Feasibility of a web-based stress management intervention for university students in Indonesia

Background University students are susceptible to excessive stress. A web-based stress management intervention holds promise to improve stress but is still at a novel stage in Indonesia. This present paper reports the feasibility of the intervention we developed ( ‘Rileks’ ) among university students in Indonesia in terms of acceptability and usability, and to propose recommendations for future improvements. Methods A single-group pre-test and post-test design was used. Participants with DASS-42 Stress scale score ≥ 15 were given access to the intervention (N= 68). The main outcome measures were the Client Satisfaction Questionnaire-8 (CSQ-8), the System Usability Scale (SUS), and intervention uptake. Participants’ experience in each session was evaluated using closed and open-ended questions for future improvements. Descriptive statistics were used to examine primary outcome and qualitative session evaluations. Participants’ responses to each topic of the open questions were summarized. Results The intervention was evaluated as being satisfactory (CSQ-8 average score 21.89 (SD 8.72), range 8-32). However, the intervention’s usability was still below expectation (SUS average score 62.8 (SD 14.74), range 0-100). The core modules were completed by 10 participants (14.7%) and the study drop out rate was 63.23% at post-assessment. The module content was rated generally positively with some notes for improvement covering content and technical aspects. Conclusions The study indicates that Rileks is potentially feasible for Indonesian university students. In order to be optimally applied in such context and before scaling up web-based intervention in general in Indonesia a further development and refinement are needed.

Application of Near-Infrared Spectroscopy for Evidence-Based Psychotherapy

This perspective article discusses the importance of evidence-based psychotherapy and highlights the usefulness of near-infrared spectroscopy (NIRS) in assessing the effects of psychotherapeutic interventions as a future direction of clinical psychology. NIRS is a safe and non-invasive neuroimaging technique that can be implemented in a clinical setting to measure brain activity via a simple procedure. This article discusses the possible benefits and challenges of applying NIRS for this purpose, and the available methodology based on previous studies that used NIRS to evaluate psychotherapeutic effects. Furthermore, this perspective article suggests alternative methodologies that may be useful, namely, the single- and multi-session evaluations using immediate pre- and post-intervention measurements. These methods can be used to evaluate state changes in brain activity, which can be derived from a single session of psychotherapeutic interventions. This article provides a conceptual schema important in actualizing NIRS application for evidence-base psychotherapy.

No Ke Ola Pono o Nā Kāne: A Culturally Grounded Approach to Promote Health Improvement in Native Hawaiian Men

In Hawai’i, Native Hawaiian men (kāne) have the highest death rate from colon cancer among all ethnic groups. While screening can prevent 90% of these cancers, data show that >58% of kāne over age 50 have never been screened. Prior research has demonstrated that community-based social networks may help kāne adopt healthy behaviors such as cancer screening, however, few studies have activated such an approach. A cross-sectional study entitled No Ke Ola Pono o Nā Kāne (for the good health of men) was conducted statewide in Hawai’i from 2014 to 2018. The study strived to perpetuate the Native Hawaiian traditional practice of “hale mua” (men’s house) to promote healthy behaviors among kāne including the adoption of colon cancer prevention strategies such as fecal immunochemical testing (FIT). The study applied a peer-led intervention model using kāne volunteers to deliver the program’s educational components, including standardized materials to help the volunteers confidently conduct the sessions. Of the 378 kāne who were recruited into the study, 232 participated in the colorectal session of which 64% ( n = 149) were over age 50. Survey data from the 149 kāne indicated that 31% had not discussed colon health or screening with their doctors but 92% had improved their knowledge about colon health from the session. In addition, 76% ( n = 113) agreed to complete a FIT. Session evaluations indicated that >91% of kāne liked the hale mua approach and benefited from talking with other kāne about their health.

Music Therapy with Active-Duty Service Members: Group Protocol Description and Secondary Analysis of Protocol Evaluations

Based on the growing need for music therapy programming at military treatment facilities and clinics that specialize in the rehabilitation of service members, this article describes a music therapy group protocol and the findings of 201 post-session evaluations. In addition, we present clinical perspectives and recommendations from three music therapists who have facilitated this group protocol on four military bases across the United States. The group session outlined in the protocol is intended as an introduction to music therapy. It familiarizes service members to various music therapy experiences specifically structured to enhance feelings of safety during emotional risk-taking. In addition, the protocol functions as an initial assessment of service members’ responses to the various receptive and interactive music experiences and includes psychoeducation regarding the role of music therapy in an interdisciplinary treatment model. The post-session evaluation data suggest that service members endorsed this introductory group as moderately to very helpful. Perceived benefits included the opportunity to express various emotions and increased awareness of somatic responses through music. A large number of requests for continued music therapy services following the introductory session suggest that the protocol is successful in facilitating understanding in service members regarding the potential benefits of music therapy in interdisciplinary treatment. Feedback from the music therapists indicated that the group protocol is a helpful initial experience for service members to acclimate to music therapy and for music therapists to learn about their patients’ specific needs to inform subsequent treatment.

ACCESS TO CARE ROUNDS: A UNIQUE FORUM FOSTERING HEALTH SYSTEM AND SOCIAL SERVICE PARTNERSHIPS FOR OLDER VETERANS

Colorado Veteran Community Partnership (VCP) aims to connect Rocky Mountain Regional VA Medical Center front-line teams with diverse community partners to create integrated networks of support for older Veterans with complex needs and their family members and caregivers. To accomplish this goal, VCP launched Access to Care Rounds in January 2018 to build bridges between the healthcare system and community-based organizations. Each Access to Care Rounds features a cross-sector panel that discusses specific efforts to link a medically-complex, older Veteran to resources. This model was developed with stakeholder input and has highlighted topics related to chronic pain management, suicide prevention, homelessness, adult protective services, transportation, home-based primary care, hospice care, and firearm safety. Each Access to Care Rounds focuses on connecting VCP members, sharing expertise and resources, and highlights lessons learned related to care coordination, communication, and key processes that others can adopt/adapt to better serve older Veterans. On average, 30 individuals attend each session. Access to Care Rounds draw diverse audiences representing social services, mental health and other healthcare specialties. The latter include Social Workers (47%), Physicians (11%), Psychologists (8%), Registered Nurses (6%), and students/trainees (6%). Participants receive a description of the Veteran situation; the names, credentials, organizational affiliations and roles/expertise of each panelist; and, a resource list relevant to the constellation of issues addressed to enhance access to information and resources. Over 38% of respondents to session evaluations reported intentions to change their professional practice as a result of what they learned during an Access to Care Rounds.

Narrative Feedback in Faculty Development

Research on faculty development and its generalizability is lagging compared to other areas of research in medical education. Providing feedback has been identified as a skill in need of improvement for medical educators, both in the classroom and at the clinical bedside. Surprisingly, little has been published on faculty skills in providing feedback during faculty development sessions, and more specifically, providing narrative feedback. An IRB-approved study analyzed the outcomes of 73 faculty development sessions conducted within one academic year. A qualitative study of the narrative portion of end-of-session evaluations examined type and scope of narrative feedback provided to presenters about their presentation skills as well as about the perceived quality and usefulness of the faculty development sessions. The findings from this study suggest that further and more in-depth professional development in providing feedback is warranted, preferably early in faculty's professional development.

Is it safe to leave my patient at home? Interprofessional community-based learning

BackgroundJoint training of clinicians working in overlapping care areas can be a powerful way to help develop cross-professional insights and knowledge, and stimulate shared reflection and development. This poster describes a novel educational evening, which saw GP trainees and South Central Ambulance Service (SCAS) staff coming together to learn and reflect through case-based discussion.AimThe aim of the educational evening was to enable participants to engage in shared learning activities using facilitated case scenarios based on common cases. Evaluation of the session highlighted in particular different approaches to risk management and uncertainty.MethodForty-seven (25 SCAS staff/22 GPs) participants attended the evening and worked in mixed SCAS/GP groups, which were facilitated by educators drawn from general practice and paramedic education. All participants completed pre-session information sheets and post-session evaluations.ResultsParticipants valued the evening and reported broadened knowledge and insight about the clinical work of the other group, including the nature of work and differences in care management practice. Participants reported that the case-based scenarios were relevant.ConclusionThe event helped participants to better understand each other’s roles gain and to learn together. The educational evening demonstrated that shared leaning can be powerful and generate insights for trainees and SCAS clinicians. Participants also made suggestions as to how the event might be developed for the future.

3368 Mentoring from the ground up: Improving mentoring relationships by empowering mentees

OBJECTIVES/SPECIFIC AIMS: Program Directors and Ph.D. students within the Clinical and Translational Science (CTS) track identified mentorship development as a knowledge gap and educational priority. Most mentors are not provided education in how to be an effective mentor. Similarly, most mentees are not provided education or training on how to optimize a mentoring relationship for their learning and professional development (Ramani, 2006). We adapted mentor training curriculum developed by the University of Wisconsin and facilitated an eight-hour program to better prepare learners to be empowered mentees as well as future mentors. METHODS/STUDY POPULATION: We utilized the Mentoring Competency Assessment (MCA) to measure CTS Ph.D. students’ self-perceptions of eight competencies through a pre and post-intervention survey design (Fleming, etal., 2013). We adapted an evidence-based curriculum (Pfund, etal., 2014) to be delivered to Ph.D. students within an existing structure of educational offerings and incorporated case based discussions, frequent low-stakes formative assessments, and peer-to-peer facilitation to heighten authenticity, relevance and immediacy to the learning experiences. This structured curriculum, intended to increase skills, knowledge, and behaviors to make students more active participants in their mentoring relationships, focuses on one competency area per monthly session and was implemented May-December 2018. Session participation by program alumni allows for contextual demonstration and competency application. RESULTS/ANTICIPATED RESULTS: Preliminary data demonstrates heightened perceived competency in most domains assessed. We found mentors generally rated their mentee’s skills at a higher level than the mentees’ perceived ratings. We also saw significant differences between groups in a few domains e. g. new vs. established relationships, females vs. males, etc. Individual session evaluations are extremely positive, and the students routinely report behavioral changes as a result of these sessions. DISCUSSION/SIGNIFICANCE OF IMPACT: We have demonstrated the successful adaptation and innovative facilitation of a successful mentorship development program for Ph.D. students. We propose that several factors discussed are critical in the success of this type of curriculum. Preliminary conclusion: A structured curriculum in mentoring relationships increases Ph.D. mentee empowerment and readiness to lead future mentoring relationships.

1323. Implementation and Effectiveness of the Asia Pacific HIV Practice Course: Building Capacity of Healthcare Workers in the Region

Background Building the capacity of healthcare workers (HCW) can positively influence service quality and patient care. Given the limited HIV training opportunities in the Asia Pacific Region, the Asia Pacific HIV Practice Course (APHPC) aims to improve knowledge and skills and encourage patient-centered practice. Methods The APHPC is organized by an interprofessional organizing committee. The course was developed based on a needs assessment of HCWs in the region and is run over 4 days. Using didactic and interactive learning approaches, the course covers psychosocial, biomedical and service delivery topics. One hundred HCWs, predominantly nurses, social workers/counselors and, pharmacists have attended the course over 2 years (2016 and 2017). Participants have attended from Singapore, Sri Lanka, Indonesia, Malaysia, Philippines, Bangladesh, Papua New Guinea, Myanmar, and Vietnam. Pre- and post-course evaluations were completed, as well as daily session evaluations and a 3-month post-course evaluation. Participants rated their confidence from 1 to 5 (not confident–very confident). A paired-samples t-test was conducted to compare mean (M) confidence levels pre- and post-course in the various topics covered. Results There was significant improvement in mean confidence scores pre-course (M = 3.40, SD 0.27) and post-course (M = 4.09, SD = 0.13); t(11)= 13.1958, P < 0.0001. This was seen across all topics (figure) with the most marked improvement found in models of care and barriers to care, topics that are not routinely or explicitly covered in the same detail or frequency as HIV basics, testing, treatment and prevention. In the 3-month post-course survey, participants shared the changes they have made to their local practice since attending the APHPC. Changes include, additional staff training, revisions to counseling models and services and the implementation of monitoring and evaluation structures. Conclusion The APHPC has proven to be an impactful and highly evaluated course. To ensure the course continues to influence and improve practice, the content of the course can be expanded to cover nonstandard topics, and further interactive learning experiences can be incorporated. Disclosures All authors: No reported disclosures.

Brief report of a tablet-delivered psychosocial intervention for men with advanced prostate cancer: Acceptability and efficacy by race

Relative to non-Hispanic whites (NHW), black men are disproportionately affected by prostate cancer (PC) incidence, have poorer PC outcomes, and report greater compromises in health-related quality of life. Despite these challenges, black men are underrepresented in psychosocial cancer research, possibly due to limited access to supportive oncology programs. The purpose of this article is to examine the acceptability and efficacy for reducing disease-specific distress of a tablet-delivered psychosocial intervention for older men with advanced PC (APC) and explore differences by race. Men with APC (N = 192, 37.5% black, age M = 68.84 years) were randomized to 10-week Cognitive Behavioral Stress Management (CBSM) or attention-control Health Promotion (HP), both delivered via tablets. Assessments occurred at baseline in person, weekly during the 10-week program via tablets, and at 6 and 12 months in person. Weekly session evaluations and postprogram exit surveys assessed acceptability. Efficacy was assessed with a measure of PC-anxiety validated with racially diverse PC patients using linear mixed effects modeling. Study retention and group attendance did not differ by race. CBSM and HP were both acceptable among older APC patients. Black men rated both conditions more favorably than NHW men. Men in CBSM (vs. HP) reported greater reductions in PC-anxiety at 6 months (not sustained at 12 months). Black men in CBSM reported greater decreases in PC-anxiety over time compared with all other groups. Tablet-delivered CBSM and HP were acceptable for black and NHW APC patients, although black men rated both conditions more favorably. Black men reported a unique intervention benefit related to reduced disease-specific distress.