The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review

Suicidal men feel the need to be self-reliant and that they cannot find another way out of relationship or socioeconomic issues. Suicide prevention is of crucial importance worldwide. The much higher rate of suicide in men engenders action. The prelude is a subjective experience that can be very isolating and severely distressing. Men may not realize a change in their thinking and behaviors, which makes it more difficult to seek and get help, thereby interrupting a “downward spiral”. Stoicism often prevents men from admitting to their personal struggle. The lack of “quality” connections and “non-tailored” therapies has led to a high number of men “walking out” on traditional clinical approaches. But there are complicated relationships in motivations and formative behaviors of suicide with regards to emotional state, psychiatric disorders, interpersonal life events and suicidal behavior method selection. Middle-aged and older men have alternated as the most at-risk of suicide. There is no one solution that applies to all men, but digital tools may be of assistance (e.g., video conferences, social networks, telephone calls, and emails). Digital interventions require higher levels of effectiveness for distress and suicidality but self-guided approaches may be the most suitable for men especially where linked with an integrated online suicide prevention platform (e.g., quick response with online chats, phone calls, and emails). Furthermore, technology-enabled models of care offer promise to advance appropriate linking to mental health services through better and faster understanding of the specific needs of individuals (e.g., socio-cultural) and the type and level of suicidality experienced. Long-term evidence for suicidality and its evaluation may benefit from progressing human computer-interaction and providing impetus for an eminent integrated digital platform.

Remote Delivery of the Chronic Pain Self-management Program Using Self-directed Materials and Small-group Telephone Support: A Pilot Study

A remote (telephone and tool kit) chronic pain program was studied using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. This 6-week pilot took place in underserved communities in Cleveland, Ohio. We determined reach by the diversity of the population, nearly 50% Black and mostly low income. Effectiveness over 7 weeks was shown with validated instruments (depression, pain, sleep, quality of life, self-rated health, and self-efficacy). Changes in pain, depression, and self-efficacy were significant. ( p < .01). Remote implementation was accomplished by sending participants a box of materials (book, exercise and relaxation CDs, a self-test, and tip sheets). Participants also participated in peer-facilitated, weekly, scripted telephone calls. Maintenance was demonstrated as the study site has offered nine additional programs with more plan. In addition, 60 additional organizations are now offering the program. This proof-of-concept study offers an alternate to in-person chronic pain self-management program delivery.

THE MULTIPLE REGRESSION MODEL WITH DICHOTOMOUS VARIABLES IN ANALYSIS OF MULTI-SECTIONAL DEMAND FOR CONNECTIVITY SERVICES – APPROACH BASED ON PER SECOND BILLING

The article presents the results of comparative research of the effectiveness of two types of models in terms of approximation and short-term forecasting of the multi-sectional demand for connectivity services. The presented results of the analyses are related to the selection of an appropriate forecasting method as an element of the Prediction System dedicated to telecommunications operators. The first tested model was a multiple regression model with dichotomous explanatory variables. The second model was a multiple regression model with dichotomous explanatory variables and autoregression. In both models, the dependent variable was the hourly counted seconds of outgoing calls within the network of the selected operator. Telephone calls were analysed in terms of such classification factors as: type of day, category of call, group of subscribers. Taking into account all levels of classification factors of the explanatory variable, 35 dichotomous explanatory variables were specified. The defined set of dichotomous explanatory variables was used in the estimation process of both compared regression models. However, in the second model, first-order autoregression was additionally applied. The second model (multiple regression model with dichotomous explanatory variables with first-order autoregression) was found to have higher approximation and predictive capabilities than the first model (multiple regression model with dichotomous explanatory variables without autoregression).

Preliminary Impact of a Social Connection Program on Older Adults

Background Research demonstrates social connections decrease loneliness and improves life satisfaction among older adults. Unfortunately, the COVID-19 pandemic has limited social connectedness, specifically for older adults. Thus, programs aiming to increase social connectedness among older adults are imperative. Purpose The primary objective of this study was to determine if the telephonic Peer-to-Peer (P2P) program can improve social connectedness and loneliness among older adults. A secondary objective was to determine whether additional improvements in life satisfaction and perception of aging were achieved. Methods Eligible older adults (age 65+) were recruited via outbound calls and/or a mailer. Participants were mailed a T1 survey, completed intervention training, and matched into a dyad. The matched dyad engaged in weekly telephone calls for 12 weeks. Post 12 weeks, participants completed a T2 survey, and a T3 four weeks later. Results Overall, 7,544 individuals were contacted to participate, and 759 expressed interest in participation. A total of 475 participants (62%) completed a T1, 372 (78%) completed training, and 348 (94%) were matched. Gender distribution was skewed towards females (74%), and most were 65-74 years old (53%). Preliminary results show significant differences between lonely and not lonely participants, with lonely participants reporting more negative health associations across all measures. Conclusion Once agreeing to participate, results showed a high likelihood of continuing in P2P, thus demonstrating a social connectedness opportunity for older adults. Delay in mailing and scheduling training may contribute to challenges in attrition. However, developing automated processes utilizing technology may decrease lag time for future phases.

STAR Caregivers: Virtual Training and Followup: Implementation

STAR Caregivers is an evidence-based intervention designed to reduce caregiver burden for caregivers of people living with dementia. This study translated the paper-based, face-to-face intervention into a 6-session, self-directed online learning program supported by 6, 30-minute telephone calls with a clinically trained coach. Our approach is designed to overcome issues of access to training. Eligible caregiver-patient dyads at Kaiser Permanente Washington were identified automatically via electronic health records. Qualitative interviews were conducted with a sample of patients to elicit information about their needs and preferences for training. We developed a “learning management system” (analogous to compliance training modules) complete with slides, voice-over narration, and testing. The training sessions are mounted on the KP Learn site and accessible to anyone. Baseline and outcomes data on standardized instruments are collected remotely via REDCap. Recruitment for the study is ongoing and initial participant feedback on the program is very positive.

Small Animal Veterinarians' Communication With Dog Owners From a Motivational Interviewing Perspective

Veterinary communication skills are fundamentally important in animal practice. Despite client-centered communication being recommended as the optimal medical communication style, a paternalistic approach is still common in veterinary medical encounters with pet owners. Motivational interviewing (MI) is a client-centered, evidence-based counseling method aiming to strengthen a person's motivation and commitment to behavior changes. In this exploratory study, the aim was to investigate Swedish small animal veterinarians' use of client centered communication with dog owners regarding dental home care in dogs. This was achieved by analyzing the use of MI-techniques among veterinarians without previous training or knowledge of the method. Individual telephone calls, reflecting a veterinary clinical scenario, between small animal veterinarians (n = 8) and a trained professional actor playing a dog owner were recorded and coded according to an MI coding protocol (MITI 4.2.1). In the present study, the degree of spontaneously used MI was low. From an MI-communication perspective, with a simulated dog owner, the veterinarians predominantly relied on asking questions, giving information, and persuasive talk. The veterinarians dominated the conversations and made minimal attempts to involve the dog owner resulting in a power imbalance between veterinarian and client. As the degree of spontaneously used MI was found to be low, MI-training may be required in order to apply the method in professional counseling. The veterinarians' communication pattern suggested a paternalistic communication style, when attempting to motivate a client to brush his or her dog's teeth. We suggest that Motivational Interviewing (MI) has a potential to improve veterinary communication and adherence to medical recommendations if introduced and implemented in veterinary practice.