Cognitive-behavioral Strategies Research Articles

Stress Management Techniques for Students: Exploring Mindfulness, Cognitive-Behavioral Strategies and Resilience

This study investigates the effectiveness of stress management techniques—mindfulness, cognitive-behavioral strategies, and resilience-building practices—among university students facing academic and personal pressures. Utilizing a quantitative research design, data was collected from 550 participants through structured surveys measuring stress levels, technique usage, and influencing factors such as sleep quality and social support. The analysis revealed that mindfulness practices significantly reduced stress levels (M = 5.5) compared to cognitive-behavioral strategies (M = 6.5) and resilience techniques (M = 6.2), thereby confirming the first hypothesis. Cognitive-behavioral strategies also contributed positively to stress reduction, supporting the second hypothesis. Additionally, higher resilience scores correlated with lower stress levels, validating the third hypothesis. Notably, sleep quality and social support were identified as critical moderating factors that enhanced the effectiveness of these techniques, confirming the fourth hypothesis. The findings underscore the importance of incorporating mindfulness and resilience practices into student wellness programs while addressing sleep quality and fostering social support networks. This research contributes to the understanding of effective stress management strategies in academic settings and highlights the need for tailored interventions to support student well-being. Future research should explore the long-term effectiveness of these techniques and consider a broader range of student demographics to enhance the applicability of the findings.

Development of the cognitive-behavioral communication (CBC) framework: A novel approach for mass communication in contact tracing during infectious disease outbreaks

The Cognitive-Behavioral Communication (CBC) Framework was developed to improve public compliance with contact tracing during infectious disease outbreaks, addressing the gaps exposed by the COVID-19 pandemic in the United States. These gaps, including public distrust, misinformation, and privacy concerns, hindered traditional contact tracing efforts. The CBC Framework integrates mass communication theories, cognitive-behavioral strategies, and AI-driven message personalization to enhance public engagement. The framework was tested through comparative field trials, with one group receiving personalized communication via the CBC model and another receiving standard public health messages. Results showed that the CBC group achieved a significantly higher compliance rate (85.6% vs. 66.4%) and a 33% reduction in privacy concerns. AI-driven messages also increased relevance over time, with 86.2% of participants reporting improved message relevance. Public trust was significantly higher in the CBC group, with positive sentiment at 67.5% compared to 45.2% in the control group. These findings have particular relevance to the U.S., where challenges like distrust and privacy concerns have impeded the effectiveness of contact tracing. The CBC Framework presents a scalable solution to improve compliance, trust, and overall public health outcomes during future outbreaks.

Supportive interventions for family caregivers of adults with mental illness: An integrative review

Background: People of all ages, genders, social classes, income levels, and geographical regions can be affected by mental illness. Families of individuals diagnosed with mental illnesses face significant burdens, particularly due to their role as family caregivers. Aim: This integrative review aims to characterize the interventions that support family caregivers to reduce their burden of caregiving. Methodology: Whittemore and Knafl’s methodology guided this integrative literature review. CINAHL, MEDLINE, and PsycINFO were searched for articles published between 2014 and 2023. Eighteen articles were identified as eligible studies to identify supportive interventions. These articles were then critically appraised and relevant data analyzed and synthesized to formulate the results. Findings: The included studies reported interventions focused on family caregivers of relatives with mental illnesses. The two main themes of these studies are (a) interventions to offset the burden of caregiving and (b) outcomes related to these interventions. These interventions include psychoeducation, adaptive cognitive-behavioral strategies, peer support, and religious support. Conclusion: Caring for a mentally ill family member is an extremely stressful situation for family caregivers. Supportive interventions found in this integrative review could help these family caregivers overcome their burdens.

Imagining Letting Go: a Preliminary Test of Written Imagery Rescripting to Facilitate Discarding in a High Hoarding Sample

AbstractMental images appear to be important mental events in hoarding that may maintain the disorder by interfering with discarding. We tested whether a novel written imagery rescripting task, focused on modifying a negative imagined outcome of discarding a hoarded object into a positive alternative, could be used to promote discarding in individuals with hoarding traits, and compared this against other cognitive-behavioural strategies used to encourage discarding. We also examined whether the success of imagery rescripting depended on imagining ability. High hoarding participants (n = 176), recruited through Cloudresearch.com, were asked to imagine a negative outcome of discarding an object they were still attached to. We then randomized them into one of four conditions: imagery rescripting, imaginal exposure, cognitive restructuring, or a positive imagery control, and presented them with a discarding task. Rescripting was associated with increased readiness and motivation to discard, and discarding frequency, compared to other conditions. Rescripting also reduced state negative emotions and increased state positive emotions relative to exposure and restructuring. We found reductions in object attachment in rescripting, restructuring, and positive imagery. The effect of rescripting on readiness and motivation to discard was moderated by imagining ability, such that higher imagining ability was associated with greater readiness and motivation to discard after rescripting. Pending replication and extension, written imagery rescripting may have promise as a clinical strategy to facilitate discarding in individuals with hoarding difficulties.

Feasibility of a nurse-initiated brief cognitive behavioral strategy intervention program for symptom clusters experienced by patients with advanced non-small cell lung cancer

BackgroundA nurse-initiated brief cognitive behavioral Strategy (CBS) intervention program has shown alleviation effects of single symptoms. However, the feasibility of the brief CBS for symptoms included in the Pain and Fatigue symptom clusters in patients with advanced nonsmall cell lung cancer (NSCLC) has not been evaluated. ObjectiveTo evaluate the feasibility of application of the nurse-initiated brief CBS intervention program focusing on pain and fatigue symptoms among the Pain and Fatigue/anorexia symptom clusters experienced by patients with advanced NSCLC. MethodsIn this one-group pretest-posttest design, participants were 15 outpatients with NSCLC undergoing medical treatment (UMIN 000026996). After expressing consent to the study participation, the participants completed a baseline questionnaire and were given a booklet explaining brief cognitive behavioral therapies (relaxation, problem-solving strategies for symptom relief), exercise therapy, and tools. We provided follow-up calls five times and evaluated the retention and changes in symptom severities till the 10th week after the intervention. ResultsOf 15 participants, 10 (66.7%) completed the program. For pain relief strategies, 87% chose deep breathing for relaxation, and 80% fatigue relief with exercises. The median symptom severities (at the baseline and Wk10) showed downward tendencies: pain (2.00, 1.00), sadness (1.00, 0.00), and anxiety (1.00, 0.50). Implications for practiceWe need a randomized controlled trial to further test the effectiveness of the intervention in alleviating symptom and improving QOL of this population. ConclusionsThe nurse-initiated brief CBS intervention program is clinically practical in this population. Nurses may provide useful support for patient symptom management by brief CBS.

Mindfulness and cognitive-behavioral strategies for psychological detachment: Comparing effectiveness and mechanisms of change.

Recovering from work is essential for maintaining occupational well-being, health, motivation, and performance, but recovery is often difficult to achieve. In this study, we evaluated and compared the effectiveness of two (parallel) interventions aimed at promoting recovery: one based on mindfulness and one involving applying cognitive-behavioral strategies. Both interventions were embedded in a measurement burst design, which allowed us to examine the mechanisms underlying change or intervention success. To explore mechanisms of change, we used the stressor-detachment model as a theoretical framework. We operationalized the interventions' effects in three ways: as changes from pretest to posttest, as changes in daily states, and as changes in daily associations. To this end, we used intensive longitudinal data to examine the roles that daily negative activation plays in detachment and strain. In a randomized controlled trial (N = 393), we administered three assessments of traits: pretest, posttest (8 weeks later), and follow-up (3 months after the posttest). We also administered 2 work weeks of experience sampling questionnaires (preintervention and postintervention). Latent change models and Bayes factor equivalence tests revealed that both interventions substantially-and to a similar extent-increased detachment. Bayesian multilevel path models showed improvements in all state variables, including improvements in negative activation, and provided some evidence that mindfulness-based and cognitive-behavioral approaches might tackle different processes at the daily level. We discuss theoretical implications for the literature on recovery from work and specifically for the stressor-detachment model. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring the Resistance Factors within Cognitive Behavioral Therapy (CBT) and Strategies to Overcome them among Therapist: An Exploratory Study

Exploring the Resistance Factors within Cognitive Behavioral Therapy (CBT) and Strategies to Overcome them among Therapist: An Exploratory Study

Electrical brain activations in preadolescents during a probabilistic reward-learning task reflect cognitive processes and behavioral strategy.

Both adults and children learn through feedback which environmental events and choices are associated with higher probability of reward, an ability thought to be supported by the development of fronto-striatal reward circuits. Recent developmental studies have applied computational models of reward learning to investigate such learning in children. However, tasks and measures effective for assaying the cascade of reward-learning neural processes in children have been limited. Using a child-version of a probabilistic reward-learning task while recording event-related-potential (ERP) measures of electrical brain activity, this study examined key processes of reward learning in preadolescents (8-12 years old; n=30), namely: (1) reward-feedback sensitivity, as measured by the early-latency, reward-related, frontal ERP positivity, (2) rapid attentional shifting of processing toward favored visual stimuli, as measured by the N2pc component, and (3) longer-latency attention-related responses to reward feedback as a function of behavioral strategies (i.e., Win-Stay-Lose-Shift), as measured by the central-parietal P300. Consistent with our prior work in adults, the behavioral findings indicate preadolescents can learn stimulus-reward outcome associations, but at varying levels of performance. Neurally, poor preadolescent learners (those with slower learning rates) showed greater reward-related positivity amplitudes relative to good learners, suggesting greater reward-feedback sensitivity. We also found attention shifting towards to-be-chosen stimuli, as evidenced by the N2pc, but not to more highly rewarded stimuli as we have observed in adults. Lastly, we found the behavioral learning strategy (i.e., Win-Stay-Lose-Shift) reflected by the feedback-elicited parietal P300. These findings provide novel insights into the key neural processes underlying reinforcement learning in preadolescents.

Effectiveness of a Therapeutic Program in the Light of Meichenbaum's Theory to Reduce Conduct Disorder and Increase Psychological Flexibility among Adolescent Students

Objective: This study aimed to design and assess a therapeutic program based on Meichenbaum's theory, focusing on reducing conduct disorder and enhancing psychological flexibility among intermediate-stage adolescent students in Riyadh. Additionally, the research sought to evaluate the program's continued effectiveness for two months post-implementation. Methods: The sample comprised 26 students aged 12 to 17 years, with an average age of 14.3 years, equally divided into experimental and control groups. The conduct disorder scale and psychological flexibility scale were administered to both groups pre- and post- intervention. Intervention: The therapeutic program, based on Meichenbaum's theory, was exclusively applied to the experimental group. Results: The program resulted in a notable decrease in conduct disorder scores and an increase in psychological flexibility scores post-intervention in the experimental group. However, the experimental group showed no significant changes between pre-intervention and follow- up. The study also noted a 23.2% increase in conduct disorders among the general student population, highlighting the necessity of counseling and therapeutic programs. Conclusion: These findings underscore the effectiveness of cognitive-behavioral therapy-based programs in a school environment and emphasize the importance of targeted interventions to address behavioral and psychological issues. The study provides valuable insights into using cognitive-behavioral strategies in education and advocates for their application.

Teacher’s Perception of Child-friendly School Environment in Public ECDE Centres in Uasin-Gishu County

Education is an important factor in improving children's social and economic development all around the world. Despite the number of developing nations providing universal primary education, the quality of such education remains a concern that must be addressed. Therefore, the purpose of this study was to evaluate the influence of teachers’ perception of child-friendly school environment in public ECDE Centres in Uasin-Gishu County. The study was underpinned by the Reggio Emilia philosophy of early childhood education. The study adopted a pragmatic paradigm utilising both qualitative and quantitative methods. The study used simple random sampling to select ECDE teachers. A purposive sampling technique was used to select head-teachers and QASO officers. The tools that were used in this study were questionnaires and an interview guide. Qualitative data from interviews were analyzed thematically. Data from questionnaires were analyzed using both descriptive and inferential statistical methods. The findings showed teachers' perceptions were positively and significantly associated with a child-friendly learning environment (r =.459, n = 271, p 0.00), indicating that teachers' perceptions influenced the child-friendly school environment by 45.9%. The study concluded that teachers had a positive attitude towards teaching and pupils while some teachers had negative attitudes towards their learners. Teacher’s attitude affects the learning environment of pre-school children. A teacher's classroom activities influence their children's learning, and a motivated teacher is one who feels satisfied with his or her job. The study recommends teachers be provided with resources to support their implementation of child-friendly practices. This could include materials such as books, games, and activities that are appropriate for young children. Also provide teachers with professional development opportunities such as workshops or seminars on cognitive-behavioral strategies to help them recognize and address negative perceptions among learners. The study suggests research analyzing the effect of teacher operational dynamics on service delivery in ECDE Centres to be pursued to determine options in all the counties in Kenya.

Perceived acceptability and appropriateness of a web-based program targeting risk for anxiety in young children and their parents

Abstract Objective This mixed-methods study examined perceived acceptability and appropriateness of a novel digital mental health program targeting anxiety risk (i.e., perfectionism or error sensitivity) in 5-to-7-year-old children and their parents. Methods Parent–child dyads participated in a modular, web-based cognitive-behavioral program targeting negative overreactions to making mistakes. The program, “Making Mistakes”, consisted of a 6-month series of short video clips, journaling activities, and weekly reminders, and modules were delivered to caregivers and children separately. 86 dyads completed self-report measures, 18 of whom participated in semi-structured interviews, following completion of the primary program module. A standard thematic analysis was used to elucidate themes from the parent and child interview content. Results Our quantitative and qualitative results were generally aligned. Children and parents viewed the novel digital mental health program as acceptable and appropriate, favoring the cognitive behavioral strategies such as modeling positive reactions to mistakes, responding positively to child mistakes, and emphasizing effort over outcome. Participants also provided helpful feedback related to program content, delivery, and engagement, as well as suggestions to enhance the program. Conclusions Findings have implications for design and content features of parent-based and dyad-based programs, as well as digital mental health programs focused on reducing anxiety risk.

Integrating Real-Time Biomechanical Feedback with Cognitive-Behavioral Interventions to Enhance the Efficacy of Strength Training

This study investigates the efficacy of integrating real-time biomechanical feedback with cognitive-behavioral interventions in enhancing the outcomes of strength training programs. A mixed-methods experimental design was utilized, involving 90 participants randomly assigned to three groups: a control group receiving traditional strength training, a biomechanical feedback group, and a combined intervention group receiving both biomechanical feedback and cognitive-behavioral strategies. The interventions lasted for 12 weeks, with assessments conducted pre- and post-intervention. Key performance indicators included improvements in one-repetition maximum (1RM) strength tests and psychological well-being metrics. Results indicated that the combined intervention group demonstrated significantly greater improvements in 1RM strength, technique efficiency, and psychological resilience compared to the other two groups. The integration of biomechanical and cognitive-behavioral strategies not only improved physical performance but also enhanced mental focus and training adherence, showcasing a holistic approach to strength training. The findings suggest that a synergistic approach, encompassing both biomechanical feedback and cognitive strategies, can substantially elevate the effectiveness of strength training regimes. These outcomes have implications for coaches, athletes, and sports medicine professionals looking to optimize performance and rehabilitation protocols. The study highlights the potential for a more personalized and psychologically supportive training environment, promising for future research and practical applications in sports science and physical training.

Programmes Addressed to Informal Caregivers' Needs: A Systematic Literature Review.

Addressing informal caregivers' needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge about programmes aimed at meeting the needs of informal caregivers of adults who are dependent on others for daily life activities. Following the PRISMA guidelines, the electronic databases EBSCOhost Research Platform, MEDLINE, CINAHL, Scopus, Web of Science and The Virtual Health Library were searched for randomized experimental studies published between 2012 and 2022 that implemented programmes addressing informal caregivers' needs to improve their experiences, health, and well-being. Quality was assessed using the standardized critical evaluation tools from the Joanna Briggs Institute. Two independent investigators performed the eligibility assessment and data extraction. Quantitative data on the effectiveness of interventions were collected, and the content of each intervention was synthesized and aggregated into categories, through narrative synthesis. The majority of the included studies (n = 16) were conducted in European countries and implemented a structured intervention programme compared to the provision of usual care. The studies were of fair to high methodological quality, with a higher risk of bias related to blinding. The results supported the achievement of favourable health outcomes among informal caregivers, namely improvements in mental health (n = 3) and quality of life (n = 3) and a decrease in psychological symptomatology (n = 5) and burden (n = 3). None of the interventions reported adverse outcomes; however, five studies did not describe significant differences in the outcomes assessed after the implementation of the programmes. Interventions focusing on training and educating caregivers (n = 14) and cognitive-behavioural strategies (n = 7) were the most common, while programmes focusing on emotional and psychological support as a resource to improve caregivers' psychological outcomes were scarce. This systematic review adds to the growing body of evidence and insight showing that programmes that address informal caregivers' needs seem to contribute to better physical and psychological health outcomes through the promotion of caregivers' educational support and the implementation of cognitive-behavioural strategies. Future research should implement methodologically robust cross-country programmes tailored to informal caregivers' physical, emotional, psychosocial, societal, and educational needs throughout the care trajectory.

Cognitive-Behavioral-Based Physical Therapy for Improving Recovery After a Traumatic Lower-Extremity Injury: The Results of a Randomized Controlled Trial.

Lower-extremity injuries can result in severe impairment and substantial years lived with a disability. Persistent pain and psychological distress are risk factors for poor long-term outcomes and negatively influence the recovery process following a traumatic injury. Cognitive-behavioral therapy (CBT) interventions have the potential to address these risk factors and subsequently improve outcomes. This study aimed to evaluate the effect of a telephone-delivered cognitive-behavioral-based physical therapy (CBPT) program on physical function, pain, and general health at 12 months after hospital discharge following lower-extremity trauma. The CBPT program was hypothesized to improve outcomes compared with an education program. A multicenter, randomized controlled trial was conducted involving 325 patients who were 18 to 60 years of age and had at least 1 acute orthopaedic injury to the lower extremity or to the pelvis or acetabulum requiring operative fixation. Patients were recruited from 6 Level-I trauma centers and were screened and randomized to the CBPT program or the education program early after hospital discharge. The primary outcome was the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) scale. The secondary outcomes were objective physical function tests (4-square step test, timed stair ascent test, sit-to-stand test, and self-selected walking speed test), PROMIS Pain Intensity and Pain Interference, and the Veterans RAND 12-Item Health Survey. Treatment effects were calculated using targeted maximum likelihood estimation, a robust analytical approach appropriate for causal inference with longitudinal data. The mean treatment effect on the 12-month baseline change in PROMIS PF was 0.94 (95% confidence interval, -0.68 to 2.64; p = 0.23). There were also no observed differences in secondary outcomes between the intervention group and the control group. The telephone-delivered CBPT did not appear to yield any benefits for patients with traumatic lower-extremity injuries in terms of physical function, pain intensity, pain interference, or general health. Improvements were observed in both groups, which questions the utility of telephone-delivered cognitive-behavioral strategies over educational programs. Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

Preparing Nursing Students to Manage Acculturative Stress Experienced During Study Abroad Experiences: Novel Use of Immersive Simulation and Cognitive Behavioral Strategies

Preparing Nursing Students to Manage Acculturative Stress Experienced During Study Abroad Experiences: Novel Use of Immersive Simulation and Cognitive Behavioral Strategies

Types of Medication Non-adherence & Approaches to Enhance Medication Adherence in Mental Health Disorders: A Narrative Review.

Medication non-adherence (MNA) presents a significant obstacle that negatively impacts treatment effectiveness in mental health disorders. The objective of this review is to study different types of MNA and interventions designed to enhance medication adherence among individuals with mental health disorders. We conducted an electronic search on PubMed and Google Scholar using keywords such as adherence, non-adherence, compliance, non-compliance, mental health disorders, psychotropic drugs, major depressive disorder (MDD), schizophrenia, anxiety disorders, and bipolar disorders (BD). From the search results, we selected studies pertinent to the objective of the review. Non-adherence can be categorized into primary nonadherence (not starting medication) and secondary non-adherence (not taking the medication as directed). Generally, we can group the reasons for non-adherence into unintentional and intentional. Unintentional non-adherence (UNA) arises when patients genuinely desire to comply with their prescribed course of therapy but are hindered by factors beyond their control. When addressing UNA, interventions should simplify medication regimens, utilize long-acting injectable (LAIs) medications, offer tools to manage medication and provide follow-up reminders. When a patient deliberately decides not to follow their treatment plan, this is known as intentional non-adherence. To improve intentional non-adherence, the focus should be on patient-centred care and shared decision-making, psychoeducation, effective doctor-patient communication, cognitive-behavioral strategies, and addressing concerns related to the side effects of psychotropic drugs. It is crucial to understand that there is no universal solution to address non-adherence in mental health disorders. Each patient has distinct needs and characteristics, making personalized strategies and interventions of utmost significance.

Clinical effectiveness of the psychological therapy Mental Health Intervention for Children with Epilepsy in addition to usual care compared with assessment-enhanced usual care alone: a multicentre, randomised controlled clinical trial in the UK

Mental health difficulties are common in children and young people with chronic health conditions, but many of those in need do not access evidence-based psychological treatments. The study aim was to evaluate the clinical effectiveness of integrated mental health treatment for children and young people with epilepsy, a common chronic health condition known to be associated with a particularly high rate of co-occurring mental health difficulties. We conducted a parallel group, multicentre, open-label, randomised controlled trial of participants aged 3-18 years, attending epilepsy clinics across England and Northern Ireland who met diagnostic criteria for a common mental health disorder. Participants were randomised (1:1; using an independent web-based system) to receive the Mental Health Intervention for Children with Epilepsy (MICE) in addition to usual care, or assessment-enhanced usual care alone (control). Children and young people in both groups received a full diagnostic mental health assessment. MICE was a modular psychological intervention designed to treat common mental health conditions in children and young people using evidence-based approaches such as cognitive behaviour therapy and behavioural parenting strategies. Usual care for mental health disorders varied by site but typically included referral to appropriate services. Participants, along with their caregivers, and clinicians were not masked to treatment allocation but statisticians were masked until the point of analysis. The primary outcome, analysed by modified intention-to-treat, was the parent-report Strengths and Difficulties Questionnaire (SDQ) at 6 months post-randomisation. The study is complete and registered with ISRCTN (57823197). 1401 young people were potentially deemed eligible for study inclusion. Following the exclusion of 531 young people, 870 participants were assessed for eligibility and completed the SDQ, and 480 caregivers provided consent for study inclusion between May 20, 2019, and Jan 31, 2022. Between Aug 28, 2019, and Feb 21, 2022, 334 participants (mean ages 10·5 years [SD 3·6] in the MICE group vs 10·3 [4·0] in control group at baseline) were randomly assigned to an intervention using minimisation balanced by age, primary mental health disorder, diagnosis of intellectual disability, and autistic spectrum disorder at baseline. 168 (50%) of the participants were female and 166 (50%) were male. 166 participants were randomly assigned to the MICE group and 168 were randomly assigned to the control group. At 6 months, the mean SDQ difficulties for the 148 participants in the MICE group was 17·6 (SD 6·3) and 19·6 (6·1) for the 148 participants in the control group. The adjusted effect of MICE was -1·7 (95% CI -2·8 to -0·5; p=0·0040; Cohen's d, 0·3). 14 (8%) patients in the MICE group experienced at least one serious adverse event compared with 24 (14%) in the control group. 68% percent of serious adverse events (50 events) were admission due to seizures. MICE was superior to assessment-enhanced usual care in improving symptoms of emotional and behavioural difficulties in young people with epilepsy and common mental health disorders. The trial therefore shows that mental health comorbidities can be effectively and safely treated by a variety of clinicians, utilising an integrated intervention across ages and in the context of intellectual disability and autism. The evidence from this trial suggests that such a model should be fully embedded in epilepsy services and serves as a model for other chronic health conditions in young people. UK National Institute for Health Research Programme Grants for Applied Research programme and Epilepsy Research UK Endeavour Project Grant.

Social and non-social cognitive behavioural therapy strategies for depression: findings from the MoodMission smartphone application

ABSTRACT Objective Cognitive behavioural therapy (CBT) is an evidence-based treatment of depression that can include strategies with a social component. Mental health apps (MHapps) are widely used amongst individuals with depression to access CBT strategies. Despite the research on CBT, it is not clear whether there is a difference in the correlation of CBT strategies for depression with a social component or not. Using MoodMission, an empirically validated MHapp that recommends CBT strategies (termed “Missions”), this study investigated whether social or non-social CBT strategies would correlate with participants’ ratings of helpfulness and distress reduction. Method A total of 4,107 participants who completed at least one social or non-social Mission and baseline 9-item Patient Health Questionnaire (PHQ-9) were included. Multilevel modelling with 2-levels was used, with level 1 entered as the fixed effect between Mission type in predicting subjective helpfulness and distress reduction, and level 2 entered as the random effects of participant covariates of age, gender, and PHQ-9 scores. Results Findings indicated that Missions without a social component was a significant positive predictor in distress reduction, but there was no significant difference in predicting subjective helpfulness. Conclusion These findings suggest that individuals with depression using MHapps could benefit from engaging in non-social CBT strategies for the reduction of subjective distress, more so than social CBT strategies. Study limitations included the self-report study design, subjective outcome measures, and a higher representation of female (80.6%) participants. Further research is required to investigate the clinical significance of these findings with a more representative sample.

Investigating age-related COVID-19 digital health literacy and sense of coherence among adolescents and young adults in schools across Northern Ghana

IntroductionThe empirical link between digital health literacy (DHL) and sense of coherence (SoC) has been extensively discussed in the literature. Yet, there seems to be limited evidence regarding the roles of age and depression status in the link between DHL and SoC of adolescents and young adults (AYAs), especially during the COVID-19 crises. This study investigated the interplay between age, DHL, SoC and psychological distress. Particularly, the study examined the following: (1) relationship between DHL and SoC, (2) moderating role of age in the relationship between DHL and SoC as well as (3) moderating role of depression in the relationship between DHL and SoC.MethodsThe study used a cross-sectional survey to select 998 AYAs in secondary schools in Northern Ghana through questionnaire administration using a stratified sampling procedure.ResultsFindings reveal that age was positively and significantly related to DHL and SoC. However, age failed to moderate the relationship between DHL and SoC. With the same level of DHL, students who exhibited depressive symptoms compared to those without, had lower levels of SoC regardless of their age.ConclusionsAlthough AYAs’ DHL are likely to differ across different age brackets, this gap does not affect their rates of SoC and depression. Nonetheless, there is a need to improve DHL through regular standard training on internet search using basic audio-visual materials like laptops, smart phones, tablets, and lab computers for adolescent and young adult students. Additionally, school authorities, in collaboration with other stakeholders should develop student-centred cognitive-behavioural strategies aimed at reducing depressive symptoms in secondary school students who are at risk of depression in Northern Ghana.

Digital Health Psychosocial Intervention in Adult Patients With Cancer and Their Families: Systematic Review and Meta-Analysis.

Patients with cancer and their families often experience significant distress and deterioration in their quality of life. Psychosocial interventions were used to address patients' and families' psychosocial needs. Digital technology is increasingly being used to deliver psychosocial interventions to patients with cancer and their families. A systematic review and meta-analysis were conducted to review the characteristics and effectiveness of digital health interventions on psychosocial outcomes in adult patients with cancer and their family members. Databases (PubMed, Cochrane Library, Web of Science, Embase, CINAHL, PsycINFO, ProQuest Dissertations and Theses Global, and ClinicalTrials.gov) were searched for randomized controlled trials (RCTs) or quasi-experimental studies that tested the effects of a digital intervention on psychosocial outcomes. The Joanna Briggs Institute's critical appraisal checklists for RCTs and quasi-experimental studies were used to assess quality. Standardized mean differences (ie, Hedges g) were calculated to compare intervention effectiveness. Subgroup analysis was planned to examine the effect of delivery mode, duration of the intervention, type of control, and dosage on outcomes using a random-effects modeling approach. A total of 65 studies involving 10,361 patients (mean 159, SD 166; range 9-803 patients per study) and 1045 caregivers or partners (mean 16, SD 54; range 9-244 caregivers or partners per study) were included in the systematic review. Of these, 32 studies were included in a meta-analysis of the effects of digital health interventions on quality of life, anxiety, depression, distress, and self-efficacy. Overall, the RCT studies' general quality was mixed (applicable scores: mean 0.61, SD 0.12; range 0.38-0.91). Quasi-experimental studies were generally of moderate to high quality (applicable scores: mean 0.75, SD 0.08; range 0.63-0.89). Psychoeducation and cognitive-behavioral strategies were commonly used. More than half (n=38, 59%) did not identify a conceptual or theoretical framework. Most interventions were delivered through the internet (n=40, 62%). The median number of intervention sessions was 6 (range 1-56). The frequency of the intervention was highly variable, with self-paced (n=26, 40%) being the most common. The median duration was 8 weeks. The meta-analysis results showed that digital psychosocial interventions were effective in improving patients' quality of life with a small effect size (Hedges g=0.05, 95% CI -0.01 to 0.10; I2=42.7%; P=.01). The interventions effectively reduced anxiety and depression symptoms in patients, as shown by moderate effect sizes on Hospital Anxiety and Depression Scale total scores (Hedges g=-0.72, 95% CI -1.89 to 0.46; I2=97.6%; P<.001). This study demonstrated the effectiveness of digital health interventions on quality of life, anxiety, and depression in patients. Future research with a clear description of the methodology to enhance the ability to perform meta-analysis is needed. Moreover, this study provides preliminary evidence to support the integration of existing digital health psychosocial interventions in clinical practice. PROSPERO CRD42020189698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189698.