship partners), and were more likely to report being alone than engaged in positive communication episodes. People with high negative relations with others also tended to have lower perceptions of affective well-being and relational connection, and greater perceptions of stress-related cognition, during moments of social interaction. Yet, results also indicated that while positive communication appears harder to come by for people with high negative relations with others, these individuals gain outsized benefits from positive interaction when it occurs (e.g., sharper increases in well-being and decreases in stress). This suggests that heightened negative relations with others might lead people to “hyperabsorb” the benefits of positive moments of communication. The results have implications for key perspectives on communication, relational life, and well-being (i.e., affection deprivation, appraisal, implicit vigilance, and resource insufficiency) and suggest potential routes for intervention development for people with difficult relational lives.

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Exploring maintenance of physical activity behaviour change among people living with and beyond gastrointestinal cancer: a cross-sectional qualitative study and typology

BMJ Open ◽

10.1136/bmjopen-2020-037136 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037136

Author(s):

Chloe Grimmett ◽

Claire Foster ◽

Katherine Bradbury ◽

Phillippa Lally ◽

Carl R May ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Intervention Development ◽

Well Being ◽

Rapid Expansion ◽

Structured Interviews ◽

Cross Sectional ◽

Gi Cancer ◽

The Impact

ObjectivesIn the last decade, there has been a rapid expansion of physical activity (PA) promotion programmes and interventions targeting people living with and beyond cancer (LWBC). The impact that these initiatives have on long-term maintenance of PA remains under-researched. This study sought to explore the experiences of participants in order to characterise those who have and have not successfully sustained increases in PA following participation in a PA intervention after a diagnosis of gastrointestinal (GI) cancer, and identify barriers and facilitators of this behaviour.DesignCross-sectional qualitative study. Semi-structured interviews with participants who had previously taken part in a PA programme in the UK, explored current and past PA behaviour and factors that promoted or inhibited regular PA participation. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Themes and subthemes were identified. Differences between individuals were recognised and a typology of PA engagement was developed.ParticipantsTwenty-seven individuals (n=15 male, mean age=66.3 years) with a diagnosis of GI cancer who had participated in one of four interventions designed to encourage PA participation.SettingUK.ResultsSeven themes were identified: disease processes, the role of ageing, emotion and psychological well-being, incorporating PA into everyday life, social interaction, support and self-monitoring and competing demands. A typology with three types describing long-term PA engagement was generated: (1) maintained PA, (2) intermittent PA, (3) low activity. Findings indicate that identifying an enjoyable activity that is appropriate to an individual’s level of physical functioning and is highly valued is key to supporting long-term PA engagement.ConclusionThe typology described here can be used to guide stratified and personalised intervention development and support sustained PA engagement by people LWBC.

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Assessment of Activity Pacing in Relation to Physical Activity and Health-Related Quality of Life in Adults with Multiple Sclerosis: A Foundation for Further Intervention Development

International Journal of MS Care ◽

10.7224/1537-2073.2020-047 ◽

2021 ◽

Author(s):

Ulric S. Abonie ◽

Bregje L. Seves ◽

Femke Hoekstra ◽

Trynke Hoekstra ◽

Lucas H.V. van der Woude ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Multiple Sclerosis ◽

Intervention Development ◽

Well Being ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Over Time

Abstract Background: Activity pacing is a behavioral strategy for coping with fatigue, optimizing physical activity (PA) levels, and achieving a paced approach to lifestyle and sustainable self-regulated exercise practice to optimize health and well-being. Yet little is known about how activity pacing affects PA and health-related quality of life (HRQOL) while controlling for fatigue and demographic characteristics over time in adults with multiple sclerosis (MS). This study examined the natural use of activity pacing and how it is associated with PA and HRQOL over time in adults with MS. Methods: Sixty-eight adults with MS (mean ± SD age, 45.2 ± 10.9 years) completed questionnaires on their activity pacing, fatigue, PA, and HRQOL 14, 33, and 52 weeks after rehabilitation. Associations between the variables were examined using multilevel models. Results: No associations were found between activity pacing and PA (β = −0.01, P = .89) or between activity pacing and HRQOL (β = −0.15, P = .09). Conclusions: This study provides an initial understanding of how activity pacing relates to PA and HRQOL in people with MS over time and indicates that there is no clear strategy among adults with MS that is successful in improving PA and HRQOL in the short- or long-term. Persons with MS may benefit from goal-directed activity pacing interventions to improve longitudinal engagement in PA, and the present study provides a foundation for further intervention development.

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Brief Report: The Application of Skills and Knowledge (ASK) model: A novel conceptualization of social performance to guide instrument development and advance adult autism research

10.31234/osf.io/bpw3s ◽

2021 ◽

Author(s):

Vanessa Bal ◽

Somer Bishop ◽

Sigan Hartley ◽

Julie Taylor ◽

Alexandra Sturm

Keyword(s):

Social Functioning ◽

Instrument Development ◽

Social Performance ◽

Intervention Development ◽

Well Being ◽

Social Competency ◽

Value Judgments ◽

Autism Research ◽

Adult Autism ◽

The Individual

Current conceptualizations of social competency often focus on value judgments (e.g., appropriateness) that are influenced by a combination of individual and environmental factors, such as a social partner’s understanding of autism. We posit that social performance is an understudied, but critical contributor to adult social functioning and present the Application of Skills and Knowledge (ASK) model to stimulate research in this area. The ASK model aims to separate social performance from other factors that may promote or adversely impact social functioning, therefore allowing for identification of treatment targets that do not solely rest on the individual. This framework can be used to accelerate future instrument and intervention development efforts to support well-being and community participation for autistic adults.

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Promoting social and emotional well-being in schools

Health Education ◽

10.1108/he-11-2016-0057 ◽

2017 ◽

Vol 117 (5) ◽

pp. 434-451 ◽

Cited By ~ 23

Author(s):

Margaret M. Barry ◽

Aleisha Mary Clarke ◽

Katherine Dowling

Keyword(s):

Intervention Development ◽

Well Being ◽

School Systems ◽

Evidence Based ◽

Common Elements ◽

Content Type ◽

Emotional Skills ◽

Social And Emotional ◽

Social And Emotional Skills

Purpose The purpose of this paper is to provide a critical perspective on the international evidence on promoting young people’s social and emotional well-being in schools. The challenges of integrating evidence-based interventions within schools are discussed and the need for innovative approaches to research and practice are considered in order to support more sustainable approaches that can be embedded into the everyday practice of school systems. Design/methodology/approach A common elements approach to intervention development and implementation is explored. A case study is presented on piloting this approach with post-primary students, based on consultations with students and teachers concerning their needs in supporting youth social and emotional well-being. Findings The integration and sustainability of evidence-based social and emotional skills programmes within the context of whole school systems is far from clearly established. Research on the use of a common elements approach to evidence-based treatment and youth prevention programmes is presented and the application of this method to the development and implementation of social and emotional learning interventions is considered. Preliminary case study findings are presented exploring this approach in school-based intervention development for post-primary school students. Research limitations/implications The potential of adopting a common elements approach is considered; however, more rigorous research is needed to identify the most potent strategies for social and emotional skills development. Originality/value Identifying a common set of evidence-based strategies for enhancing adolescents’ social and emotional skills could lead to innovative approaches to intervention delivery that would extend the impact and reach of evidence-based practice across diverse educational systems and school settings.

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Effects of end-of-life care on medical health professionals: A dialectical approach

Palliative & Supportive Care ◽

10.1017/s1478951521000365 ◽

2021 ◽

pp. 1-8

Author(s):

Yaffa Naomi Stokar ◽

Ruth Pat-Horenczyk

Keyword(s):

End Of Life ◽

Medical Center ◽

Demographic Data ◽

Relative Proportion ◽

Intervention Development ◽

Well Being ◽

Dialectical Approach ◽

Significant Difference ◽

Medical Health ◽

Eol Care

Abstract Objective The provision of end-of-life (EOL) care has complex effects on both the professional and personal well-being of medical health personnel (MHP). Previous studies have mostly focused on negative or positive influences as mutually exclusive effects. This study offers a new conceptualization by applying a dialectical lens, looking at secondary traumatic stress (STS) and post-traumatic growth (PTG) as dual possible coexisting phenomena. The creation of four theoretically possible profiles, based on the combinations of high or low levels in each dimension, offers a practical translation of this idea toward intervention development. Method Data were collected at a large tertiary pediatric medical center (n = 1,123) aiming at assessing all personnel. Research methods included collecting demographic data and using validated scales to assess STS, PTG, burnout, compassion satisfaction, and both personal and professional social support. Results We classified four response profiles according to the STS and PTG levels: (1) Dialectical-impact, high STS/high PTG, (2) Growth-dominant, high PTG/low STS, (3) Stress-dominant, high STS/low PTG, and (4) Limited-impact, low STS/low PTG. The four profiles differed based on profession, but not other demographics. Physicians were represented significantly higher in the Stress-dominant profile; nurses were highly represented in the Dialectical-impact profile. A significant difference was found when adding reported EOL care as a distinct factor with a higher relative proportion of the “dialectical” response among those reporting providing EOL care. Significance of results Findings from this study point toward the recognition and understanding of the complexity resulting from the provision of EOL care. A more complex profile classification, including the dialectical profile, may reflect a broader tendency to ways that MHP are affected by their work. Introducing “dialectical thinking” can lead to more personalized and precise intervention planning for MHP. Tailored interventions promoting personal and professional well-being, based on individual profiles, can contribute to more effective interventions and better resource utilization.

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