Interventions For Persons Research Articles

Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders’ perspectives in Bangladesh

IntroductionBangladesh is a developing country where 11% of the population has at least one disability, but no community-level mental health service is available. There is limited evidence of the burden of mental health issues and health-seeking behaviour among this population. This study assessed the feasibility of a training intervention for persons with disabilities, where peer support providers provided community-based disability-inclusive mental health services.MethodsFour stakeholder groups participated in this qualitative study: peer responders (trained persons with disabilities), trainers, representatives of organisations of persons with disabilities and disability-specific organisations, and officials of international and national non-governmental organisations. Two types of qualitative interviews were used to collect data, and thematic analysis techniques were utilised.ResultStakeholders perceived the peer responder training programme as acceptable for persons with disabilities to develop themselves as peer support providers, with potential benefits including increased mental health literacy, ensuring accessible mental health services, and improving the well-being of persons with disabilities. Potential challenges included receiving training and delivering services. Increased training duration, more fieldwork, supervision opportunities, and refresher training were recommended to mitigate training challenges. Financial support and formal community recognition were deemed necessary for training delivery.ConclusionThe peer responder training programme was feasible to ensure accessible mental health services for persons with disabilities, build a workforce to screen for mental health conditions, and provide appropriate referrals. A multi-sectoral collaboration of government and non-governmental institutions is recommended to policy advocates to expand the peer responder training programme in the mainstream mental healthcare system.

Examining students’ tripartite efficacy beliefs in physical education through a teaching personal and social responsibility intervention

Purpose: This study investigated the effects of a Teaching Personal and Social Responsibility (TPSR)-based physical education (PE) program on students’ responsibility and tripartite efficacy beliefs (i.e., self-efficacy, other-efficacy, and relation-inferred self-efficacy (RISE)). Methods: A quasiexperimental design with pretest and posttest quantitative methods was applied. The participants were 114 students assigned to the control or experimental group. Results: The results indicated that compared with both control group students and their own baseline values, the experimental group reported significant improvements in responsibility, self-efficacy, other-efficacy, and RISE. Conclusions: Implementing the TPSR model in PE can not only positively affect students’ responsibility but also boost students’ efficacy beliefs through the model’s five formats (e.g. awareness talk) and application strategies (e.g. empowerment). PE educators are encouraged to strictly comply with implementing details of the TPSR model to effectively improve efficacy beliefs.

Women with disabilities, body image, and wellbeing: Assessing the effectiveness of dance sessions

IntroductionThere is growing research evidence on bodily discourses and body image issues of women with disabilities. Within the art-based intervention repertoire for persons with disabilities, dance and movement-based therapies and interventions are gaining prominence. The aim of this study was to examine the impact of dance sessions (delivered online) on body image, body satisfaction/dissatisfaction, and wellbeing of women with disabilities. MethodA quasi-experimental waitlist control design study was conducted with data collected at two time points: baseline or pre-test and five-months later or post-test. Outcomes were measured using the Body Image Scale and the WHO-5-Wellbeing Index. ResultsThe dance sessions were effective (Hedges’ g = −0.56 –0.88; p < 0.01) and post-test body dissatisfaction scores were lower and wellbeing scores were higher for participants with a college degree or postgraduate degree, self-employed or students, and whose intervention compliance was above threshold (>50% dance sessions attended and corresponding homework sessions completed). Tobit regression models indicated that it was possible to estimate post-test outcomes due to dance sessions alone, controlling for significant socio-demographics. DiscussionThe domain knowledge of non-pharmacological art-based interventions for persons with disabilities, particularly women, is supported. ConclusionsFindings commend dance sessions as effective psychotherapeutic mechanisms to mitigate body dissatisfaction, improve body image and wellbeing of women with disabilities. Future research may focus on large-scale cross-sectional trials, variations in the repertoire for women with different disability types and histories, and qualitative narratives.

An Umbrella Review of Self-Management Interventions for Health Conditions With Symptom Overlap With Traumatic Brain Injury.

To synthesize evidence for the effectiveness of self-management interventions for chronic health conditions that have symptom overlap with traumatic brain injury (TBI) in order to extract recommendations for self-management intervention in persons with TBI. An umbrella review of existing systematic reviews and/or meta-analyses of randomized controlled trials or nonrandomized studies targeting self-management of chronic conditions and specific outcomes relevant to persons with TBI. A comprehensive literature search of 5 databases was conducted using PRISMA guidelines. Two independent reviewers conducted screening and data extraction using the Covidence web-based review platform. Quality assessment was conducted using criteria adapted from the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2). A total of 26 reviews met the inclusion criteria, covering a range of chronic conditions and a range of outcomes. Seven reviews were of moderate or high quality and focused on self-management in persons with stroke, chronic pain, and psychiatric disorders with psychotic features. Self-management interventions were found to have positive effects on quality of life, self-efficacy, hope, reduction of disability, pain, relapse and rehospitalization rates, psychiatric symptoms, and occupational and social functioning. Findings are encouraging with regard to the effectiveness of self-management interventions in patients with symptoms similar to those of TBI. However, reviews did not address adaptation of self-management interventions for those with cognitive deficits or for populations with greater vulnerabilities, such as low education and older adults. Adaptations for TBI and its intersection with these special groups may be needed.

Physical Activity in Individuals Newly Diagnosed With Multiple Sclerosis Through the Lens of the COM-B Model.

Physical activity (PA) is a promising intervention for disease modification and symptom management in multiple sclerosis (MS); however, there is a lack of research focusing on PA behavior change interventions for persons newly diagnosed with MS. Such PA behavior change interventions should be developed based on a strong empirical foundation of understanding the behavior and its determinants (ie, what to target for changes to occur). To that end, this qualitative study examined factors explaining PA in persons newly diagnosed with MS and identified potential targets for future behavior change intervention development based on the Capability-Opportunity-Motivation-Behavior (COM-B) model. Twenty individuals diagnosed with MS within the past 2 years underwent one-on-one semistructured interviews using questions developed based on the COM-B model. Data were analyzed using reflective thematic analysis, and the identified themes were then mapped with the COM-B model. Factors explaining PA in the study sample were identified across the COM-B components. The typical factors include knowledge and skills to sufficiently engage in PA with appropriate approaches, ability to adapt and navigate through new environmental and social difficulties after diagnosis, and motivation resulting from a combination of factors, such as outcome expectation, belief of capabilities, role/identity, reinforcement, and emotions. The COM-B model was applied successfully in this study to understand PA behavior and identify potential targets for behavior change in individuals newly diagnosed with MS. Future behavior change interventions should consider addressing these factors to generate effective PA behavior change in this population.

Assessing Interest in a Peer Support Person for Patients Experiencing Early Pregnancy Loss: Results from a National Survey.

The use of a peer support person as an intervention for early pregnancy loss (EPL) is not well studied. In addition, limited literature exists regarding the type of support patients need when experiencing EPL. The objective of this study is to quantify interest in a peer EPL support person intervention, to assess the types of support desired following EPL, and to investigate if there is an association between self-compassion or resilience and coping ability post-EPL. We conducted a cross-sectional, web-based survey with 110 individuals who experienced EPL in the past 2 years. Questions explored interest in a peer EPL support person and different types of support, as well as perceived self-compassion and resilience. Analyses of variance were used to test if interest in the peer support intervention and in different types of support varied by demographics, while linear regression modeling was used to test the relationship between self-compassion, resilience, and coping ability. Nearly all participants (98.2%, n = 108) were interested in peer support. The majority (31.8%, n = 35) of participants prioritized informational and educational support at the time of their EPL and in the months following. There was a positive relationship between self-compassion scores and ability to cope with EPL (p = 0.2) and between resilience scores and coping ability (p < 0.05). Almost all participants were interested in a peer support person for coping with EPL. Given the types of support participants identified in this study, a peer support person may provide emotional and informational support as well as resilience training.

Personal Recovery Among People at Risk for Developing Serious Mental Health Problems: A Qualitative Systematic Review.

Personal recovery refers to a person's pursuit of a full, meaningful life despite the potentially debilitating impact of a mental illness. An evidence base describing personal recovery among people at risk for developing a mental illness is lacking, limiting the potential for mental health services to support personal recovery. To address this gap, the authors synthesized the extant research describing personal recovery among people at risk for developing a mental illness. A systematic search of several literature databases (MEDLINE, Embase, APA PsycInfo, Web of Science Core Collection, and Cochrane Library) was conducted to retrieve qualitative and case studies and first-person accounts. The Joanna Briggs Institute guidelines for systematic reviews were followed. Included studies reported on participants at variable risk for developing a schizophrenia spectrum, bipolar, major depressive, or borderline personality disorder. Articles were retrieved through a librarian-assisted search and through use of additional strategies (e.g., expert consultation). Abstracts were screened by the research team, and themes were developed by using thematic synthesis. The 36 included articles were synthesized, and six themes were generated: difficulties and challenges; establishing an understanding of, and finding ways to cope with, one's mental health challenges; reestablishing a sense of agency and personhood; receiving support from people and services, as well as restoring relationships; reestablishing hope, meaning, and purpose; and overcoming stigma and destigmatizing mental illness in others. These findings provide a conceptual foundation that can guide future research on personal recovery and clinical interventions that foster it among people at risk for mental illness.

Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke.

There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.

Examining patterns of patient adherence to Cognitive Behavioural Therapy in chronic physical illnesses and comorbid mental health disorders: a scoping review protocol

Objective To examine the patient adherence patterns to Cognitive Behaviour Therapy (CBT) intervention in persons living with long term physical illness and co-occurring mental health conditions. Introduction Current literature on patient treatment adherence is mostly focused on the medical/pharmacological treatment or is disorder/ therapy specific and does not address co-occurring or comorbid mental health disorders with physical health disorders in general. The objective of this scoping review is to provide insights into adherence behaviours and patterns outside of pharmacological intervention focusing on psychotherapeutic intervention specifically Cognitive Behaviour Therapy (CBT) in persons living with long-term medical conditions with co-existing mental health disorders/ conditions. The results of the review will highlight different aspects of adherence to CBT including facilitating and impeding factors influencing adherence, and variations across comorbid mental and physical health conditions. These results will aid in developing targeted CBT interventions and strategies to improve adherence rates. Furthermore, identifying gaps in the existing literature will guide future research to optimise health outcomes in this population. Inclusion Criteria Using the Population, Concept, and Context (PCC) criteria, studies will be included if they reported on patient adherence patterns of CBT in persons living with chronic medical conditions and co-occurring mental health conditions. Methods The scoping review will follow the Joanna Briggs Institute (JBI) guidelines for scoping review and reported according to the PRISMA-ScR checklist. A systematic search of PubMed, CINAHL Plus (including full academic search, APA PsychInfo, and Medline), Scopus, Cochrane library, EMBASE, Google Scholar, and University College Cork (UCC) library’s one search platform will be conducted. The JBI standard data extraction tool will be tailored to the review objectives. The findings will be presented using a descriptive and narrative approach.

Palliative Care Interventions for Persons With Neurodegenerative Disease: A Scoping Review of Clinical Trial Study Design Features.

Background: Within palliative care research, best practice guidelines to conduct scientifically rigorous clinical trials for neurodegenerative diseases are underexplored. This patient population experiences unique challenges, including fluctuations in cognitive capacity, care partner (CP) and proxy involvement, and high adverse events (AEs), that necessitate special consideration when designing clinical trials. Objective: The objective of this study was to describe and identify clinical trial design features that have been documented in studies involving a neuropalliative intervention for persons with neurodegenerative diseases, highlighting features that have been adapted for this unique patient population. Design: We conducted a scoping review of clinical trials with a neuropalliative intervention for persons with neurodegenerative disease. We searched Cochrane, Web of Science, EMBASE, Scopus, and PubMed (MEDLINE) databases for articles published in English between 1950 and 2023. Two reviewers screened, extracted, and synthesized data from the included articles. A third reviewer adjudicated instances of conflict. The data were analyzed using a thematic framework approach. Results: Of 1025 texts, 44 articles were included. Seven study design features were analyzed: (1) consent, (2) proxies and CPs, (3) recruitment strategies, (4) retention strategies, (5) choice of comparator, (6) AEs, and (7) internal validity. This scoping review found disparities in study design features around structured consent, proxies and CPs, comparators, and AEs. Conclusions: To date, neuropalliative care clinical trials have had varied study designs and the majority of research has focused on dementia. Research guideline development for high-quality neuropalliative care clinical trials is greatly needed across the range of neurodegenerative diseases. To increase the scientific rigor of clinical trials and neuropalliative care, we recommend a standardized capacity assessment for consent, defining conditions for the CP, proxy, and AEs, systematizing appropriate comparators, and outlining preemptive recruitment and retention strategies to address the broader unpredictable challenges of palliative care research.

Perspectives on Self-Harm and Suicidal Ideation in Nigeria: A Mixed-Methods Study of Patients, Family Caregivers, Clinicians, and the Public

Background Suicide and self-harm are global disease burden that contributes significantly to years of lost life and mortality. Despite the increasing rates of suicide and self-harm in Nigeria, this topic is understudied. Methods A mixed-methods design was adopted. Study 1 interviewed n = 18 participants (n = 11 clinicians; n = 5 patients with a history of self-harm and suicide ideation; and n = 2 caregivers). All interviews were audio-recorded, transcribed verbatim, and analyzed using IPA. Study 2 surveyed n = 562 non-clinical sample about their tolerance toward self-harm and the data was analyzed using One-way ANOVA in SPSS. Results Study 1 qualitative findings showed substance use, perceived rejection and social isolation were considered predisposing factors for suicide and self-harm. Cultural and religious beliefs shaped help-seeking behaviours. Although Study 2 found no significant differences in demographic characteristics concerning public tolerance toward persons with a history of self-harm, 64% believed that individuals who died by suicide would face punishment after death; 51% believed that victims of attempted suicide are a source of shame to their families; and 33.8% agreed that dying by suicide is the correct behaviour. Conclusions Patients with a history of self-harm and suicidal ideation consider family members and close friends as valuable sources of support. Due to the potential clinical implication of cultural and religious beliefs, as shown in the present study’s findings, the authors recommend a co-development of culturally appropriate psychological intervention for persons with a history of self-harm and suicidal ideation to be tested in randomized control trials.

Interventions for Persons with Young-Onset Dementia and Their Families: A Scoping Review.

Dementia occurring before age 65 is known as young-onset dementia (YOD), with Alzheimer's disease being the most common type. YOD poses unique challenges for persons and families, impacting their working-age years and family responsibilities. Person-centered interventions and services are essential to improve their quality of life and social engagement. This study aims to synthesize non-pharmacological interventions for persons with YOD and their families to inform future targeted interventions. We conducted a systematic literature search across four databases: PubMed, PsycINFO, Scopus, and CINAHL. The included articles were carefully screened, categorized, and synthesized by following Arksey and O'Malley's five stages framework. We included 20 studies reported in 24 papers, with 11 studies (14 papers) on persons with YOD and nine studies (10 papers) on families. Quantitative intervention results vary, but qualitative interviews show positive feedback. Stakeholders provided positive evaluations, stating these interventions provided a sense of normalcy, facilitated communication among families, enhanced the independence of persons with YOD, and improved the families' caregiving self-efficacy, thereby reducing care burden and psychological distress. The heterogeneity among the studies posed integration challenges. Interventions for YOD can improve the quality of life for both persons with YOD and their families. More extensive intervention studies are urgently needed, especially in developing countries, with a focus on family-centered and life course perspectives. In future intervention research design, a more extensive incorporation of stakeholder involvement is essential for successful implementation. Moreover, the integration of new technologies shows promise as a potential avenue for intervention advancement.

Systematic identification of the role of gut microbiota in mental disorders: a TwinsUK cohort study

Mental disorders are complex disorders influenced by multiple genetic, environmental, and biological factors. Specific microbiota imbalances seem to affect mental health status. However, the mechanisms by which microbiota disturbances impact the presence of depression, stress, anxiety, and eating disorders remain poorly understood. Currently, there are no robust biomarkers identified. We proposed a novel pyramid-layer design to accurately identify microbial/metabolomic signatures underlying mental disorders in the TwinsUK registry. Monozygotic and dizygotic twins discordant for mental disorders were screened, in a pairwise manner, for differentially abundant bacterial genera and circulating metabolites. In addition, multivariate analyses were performed, accounting for individual-level confounders. Our pyramid-layer study design allowed us to overcome the limitations of cross-sectional study designs with significant confounder effects and resulted in an association of the abundance of genus Parabacteroides with the diagnosis of mental disorders. Future research should explore the potential role of Parabacteroides as a mediator of mental health status. Our results indicate the potential role of the microbiome as a modifier in mental disorders that might contribute to the development of novel methodologies to assess personal risk and intervention strategies.

Why Do We Not Wear Masks Anymore during the COVID-19 Wave? Vaccination Precludes the Adoption of Personal Non-Pharmaceutical Interventions: A Quantitative Study of Taiwanese Residents.

Background and Objectives: This study examined whether the decline in people's adoption of personal NPIs (e.g., mask wearing) results from the preclusion by vaccination. This study also incorporates the concepts of risk perception and the risk-as-feelings model to elucidate the possible mechanisms behind this preclusion. Materials and Methods: Two cross-sectional surveys (N = 462 in Survey 1 and N = 505 in Survey 2) were administered before and during the first outbreak of COVID-19 in Taiwan. The survey items were designed to measure participants' perceived severity of COVID-19, worry about COVID-19, intention to adopt personal NPIs, and attitudes toward COVID-19 vaccines. Utilizing the risk perception framework, we conducted multigroup SEM (Structural Equation Modeling) to construct the optimal structural model for both samples. Results and Conclusions: The multigroup SEM results showed that worry (i.e., the emotional component of risk perception) fully mediates the influence of the perceived severity of COVID-19 (i.e., the cognitive component of risk perception) on the intention to adopt NPIs in both surveys [z = 4.03, p < 0.001 for Survey 1 and z = 2.49, p < 0.050 for Survey 2]. Before the outbreak (i.e., Survey 1), people's attitudes toward COVID-19 vaccines showed no significant association with their worry about COVID-19 [z = 0.66, p = 0.508]. However, in Survey 2, following the real outbreak of COVID-19, people's attitudes toward COVID-19 vaccines negatively predicts their worry about COVID-19 [z = -4.31, p < 0.001], indirectly resulting in a negative effect on their intention to adopt personal NPIs. This suggests the occurrence of the Peltzman effect. That is, vaccination fosters a sense of safety, subsequently diminishing alertness to COVID-19, and thus reducing the intention to adopt personal NPIs.

Understanding the individual in personal initiative action-based entrepreneurial interventions

Understanding the individual in personal initiative action-based entrepreneurial interventions

Posttraumatic symptomatology, meaning in life, and perceived family functioning in nonclinical trauma-exposed university students.

This study aims to explore and analyze the associations among posttraumatic symptoms, meaning in life dimensions, and perceived family functioning in trauma-exposed university students. Participants (N = 158) answered a sociodemographic questionnaire, the Posttraumatic Stress Global Assessment (Crespo et al., 2017), the Purpose in Life Test (Crumbaugh & Maholick, 1969), and the Family APGAR (Smilkstein, 1978). Outcomes indicated several negative associations between posttraumatic symptoms and both meaning in life and family functioning areas. These findings suggest family functioning and meaning-in-life clinical practical relevance concerning the assessment, prevention, and intervention in persons affected by trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An empowering story: Participatory design and feasibility of a recovery-focused narrative group intervention for persons with personality disorders.

An empowering story: Participatory design and feasibility of a recovery-focused narrative group intervention for persons with personality disorders.

Repurposing the book as a message: Italian lyric manuscripts in prison

AbstractMany manuscripts copied in various prisons have been identified. In the late Middle Ages, prisoners were allowed not only to compose new texts, but also to be employed as scribes. The present article focuses on three manuscripts produced in prison in the fifteenth century which pair Dante and Petrarch's lyric poems with the poetry of others and of the scribes themselves. These manuscripts combine lyric collections with personal works – lyric poems, letters, drawings – penned by those who made them, resulting in individual literary organisms. By exploring three case studies of Italian lyric manuscripts produced by incarcerated scribes, the article defines a ‘genre of book’ which combined personal interventions with lyric poetry of major authors, in a complex editorial process that made of the codex a new text in itself. They illuminate the ways in which the practice of assembling lyric poetry by major authors (chiefly Dante and Petrarch) combined with personal touches, was used by readers and compilers to craft a variety of identities; but most importantly, the ways in which the codex may become a performative event, as well as a site of memory and, when sent outside of prison, a message taking the form of the book.

Coping and self-care: Mediating the association of job stressors with vicarious trauma and vicarious resilience

Summary The indirect exposure to patients’ traumatic experiences may generate contrasting reactions in helping professionals, such as vicarious trauma and vicarious resilience. Theoretical models predict that job stressors facilitate vicarious trauma and reduce vicarious resilience and that personal resources may mediate this relationship. However, there is little empirical research linking some of these variables. This study aims to test: (a) Whether job stressors (family-work conflict, work-family conflict and role conflict) predict personal resources (coping strategies and self-care practices) and reactions to indirect exposure to trauma (vicarious trauma and vicarious resilience); and (b) whether personal resources predict these reactions and mediate their association with job stressors. A convenience sample of 448 social workers from Spain completed an online questionnaire between October 2020 and January 2021. Findings Structural equation modelling revealed that job stressors generally hindered problem-focused coping and self-care and enabled emotion-focused coping; only vicarious trauma was directly associated with role conflict. Primarily, personal resources predicted the reactions to indirect exposure to trauma and mediated the influence of job stressors in these reactions. Applications In line with previous research, results support the need for personal and organizational interventions to decrease vicarious trauma and promote vicarious resilience.

It takes a village: A pilot study of a group telehealth intervention for support persons affected by opioid use disorder

IntroductionOpioid use disorder (OUD) has devastating effects on individuals, families, and communities. The Community Reinforcement and Family Training (CRAFT) is a Support Person (SP)-focused intervention that aims to increase SPs' communication strategies, positive reinforcement/rewards, and social support. This pilot study, called eINSPIRE (INtegrating Support Persons Into REcovery), adapted CRAFT for delivery via group telehealth. The aims were to evaluate the feasibility, acceptability, and preliminary effectiveness of this intervention on patient buprenorphine retention and SP mental health. MethodsThe study recruited patients receiving buprenorphine treatment in a primary care setting across five community health centers with their SP (N = 100 dyads). SP participants were randomly assigned to receive usual care (UC) or the eINSPIRE intervention. We interviewed Patients and SPs at baseline and three months later. The study collected patient buprenorphine retention data from the electronic medical record three months post-baseline. ResultsAbout 88 % (656/742) of potentially eligible patients were able to nominate a SP and 69 % (100/145) of nominated SPs were eligible and consented to the study. eINSPIRE groups had low reach (25 % of SPs attended), but high exposure (M = 7 of 10 sessions attended) and acceptability (classes helped them with their patient's OUD). The proportion of eINSPIRE patients (68 %) and UC patients (53 %) retained on buprenorphine at follow-up were similar (p = 0.203). SPs in both conditions reported similar reductions in their depression, anxiety, and impairment symptoms. ConclusionsPreliminary data suggest that eINSPIRE groups may not be feasible in primary care without further adaptations for this population. A future study with a larger sample size is needed to elucidate the observed distribution differences in buprenorphine retention. Future research should also explore methods to reduce barriers to SP session attendance to improve the reach of this evidence-based intervention.