Problem-solving Education Research Articles

Impact of Directed Problem-Solving Education on Secondary School Students' Physics Achievement

This study was done to examine the psychosocial effects of sexual partner seeking via social media accounts among adolescents; and assess whether sexual partner seeking matches with sexual orientations among adolescents using social media accounts in Dar es Salaam. Correlational research design and questionnaires were used to collect data among 264 adolescents in universities and 234 adolescents in secondary schools, who were sampled using stratified sampling technique. The obtained data were subjected to descriptive and correlational analysis and test using SPSS IBM Version 20 and presented in tables. The results indicate that sexual partner seeking via social media accounts has enhanced adolescents to be sexually overambitious to the extent of engaging in risky sexual debuts, disclosure of adolescents’ privacy/secrecy, demoralization due to postage of naked pictures or their sex videos after breaking up with the partners, together with intimidations, cyber-sexual abuse and sexual insults after meeting with untrustworthy sexual partner seekers. They also indicate that sexual partner seeking is relative to sexual orientations of adolescents as driven by self-interests and sexual feelings. Therefore, it is concluded that sexual partner seeking via social media accounts is done under risky circumstances and affects the psychosocial wellbeing of adolescents. It is also recommended that more studies should be done in order to inform about coping mechanisms for the adolescents who encounter the psychosocial effects after meeting sexual partner seekers via social media accounts.

Impact of Directed Problem-Solving Education on Secondary School Students' Physics Achievement

This study looked at how students' achievement in Physics in senior secondary school one was affected by explicit problem solving instruction. A quasi-experimental pre-test-post-test design was used. The study involved two student groups: the Experimental Group and the Control Group. While the control group did not receive formal teaching on problem-solving techniques, the experimental group did receive such training. Utilizing the Physics Achievement Test, data were gathered and analysed using descriptive statistics and ANCOVA. The findings show that providing clear guidance on how to solve problems improves students' achievement in physics. According to this study, providing clear instructions on problem solving was beneficial for both males and females. To improve students' achievement in Physics, physics teachers should provide clear guidance on problem solving to their students.

Determining University Students' Anxiety and Problem Solving Skills in the COVID-19 Pandemic Process

Objective: This study is a descriptive cross-sectional study that was conducted to assess the problem-solving skills and anxiety levels of all students who agreed to participate in the study at the vocational school of health services. Methods: The population of the study included 1800 students from all departments of the 2021-2022 academic year health services vocational school at a state university in Konya, and the sample included 356 students who voluntarily agreed to participate in the study and provided informed consent. Frequency, percentage, mean, standard deviation, t-test, one-way analysis of variance Kruskal-Wallis H, and Mann-Whitney U tests were used to analyze the data. Results: When the total mean scores of the Problem-Solving Inventory (PSI) were compared based on the variables of gender, department of education, class, childhood location, income level, family type, and status of receiving problem-solving education, no statistical significance was found. The mean approach PSI score of those with chronic diseases, on the other hand, showed a statistically significant difference. The Generalized Anxiety Disorder (GAD) score was found to be statistically significantly higher in smokers, those with chronic diseases, and those with low income (p-value<0.05). Conclusion: It is important to plan initiatives and, if necessary, revise curricula to improve the problem-solving and anxiety-management abilities of future healthcare professionals.

Effect of Immediate Referral vs a Brief Problem-solving Intervention for Screen-Detected Peripartum Depression

The US Preventive Services Task Force recommends screening adults for depression in settings with programs in place to ensure receipt of appropriate care. Best practices regarding how to ensure such care are unknown, particularly for pregnant and postpartum persons. To compare the effectiveness of 2 strategies for the initial management of screen-detected peripartum depressive symptoms. This randomized comparative effectiveness trial was performed from February 1, 2018, to June 30, 2020, at the prenatal clinic, postpartum unit, and pediatric clinic within an urban safety-net hospital. Participants included peripartum persons with positive depression screen results. Data were analyzed from July 6, 2020, to September 21, 2022, based on intention to treat. Engagement-focused care coordination (EFCC), which used shared decision-making and motivational techniques to refer patients to outside mental health services, and problem-solving education (PSE), a brief cognitive-behavioral program delivered at the screening site. The primary outcome consisted of severity of depressive symptoms; secondary outcomes included severity of anxiety symptoms and engagement with care, each measured bimonthly over 12 months. Rates of symptom elevations were modeled using negative binomial regression; rates of symptom trajectories were modeled using treatment × time interactions. Among the 230 participants (mean [SD] age, 29.8 [5.8] years), 125 (54.3%) were Black and 101 (43.9%) were Hispanic or Latina. At baseline, 117 participants (50.9%) reported at least moderately severe depressive symptoms (Quick Inventory of Depressive Symptomatology score ≥11), and 56 (24.3%) reported clinically significant anxiety symptoms (Beck Anxiety Inventory score ≥21). Across 6 assessment time points, the mean (SD) number of moderately severe depressive symptom episodes in EFCC was 2.2 (2.2), compared with 2.2 (2.1) in PSE, for an adjusted rate ratio (aRR) of 0.95 (95% CI, 0.77-1.17). The mean (SD) number of anxiety symptom elevations in EFCC was 1.1 (1.8), compared to 1.1 (1.6) in PSE, for an aRR of 0.98 (95% CI, 0.69-1.39). There were significant treatment × time interactions relative to mean depressive symptom scores (-0.34 [95% CI, -0.60 to -0.08]; P = .009 for interaction term), favoring EFCC. There were no differences in engagement with care. In this randomized comparative effectiveness trial, there were no differences in depressive or anxiety symptom burden across comparators; however, the evidence suggested improved depressive symptom trajectory with immediate referral. Further work is necessary to guide approaches to management following depression screening for peripartum persons. ClinicalTrials.gov Identifier: NCT03221556.

기업체에서 코칭 기법을 활용한 창의적 문제해결 수업모형 개발

The purpose of this study is to develop a class model for creative problem-solving using coaching techniques. Regarding the research method, a draft of the class model was devised, and the final form was derived through expert verification. Concerning the final draft, the validity of the teaching model was verified by professors who were employed by companies that specialized in the teaching of creative problem solving and by experts with a doctorate in education. Unlike the draft instructional model, the final instructional model included the application of coaching techniques to each stage of the creative problem-solving model. Consequently, a model focusing on the creative problem-solving technique was developed. The class model for creative problem-solving developed in this study provides a class model to educate businesses to solve problems creatively. Therefore, I expect that the model can help teachers to introduce creative problem-solving education and to provide education that is more systematic.

Exploring the Perceptions of Secondary School Teachers about Critical Pedagogy at Secondary School Level

Critical teaching combines learning with reflective thinking. It allows students to understand the relationship between ideas, encourages questioning and challenges all forms of injustice and social disorientation. One principle of critical pedagogy is problem-solving education, which is an alternative to the banking model education in which the teacher is active, and the student is inactive in the learning process. Teachers in critical pedagogy are concerned about society and allow students to think critically and act within society. The present study examines critical teaching (CP) methods at the secondary school level. The aim of this study was to explore the perception of secondary school teachers about critical pedagogy, to examine the practices of critical pedagogy adopted by secondary school teachers. In the present study, mixed methods were adopted, which included both quantitative and qualitative methods. The design of this study was descriptive and survey type. The population for this study consisted of teachers from all public sector secondary schools (male) working in Hazara Division of Khyber Pakhtunkhwa (KP) and teaching English, Urdu, Pakistan studies, and Islamic studies subjects. There are a total of 380 secondary level schools for both boys in Hazara Division (KP), where 6408 teachers are working. Four out of eight districts (50%) were selected as a sample of study. Further, researcher used cluster sampling technique. Questionnaire was used as research tool. Then, according to the suggestions and recommendations of experts and based on evidence of piloting, necessary changes were made in the instrument. The reliability of this study was determined by Cronbach Alpha. The researcher visited personally to sample institutions to collect data. Quantitative data obtained from teacher’s questionnaires were compiled and tabulated. Percentages and mean scores were calculated to obtain results from quantitative data, and it was analysed and interpreted with the help of descriptive statistics, chi square (c2).

Effectiveness of spirituality-based problem solving on moral responsibility, and spiritual education of students

ABSTRACT This study purposed to the effectiveness of spirituality-based problem solving on Moral Responsibility)MR), and Spiritual Education (SE) of students. This study is practical in terms of purpose and semi-experimental in terms of the method with control and experimental groups. The survey sample consisted of two (test and control) groups of 25 people selected by the multi-stage cluster sampling method. The problem-solving education protocol was executed for the test group based on the model of Boalhari and Mohseni Kabir in seven 60-minute sessions. Data gathering tools included a) Sajedi Questionnaire and b) Carol spiritual education questionnaire. Results of the covariance analysis showed that problem solving based on spirituality have a positive and meaningful impact on the spiritual education (recognition, 0.63 behaviour, 0.53 and emotional 0.56) components of students, the findings also indicate that spirituality-based problem solving have a positive and meaningful impact on the students’ moral responsibility (civil, 0.45 and criminal, 0.36).

Developing a Problem-Solving Intervention to Address Methods of Self-Management and Transition Challenges in Adolescents with Sickle Cell Disease: A Qualitative Investigation

Introduction: Given recent advances in medical care for children with Sickle Cell Disease (SCD), families are now seeing their children survive into adulthood. This presents new challenges around transition from pediatric to adult medical care, with responsibility for self-management shifting from parent to child. Interventions to improve self-management skills, such as problem solving education (PSE), have been used to increase self-efficacy and medication adherence in youth with other chronic diseases. The present study sought to explore common barriers and facilitators of disease management during the transition period and the acceptability of adapting PSE to improve transition readiness in adolescents with SCD.Methods: We purposively sampled adolescents with SCD ages 13 to 18 who received care at either Boston Medical Center (BMC) or Boston Children's Hospital and their primary caregiver to participate in focus groups. Each focus group was audio recorded and transcribed. Data were analyzed through use of grounded theory and coded with NVivo, a qualitative analysis software. Transcripts were double-coded until thematic saturation was achieved.Results: A total of 17 adolescents and 15 adult caregivers participated in five focus groups. Groups initially met together to discuss barriers and facilitators of self-management and then split into separate groups of teens and parents to discuss PSE. Teens and parents identified common methods of disease management includingtaking medication, staying warm and dressing appropriately, maintaining hydration and a healthy diet, and staying rested. Teens identified having a daily routine and sharing responsibility with a caregiver as facilitators of self-management. Caregivers commonly mentioned using a set of reminder techniques to help teens manage their health. Barriers to increasing teens' self-management included wanting to fit in with peers and lacking appropriate knowledge. Parents found it challenging to allow teens more responsibility.Parents and teens unanimously approved the adaption of PSE to SCD management and transition. Though a small number of parents stated low interest in participating either for social reasons or lack of perceived need, many identified the potential benefits of the intervention for both parents and teens. Parents felt that educational support would be most beneficial to them, while teens prioritized the benefits of emotional support during the transition period. Most participants would prefer that parents and teens meet separately in a group setting at the hospital or a comfortable environment outside of the home, then join together for a final session. Groups would be held on a weekly basis for a minimum of two months. However, some participants felt the support was imperative and thus could be effective for a year. Participants favored a mentor-style structure where a knowledgeable, college-aged individual with sickle cell disease would serve as the interventionist. This appeared to be a common preference for both parents and teens as they felt it was important to work with an individual that excelled independently and academically, despite any challenges with SCD.Parents and teens willingly identified specific scenarios where they felt PSE would be most valuable. Common PSE scenarios for teens were related to disclosing the diagnosis to peers, enhancing methods of management, and addressing identified barriers to transitioning. PSE scenarios for parents involved working with healthcare and school systems on select adaption issues and learning to “let go” of their teen.Conclusion: Though parents and teens have adapted management techniques to facilitate their transition from pediatric to adult medical care, barriers still exist across medical, personal and educational environments. Applying PSE as an intervention for both parents and teens of a sickle cell population could improve self-management and transition readiness in this vulnerable population. DisclosuresNo relevant conflicts of interest to declare.

570-P: Impact of Psychosocial Factors, Self-Efficacy, Knowledge, and Nutrition Using 12-Week Courses on Diabetes Management for Veterans

Background: Approximately 25% of U.S. veterans have diabetes and suffer from psychosocial complications. The Diabetes Empowerment Group (DEG), developed by Loma Linda VA Hospital’s Behavioral Medicine Service, is a 12-week interdisciplinary group to help veterans manage their diabetes. Curriculum included values assessment, SMART goal setting, stress management, problem solving, mindful eating and nutritional education. Methods: Veterans attended their respective 12-week DEG group. Hemoglobin A1c levels were measured and participants completed QI measures at the beginning and end of their group cycles. Scores on QI measures were used to determine if group content impacted veterans’ HbA1c levels, diabetes-related psychosocial self-efficacy, knowledge, emotional distress, confidence to perform management behaviors and depressive symptoms. Paired sample t-tests compared pre- and post-group values. Results: Eighty veterans completed lab work and QI measures. Significant mean differences were found between scores on pre- and post-treatment measures for A1c levels, depressive symptoms, diabetes knowledge, distress, psychosocial self-efficacy and confidence to manage their diabetes. Post-treatment scores were significantly lower than pre-treatment scores for A1C levels, depressive symptoms, and diabetes distress. Post-treatment scores were significantly higher than pre-treatment scores for diabetes knowledge, psychosocial self-efficacy, and confidence. Conclusion: Findings expand on a previous QI study and demonstrate the efficacy of the DEG group at helping manage diabetes, reducing biopsychosocial complications and increasing knowledge. Future options for QI include evaluation of future programs (e.g., Diabetes Support Grp and DEG mobile app) to support current and alumni group members with maintenance of diabetes management skills learned. Disclosure N. Farrell: None. J. S. Shaheed: None. J. Davis: None. G. Valencia: None. R. Clark: None. D. J. Colella: None.

Social Problem-Solving Activities in The Life Skills Course: Do Primary School Students Have Difficulty Solving Daily Life Problems?

This study aimed to investigate how a social problem-solving education program implemented in the life skills course affected the social problem-solving skills of third-grade primary school students. For this purpose, using a mixed-methods research design, the participant students received social skills education over 20 class hours. The data collection tools used in the study were the Social Problem-Solving Skills Scale, semi-structured interviews, and document analysis. The study was conducted with 35 students attending a public school on the European side of Istanbul, Turkey. The dependent t-test was employed to analyze the quantitative data and content analysis for qualitative data. As a result, it was seen that the qualitative data supported the quantitative data. According to the quantitative data, after receiving social problem-solving education, the students developed the skills of creating alternative solutions, selecting a suitable solution, and estimating the outcomes of the selected solution. The students were also found to retain these skills four months after the education program. Furthermore, it was determined that the students mostly liked solving social problems, were able to solve the problems clearly and by associating them with the topic, generally enjoyed the problem-solving process, and produced various creative outputs. It is thought that the results obtained from this study will guide teaching practices involving social problem solving-based activities.

Children’s problem solving skills: Does Drama Based Storytelling Method work?

In this research, it was aimed to investigate The Effect Of Problem Solving Training Provided By The Drama Based Storytelling Method on the problem solving skills of five-year-old children. The research is designed according to quasi-experimental model which is one of the quantitative research methods. In the research, semi-experimental design with pretest-posttest control group was used. A total of 40 children, including 20 children in the experimental group and 20 children in the control group, were included in the research. In addition to the Turkey Ministry of National Education Preschool Education Program, children who constitute the experimental group have been given problem solving training with The Drama Based Storytelling Method for a total of 7 weeks, 2 days a week and 1 hour. The children in the control group were not included in this education, but continued their daily education programs only using the Ministry of Education Preschool Education Program currently implemented. The problem solving skills of the children participating in the research were evaluated with The Scale of Problem Solving Skills. The test were applied to children before and after the intervention period; In addition, it was reapplied to the experimental group after 2 weeks. As a result of the research, it can be said that the problem-solving education provided with The Drama Based Storytelling Method, which is implemented in integration with the Ministry of National Education Preschool Education Program, has contributed positively to the problem-solving skills of five-year-old children.

The Effectiveness of Problem-Solving Education on Perceived Stress of Mothers with Children with Special Learning Disabilities.

Abstract Objectives: The purpose of this study was to determine the effectiveness of problem-solving education on perceived stress of mothers with children with specific learning disabilities in Tehran in 2019. Methods: The method of this study was quasi-experimental with pretest-posttest design with control group. The statistical population of the study was all mothers with children with specific learning disabilities in Tehran. Using convenience sampling method, 40 mothers (20 for each group) were selected from mothers of children with special learning disabilities in Tehran and were randomly divided into experimental and control groups. The experimental group received 7 60-minute sessions of problem-solving training and the control group remained on the waiting list. Data were collected using Cohen's Perceived Stress Questionnaire (1983). Results: Data analysis was done by SPSS 20 software in two parts: descriptive and inferential (covariance analysis). The results showed that the mean of experimental group decreased in perceived stress of mothers with children with specific learning disabilities compared to control group. Conclusions: It can be said that problem solving training has been effective on the perceived stress of mothers of children with specific learning disabilities, so the results represent new horizons in clinical interventions and can be used as an effective intervention method.

The effectiveness of problem-solving education on perceived stress and quality of life of mothers with children with special learning disabilities

The purpose of this study is to determine the effectiveness of problem-solving education on perceived stress and quality of life of mothers with children with specific learning disabilities in Tehran in 2019. By using the convenience sampling method, 40 mothers (20 for each group) were selected having children with special learning disabilities in Tehran and they were randomly divided into experimental and control groups. The experimental group received seven 60-minutes sessions of problem-solving training and the control group remained on the waiting list. Data were collected using the perceived stress questionnaire and quality of life questionnaire. The results show that the mean of experimental group decreased in perceived stress of mothers with children with specific learning disabilities compared to the control group. It can be said that problem-solving training has been effective on the perceived stress and quality of life of mothers of children with specific learning disabilities; therefore, the results represent new horizons in clinical interventions.

PENINGKATAN KREATIVITAS BELAJAR MATEMATIKA MELALUI PEMBELAJARAN PROBLEM SOLVING

The aim of this research’s are : 1) giving opportunity for asking the material what given by the lecturer, 2) giving the alternative how to solve the problem, 3) giving the stimulus of the student for show and understanding the idea, 4) giving the opportunity for see and find the giving solution of problem and 5) giving the stimulus to take the resk. This research is use the Problem Solving Education for increasing the creativity of study math in Mathematic subject in Muhammadiyah University of Purwokerto. And the result of this research’s are : 1) Reaching the knowledge of understanding the material of mathematic, 2) have the skill of show their suggestion and respecting some suggestion of their friends, 3) have the knowledge to see and problem solving to do the exercise of mathematic, 4) have the ability of showing their suggestion, and 5) have the ability to take a resk and improving their ability for solving some problems in mathematic it self.

대학생의 지역사회 문제해결 학습에 대한 혼합연구

대학생의 지역사회 문제해결 학습에 대한 혼합연구

Developing a Problem-solving Intervention to Improve Self-Management and Transition Readiness in Adolescents with Sickle Cell Disease

PurposeAdolescents and young adults (AYA) with sickle cell disease (SCD) are at risk for serious complications including increased morbidity and early mortality during their transition from pediatric to adult care. Self-management support may help improve transition outcomes in this vulnerable population. Interventions based on teaching problem solving skills have been shown to improve adherence to therapy for AYA with other chronic disease and is a promising intervention in SCD. We sought patient and parent perspectives on improving self-management and input on the development of a problem-solving education (PSE) intervention. Design and methodsWe held focus groups with AYA with SCD and caregivers to discuss barriers and facilitators of self-management, acceptability of PSE and intervention content and delivery. ResultsFive focus groups were held with AYA (n = 17) and caregivers (n = 15). Groups participated jointly to discuss self-management and then separately to discuss PSE. Data were analyzed using grounded theory and double-coded until thematic saturation was achieved. ConclusionsBoth groups endorsed PSE as an acceptable intervention. Barriers to self-management included wanting to fit in with peers (AYA) and trouble letting go (parents); facilitators included having a regular routine (AYA) and sharing responsibility (parents). Participants suggested meeting in small groups for PSE sessions rather than individually and adding group sessions for parents. Practical implicationsUnderstanding AYA and caregivers' perceptions of barriers and facilitators of transition in SCD can help us better prepare AYA for transition. The specifics both groups identified as helpful will guide intervention development.

Engaging Mothers With Depressive Symptoms in Care: Results of a Randomized Controlled Trial in Head Start.

The authors sought to determine whether a multicomponent, community-based program for preventing maternal depression also promotes engagement with mental health services for individuals with persistent symptoms. Mothers of children enrolled in Head Start were randomly assigned between February 2011 and May 2016 to Problem-Solving Education (PSE) (N=111) or usual services (N=119) and assessed every two months for 12 months. Among 230 participants, 66% were Hispanic; 223 participants were included in the analysis. For all PSE participants, engagement with specialty mental health services increased from approximately 10% to 21% between two and 12 months. The PSE group was more likely than the control group to be engaged in specialty services at 12 months (adjusted odds ratio [AOR]=2.36, 95% confidence interval [CI]=1.07-5.20), and the rate of engagement with specialty services over time (treatment × time interaction) favored PSE (p=.016). Among PSE participants with persistent depressive symptoms over the follow-up period, engagement with specialty services increased from 12% (two months) to approximately 46% (12 months), whereas among control group participants, engagement fluctuated between 24% and 33%, without a clear trajectory pattern. At 12 months, PSE participants with persistent symptoms were more likely to engage with specialty care compared with their counterparts in the control group (AOR=6.95, CI=1.50-32.19). The treatment × time interaction was significant for the persistently symptomatic subgroup (p=.029) but not for the episodically symptomatic or the asymptomatic subgroups. Embedding mental health programs in Head Start is a promising strategy to engage parents with depressive symptoms in care, especially those with persistent symptoms.

Construction of a nurse post core competency evaluation index system based on specific nursing group model

Objective To construct a clinical nurse specialism post core competency evaluation index system based on specific nursing group model. Methods In March 2017, we establish a clinical nurse specialism post core competency evaluation index system based on specific position requirements, specific nursing development and demand for comprehensive ability improvement of nurses through literature review, semi-structured interview and Delphi expert consultation. The index weight was confirmed by precedence chart. Results There were 30 letter questionnaires which were sent out in two rounds of expert consultation with 100% for the recovery rate of questionnaire. The authority coefficient (Cr) of consultation expert was 0.851 3. Totals of 8 items of primary indexes and 45 items of secondary indexes were established. The primary indexes included fundamental practice ability, post specific nursing ability, post problem-solving ability, learning and education ability, organization and coordination ability, critical thinking ability, post practice and innovation ability as well as nursing scientific research ability. Conclusions The construction of index system provides a basis and reference for the clinical nurse specialism post core competency based on specific nursing group model and the ways, methods as well as evaluation of training effects of specialized training for nurses in China. Key words: Post management; Nurse specialism; Core competency; Evaluation index; Delphi method

Blended PBL을 위한 문제해결형 온라인 교육시스템 설계 및 개발

Blended PBL을 위한 문제해결형 온라인 교육시스템 설계 및 개발

Problem-Solving Education to Prevent Depression Among Low-Income Mothers

Although problem solving has been an important component of successful depression prevention and treatment interventions, evidence to support problem solving's mechanism of action is sparse. To understand the mechanism of an efficacious depression prevention intervention, problem-solving education (PSE). A multivariate path analysis was embedded within a randomized efficacy trial (February 15, 2011, to May 9, 2016). Participants were mothers with depressed mood, anhedonia, or depression history (but not in current major depressive episode) at 1 of 6 Head Start agencies. Participants were followed up for 12 months with serial assessments of potential intervention mediators and depressive symptoms. Problem-solving education (n = 111) and usual Head Start services (n = 119). Primary outcomes were depressive symptom elevations, which were measured bimonthly. Eight plausible intervention mediators were assessed: problem-solving ability; mastery; self-esteem; perceived stress; behavioral activation; and avoidant, problem-focused, and social coping. Among 230 participants, 152 (66.1%) were Hispanic; mean (SD) age was 31.4 (7.3) years. Based on associations with either PSE participation or depressive symptom outcomes, problem-solving ability, perceived stress, behavioral activation, and problem-focused coping were included in a parsimonious, multivariate path model. In this model, only perceived stress was associated with both PSE participation and depressive symptoms. Participants in the PSE group had adjusted standardized perceived stress change scores that were 11% lower than controls (95% CI, -0.19 to -0.03), and improvement in perceived stress generated an adjusted rate ratio (aRR) of 0.42 (95% CI, 0.33-0.53) for depressive symptom elevations. Participants in the intervention group also had standardized behavioral activation change scores 15% greater than controls (95% CI, 0.01-0.30) and problem-focused coping change scores 17% greater than controls (95% CI, 0.03-0.31); however, changes in these constructs were not associated with a differential rate of depressive symptom elevations. The direct effect of PSE on depressive symptom elevations (aRR, 0.72; 95% CI, 0.52-0.97) was greater than the mediated effect explained by improvement in perceived stress (aRR, 0.91; 95% CI, 0.85-0.98). Problem-solving education is efficacious in preventing depressive symptoms and appears to work by decreasing perceived stress; however, the mechanism for much of PSE's impact on depression remains unexplained. These results can be used to simplify the intervention model in preparation for effectiveness testing. ClinicalTrials.gov Identifier: NCT01298804.