Group Sessions Research Articles

Increasing perceived health and mental health literacy among separated refugee Ukrainian families with urgent needs occasioned by invasion—a group intervention study with participatory methodology in Sweden

BackgroundWith the increasing numbers of refugees from Ukraine affected by the ongoing war, there is a high risk of trauma-related stress due to low local health and mental health literacy care. Perceived good health is a human right. Earlier studies show that intervention for refugees can reduce and prevent post-migration stress and anxiety. The present explorative study aimed to investigate the feasibility and effectiveness of a short, trauma-focused group intervention (in Swedish “hälsoskola”) for Ukrainian-speaking refugees (EU’s mass refugee directive). This intervention was part of an ESF project aiming to get the subjects closer to the labor market in Västernorrland County, Sweden.Materials and methodsA mixed-methods design, a participatory methodology, and an evaluation were used. Data were obtained with a short questionnaire in Ukrainian. It included a visual analogue health-rating scale, an observation, and an oral evaluation in groups. For practical and ethical reasons, there was no control group. Each group met five times for 2 h, a total of 10 h excluding pre- and post-assessment. There were eight sets of five group sessions per set, a total of 40 sessions. Brief initial and concluding breathing exercises sought to reduce stress among the participants.ResultsBaseline data were obtained from 99 participants, mostly females. Data gathered directly after the group intervention from 57 participants who had filled in both the pre- and post-questionnaires showed that (1) perceived anxiety/stress was significantly reduced (chi-2 25,53, df = 4, p < 001). (2) The participants showed significantly better perceived health as assessed on a visual analogue scale (average change from 63.16 to 71.18, p < 0.001). This result was supported by the participants’ questions, which were qualitatively evaluated using thematic content analysis. Five general themes stemmed from questions raised in dialogue with the participants plus observation with the respective local expert. The participants received answers to their questions, and their perceived negative attitudes to authorities changed to more positive ones.ConclusionBy dialogue between the participants’ needs of knowledge and direct answers by the local expert, respectively, was feasible and effective as they perceived trust and health and mental health literacy increased. Implications for primary prevention are discussed.

ØCD: protocol for the development and evaluation of a cognitive-behavioral prevention program for obsessive-compulsive disorder

BackgroundObsessive-compulsive disorder (OCD) imposes significant burdens on individuals, families, and healthcare systems and the COVID-19 pandemic appears to have exacerbated OCD symptoms. Currently, there are no validated prevention programs for OCD, highlighting a critical gap in mental health services. This study aims to develop and validate the first ØCD prevention program, for at-risk adults, utilizing cognitive-behavioral therapy (CBT) and exposure response prevention (ERP) techniques.MethodsA single-blind, randomized controlled trial comparing the ØCD prevention program to a waitlist control group will be conducted. Participants, at-risk adults (18–65 years) with subclinical OCD symptoms (OCI-R score ≥ 12), will be recruited for the study. The ØCD prevention program compresise of six online group sessions incorporating CBT and ERP techniques over three modules. The primary outcomes are OCD symptom severity (measured by the Obsessive-Compulsive Inventory- revised form; OCI-R), depression symptoms (measured by the Patient Health Questionnaire; PHQ-9), and anxiety symptoms (measured by the Generalised Anxiety Disorder 7-item; GAD-7). Secondary outcomes include OCD-related beliefs, experiential avoidance, resilience, quality of life, uncertainty intolerance, automatic thoughts, and distress. Outcome measures will be collected at baseline, at completion of the intervention, and one year later (follow-up). At follow-up, we will also analyze the OCD diagnostic incidence, using the Structured Clinical Interview for DSM-5. We will employ a multivariate analysis of variance (MANOVA) to explore whether significant differences exist between groups across dependent variables. To compare the OCD incidence levels from the pre-test to the follow-up we will use the chi-squared test.DiscusionThe present study may contribute novel data on the efficacy of OCD prevention approaches, leading to the development of an evidence-based OCD prevention program that could alleviate individual and societal burdens associated with OCD.Trial registrationThis trial was approved by the University Ethical Review Authority (937/ 28.11.2023) at Babeș-Bolyai University and is registered on clinicaltrials.gov (ID: NCT06262464).

Effectiveness of a mindfulness and acceptance-based intervention for improving the mental health of adolescents with HIV in Uganda: An open-label trial.

Adolescents with HIV (AWH) face the double burden of dealing with challenges presented by their developmental phase while coping with stigma related to HIV, affecting their mental health. Poor mental health complicates adherence to daily treatment regimens, requiring innovative psychosocial support strategies for use with adolescents. We assessed the effectiveness of a mindfulness and acceptance-based intervention on the mental health of AWH in Uganda. One hundred and twenty-two AWH, mean age 17 ±1.59 (range 15 to 19 years), 57% female, receiving care at a public health facility in Kampala were enrolled in an open-label randomized trial (ClinicalTrials.gov: NCT05010317) with assessments at pre-and post-intervention. The mindfulness and acceptance-based intervention involved weekly 90-minute group sessions for four consecutive weeks facilitated by two experienced trainers. Sessions involved clarifying values, skillfully relating to thoughts, allowing and becoming aware of experiences non-judgmentally, and exploring life through trial and error. The control group received the current standard of care. Three mental health domains (depression, anxiety, and internalized stigma) were compared between the intervention and control groups. A linear mixed effects regression was used to analyze the effect of the intervention across the two time points. Results showed that the intervention was associated with a statistically significant reduction in symptoms of depression (β = -10.72, 95%CI: 6.25, -15.20; p < .0001), anxiety (β = -7.55, 95%CI: 2.66, -12.43; p = .0003) and stigma (β = -1.40, 95%CI: 0.66 to -2.15; p = .0004) over time. Results suggest that mindfulness and acceptance-based interventions have the potential to improve the mental health of AWH.

Peer Ambassador Perspectives in a Culturally Tailored Self-Management Intervention for African Americans with Type 2 Diabetes: A Qualitative Study

Objective: Diabetes disproportionately affects African Americans, leading to higher morbidity and mortality. This study explores the experiences of African American adults who successfully self-manage their type 2 diabetes (called Peer Ambassadors) and provided phone-based peer support in a 6-month culturally tailored diabetes self-management program for African Americans guided by the information–motivation–behavioral skills model. Design: A group discussion using a semi-structured discussion guide was conducted. Qualitative content analysis was used to identify the facilitators and barriers to completing the role of a Peer Ambassador and to develop strategies for overcoming possible challenges in the future. Setting: Key informant discussions were conducted in a community location to gain insights into Ambassadors’ motivations and challenges in delivering peer support. Participants: Three Peer Ambassadors completed ethics training and peer mentor training and received a phone call guide before providing support to their peers. Results: There were four core themes related to Peer Ambassador experiences: (1) Motivation to be a Peer Ambassador, (2) program elements that supported Peer Ambassador role, (3) key elements of achieving engagement, and (4) challenges related to being a Peer Ambassador. Conclusions: This study showed Peer Ambassadors in a culturally tailored peer supported self-management program found fulfillment in sharing experiences and supporting peers. They highly valued educational group sessions for knowledge updates and sustaining their health-related goals, suggesting the potential benefits of recognizing milestones or providing advanced training for future program sustainability. Findings suggest the importance of recruiting motivated patients and providing effective facilitation for peer support roles, including addressing barriers such as time commitment and lack of socialization opportunities.

A blended face-to-face and eHealth lifestyle intervention on physical activity, diet, and health outcomes in Hong Kong community-dwelling older adults: a study protocol for a randomized controlled trial

BackgroundAging individuals are vulnerable to various Noncommunicable Diseases (NCDs). Different behaviors are closely related to a decreased risk of suffering from NCDs: sufficient Physical Activity (PA) (e.g., at least 150 mins Moderate-to-vigorous Physical Activity (MVPA) per week) and a healthy daily diet (e.g., at least five portions of Fruit and Vegetable Intake (FVI), 5–6 taels (189.0–226.8 g) Meat, Fish, Egg and Alternatives (MFEA)). Traditional face-to-face interventions were effective in behavior change. However, it was revealed to be resource-intensive and limited transfer due to poor self-regulation skills outside of face-to-face sessions. Thus, eHealth could be a supplement for older adults outside traditional face-to-face settings. The blended approach combining these two interventions might optimize the intervention effects on lifestyle behavior initiation and maintenance, but little research can be found among Hong Kong older adults. Therefore, the study aims to test a blended intervention to promote PA, diet, and health outcomes among Hong Kong community-dwelling older adults.MethodsThis study will adopt a 10-week three-arm randomized controlled trial. The blended group will receive weekly (1) two 60-min face-to-face sessions with one for PA and one for diet, and (2) two web-based sessions with one for PA and one for diet. The face-to-face group will receive the same intervention content as the face-to-face sessions in the blended group. The control condition will receive a biweekly telephone call. The outcomes will include MVPA (minutes/week), FVI (portions/day), MFEA consumption (taels/day), social-cognitive factors (self-efficacy, planning, social support, action control), physical health outcomes (clinical indicators, senior physical fitness), mental health outcomes (depression, loneliness) and health-related quality of life. Data collection will be implemented at the pre-test, post-test, and 3-month follow-up test.DiscussionThis is the first study evaluating a blended intervention promoting multiple health behaviors among Hong Kong community-dwelling older adults. If the effect of the blended intervention is superior to the traditional face-to-face group and the control group, it will enrich lifestyle intervention approaches and can be applied to older adults, helping them obtain health benefits. Furthermore, a better understanding of mechanisms will also have implications for theory-building.Clinical trial registrationhttps://www.isrctn.com/ISRCTN32329348, ISRCTN32329348.

‘Counselling is not just providing information’: perceptions of caregivers and stakeholders on the design of nutrition and health counselling interventions for families with young children in rural Kenya

BackgroundGlobally, a fifth of the children continue to face chronic undernutrition with a majority of them situated in the Low- and Middle-Income Countries (LMIC). The rising numbers are attributed to aggravating factors like limited nutrition knowledge, poor feeding practices, seasonal food insecurity, and diseases. Interventions targeting behaviour change may reduce the devastating nutrition situation of children in the LMICs.ObjectiveFor the co-design of a Behaviour Change Communication (BCC) intervention for young children in rural Kenya, we aimed to identify the experiences, barriers, facilitators, and preferences of caregivers and stakeholders regarding nutrition and health counselling.DesignWe employed a qualitative study design and used a semi-structured interview guide. The in-depth interviews were recorded, transcribed, and analysed using content analysis, facilitated by the software NVivo.SettingHealth and Demographic Surveillance System (HDSS) area in Siaya County, rural Kenya.ParticipantsWe interviewed 30 caregivers of children between 6 and 23 months of age and 29 local stakeholders with experience in implementing nutrition projects in Kenya.ResultsNutrition and health counselling (NHC) was usually conducted in hospital settings with groups of mothers. Barriers to counselling were long queues and delays, long distances and high travel costs, the inapplicability of the counselling content, lack of spousal support, and a high domestic workload. Facilitators included the trust of caregivers in Community Health Volunteers (CHVs) and counselling services offered free of charge. Preferences comprised (1) delivering of counselling by CHVs, (2) offering individual and group counselling, (3) targeting male and female caregivers.ConclusionThere is a disconnect between the caregivers’ preferences and the services currently offered. Among these families, a successful BCC strategy that employs nutrition and health counselling should apply a community-based communication channel through trusted CHVs, addressing male and female caregivers, and comprising group and individual sessions.

Abstract PO3-11-03: A Randomized Controlled Trial to Assess the Benefit of Art &amp; Music Therapy on Quality of Life in Patient with Breast Cancer

Abstract Introduction: Quality of life (QoL) in oncology captures the well-being of a patient and is considered a significant outcome criterion. Breast cancer (BC) is the most diagnosed cancer in women, however, standardizing integrative therapies to alleviate the burden of cancer and improve QoL is still an unmet need. Art and music therapy might mitigate psychological and emotional distress. We sought to evaluate their efficacy compared to control among patients with BC during or after active therapy. Methods: Seventy-six treated patients with Stages I-III BC were randomly assigned to art, music therapy, or routine oncology care standard of care arm (SOC) for 3 months and received two sessions per month by a licensed therapist (including in-person/virtual and group sessions). The primary outcome was an improvement in QoL measured by the Functional Assessment of Cancer Therapy–Breast (FACT-B) questionnaire and secondary outcomes included: cognitive function measured by Functional Assessment of Cancer Therapy–Cognition (FACT-Cog), response to a 4-component Cleveland Clinic Visual Analog Scale (CCVAS), indicators of anxiety and depression assessed by the Generalized Anxiety Disorder-7 item (GAD-7) and Patient Health Questionnaire-9 item (PHQ-9). All questionnaires were assessed at baseline, 30, 90, and 180 days. Statistical considerations included stratified randomization, and a mean difference in 15 points between either of the interventions. SOC arm was considered relevant at the 3-month mark. Mean improvement within groups was performed using paired t-tests whereas independent t-tests were used to evaluate mean improvement between interventions (1 or 2 vs. SOC arm). All analyses were performed using SPSS version 26 (IBM, Armonk, NY). Results: Forty-five participants completed the study to date and were included in the interim analysis. Median age was 58 (57-59), white race (51.1%), patients on active treatment (45%), art therapy group (n=16), music therapy (n=15) and standard of care (n=14). Significant improvement was noted in the art therapy arm at 3 months in FACT-B physical well-being (p=0.04), functional well-being (p=0.008) domains as well as GAD-7 (p=0.003), PHQ-9 (p=0.04) and FACT-Cog section “impact on quality of life” (p=0.03). At 6 months, the art therapy arm demonstrated lower scores in the CCVAS questionnaire total score, emotional distress (p=0.01) and anxiety (p=0.004) scales. Music therapy participants reported a significant improvement only in GAD-7 index(p=0.04) at 3 and 6 months compared to SOC. No significant difference was found between art and music therapy arms. Conclusion: Art therapy patients exhibited significant improvement in overall QoL (including anxiety, depression, improvement in cognitive function) and 4-scale CCVAS (emotional distress, anxiety, depression, and pain). Music therapy improved anxiety scores (GAD-7). Art and music therapy should be considered in the care of patients to manage cancer associated distress and improve their quality of life. Table 1. Comparison of test changes from 3 months to baseline within groups Table 2. Comparison of test changes from 6 months to baseline within groups Citation Format: Maria Herran, Mohamed Mohanna, Saad Sabbagh, Barbara Dominguez, Kaylee Sarna, Rachel Upton-Rice, Angie Burdine, Zeina Nahleh. A Randomized Controlled Trial to Assess the Benefit of Art &amp; Music Therapy on Quality of Life in Patient with Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-03.

Abstract PO2-11-12: The power of storytelling to heal, build community, and understand the experiences of Black breast cancer survivors

Abstract Background: The BRIDGE community focus group was designed to support and empower current and former Black breast cancer patients. The overarching goals of the focus group were to provide a mechanism for participants to amplify their voices through storytelling, foster healing, and establish a supportive community. Additionally, the research team aimed to gather qualitative data on social support, treatment adherence barriers, interactions with medical providers, and experiences with race and racism within and outside of the healthcare system. Approach: The focus group consisted of six sessions, each with a specific agenda and activities. Participants were encouraged to keep journals throughout the program. Each session began with an icebreaker and journal discussion. Session-specific activities were designed to encourage self-reflection, exploration of personal identities, and discussion of fears. These topics were explored through creative outlets such as role-play, storyboards, and jewelry-making. Each session ended with a unifying affirmation and opportunity for fellowship. Results: We enrolled 10 Black women previously diagnosed with breast cancer and provided a safe space for them to reflect on their breast cancer journey, associated fears, and the role of race in their healthcare experience. Participants discussed positive and negative experiences with healthcare providers, highlighting the knowledge and access gaps that often exist in marginalized communities. The program also provided insights into the multi-level concept of support and its impact on breast cancer outcomes. Participants discussed the positive aspects of familial and community support but identified several areas where system and structural supports may have improved their outcomes. After completing all six sessions, women reported an improvement in their overall self-actualization and purpose—with several describing their time in the program as ‘life-changing’. Notably, the focus group facilitated deep connection and friendship among participants and improved general wellness and satisfaction. Discussion: Through the sharing of personal narratives and supportive discussions, the focus group created a safe environment where participants felt empowered to express their emotions, address challenges, and dismantle fears related to breast cancer mortality. The BRIDGE research team will summarize the themes that emerged across sessions to share with scientific, clinical, and community stakeholders. In parallel, they will explore opportunities for continued community building and support for participants beyond the focus group sessions. Overall, this storytelling focus group showcased the significance of amplifying the voices of historically marginalized groups, providing support, and fostering community. The insights gained have the potential to inform future interventions and support services for Black breast cancer survivors, addressing their unique needs and challenges and ultimately improving cancer health equity. Citation Format: Lauren McCullough, Cynthia Young, Chava Bowden, Madison Gardner, Breanna Berry, Alexix Smith, Jacquelyn Anthony Bryant. The power of storytelling to heal, build community, and understand the experiences of Black breast cancer survivors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-12.

Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery

BackgroundSinging for lung health (SLH) is an arts-based breathing control and movement intervention for people with long-term respiratory conditions, intended to improve symptoms and quality of life. Online, remotely delivered...

Reducing symptoms of attention deficit/hyperactivity disorder (ADHD) in elementary students: the effectiveness of neurofeedback.

This research was conducted to investigate the effectiveness of neurofeedback on the symptoms of hyperactivity and attention deficit in primary school students with attention deficit/hyperactivity disorder (ADHD) disorder. The present study utilized a randomized clinical trial with pre-test and post-test measurements and included a control group. The research population included all primary school students with ADHD in 2023; 50 of these children were selected as the experimental group based on the accessible sampling method, and 50 were also included in the control group. Neurofeedback treatment sessions for the experimental group were 30 sessions. Research data were collected in three stages: pre-test and post-test, using a questionnaire based on the Conners rating scale from parents. SPSS-25 analyzed the data. The results showed that neurofeedback is associated with significant effectiveness in the symptoms of attention deficit disorder and hyperactivity of students (P<0.05). Based on the findings of this research, it can be said that neurofeedback treatment is effective in reducing attention deficit and hyperactivity symptoms of students with ADHD disorder. It is suggested to widely use neurofeedback to reduce the symptoms of attention deficit and hyperactivity disorder.

The effect of emotional freedom techniques on test anxiety in Iranian Paramedical students: a randomized controlled trial study.

Based on evidences, there has been no study conducted on the effects of emotional freedom techniques on Iranian medical students. Therefore, the present study aims to investigate the impact of emotional freedom techniques on examination anxiety in Iranian nursing and allied students. This randomized controlled clinical trial study was conducted in 2021. The sample included students from the School of Nursing and Midwifery and the School of Paramedical Sciences enroled from the second to eighth semesters. Based on inclusion criteria, 30 students were assigned to each group. The test anxiety questionnaire was utilized to assess the test anxiety of students. The educational sessions in the intervention group were structured according to the Church's educational package and were delivered in six non-face-to-face (online) sessions, each lasting 45 min, once a week. In the control group, no intervention was implemented. All statistical analyses were performed using IBM SPSS Statistics software version 24 (IBM SPSS Statistics). The mean age of students in the intervention and control groups were 25.22±1.85 and 22.80±1.80 years, respectively. After the intervention, the mean examination anxiety in the experimental group (50.88) significantly decreased to within the moderate range (25-75), compared to the mean examination anxiety in the control group (65.36) within the same range (P<0.001). Furthermore, the ANCOVA analysis indicated that the group and examination anxiety before the intervention were statistically significant. This positive impact on test anxiety is particularly promising for medical sciences students, who often endure heightened stress levels due to the rigorous nature of their studies and the demands of their profession.

The Impact of Covid-19 on the Change of Customer Buying Behaviour

Background: The retail sector is rapidly developing over the past years. Retailers are investing more efforts and resources to provide a seamless experience through multiple channels. These developments led to significant changes in customer behaviour. Customers buying activities and way of selecting the products and retailers faced different changes and developments. The online retailing sector is entitled to continuous development. The latest development was due to the Covid-19 global pandemic that came without any previous notice. The customer behaviour starts adopting the digital online channels in most of their needs and wants. The appearance of new customer behaviour patterns due to Covid-19 lead to the emergence of new customer behaviour. Purpose: This study is of an exploratory and constructive nature. It is concerned with deepening the knowledge about the change in customer buying behaviour brought by Covid-19 on the retailing sector. The aim of the study is to identify and test new behavioural patterns that would influence the Swedish millennials’ in selecting between online and offline stores for shopping and buying fashion products. Method: An abductive approach was followed in this paper. Mixed methods of both qualitative and quantitative were used to fulfil the purpose of this exploratory research. The research followed a sequential exploratory design of two data collection phases. The ii empirical data was conducted from focus groups sessions with a total number of interviewee, and relevant responses from a web-based survey. Conclusion: The study has revealed two significant findings and contributed to propose a conceptual model. The fruitful results of this study are: (1) there is a vast customers’ migration towards online stores. (2) there are new behavioural patterns related to Covid 19 that are influencing the customer buying behaviour. (3) A proposed conceptual model which is concerned with the factors influencing the customer buying behaviour in selecting between online and offline fashion stores.

A LITTLE BIT OF EXERCISE GOES A LONG WAY – INCREASING INDEPENDENCE OF AGED CARE RESIDENTS WITH PARKINSON’S DISEASE

INTRODUCTION &amp; AIMS Supporting people with Parkinson’s Disease to remain active when living in residential aged care (RAC) is assumed to have benefits, such as reducing falls risk, improving ability to transfer independently, and reducing time spent being sedentary. However, many RAC-facilities are under-resourced making it difficult for staff to support residents with exercise. Accredited exercise physiologists (AEP) enable residents to improve or maintain movement through exercise. The aim of this study was to establish feasibility and value of AEP-services for people with Parkinson’s Disease in RAC. METHODS A 12-week AEP-led exercise program was delivered at multiple RAC-sites across Perth. An individualised exercise plan was designed for each participant, comprising 2 x 50-minute supervised group sessions per week, together with a 15-minute unsupervised morning program. Baseline and follow-up testing was undertaken by the AEP, inclusive of balance (mini-Balance-Evaluation-System-Test (miniBESTest)), mobility (2-minute-walk-distance, Actigraph), fatigue (PD fatigue scale) and quality of life. Descriptive analysis will be presented, reflecting the total hours of AEP-training provided, room attendance records from RAC-staff, and changes in pre-post balance, mobility, falls, quality of life, depression, behaviour, and fatigue. RESULTS To date, five participants have enrolled (3 women; 2 men) (recruitment is ongoing). Individual results for baseline testing showed the range of abilities and challenges for these participants (Mini-BESTest range of 5-16 and 2-minute walk distance of range 0-61). Not all tests could be completed by all participants. Post-test and change scores will be presented. CONCLUSION Due to the clinical heterogeneity of the disease, the AEP is required to prescribe according to each individual needs whilst maintaining the fidelity of the exercise intervention. Challenges have been presented with conducting research in this environment including recruitment of participants due to level of cognition, conflicts with participant scheduling, operational needs of the facility and facility closures (Covid- and gastro-outbreak).

Shared group session key-based conditional privacy-preserving authentication protocol for VANETs

Vehicular Ad-Hoc Networks (VANETs) have significantly enhanced driving safety and comfort by leveraging vehicular wireless communication technology. Due to the open nature of VANETs, conditional privacy-preserving authentication protocol should be offered against potential attacks. Efficient and secure authentication among vehicles in VANETs are important requirements, but there are various limitations in the existing conditional privacy-preserving authentication protocols for securing VANETs. To cope with the inherent issues, we propose a conditional privacy-preserving authentication protocol based share group session key (SGSK) by integrating the self-healing key distribution technique, blockchain, and MTI/C0 protocol. In our protocol, we use SGSK instead of the time-consuming Certificate Revocation List (CRL) checking, and we revoke malicious vehicles by updating SGSK. It is shared among unrevoked vehicles within a domain and across-domain. As a result, when a malicious revoked vehicle enters a new domain, it is difficult for it to access the system and send false messages. Furthermore, our protocol can not only achieve computation efficiency by reducing the number of computing operations of bilinear pairing but also resist various attacks while keeping conditional privacy protection. We implement our protocol in the Hyperledger Fabric platform. The experimental results show that our protocol is available to revoke 180 malicious vehicles in across-domain scenarios within one second, and it can meet the requirement of verifying 600 messages per second easily. Moreover, our comprehensive performance evaluations demonstrates that our protocol outperforms other approaches in terms of vehicle revocation checking cost, computation overhead, and communication overhead. In addition, to show the feasibility and validity of our protocol, we use SUMO and NS2 to simulate the actual VANET scenario and validate the efficiency and performance of our protocol. Simulation results prove the practicability of our protocol for VANETs.

Empowering Midwifery Students: Educational Intervention Based on Group Counseling for Clinical Stress Management

Background: Clinical education in medical sciences is highly stressful. Students face stressors not only related to the learning environment but also in the clinical setting. Objectives: This study aimed to investigate the impact of group counseling on clinical stress management among midwifery students at a medical university in southeastern Iran. Methods: In this quasi-experimental interventional study, a before-after design was employed using the census method involving 48 midwifery students. A researcher-designed questionnaire was utilized to evaluate factors contributing to stress. The educational interventions were conducted in eight group sessions from November 2021 to February 2022 at Pastor Educational and Medical Hospital in Bam City, Kerman province. Data analysis was conducted using the MIC-MAC model, and statistical analyses included the paired sample t-test and Pearson correlation coefficient through SPSS. Results: Overall, mean scores of stressors decreased significantly after the educational intervention (P = 0.006). Before the intervention, the highest and lowest mean scores were related to "teacher role" (3.15 ± 0.84) and "student's personality" (2.18 ± 0.61), respectively. After the intervention, these subareas continued to have the highest and lowest mean scores of stressors, (2.73 ± 0.94) and (2.19 ± 0.66), respectively. All stressors showed a significant correlation with the total stress score after the intervention. Conclusions: The presence of stress management programs tailored to the specific needs of medical science students, both in academic and clinical settings, is crucial. These programs should prioritize enhancing communication skills between teachers and students, improving interpersonal relationships, and providing incentives to boost student self-confidence.

Remote music therapy group sessions during the COVID-19 pandemic with adults with psychotic disorders and staff: A multiple case study

The aim of the present study was to investigate the influence of 12 remote music therapy group sessions with adults with psychotic disorders during the pandemic of COVID-19 (February-June 2021). Two different methods were used: a) Nordoff-Robbins scales 1 and 2 with six caretakers, b) thematic analysis of semi-structured interviews with six caretakers and three caregivers. The clinical approach used in the sessions was Synthetic Music Therapy. Even though the music therapy group was remote and despite the social withdrawal and isolation due to the universal quarantine, there was evidence of significant positive changes in the caretakers’ clinical image, as their social skills improved. Furthermore, the caretakers managed to build and maintain a consistent and trusting therapeutic relationship. During the music therapy process almost all group members showed evidence of a linear progress in psychological and musical aspects, approaching the fully functioning state of being, called FA-fonie (FA-voice). Almost all participants highlighted that they would prefer the music therapy group to have been conducted at location. In the section of discussion, a further analysis of the results, the research limitations and proposals for future research are presented.

Effects of Inpatient Occupational Rehabilitation vs. Outpatient Acceptance and Commitment Therapy on Sick Leave and Cost of Lost Production: 7-Year Follow-Up of a Randomized Controlled Trial.

Previously, we reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective than outpatient Acceptance and Commitment Therapy (O-ACT) in reducing sickness absence and was cost-effective over a 24-month period. Here we present 7-years of follow-up on sick leave and the cost of lost production. We randomized individuals aged 18-60, sick-listed due to musculoskeletal or mental health disorders to I-MORE (n = 82) or O-ACT (n = 79). I-MORE, lasting 3.5weeks, integrated ACT, physical training, and work-related problem-solving. In contrast, O-ACT mainly offered six weekly 2.5h group sessions of ACT. We measured outcomes using registry data for days on medical benefits and calculated costs of lost production. Our analysis included regression analyses to examine differences in sickness absence days, logistic general estimating equations for repeated events, and generalized linear models to assess differences in costs of lost production. Unadjusted regression analyses showed 80 fewer days of sickness absence in the 7-year follow-up for I-MORE compared to O-ACT (95% CI -264 to 104), with an adjusted difference of 114 fewer days (95% CI -298 to 71). The difference in costs of production loss in favour of I-MORE was 27,048 euros per participant (95% CI -35,009 to 89,104). I-MORE outperformed O-ACT in reducing sickness absence and production loss costs during seven years of follow-up, but due to a limited sample size the results were unprecise. Considering the potential for substantial societal cost savings from reduced sick leave, there is a need for larger, long-term studies to evaluate return-to-work interventions.

Can coaching bridge the gap for incoming Latinx graduate students?

ABSTRACT Attrition rates in the first two years of graduate school are high and ∼50% higher for underrepresented students. Here we evaluate an online group coaching intervention using a controlled and an experimental group to determine its impact on skills that are likely predictors of student success, namely the Hallmark of Success indices developed by the National Institutes of Health (NIH). Our intervention includes eight online coaching sessions (four prior to the first year of graduate school and four during the first year of graduate school). Coaching group sessions, led by certified coaches, address Resilience, Risk and Protective Factors, Accountability, Leadership, Teamwork, Professional Networking, and Self-Assessment. We evaluated the change in Hallmark of Success indices with a pre- and post-questionnaire of 44 items used to assess students’ self-evaluation in nine areas. Students in the experimental coaching group showed a significant increase in the Hallmark of Success indices in seven out of nine areas of student performance between the pre- and post-questionnaires compared to the null model of no changes between time periods. In addition, in all of the nine indices of success, we noted significant differences between the pre- and post-surveys for the experimental group. Our experimental design shows that our cost-effective coaching model improves student performance as perceived by the students.

"I am still human and worth a life:" a qualitative study of the impacts of a community based, peer-led, treatment support model for young adults living with HIV in Zimbabwe.

A persistent treatment gap remains between children and adults living with HIV. The Zvandiri program, developed by Africaid, is one of the few models of differentiated service delivery for children, adolescents, and youth that has been shown to improve outcomes along the HIV care continuum, employing Community Adolescent Treatment Supporters (CATS) to offer peer counseling and patient navigation. Our qualitative study provides an in-depth analysis of the feelings and experiences Zimbabwean youth had following an HIV diagnosis, and the ways that CATS facilitated linkage and retention in care. We conducted in-depth interviews in Shona with adolescents and young adults who were recently diagnosed with HIV in Zimbabwe. Interviews were audio-recorded, transcribed, and then translated to English. Interviews were coded in Dedoose using a structured a priori codebook. We wrote semi-structured summary memos for each interview. We co-conducted thematic analysis, guided by interpretive phenomenology with a team of Zimbabwean and American experienced qualitative researchers and community partners. We co-developed memos to elaborate and understand key themes across interviews. Most of our interview participants recounted an immediate sense of loss upon testing HIV positive and a fear that "there was no hope for the future." CATS played a pivotal role for youth, providing emotional, educational, and logistical support to facilitate treatment initiation, adherence, and persistence in care. The CATS program supported youth through multiple approaches: group sessions, individual meetings, and via text or phone. While CATS offered counseling and comfort to participants, they emphasized the long-term importance of identifying at least one other person in participants' lives who could know their status and support them around HIV. Our findings delineate some of the key concerns that face youth after receiving an HIV diagnosis and the ways that a community-based adherence peer navigation program supported participants to navigate both their feelings and the health care system. Results can inform practice at community-based agencies that are implementing or considering peer youth navigation programs and garner support for policy to fund interventions for youth.

E077 Evaluation of group education for patients with large vessel vasculitis prescribed subcutaneous methotrexate

Abstract Background/Aims Patient education in rheumatology is of proven value to educate as well as to reduce demand on health care services. This can be delivered in a multitude of ways, in person and more recently with the use of multi-media modalities. There is limited evidence to specifically demonstrate the benefit of patient education for patients with vasculitis. Education needs to be adapted to meet patient needs. In addition to one-to-one appointments, we have been conducting in-person group education for this patient group. We present our experience. Methods Patients prescribed subcutaneous methotrexate for large vessel vasculitis were given the opportunity to attend a group education session run by the specialist nurse. The sessions were held over a 4-month period, in groups of 3-5 individuals. Patients were provided with written information including the links to online resources prior to attending the group education session which consisted of a verbal presentation and a short video. Patients also had the opportunity to ask questions during the group session. If patients were happy to proceed with the planned treatment, a prescription for the subcutaneous methotrexate was provided and initial blood monitoring commenced. After attending the group session, patients were given an evaluation form to complete Results The responses from the evaluation forms are shown in the following table: Conclusion Group education has proved to be a successful way of providing education to patients with large vessel vasculitis needing to learn about the indications for use, along with the safe handling and administration of subcutaneous methotrexate. Disclosure G. Ducker: None. C.B. Mukhtyar: None.