Positive Participant Feedback Research Articles

275 Cultural Adaptation and Implementation of Cognitive Behavior Therapy in a Rural Mental Health Clinic of Puerto Rico

OBJECTIVES/GOALS: Culturally Centered Cognitive-Behavioral Therapy (CCCBT) is a therapeutic approach that acknowledges the effect of cultural values, beliefs, and norms on mental health. Study aims to develop a CCCBT for rural community by enhancing engagement, relevance, and outcomes through culturally tailored interventions, and evaluate its implementation. METHODS/STUDY POPULATION: Diverse mixed methods study with participants ages 18-65 from Partial Hospitalization Program in rural community located in Puerto Rico Mountain region. CCCBT intervention will have a span of 9 consecutive bi-weekly sessions. The study consists of 2 phases: 1. Evaluate intervention acceptability through focus groups (n=12) with repeated measures to learn about enhancing mental health outcomes, 2. Measure intervention effectiveness in reducing mild-moderate depression and anxiety symptoms using validated questionnaires (PHQ-9 and GAD-7) with a 100 participants from same region. Descriptive analysis for sociodemographic characteristics will be used to provide overview of participants characteristics. Qualitative analysis of focus groups will be obtained through feedback and content analysis. RESULTS/ANTICIPATED RESULTS: We anticipate high intervention acceptability through positive participant feedback and cultural relevance feedback from focal groups. We expect to find significant reduction in symptoms of depression and anxiety post-intervention, demonstrating the efficacy of CCCBT in Puerto Rican rural communities. These results will support the feasibility of implementing this approach, addressing mental health disparities, and enhancing treatment engagement and outcomes in underserved populations. The study will inform future research to refine and expand this intervention in rural communities of Hispanics and/or other rural underserved populations in the US. DISCUSSION/SIGNIFICANCE: This study’s success will advance culturally tailored mental health care in underserved rural Puerto Rican communities, reducing disparities and enhancing treatment relevance and engagement, with potential implications for improving mental health outcomes in similar populations in the US and worldwide.

Longitudinal Exploration of Strategies Advancing Continuing Professional Pharmacy Education in a Major University: an in- Depth Study on Impact

Background: In the dynamic healthcare landscape, pharmacists contend with the challenge of staying current with evolving knowledge. Continuing Pharmacy Education (CPE) programs, play a pivotal role in addressing this need. This study focuses on a six-year evaluation of CPE programs at a College of Pharmacy, aiming to assess the impact of a multifaceted approach on various educational outcomes. Materials and Methods: The University College of Pharmacy Office of Continuing Professional Education implemented a multifaceted approach from 2017 to 2022. Changes included hiring a full-time coordinator, offering on-site and online programs, establishing partnerships, identifying knowledge gap through surveying participants, and enhancing digital presence beyond others. Data from this period were compared with the preceding six years (2010 2016). Evaluation metrics covered attendee the number and diversity, program growth, and professional impact. Results: The study showcased significant improvements in various aspects of CPE programs. Pharmacist attendees increased by 816.67%, with a notable rise in non-pharmacy participants. Geographical distribution saw a surge in out-of-state and international participants. Program content witnesseda shift towardsinfectious diseases and pain management. The number of CPE programsand awarded hours experienced a fivefold increase, reflecting a commitment to a diverse curriculum. Participant feedback consistently indicated high satisfaction with knowledge enhancement, applicability, and program usefulness. Conclusion: Over the six-year period,the evaluation revealedsubstantial advancements in our CPE programs. Increased pharmacist attendance, diversified participant engagement, and expandedgeographical reach underscored the program's success.The exponential growth in program offerings reflected a commitment to diverse and extensive education. Positive participant feedback, indicating sustained impact on drug therapy management, patient safety, and public health outcomes, affirmedthe enduring effectiveness of the CPE programs. While acknowledging study limitations, this comprehensive analysis highlights the success and ongoing efforts to enhance CPE programs at major university. Future research should address these constraints for a more nuanced understanding of CPE program impact.

Mental Health Allyship.

There is increasing focus by corporations to support mental health in the workplace. This editorial will present an example of a corporation’s internally developed Mental Health Ally course which helped employees understand their role in advocating and promoting a positive culture of workplace mental health. The positive participant feedback received highlights the importance of having this type of global offering, but also serves as a call to action for further research to evaluate the longer-term benefits.

Integrating Civic Engagement Into a Lifestyle Intervention for Rural Women - A Mixed Methods Process Evaluation.

The present study aimed to evaluate the implementation of a civic engagement curriculum (HEART Club) designed to catalyze positive environmental change in rural communities. The HEART Club curriculum was integrated into a six-month community-based health behavior intervention to reduce cardiovascular disease risk. Participants were recruited from eight rural towns in Montana and New York. 101 midlife and older women. Participants worked to address an issue related to their local food or physical activity environment and establish progress monitoring benchmarks. Evaluation components included after-class surveys, program leader interviews (n = 15), participant focus groups (n = 8), and post-intervention surveys. Intervention sites reported high fidelity (78%) to the curriculum. Average attendance was 69% and program classes were rated as highly effective (4.1 out of 5). Despite positive participant feedback, low readiness for civic engagement and insufficient time were implementation challenges. The majority of HEART Club groups had accomplished two or more benchmarks post-intervention. Facilitators of progress included community support, effective leadership, and collective effort. Participants also indicated that trying to affect community change while simultaneously making personal health improvements likely stalled initial progress. These findings highlight the potential and challenges associated with civic engagement within the context of rural lifestyle interventions. Future implementation efforts should focus on reframing civic engagement as an approach to support and maintain behavior change.

An 8-Week Virtual Exercise Training Program for Pediatric Solid Organ Transplant Recipients.

Musculoskeletal strength can be impaired in pediatric solid organ transplant recipients. Exercise training programs can be beneficial but in-person delivery can be challenging; virtual exercise programs can alleviate some of these challenges. This feasibility study aimed to deliver an 8-week virtual exercise program in pediatric solid organ transplant recipients. Program delivery occurred 3 times per week for 30minutes. An exercise stress test was completed prior to program start. The Bruininks-Oseretsky Test of Motor Proficiency strength subtest and self-report surveys were used to assess musculoskeletal strength, quality of life, fatigue, and physical activity. Contact was maintained through a text messaging platform. Z scores were calculated using standardized normative data. Medians (interquartile range) are reported for all other data. Eleven participants completed the program (2 liver, 5 kidney, 4 heart; 58% females; median age = 11.5 [10.3-13.8]y). Six participants attended ≥60% of classes, 5 participants attended <50% of classes. After 8weeks, strength scores improved (Z score, Pre: -1.0 [-1.65 to -0.60] to Post: -0.2 [-1.30 to 0.40]; P = .007) with no change in other outcome measures. The virtual exercise program was delivered without technical issues and received positive participant feedback. Engagement and costs need to be considered.

Strengthening laboratory biosafety in Liberia during the COVID-19 pandemic: Experience from the Global Laboratory Leadership Programme

BackgroundThe Global Laboratory Leadership Programme (GLLP) has biosafety and biosecurity as one of its core competencies and advocates for a One Health approach involving all relevant sectors across the human-animal-environment interface to empower national laboratory systems and strengthen health security. Decentralization of SARS-CoV-2 testing in Liberia coupled with an increase in the number of COVID-19 infections among laboratory professionals raised biosafety concerns. In response, a set of trainings on laboratory biosafety was launched for lab personnel across the country under the framework of the GLLP. The goal was to deliver a comprehensive package for laboratory biosafety in the context of SARS-CoV-2 through active learning. MethodsThree one-day workshops were conducted between September and October 2020, training personnel from human, animal and environmental laboratories through a One Health approach. Concepts critical to laboratory biosafety were delivered in an interactive engagement format to ensure effective learning and retention of concepts. Pre- and post-training assessments were performed, and a paired t-test was used to assess knowledge gain. ResultsOf the 67 participants, 64 were from the human health sector, one from veterinary sector and two from environmental health sector. The average pre-test score was 41%. The main gaps identified were failure to acknowledge surgical antisepsis as a form of hand hygiene and recognition of PPE as the best risk control measure. The average post-test score was 75.5%. The mean difference of pre-test and post-test scores was statistically significant (p-value <0.001). Participants indicated satisfaction with the workshop content, mode of delivery and trainers' proficiency. ConclusionsThe workshops were impactful as evidenced by significant improvement (34.5%) in the post-test scores and positive participant feedback. Repeated refresher trainings are vital to addressing the gaps, ensuring compliance, and promoting biosafety culture. GLLP's approach to cultivating multisectoral national laboratory leaders ready to take responsibility and ownership for capacity building provides a sustainable solution for attaining strong national laboratory systems better prepared for health emergencies and pandemics like COVID-19.

A Tai Chi for Arthritis and Fall Prevention Program for Older Adults During COVID-19.

To minimize COVID-19 transmission, the University of Iowa suspended all in-person fall injury prevention programs in March 2020. However, falls continued to be the leading cause of injury-related mortality in Iowa; therefore, the university converted its in-person Tai Chi for Arthritis and Fall Prevention (TCAFP) program to a virtual program. Here, the authors describe the virtual TCAFP program and participants' overall experience. Among 83 older adults who participated in the first three virtual programs, 61 (73.5%) completed the programs. Of the 31 (37.3%) participants who filled out the postprogram satisfaction surveys, 30 (96.8%) found the Zoom platform easy to use and said the program met their expectations, 28 (90.3%) were happy with the quality of the instruction, and 29 (93.5%) said they learned the tai chi forms taught during the program and used an online video to practice between classes. Judging by the largely positive participant feedback, the authors considered the implementation of a virtual TCAFP program a success. The potential for the use of such a program beyond the pandemic to improve injury prevention efforts in rural environments warrants further exploration.

Compassion Focused Group Therapy for Adult Female Survivors of Childhood Sexual Abuse: a Preliminary Investigation

ObjectivesThe adverse effects of childhood sexual abuse (CSA) are often significant and enduring. It is therefore important to identify therapeutic interventions that can effectively minimize these effects. Compassion focused therapy (CFT) was originally developed for people with high levels of self-criticism and shame. It holds significant promise as an intervention for survivors of CSA, but has not yet been empirically tested. This study explored both the acceptability and preliminary efficacy of a CFT group intervention (CFT-SA) for adult female survivors of CSA.MethodsCFT-SA was developed and tested with adult female survivors of CSA, to determine if there was any change in outcome measure scores after participating in the 12-week intervention (n = 30) and at 3-month post-intervention follow-up (n = 25).ResultsLow attrition and high session attendance, in addition to positive participant feedback, suggested the program had high acceptability. Significant improvement was observed across all outcome variables from pre- to post-intervention (n = 30), which were maintained at follow-up (n = 25). Participants demonstrated increased self-compassion and self-reassurance, and reduced symptoms of post-traumatic stress, shame, and self-criticism, as well as fears of compassion, depression, anxiety, and stress, with medium to large effect sizes (d = .55 to 1.36). Across all measures, between 20 and 57% of participants demonstrated reliable change pre- to post-intervention, and 22 to 57% from pre-intervention to follow-up.ConclusionsThis study provides preliminary support for the acceptability and potential benefits of utilizing CFT-SA as an intervention for adult female survivors of CSA and offers recommendations for future research.Trial Registration.Australian New Zealand Clinical Trials Registry, ACTRN12616001041448.

NeuroSask Active and Connected: A neurorehab 2-way knowledge mobilization initiative

<h3>Research Objectives</h3> To use a virtual program to mobilize evidence-based knowledge on physical activity, mental health, and social support. To also use this platform as an avenue to provide updates on rapidly changing COVID-19 information specific to neurological conditions, and to gain insight on the current needs and concerns of participants. <h3>Design</h3> Program evaluation post and follow up (1-year). <h3>Setting</h3> ‘NeuroSask Active and Connected' started as a COVID-19 virtual knowledge-mobilization program designed to share information on evidence-based health-promoting behaviours, and to support social-connectedness amongst individuals with neurological conditions. <h3>Participants</h3> The project targeted individuals with moderate disability from a neurological condition and was inclusive of wheelchair users. <h3>Interventions</h3> The primary activity was a 10-week virtual program that ran twice weekly and included an ‘Active' and a ‘Connected' portion. Program evaluation involved surveying participants at the end of the 10-weeks. Based on high uptake and positive participant feedback, the program was extended, and a one-year evaluation of the program was completed. <h3>Main Outcome Measures</h3> Program evaluation. <h3>Results</h3> 800 participants registered for the initial 10-week program; approximately 1200 participants are enrolled in the extended program. 325 participants completed the one-year evaluation. 70% of participants have multiple sclerosis, with the remaining participants affected by other neurological conditions including Parkinson's disease, spinal cord injury, stroke, traumatic brain injury, cerebral palsy, and spinal cerebellar ataxia. Level of enjoyment was rated at 97%, and 100% agreed it was important for the program to continue running. Only 10% reported preferring in-person programs even outside of the pandemic (74% preferred virtual and 16% no preference). Participant-reported benefits included improved: physical wellbeing (96%); mental wellbeing (87%); sense of support (80%); awareness of existing resources (73%) and symptom management (55%). <h3>Conclusions</h3> NeuroSask provided support at a time of uncertainty and while the usual community physical activity/rehab, and social support programs were unavailable. Based on the reach, relevance, relationships, and results, this project had a substantial impact on participants. <h3>Author(s) Disclosures</h3> No conflicts of interest.

Enhancing stress reactivity and wellbeing in early schizophrenia: A randomized controlled trial of Integrated Coping Awareness Therapy (I-CAT)

Individuals with schizophrenia spectrum disorders (SSD) are at heightened risk for exposure to stressful life events which can lead to increased sensitivity to stress and a dysregulated stress response, which are in turn associated with poor long-term functioning. Stress reactivity is thus a promising treatment target in the early stages of SSD. Integrated-Coping Awareness Therapy (I-CAT) is a manualized intervention integrating mindfulness and positive psychology to target a dysregulated stress response in SSD. The current study is a preliminary randomized-controlled trial (RCT) comparing I-CAT (n = 18) with treatment as usual (TAU; n = 18) in individuals in the early stages of SSD. I-CAT was hypothesized to be more effective than TAU on primary outcomes: increasing positive emotions, decreasing negative emotions, reducing stress, and improving functioning and quality of life; and secondary outcomes: reducing symptoms, increasing mindfulness, and improving overall well-being. Excellent therapy attendance rates, low study attrition, and positive participant feedback demonstrated that I-CAT was a feasible and well-tolerated psychosocial intervention. Results suggest I-CAT led to greater reduction in symptoms (i.e., overall, negative, and disorganized symptoms), increased observational mindfulness, increased endorsement of a sense of purpose in life, and preservation of work abilities and school social functioning compared with TAU. Future work should replicate and extend these findings in a larger-scale RCT.

"Train Your Brain" Cognitive Intervention Group Program for Singaporean Older Adult Patients With Mild Cognitive Impairment: A Pilot Feasibility Study.

The "Train Your Brain" (TYB) cognitive intervention group program was developed based on previous research with the goal of remediating cognitive impairments for elderly Singaporean people with mild cognitive impairment (MCI). This study reports a pilot evaluation of feasibility (defined as participant attendance, retention rate, satisfaction and usefulness) and preliminary efficacy of the TYB program. Nineteen participants with MCI aged ≥ 50 years were recruited from a memory clinic in Singapore, with 14 receiving the TYB intervention. Participants were allocated in order of recruitment into consecutive identical groups for a 9-session program on brain health and cognitive training. Participants received pre- and post-intervention measures of cognition and completed feedback forms reporting on satisfaction with, and utility of, the TYB program. TYB was well attended (85% attendance for the first 6 sessions; 83% for the full 9-session TYB program). Participant satisfaction was high, with positive participant feedback reporting that TYB offered useful cognitive strategies which participants could implement in their daily life. Despite the small sample size and absence of control group, repeated-measures t-tests revealed significant pre- to post-intervention intra-individual improvement in global cognition measured by the Montreal Cognitive Assessment, and in executive function on the Brixton Spatial Anticipation Test. This pilot study provides supportive preliminary evidence for feasibility of TYB, with suggestions of efficacy of this program as a culturally and linguistically appropriate intervention for English-speaking older adults with MCI in Singapore.

Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder

BackgroundThere is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress.MethodTen groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention).ResultsParticipants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program.LimitationsThe absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study.ConclusionsThese findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.

A Culturally Adapted SMS Text Messaging Intervention to Promote Antiretroviral Therapy Adherence Among African Americans: Protocol for a Single-Arm Trial.

BackgroundAfrican Americans are disproportionally affected by HIV and have poorer rates of antiretroviral therapy (ART) adherence compared to other racial or ethnic groups in the United States. Factors associated with poor HIV disease outcomes are commonly associated with sociostructural barriers that prevent engagement with and retention in HIV care. SMS text messaging interventions to promote ART adherence among predominantly non-Hispanic White persons with HIV (PWH) have been shown to be efficacious; however, limited research has been devoted to culturally tailoring interventions for underrepresented racial/ethnic groups. Considering African Americans show poorer engagement along the HIV care continuum, we developed an individualized and culturally tailored two-way SMS text messaging intervention to improve ART adherence and associated virologic suppression among African American PWH.ObjectiveIn this paper we describe the protocol of a culturally tailored individualized Texting for Adherence Building (iTAB) intervention in a 24- to 48-week, single-arm study.MethodsWe developed a culturally tailored iTAB intervention, which we are implementing in a 24- to 48-week, single-arm study. Participants were recruited from the Family Health Centers of San Diego (FHCSD), a federally qualified health center. Patient inclusion criteria were (1) receiving care at the FHCSD, (2) living with HIV, (3) self-identification as Black, African American, or of African ancestry, (4) English speaking, (5) age 18 or older, (6) currently on ART, and (7) able to provide informed consent. Study enrollment began in November 2017 and closed in July 2019. A total of 90 participants from the FHCSD enrolled in the iTAB intervention, and we anticipate completing data collection in July 2020. Participants were assisted in individualizing and customizing their SMS text message preferences at the baseline study visit. Self-assessment measures are collected at baseline, interim, and final study visits. Problems related to sending/receiving SMS text messages and barriers to ART adherence are assessed at each interim study visit. The FHCSD staff monitors and tracks participants’ daily SMS text message responses to ART adherence reminders using a clinical dashboard.ResultsWe hypothesize that the proportion of individuals achieving HIV virologic suppression (viral load <40 copies/mL) will be greater at the end of the intervention period compared to the proportion prior to study implementation. Additionally, we anticipate that rates of virologic suppression at the end of the intervention among participants receiving iTAB will be comparable to those among the general FHCSD non-African American population who did not receive iTAB. Finally, we anticipate a high response rate to iTAB SMS text messages as well as positive participant feedback at the end of the intervention with regard to the acceptability of, satisfaction with, and perceived efficacy of iTAB.ConclusionsThe iTAB intervention is a novel individualized two-way SMS text messaging intervention that has been culturally tailored for use among African Americans with HIV. We anticipate that iTAB will demonstrate efficacy in future randomized control trials and will be supportive of medication adherence among other populations facing health disparities.International Registered Report Identifier (IRRID)DERR1-10.2196/21592

Simulation in perfusion: evaluating the efficacy of a specific training with eye-tracking.

With the aim of integrating simulation training into the training of perfusionists, we examined whether the participants were able to transfer a specific learning content to the same and different situations and assessed their feedback on the simulation training. Eye-tracking was tested as a measure and supplemented by additional measures. A 2 × 2 mixed design was used, with test time (pre- and post-test) and training group (same and different content training) as factors. In the pre- and post-test, the participant had to handle a critical situation on the cardiopulmonary bypass, namely, a drop in arterial partial oxygen pressure. Between the two test times, the participant practised under guidance the handling of either the same critical situation (Group 1) or a different one, that is, impaired venous return (Group 2). Dependent measures were fixations of the eyes on specific areas of interest on the heart-lung machine, measures of latency and subjective assessments. Moreover, participants gave feedback on the simulation training. Fixation analyses showed that the training led to an increased gaze on areas of interest relevant to the drop in arterial partial oxygen pressure in both groups, with a significant increase only for Group 1. The surveys revealed a great interest in the integration of simulation training into education. In combination with other measures, eye-tracking is suitable for the evaluation of simulation training. Due to the positive training effects and positive participant feedback, the integration of simulation into the training of perfusionists is advocated. Concerning transfer of learning content, more research is needed.

An Intervention to Support Collegiate Student-Athletes in the Transition to Meaningful Lifetime Physical Activity

Former student-athletes (SAs) experience unique barriers to maintaining their physical activity, such as loss of team support, less motivation without specific goals, and identity-related changes. Informed by a self-determination theory framework, the authors developed a 6-week Pilates-based intervention to support the physical and psychological wellness of SAs by fostering self-determined motivation and basic psychological needs satisfaction as they make the transition to physically active alumni. In this case study, the authors outline the development and implementation of the program with final-year SAs (N = 12) at a Division III institution. Feasibility was demonstrated through high adherence and positive participant feedback suggesting they valued their experiences in the program and felt more confident in pursuing new forms of physical activity beyond college sports. To extend this type of programming at other institutions, the authors recommend that sport psychology professionals consider unique institutional barriers and opportunities for supporting SAs in their transition to meaningful lifetime activity.

A police-led community response to Child abuse and Youth Sexual Violence and Abuse in Indigenous communities in Far North Queensland: “Speak Up. Be strong. Be Heard.”

BackgroundChild abuse and Youth Sexual Violence and Abuse (YSVA) are persistent social issues across the globe. The development and implementation of effective prevention strategies are a common focus for those working at the coalface. The Cairns Child Protection Investigation Unit of the Queensland Police Service (QPS) developed and implemented the “Speak Up. Be Strong. Be Heard.” (SUBSBH) initiative. This police-led multi-component child abuse prevention initiative has been implemented in 26 Aboriginal and Torres Strait Islander communities across the Far North Queensland Police District since June 2016. ObjectiveThe aim of this research was to evaluate the success of the SUBSBH initiative. Participants and settingExisting data held by QPS were examined. These data include statistics on reporting of YSVA offences, internal program documents and reports, and evaluation feedback forms completed prior to this evaluation study. Information collected via these sources pertained to 26 Indigenous communities within the Far North Queensland Police District. The above-mentioned feedback forms were completed by 307 participants, of whom approximately 90% are Indigenous. MethodsThis study adopted desktop analysis and triangulation through a range of qualitative and quantitative data to ensure robust and rigorous evaluation of the SUBSBH initiative. ResultsThe study found that the initiative was successful in meeting basic accepted practice for child abuse and YSVA prevention programs, receiving positive participant feedback on the educational program, achieving the initiative’s objective to increase reporting of YSVA, and achieving cost-efficiency in meeting outcomes. Importantly, the increase in reporting of YSVA was statistically significant. ConclusionThis study contributes to current understanding regarding the implementation of multi-component child abuse prevention initiatives and provides an example of a cost-efficient police-led community response to child abuse and YSVA in Indigenous communities. The findings may guide responses in other communities which grapple with this critical social issue.

Co-Reflective System: Supporting Collaborative Critical Thinking and Knowledge Building

Service-learning pedagogy provides practical learning experience for students by integrating community service with academic learning. However, experience is not enough, reflection on that experience is essential to produce new understanding. The concept of collaborative reflection has been recognized recently however, there is lack of research on how to structure guided collaborative reflection to view the process of knowledge building and how technologies can support it. To shed light on this issue, this study proposed a computational workflow of structured collaborative reflection which is adopted from integrated collaborative reflection model and implement a prototype (i.e. named as ‘Co-Reflective’) to proof the concept how Computer Supported Collaborative Reflection System (CSCRS) is supporting collaborative critical thinking and knowledge building. For this purpose, design science research methodology was employed in this study. The evaluation of Co-Reflective is provided where we asked our participants to evaluate their experience and give feedback about system. Based on the positive feedback of participants we conclude that Co-Reflective can effectively support for guided collaborative reflection activities to promote collaborative critical thinking and knowledge building. Implementation of Co-Reflective not only addresses the limitations of current technologies but also contribute in the body of knowledge by presenting the concept of integrated collaborative reflection model that promotes collaborative critical thinking and knowledge building.&#x0D; Keywords—collaborative knowledge building, collaborative reflection, Computer Supported Collaborative Reflection System (CSCRS), service learning.

STROLL SAFE OUTDOOR FALL PREVENTION PROGRAM

AbstractFall prevention programs have largely focused on indoor falls. To fill this gap, the Stroll Safe outdoor fall prevention program was developed using the Ecological and Health Belief Models and research on common causes and locations of outdoor falls as a guide. The 7-week educational intervention includes didactic presentations, group discussion/problem solving, mobility training, and self-advocacy regarding reporting environmental hazards. The purpose of this study was to assess the program’s feasibility and to use the findings to plan a large scale efficacy trial. Consistent with suggested guidelines for feasibility studies, process, scientific, management and resource assessments were conducted. Feasibility was assessed quantitatively using retention rates and attendance records, and qualitatively using a fidelity assessment, reflective log, and an audio recorded focus group. The scientific assessment included descriptive statistics to explore trends pertaining to changes in fall prevention strategy use, concern about falling outdoors, and number of slips, trips and falls outdoors from study enrollment through 2 month follow up. Findings included successful recruitment (N=24, 100%) and retention of the majority of participants (83%), and predominantly positive participant feedback, with no adverse events. The Stroll Safe program appears to be feasible to implement among active, community-dwelling older adults. Feedback was obtained to refine the program and research methodology for a larger study, including considerations for hiring and training of research assistants, staffing, program content, and choice of measures. Preliminary results reveal program benefits including increased use of prevention strategies and a decrease in trips, slips and falls.

Collaborative Formative Evaluation for Implementation of Primary Care–Based Peer Support in the Shanghai Integration Model

Peer support (PS) is effective in promoting diabetes self-management, but pragmatic models are needed for specific cultural contexts and healthcare systems. Although rare in China, recent government priorities have created opportunities for PS by encouraging the integration of specialty/hospital with primary/community care. In particular, the Shanghai Integration Model coordinates specialty/hospital care with primary care in Community Health Centers (CHCs), providing an organizational base for implementation of PS. This study reports formative evaluation for PS within the Shanghai model, emphasizing collaboration with CHCs. Intervention refinement was guided by structured interviews with 15 CHC staff and patients and a focus group with as well as monthly feedback from CHC staff. Based on these, the intervention emphasizes education on medication use, healthy diet, and sustaining physical activity among older adults, and addresses diabetes distress and barriers to insulin treatment. Results of this collaborative formative evaluation include focus on group as opposed to individual PS with theme-based, interactive activities co-led by CHC staff along with peer leaders. In addition, peer leaders follow-up with individuals and organize neighborhood activities for physical activity, healthy diet, and feelings of comradery. To date, PS has been implemented in 9 CHCs, involving 74 trained peer leaders, reaching 885 adults. Mean age is 68.24, years with diabetes is 12.52, and HbA1c lower than expected at 7.36%. Counter to common difficulties in reaching men, 41.1% are male. Only 14.2% are taking insulin but 75.9% take oral medications. Important implementation benchmarks include clinician buy-in, high retention, positive participant and peer leader feedback, and extension of programs through engagement with neighborhood residential committees. Collaboration with CHC staff in program refinement have been important in implementation success. Disclosure M.M. Coufal: Research Support; Self; Sanofi, Merck Foundation, Novo Nordisk Inc. P.Y. Tang: Research Support; Self; Sanofi, Merck Foundation, Novo Nordisk A/S. E.B. Fisher: Research Support; Self; Sanofi, Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Merck Foundation. W. Jia: None.

Pilot evaluation of a resilience training program for people with multiple sclerosis.

To evaluate the feasibility and psychosocial outcomes of an Acceptance and Commitment Therapy (ACT)-based group resilience training program for people with multiple sclerosis (PwMS). Research Method/Design: The study used a pre-post group intervention design with 3-month follow-up. The intervention consisted of 8 group sessions of 2.5 hours each with 7 weekly sessions plus a booster Session 5 weeks later. Thirty-seven PwMS completed questionnaires. Primary psychosocial outcomes were resilience, quality of life (QoL), and distress. Secondary outcomes were the ACT processes: mindfulness, defusion, values and acceptance. Significant improvements were observed for resilience (p = .005; Hedge's g = .47), physical health QoL (p < .001; g = -.76), mental health QoL (p = .006; g = -.46), depression (p = .009; g = .38), stress (p = .025; g = .33), and 3 ACT processes: defusion (p = .013; g = -.54), values (p = .010; g = -.38), and acceptance (p = .006; g = -.39). Values and defusion emerged as mediators of physical health QoL and stress (90% CI), respectively. Program feasibility was supported by positive participant feedback; high rates of recruitment, attendance, retention, and homework engagement; and good intervention fidelity. Findings provide preliminary support for the utility and feasibility of a community organization delivered ACT-based group resilience training program for improving resilience, QoL, depression, stress, and protective factors (defusion, values, acceptance) in PwMS. (PsycINFO Database Record