Interventions For Persons Research Articles

China Initiative for Multi-Domain Intervention (CHINA-IN-MUDI) to Prevent Cognitive Decline: Study Design and Progress.

Alzheimer's disease (AD), the most common type of irreversible dementia, is predicted to affect 152 million people by 2050. Evidence from large-scale preventive randomized controlled trials (RCTs) on modifiable risk variables in Europe has shown that multi-domain lifestyle treatments for older persons at high risk of dementia may be practical and effective. Given the substantial differences between the Chinese and European populations in terms of demographics and living conditions, direct adoption of the European program in China remains unfeasible. Although a RCT has been conducted in China previously, its participants were mainly from rural areas in northern China and, thus, are not representative of the entire nation.There is an urgent need to establish cohorts that represent different economic, cultural, and geographical situations in order to explore implementation strategies and evaluate the effects of early multi-domain interventions more comprehensively and accurately. We developed an integrated intervention procedure implemented in urban neighborhood settings, namely China Initiative for Multi-Domain Intervention (CHINA-IN-MUDI). CHINA-IN-MUDI is a 2-year multicenter open-label cluster-randomised controlled trial centered around a Chinese-style multi-domain intervention to prevent cognitive decline. Participants aged 60-80 years were recruited from a nationally representative study, i.e. China Healthy Aging and Dementia Study cohort. An external harmonization process was carried out to preserve the original FINGER design. Subsequently, we standardized a series of Chinese-style intervention programs to align with cultural and socioeconomic status. Additionally, we expanded the secondary outcome list to include genomic and proteomic analyses. To enhance adherence and facilitate implementation, we leveraged an e-health application. Screening commenced in July 2022. Currently, 1,965 participants have been randomized into lifestyle intervention (n = 772) and control groups (n = 1,193). Both the intervention and control groups exhibited similar baseline characteristics. Several lifestyle and vascular risk factors were present, indicating a potential window of opportunity for intervention. The intervention will be completed by 2025. This project will contribute to the evaluation of the effectiveness and safety of intervention strategies in controlling AD risk and reducing clinical events, providing a basis for public health decision-making in China.

Inconsistent Music-Based Intervention Reporting in Dementia Studies: A Systematic Mapping Review.

Recent research has shown beneficial results for music-based interventions (MBIs) for persons living with Alzheimer's disease and related dementias (AD/ADRD), but reports often lack sufficient detail about the MBI methodology, which reduces replicability. A detailed checklist for best practices in how to report MBIs was created in 2011 by Robb and colleagues to remedy the lack of detail in MBI descriptions. The implementation of the checklist specifically in AD/ADRD research has not been established. Given the complexity of music and the variety of uses for research and health, specific MBI descriptions are necessary for rigorous replication and validation of study results. This systematic mapping review utilized the "Checklist for Reporting Music-Based Interventions" to evaluate the current state of MBI descriptive specificity in AD/ADRD research. Research articles testing MBIs and reviews of MBI efficacy published between January 2015 and August 2023 were scored using the checklist and the results were summarized. Forty-eight studies were screened, and reporting was inconsistent across the 11 checklist criteria. Ten out of 48 studies fully reported more than 5 of the 11 criteria. Only one of the 11 scoring criteria was at least partially reported across 47 of 48 studies. Thorough reporting of intervention detail for MBIs remains limited in AD/ADRD MBI research. This impedes study validation, replication, and slows the progress of research and potential application of music in practice. Greater implementation of the reporting guidelines provided by Robb and colleagues would move the field of MBI research for AD/ADRD forward more quickly and efficiently.

Drivers of Women Entrepreneurship in the Oke-Ogun Region, Oyo State, Nigeria.

The idea of entrepreneurship is frequently associated with men and is seen as a manly pursuit. But recently, it has become clear how important female entrepreneurs are and how much they contribute to the economy. Over time, the Nigerian business community has come to view women as an unequal gender, partly due to the country’s cultural legacy of expecting all women to be subservient. Finding the main entrepreneurship drivers and how they have aided women’s entrepreneurship in the Oke-ogun district of Oyo state, Nigeria, is the aim of this study. The objective of the study is to examine the effect of some identified variables as drivers towards entrepreneurial ability of women entrepreneurs in the study area. Using a survey design approach, the study’s target respondents—women business owners, were purposively selected based on their levels of entrepreneurial activity, and a structured questionnaire was used to collect data. The data was analyzed using the ANOVA and Pearson correlation coefficient. The results indicated that the three independent variables—personal entrepreneurship traits, inner motivation, and credit intervention schemes, each had a correlation co-efficient and probability value of (β1= 0.302, p<0.05, β2= 0.325, p<0.05, and β3= -0.278, p<0,05) that, taken separately, suggested a weak relationship with women’s entrepreneurship during the study period. Among other things, it is recommended that official lenders and other government organizations provide women entrepreneurs with sufficient assistance so that they can make their fair share of contributions to the country’s economy.

Provider Perspectives of Facilitators and Barriers to Reaching and Utilizing Chronic Pain Healthcare for Persons With Traumatic Brain Injury: A Qualitative NIDILRR and VA TBI Model Systems Collaborative Project.

To identify facilitators and barriers to reaching and utilizing chronic pain treatments for persons with traumatic brain injury (TBI) organized around an Access to Care framework, which includes dimensions of access to healthcare as a function of supply (ie, provider/system) and demand (ie, patient) factors for a specified patient population. Community. Clinicians (n = 63) with experience treating persons with TBI were interviewed between October 2020 and November 2021. Descriptive, qualitative study. Semistructured open-ended interview of chronic pain management for persons with TBI. Informed by the Access to Care framework, responses were coded by and categorized within the core domains (reaching care, utilizing care) and relevant subdimensions from the supply (affordability of providing care, quality, coordination/continuity, adequacy) and demand (ability to pay, adherence, empowerment, caregiver support) perspective. Themes from provider interviews focused on healthcare reaching and healthcare utilization resulted in 19 facilitators and 9 barriers reaching saturation. The most themes fell under the utilization core domain, with themes identified that impact the technical and interpersonal quality of care and care coordination/continuity. Accessibility and availability of specialty care and use of interdisciplinary team that permitted matching patients to treatments were leading thematic facilitators. The leading thematic barrier identified primarily by medical providers was cognitive disability, which is likely directly linked with other leading barriers including high rates of noncompliance and poor follow-up in health care. Medical and behavioral health complexity was also a leading barrier to care and potentially interrelated to other themes identified. This is the first evidence-based study to inform policy and planning for this complex population to improve access to high-quality chronic pain treatment. Further research is needed to gain a better understanding of the perspectives of individuals with TBI/caregivers to inform interventions to improve access to chronic pain treatment for persons with TBI.

Provider Perceived Facilitators and Barriers to Identifying, Perceiving, and Seeking Healthcare for Chronic Pain After TBI: A Qualitative NIDILRR and VA TBI Model Systems Collaborative Project.

Identify determinants to chronic pain healthcare for persons with traumatic brain injury (TBI) informed by an Access to Care Framework. Findings related to the Access Framework's core domains of identifying a need, perceptions of the need, and seeking healthcare are reported. Community. Healthcare providers (n = 63) with 2 or more years of experience treating persons with TBI interviewed between October 2020 and November 2021. Descriptive, qualitative study. Semi-structured interviews with open-ended questions of chronic pain management for persons with TBI. Informed by the Access Framework, responses were coded by and categorized within the domains of identifying healthcare needs, perceptions of needs, and factors related to healthcare seeking from the supply and demand perspective. For the overall sample, 14 facilitators and 6 barriers were endorsed by more than 20% of the provider cohort. Top facilitators included on-site availability of needed resources and treatments (94%), adequate time and provider capability to ensure patient comprehension of diagnosis and treatment plans (83%), and establishing patient motivation and buy-in with the treatment plan (75%). Barriers most endorsed included policies impacting access (46%), wait times for services (41%), and patient uncertainty regarding telehealth commonly due to cognitive and physical challenges (37%). Unique determinants are reported across civilian versus Department of Veterans Affairs (VA) healthcare systems and different provider types. This is the first evidence-based study to inform policy and planning to improve access to high-quality chronic pain treatments for persons with TBI. Results will inform future interventions at the systems, patient, and policy levels of healthcare that can be tailored to healthcare settings (VA, Civilian) and types of providers (rehabilitation therapists, psychologists, and medical). Evidence-informed interventions may help minimize healthcare disparities experienced by persons with TBI and facilitate access to high-quality, evidence-informed chronic pain care.

Telehealth delivery of physical therapist-led interventions for persons with chronic low back pain in underserved communities: lessons from pragmatic clinical trials.

In this perspective, we present our experience developing and conducting two pragmatic clinical trials investigating physical therapist-led telehealth strategies for persons with chronic low back pain. Both trials, the BeatPain Utah and AIM-Back trials, are part of pragmatic clinical trial collaboratories and are being conducted with persons from communities that experience pain management disparities. Practice guidelines recommend nonpharmacologic care, and advise against opioid therapy, for the primary care management of persons with chronic low back pain. Gaps between these recommendations and actual practice patterns are pervasive, particularly for persons from racial or ethnic minoritized communities, those with fewer economic resources, and those living in rural areas including Veterans. Access barriers to evidence-based nonpharmacologic care, which is often provided by physical therapists, have contributed to these evidence-practice gaps. Telehealth delivery has created new opportunities to overcome access barriers for nonpharmacologic pain care. As a relatively new delivery mode however, telehealth delivery of physical therapy comes with additional challenges related to technology, intervention adaptations and cultural competence. The purpose of this article is to describe the challenges encountered when implementing telehealth physical therapy programs for persons with chronic low back pain in historically underserved communities. We also discuss strategies developed to overcome barriers in an effort to improve access to telehealth physical therapy and reduce pain management disparities. Inclusion of diverse and under-represented communities in pragmatic clinical trials is a critical consideration for improving disparities, but the unique circumstances present in these communities must be considered when developing implementation strategies.

Programmatic implementation of depression screening and remote mental health support sessions for persons recently diagnosed with TB in Lima, Peru during the COVID-19 pandemic.

Few studies have explored a stepped care model for delivering mental health care to persons with tuberculosis (TB). Here, we evaluated depression screening and remote low-intensity mental health interventions for persons initiating TB treatment in Lima, Peru during the COVID-19 pandemic. We used the Patient Health Questionnaire 9 (PHQ-9) to screen participants for depressive symptoms (PHQ-9≥5). Participants with PHQ-9, 5-14 received remote Psychological First Aid (PFA) or Problem Management Plus (PM+). Participants were reevaluated 6months after intervention completion. We then compared the change in median PHQ-9 scores before and after intervention completion. Those with PHQ-9≥15 were referred to higher-level care. We found that 62 (45.9%) of the 135 participants had PHQ-9≥5 at baseline. Then, 54 individuals with PHQ-9, 5-9 received PFA, of which 44 (81.5%) were reevaluated. We observed significant reductions in median PHQ-9 scores from 6 to 2 (r=0.98; p<0.001). Four participants with PHQ-9, 10-14 received PM+ but were unable to be reevaluated. Four participants with PHQ-9≥15 were referred to higher-level care. Depressive symptoms were common among persons recently diagnosed with TB. We observed improvements in depressive symptoms 6months later for most participants who received remote sessions of PFA.

Success Stories of Top Performers in Teacher Education and Liberal Arts

This study was conducted to describe the journey of topnotchers from a private Catholic higher education institution in Tuguegarao City. Employing a phenomenological study approach, this study explored the lived experiences of the four topnotchers from the School of Education, Criminology, Arts, and Psychology between 2013 and 2023. Using thematic analysis to analyze the answers of the top notchers to the validated semi-structured interview questionnaire, several key factors that contributed to their success in achieving top placements in the board examinations were revealed. These factors were strong institutional support, effective teacher mentorship, good personal characteristics, a supportive family, peer support, and strategic personal interventions. These emphasize how important it is to have a solid support system inside and outside the school setting. Based on these results, the study offers various recommendations for the institution to enhance further its support for those students who are determined to succeed. These include strengthening academic and emotional support strategies from the school, family members, and peers. Moreover, it is important to invest in faculty development, enrich library resources, and intensify board exam review courses to incorporate meaningful learning experiences and test the effectiveness of a certain practice. Additionally, assessing students’ study routines to improve effective study habits and leveraging more top-notch testimonies for promotional purposes to attract more enrollees. These could serve as a source of inspiration for students and a means of enhancing the school’s standing as a producer of high scorers on board exams. Therefore, this study encourages students to pass and ace the board examinations.

Frequency Of Burnout Among Healthcare Professionals In A Tertiary Care Hospital, After The COVID-19 Pandemic

Objective: In this study, we plan to estimate the frequency of burnout among healthcare providers in a specialized teaching Hospital. Methods: A questionnaire based on the Copenhagen Burnout Inventory (CBI) including personal, work and client subscale was administered to various healthcare workers including staff nurses, residents and consultants. Results: When the demographic data of 100 participants was analyzed it showed that there were 39 (39 %) males and 61(61 %) females. The mean age of participants was 32.2 years. Professional categories enrolled were 40 nurses, 32 consultants and 28 postgraduate trainees. The mean level of personal burnout was 47.15±15.73, 38.53 ± 17.64 and 41.06 ± 15.78 among nurses, postgraduate trainees and consultants respectively. The level of work-related burnout was 45.95 ± 19.01, 36.60 ± 14.93 and 36.75 ± 14.99 among nurses, postgraduate trainees and consultants respectively. Whereas client-related burnout was found to be 42.62 ± 16.63, 27.67 ± 12.22 and 30.71 ± 18.04 among nurses, postgraduate trainees and consultants respectively. Burnout severity was higher among nurses, and also more commonly seen among females as compared to males. Lastly, younger respondents were more burned out compared to older respondents. Conclusion: In conclusion, addressing burnout among healthcare professionals, particularly nurses, is crucial for the well-being of the healthcare force and the safety and quality of patient care. The study’s recommendation for personal and institutional interventions is an essential step in mitigating this issue and ensuring a healthier, more effective healthcare system. Keywords: Burnout severity, moderate burnout, Copenhagen Burnout Inventory.

Bio-Experiential Technology to Support Persons With Dementia and Care Partners at Home (TEND): Protocol for an Intervention Development Study.

Alzheimer disease and related dementias are debilitating and incurable diseases. Persons with dementia and their informal caregivers (ie, dyads) experience high rates of emotional distress and negative health outcomes. Several barriers prevent dyads from engaging in psychosocial care including cost, transportation, and a lack of treatments that target later stages of dementia and target the dyad together. Technologically informed treatment and serious gaming have been shown to be feasible and effective among persons living with dementia and their care partners. To increase access, there is a need for technologically informed psychosocial interventions which target the dyad, together in the home. This study aims to develop the toolkit for experiential well-being in dementia, a dyadic, "bio-experiential" intervention for persons with dementia and their caregivers. Per our conceptual model, the toolkit for experiential well-being in dementia platform aims to target sustained attention, positive emotions, and active engagement among dyads. In this paper, we outline the protocol and conceptual model for intervention development and partnership with design and development experts. We followed the National Institutes of Health (NIH) stage model (stage 1A) and supplemented the model with principles of user-centered design. The first step includes understanding user needs, goals, and strengths. We met this step by engaging in methodology and definition synthesis and conducting focus groups with dementia care providers (N=10) and persons with dementia and caregivers (N=11). Step 2 includes developing and refining the prototype. We will meet this step by engaging dyads in up to 20 iterations of platform β testing workshops. Step 3 includes observing user interactions with the prototype. We will meet this step by releasing the platform for feasibility testing. Key takeaways from the focus groups include balancing individualization and the dyadic relationship and avoiding confusing stimuli. As of September 2023, we have completed focus groups with providers, persons with dementia, and their caregivers. Additionally, we have conducted 4 iterations of β testing workshops with dyads. Feedback from focus groups informed the β testing workshops; data have not yet been formally analyzed and will be reported in future publications. Technological interventions, particularly "bio-experiential" technology, can be used in dementia care to support emotional health among persons with a diagnosis and caregivers. Here, we outline a collaborative intervention development process of bio-experiential technology through a research, design, and development partnership. Next, we are planning to test the platform's feasibility as well as its impact on clinical outcomes and mechanisms of action. DERR1-10.2196/52799.

BE-EMPOWERed program: Belgian study Enhancing the uptake and the Effectiveness of a Multifactorial fall Prevention intervention in older community-dwelling persons.

Background: 24 to 40% community-dwelling older persons (65+) fall annually, of which 21 to 45% fall recurrently. There is evidence for the use of a multifactorial fall prevention intervention. However, recent pragmatic trials, conclude that there is no effect on rate of falls. A possible explanation for these differences in results is the poor implementation of recommendations. This project aims to enhance the uptake and the effectiveness of a multifactorial fall prevention intervention in older community-dwelling persons in Flanders, Belgium.&#x0D; Methods: The BE-EMPOWERed project consists of three phases: 1) preparation, 2) development and 3) evaluation. The preparation phase is completed and it consisted of several sub studies: [1] a systematic review on implementation strategies, [2] a systematic review on influencing factors and [3] a qualitative study analyzing the context of the community setting. &#x0D; Both reviews are registered in PROSPERO (CRD42020187450, CRD42022295988). Searches were performed in five databases and mapped following PRISMA guidelines. The Mixed Method Appraisal Tool was used to assess methodological quality. The implementation strategies were described following the recommendations for specifying and reporting implementation strategies and the Taxonomy of Behavioral Change Methods. For the review on influencing factors, the determinants were categorized using ‘The Integrated Checklist of Determinants of practice’ (TICD checklist).&#x0D; The contextual analysis consisted of semi-structured interviews and focus group interviews with healthcare professionals, local policy makers and older persons. The TICD checklist was used to obtain more insights into the context. The interviews were verbatim transcribed, analyzed using the Qualitative Analysis Guide of Leuven and coded in NVivo.&#x0D; &#x0D; Results: In the systematic review on implementation strategies fifteen studies were included, describing more than 38 implementation strategies. The most frequently used strategies at the level of the older person were tailoring, personalize risk, active learning and participation. At the level of the environment, technical assistance, peer education, participatory problem solving, forming coalitions and increasing stakeholders influence were most often described.&#x0D; The review on influencing factors consisted of 25 studies. In total, 37 barriers and 32 facilitators were identified. Most frequently mentioned factors were availability of necessary resources, knowledge and motivation, compatibility with current practice and professional interaction.&#x0D; The results of the contextual analysis showed the need to integrate a multifactorial fall prevention intervention into the life of the older persons, to increase awareness and knowledge, to create a shared vision and responsibility, to implement a multifactorial fall prevention intervention into an organized structure and to increase collaboration and communication.&#x0D; Based on the insights of the systematic reviews and contextual analysis the BE-EMPOWERed program is currently being developed. The BE-EMPOWERed program will consist of implementation strategies at different levels of the context (e.g. group program for older persons, training and support of group leaders, workshops for healthcare professionals and implementation plan for local policy makers). In 2023 this program will be pilot tested in one primary care area in Flanders.&#x0D; Conclusion: Understanding the existing structures, norms, policies and other determinants allowed us to identify potential barriers and to proactively tailor the implementation strategies and the intervention.&#x0D;

INVESTIGATING THE NEURAL CORRELATES OF SOCIAL AND INDIVIDUAL SINGING IN PERSONS WITH DEMENTIA

Abstract Music interventions for persons with Alzheimer’s Disease and related dementias (PwADRD) have documented psychological benefits; however, the neurological correlates underlying these advantages remain less certain. Using functional near infrared spectroscopy (fNIRS), the present study i) investigated within-person patterns of cortical oxygenation during choral vs. individual singing; ii) explored how singing context (choral vs. individual) modulated patterns of functional connectivity (FC) within and across frontal and parietal cortices; and iii) leveraged these functional activations as predictors of cognitive status (degree of impairment) in a series of discriminant function analyses (DFA). Participants were 13 PwADRD who volunteered from a larger, ongoing social-cognitive choir intervention. fNIRS data were collected using a TechEn Cw6 system during both choral and individual singing conditions. Paired sample t-tests evaluated differences in activation patterns between singing conditions, with DFA used to determine whether these activations and neuropsychological function were predictive of between-person differences in cognitive impairment. Significant differences in cerebral oxygenation were identified in the right anterior PFC, with individual singing associated with significantly greater cortical oxygenation relative to group singing. Although not significant, individual singing was also associated with bilateral increases in cortical oxygenation across the majority of fNIRS channels, as well as increased FC, relative to group singing. The DFA analyses were not significant. This novel study is the first to examine differences in music-cognition correlates across environmental contexts for PwADRD. Patterns of functional activation suggest that choral singing in particular may represent an optimal lifestyle activity, placing comparatively fewer demands on cognitive function.

ADVANCING TECHNOLOGY OF A GROUP MUSIC INTERVENTION FOR PERSONS WITH DEMENTIA: FINDINGS FORM A FOCUS GROUP STUDY

Abstract The benefits of using music to engage persons living with dementia (PLWD) are widely reported in the literature Music can elicit memories and positive feelings as well as decrease anxiety and agitation in PLWD. Moreover, conducting music interventions in a group setting has been shown to increase social interaction, produce positive mood, and promote feelings of belonging. This paper discusses the adaptation and technological development of a group music intervention for persons living in the mild to moderate stages of dementia, Making Connections through Music (MCTM). Originally, MCTM was comprised of 6 individually themed sessions containing songs and corresponding discussion prompts; materials such as handheld instruments, photos, and props were used to elicit engagement and increase socialization among group members. Session leaders, older adult volunteers, were trained to provide the experience by offering the necessary structure and support PLWD need for successful participation. This paper will focus on the technological adaptation of the original MCTM intervention. Prototypes of a tablet application and online training course for volunteers were evaluated across seven focus groups with LTC staff (n=25) and older adult volunteers (n=25). Results from focus groups demonstrated 95% of volunteers and 100% of staff were satisfied with both the tablet app and training course. Acceptability and feasibility findings will be presented. Discussion also will highlight the implementation of this program within senior centers, adult day, and residential care as well as next steps in technological advancement of this intervention and associated training.

ACCEPTABILITY OF A REMINISCENCE THERAPY TABLET APP: IMPACT ON RESIDENTIAL CARE STAFF OF PERSONS LIVING WITH DEMENTIA

Abstract With dementia prevalence rapidly on the rise and no viable pharmacological treatments currently available, the development of accessible, efficacious, and low-cost non-pharmacologic interventions for persons living with dementia (PLWD) has become critical. Reminiscence therapy (RT) and life story can be built into residential care provision to provide person-centered solutions that elicit conversation, engagement, and socialization with staff. RT tools can also help inform care staff about residents’ lives and preferences to provide higher quality and meaningful interactions. This paper details the development and evaluation of LifeBio Memory, a tablet application designed to record the life stories and care preferences of PLWD in residential care communities. Care staff (n = 60) from 10 communities in Ohio, including memory care, assisted living and nursing homes, were trained to implement LifeBio Memory in their organizations. A pre-post design was used with staff, mainly comprised of life enrichment, administration, social work, rehab, and direct care staff. Outcomes presented include but will not be limited to: 1) acceptability, feasibility, and satisfaction with the tablet app, 2) staff knowledge of resident care preferences and interests, 3) utilization of person-centered care practices, 4) quality of communication between the resident and themselves and other staff, 5) their current understanding of that resident’s life history, and 6) level of tension and frustration with the resident. Discussion will focus on the need for sustainable RT interventions that promote person-centered care for PLWD and ways in which technological advancements can be integrated into residential care staff workflow.

Healthcare professionals' perspectives of barriers to cancer care delivery for American Indian, rural, and frontier populations

ObjectiveThis descriptive qualitative study sought to understand the barriers affecting cancer care delivery from the perspective of healthcare professionals (HCPs) serving American Indian (AI), rural, and frontier populations. MethodsOne-on-one, semi-structured interviews with multidisciplinary HCPs (N = 18) who provide cancer care to AI, rural, and frontier populations were conducted between January and April 2022. Interviews were conducted via Zoom. Data were analyzed following thematic content analysis methodologies. ResultsThematic content analysis revealed three major themes: (a) Access, (b) Time, and (c) Isolation. The themes represent the HCP perspectives of the needs and barriers of persons with cancer to whom they provide cancer care. Furthermore, these themes also reflect the barriers HCPs experience while providing cancer care to AI, rural and frontier populations. ConclusionsThis study provides preliminary evidence for the need and strong multidisciplinary support for an early palliative care intervention in rural and frontier South Dakota (SD). This intervention could support the needs of persons with advanced cancer as well as the HCPs delivering cancer care in rural settings. InnovationThis study is the initial step to develop the first culturally responsive, nurse-led, early palliative care intervention for AI, rural, and frontier persons with advanced cancer in SD.

Effects of three personal resources interventions on employees’ burnout

Personal resources are related to positive psychological states that can translate into lower burnout among employees. However, although these personal resources can be promoted through ad hoc interventions, there are few studies that analyze this type of interventions in workers. The aim of this study was to assess the effectiveness of three interventions on personal resources on reducing employees' burnout. To this end, it was hypothesized that a positive psychological capital intervention (PsyCap), a job crafting intervention and a combined intervention would have a positive impact on burnout levels. This research used a quasi-experimental, longitudinal, pretest–posttest design, with repeated measures and a waiting list control group. Study participants (N = 144) were all workers divided into three interventions and a control group. A noteworthy aspect of the study design is that the intervention was implemented as a voluntary online training activity. This study showed that personal resources interventions were effective in reducing burnout among employees. The PsyCap intervention and the combined intervention showed the greatest efficacy. Contrary to expectations, the combined intervention did not show significantly greater efficacy than the other two experimental groups. The study concludes with a discussion of its limitations and practical implications for future personal resources intervention studies.

Psychosocial and physiological effects of choir singing in people with dementia: A pilot study

AbstractBackgroundResearch suggests that music‐based interventions can improve emotional well‐being and quality of life in people with dementia. However, investigations are generally confined to specific music therapy settings. Complex music‐based interventions from day‐to‐day life, such as choir singing, have rarely been studied, not least because of the methodological challenges. Here we report on a pilot study examining the benefits of singing in persons with dementia that had joined a choir created especially for them.MethodIn preparation for a larger study on the impact of regular choir singing in dementia, we conducted a feasibility study to assess the expected effects on psychosocial and physiological outcomes. Emotional well‐being, depression, neuropsychiatric symptoms, physiological stress markers and quality of life were measured in the 19 choir members, all of whom had mild to moderate dementia (age: M = 76.95 [SD = 8.18]; f = 10 (52.6%); MMSE: M = 16.42 [SD = 5.79]) and were accompanied by their caregiving relatives. The weekly choir rehearsals took place over two months. Sessions were evaluated individually (situational measurements) and overall (pre/post‐tests).ResultOur data suggested significant increases in emotional well‐being during the choir sessions (p &lt; .05; Cohen’s dRM between 0.5 and 0.9), as well as significant reductions in cortisol levels in saliva as an indicator of stress (p &lt; .05; dRM between ‐0.2 and ‐0.76). A pre‐post evaluation (paired sample t‐tests) showed noticeable, but not significant improvements in neuropsychiatric symptoms, depression, and quality of life. Caregivers’ observations confirmed the positive influence of choir singing on participants’ emotional and communication behavior.ConclusionThe results of the pilot study reveal the therapeutic potential of choir‐based music interventions in persons with dementia and show that these effects can be demonstrated under real‐world conditions. A large‐scale randomized controlled study should further investigate the effects of choir singing in dementia.

Workshop 5: Mitigating Ageism in Everyday Clinical Care

Learning objectives:At the end of this workshop, participants will be able to: -Integrate a human rights and dignity-based strategies into daily clinical care for older persons with mental health conditions-Identify the effects of intersections of ageism, ableism, mentalism and elder abuse on the care provided to older persons with mental health conditions-Describe and support the need for an international (UN) Convention on the rights of older persons to improve the care of older persons with mental health conditionsBackground:Our world faces rapid population aging. Based on the WHO estimates, nearly 20% of older persons will have mental health conditions such as dementia, depression, anxiety and substance use, often complicated by physical and psychosocial comorbidities. Various mental health inequalities exist in this vulnerable population negatively influencing their healthcare and social status. This includes the ‘triple jeopardy’ of ageism, ableism and mentalism. The ongoing COVID-19 crisis has only widened the marginalization of older persons and especially those with mental health conditions.Methods:Even though there has been a paradigm-shift in neurobiological understanding of psychogeriatrics, dignity-based mental healthcare is still silent in research as well as practice. This workshop brings in recommendations to include the principles of rights, dignity, equality, equity and respect in clinical care for older persons living with mental health conditions, including dementia. These suggestions are based on literature review, position statements of global organizations working in this area, the Decade enablers of the UN Decade of Healthy Aging (2021-2030) and also clinical experience of the authors. Special focus will be on end-of-life care, advance directives and those in institutionalized settings.Mode of conduction:The workshop will involve a strategic and interactive discussion based on real-life case vignettes. Feedback will be sought on the perceived status of dignity and human rights in current clinical practice. Focus will be on ensuring dignity and promoting human rights in routine clinical care and patient-physician communication, age-friendly healthcare settings for older persons and the role of dignity therapy. The need for an International Convention for the rights of older persons will also be highlighted with evidence.Elder abuse and inadequate end-of-life care as two of the many common manifestations of the implicit bias and core root cause of the phenomenon of the “ageism spectrum”. Ensuring dignity and human rights in older persons can combat ageism and prevent elder abuse. Adequate sensitivity and training of professionals in this area will set the future pathway for dignified mental health interventions in the older persons with mental health conditions that are devoid of age-based discrimination and prejudice.

Factors Associated With Dementia‐Related Behaviors Among Caregivers Experiencing Poor Sleep

AbstractBackgroundNeuropsychiatric symptoms of dementia are common and have the potential to negatively impact the physical and mental health of family caregivers, hindering their ability to provide care. Such impact may be worse among caregivers experiencing poor sleep. This study aimed to explore factors associated with the frequency of and caregivers’ distress to dementia‐related problematic behaviors.MethodThis was a cross‐sectional study, using data from a clinical trial of dyadic sleep intervention for persons living with dementia (PLWD) and their family caregivers. Dementia‐related behaviors were measured using a 24‐item, Revised Memory and Behavioral Problems Checklist (RMBPC): total scores of frequencies and caregivers’ distress; scores for three subscales (memory‐related, depression, and disruptive behaviors). Caregiver‐related variables included demographic background, Zarit Burden Interview (ZBI), Positive Aspects of Caregiving (PAC), Pittsburgh Sleep Quality Index (PSQI), and Center for Epidemiological Studies of Depression (CESD). Patient‐related variables included activities of daily living (ADLs), instrumental ADLs (IADLs), and Mini‐Mental State Examination (MMSE) scores. A total of 47 dyads were included in the analysis (caregivers: n = 29 spouses, n = 17 non‐spouses; 40% Whites). Pearson correlation analyses were conducted.ResultHigher ZBI and CESD scores were significantly associated with higher RMBPC frequency total (r = 0.41, r = 0.48, respectively; p&lt;0.01) and caregiver distress total scores (r = 0.58, r = 0.43, respectively; p&lt;0.01). Lower PAC (r = ‐0.31, p = 0.04) and higher MMSE scores (r = 0.37, p = 0.03) were also associated with higher caregiver distress total scores. ZBI and CESD scores were associated with RMBPC‐depression subscale scores (frequency/caregiver distress). There were positive associations between CESD and MMSE with RMBPC‐disruptive behaviors (frequency), and ZBI and PAC scores with RMBPC‐disruptive behaviors (caregiver distress). No patient or caregiver‐related factors were associated with RMBPC‐memory subscale scores. There was no significant association between PSQI scores and RMBPC total/subscale scores. Patient factors were not significantly associated with RMBPC frequency total or caregiver distress total scores.ConclusionDementia‐related problems, particularly depressive symptoms and disruptive behaviors of PLWD are associated with both positive and negative aspects of caregiving. Future studies will need to further examine how each RMBPC subscale of behavior contributes to caregiver burden or perceived caregiving experiences among family caregivers.

A Community-Engaged Process for Adapting a Cardiovascular Health Intervention for Persons with Serious Mental Illness.

People with serious mental illness experience grave disparities in cardiovascular disease risk factors. To promote scale-up of effective cardiovascular disease risk reduction interventions from clinical trials, it is important to involve end-users in adapting interventions to fit the needs of community-based settings. We describe a novel, theory-informed process of garnering community input to adapt IDEAL Goals, an evidence-based intervention for improving cardiovascular disease risk factors in persons with serious mental illness. Outpatient community mental health programs in Maryland and Michigan implementing behavioral health homes, which provide enhanced support to people living with both physical and mental illnesses. Clinicians, frontline staff, and administrators from community mental health organizations and persons with serious mental illness. Our approach to community engagement is based on the Replicating Effective Programs (REP) framework. During the REP preimplementation phase, we used 2 community engagement activities: (1) a "needs assessment" to identify anticipated implementation barriers and facilitators, and (2) "community working groups" to collaboratively engage with end-users in adapting the intervention and implementation strategies. We used the Stakeholder Engagement Reporting Questionnaire to describe our processes for conducting a needs assessment, involving site-level surveys (N=26) and individual interviews (N=94), and convening a series of community working groups with clinicians and staff (mean, 24 per meeting) and persons with serious mental illness (mean, 8 per meeting). By specifying the nature and extent of our community engagement activities, we aim to contribute to the evidence base of how to better integrate and measure community-engaged processes in the adaptation of evidence-based interventions.