Mediating Effects of Stigma and Depressive Symptoms in a Social Media-based Intervention to Improve Long-term QOL among People Living with HIV: Secondary Analysis of a Randomized Controlled Trial Using Structural Equation Model. (Preprint)

2021 ◽  
Author(s):  
Yiran Li ◽  
Yan Guo ◽  
Y.Alicia Hong ◽  
Chengbo Zeng ◽  
Yu Zeng ◽  
...  
Keyword(s):  
Social Media ◽  
Depressive Symptoms ◽  
Structural Equation ◽  
Intervention Group ◽  
Equation Model ◽  
Control Group ◽  
People Living With Hiv ◽  
Mediating Effects ◽  
Related Stigma

BACKGROUND Mobile health (mHealth) interventions have been shown to effectively improve quality of life (QOL) among people living with HIV (PLWH). However, little is known about the mechanisms of how mHealth interventions take effects, especially in the long term. OBJECTIVE This study aimed to explore the intervention mechanisms of a social media-based intervention, Run4Love, on QOL over 9-month follow-up. METHODS We recruited PLWH who were concurrently experiencing elevated depressive symptoms from the HIV outpatient clinic in South China. A total of 300 eligible participants were randomized to the intervention group or control group in a 1:1 ratio after informed consent and baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines besides usual care for HIV treatment. Neither participants nor research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on QOL. RESULTS About 91.3%, 88.3%, and 86.7% participants completed follow-up surveys at 3, 6, and 9 months. Results showed that the intervention had significantly improved QOL at 9 months via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. CONCLUSIONS The findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effect on QOL improvements. We call for targeted mHealth interventions to improve QOL among PLWH, especially social media-based interventions that can address HIV-related stigma and alleviate depressive symptoms. CLINICALTRIAL The trail was registered in the Chinese Clinical Trial Registry (ChiCTR-IPR-17012606).

scholarly journals Mediating Effects of Stigma and Depressive Symptoms in a Social Media–Based Intervention to Improve Long-term Quality of Life Among People Living With HIV: Secondary Analysis of a Randomized Controlled Trial

10.2196/27897 ◽  
2021 ◽  
Vol 23 (11) ◽  
pp. e27897
Author(s):  
Yiran Li ◽  
Yan Guo ◽  
Y Alicia Hong ◽  
Chengbo Zeng ◽  
Yu Zeng ◽  
...  
Keyword(s):  
Social Media ◽  
Depressive Symptoms ◽  
Intervention Group ◽  
Control Group ◽  
People Living With Hiv ◽  
Mediating Effects ◽  
Long Term Effects ◽  
Related Stigma ◽  
Living With Hiv

Background Mobile health (mHealth) interventions have been shown to effectively improve the quality of life (QOL) among people living with HIV. However, little is known about the long-term effects of mHealth interventions. Objective This study aims to explore the intervention mechanisms of a social media–based intervention, Run4Love, on the QOL of people with HIV over across a 9-month follow-up period. Methods We recruited people living with HIV who were concurrently experiencing elevated depressive symptoms from an HIV outpatient clinic in South China. A total of 300 eligible participants were randomized either to the intervention group or the control group in a 1:1 ratio after they provided informed consent and completed a baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines in addition to the usual care for HIV treatment. Neither participants nor the research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on participants’ QOL. Results About 91.3% (274/300), 88.3% (265/300), and 86.7% (260/300) of all participants completed follow-up surveys at 3, 6, and 9 months, respectively. Results showed that the intervention had significantly improved participants' QOL at 9 months, via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. Conclusions These findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effects on QOL improvements. We call for targeted mHealth interventions to improve QOL among people living with HIV, especially social media–based interventions that can address HIV-related stigma and alleviate depressive symptoms. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019

Effectiveness of a School-Based Intervention to Empower Children to Cope With Advertising

2020 ◽  
Vol 32 (3) ◽  
pp. 107-118 ◽  
Author(s):  
Esther Rozendaal ◽  
Bernd Figner
Keyword(s):  
Coping Strategies ◽  
Structural Equation ◽  
Coping Behavior ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Long Term Effects ◽  
Mixed Effect ◽  
School Based

Abstract. This study tested the effectiveness of a theory-driven, school-based advertising intervention entitled Ad Masters that aimed to stimulate children’s advertising coping behavior in the current media landscape. A cluster randomized controlled trial was completed among 704 children (7–12 years old) in schools. The schools were allocated to either the intervention group ( n = 399) or control group ( n = 305). Both short-term (directly after the intervention) and long-term effects (3 months after the end of the intervention) were measured. Bayesian mixed-effect analyses showed positive short- and long-term effects of the intervention on children’s understanding of advertising’s tactics. Structural equation analysis showed that the intervention-induced changes in children’s understanding of advertising’s tactics were not related to any changes in their use of advertising coping strategies or their advertising susceptibility. No other intervention effects were found. However, structural equation analyses showed that, regardless of the intervention, motivation and ability to use advertising coping strategies are both associated with children’s actual coping behavior. These findings indicate that motivation and ability to effectively use advertising coping strategies are important empowering factors that should be taken into account in future research on children’s advertising coping behavior and in advertising intervention development.

scholarly journals A Structural Equation Model of HIV-Related Stigma, Depressive Symptoms, and Medication Adherence

2011 ◽  
Vol 16 (3) ◽  
pp. 711-716 ◽  
Author(s):  
Deepa Rao ◽  
Betsy J. Feldman ◽  
Rob J. Fredericksen ◽  
Paul K. Crane ◽  
Jane M. Simoni ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Medication Adherence ◽  
Structural Equation Model ◽  
Structural Equation ◽  
Equation Model ◽  
Related Stigma

scholarly journals Effect of a WeChat-Based Intervention (Run4Love) on Depressive Symptoms Among People Living With HIV in China: A Randomized Controlled Trial

10.2196/16715 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e16715 ◽  
Author(s):  
Yan Guo ◽  
Y Alicia Hong ◽  
Weiping Cai ◽  
Linghua Li ◽  
Yuantao Hao ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Depressive Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
People Living With Hiv ◽  
Mhealth Intervention ◽  
Randomized Controlled ◽  
Hair Samples ◽  
Living With Hiv

Background People living with HIV (PLWH) have high rates of depressive symptoms. However, only a few effective mental health interventions exist for this vulnerable population. Objective The aim of this study was to assess the efficacy of a WeChat-based intervention, Run4Love, with a randomized controlled trial among 300 people living with HIV and depression (PLWHD) in China. Methods We recruited PLWH from the HIV outpatient clinic in South China. Participants were screened based on the Center for Epidemiologic Studies-Depression (CES-D) scale. Those who scored 16 or higher were eligible to participate. A total of 300 eligible patients were enrolled. After obtaining informed consent from the participants, completion of a baseline survey, and collection of participants’ hair samples for measuring cortisol, the participants were randomly assigned to an intervention or a control group in a 1:1 ratio. The intervention group received the Run4Love program, delivered via the popular social media app WeChat. Cognitive behavioral stress management courses and weekly reminders of exercise were delivered in a multimedia format. Participants’ progress was monitored with timely and tailored feedback. The control group received usual care and a brochure on nutrition for PLWH. Data were collected at 3, 6, and 9 months. The primary outcome was depression, which was measured by a validated instrument. Results Participants in the intervention and control groups were comparable at baseline; about 91.3% (139/150), 88.3% (132/150), and 86.7% (130/150) participants completed the 3-, 6-, and 9-month follow-ups, respectively. At the 3-month follow-up, a significant reduction in CES-D score was observed in the intervention group (from 23.9 to 17.7 vs from 24.3 to 23.8; mean difference=−5.77, 95% CI −7.82 to −3.71; P<.001; standard effect size d=0.66). The mean changes in CES-D score from baseline to the 6- and 9-month follow-ups between the two groups remained statistically significant. No adverse events were reported. Conclusions The WeChat-based mobile health (mHealth) intervention Run4Love significantly reduced depressive symptoms among PLWHD, and the effect was sustained. An app-based mHealth intervention could provide a feasible therapeutic option for many PLWHD in resource-limited settings. Further research is needed to assess generalizability and cost-effectiveness of this intervention. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showproj.aspx?proj=21019 (Archived by WebCite at https://www.webcitation.org/78Bw2vouF)

#INCLUSION – THE IMPACT OF SOCIAL MEDIA COMMUNICATION ON THE LEGITIMACY OF ARMED FORCES

2019 ◽  
pp. 43-60
Author(s):  
EVA MOEHLECKE DE BASEGGIO ◽  
OLIVIA SCHNEIDER ◽  
TIBOR SZVIRCSEV TRESCH
Keyword(s):  
Social Media ◽  
Political Communication ◽  
Structural Equation ◽  
Armed Forces ◽  
Equation Model ◽  
Media Communication ◽  
The Public ◽  
Political Legitimation ◽  
Social Media Communication ◽  
The Impact

The Swiss Armed Forces (SAF), as part of a democratic system, depends on legitimacy. Democracy, legitimacy and the public are closely connected. In the public sphere the SAF need to be visible; it is where they are controlled and legitimated by the citizens, as part of a deliberative discussion in which political decisions are communicatively negotiated. Considering this, the meaning of political communication, including the SAF’s communication, becomes obvious as it forms the most important basis for political legitimation processes. Social media provide a new way for the SAF to communicate and interact directly with the population. The SAF’s social media communication potentially brings it closer to the people and engages them in a dialogue. The SAF can become more transparent and social media communication may increase its reputation and legitimacy. To measure the effects of social media communication, a survey of the Swiss internet population was conducted. Based on this data, a structural equation model was defined, the effects of which substantiate the assumption that the SAF benefits from being on social media in terms of broadening its reach and increasing legitimacy values.

scholarly journals Effects of a psychosocial intervention at one-year follow-up in a PREDIMED-plus sample with obesity and metabolic syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Núria Mallorquí-Bagué ◽  
María Lozano-Madrid ◽  
Cristina Vintró-Alcaraz ◽  
Laura Forcano ◽  
Andrés Díaz-López ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Depressive Symptoms ◽  
Psychosocial Support ◽  
Food Addiction ◽  
Intervention Group ◽  
Control Group ◽  
Lifestyle Recommendations ◽  
One Year ◽  
Mediational Role

AbstractThis study examines if overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms, and if these variables could be modified after 1 year of a multimodal intervention (diet, physical activity, psychosocial support). 342 adults (55–75 years) with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus Cognition study were randomized to the intervention or to the control group (lifestyle recommendations). Cognitive and psychopathological assessments were performed at baseline and after 1-year follow-up. At baseline, higher impulsivity was linked to higher food addiction and depressive symptoms, but not to body mass index (BMI). Food addiction not only predicted higher BMI and depressive symptoms, but also achieved a mediational role between impulsivity and BMI/depressive symptoms. After 1 year, patients in both groups reported significant decreases in BMI, food addiction and impulsivity. BMI reduction and impulsivity improvements were higher in the intervention group. Higher BMI decrease was achieved in individuals with lower impulsivity. Higher scores in food addiction were also related to greater post-treatment impulsivity. To conclude, overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms in mid/old age individuals with MetS. Our results also highlight the modifiable nature of the studied variables and the interest of promoting multimodal interventions within this population.

scholarly journals Driving Mechanism of Farmers’ Utilization Behaviors of Straw Resources—An Empirical Study in Jilin Province, the Main Grain Producing Region in the Northeast Part of China

2021 ◽  
Vol 13 (5) ◽  
pp. 2506
Author(s):  
Hongpeng Guo ◽  
Shuang Xu ◽  
Xiaotong Wang ◽  
Wen Shu ◽  
Jia Chen ◽  
...  
Keyword(s):  
Structural Equation ◽  
Positive Impact ◽  
Agricultural Waste ◽  
Equation Model ◽  
Subjective Norms ◽  
Jilin Province ◽  
Policy Implications ◽  
Driving Mechanism ◽  
Perceived Behavior Control

In recent years, the unsustainable behaviors of straw utilization have led to waste straw being one of the sources of agricultural non-point source pollution. Studying the resource utilization of crop straw is conducive to expediate the development of ecological and green agriculture. More importantly, it has long-term significance for the recycling of agricultural waste, improving the quality of rural life, and the employment of farmers. Based on the theory of planned behavior (TPB), taking the representative survey questionnaire of farmers in Jilin Province, China as the sample, the structural equation model (SEM) was constructed to study the main factors that drive the utilization behaviors of straw resources of farmers and to explore the driving mechanism of the farmers behaviors in Jilin Province. The results show that the behavioral attitude and subjective norms of farmers in Jilin Province not only indirectly affect their actual behaviors through behavioral willingness, but also has significant direct effects on their behaviors. The most critical factors that affect the willingness of farmers to utilize the straw resources in Jilin Province are subjective norms and moral responsibilities. The subjective norms of farmers have a direct and significant positive impact on their willingness and behaviors. Behavioral attitude and perceived behavior control have a significant positive impact on their willingness. The behavioral willingness has a significant positive impact on their actual behaviors. This study provides guidance for the utilization of straw resources policy implications.

scholarly journals Efficacy of implementing intermittent STOP THE BLEED® reviews on long term retention of hemorrhage control skills of first year medical students

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Enkhtsogt Sainbayar ◽  
Nathan Holt ◽  
Amber Jacobson ◽  
Shalini Bhatia ◽  
Christina Weaver
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Training Session ◽  
Likert Scale ◽  
Control Group ◽  
First Year ◽  
Hemorrhage Control ◽  
Term Retention ◽  
Long Term Retention

Abstract Context Some medical schools integrate STOP THE BLEED® training into their curricula to teach students how to identify and stop life threatening bleeds; these classes that are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. Objectives To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention of hemorrhage control skills and improving perceived confidence. Methods First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4 min STOP THE BLEED® review video (intervention group) or a “distractor” video (control group) at 4 week intervals. After the 12 weeks, the students were asked to complete an 11 item survey. Results Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median = 21.4 points vs. control group median = 16.8 points). Conclusions Intermittent review videos for STOP THE BLEED® training improved medical students’ confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.

scholarly journals Validity and Internal Consistency of the Preschool-FLAT, a New Tool for the Assessment of Food Literacy in Young Children from the Training-To-Health Project

2020 ◽  
Vol 17 (8) ◽  
pp. 2759
Author(s):  
Garden Tabacchi ◽  
Giuseppe Battaglia ◽  
Giuseppe Messina ◽  
Antonio Paoli ◽  
Antonio Palma ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Content Validity ◽  
Structural Equation ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Intervention Group ◽  
Equation Modeling ◽  
Control Group ◽  
Food Literacy ◽  
Health Project

Background: The importance of assessing “food literacy” since youth has been highlighted and, to this purpose, valid and consistent instruments are needed. This study aimed to assess the validity and internal consistency of the preschool-FLAT (Food Literacy Assessment Tool). Methods. 505 children from 21 kindergartens, recruited within the Training-to-Health Project in Palermo (Italy), underwent oral sessions and activities on food-related aspects. Their knowledge/skills were recorded in the preschool-FLAT. The following scale measures were assessed: Content validity; internal consistency (Chronbach’s alpha coefficients); construct validity (Structural Equation Modeling—SEM); discriminant validity (intervention subgroup of 100 children vs. control group of 27 children). Results. Acceptable content validity of a 16-items scale and overall adequate internal consistency were revealed: Content validity index (CVI) 0.94, content validity ratio (CVR) 0.88, Chronbach’s alpha 0.76. The SEM revealed a 4-factor model fitting the data well (comparative fit index 0.939, root mean square error of approximation 0.033). Discriminant validity was good (intervention group scoring higher than control, p < 0.001, unpaired Student’s t-test). Conclusion. The preschool-FLAT revealed good psychometric properties, adequate validity and internal consistency. This is the only instrument in the literature specifically targeted to 3–6 years old children that could be effectively used to assess food literacy.

scholarly journals Effectiveness of a short Yoga Nidra meditation on stress, sleep, and well-being in a large and diverse sample

2020 ◽  
Author(s):  
Esther N. Moszeik ◽  
Timo von Oertzen ◽  
Karl-Heinz Renner
Keyword(s):  
Structural Equation ◽  
Well Being ◽  
Equation Model ◽  
Future Research ◽  
Control Group ◽  
Core Element ◽  
Waitlist Control Group ◽  
Affective Components ◽  
Meditation Group ◽  
Yoga Nidra

Abstract Previous studies have shown that meditation-based interventions can have a significant impact on stress and well-being in various populations. To further extend these findings, an 11-min Yoga Nidra meditation that may especially be integrated in a busy daily schedule by people who can only afford short time for breaks was adapted and analyzed in an experimental online study design. The effects of this short meditation on stress, sleep, well-being and mindfulness were examined for the first time. The meditation was provided as audio file and carried out during a period of 30 days by the participants of the meditation group. A Structural Equation Model (SEM) was used to analyze the data with Full Information Maximum Likelihood (FIML) in order to cope with missing data. As expected, the meditation group (N = 341) showed lower stress, higher well-being and improved sleep quality after the intervention (very small to small effect sizes) compared with a waitlist control group (N = 430). It turned out that the meditation had a stronger impact on the reduction of negative affect than on the increase of positive affect and also a stronger effect on affective components of well-being. Mindfulness, as a core element of the meditation, increased during the study within the meditation group. All effects remained stable at follow-up six weeks later. Overall, a large, heterogeneous sample showed that already a very short dose of meditation can positively influence stress, sleep, and well-being. Future research should consider biological markers as well as active control groups.

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