Group-based Setting Research Articles

Experiences and perceptions of people with a severe mental illness and health care professionals of a one-year group-based lifestyle programme (SMILE).

This was to elucidate the experiences and perceptions of people with severe mental illness (SMI) and their health care professionals with the SMILE (Severe Mental Illness Lifestyle Evaluation) group-based lifestyle intervention. SMILE focuses primarily on promoting healthy diet, physical activity and weight loss. A qualitative study with semi-structured interviews was conducted using purposive sampling. Interviews were conducted with 15 clients and 13 health care professionals (HCPs). Data were analysed according to a thematic analysis. Four overall themes were identified: interest in a lifestyle programme; group-based setting; changes in lifestyle behaviour; and preconditions for changing health behaviour. The results showed that clients valued the programme and were interested in the subject of lifestyle. The group-based setting was seen as a positive and important aspect of the intervention. Making lifestyle changes was acknowledged as difficult, especially in combination with the presence of psychiatric symptoms. Clients acquired an improved awareness of different aspects related to lifestyle behaviour. Irrespective of weight loss achieved, clients found their efforts successful with relatively 'small' changes. Some needed more support during the intervention than others. The practical activities in group sessions were regarded as most useful. HCPs were enthusiastic about the programme and their interactions with lifestyle improvements. The results of this study shed light on different aspects that were considered important when delivering a lifestyle intervention to people with SMI. We recommend considering these aspects when implementing a lifestyle intervention in a mental health care setting for clients with SMI.

“Groupwork or teamwork?”: Creating the same page for improving team-based learning experience

The increasing popularity of the team-based learning (TBL) approach signifies how much the student-centered learning environment contributes to the effectiveness of teaching. Given the need to establish an agreement for groups to communicate their visions for collaborative efforts within the teamwork, this activity provides a basic communicative template for group members to exchange their thoughts and ideas on what distinguishes teamwork from groupwork and what constitutes good teamwork. This activity essentially offers a playground for student groups to engage with the notion of teamwork, identify potential challenges in their team communication, and actively seek solutions to improve their TBL experience. Courses: This activity applies to foundational courses in communication (courses requiring students to work in a team setting for an extended time). Objectives: This activity engages students in a conversational space within a group-based setting, sharing their understanding of what constitutes good teamwork. Thus, the activity is intended to: (1) encourage team members to communicate their goals and expectations, (2) increase the understanding of contribution and appreciation of teamwork, (3) improve the overall TBL experience for team members, and (4) help students understand the differences between group-based learning and TBL experiences.

Exercise in allogeneic bone marrow transplantation: a qualitative representation of the patient perspective

PurposeExercise is emerging as a vital aspect of care to alleviate the physical and psychosocial symptom burden associated with allogeneic bone marrow transplantation (BMT). Understanding the patient perspective regarding exercise is important to move towards implementation. This study aimed to characterise experiences and views regarding participation in an exercise program in adults receiving treatment for haematological disease with allogeneic BMT.MethodsIndividual semi-structured interviews were conducted with 35 participants from either an early- or late-commencing supervised group-based exercise program. Using an inductive, conventional approach to qualitative content analysis data were independently analysed by two researchers.ResultsSix major themes and 33 sub-themes were identified: this encompassed motivation, physical opportunity and capability to exercise; psychosocial effects of group-based exercise; experienced impact of participation in an exercise program; and intervention design considerations. Key barriers to exercise included symptom severity and fluctuating health and distance or difficult access to an exercise facility or equipment, whilst facilitators included encouragement from staff; peer support in the group-based setting; flexibility; education; and ability to measure change.ConclusionThis study highlights the importance of a flexible approach to exercise with consideration of individual symptoms and preferences. The perceived psychological impact of exercise should not be underestimated; future exercise programs should be designed in partnership with patients, with consideration of group-based activities to reduce social isolation if this is feasible in the treatment context. Intervention design should also acknowledge the individual’s physical and psychological capability, opportunity and automatic and reflective motivation to direct and sustain exercise behaviours following BMT.

Promoting Resilience and Flourishing Among Older Adult Residents in Community Living: A Feasibility Study.

The Stress Management and Relaxation Training-Relaxation Response Resiliency Program (SMART-3RP) is a mind-body group intervention that integrates relaxation training with cognitive behavioral and positive psychology techniques. This study assessed SMART-3RP feasibility, acceptability, and preliminary efficacy for enhancing resilience and flourishing among older adults in continuing care retirement communities (CCRCs). We conducted a prospective single-arm study of SMART-3RP groups delivered by clinicians at 4 CCRCs (n = 80). Eligible residents lived in community apartments. Participants completed pre- and postintervention surveys. We evaluated attendance (hypothesis: ≥60% attend ≥6 of 9 sessions), enrollment, and retention. Mixed methods were used to explore acceptability. Paired samples t-tests were conducted to explore changes in resilience, flourishing, and key intervention targets. From March to June 2021, we screened 89 residents with 87 (98%) consenting to participate and 80 (90%) enrolling in the study. Among 80 participants (85% female; 98% non-Hispanic White; M age = 80 years [SD = 6]), 88% attended ≥6 sessions, and 89% completed the postintervention survey. Participants found meaning in participation and practiced skills in the context of challenges such as caregiving burden or bereavement. Survey results, showing increases in resilience, flourishing, and several intervention targets, aligned with participants' perceived intervention value. SMART-3RP was feasible and acceptable for CCRC residents; participants perceived value in practicing mind-body strategies in a group-based setting. Preliminary evidence suggested a pattern of improvements in resilience, flourishing, and intervention targets. Findings provide insights for mind-body interventions and recommendations for adaptations to late-in-life concerns and community settings. NCT04720014.

Personalizing Transient Noise Reduction Algorithm Settings for Cochlear Implant Users.

Objectives:Speech understanding in noise is difficult for patients with a cochlear implant. One common and disruptive type of noise is transient noise. We have tested transient noise reduction (TNR) algorithms in cochlear implant users to investigate the merits of personalizing the noise reduction settings based on a subject’s own preference.Design:The effect of personalizing two parameters of a broadband and a multiband TNR algorithm (TNRbb and TNRmb, respectively) on speech recognition was tested in a group of 15 unilaterally implanted subjects in cafeteria noise. The noise consisted of a combination of clattering dishes and babble noise. Each participant could individually vary two parameters, namely the scaling factor of the attenuation and the release time (τ). The parameter τ represents the duration of the attenuation applied after a transient is detected. As a reference, the current clinical standard TNR “SoundRelax” from Advanced Bionics was tested (TNRbb-std). Effectiveness of the algorithms on speech recognition was evaluated adaptively by determining the speech reception threshold (SRT). Possible subjective benefits of the algorithms were assessed using a rating task at a fixed signal-to-noise ratio (SNR) of SRT + 3 dB. Rating was performed on four items, namely speech intelligibility, speech naturalness, listening effort, and annoyance of the noise. Word correct scores were determined at these fixed speech levels as well.Results:The personalized TNRmb improved the SRT statistically significantly with 1.3 dB, while the personalized TNRbb degraded it significantly by 1.7 dB. For TNRmb, we attempted to further optimize its settings by determining a group-based setting, leaving out those subjects that did not experience a benefit from it. Using these group-based settings, however, TNRmb did not have a significant effect on the SRT any longer. TNRbb-std did not affect speech recognition significantly. No significant effects on subjective ratings were found for any of the items investigated. In addition, at a constant speech level of SRT + 3 dB, no effect of any of the algorithms was found on word correct scores, including TNRmb with personalized settings.Conclusions:Our study results indicate that personalizing noise reduction settings of a multiband TNR algorithm can significantly improve speech intelligibility in transient noise, but only under challenging listening conditions around the SRT. At more favorable SNRs (SRT + 3 dB), this benefit was lost. We hypothesize that TNRmb was beneficial at lower SNRs, because of more effective artifact detection under those conditions. Group-averaged settings of the multiband algorithm did not significantly affect speech recognition. TNRbb decreased speech recognition significantly using personalized parameter settings. Rating scores were not significantly affected by the algorithms under any condition tested. The currently available TNR algorithm for Advanced Bionics systems (SoundRelax) is a broadband filter that does not support personalization of its settings. Future iterations of this algorithm might benefit from upgrading it to a multiband variant with the option to personalize its parameter settings.

Group-Based Naturopathic Education for Primary Prevention of Noncommunicable Disease in Families and Children: A Feasibility Study.

Objectives: Naturopathic medicine has demonstrated efficacy at reducing risk factors for chronic disease. Targeting health behaviors of parents and caregivers in a group-based setting may improve the behaviors of children in their care. This study sought to assess the feasibility of such a program. Design: Participants of a six-session health education series were invited to respond to surveys and participate in a focus group about their health behaviors and their experience in the program. Subjects: Caregivers of children aged 0-6 attending publicly funded community centers in Ontario, Canada. Interventions: A 6-week group-based naturopathic education program to promote healthy lifestyle behaviors among caregivers. Outcome measures: Satisfaction with content and delivery, and frequency of healthy behaviors. Results: The majority of responses indicated satisfaction with the program, and an ongoing benefit 6 weeks and more after completion. There was a clear correlation between healthy behaviors of parents and children. Conclusions: A group-based naturopathic education program may be a feasible method of delivering primary-prevention education to caregivers, particularly in the domains of practicality and acceptability.

Advancing Medical Students’ Non-technical Skills in a Group-Based Setting

Aim of the study: Introduction of non-technical skill (NTS) modules in undergraduate medical curricula is essential to prevent errors that occur due to inadequate communication and malfunctioning teams. We primarily aimed to observe medical students’ NTS performance improvement in a group-based setting and compare it across participants of different countries of study. Secondarily, we aimed to assess students’ views on such initiatives. Material and Methods: We designed a pilot module for assessing and improving a group’s NTS performance. This was based on three main pillars: simulation-based learning, constructive feedback and objective assessment. Senior medical students from EU universities were invited to apply online. Delegates were divided according to their country of study and participated in two surgical scenarios. Groups had two attempts at each scenario and feedback was given in between. Performance was assessed using a modified version of the Individual Teamwork Observation and Feedback Tool (iTOFT). Participant feedback was collected at the end of the module. Results: Eighty delegates were recruited and finished the study. A mean increase performance of 0.81 out of 3 was noted between attempts in trauma-case scenarios and 0.88 out of 3 in ward round scenarios. Overall performance improvement was similar across all groups (p > 0.05). Feedback of delegates was encouragingly positive. Conclusions: The reported improvement and positive feedback received highlight that such an intervention can be implemented in medical school curricula of all countries. Our module design, along with the use of iTOFT, should act as the basis for future development of group-based learning and assessment in undergraduate medical education.

Effect of Group-Based Rehabilitation Combining Action Observation with Physiotherapy on Freezing of Gait in Parkinson's Disease.

Freezing of gait (FoG) is among the most disabling symptoms of Parkinson's disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.

Performance of methods for estimating the effect of covariates on group membership probabilities in group-based trajectory models.

One purpose of a longitudinal study is to gain insight of how characteristics at earlier points in time can impact on subsequent outcomes. Typically, the outcome variable varies over time and the data for each individual can be used to form a discrete path of measurements, that is a trajectory. Group-based trajectory modelling methods seek to identify subgroups of individuals within a population with trajectories that are more similar to each other than to trajectories in distinct groups. An approach to modelling the influence of covariates measured at earlier time points in the group-based setting is to consider models wherein these covariates affect the group membership probabilities. Models in which prior covariates impact the trajectories directly are also possible but are not considered here. In the present study, we compared six different methods for estimating the effect of covariates on the group membership probabilities, which have different approaches to account for the uncertainty in the group membership assignment. We found that when investigating the effect of one or several covariates on a group-based trajectory model, the full likelihood approach minimized the bias in the estimate of the covariate effect. In this '1-step' approach, the estimation of the effect of covariates and the trajectory model are carried out simultaneously. Of the '3-step' approaches, where the effect of the covariates is assessed subsequent to the estimation of the group-based trajectory model, only Vermunt's improved 3 step resulted in bias estimates similar in size to the full likelihood approach. The remaining methods considered resulted in considerably higher bias in the covariate effect estimates and should not be used. In addition to the bias empirically demonstrated for the probability regression approach, we have shown analytically that it is biased in general.

English

INTRODUCTION : Exercise rehabilitation has previously been reported effective in attenuating numerous cancer treatment-related toxicities and enhancing the quality of life (QOL) of patients. However, approximately 85% of the patients we see at Maple Tree Cancer Alliance were previously sedentary. These individuals report experiencing much anxiety about starting an exercise program for the first time, and compliance with such programs has been an issue. Therefore, we created a group-based exercise class as an introduction to exercise. Our goal in doing so was to see the impact of this class on fitness parameters, QOL, and exercise compliance after the program ended. METHODS :82 individuals who were currently undergoing cancer treatment participated in this group-based exercise class. Their results were compared to 200 different individuals who completed one-on-one exercise training. Each group underwent a comprehensive fitness assessment and completed McGill QOL questionnaires at the start of their exercise training, and after 12-weeks of training.Compliance data was also measured for each group. Data was analyzed at the 0.05 level of significance using descriptive statistics RESULTS :Exercise has a positive impact on fitness parameters for both groups. On average, the one-on-one exercise group experienced greater improvements in all measured parameters. Likewise, QOL improved for both groups, but to a greater extent in the group exercisers. Finally, the group-based exercise had the highest compliance rate (70% vs. 32% in the one-on-one exercise group). (p<0.001). CONCLUSIONS :Based on these data, it appears as though exercise can improve fitness parameters during cancer treatment. The individualized, one-on-one approach is the most effective at improving fitness. However, compliance and QOL was higher for those who exercised in a group-based setting. Therefore, this form of exercise may be appropriate to help individuals who are new to exercise get started on a program in a relaxed, supportive atmosphere.

Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer.

Androgen deprivation therapy (ADT) for the management of prostate cancer results in a range of side effects including sexual dysfunction. Exercise is proposed as a potentially effective therapy to counteract changes in sexual function. The current study explored the impact of ADT on men's sexuality and the effect of exercise on this experience. Semi-structured, in-depth interviews were conducted with 18 men (age = 63.1 ± 3.8) who were on ADT for prostate cancer for ≤12months and who were part of a pre-existing exercise intervention trial. Sexual concerns for men included changes in body image, partner relationships, sex drive, sexual performance and masculinity. In coping with these concerns, men described a sense of personal acceptance of sexual changes through a shift in priorities and values away from penetrative sexual intercourse, knowledge and understanding about ADT, and partner support. Exercise in a group-based setting contributed to the acceptance of sexual changes through affirming strength-based aspects of masculinity and peer support. Exercise appears to have utility as a strategy to assist men to manage the negative impact of ADT on sexuality and masculinity more broadly.

Using Football Metaphor to Engage Men in Therapeutic Support

This paper is an account of a small scale exploratory study about the use and value of football metaphor as a device for facilitating therapeutic work. It is based on an evaluation which used a range of qualitative and quantitative approaches. In this paper, we selectively draw on the qualitative data to provide examples to inform our discussion. We illustrate various ways in which football metaphor can support therapeutic change: by aiding initial engagement, facilitating mutual support, enabling self-understanding and motivating change. We relate our analysis to the literature about the therapeutic value of metaphor and highlight the salience of using football metaphor in a group-based setting for men who are often seen as ‘hard to engage’ in therapeutic support. With some caveats, we argue that football metaphor offers a potentially rich and flexible therapeutic resource.

Evaluation of An Australian Day Treatment Program for Eating Disorders

AbstractDay treatment programs (DTP) for eating disorders are being recognised as having therapeutic benefits. However, research is needed to evaluate the effectiveness of DTP to establish their validity. This article reports on the evaluation of a pilot DTP in an Australian mental health setting, which utilised an integrative approach combining evidence-based treatments such as dialectical-behavioural therapy and intensive short-term dynamic psychotherapy offered in a group-based setting. Comparison of pre- and post-treatment data outcome measures for eating disorder pathology and comorbid symptoms was undertaken. Patient satisfaction was also evaluated using qualitative methods. Results indicated a significant reduction in depressive symptoms post-treatment, along with a high degree of satisfaction with the treatment. Limitations of this study, along with the implications of the findings and directions for future research, are discussed.

Collaborative information behaviour--exploring Kuhlthau's Information Search Process model in a group-based educational setting

Though much information behaviour takes place in collaborative settings, information behaviour processes are commonly perceived and modelled by information scientists as individual processes. The p...

The Immediate Effects of a Group-Based Horticulture Experience on the Quality of Life of Persons with Chronic Mental Illness

The purpose of this research was to study the impact of horticulture, a purposeful activity, on group participants in a clubhouse facility. This impact was analyzed according to Zhan's (1992) conceptual model of quality of life (QOL) which includes: (a) life satisfaction, (b) self-concept, (c) health and functioning, and (d) socio-economic factors. Ten members diagnosed with chronic mental illnesses participated in this 6-week study. This investigation interpreted the description of the horticulture experience from the participants' perspective. The researchers immersed themselves in this experience by interacting with participants throughout the duration of the study. The 7 themes that emerged included the impact of the horticulture activities on group experiences, sharing, learning, sensory stimulation, creativity, emotions and memories. The results suggested that horticulture, when used in a group-based setting, has an immediate and positive effect on life satisfaction, well being, and self-concept, which are components of QOL.

Potential cost savings attributable to influenza vaccination of school-aged children.

To analyze the costs and benefits of influenza vaccination of healthy school-aged children. The analysis was based on data from the literature. Total costs included direct medical costs for vaccination, physician visits, and treatment as well as indirect costs. Indirect costs were in the form of lost productivity when working parents stayed home to care for ill children or to take children to an office for vaccination. The total costs of vaccination strategies were compared with the total cost of not vaccinating. For the base case, the vaccine was assumed to have no effect on rates of otitis media. Two hypothetical scenarios were investigated 1) individual-initiated vaccination and 2) vaccination in a group-based setting. The former scenario required the child to be accompanied to a clinic by a parent during usual work hours. Vaccination resulted in a net savings per child vaccinated of $4 for individual-initiated vaccination and of $35 for group-based vaccination. The savings were caused primarily by averted indirect costs. Moderate increases in the cost of vaccination or reductions in the rate of influenza would eliminate the savings for individual-initiated vaccination but not for group-based vaccination. Alternatively, if influenza vaccination was effective in reducing rates of otitis media, the net savings from vaccination would be substantially higher than the base case. Vaccination of school-aged children against influenza could have substantial financial benefits to society, especially if performed in a group-based setting. influenza, cost-effectiveness, vaccination, children, cost.

Influenza immunization of schoolchildren: can we interrupt community epidemics?

In this month's issue of Pediatrics electronic pages, White et al discuss the potential cost savings of immunizing schoolchildren.1 White and colleagues report that immunization of schoolchildren may have substantial benefits to society, particularly if performed in a group-based setting. Specifically, influenza immunization resulted in net savings of between $4 to $35 in their best-case scenario. Importantly, the cost savings were markedly robust through a range of sensitivity analyses, particularly for group-based as opposed to individual-initiated immunization. In addition, they suggest other potential beneficial effects, such as reduced school absenteeism, decreased transmission of influenza to others (including parents and the cost of missing work), and a reduction in the incidence of otitis media and its associated costs (at least in young children), likely would result from such a program. Currently, the Advisory Committee on Immunization Practices2 and the Red Book 3advise influenza immunization for children 6 months of age and older who are at high risk for complications of influenza. Immunization of children who do not have risk factors is not routinely recommended, emphasized, or particularly encouraged. Nonetheless, interest in the idea of immunizing otherwise healthy children against influenza is engendered by several observations and concerns: 1) Because children are the primary source of the “spread” of influenza, can we interrupt influenza outbreaks by mass immunization of schoolchildren? 2) Considering the huge direct and indirect costs of the yearly outbreaks of influenza does mass immunization of children make economic sense? 3) Because influenza illness is a universal experience, can we prevent a major cause of pain, suffering, and death in the population by mass immunization of school-aged children? 4) Should immunization of all school-aged children against influenza be elective or required? Would mass immunization of schoolchildren interrupt the spread of influenza leading to control of influenza in …